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NURc > Chapter 42 Test Bank Questions and Answers ( Complete) 2020/2021

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Chapter 42: Sleep Test Bank MULTIPLE CHOICE 1. The nurse is caring for a young adult patient on the medical-surgical unit. When doing midnight checks, she sees that the patient is awake and is doing a puzzle. What is the best explanation for the patient being awake? a. The patient was waiting to ta...

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  • January 15, 2021
  • 12
  • 2020/2021
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Chapter 42: Sleep

Test Bank


MULTIPLE CHOICE

1. The nurse is caring for a young adult patient on the medical-surgical unit. When doing midnight
checks, she sees that the patient is awake and is doing a puzzle. What is the best explanation for
the patient being awake?
a. The patient was waiting to talk with the nurse.
b. The patient misses his family and is lonely.
c. The patient’s sleep-wake cycle preference is late evening.
d. The patient has been kept up with the noise on the unit.
ANS: C
All persons have biological clocks that synchronize their sleep-wake cycle. This explains why
some individuals fall asleep in the early evening and some late evening or early morning. This
patient is awake and alert enough to do a puzzle. The individual’s sleep-wake preference is
probably late evening. Waiting to talk with the nurse, being lonely, and noise on the unit may
contribute to lack of sleep, but the best explanation for the patient being awake is the biological
clock.

DIF: Understand REF: 939-940
OBJ: Explain the effect the 24-hour sleep-wake cycle has on biological function.
TOP: Evaluation MSC: Physiological Integrity: Basic Care and Comfort

2. The nurse is providing an educational session on sleep regulation for new nurses in the Sleep
Disorder Treatment Center. Which of these statements by the nurses would best indicate that
learning has occurred?
a. “If the patient has a disease process in the central nervous system, it can influence
the functions of sleep.”
b. “If the patient has a disease process in the cranial nerves, it can influence the
functions of sleep.”
c. “If the patient has an interruption in the motor pathways, it can influence the
functions of sleep.”
d. “If the patient has an interruption in the spinal reflexes, it can influence the functions
of sleep.”
ANS: A
Sleep involves a sequence of physiological states maintained by the central nervous system.
Current theory indicates that it is an active multiphase process that involves many parts of the
brain and hormone and chemical secretion. A disease process associated with the cranial nerves,
motor pathway, or spinal reflexes may influence a person’s ability to sleep, but the best answer
is the central nervous system.

DIF: Understand REF: 939-940 OBJ: Discuss mechanisms that regulate sleep.
TOP: Assessment MSC: Physiological Integrity: Basic Care and Comfort

, 3. The nurse is caring for a patient who is having trouble sleeping. To encourage decreased
stimulus to the reticular activating system and activation of the bulbar synchronizing region,
which actions would the nurse implement?
a. Encourage television for distraction.
b. Encourage relaxed positions.
c. Walk with the patient.
d. Provide a favorite beverage.
ANS: B
Researchers believe that the ascending reticular activating system (RAS) located in the upper
brainstem contains special cells that maintain alertness and wakefulness. Researchers also
hypothesize that the release of serotonin from specialized cells in the bulbar synchronizing
region (BSR) produces sleep. As the patient closes his eyes and assumes relaxed positions,
stimuli to the RAS decrease, and at some point the BSR takes over. Television, walking, and
drinking a favorite beverage would not necessarily encourage sleep.

DIF: Understand REF: 940 OBJ: Discuss mechanisms that regulate sleep.
TOP: Implementation MSC: Physiological Integrity: Basic Care and Comfort

4. The nurse is caring for a patient in the sleep lab. The nurse recognizes that the patient is in stage
4 NREM from which of the following assessments?
a. The patient awakens easily.
b. Body functions slow.
c. The patient is difficult to awaken.
d. Eyes rapidly move.
ANS: C
Stage 4 NREM is the deepest stage of sleep. The patient is difficult to arouse, vital signs are
significantly lower, and this stage lasts about 15 to 30 minutes. Sleep walking and enuresis
sometimes occur. Lighter sleep is seen in stages 1 and 2, where the patient awakens easily. In
stage 2, body functions slow and REM sleep is characterized by rapid eye movement.

DIF: Understand REF: 940-941 OBJ: Describe the stages of a normal sleep cycle.
TOP: Assessment MSC: Physiological Integrity: Basic Care and Comfort

5. The patient shares with the nurse the vivid, full color dreams experienced by the patient last
night. These data would indicate that the patient has reached what stage of sleep?
a. Stage 1 NREM
b. Stage 2 NREM
c. Stage 3 NREM
d. REM
ANS: D
Vivid, full color dreaming occurs during REM sleep. This stage usually begins about 90
minutes after sleep has begun. The eyes move rapidly, and heart rate, respiratory rate, and blood
pressure fluctuate; loss of skeletal muscle tone occurs. The patient has an increase in gastric
secretions and is difficult to arouse.

DIF: Remember REF: 940-941 OBJ: Describe the stages of a normal sleep cycle.
TOP: Assessment MSC: Physiological Integrity: Basic Care and Comfort

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