Ch.3 Nursing Care Of The Patient With + Test Bank Docx - Medical Surgical Nursing 7e | Test Bank by LeMone, Burke, Bauldoff by LeMone, Burke, Gerene Bauldoff. DOCX document preview.
LeMone & Burke's Medical-Surgical Nursing, 7e (Bauldoff/Gubrud/Carno)
Chapter 3 Nursing Care of the Patient with Alterations of Sleep
1) The nurse is preparing a teaching tool about rest and sleep for a group of college students. What should the nurse explain as the difference between rest and sleep?
1. Rest and sleep are the same.
2. Prolonged bed rest can be harmful.
3. Hormones are released during rest.
4. Glucose metabolism slows during sleep.
Page Ref: 53
Cognitive Level: Applying
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral and follow-up throughout the lifespan | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 3.1 Describe the physiology of sleep, normal sleep patterns, and factors affecting sleep.
MNL Learning Outcome: 1. Examine normal physiology, pathophysiology, risk factors, and clinical manifestations for patients with alterations of sleep.
2) A patient reports an inability to sleep more than 2 hours each night. In which body system should the nurse expect to assess an alteration in functioning? Select all that apply.
1. Mood
2. Satiety
3. Urine output
4. Immune system
5. Cognitive ability
Page Ref: 53
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 3.1 Describe the physiology of sleep, normal sleep patterns, and factors affecting sleep.
MNL Learning Outcome: 3. Perform assessment for patients with alterations of sleep.
3) During an assessment, a patient states the inability to fall asleep at night. Which question should the nurse ask to help determine the reason for the patient's difficulty with sleep?
1. "Do you sleep with the television on?"
2. "What time do you usually go to bed?"
3. "How many hours a day do you work?"
4. "What time do you get up in the morning?"
Page Ref: 53
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 3.1 Describe the physiology of sleep, normal sleep patterns, and factors affecting sleep.
MNL Learning Outcome: 3. Perform assessment for patients with alterations of sleep.
4) A patient is in the intensive care area. When should the nurse expect the patient to have the best chance of falling asleep?
1. When hungry
2. When the stomach is full
3. When the body temperature increases
4. When the body temperature decreases
Page Ref: 53
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Basic Care and Comfort
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 3.1 Describe the physiology of sleep, normal sleep patterns, and factors affecting sleep.
MNL Learning Outcome: 1. Examine normal physiology, pathophysiology, risk factors, and clinical manifestations for patients with alterations of sleep.
5) The nurse is preparing a teaching tool on the physiologic effects of sleep for a group of new colleagues. Which information should the nurse include? Select all that apply.
1. Cortisol is decreased during the day.
2. Melatonin is increased during the day.
3. Testosterone increases during the night.
4. Blood pressure decreases during the night.
5. Growth hormone increases during the night.
Page Ref: 54
Cognitive Level: Applying
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral and follow-up throughout the lifespan | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 3.1 Describe the physiology of sleep, normal sleep patterns, and factors affecting sleep.
MNL Learning Outcome: 1. Examine normal physiology, pathophysiology, risk factors, and clinical manifestations for patients with alterations of sleep.
6) A hospitalized patient is aroused from sleep every 2 hours for blood samples and vital sign assessments. Which potential health problem should the nurse add to this patient's plan of care?
1. Risk for injury
2. Fluid volume overload
3. Potential for ineffective coping
4. Ineffective self-help management
Page Ref: 55
Cognitive Level: Applying
Client Need & Sub: Safe and Effective Care Environment: Safety and Infection Control
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Quality & Safety; Practice-Know-How; Use technologies that contribute to safety | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 3.1 Describe the physiology of sleep, normal sleep patterns, and factors affecting sleep.
MNL Learning Outcome: 4. Determine appropriate nursing care for patients with alterations of sleep.
7) The nurse manager is identifying actions to improve the quality of sleep for patients on the care area. Which extrinsic factor should be identified as affecting sleep?
1. Noise
2. Rumination
3. Emotional state
4. Disease process
Page Ref: 55
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Basic Care and Comfort
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 3.1 Describe the physiology of sleep, normal sleep patterns, and factors affecting sleep.
MNL Learning Outcome: 1. Examine normal physiology, pathophysiology, risk factors, and clinical manifestations for patients with alterations of sleep.
8) A patient seeks medical attention for insomnia that occurs several times a week. Which potential health problem should the nurse identify that this patient is at risk for developing? Select all that apply.
1. Hypertension
2. Coronary artery disease
3. Cerebrovascular disease
4. Gastrointestinal disorder
5. Subclinical atherosclerotic disease
Page Ref: 55
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 3.1 Describe the physiology of sleep, normal sleep patterns, and factors affecting sleep.
MNL Learning Outcome: 1. Examine normal physiology, pathophysiology, risk factors, and clinical manifestations for patients with alterations of sleep.
9) The nurse notes that a patient has significant daytime sleepiness. Which medication should the nurse identify could be causing this patient's symptom? Select all that apply.
1. Levodopa
2. Tiotopium
3. Metoprolol
4. Procainamide
5. Amitriptyline
Page Ref: 56
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 3.1 Describe the physiology of sleep, normal sleep patterns, and factors affecting sleep.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with alterations of sleep.
10) The nurse is planning care for a patient with chronic obstructive pulmonary disease (COPD). Which should the nurse consider to ensure this patient receives adequate sleep?
1. Wheezing will increase the amount of sleep.
2. Bronchodilators will enhance the onset of sleep.
3. The disease process and medications to treat will affect sleep.
4. Chronic coughing will have minimal effect on quality of sleep.
Page Ref: 56
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Basic Care and Comfort
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 3.1 Describe the physiology of sleep, normal sleep patterns, and factors affecting sleep.
MNL Learning Outcome: 1. Examine normal physiology, pathophysiology, risk factors, and clinical manifestations for patients with alterations of sleep.
11) A college student is having difficulty staying awake during classes and is doing poorly in school. What should the nurse recommend to improve this patient's quality of sleep? Select all that apply.
1. Exercise daily.
2. Limit caffeine in the afternoon.
3. Have a consistent wakeup time.
4. Keep the bedroom cool, dark, and quiet.
5. Turn the volume of the television to low.
Page Ref: 57
Cognitive Level: Applying
Client Need & Sub: Health Promotion and Maintenance: Self-Care
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral and follow-up throughout the lifespan | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 3.2 Summarize topics that nurses teach to promote healthy sleep across the lifespan.
MNL Learning Outcome: 4. Determine appropriate nursing care for patients with alterations of sleep.
12) The nurse is caring for patients during the night shift. Which action should the nurse take to prevent interrupting the patients' sleep?
1. Keep the room doors open.
2. Turn on the overhead light.
3. Use a flashlight in the rooms.
4. Keep the curtains open between patients.
Page Ref: 57
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Basic Care and Comfort
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 3.2 Summarize topics that nurses teach to promote healthy sleep across the lifespan.
MNL Learning Outcome: 4. Determine appropriate nursing care for patients with alterations of sleep.
13) A patient reports having difficulty sleeping since being discharged from the hospital. Which should the nurse recommend to this patient to improve sleep?
1. Take brief naps throughout the day.
2. Watch a movie on the television when going to bed.
3. Limit the amount of physical activity obtained during the day.
4. Open the curtains immediately upon waking up in the morning.
Page Ref: 56-57
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Basic Care and Comfort
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 3.2 Summarize topics that nurses teach to promote healthy sleep across the lifespan.
MNL Learning Outcome: 4. Determine appropriate nursing care for patients with alterations of sleep.
14) A patient reports having problems sleeping over the last few weeks. What should the nurse do to support the assessment process?
1. Encourage the patient to wait it out.
2. Recommend the patient keep a sleep diary.
3. Ask family members to describe the patient's sleep.
4. Suggest the patient videotape the hours during sleep.
Page Ref: 57-58
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Basic Care and Comfort
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 3.3 Outline the components of the assessment of sleep including topics for the health assessment interview, techniques for physical assessment, and the diagnostic tests used in the assessment.
MNL Learning Outcome: 3. Perform assessment for patients with alterations of sleep.
15) A patient with several chronic health problems reports difficulty sleeping through the night. What should the nurse include when assessing this patient? Select all that apply.
1. Weight
2. Neck size
3. Oropharynx
4. Blood pressure
5. Body mass index
Page Ref: 57
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Basic Care and Comfort
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 3.3 Outline the components of the assessment of sleep including topics for the health assessment interview, techniques for physical assessment, and the diagnostic tests used in the assessment.
MNL Learning Outcome: 3. Perform assessment for patients with alterations of sleep.
16) A patient is experiencing extreme daytime sleepiness but is unable to sleep during the night. For which diagnostic test should the nurse prepare teaching for this patient?
1. Polysomnography
2. CT scan of the brain
3. Electroencephalogram
4. Nerve conduction studies
Page Ref: 58
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Planning/Teaching/Learning
Learning Outcome: 3.3 Outline the components of the assessment of sleep including topics for the health assessment interview, techniques for physical assessment, and the diagnostic tests used in the assessment.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with alterations of sleep.
17) A patient experiencing menopause is concerned about the inability to sleep through the night. For which potential health problem should the nurse assess this patient?
1. Osteoporosis
2. Heart disease
3. Obstructive sleep apnea
4. Chronic obstructive pulmonary disease
Page Ref: 59
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 3.4 Differentiate considerations for assessing the sleep of older adults, veterans, and individuals in the LGBTQI population.
MNL Learning Outcome: 3. Perform assessment for patients with alterations of sleep.
18) The spouse of a Middle East war veteran is concerned because the patient screams often during sleep and wakes up the entire household. What should the nurse consider as the reason for the patient's behavior during sleep?
1. Alcoholism
2. Depression
3. Posttraumatic stress disorder
4. Adverse medication reaction
Page Ref: 59
Cognitive Level: Analyzing
Client Need & Sub: Psychosocial Integrity: Stress Management
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 3.4 Differentiate considerations for assessing the sleep of older adults, veterans, and individuals in the LGBTQI population.
MNL Learning Outcome: 3. Perform assessment for patients with alterations of sleep.
19) The nurse suspects that a patient is experiencing difficulty sleeping. Which assessment finding caused the nurse to make this clinical determination? Select all that apply.
1. Irritable
2. Slow reflexes
3. Heart rate 108 bpm
4. Inability to concentrate
5. Blood pressure 110/68 mmHg
Page Ref: 59
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Basic Care and Comfort
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 3.5 Describe the pathophysiology and manifestations of sleep deprivation, and outline the interprofessional care and nursing care of patients with this disorder.
MNL Learning Outcome: 3. Perform assessment for patients with alterations of sleep.
20) A patient being treated for a sleep disorder reports no change in the ability to sleep through the night. What should the nurse assess first with this patient?
1. Vital signs
2. Amount of stress
3. Home environment
4. Adherence with the prescribed treatment
Page Ref: 59
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Basic Care and Comfort
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 3.5 Describe the pathophysiology and manifestations of sleep deprivation, and outline the interprofessional care and nursing care of patients with this disorder.
MNL Learning Outcome: 3. Perform assessment for patients with alterations of sleep.
21) The nurse is assessing a patient with insomnia. Which additional health problem should the nurse include in the assessment? Select all that apply.
1. Anxiety
2. Gastritis
3. Headaches
4. Depression
5. Osteoarthritis
Page Ref: 60
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 3.6 Describe the pathophysiology and manifestations of insomnia, and outline the interprofessional care and nursing care of patients with this disorder.
MNL Learning Outcome: 1. Examine normal physiology, pathophysiology, risk factors, and clinical manifestations for patients with alterations of sleep.
22) The nurse is reviewing the process of insomnia with a group of colleagues. Which should the nurse identify as a predisposing factor for the health problem?
1. Worry
2. Life stress
3. Loss of a job
4. Poor coping skills
Page Ref: 60
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.6. Use information and communication technologies in preventive care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Communication and Documentation
Learning Outcome: 3.6 Describe the pathophysiology and manifestations of insomnia, and outline the interprofessional care and nursing care of patients with this disorder.
MNL Learning Outcome: 1. Examine normal physiology, pathophysiology, risk factors, and clinical manifestations for patients with alterations of sleep.
23) A patient seeks medical attention for insomnia that has been occurring over the last several months. For which reason would actigraphy be used for this patient?
1. Confirm the diagnosis of insomnia.
2. Identify the degree of difficulty sleeping.
3. Evaluate the effectiveness of medication.
4. Determine the best medication to prescribe.
Page Ref: 60
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 3.6 Describe the pathophysiology and manifestations of insomnia, and outline the interprofessional care and nursing care of patients with this disorder.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with alterations of sleep.
24) A patient with insomnia asks for medication "to sleep." Which should the nurse explain about using this type of medication?
1. It does not cure the problem.
2. It is the best treatment approach for the problem.
3. It will eliminate the problem if used consistently.
4. It will provide the best rest with minimal side effects.
Page Ref: 60
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.4. Communicate effectively with all members of the healthcare team, including the patient and the patient's support network | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Communication and Documentation
Learning Outcome: 3.6 Describe the pathophysiology and manifestations of insomnia, and outline the interprofessional care and nursing care of patients with this disorder.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with alterations of sleep.
25) A patient has a motor vehicle crash but does not remember getting into the car to drive. Which question should the nurse ask when assessing this patient?
1. "What medication are you taking?"
2. "What health problems do you have?"
3. "What is the last thing you remember?"
4. "Where do you think you were going?"
Page Ref: 61
Cognitive Level: Applying
Client Need & Sub: Safe and Effective Care Environment: Safety and Infection Control
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 3.6 Describe the pathophysiology and manifestations of insomnia, and outline the interprofessional care and nursing care of patients with this disorder.
MNL Learning Outcome: 3. Perform assessment for patients with alterations of sleep.
26) A patient is given zolpidem (Ambien) at bedtime. Which action should the nurse take when the patient needs to void in the middle of the night?
1. Provide a bedpan.
2. Insert a urinary catheter.
3. Provide a bedside commode.
4. Ambulate the patient to the bathroom.
Page Ref: 61
Cognitive Level: Applying
Client Need & Sub: Safe and Effective Care Environment: Safety and Infection Control
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 3.6 Describe the pathophysiology and manifestations of insomnia, and outline the interprofessional care and nursing care of patients with this disorder.
MNL Learning Outcome: 4. Determine appropriate nursing care for patients with alterations of sleep.
27) A patient who has been taking zaleplon (Sonata) for several months asks for a prescription refill before the appropriate length of time. Which action should the nurse take?
1. Assess about frequency of use.
2. Ask the healthcare provider to renew the prescription.
3. Suggest the patient use alternative approaches to sleep.
4. Explain that the patient will have to wait until the prescription can be refilled.
Page Ref: 61
Cognitive Level: Applying
Client Need & Sub: Psychosocial Integrity: Chemical and Other Dependencies/Substance Use Disorder
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 3.6 Describe the pathophysiology and manifestations of insomnia, and outline the interprofessional care and nursing care of patients with this disorder.
MNL Learning Outcome: 3. Perform assessment for patients with alterations of sleep.
28) The nurse instructs a patient about the prescribed medication zolpidem (Ambien). Which patient statement indicates that teaching was effective?
1. "This medication causes no side effects."
2. "I should report any confusion or hallucinations."
3. "I can take this medication with my evening cocktail."
4. "I can take this medication any time before going to bed."
Page Ref: 61
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.9. Monitor client outcomes to evaluate the effectiveness of psychobiological interventions | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Evaluation/Teaching/Learning
Learning Outcome: 3.6 Describe the pathophysiology and manifestations of insomnia, and outline the interprofessional care and nursing care of patients with this disorder.
MNL Learning Outcome: 4. Determine appropriate nursing care for patients with alterations of sleep.
29) The nurse is preparing a teaching tool about obstructive sleep apnea. Which information about risk factors should the nurse include? Select all that apply.
1. Obesity
2. Male gender
3. Alcohol intake
4. Large neck size
5. Small oropharynx
Page Ref: 62
Cognitive Level: Applying
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.9. Monitor client outcomes to evaluate the effectiveness of psychobiological interventions | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Planning/Teaching/Learning
Learning Outcome: 3.7 Describe the pathophysiology and manifestations of sleep-disordered breathing, and outline the interprofessional care and nursing care of patients with this disorder.
MNL Learning Outcome: 1. Examine normal physiology, pathophysiology, risk factors, and clinical manifestations for patients with alterations of sleep.
30) The nurse suspects that a patient has undiagnosed obstructive sleep apnea (OSA). What observation caused the nurse to come to this conclusion about the patient? Select all that apply.
1. Poor coordination
2. Morning headache
3. Daytime sleepiness
4. Snoring while asleep
5. Waking up gasping for air
Page Ref: 62
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 3.7 Describe the pathophysiology and manifestations of sleep-disordered breathing, and outline the interprofessional care and nursing care of patients with this disorder.
MNL Learning Outcome: 1. Examine normal physiology, pathophysiology, risk factors, and clinical manifestations for patients with alterations of sleep.
31) An overweight patient is diagnosed with obstructive sleep apnea (OSA). What teaching material should the nurse consider first for this patient?
1. Oral device
2. Neurostimulator
3. Weight management
4. Positive airway pressure
Page Ref: 62
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Planning/Teaching/Learning
Learning Outcome: 3.7 Describe the pathophysiology and manifestations of sleep-disordered breathing, and outline the interprofessional care and nursing care of patients with this disorder.
MNL Learning Outcome: 4. Determine appropriate nursing care for patients with alterations of sleep.
32) A patient with obstructive sleep apnea (OSA) asks why a mouth retainer is prescribed since there are no problems with the teeth. Which response should the nurse make to the patient?
1. "Obstructive sleep apnea is caused by misaligned teeth."
2. "The mouth retainer will keep your jaw in alignment while sleeping."
3. "The mouth retainer decreases the diameter of the back of the throat."
4. "The mouth retainer will help you keep your mouth closed while sleeping."
Page Ref: 62
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.4. Communicate effectively with all members of the healthcare team, including the patient and the patient's support network | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Communication and Documentation
Learning Outcome: 3.7 Describe the pathophysiology and manifestations of sleep-disordered breathing, and outline the interprofessional care and nursing care of patients with this disorder.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with alterations of sleep.
33) A patient is being considered for a hypoglossal nerve stimulator. Which patient criteria was most likely used for this treatment to be identified?
1. Is obese
2. Sleeps with three pillows
3. Takes medication for hypertension
4. Has moderate to severe obstructive sleep apnea (OSA)
Page Ref: 63
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 3.7 Describe the pathophysiology and manifestations of sleep-disordered breathing, and outline the interprofessional care and nursing care of patients with this disorder.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with alterations of sleep.
34) The nurse is preparing a teaching tool for patients who are prescribed continuous positive airway pressure (CPAP) as treatment for obstructive sleep apnea (OSA). Which potential adverse effect from the use of the device should the nurse include? Select all that apply.
1. Dry nose
2. Neck pain
3. Air swallowing
4. Facial excoriations
5. Esophageal spasms
Page Ref: 63
Cognitive Level: Applying
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 3.7 Describe the pathophysiology and manifestations of sleep-disordered breathing, and outline the interprofessional care and nursing care of patients with this disorder.
MNL Learning Outcome: 4. Determine appropriate nursing care for patients with alterations of sleep.
35) The nurse is asked to explain central sleep apnea (CSA). In which way should the nurse respond? Select all that apply.
1. "It is seen with substance abuse."
2. "It can be caused by medication."
3. "It is associated with medical disorder."
4. "It occurs with Cheyne-Stokes breathing."
5. "It is another term for the obstructive form."
Page Ref: 63
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 3.7 Describe the pathophysiology and manifestations of sleep-disordered breathing, and outline the interprofessional care and nursing care of patients with this disorder.
MNL Learning Outcome: 1. Examine normal physiology, pathophysiology, risk factors, and clinical manifestations for patients with alterations of sleep.
36) A patient is being evaluated for central sleep apnea (CSA). What should the nurse expect to assess in this patient? Select all that apply.
1. Daytime fatigue
2. Daytime sleepiness
3. Nighttime pauses in breathing
4. Nighttime drop in blood pressure
5. Daytime increase in blood glucose
Page Ref: 64
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 3.7 Describe the pathophysiology and manifestations of sleep-disordered breathing, and outline the interprofessional care and nursing care of patients with this disorder.
MNL Learning Outcome: 1. Examine normal physiology, pathophysiology, risk factors, and clinical manifestations for patients with alterations of sleep.
37) The nurse is planning care for a patient with central sleep apnea (CSA). For which treatment should the nurse plan interventions? Select all that apply.
1. Surgery
2. Medication therapy
3. Supplemental oxygen
4. Noninvasive ventilation
5. Positive airway pressure
Page Ref: 64
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 3.7 Describe the pathophysiology and manifestations of sleep-disordered breathing, and outline the interprofessional care and nursing care of patients with this disorder.
MNL Learning Outcome: 4. Determine appropriate nursing care for patients with alterations of sleep.
38) The nurse is reviewing data collected during a patient assessment. Which information should the nurse identify that supports the patient's diagnosis of restless leg syndrome (RLS)?
1. Low iron level
2. Low potassium level
3. Elevated platelet level
4. Elevated hemoglobin level
Page Ref: 64
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 3.8 Describe the pathophysiology and manifestations of restless legs syndrome, and outline the interprofessional care and nursing care of patients with this disorder.
MNL Learning Outcome: 1. Examine normal physiology, pathophysiology, risk factors, and clinical manifestations for patients with alterations of sleep.
39) The nurse is preparing a teaching tool about restless leg syndrome (RLS). Which risk factor should the nurse include about this health problem? Select all that apply.
1. Renal failure
2. Heart disease
3. Family history
4. Gastroenteritis
5. Parkinson disease
Page Ref: 64
Cognitive Level: Applying
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Planning/Teaching/Learning
Learning Outcome: 3.8 Describe the pathophysiology and manifestations of restless legs syndrome, and outline the interprofessional care and nursing care of patients with this disorder.
MNL Learning Outcome: 4. Determine appropriate nursing care for patients with alterations of sleep.
40) A patient seeks medical treatment for restless leg syndrome (RLS). Which medication should the nurse expect to be prescribed first for this patient?
1. Opioids
2. Dopamine
3. Gabapentin
4. Iron supplement
Page Ref: 64
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 3.8 Describe the pathophysiology and manifestations of restless legs syndrome, and outline the interprofessional care and nursing care of patients with this disorder.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with alterations of sleep.
Document Information
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Medical Surgical Nursing 7e | Test Bank by LeMone, Burke, Bauldoff
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Chapter 1 Medical-Surgical Nursing In The 21St Century
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