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Eliopoulos - Gerontological Nursing 8th Ed - Rest and Sleep, Sleep and Rest Exam
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Eliopoulos - Gerontological Nursing 8th Ed - Rest and Sleep, Sleep and Rest Exam
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Eliopoulos - Gerontological Nursing 8thEd - Rest and Sleep, Sleep and Rest
Exam
The nurse is identifying the different sleep patterns of assigned patients on a geriatric
care unit. Which patient is demonstrating the typical sleep pattern of a patient who is
older?
A) Age 82 patient sleeps a total of more than 12 hours out of 24B) Age 90 patient
describes the quality of sleep as "better than it ever was"C) Age 80 patient falls asleep
early in the evening but wakes up before dawnD) Age 79 patient sleeps in until 9 o'clock
each morning despite a lifetime of early rising - Answers -Ans: C
Feedback:The patient who falls asleep early in the evening but wakes up before dawn is
demonstrating the behavior of phase advance. The other patients are not demonstrating
typical sleep patterns of an older person.
An older patient suffering from chronic exhaustion has an EEG that shows little time is
spent in REM sleep. After reviewing the patient's history, what does the nurse suspect
might be contributing to the patient's sleep problem?
A) Has two or three glasses of wine near bedtime
B) Obese and diagnosed with type 2 diabetes 6 years ago
C) Takes low-dose aspirin for the prevention of heart disease
D) Stressed due to the spouse's new diagnosis of Alzheimer disease - Answers -Ans: A
Feedback:Certain drugs can decrease REM sleep, including alcohol. The use of aspirin
has not been associated with decreased REM sleep. Obesity, type 2 diabetes, and
stress have not been linked to specifically reducing the amount of REM sleep although
these health problems can negatively impact sleep overall.
An older patient hospitalized for pneumonia is having difficulty sleeping and is frustrated
with the noises at night. What should the nurse do about this situation?
A) Obtain an order for a benzodiazepine to be taken at bedtime
B) Change the temperature of the client's room to be more conducive to sleep
C) Provide a form of white noise and plan to minimize noise during caregiving activities
D) Teach the client about the normal changes in sleep quality and quantity that
accompany aging - Answers -Ans: C
Feedback:Reorganizing care to avoid awakening and providing white noise can
facilitate sleep. These actions would be preferable to pharmacologic measures while
changing the temperature does not specifically address the patient's concerns.
Teaching on sleep changes would be inappropriate given the nature and context of the
patient's concerns.
, An older patient is experiencing restless legs that are interfering with sleep. What
should the nurse respond to this patient's problem?
A) "Some people find that daily exercise helps with this problem."
B) "Most often restless legs can be traced to a deficiency in dietary calcium."
C) "There are prescription drugs that nearly always provide relief from this problem."
D) "There are a number of different medications that can cause this problem or make it
worse." - Answers -Ans: D
Feedback:Antidepressants, antihistamines, antipsychotics, alcohol, caffeine,
hypoglycemia, and simple and refined carbohydrates can contribute to restless legs
syndrome. Exercise and medications are not noted to provide a solution and calcium is
not noted to be implicated in the etiology.
An older patient complains of overwhelming daytime fatigue, which the spouse
attributes to loud snoring and erratic breathing patterns during the night. Which health
problem should the nurse suspect as causing this patient's fatigue?
A) Insomnia
B) Central sleep apnea
C) Nocturnal myoclonus
D) Obstructive sleep apnea - Answers -Ans: D
Feedback:Obstructive sleep apnea is characterized by periods without breathing during
sleep and is most often accompanied by snoring. Central sleep apnea is not as
frequently marked by snoring and neither insomnia nor nocturnal myoclonus is
suggested by the patient's particular signs and symptoms.
Which patient on a geriatric medicine unit would the nurse recognize as being most
prone to sleep problems?
A) An obese female patient receiving IV antibiotics for the treatment of a urinary tract
infection
B) A 74-year-old female receiving transfusions of packed red blood cells for an upper GI
bleed
C) A 78-year-old male recovering from an ischemic stroke and has skin breakdown on
the coccyx
D) A male patient admitted for exacerbation of chronic obstructive pulmonary disease
(COPD) with a history of angina - Answers -Ans: D
Feedback:COPD and conditions involving cardiac ischemia are often associated with
sleep problems. Infections, ischemic stroke, skin breakdown, and GI bleeds are not
noted to be specifically associated with sleep difficulties.
An older patient with multiple health problems asks the nurse for advice about recurrent
insomnia. Which statement made by the nurse is most accurate?
A) "Caffeine obviously makes it hard for you to sleep, while a moderate amount of
alcohol at bedtime is useful."
B) "You should try over-the-counter sleep aides for several weeks before you move on
to prescription options."
C) "It's very normal for the quality of sleep to decrease with age, so this is usually a
problem that requires accommodation rather than treatment."
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