NSG 4067: SLEEP AND REST
1. A nurse presents at a conference about the concept of sleep. Which of the following statements
should the nurse include in the teaching?
A) "Increased sleep efficiency is considered a normal, age-related change."
B) "Sleep efficiency is quite consistent across different age groups."
C) "Both pathologic conditions and age-related changes influence sleep efficiency."
D) "Older adults often experience increased sleep latency and decreased numbers of
awakenings."
Ans: C
Feedback:
Age-related changes and pathologic conditions together contribute to the decreased sleep
efficiency associated with older age. Sleep efficiency tends to decrease, not increase, with
increasing age and is not generally consistent with that of younger people. Older adults tend to
experience both increased sleep latency (time required to fall asleep) and increased numbers of
awakenings during the night.
2. A nurse is responsible for the care of group of older adults on an acute medical unit. Which of
the following clients should the nurse monitor closely at night for worsening symptomatology?
A) A client with a diagnosis of chronic obstructive pulmonary disease (COPD)
B) A client with diagnoses of osteoarthritis and failure to thrive
C) A client with a diagnosis of foot cellulitis secondary to diabetic neuropathy
D) A client with chronic anemia receiving transfusions of packed red blood cells
Ans: A
Feedback:
The symptoms of individuals with COPD are often exacerbated during sleep, because of both
positioning and decreased oxygen saturation that occurs during sleep. Clients with osteoarthritis,
cellulitis, or anemia would not be as likely to have increased symptoms at night.
3. A nurse plans the care for an older adult man who consumes two alcoholic beverages each
evening. Which of the following should be included in the plan of care?
A) Allow for a later bedtime.
B) Encourage the client to cease all alcohol intake.
C) Monitor for nocturnal awakenings.
D) Watch for an increased rapid eye movement (REM) sleep.
Ans: C
, Feedback:
Alcohol consumption is associated with both initial drowsiness and increased numbers of
awakenings during the night, as well as overall decreases in both total sleep time and REM sleep.
Individuals who are accustomed to the depressant effect of alcohol are prone to insomnia once
they stop consuming it.
4. A nurse counsels an older adult with chronic insomnia. Which of the following statements
should the nurse include in the teaching?
A) "Consider making your environment more conducive to sleep."
B) "Continuing with the hypnotic medications you've been prescribed should soon provide a
solution."
C) "Decreased sleep is a normal age-related change that you will need to accommodate."
D) "Moderate alcohol consumption will help you fall asleep more quickly."
Ans: A
Feedback:
Environmental modification can be a useful intervention in promoting sleep in older adults.
While age-related changes do influence sleep in older adults, this does not mean that
interventions and strategies are unnecessary in mitigating these changes. Alcohol consumption
and the use of hypnotics are not recommended solutions to sleep disturbances.
5. A nurse teaches a nursing student about pharmacologic interventions for the treatment of sleep
problems among older adults. Which of the following statements by the student shows
understanding of the care of those with sleep disturbances?
A) "Behavioral therapies are preferable to the use of drugs."
B) "Benzodiazepines are the drug group likely to have the fewest adverse effects."
C) "L-Tryptophan and melatonin are chemicals the body produces that can be supplemented
to improve sleep."
D) "Older adults should not use hypnotics or other pharmacologic aids for sleep."
Ans: A
Feedback:
In general, behavioral therapies are preferable to hypnotics and other drugs for the treatment of
sleep disorders. Benzodiazepines are the drug category with the greatest risk of adverse effect,
and L-tryptophan is found in foods rather than produced by the body. Even though there are
risks, there is still a role for pharmacologic interventions in the short-term treatment of sleep
problems and they should not be categorically discounted.
1. A nurse presents at a conference about the concept of sleep. Which of the following statements
should the nurse include in the teaching?
A) "Increased sleep efficiency is considered a normal, age-related change."
B) "Sleep efficiency is quite consistent across different age groups."
C) "Both pathologic conditions and age-related changes influence sleep efficiency."
D) "Older adults often experience increased sleep latency and decreased numbers of
awakenings."
Ans: C
Feedback:
Age-related changes and pathologic conditions together contribute to the decreased sleep
efficiency associated with older age. Sleep efficiency tends to decrease, not increase, with
increasing age and is not generally consistent with that of younger people. Older adults tend to
experience both increased sleep latency (time required to fall asleep) and increased numbers of
awakenings during the night.
2. A nurse is responsible for the care of group of older adults on an acute medical unit. Which of
the following clients should the nurse monitor closely at night for worsening symptomatology?
A) A client with a diagnosis of chronic obstructive pulmonary disease (COPD)
B) A client with diagnoses of osteoarthritis and failure to thrive
C) A client with a diagnosis of foot cellulitis secondary to diabetic neuropathy
D) A client with chronic anemia receiving transfusions of packed red blood cells
Ans: A
Feedback:
The symptoms of individuals with COPD are often exacerbated during sleep, because of both
positioning and decreased oxygen saturation that occurs during sleep. Clients with osteoarthritis,
cellulitis, or anemia would not be as likely to have increased symptoms at night.
3. A nurse plans the care for an older adult man who consumes two alcoholic beverages each
evening. Which of the following should be included in the plan of care?
A) Allow for a later bedtime.
B) Encourage the client to cease all alcohol intake.
C) Monitor for nocturnal awakenings.
D) Watch for an increased rapid eye movement (REM) sleep.
Ans: C
, Feedback:
Alcohol consumption is associated with both initial drowsiness and increased numbers of
awakenings during the night, as well as overall decreases in both total sleep time and REM sleep.
Individuals who are accustomed to the depressant effect of alcohol are prone to insomnia once
they stop consuming it.
4. A nurse counsels an older adult with chronic insomnia. Which of the following statements
should the nurse include in the teaching?
A) "Consider making your environment more conducive to sleep."
B) "Continuing with the hypnotic medications you've been prescribed should soon provide a
solution."
C) "Decreased sleep is a normal age-related change that you will need to accommodate."
D) "Moderate alcohol consumption will help you fall asleep more quickly."
Ans: A
Feedback:
Environmental modification can be a useful intervention in promoting sleep in older adults.
While age-related changes do influence sleep in older adults, this does not mean that
interventions and strategies are unnecessary in mitigating these changes. Alcohol consumption
and the use of hypnotics are not recommended solutions to sleep disturbances.
5. A nurse teaches a nursing student about pharmacologic interventions for the treatment of sleep
problems among older adults. Which of the following statements by the student shows
understanding of the care of those with sleep disturbances?
A) "Behavioral therapies are preferable to the use of drugs."
B) "Benzodiazepines are the drug group likely to have the fewest adverse effects."
C) "L-Tryptophan and melatonin are chemicals the body produces that can be supplemented
to improve sleep."
D) "Older adults should not use hypnotics or other pharmacologic aids for sleep."
Ans: A
Feedback:
In general, behavioral therapies are preferable to hypnotics and other drugs for the treatment of
sleep disorders. Benzodiazepines are the drug category with the greatest risk of adverse effect,
and L-tryptophan is found in foods rather than produced by the body. Even though there are
risks, there is still a role for pharmacologic interventions in the short-term treatment of sleep
problems and they should not be categorically discounted.
