Chapter 07: Sleep and Sleep Disorders
Test Bank for Lewis Medical Surgical Nursing 11th Edition by
Harding
MULTIPLE CHOICE
1. A patient complains of difficulty falling asleep and daytime fatigue for the past 6
weeks. What is the best initial action for the nurse to take in determining whether
this patient has chronic insomnia?
a. Schedule a polysomnography (PSG) study.
b. Arrange for the patient to have a sleep study.
c. Ask the patient to keep a 2-week sleep diary.
d. Teach the patient about the use of an actigraph.
ANS: C
The diagnosis of insomnia is made on the basis of subjective complaints and an
evaluation of a 1- to 2-week sleep diary completed by the patient. Actigraphy and
PSG studies/sleep studies may be used for determining specific sleep disorders
but are not necessary to make an initial insomnia diagnosis.
DIF: Cognitive Level: Apply (application)
OBJ: Special Questions: Prioritization TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity
2. A patient with chronic insomnia asks the nurse about ways to improve sleep quality.
What is the nurses best response?
a. Avoid aerobic exercise during the day.
b. Read in bed for a few minutes each night.
c. Keep the bedroom temperature slightly warm.
d. Try to go to bed at the same time every evening.
ANS: D
A regular evening schedule is recommended to improve sleep time and quality.
Aerobic exercise may improve sleep quality but should occur at least 6 hours
before bedtime. Reading in bed is discouraged for patients with insomnia. The
bedroom temperature should be slightly cool.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
3. Which patient statement indicates a need for further teaching about extended-release
zolpidem (Ambien CR)?
a. I will take the medication an hour before bedtime.
b. I should take the medication on an empty stomach.
, c. I should not take this medication unless I can sleep for at least 6 hours.
d. I will schedule activities that require mental alertness for later in the day.
ANS: A
Benzodiazepine receptor agonists such as zolpidem work quickly and should be
taken immediately before bedtime. The other patient statements are correct.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity
4. The nurse cares for a critically ill patient in the intensive care unit (ICU). Which
intervention should the nurse include in the plan of care to improve this patients sleep
quality?
a. Ask all visitors to leave the ICU for the night.
b. Lower the level of lights from 8:00 PM until 7:00 AM.
c. Avoid the use of opioids for pain relief during the evening hours.
d. Schedule assessments to allow at least 4 hours of uninterrupted sleep.
ANS: B
Lowering the level of light will help mimic normal day/night patterns and
maximize the opportunity for sleep. Although frequent assessments and opioid
use can disturb sleep patterns, these actions are necessary for the care of critically
ill patients. For some patients, having a family member or friend at the bedside
may decrease anxiety and improve sleep.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity
5. What teaching should be included in the plan of care for a patient with narcolepsy?
a. Driving an automobile may be possible with appropriate treatment of
narcolepsy.
b. Changes in sleep hygiene are ineffective in improving sleep quality in
narcolepsy.
c. Antidepressant drugs are prescribed to treat the depression caused by the
disorder.
d. Stimulant drugs should be used for only a short time because of the risk for
abuse.
ANS: A
The accident rate for patients with narcolepsy who are receiving appropriate
treatment is similar to the general population. Stimulant medications are used on
an ongoing basis for patients with narcolepsy. The purpose of antidepressant
drugs in the treatment of narcolepsy is the management of cataplexy, not to treat
depression.
Changes in sleep hygiene are recommended for patients with narcolepsy to
improve sleep quality.
Test Bank for Lewis Medical Surgical Nursing 11th Edition by
Harding
MULTIPLE CHOICE
1. A patient complains of difficulty falling asleep and daytime fatigue for the past 6
weeks. What is the best initial action for the nurse to take in determining whether
this patient has chronic insomnia?
a. Schedule a polysomnography (PSG) study.
b. Arrange for the patient to have a sleep study.
c. Ask the patient to keep a 2-week sleep diary.
d. Teach the patient about the use of an actigraph.
ANS: C
The diagnosis of insomnia is made on the basis of subjective complaints and an
evaluation of a 1- to 2-week sleep diary completed by the patient. Actigraphy and
PSG studies/sleep studies may be used for determining specific sleep disorders
but are not necessary to make an initial insomnia diagnosis.
DIF: Cognitive Level: Apply (application)
OBJ: Special Questions: Prioritization TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity
2. A patient with chronic insomnia asks the nurse about ways to improve sleep quality.
What is the nurses best response?
a. Avoid aerobic exercise during the day.
b. Read in bed for a few minutes each night.
c. Keep the bedroom temperature slightly warm.
d. Try to go to bed at the same time every evening.
ANS: D
A regular evening schedule is recommended to improve sleep time and quality.
Aerobic exercise may improve sleep quality but should occur at least 6 hours
before bedtime. Reading in bed is discouraged for patients with insomnia. The
bedroom temperature should be slightly cool.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
3. Which patient statement indicates a need for further teaching about extended-release
zolpidem (Ambien CR)?
a. I will take the medication an hour before bedtime.
b. I should take the medication on an empty stomach.
, c. I should not take this medication unless I can sleep for at least 6 hours.
d. I will schedule activities that require mental alertness for later in the day.
ANS: A
Benzodiazepine receptor agonists such as zolpidem work quickly and should be
taken immediately before bedtime. The other patient statements are correct.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity
4. The nurse cares for a critically ill patient in the intensive care unit (ICU). Which
intervention should the nurse include in the plan of care to improve this patients sleep
quality?
a. Ask all visitors to leave the ICU for the night.
b. Lower the level of lights from 8:00 PM until 7:00 AM.
c. Avoid the use of opioids for pain relief during the evening hours.
d. Schedule assessments to allow at least 4 hours of uninterrupted sleep.
ANS: B
Lowering the level of light will help mimic normal day/night patterns and
maximize the opportunity for sleep. Although frequent assessments and opioid
use can disturb sleep patterns, these actions are necessary for the care of critically
ill patients. For some patients, having a family member or friend at the bedside
may decrease anxiety and improve sleep.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity
5. What teaching should be included in the plan of care for a patient with narcolepsy?
a. Driving an automobile may be possible with appropriate treatment of
narcolepsy.
b. Changes in sleep hygiene are ineffective in improving sleep quality in
narcolepsy.
c. Antidepressant drugs are prescribed to treat the depression caused by the
disorder.
d. Stimulant drugs should be used for only a short time because of the risk for
abuse.
ANS: A
The accident rate for patients with narcolepsy who are receiving appropriate
treatment is similar to the general population. Stimulant medications are used on
an ongoing basis for patients with narcolepsy. The purpose of antidepressant
drugs in the treatment of narcolepsy is the management of cataplexy, not to treat
depression.
Changes in sleep hygiene are recommended for patients with narcolepsy to
improve sleep quality.
