ESTUDYR
ATI RN COMFORT, REST, AND SLEEP ASSESSMENT 2.0 –
NCLEX-STYLE INTENSIVE QUESTIONS (1–75)
1. A nurse is caring for a client who has a new prescription for a nonbenzodiazepine hypnotic to
promote sleep. Which adverse effect should the nurse monitor?
A. Retrograde amnesia
B. Urinary discomfort
C. Dry mouth
D. Hallucinations
Answer: D. Hallucinations
Rationale: Nonbenzodiazepine hypnotics (e.g., zolpidem) can cause hallucinations, dizziness, or
sleep-related behaviors. The nurse should monitor the client closely for these CNS effects.
2. Which statement about hypersomnia should be included in a teaching presentation?
A. Hypersomnia does not improve with increased sleep
B. Hypersomnia is associated with a disturbed circadian rhythm
C. Clients with hypersomnia have a longer attention span
D. Clients with hypersomnia lack hypocretin
Answer: A. Hypersomnia does not improve with increased sleep
Rationale: Hypersomnia is characterized by excessive daytime sleepiness that persists even after
extended sleep periods.
3. Narcolepsy (NT1) with cataplexy is caused by a deficiency of which hormone?
A. Hypocretin
B. Melatonin
C. Estrogen
D. Insulin
Answer: A. Hypocretin
Rationale: Hypocretin (orexin) maintains wakefulness. NT1 narcolepsy is associated with low
levels of hypocretin, causing sleep attacks and cataplexy.
,ESTUDYR
4. Which area of the brain transmits sensory data used to develop dreams during REM sleep?
A. Hypothalamus
B. Thalamus
C. Cerebral cortex
D. Pineal gland
Answer: B. Thalamus
Rationale: The thalamus relays sensory information to the cerebral cortex, which is integrated
into dreams during REM sleep.
5. A client takes an over-the-counter (OTC) sleep aid nightly. Which finding should the nurse
identify as a potential adverse effect?
A. Hyperactivity
B. Diarrhea
C. Excessive salivation
D. Urinary retention
Answer: D. Urinary retention
Rationale: OTC sleep aids, particularly antihistamine-based ones, can cause urinary retention,
constipation, daytime drowsiness, dry mouth, and blurred vision.
6. An older adult client reports frequent nighttime awakenings. Which characteristic of older
adult sleep might explain this?
A. More time in stage 4 sleep
B. More time in stage 3 sleep
C. Less time in stage 1 sleep
D. More time in stage 2 sleep
Answer: D. More time in stage 2 sleep
Rationale: Older adults spend more time in lighter stage 2 sleep, making them more susceptible
to arousal from environmental stimuli.
, ESTUDYR
7. Teaching newly licensed nurses about sleep promotion, which statement is correct?
A. "Taking a cool shower before bedtime can help with sleep."
B. "If you do not fall asleep within 20 minutes of lying down, go to another room and listen to
soft music."
C. "To promote nighttime sleep, limit daytime naps to 1 hour."
D. "Exercising 1 hour before bedtime promotes relaxation and sleep."
Answer: B. "If you do not fall asleep within 20 minutes of lying down, go to another room
and listen to soft music."
Rationale: Cognitive-behavioral strategies for insomnia include leaving the bed when unable to
sleep to avoid negative associations with the sleep environment.
8. Which factors may contribute to migraine recurrence related to sleep? (Select all that apply)
A. Sleep-wake homeostasis
B. Sensory overload
C. Sleep deprivation
D. Increased melatonin
E. Decreased hypocretin levels
Answer: A. Sleep-wake homeostasis, B. Sensory overload, C. Sleep deprivation
Rationale: Disruptions in sleep patterns, sensory overstimulation, and insufficient sleep are
known triggers for migraines.
9. A client reports excessive daytime sleepiness and involuntary episodes of muscle weakness.
These are manifestations of:
A. Hypersomnia
B. Narcolepsy (NT2)
C. Narcolepsy (NT1)
D. Insomnia
Answer: C. Narcolepsy (NT1)
Rationale: NT1 narcolepsy is characterized by cataplexy (sudden muscle weakness) and sleep
attacks due to hypocretin deficiency.
ATI RN COMFORT, REST, AND SLEEP ASSESSMENT 2.0 –
NCLEX-STYLE INTENSIVE QUESTIONS (1–75)
1. A nurse is caring for a client who has a new prescription for a nonbenzodiazepine hypnotic to
promote sleep. Which adverse effect should the nurse monitor?
A. Retrograde amnesia
B. Urinary discomfort
C. Dry mouth
D. Hallucinations
Answer: D. Hallucinations
Rationale: Nonbenzodiazepine hypnotics (e.g., zolpidem) can cause hallucinations, dizziness, or
sleep-related behaviors. The nurse should monitor the client closely for these CNS effects.
2. Which statement about hypersomnia should be included in a teaching presentation?
A. Hypersomnia does not improve with increased sleep
B. Hypersomnia is associated with a disturbed circadian rhythm
C. Clients with hypersomnia have a longer attention span
D. Clients with hypersomnia lack hypocretin
Answer: A. Hypersomnia does not improve with increased sleep
Rationale: Hypersomnia is characterized by excessive daytime sleepiness that persists even after
extended sleep periods.
3. Narcolepsy (NT1) with cataplexy is caused by a deficiency of which hormone?
A. Hypocretin
B. Melatonin
C. Estrogen
D. Insulin
Answer: A. Hypocretin
Rationale: Hypocretin (orexin) maintains wakefulness. NT1 narcolepsy is associated with low
levels of hypocretin, causing sleep attacks and cataplexy.
,ESTUDYR
4. Which area of the brain transmits sensory data used to develop dreams during REM sleep?
A. Hypothalamus
B. Thalamus
C. Cerebral cortex
D. Pineal gland
Answer: B. Thalamus
Rationale: The thalamus relays sensory information to the cerebral cortex, which is integrated
into dreams during REM sleep.
5. A client takes an over-the-counter (OTC) sleep aid nightly. Which finding should the nurse
identify as a potential adverse effect?
A. Hyperactivity
B. Diarrhea
C. Excessive salivation
D. Urinary retention
Answer: D. Urinary retention
Rationale: OTC sleep aids, particularly antihistamine-based ones, can cause urinary retention,
constipation, daytime drowsiness, dry mouth, and blurred vision.
6. An older adult client reports frequent nighttime awakenings. Which characteristic of older
adult sleep might explain this?
A. More time in stage 4 sleep
B. More time in stage 3 sleep
C. Less time in stage 1 sleep
D. More time in stage 2 sleep
Answer: D. More time in stage 2 sleep
Rationale: Older adults spend more time in lighter stage 2 sleep, making them more susceptible
to arousal from environmental stimuli.
, ESTUDYR
7. Teaching newly licensed nurses about sleep promotion, which statement is correct?
A. "Taking a cool shower before bedtime can help with sleep."
B. "If you do not fall asleep within 20 minutes of lying down, go to another room and listen to
soft music."
C. "To promote nighttime sleep, limit daytime naps to 1 hour."
D. "Exercising 1 hour before bedtime promotes relaxation and sleep."
Answer: B. "If you do not fall asleep within 20 minutes of lying down, go to another room
and listen to soft music."
Rationale: Cognitive-behavioral strategies for insomnia include leaving the bed when unable to
sleep to avoid negative associations with the sleep environment.
8. Which factors may contribute to migraine recurrence related to sleep? (Select all that apply)
A. Sleep-wake homeostasis
B. Sensory overload
C. Sleep deprivation
D. Increased melatonin
E. Decreased hypocretin levels
Answer: A. Sleep-wake homeostasis, B. Sensory overload, C. Sleep deprivation
Rationale: Disruptions in sleep patterns, sensory overstimulation, and insufficient sleep are
known triggers for migraines.
9. A client reports excessive daytime sleepiness and involuntary episodes of muscle weakness.
These are manifestations of:
A. Hypersomnia
B. Narcolepsy (NT2)
C. Narcolepsy (NT1)
D. Insomnia
Answer: C. Narcolepsy (NT1)
Rationale: NT1 narcolepsy is characterized by cataplexy (sudden muscle weakness) and sleep
attacks due to hypocretin deficiency.
