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The sleep history of a client experiencing sleep problems reveals that the client ingests a significant amount of caffeine each day. When reviewing the effect of caffeine on sleep with the client, which of the following would the nurse incorporate into the discussion as a caffeine effect?
- A. Decreased sleep latency
- B. Increased total sleep time
- C. Decreased REM sleep
- D. Increased slow-wave sleep
Correct Answer: C
Rationale: Caffeine, a stimulant, decreases REM sleep (C) by increasing arousal, disrupting sleep quality. It increases sleep latency (A), decreases total sleep time (B), and does not enhance slow-wave sleep (D).
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A nurse is preparing a presentation on sleep disorders for a community group. Which of the following would the nurse include when explaining the differences between narcolepsy and obstructive sleep apnea syndrome?
- A. Symptoms of both disorders are essentially the same, so it is difficult to differentiate between the two disorders.
- B. People with narcolepsy awaken from a nap feeling rested and replenished, but those with obstructive sleep apnea do not.
- C. People with obstructive sleep apnea syndrome can experience temporary paralysis with naps.
- D. Naps are not recommended for clients with narcolepsy because of their association with severe loss of muscle tone.
Correct Answer: B
Rationale: Narcolepsy involves refreshing naps (B), unlike obstructive sleep apnea (OSA), where naps are non-restorative due to fragmented sleep. Symptoms differ significantly (A), paralysis is specific to narcolepsy (C), and naps are beneficial for narcolepsy (D).
A client with insomnia is prescribed zolpidem. When describing the action of this medication to the client, the nurse would incorporate information related to the medication?s effect on which of the following?
- A. GABA
- B. Serotonin
- C. Dopamine
- D. Norepinephrine
Correct Answer: A
Rationale: Zolpidem, a non-benzodiazepine hypnotic, enhances GABA (A) activity to promote sleep. It does not primarily affect serotonin (B), dopamine (C), or norepinephrine (D).
After teaching a class about circadian rhythm disorders, a nursing instructor determines that the teaching was successful when the class identifies which of the following as a subtype? Select all that apply.
- A. Delayed sleep phase
- B. Nightmare
- C. Sleep terror
- D. Jet lag
- E. Shift work
Correct Answer: A,D,E
Rationale: Circadian rhythm disorders include delayed sleep phase (A), jet lag (D), and shift work (E) disorders, which disrupt sleep-wake timing. Nightmare (B) and sleep terror (C) are parasomnias, not circadian disorders.
A client with insomnia is taught to avoid watching television, eating, and doing work in the bedroom. Which technique is being used?
- A. Sleep restriction
- B. Relaxation training
- C. Cognitive behavior therapy
- D. Stimulus control
Correct Answer: D
Rationale: Avoiding non-sleep activities in the bedroom is a stimulus control technique (D), strengthening the bed-sleep association. Sleep restriction (A) limits time in bed, relaxation training (B) focuses on calming techniques, and cognitive behavior therapy (C) is broader.
A client has been admitted to the psychiatric unit with a diagnosis of narcolepsy. Which client statement would the nurse interpret as reflecting this condition?
- A. Sometimes when I?m falling asleep, I see and hear things that my wife doesn?t.
- B. I often have brief periods of intense excitement when going to sleep, and my legs won?t hold still.
- C. I lie there and worry all night, and it keeps me awake. I just can?t relax.
- D. I think my sleep pattern is messed up because I took sleeping pills when I was younger.
Correct Answer: A
Rationale: Hallucinations while falling asleep (A) are hypnagogic hallucinations, a hallmark of narcolepsy. Restless legs (B) suggest restless leg syndrome, worry (C) indicates insomnia, and past sleeping pill use (D) is unrelated to narcolepsy.