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10 Cards in this Set

  • Front
  • Back
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
a. The client would not know this information.
c. This is a treatment for sleep apnea.
d. Although this is a diagnostic tool, the first thing the nurse would do is question the spouse. This may lead to determining whether more tests are needed.
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)
B. Opioids
C. Anticonvulsants
D. Antidepressants
E. Adjuvants
b. Clients with obstructive sleep apnea are particularly sensitive to opioids. Thus the risk of respiratory depression is increased. The nurse must recognize that clients with OSA should start out receiving very low doses of opioids.
a, c, d, and e. These have not been shown to increase the risk of respiratory depression in clients with OSA.
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
c. The nurse should not startle the client but should gently awaken the client and lead him or her back to bed.
a. Sleepwalkers are unaware of their surroundings. Asking them this question is fruitless. The nurse may or may not need assistance.
b. Startling the client may result in injury.
d. Blocking the walkway with chairs may result in injury.
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. First
B. Second
C. Third
D. Fourth
a. The client is most sensitive to noise in the hospital setting the first night because everything is new. This represents sensory overload, which interferes with sleep and decreases rapid eye movement (REM) as well as total sleep time.
b, c, and d. These are simply not correct
Which of the following medications are the safest to administer to adults needing assistance in falling asleep?
A. Sedatives
B. Hypnotics
C. Benzodiazepines
D. Antianxiety agents
c. The group of drugs that are the safest are the benzodiazepines. They facilitate the action of the neurons in the central nervous system (CNS) that suppress responsiveness to stimulation, therefore decreasing levels of arousal.
a, b, and d. These can be used, but long-term use of antianxiety, sedative, or hypnotic agents can disrupt sleep and lead to more serious problems.
The older adult client asks the nurse if taking nonprescription over-the-counter sleeping medications is advisable. The nurse responds by saying ___________:
No, because of the risks involved with these medications, which include confusion, increased risk for falls, dependency, and further sleep disruption. Older adults are more vulnerable to the side effects of sleeping pills
Strategies that the nurse suggests to parents to help their young preschool children to sleep include:
establishing a bedtime ritual such as reading the child a bedtime story, rocking the child, or playing a quiet game with the child. Bedtime routines and consistent bedtime environments have been shown to assist the child in falling asleep.
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 bedtime
C. Consuming a small glass of warm milk at bedtime
D. Performing mild exercises 30 minutes before going to bed
c. A small glass of milk relaxes the body and promotes sleep.
a, b, and d. Alcohol, large meals, and exercising all within 1 to 2 hours of bedtime have insomnia-producing effects and may, in fact, stimulate wakefulness. Large meals could also produce indigestion
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
a, c, and d. These symptoms are often reported by clients with insomnia. Clients report nonrestorative sleep. Arising once at night to urinate (nocturia) is not in and of itself insomnia.
b. Falling asleep at inappropriate times is indicative of narcolepsy
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):
A. Prone
B. Side lying
C. Supine
D. Fowler's
b and c. Research demonstrates that the occurrence of SIDS is reduced with these two positions.
a and d. These have not been shown to influence the incidence of SIDS.