9.A patient who has been diagnosed with
hypothyroidism is admitted to a nursing
home. On performing a sleep history on this
patient, you find out that the patient is suf-
fering from fatigue, lethargy, depression, and
difficulty executing the tasks of everyday liv-
ing. This patient is probably experiencing
which of the following types of sleep
deprivation?
a.REM deprivation
b.NREM deprivation
c.Total sleep deprivation
d.Insomnia
10.Most authorities agree that an individual’s
sleep–wake cycle is fully developed by what
age?
a.9 months to 1 year
b.1 year to 18 months
c.2 to 3 years
d.4 to 6 years
11.Which of the following interventions
would be recommended for a patient
with insomnia?
a.Nap frequently during the day to make up
for the lost sleep at night.
b.Eliminate caffeine and alcohol in the
evening because both are associated with
disturbances in the normal sleep cycle.
c.Exercise vigorously before bedtime to pro-
mote drowsiness.
d.Avoid food high in carbohydrates before
bedtime.
12.Mrs. Leister, a new patient in the medical–
surgical unit, complains of difficulty sleeping.
She is scheduled for an exploratory laparotomy
in the morning. Your diagnosis is Sleep
Pattern Disturbance: Insomnia related to fear
of impending surgery. Which one of the
following steps is the most appropriate in
planning care for this diagnosis?
a.Help her maintain her normal bedtime
routine and time for sleep.
b.Provide an opportunity for her to talk
about her concerns.
c.Use tactile relaxation techniques, such as a
back massage.
d.Bring her a warm glass of milk at bedtime.ALTERNATE-FORMAT QUESTIONS
Multiple Response Questions
Circle the letters that correspond to the best
answers for each question.
1.Which of the following statements accurately
describe the physiology of sleep? (Select all that
apply.)
a.The reticular activating system (RAS)
extends upward through the medulla,
the pons, and the midbrain and into the
hypothalamus.
b.The bulbar synchronizing region facilitates
reflex and voluntary movements as well
as cortical activities related to a state of
alertness.
c.During sleep, the RAS experiences few stim-
uli from the cerebral cortex and the periph-
ery of the body.
d.The medulla has control centers for several
involuntary activities of the body, one of
which concerns sleeping and waking.
e.GABA appears to be necessary for inhibition.
f.Injury to the hypothalamus may cause a
person to remain awake for long periods
of time.
2.Which of the following are characteristics of
REM sleep? (Select all that apply.)
a.The person is in a transitional stage between
wakefulness and sleep.
b.The person can be aroused with relative
ease.
c.The person reaches the greatest depth of
sleep, called delta sleep.
d.Respirations are irregular and sometimes
interspersed with apnea.
e.Metabolism and body temperature increase.
f.It constitutes about 20% to 25% of sleep.
3.Which of the following statements accurately
describe developmental patterns of sleep?
(Select all that apply.)
a.Newborns sleep an average of 16 hours per
day.
b.NREM sleep constitutes much of the sleep
cycle of a young infant.
c.The need for sleep in toddlers increases
with age due to the more active state they
are in.216 UNIT VII PROMOTING HEALTHY PHYSIOLOGIC RESPONSES
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