Basic Geriatric Nursing 5th Edition by Gloria Hoffman Wold Test bank

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Basic Geriatric Nursing 5th Edition by Gloria Hoffman Wold Test bank

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WITH ANSWERS
Basic Geriatric Nursing 5th Edition by Gloria Hoffman Wold Test bank

Wold: Basic Geriatric Nursing, 5th Edition

 

Chapter 02: Theories of Aging

 

Test Bank

 

MULTIPLE CHOICE

 

  1. A theory differs from a fact in that a theory:
a. proves how different influences affect a particular phenomenon.
b. attempts to explain and give some logical order to observations.
c. is a collection of facts about a particular phenomenon.
d. shows a relationship among facts about a particular phenomenon.

 

ANS:   B

A theory is an unproven concept that attempts to explain and give some logical order to observations. For a theory to become a fact, there must be reproducible evidence.

DIF:    Cognitive Level: Comprehension       REF:    28        OBJ:    1

TOP:    Fact vs. Theory                       KEY:   Nursing Process Step: N/A

MSC:   NCLEX: N/A

 

  1. The biological theory of aging uses a genetic perspective and suggests that aging is a programmed process in which:
a. each person will age exactly like those in the previous generation.
b. a biological clock ticks off a predetermined number of cell divisions.
c. genetic traits can overcome environmental influences.
d. age-related physical changes are controlled only by genetic factors.

 

ANS:   B

The biological theory of programmed process suggests that there is a biologic clock set with a predetermined number of cell divisions that will occur before the introduction of the aging process.

DIF:    Cognitive Level: Application  REF:    28        OBJ:    2

TOP:    Biological Theory                    KEY:   Nursing Process Step: N/A

MSC:   NCLEX: N/A

 

  1. The Gene Theory of aging proposes that:
a. the presence of a master gene prolongs youth.
b. genes interact with each other to resist aging.
c. specific genes target specific body systems to initiate system deterioration.
d. the activation of harmful genes initiates the aging process.

 

ANS:   D

The Gene Theory suggests that there is an activation of harmful genes that initiate the aging process.

DIF:    Cognitive Level: Application  REF:    28        OBJ:    2

TOP:    Gene Theory                           KEY:   Nursing Process Step: N/A

MSC:   NCLEX: N/A

 

  1. The theory that identifies an unstable molecule as the causative factor in aging is the _____ theory.
a. free radical
b. molecular
c. neuroendocrine
d. crosslink

 

ANS:   A

The free radical theory identifies free radicalsunstable moleculesthat will cause aging after accumulation in the body.

DIF:    Cognitive Level: Application  REF:    29        OBJ:    2

TOP:    Free Radical Theory                KEY:   Nursing Process Step: N/A

MSC:   NCLEX: N/A

 

  1. The nurse assesses that the patient who uses good health maintenance practices believes in the aging theory known as the _____ theory.
a. wear-and-tear
b. free radical
c. neuroendocrine
d. molecular

 

ANS:   A

The wear-and-tear theory suggests that health maintenance practices will prevent wear and tear on the cells of the body and will delay the aging process.

DIF:    Cognitive Level: Analysis       REF:    29        OBJ:    2

TOP:    Wear-and-Tear Theory            KEY:   Nursing Process Step: Assessment

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

 

  1. The nurse describes the neuroendocrine theory of aging as a complex process of:
a. relating thyroid function to age-related changes.
b. the effects of adrenal corticosteroids, which inhibit the aging process.
c. stimulation and/or inhibition of the hypothalamus, causing age-related changes.
d. adrenal medulla inhibition of epinephrine, causing age-related changes.

 

ANS:   C

The neuroendocrine theory proposes that the hypothalamus stimulates or inhibits the pituitary gland to produce hormones that initiate the aging process.

DIF:    Cognitive Level: Application  REF:    29        OBJ:    2

TOP:    Neuroendocrine Theory          KEY:   Nursing Process Step: Implementation

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

 

  1. The nurse explains that psychosocial theories differ from biologic theories in that psychosocial theories:
a. focus on methods to delay the aging process.
b. are directed at decreasing depression in the older adult.
c. are organized to enhance the perception of aging.
d. attempt to explain responses to the aging process.

 

ANS:   D

Psychosocial theories attempt to explain the various responses of persons to the aging process.

DIF:    Cognitive Level: Comprehension       REF:    30        OBJ:    3

TOP:    Focus of Psychosocial Therapies        KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Health Promotion and Maintenance: Growth and Development

 

  1. The major objection to the disengagement theory is that the theory:
a. justifies ageism.
b. addresses the diversity of older adults.
c. does not clarify the aging process.
d. diminishes the self-esteem of the older adult.

 

ANS:   A

The disengagement theory seems to justify ageism by proposing that there is a mutual desire between the community and the older adult to be disengaged. According to the theory, this desire apparently does not diminish self-esteem because the older adult desires to be disengaged.

DIF:    Cognitive Level: Application  REF:    30        OBJ:    3

TOP:    Disengagement Theory           KEY:   Nursing Process Step: N/A

MSC:   NCLEX: Psychosocial Integrity: Coping and Adaptation

 

  1. The 80-year-old who teaches Sunday school every week and delivers food for Meals on Wheels is following _____ theory.
a. Newmans developmental
b. the life course
c. the activity
d. the disengagement

 

ANS:   C

Purposeful activity increases self-esteem and maintains cognitive function well into older age.

DIF:    Cognitive Level: Application  REF:    30        OBJ:    3

TOP:    Activity Theory                       KEY:   Nursing Process Step: N/A

MSC:   NCLEX: N/A

 

  1. The nurse would recognize successful aging according to Jungs theory when the nurse notes that a resident at a long-term care facility:
a. takes special care to dress for dinner in a manner that pleases his tablemates.
b. asks permission to sit on the patio with other residents.
c. asks persons in his hall if his television is bothering them.
d. wears a large cowboy hat at all times because he likes it.

 

ANS:   D

Jung describes a successful adjustment to aging as being accepting and valuing of self regardless of the view of others.

DIF:    Cognitive Level: Application  REF:    30        OBJ:    3

TOP:    Jungs Developmental Theory KEY:   Nursing Process Step: Evaluation

MSC:   NCLEX: Health Promotion and Maintenance: Growth and Development

 

  1. The older adult female patient is positive that the free radical lipofuscin can be counteracted by:
a. avoiding animal fat.
b. use of antioxidants.
c. building up muscle mass.
d. outdoor exercise.

 

ANS:   B

Individuals who follow this theory believe that free radicals can be reduced by antioxidants such as vitamins A, C, E, zinc, and phytochemicals.

DIF:    Cognitive Level: Comprehension       REF:    29        OBJ:    2

TOP:    Antioxidants                           KEY:   Nursing Process Step: Planning

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

 

  1. A recently widowed woman moved to an assisted living community because of her hypertension and joined a group to learn how to do water color painting with other women her age. The nurse assesses that the patient is following the aging theory of:
a. Jung.
b. Havighurst.
c. Erikson.
d. Newmon.

 

ANS:   B

Havighurst proposes that the process of aging is defined by adjusting to the loss of a spouse, establishing a relationship with ones own age group, and establishing a satisfactory living arrangement.

DIF:    Cognitive Level: Application  REF:    30        OBJ:    3

TOP:    Havighurst      KEY:   Nursing Process Step: Assessment

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

 

MULTIPLE RESPONSE

 

  1. The nurses list of age-related illnesses thought to cause the accumulation of free radicals includes __________. (Select all that apply.)
a. arthritis
b. colon cancer
c. osteoporosis
d. diabetes
e. atherosclerosis

 

ANS:   A, D, E

Cancer and osteoporosis are not considered to be diseases that accumulate free radicals.

DIF:    Cognitive Level: Application  REF:    29        OBJ:    2

TOP:    Free Radical Influence            KEY:   Nursing Process Step: Implementation

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

 

  1. The nurse emphasizes that the relatively new theory that correlates restricted caloric intake to slowing of the aging process would probably extend the life span of the person, provided that the person __________. (Select all that apply.)
a. consistently eats high-nutrient, low-calorie foods
b. maintains a regular exercise program
c. consumes 2000 to 3000 mL of fluid a day
d. supports the diet with adequate fat-soluble vitamins
e. eats only organically grown foods

 

ANS:   A, B

This new theory encourages high-nutrient, low-calorie foods combined with regular exercise to delay the aging process.

DIF:    Cognitive Level: Application  REF:    30        OBJ:    2

TOP:    Calorie Restriction Theory      KEY:   Nursing Process Step: Implementation

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

 

  1. The nurse points out that the positive outcomes from a life review, according to Erikson, would include __________. (Select all that apply.)
a. wisdom and integrated self-image
b. comparing self with others
c. understanding self and relationships
d. seeking anothers opinion of his or her achievement
e. acceptance of self

 

ANS:   A, C, E

Acceptance of self and understanding self and relationships with accumulated wisdom is the goal of Erikson. Seeking the opinion of others suggests that the older adult is experiencing doubt and gloom, which are negative outcomes according to Erikson.

DIF:    Cognitive Level: Application  REF:    30        OBJ:    2

TOP:    Eriksons Developmental Theory        KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Health Promotion and Maintenance: Growth and Development

 

  1. When a patient asks what can be done to neutralize the free radicals in his system, the nurse responds that antioxidant therapy is thought to inhibit free radicals. Antioxidants include __________. (Select all that apply.)
a. fruits
b. vegetables
c. organ meat
d. folic acid
e. vitamin D

 

ANS:   A, B, D

Antioxidants can be obtained largely from fruits and vegetables. Organ meat and vitamin D are not antioxidants.

DIF:    Cognitive Level: Comprehension       REF:    29        OBJ:    4

TOP:    Antioxidants                           KEY:   Nursing Process Step: Implementation

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

 

COMPLETION

 

  1. The theory that proposes that defects in ribonucleic acid (RNA) protein production cause a progressive decline in the function of all cells is the __________ theory.

 

ANS:   error

The error theory proposes that errors in ribonucleic acid protein synthesis cause changes such as decreased muscle mass, increased body fat, and changes in reproductive function.

DIF:    Cognitive Level: Comprehension       REF:    28-29   OBJ:    2

TOP:    Error Theory                            KEY:   Nursing Process Step: N/A

MSC:   NCLEX: N/A

 

  1. The nurse clarifies that the biologic theory that proposes that aging is based on the using up of a finite number of breaths or heartbeats is the __________ of __________ theory.

 

ANS:   rate; living

The rate of living theory proposes that individuals have a finite number of breaths or heartbeats that are used up over a period of time.

DIF:    Cognitive Level: Comprehension       REF:    28        OBJ:    2

TOP:    Rate of Living Theory            KEY:   Nursing Process Step: Implementation

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

 

Wold: Basic Geriatric Nursing, 5th Edition

 

Chapter 20: Sleep and Rest

 

Test Bank

 

MULTIPLE CHOICE

 

 

  1. The nurse is aware that the initial entry to deep sleep is:
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: Comprehension       REF:    329, Box 20-1

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

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. The phenomenon of sleep walking is most likely to occur in the sleep stage of:
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 sleep walking is most likely to occur.

DIF:    Cognitive Level: Comprehension       REF:    329, Box 20-1

OBJ:    1          TOP:    Sleep Walking

KEY:   Nursing Process Step: Assessment

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. The nurse explains that older adults often experience a disturbed sleep-wake cycle because of hormonal changes, which include a(n) _____ level.
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: Application  REF:    329      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:    330      OBJ:    2

TOP:    Terminal Insomnia                  KEY:   Nursing Process Step: Assessment

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. The newly admitted older adult who cannot fall asleep and asks for a sedative every night is most probably experiencing a difficulty with sleep:
a. initiation 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 initiation issues are usually associated with anxiety.

DIF:    Cognitive Level: Application  REF:    330      OBJ:    2

TOP:    Insomnia         KEY:   Nursing Process Step: Assessment

MSC:   NCLEX: Psychosocial Integrity: Coping and Adaptation

 

  1. The home health nurse assesses that the patient is probably experiencing myoclonus when his wife says:
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:    330      OBJ:    2

TOP:    Myoclonus      KEY:   Nursing Process Step: Assessment

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. The nurse would question the order for lorazepam (Ativan), 5 mg at bedtime, for a patient with:
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:    330, Table 20-1

OBJ:    3          TOP:    Lorazepam      KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity: Pharmacological Therapies

 

  1. In order to assist a 75-year-old male resident in a long-term care facility to decrease his problems with sleep initiation, the nurse would:
a. provide a heavy snack at bedtime.
b. reschedule the 8 PM albuterol inhalation treatment to 4 PM.
c. coach the resident in 10 minutes of exercise before bedtime.
d. provide a cola drink, strong tea, or cocoa at bedtime.

 

ANS:   B

Albuterol is a drug that may interfere with sleep schedules.

DIF:    Cognitive Level: Analysis       REF:    331, Table 20-2

OBJ:    7          TOP:    Insomnia         KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity: Pharmacological Therapies

 

  1. The nurse cautions the patient who has just started on the antidepressant trazodone hydrochloride to help relieve insomnia to:
a. increase fluids.
b. avoid aged cheese and red wine.
c. decrease sodium intake.
d. avoid excessive exposure to the sun.

 

ANS:   D

Trazodone makes persons photosensitive.

DIF:    Cognitive Level: Application  REF:    330, Table 20-1

OBJ:    7          TOP:    Trazodone       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 tosses and turns and gets so frustrated that he gets up and drinks coffee all night. The nurse suggests that when he has not fallen asleep after 30 minutes, he should:
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:    331      OBJ:    7

TOP:    Insomnia         KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. The nurse clarifies that the continuous positive airway pressure (CPAP) machine decreases the incidence of episodes of sleep apnea by:
a. stimulating inspiration to be deeper.
b. taking over respiratory activity when the patient ceases to breathe.
c. sounding an alarm if respirations have ceased.
d. keeping alveoli from collapsing.

 

ANS:   D

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

DIF:    Cognitive Level: Comprehension       REF:    332      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. When the patient tells the home health nurse that he has flung himself out of bed three times in the course of a violent nightmare, the nurse recognizes the cardinal indicator of:
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:    332      OBJ:    5

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

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. The nurse cautions that although activity and exercise during the day are an effective sleep aid, activity and exercise should be avoided within _____ before bedtime.
a. 30 minutes
b. 1 hour
c. 2 hours
d. 3 hours

 

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:    334      OBJ:    7

TOP:    Exercise           KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. The patient is encouraged to decrease fluid intake in the late evening to prevent interruption of sleep from:
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:    334-335           OBJ:    7

TOP:    Nocturia          KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. The nurse makes arrangements to promote normal circadian rhythm in a long-term care facility by ensuring that all rooms have:
a. bright lights during the daytime.
b. dim lights to promote relaxation.
c. appropriate environmental temperature.
d. 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:    333      OBJ:    7

TOP:    Circadian Rhythm                   KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity: Basic Care and Comfort

 

MULTIPLE RESPONSE

 

  1. The nurse is aware that an older adults diurnal patterns can be altered by __________. (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:    328      OBJ:    1

TOP:    Factors That Disrupt Diurnal Patterns

KEY:   Nursing Process Step: Assessment

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. The long-term care facility nurse takes into consideration that most residents go to sleep early and awaken early because of __________. (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:    329      OBJ:    2

TOP:    Age-Related Changes in Circadian Rhythm

KEY:   Nursing Process Step: Assessment

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. The nurse gives the antihistamine diphenhydramine (Benadryl) as a sleep aid with caution because the older adult may experience side effects, such as __________. (Select all that apply.)
a. confusion
b. urinary retention
c. hypotension
d. depression of respiration
e. diarrhea

 

ANS:   A, B, C

Benadryl can cause confusion, urinary retention, and hypotension in the older adult.

DIF:    Cognitive Level: Application  REF:    330, Table 20-1

OBJ:    7          TOP:    Antihistamines as Sedatives   KEY:   Nursing Process Step: N/A

MSC:   NCLEX: Physiological Integrity: Pharmacological Therapies

 

  1. When mild sedation has failed to solve the problem of insomnia in the older adult, the nurse suggests __________. (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:    331, Health Promotions

OBJ:    7          TOP:    Insomnia         KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation

  1. The nurse explains that factors that contribute to sleep apnea include __________. (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:    331-332           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:    331-332           OBJ:    5

TOP:    Sleep Apnea    KEY:   Nursing Process Step: Assessment

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. The nursing staff helps encourage sleep in long-term care facility residents by __________. (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:    332-333           OBJ:    7

TOP:    Sleep Support                          KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity: Basic Care and Comfort

  1. The nurse knows that the older adult experiences changes in patterns of sleep, which typically include __________. (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:    329      OBJ:    3

TOP:    Effects of Disease Processes on Sleep

KEY:   Nursing Process Step: Assessment

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. The nurse assesses that the resident may be experiencing changes in sleep and rest patterns when she states__________. (Select all that apply.)
a. I dont know why everything seems to bother me lately.
b. Ive been so clumsy.
c. Im 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:    328      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:    328      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:    334      OBJ:    7

TOP:    Tryptophan      KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation

 

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

 

ANS:   circadian

diurnal

DIF:    Cognitive Level: Knowledge  REF:    328      OBJ:    1

TOP:    Circadian Rhythm                   KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation

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