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Basic Geriatric Nursing 6th Edition Williams Test Bank

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Basic Geriatric Nursing 6th Edition Williams Test Bank

ISBN-13: 978-0323187749

ISBN-10: 0323187749

 

Description

Basic Geriatric Nursing 6th Edition Williams Test Bank

ISBN-13: 978-0323187749

ISBN-10: 0323187749

 

 

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Below you will find some free nursing test bank questions from this test bank:

Chapter 20: Sleep and Rest

Test Bank

 

MULTIPLE CHOICE

 

  1. What stage of sleep is the initial phase of deep sleep?
a. Stage 1 nonrapid eye movement (NREM)
b. Stage 3 NREM
c. Stage 5 NREM
d. Rapid eye movement (REM) sleep

 

 

ANS:  B

Stage 3 NREM is the initial phase of deep sleep in which there is complete muscular relaxation and vital signs begin to decline.

 

DIF:    Cognitive Level: Knowledge            REF:   Box 20-1, p. 332

OBJ:   1                    TOP:   Deep Sleep     KEY:  Nursing Process Step: Assessment

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. In what stage of sleep is sleepwalking most likely to occur?
a. Stage 1 NREM
b. Stage 2 NREM
c. Stage 4 NREM
d. REM sleep

 

 

ANS:  C

Stage 4 NREM is the deepest stage of sleep in which sleepwalking is most likely to occur.

 

DIF:    Cognitive Level: Knowledge            REF:   Box 20-1, p. 332

OBJ:   1                    TOP:   Sleepwalking

KEY:  Nursing Process Step: Assessment

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. Which of the following can attribute to a sleep-wake cycle disturbance in the older adult?
a. Increase in angiotensin
b. Decrease in insulin
c. Increase in growth hormone
d. Decrease in melatonin

 

 

ANS:  D

A decrease in the melatonin level causes age-related sleep disturbances.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 332             OBJ:   1

TOP:   Hormonal Changes                          KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. The older man in a long-term care facility consistently wakes at 3 AM and does not return to sleep. The nurse records this behavior as _____ insomnia.
a. sleep initiation
b. sleep maintenance
c. terminal
d. undifferentiated

 

 

ANS:  C

Terminal insomnia is a sleep disturbance in which the patient consistently wakes at an early hour and cannot return to sleep.

 

DIF:    Cognitive Level: Application           REF:   p. 333             OBJ:   2

TOP:   Terminal Insomnia                          KEY:  Nursing Process Step: Assessment

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. A newly admitted older adult asks for a sedative every night and states that she cannot fall asleep. What type of sleep disorder is the patient most likely experiencing?
a. Onset related to anxiety of relocation
b. Maintenance related to unfamiliar environment
c. Initiation related to depression associated with relocation
d. Maintenance related to episodes of nocturnal movement disorders

 

 

ANS:  A

Sleep onset issues are usually associated with anxiety.

 

DIF:    Cognitive Level: Application           REF:   p. 333             OBJ:   2

TOP:   Insomnia        KEY:  Nursing Process Step: Assessment

MSC:  NCLEX: Psychosocial Integrity: Coping and Adaptation

 

  1. What statement by a patient’s wife would indicate that the patient is experiencing myoclonus?
a. “His loud snoring and jerking awake wakes me up, too.”
b. “I am black and blue from his kicking me every night.”
c. “He wakes up at 2 AM every morning and walks around the house.”
d. “His constant leg movements tear up the covers and keep me awake.”

 

 

ANS:  B

Myoclonus is a periodic kicking movement of the lower extremities, which can be severe.

 

DIF:    Cognitive Level: Application           REF:   p. 333             OBJ:   2

TOP:   Myoclonus     KEY:  Nursing Process Step: Assessment

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. The nurse would question the order for a sedative for a patient with which of the following diagnoses?
a. Chronic obstructive pulmonary disease (COPD)
b. Any form of dementia
c. Hypertension
d. Sleep apnea

 

 

ANS:  D

Sedation may prevent the patient with sleep apnea to awaken to restore respiration.

 

DIF:    Cognitive Level: Application           REF:   p. 334             OBJ:   3

TOP:   Lorazepam     KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity: Pharmacological Therapies

 

  1. A 75-year-old resident in a long-term care facility has problems with sleep onset. What would be an appropriate nursing intervention to aid with sleep?
a. Provide a back rub at bedtime.
b. Provide a heavy snack at bedtime.
c. Coach the resident in 10 minutes of exercise before bedtime.
d. Provide a cola drink at bedtime.

 

 

ANS:  A

A back rub can provide relaxation and aid in onset of sleep.

 

DIF:    Cognitive Level: Analysis                REF:   p. 338             OBJ:   7

TOP:   Insomnia        KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity: Pharmacological Therapies

 

  1. The 80-year-old man complains that when he goes to bed and cannot fall asleep, he becomes very upset. What would be an appropriate suggestion for when he has not fallen asleep within 30 minutes?
a. Take two tablets of a sedative medication.
b. Get up and do a mild stretching exercise for 15 minutes.
c. Remain in bed with his eyes closed.
d. Get up and read until he feels sleepy and then return to bed.

 

 

ANS:  D

Getting up and reading or watching TV is more restful than experiencing the frustration of inability to fall asleep. Sleep-inducing drugs frequently have a negative effect on older adults, exercising is stimulating, and lying in bed may increase tension.

 

DIF:    Cognitive Level: Application           REF:   p. 337             OBJ:   7

TOP:   Insomnia        KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. The patient asks how the continuous positive airway pressure (CPAP) machine decreases the incidence of sleep apnea. What is the correct response by the nurse?
a. By stimulating inspiration to be deeper
b. By taking over respiratory activity when the patient ceases to breathe
c. By sounding an alarm if respirations have ceased
d. By preventing relaxation of the tissues

 

 

ANS:  D

The use of CPAP keeps alveoli from collapsing and causing periodic apnea.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 335             OBJ:   7

TOP:   Continuous Positive Airway Pressure Machine

KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

 

  1. The patient tells the home health nurse that he has flung himself out of bed three times in the course of a violent nightmare. What sleep disorder does the nurse suspect?
a. Myoclonus
b. Restless legs syndrome
c. Rapid eye movement (REM) sleep disorder
d. Epilepsy

 

 

ANS:  C

REM sleep disorders excite excessive muscle activity during a nightmare, which causes the patient to thrash about to the point that he or she falls out of bed.

 

DIF:    Cognitive Level: Application           REF:   p. 336             OBJ:   5

TOP:   REM Sleep Disorder                       KEY:  Nursing Process Step: Assessment

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. To avoid interfering with sleep, when should activity be avoided during the day?
a. 30 minutes before bedtime
b. 1 hour before bedtime
c. 2 hours before bedtime
d. 3 hours before bedtime

 

 

ANS:  C

Exercise should be avoided within 2 hours of bedtime because activity increases the metabolic rate and may interfere with sleep.

 

DIF:    Cognitive Level: Knowledge            REF:   p. 338             OBJ:   7

TOP:   Exercise         KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. What does decreasing fluid intake in the late evening prevent?
a. Increased digestive processes in the bowel
b. Episodes of nocturia
c. Gastroesophageal reflux
d. Changes in body temperature

 

 

ANS:  B

Reduced fluid intake in the evening will prevent nocturia, which interrupts sleep.

 

DIF:    Cognitive Level: Knowledge            REF:   p. 338             OBJ:   7

TOP:   Nocturia         KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. What can a nurse in a long-term care facility do to best promote normal circadian rhythm in all patient rooms?
a. Keep bright lights on during the daytime.
b. Dim lights to promote relaxation.
c. Maintain appropriate environmental temperature.
d. Pull curtains for privacy.

 

 

ANS:  A

Bright lights during the day support normal circadian rhythm. Environmental temperature control and privacy are important but do not affect circadian rhythm.

 

DIF:    Cognitive Level: Application           REF:   p. 337             OBJ:   7

TOP:   Circadian Rhythm                           KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity: Basic Care and Comfort

 

MULTIPLE RESPONSE

 

  1. What can alter an older adult’s diurnal patterns? (Select all that apply.)
a. Shift work
b. Time zone changes
c. Altered nutrition
d. Illness
e. Medications

 

 

ANS:  A, B, D, E

Nutrition does not alter diurnal patterns. All other options have the potential to alter the diurnal patterns of the older adult.

 

DIF:    Cognitive Level: Knowledge            REF:   p. 331             OBJ:   1

TOP:   Factors That Disrupt Diurnal Patterns

KEY:  Nursing Process Step: Assessment

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. What are reasons that most long-term care residents go to sleep early and awaken early? (Select all that apply.)
a. Increased blood pressure
b. Drop in core temperature
c. Diminished food intake
d. Diminished hormone production
e. Decreased exposure to light

 

 

ANS:  B, E

Decrease in body temperature and diminished light exposure cause circadian changes, which result in going to bed early and rising early.

 

DIF:    Cognitive Level: Analysis                REF:   p. 332             OBJ:   2

TOP:   Age-Related Changes in Circadian Rhythm

KEY:  Nursing Process Step: Assessment

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. What are common side effects of sleep medications? (Select all that apply.)
a. Hangover effect
b. Urinary retention
c. Hypotension
d. Dizziness
e. Diarrhea

 

 

ANS:  A, B, C, D

Common side effects of sleep medications include a hangover effect, urinary retention, hypotension, and dizziness.

 

DIF:    Cognitive Level: Application           REF:   p. 338             OBJ:   7

TOP:   Antihistamines as Sedatives             KEY:  Nursing Process Step: N/A

MSC:  NCLEX: Physiological Integrity: Pharmacological Therapies

 

  1. What can the nurse suggest as nonpharmacological alternatives to treating insomnia? (Select all that apply.)
a. Relaxation therapy
b. Taking a cool bath or shower before bedtime
c. Listening to relaxing music
d. Arranging the sleep environment to promote sleep
e. Going to bed at a regular time after observing routine “sleep rituals”

 

 

ANS:  A, C, D, E

Taking a cool bath or shower will not promote relaxation. All other options listed would encourage sleep.

 

DIF:    Cognitive Level: Comprehension     REF:   pp. 333-334    OBJ:   7

TOP:   Insomnia        KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. What factors can contribute to sleep apnea? (Select all that apply.)
a. Obesity
b. Diabetes
c. Hypotension
d. African American heritage
e. Use of alcohol

 

 

ANS:  A, B, D, E

Hypotension does not contribute to sleep apnea. All other options are considered to be factors that contribute to sleep apnea.

 

DIF:    Cognitive Level: Comprehension     REF:   pp. 334-345    OBJ:   5

TOP:   Sleep Apnea   KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

 

  1. The wife of a patient tells the home health nurse that she suspects her husband has sleep apnea because he __________. (Select all that apply.)
a. snores loudly
b. interrupts snoring with several seconds of silence
c. complains of daytime drowsiness
d. frequently is incontinent of urine
e. has episodes of myoclonus

 

 

ANS:  A, B, C

Incontinence and myoclonus are not associated with sleep apnea.

 

DIF:    Cognitive Level: Application           REF:   p. 335             OBJ:   5

TOP:   Sleep Apnea   KEY:  Nursing Process Step: Assessment

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. How can the nursing staff encourage sleep in long-term care facility residents? (Select all that apply.)
a. Using the minimum light necessary when making rounds
b. Making necessary sleep interruptions at the same time every night
c. Keeping conversational noise at the nursing station to a minimum
d. Answering call lights promptly
e. Providing heavy blankets for warmth

 

 

ANS:  A, B, C, D

Heavy blankets may initially feel warm to the resident but eventually make the resident uncomfortable and unable to sleep. All other options listed will help diminish sleep interruptions.

 

DIF:    Cognitive Level: Comprehension     REF:   pp. 336-338    OBJ:   7

TOP:   Sleep Support                                 KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity: Basic Care and Comfort

 

  1. What changes in sleep patterns are often seen in older adults? (Select all that apply.)
a. Inability to sleep throughout the night
b. Sleeping soundly all night
c. Increase in the number of hours asleep at night
d. Difficulty in arousing from deep sleep
e. Waking up early

 

 

ANS:  A, E

The older adult has a decreased number of hours of sleep, wakes early, and rarely sleeps soundly.

 

DIF:    Cognitive Level: Knowledge            REF:   p. 332             OBJ:   3

TOP:   Effects of Disease Processes on Sleep

KEY:  Nursing Process Step: Assessment

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. What statements by the resident would indicate that she may be experiencing changes in sleep and rest patterns? (Select all that apply.)
a. “I don’t know why everything seems to bother me lately.”
b. “I’ve been so clumsy.”
c. “I’m having trouble concentrating.”
d. “My daughter says I talk in my sleep.”
e. “I cry for no reason at all.”

 

 

ANS:  A, B, C, E

Sleep talking occurs within the sleep cycle. Irritability, increased accidents, difficulty paying attention, and altered emotional stability are symptoms of an altered sleep and rest pattern.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 336             OBJ:   3

TOP:   Changes in Sleep and Rest Patterns

KEY:  Nursing Process Step: Assessment

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

COMPLETION

 

  1. The nurse reminds the CNAs that most older adults require a minimum of _____ hours of sleep per day.

 

ANS:

7.5

7 1/2

 

DIF:    Cognitive Level: Knowledge            REF:   p. 331             OBJ:   2

TOP:   Sleep Requirements                         KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. The nurse encourages the long-term facility resident experiencing insomnia to drink a glass of milk with supper and again before bedtime because milk contains the sleep-inducing agent __________.

 

ANS:  tryptophan

 

DIF:    Cognitive Level: Comprehension     REF:   p. 338             OBJ:   7

TOP:   Tryptophan     KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. The nurse clarifies that the individual’s pattern of wakefulness and sleeping is referred to as the __________ rhythm.

 

ANS:

circadian

diurnal

 

DIF:    Cognitive Level: Knowledge            REF:   p. 331             OBJ:   1

TOP:   Circadian Rhythm                           KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation