Chapter 19: Sleep–Wake Disorders |Halter: Varcarolis’ Foundations of Psychiatric Mental Health Nursing: A Clinical Approach, 8th Edition

MULTIPLE CHOICE 1. A nurse cares for these four patients. Which patient has the highest risk for problems with sleep physiology? a. Retiree who volunteers twice a week at Habitat for Humanity b. Corporate accountant who travels frequently c. Parent with three teenagers d. Lawn care worker ANS: B The corporate accountant is likely to work long hours and have significant stress associated with work demands. Compounded by travel, these factors are likely to precipitate unstable sleep patterns and inadequate sleep time. The retiree and lawn care worker engage in physical activity during the day, which will promote natural fatigue and sleep. The parent‘s sleep is unlikely to be disturbed; teenagers sleep through the night. PTS: 1 DIF: Cognitive Level: Analyze (Analysis) REF: Page 19-12 TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance 2. Which comment is most likely from a patient with chronic sleep deprivation? a. I turn on the television every night to get to sleep. I set the timer so it goes off in 30 minutes.‖ b. I have diarrhea frequently and not much energy, so I stay at home most of the time.‖ c. I only sleep about 7 hours a night, but I know I should sleep 8 or 9 hours.‖ d. When my alarm clock goes off every morning, it seems like I am dreaming.‖ ANS: B A discrepancy between hours of sleep obtained and hours required leads to sleep deprivation. Adults with less than 6 hours of sleep per night often suffer from chronic sleep deprivation. Common complaints include poor general health, physical and mental distress, limitations in ADLs, depressive or anxious symptoms, and pain. One distracter indicates a problem with sleep hygiene (television). The remaining distracters do not indicate a problem. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 19-3, 4, 22, 23 TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity 3. The nurse provides health education for an adult experiencing sleep deprivation. Which instruction has the highest priority? a. It‘s important to limit your driving to short periods. Sleep deprivation increases your risks for serious accidents.‖ b. Sleep deprivation is usually self-limiting. See your health care provider if it lasts more than a year.‖ c. Turn the radio on with a soft volume as you prepare for bed each evening. It will help you relax.‖ d. Three glasses of wine each evening helps many patients who suffer from sleep deprivation.‖ ANS: A Safety is the highest priority for this patient. Sleep deprivation causes psychomotor deficits. Driver drowsiness and fatigue lead to many automobile injuries and fatalities. Alcohol compounds problems associated with sleep deprivation. Sleep deprivation should be evaluated and treated; a 1-year delay is too long. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 19-2 (Health Policy), 3, 4, 24 TOP: Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment 4. A nurse provides health education for an adult with sleep deprivation. It is most important for the nurse to encourage caution when the patient engages in a. using a vacuum cleaner. b. cooking a meal. c. driving a car. d. bathing. ANS: C Safety is the highest priority for this patient. Sleep deprivation causes psychomotor deficits. Driver drowsiness and fatigue lead to many automobile injuries and fatalities. The distracters are less likely to be associated with serious injury. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 19-2 (Health Policy), 3, 4, 24 TOP: Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment 5. A patient needs diagnostic evaluation of sleep problems. Which test will evaluate the patient for possible sleep-related problems? a. Skull x-rays b. Electroencephalogram (EEG) c. Positron emission tomography (PET) d. Single photon emission computed tomography (SPECT) ANS: B EEG measures nonrapid eye movement (NREM) and rapid eye movement (REM) sleep. The distracters represent ways to diagnose structural and metabolic problems. PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Pages 19-5, 6 TOP: Nursing Process: Implementation MSC: Client Needs: Physiological Integrity 6. A patient says, ―It takes me about 15 minutes to go to sleep each night.‖ This comment describes a. delta sleep. b. parasomnia. c. sleep latency. d. REM sleep.