Yoost & Crawford: Fundamentals of Nursing: Active Learning for Collaborative Practice, 2nd Edition

Chapter 33: Sleep Yoost & Crawford: Fundamentals of Nursing: Active Learning for Collaborative Practice, 2nd Edition MULTIPLE CHOICE 1. The nurse identifies what physiological response occurs with the onset of darkness and in preparation for sleep? a. Cortisol levels peak b. Cortisol levels increase c. Core body temperature increases d. Melatonin levels increase ANS: D Melatonin levels increase and core temperature and cortisol levels decrease with the onset of darkness. Cortisol levels peak at 6 a.m. DIF: Understanding OBJ: 33.1 TOP: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity NOT: Concepts: Caring Interventions 2. The nurse recognizes what function of the reticular activating system (RAS)? a. Records brain waves and other variables. b. Relays motor impulse to the hypothalamus. c. Influences patterns of biological functioning. d. Is affected by the light-dark cycle. ANS: B The RAS receives sensory impulses from the spinal cord and relays motor impulses to the thalamus and all parts of the cerebral cortex. Polysomnography is the recording of brain waves and other physiologic variables, such as muscle activity and eye movements, during sleep. The circadian rhythms influence patterns of biological and behavioral functions, and the sleep-wake circadian rhythm is affected by the light-dark cycle. DIF: Understanding OBJ: 33.1 TOP: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity NOT: Concepts: Caring Interventions 3. The nurse is educating a patient about taking measures to help avoid disruption to the circadian rhythm. Which statement by the patient indicates a need for further education? a. “I know the circadian rhythm influences biological functions.” b. “I know the circadian rhythm exists only in humans.” c. “I know the sleep-wake circadian rhythm is impacted by the light-dark cycle.” d. “The most familiar circadian rhythm is the day-night 24-hour cycle.” ANS: B NURSINGTB.COM Fundamentals of Nursing 2nd Edition Yoost Test Bank This study source was downloaded by from CourseH on :06:26 GMT -05:00 Your text here 1 NU RS IN GT B.CO M Biological rhythms exist in plants, animals, and humans. In humans, these biorhythms, along with internal and external factors, affect sleep. The most familiar rhythm is the day-night, 24-hour circadian rhythm cycle. Circadian rhythms influence patterns of biological and behavioral functions. Some creatures are diurnal, or primarily active during the day, whereas others are nocturnal, with most of their activity during the night. DIF: Applying OBJ: 33.1 TOP: Implementation MSC: NCLEX Client Needs Category: Physiological Integrity NOT: Concepts: Caring Interventions 4. The nurse teaches the patient what information about polysomnograpy? a. This is the recording of brain waves and other variables. b. This is the relay of motor impulse to the hypothalamus. c. This is the patterns of biological functioning. d. This is the recording of seizure activity in the brain. ANS: A Polysomnography is the recording of brain waves and other physiologic variables, such as muscle activity and eye movements, during sleep. The reticular activating system (RAS) receives sensory impulses from the spinal cord and relays motor impulses to the thalamus. The circadian rhythms influence patterns of biological and behavioral functions. An electroencephalogram is used to record seizure activity in the brain. DIF: Understanding OBJ: 33.1 TOP: Implementation MSC: NCLEX Client Needs Category: Physiological Integrity NOT: Concepts: Caring Interventions 5. The nurse identifies which sequence to be the usual progression of sleep? a. NREM 1-3 then REM, then back through NREM 1 and 2 b. REM then NREM 1-4, then back through NREM 2 and 3 c. NREM 1-3 then back through NREM 3 and 2 then REM d. REM then NREM 1-4 then back through NREM 3 ANS: C The usual sleep sequence for a person is a fairly rapid progression through NREM 1 through 3, back through NREM 3 and 2, and then into REM sleep. There is no NREM stage 4. DIF: Understanding OBJ: 33.1 TOP: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity NOT: Concepts: Caring Interventions 6. The nurse is providing discharge instructions to the parents of a toddler about sleeping habits. Which statement indicates further education is needed? a. “Sleep needs may change during growth spurts.” b. “Children sleep 12 hours a day.” c. “Toddlers will often resist going to bed.” d. “The bedtime routine can vary.” ANS: D The regular bedtime routine should be consistently followed. Children need 11 to 14 hours of sleep a day, and toddlers and preschoolers may exhibit resistance to going to bed. Sleep needs fluctuate with growth spurts. NURSINGTB.COM Fundamentals of Nursing 2nd Edition Yoost Test Bank This study source was downloaded by from CourseH on :06:26 GMT -05:00 NU RS IN GT B.CO M DIF: Applying OBJ: 33.1 TOP: Implementation MSC: NCLEX Client Needs Category: Physiological Integrity NOT: Concepts: Caring Interventions 7. When the nurse is explaining cataplexy to the patient, which description should be included? a. It is an uncontrolled desire to sleep. b. It is falling asleep for several minutes. c. It is loss of voluntary muscle tone. d. It is a sleep cycle that begins with NREM. ANS: C Cataplexy is characterized by the sudden loss of voluntary muscle tone; vivid hallucinations during sleep onset or on awakening; and brief episodes of total paralysis at the beginning or end of sleep. An uncontrolled desire to sleep and falling asleep for several minutes define narcolepsy. Narcolepsy begins with REM sleep. DIF: Understanding OBJ: 33.2 TOP: Implementation MSC: NCLEX Client Needs Category: Physiological Integrity NOT: Concepts: Caring Interventions 8. The nurse is providing discharge instructions to a patient who has had sleep alterations. Which statement by the patient indicates further education is needed? a. “I should avoid drinking caffeine too close to bedtime.” b. “I should not eat anything too close to bedtime.” c. “I should exercise regularly to help with sleeping.” d. “I can gain weight if I don’t sleep enough.” ANS: B Going to bed hungry or eating a large, heavy, or spicy meal just before going to bed can interfere with sleep. Bedtime snacks that contain complex carbohydrates are recommended to promote calmness and relaxation. Highly caffeinated substances such as coffee, cola, and chocolate are central nervous system stimulants that can disrupt the sleep cycle. Exercise can assist with weight-loss efforts and promote fatigue and relaxation, but excessive exercise, especially in the evening, interferes with sleep. Both children and adults who sleep less than the recommended number of hours each night are more likely to be overweight. DIF: Applying OBJ: 33.2 TOP: Implementation MSC: NCLEX Client Needs Category: Physiological Integrity NOT: Concepts: Caring Interventions 9. The nurse is performing an assessment of the patient’s sleep patterns. Which question by the nurse will elicit the best response? a. “Do you feel rested when you awaken?” b. “What is your normal eating pattern?” c. “Do you awaken during the night?” d. “Do you drin