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A nurse on a maternity ward is teaching new mothers about the sleep patterns of infants and how to keep them safe during this stage. What comment from a parent alerts the nurse that further teaching is required?

A)"I can expect my newborn to sleep an average of 16 to 24 hours a day."

B) "If I see eye movements or groaning during my baby's sleep I will call the pediatrician."

C)"I will place my infant on his back to sleep."

D)"I will not place pillows or blankets in the crib to prevent suffocation."

b

A nurse observes involuntary muscle jerking in a sleeping patient. What would be the nurse's next action?

A)No action is necessary as this is a normal finding during sleep.

B) Call the primary care provider to report possible neurologic deficit.

c)Lower the temperature in the patient's room.

d)Awaken the patient as this is an indication of night terrors.

a

A nurse observes a slight increase in a patient's vital signs while he is sleeping during the night. According to the patient's stage of sleep, the nurse expects what conditions to be true? Select all that apply.

a He is aware of his surroundings at this point.

b He is in delta sleep at this time.

c It would be most difficult to awaken him at this time.

d This is most likely an NREM stage.

e This stage constitutes around 20% to 25% of total sleep.

f The muscles are relaxed in this stage.

c,e

A nurse working in a sleep lab observes the developmental factors that may affect sleep. Which statements accurately describe these variations? Select all that apply.

a REM sleep constitutes much of the sleep cycle of a preschool child.

b By the age of 8 years, most children no longer take naps.

c Sleep needs usually decrease when physical growth peaks.

d Many adolescents do not get enough sleep.

e Total sleep decreases in adults with a decrease in stage IV sleep.

f Sleep is less sound in older adults and stage IV sleep may be absent.

d,e,f

A nurse is discussing with an older adult patient measures to take to induce sleep. What teaching point might the nurse include?

a Drinking a cup of regular tea at night induces sleep.

b Using alcohol moderately promotes a deep sleep.

c Having a small bedtime snack high in tryptophan and carbohydrates improves sleep.

d Exercising right before bedtime can hinder sleep.

c

A nurse is assessing patients in a skilled nursing facility for sleep deficits. Which patients would be considered at a higher risk for having sleep disturbances? Select all that apply.

a A patient who has uncontrolled hypothyroidism.

b A patient with coronary artery disease.

c A patient who has GERD.

d A patient who is HIV positive.

e A patient who is taking corticosteroids for arthritis.

f A patient with a urinary tract infection.

a,b,c

A nurse is providing discharge teaching for patients regarding their medications. For which patients would the nurse recommend actions to promote sleep? Select all that apply.

a A patient who is taking iron supplements for anemia.

b A patient with Parkinson's disease who is taking dopamine.

c An older adult taking diuretics for congestive heart failure.

d A patient who is taking antibiotics for an ear infection.

e A patient who is prescribed antidepressants.

f A patient who is taking low-dose aspirin prophylactically.

b,c,e

A nurse working the night shift in a pediatric unit observes a 10-year-old patient who is snoring and appears to have labored breathing during sleep. Upon reporting the findings to the primary care provider, what nursing action might the nurse expect to perform?

a Preparing the family for a diagnosis of insomnia and related treatments.

b Preparing the family for a diagnosis of narcolepsy and related treatments.
c Anticipating the scheduling of polysomnography to confirm OSA.

d No action would be taken, as this is a normal finding for hospitalized children.

C

A nurse is performing a sleep assessment on a patient being treated for a sleep disorder. During the assessment, the patient falls asleep in the middle of a conversation. The nurse would suspect which disorder?

a Circadian rhythm sleep-wake disorder

b Narcolepsy

c Enuresis

d Sleep apnea

b

A nurse is teaching a patient with a sleep disorder how to keep a sleep diary. Which data would the nurse have the patient document? Select all that apply.

a Daily mental activities

b Daily physical activities

c Morning and evening body temperature

d Daily measurement of fluid intake and output

e Presence of anxiety or worries affecting sleep

f Morning and evening blood pressure readings

a,b,e

To promote sleep in a patient, a nurse suggests what intervention?

a Follow the usual bedtime routine if possible.

b Drink two or three glasses of water at bedtime.

c Have a large snack at bedtime.

d Take a sedative-hypnotic every night at bedtime.

a

A nurse is caring for an older adult who is having trouble getting to sleep at night and formulates the nursing diagnosis Disturbed sleep pattern: Initiation of sleep. Which nursing interventions would the nurse perform related to this diagnosis? Select all that apply.

a Arrange for assessment for depression and treatment.

b Discourage napping during the day.

c Decrease fluids during the evening.

d Administer diuretics in the morning.

e Encourage patient to engage in some type of physical activity.

f Assess medication for side effects of sleep pattern disturbances.

a, b,e,f

A nurse is caring for a patient who states he has had trouble sleeping ever since his job at a factory changed from the day shift to the night shift. For what recommended treatment might the nurse prepare this patient?

a The use of a central nervous system stimulant

b Continuous positive airway pressure machine (CPAP)

c Chronotherapy

d The application of heat or cold therapy to promote sleep

c

A nurse caring for patients in a busy hospital environment should implement which recommendation to promote sleep?

a Keep the room light dimmed during the day.

b Keep the room cool.

c Keep the door of the room open.

d Offer a sleep aid medication to patients on a regular basis.

b

A nurse caring for patients in a long-term care facility is implementing interventions to help promote sleep in older adults. Which action is recommended for these patients?

a Increase physical activities during the day.

b Encourage short periods of napping during the day.

c Increase fluids during the evening.

e Dispense diuretics during the afternoon hours.

a