Answer the following questions for the NCLEX topic: Sleep
1. To validate the suspicion that a married male client has sleep apnea the nurse first:
a. asks the client if he experiences apnea in the middle of the night
b. Questions the spouse if she is awakened by her husband’s snoring
c. Places the client on a continuous positive airway pressure (CPAP) device
d. Schedules the client for a sleep test
2. When analgesics are ordered for a client with obstructive sleep apnea (OSA) following surgery, the nurse is most concerned about:
a. Nonsteroidal antiinflammatory drugs (NSAIDs)
3. The nurse finds a client sleep walking down the unit hallway. An appropriate intervention the nurse implements is:
a. Asking the client what he or she is doing and call for help
b. Quietly approaching the client and then loudly calling his or her name
c. Lightly tapping the client on the shoulder and leading him or her back to bed
d. Blocking the hallway with chairs and seating the client
4. The nurse is sure to implement strategies to reduce noise on the unit particularly on the ______ night of admission, when the client is especially sensitive to hospital noises.
a. 1st b. 2nd c. 3rd d. 4th
5. Which of the following medications are the safest to administer to adults needing assistance in falling asleep?
d. Anti-anxiety agents
6. To assist an adult client to sleep better the nurse recommends which of the following? (Select all that apply.)
a. Drinking a glass of wine just before retiring to bed
b. Eating a large meal 1 hour before bedtimex
c. Consuming a small glass of warm milk at bedtime
d. Performing mild exercises 30 minutes before going to bed
7. The nurse recognizes that a client is experiencing insomnia when the client reports (select all that apply):
a. Extended time to fall asleep
b. Falling asleep at inappropriate times
c. Difficulty staying asleep
d. Feeling tired after a night’s sleep
8. The nurse teaches the mother of a newborn that in order to prevent sudden infant death syndrome (SIDS) the best position to place the baby after nursing is (select all that apply):
9. When assessing a client for obstructive sleep apnea (OSA), the nurse understands the most common symptom is:
b. Early awakening
c. Impaired reasoning
d. Excessive daytime sleepiness
10. The nurse understands that the most vivid dreaming occurs during:
a. REM sleep
b. Stage 1 NREM
c. Stage 4 NREM
d. Transition period from NREM to REM sleep
11. A client taking a beta adrenergic blockers for HTN can experience interference with sleep patterns such as:
b. Increased daytime sleepiness
c. Increased awakening from sleep
d. Increased difficulty falling asleep
12. Narcolepsy can be best explained as:
a. A sudden muscle weakness during exercise
b. Stopping breathing for short intervals during sleep
c. Frequent awakenings during the night
d. An overwhelming wave of sleepiness and falling asleep
13. A nursing measure to promote sleep in school-age children is to:
a. Make sure the room is dark and quiet
b. Encourage evening exercise
c. Encourage television watching
d. Encourage quiet activities prior to bed time.
14. A female client verbalizes that she has been having trouble sleeping and feels wide awake as soon as getting into bed. The nurse recognizes that there are many interventions the promote sleep. Check all that apply.
a. Eat a heavy snack before bedtime
b. Read in bed before shutting out the light
c. Leave the bedroom if you are unable to sleep
d. Drink a cup of warm tea with milk at bedtime
e. Exercise in the afternoon rather than the evening
f. Count backwards from 100 to 0 when your mind is racing.
15. A client has a diagnosis of primary insomnia. Before assessing this client, the nurse recalls the numerous causes of this disorder. Select all that apply:
a. Chronic stress
b. Severe anxiety
c. Generalized pain
d. Excessive caffeine
e. Chronic depression
f. Environmental noise
16. A hospitalized client is prescribed chloral hydrate (Noctec). The nurse includes which action in the plan of care?
a. Monitor apical heart rate every 2 hours
b. Monitor blood pressure every 4 hours
c. Instruct the client to call for ambulation assistance
d. Clear a path to the bathroom at bedtime.
17. Select all that apply to the use of barbiturates in treating insomnia:
a. Barbiturates deprive people of NREM sleep
b. Barbiturates deprive people of REM sleep
c. When the barbiturates are discontinued, the NREM sleep increases.
d. When the barbiturates are discontinued, the REM sleep increases.
e. Nightmares are often an adverse effect when discontinuing barbiturates.
18. Select all that apply that is appropriate when there is a benzodiazepine overdose:
a. Administration of syrup of ipecac
b. Gastric lavage
c. Activated charcoal and a saline cathartic
e. Administration of Flumazenil
19. A patient is admitted to the emergency department with an overdose of a benzodiazepine. The nurse immediately prepares to administer which of the following antidotes from the emergency drug cart?
a. naloxone (Narcan)
b. naltrexone (ReVia)
c. nalmefene (Revex)
d. flumazenil (Romazicon)
20. Older adults who take long-acting sedatives or hypnotics are likely to experience: