ELIOPOULOS , GERONTOLOGICAL NURSING 8TH EDITION
REST AND SLEEP EXAM Q&A WITH CORRECT SOLUTIONS
1. The nurse is identifying the different sleep patterns of assigned patients on a geriatric care unit.
Which patient is demonstrating the typical sleep pattern of a patient who is older?
A) Age 82 patient sleeps a total of more than 12 hours out of 24
B) Age 90 patient describes the quality of sleep as "better than it ever was"
C) Age 80 patient falls asleep early in the evening but wakes up before dawn
D) Age 79 patient sleeps in until 9 o'clock each morning despite a lifetime of early rising
Ans: C
Feedback:
The patient who falls asleep early in the evening but wakes up before dawn is demonstrating the
behavior of phase advance. The other patients are not demonstrating typical sleep patterns of an
older person.
2. An older patient suffering from chronic exhaustion has an EEG that shows little time is spent in REM
sleep. After reviewing the patient's history, what does the nurse suspect might be contributing to the
patient's sleep problem?
A) Has two or three glasses of wine near bedtime
B) Obese and diagnosed with type 2 diabetes 6 years ago
C) Takes low-dose aspirin for the prevention of heart disease
D) Stressed due to the spouse's new diagnosis of Alzheimer disease
Ans: A
Feedback:
Certain drugs can decrease REM sleep, including alcohol. The use of aspirin has not been associated
with decreased REM sleep. Obesity, type 2 diabetes, and stress have not been linked to specifically
reducing the amount of REM sleep although these health problems can negatively impact sleep
overall.
3. An older patient hospitalized for pneumonia is having difficulty sleeping and is frustrated with the
noises at night. What should the nurse do about this situation?
A) Obtain an order for a benzodiazepine to be taken at bedtime
B) Change the temperature of the client's room to be more conducive to sleep
C) Provide a form of white noise and plan to minimize noise during caregiving activities
D) Teach the client about the normal changes in sleep quality and quantity that accompany aging
Ans: C
Feedback:
Reorganizing care to avoid awakening and providing white noise can facilitate sleep. These actions
would be preferable to pharmacologic measures while changing the temperature does not specifically
address the patient's concerns. Teaching on sleep changes would be inappropriate given the nature
and context of the patient's concerns.
4. An older patient is experiencing restless legs that are interfering with sleep. What should the nurse
respond to this patient's problem?
A) "Some people find that daily exercise helps with this problem."
B) "Most often restless legs can be traced to a deficiency in dietary calcium."
C) "There are prescription drugs that nearly always provide relief from this problem."
D) "There are a number of different medications that can cause this problem or make it worse."
Ans: D
Feedback:
Antidepressants, antihistamines, antipsychotics, alcohol, caffeine, hypoglycemia, and simple and
refined carbohydrates can contribute to restless legs syndrome. Exercise and medications are not
noted to provide a solution and calcium is not noted to be implicated in the etiology.
, 5. An older patient complains of overwhelming daytime fatigue, which the spouse attributes to loud
snoring and erratic breathing patterns during the night. Which health problem should the nurse
suspect as causing this patient's fatigue?
A) Insomnia
B) Central sleep apnea
C) Nocturnal myoclonus
D) Obstructive sleep apnea
Ans: D
Feedback:
Obstructive sleep apnea is characterized by periods without breathing during sleep and is most often
accompanied by snoring. Central sleep apnea is not as frequently marked by snoring and neither
insomnia nor nocturnal myoclonus is suggested by the patient's particular signs and symptoms.
6. Which patient on a geriatric medicine unit would the nurse recognize as being most prone to sleep
problems?
A) An obese female patient receiving IV antibiotics for the treatment of a urinary tract infection
B) A 74-year-old female receiving transfusions of packed red blood cells for an upper GI bleed
C) A 78-year-old male recovering from an ischemic stroke and has skin breakdown on the coccyx
D) A male patient admitted for exacerbation of chronic obstructive pulmonary disease (COPD) with a
history of angina
Ans: D
Feedback:
COPD and conditions involving cardiac ischemia are often associated with sleep problems. Infections,
ischemic stroke, skin breakdown, and GI bleeds are not noted to be specifically associated with sleep
difficulties.
7. An older patient with multiple health problems asks the nurse for advice about recurrent insomnia.
Which statement made by the nurse is most accurate?
A) "Caffeine obviously makes it hard for you to sleep, while a moderate amount of alcohol at bedtime
is useful."
B) "You should try over-the-counter sleep aides for several weeks before you move on to prescription
options."
C) "It's very normal for the quality of sleep to decrease with age, so this is usually a problem that
requires accommodation rather than treatment."
D) "A lot of medications have the potential to interfere with sleep, so it would be useful to review
your medications with your physician or a pharmacist."
Ans: D
Feedback:
Numerous medications are noted to be detrimental to sleep in older adults. Nonprescription sleep
aides carry risks, and alcohol is not a recommended intervention. While sleep quality does decrease
with age, this does not mean that measure cannot be taken to address the problem.
8. An older resident of a long-term care facility has recently been prescribed a non-barbiturate
sedative. For which effect should the nurse assess in this patient?
A) Anticholinergic effects
B) Daytime sedation and confusion
C) Respiratory depression and sleep apnea
D) Changes in blood pressure and heart rate
Ans: B
Feedback:
Patients who are receiving sedation should be monitored for daytime sluggishness and confusion.
Heart rate and blood pressure are not noted to be affected by these drugs and they are not
REST AND SLEEP EXAM Q&A WITH CORRECT SOLUTIONS
1. The nurse is identifying the different sleep patterns of assigned patients on a geriatric care unit.
Which patient is demonstrating the typical sleep pattern of a patient who is older?
A) Age 82 patient sleeps a total of more than 12 hours out of 24
B) Age 90 patient describes the quality of sleep as "better than it ever was"
C) Age 80 patient falls asleep early in the evening but wakes up before dawn
D) Age 79 patient sleeps in until 9 o'clock each morning despite a lifetime of early rising
Ans: C
Feedback:
The patient who falls asleep early in the evening but wakes up before dawn is demonstrating the
behavior of phase advance. The other patients are not demonstrating typical sleep patterns of an
older person.
2. An older patient suffering from chronic exhaustion has an EEG that shows little time is spent in REM
sleep. After reviewing the patient's history, what does the nurse suspect might be contributing to the
patient's sleep problem?
A) Has two or three glasses of wine near bedtime
B) Obese and diagnosed with type 2 diabetes 6 years ago
C) Takes low-dose aspirin for the prevention of heart disease
D) Stressed due to the spouse's new diagnosis of Alzheimer disease
Ans: A
Feedback:
Certain drugs can decrease REM sleep, including alcohol. The use of aspirin has not been associated
with decreased REM sleep. Obesity, type 2 diabetes, and stress have not been linked to specifically
reducing the amount of REM sleep although these health problems can negatively impact sleep
overall.
3. An older patient hospitalized for pneumonia is having difficulty sleeping and is frustrated with the
noises at night. What should the nurse do about this situation?
A) Obtain an order for a benzodiazepine to be taken at bedtime
B) Change the temperature of the client's room to be more conducive to sleep
C) Provide a form of white noise and plan to minimize noise during caregiving activities
D) Teach the client about the normal changes in sleep quality and quantity that accompany aging
Ans: C
Feedback:
Reorganizing care to avoid awakening and providing white noise can facilitate sleep. These actions
would be preferable to pharmacologic measures while changing the temperature does not specifically
address the patient's concerns. Teaching on sleep changes would be inappropriate given the nature
and context of the patient's concerns.
4. An older patient is experiencing restless legs that are interfering with sleep. What should the nurse
respond to this patient's problem?
A) "Some people find that daily exercise helps with this problem."
B) "Most often restless legs can be traced to a deficiency in dietary calcium."
C) "There are prescription drugs that nearly always provide relief from this problem."
D) "There are a number of different medications that can cause this problem or make it worse."
Ans: D
Feedback:
Antidepressants, antihistamines, antipsychotics, alcohol, caffeine, hypoglycemia, and simple and
refined carbohydrates can contribute to restless legs syndrome. Exercise and medications are not
noted to provide a solution and calcium is not noted to be implicated in the etiology.
, 5. An older patient complains of overwhelming daytime fatigue, which the spouse attributes to loud
snoring and erratic breathing patterns during the night. Which health problem should the nurse
suspect as causing this patient's fatigue?
A) Insomnia
B) Central sleep apnea
C) Nocturnal myoclonus
D) Obstructive sleep apnea
Ans: D
Feedback:
Obstructive sleep apnea is characterized by periods without breathing during sleep and is most often
accompanied by snoring. Central sleep apnea is not as frequently marked by snoring and neither
insomnia nor nocturnal myoclonus is suggested by the patient's particular signs and symptoms.
6. Which patient on a geriatric medicine unit would the nurse recognize as being most prone to sleep
problems?
A) An obese female patient receiving IV antibiotics for the treatment of a urinary tract infection
B) A 74-year-old female receiving transfusions of packed red blood cells for an upper GI bleed
C) A 78-year-old male recovering from an ischemic stroke and has skin breakdown on the coccyx
D) A male patient admitted for exacerbation of chronic obstructive pulmonary disease (COPD) with a
history of angina
Ans: D
Feedback:
COPD and conditions involving cardiac ischemia are often associated with sleep problems. Infections,
ischemic stroke, skin breakdown, and GI bleeds are not noted to be specifically associated with sleep
difficulties.
7. An older patient with multiple health problems asks the nurse for advice about recurrent insomnia.
Which statement made by the nurse is most accurate?
A) "Caffeine obviously makes it hard for you to sleep, while a moderate amount of alcohol at bedtime
is useful."
B) "You should try over-the-counter sleep aides for several weeks before you move on to prescription
options."
C) "It's very normal for the quality of sleep to decrease with age, so this is usually a problem that
requires accommodation rather than treatment."
D) "A lot of medications have the potential to interfere with sleep, so it would be useful to review
your medications with your physician or a pharmacist."
Ans: D
Feedback:
Numerous medications are noted to be detrimental to sleep in older adults. Nonprescription sleep
aides carry risks, and alcohol is not a recommended intervention. While sleep quality does decrease
with age, this does not mean that measure cannot be taken to address the problem.
8. An older resident of a long-term care facility has recently been prescribed a non-barbiturate
sedative. For which effect should the nurse assess in this patient?
A) Anticholinergic effects
B) Daytime sedation and confusion
C) Respiratory depression and sleep apnea
D) Changes in blood pressure and heart rate
Ans: B
Feedback:
Patients who are receiving sedation should be monitored for daytime sluggishness and confusion.
Heart rate and blood pressure are not noted to be affected by these drugs and they are not
