A nurse is assessing a client who reports difficulty initiating or maintaining sleep, causing impairment and distress. Which of the following statements made by the nurse reflects an appropriate assessment?
"Do you often find yourself experiencing excessive daytime sleepiness?".
"Have you been sleeping for more than 9 hours a night?".
"Are you experiencing episodes of abnormal respiratory patterns during sleep?".
"Have you been falling asleep at inappropriate times during the day?".
The Correct Answer is A
Choice A rationale:
Excessive daytime sleepiness is a common consequence of insomnia. This question aims to assess whether the client experiences daytime impairment due to poor sleep initiation or maintenance. Inquiring about excessive daytime sleepiness is crucial because it reflects the potential impact of insomnia on the client's daily functioning.
Choice B rationale:
Asking about whether the client sleeps for more than 9 hours a night is not directly related to insomnia. While prolonged sleep can be seen in certain conditions like hypersomnolence, it doesn't address the core symptom of difficulty initiating or maintaining sleep associated with insomnia.
Choice C rationale:
Inquiring about abnormal respiratory patterns during sleep is relevant for sleep disorders like sleep apnea, which can cause disruptions in sleep due to breathing difficulties. However, this question is not specific to the symptoms of insomnia, which involve difficulties falling asleep or staying asleep.
Choice D rationale:
Asking about falling asleep at inappropriate times during the day is more aligned with narcolepsy, a disorder characterized by sudden and uncontrollable episodes of falling asleep. While some individuals with insomnia might experience daytime sleepiness, it's not a defining feature of the disorder.
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Related Questions
Correct Answer is C
Explanation
Choice A rationale:
Sleep diary involves individuals tracking their sleep patterns and habits over a certain period of time, usually done by the individual themselves. It does not involve monitoring physiological parameters during sleep, such as brain waves, eye movements, muscle activity, heart rate, breathing patterns, and body position. A sleep diary is a subjective self-reporting tool rather than a comprehensive assessment method.
Choice B rationale:
Physical examination can provide some information about a person's overall health, but it doesn't directly involve monitoring the specific physiological parameters mentioned. It focuses more on identifying physical health issues through a general examination rather than assessing sleep and wakefulness disorders.
Choice C rationale:
Polysomnography (PSG) is the correct choice. PSG is a comprehensive sleep study that involves monitoring various physiological parameters during sleep, including brain waves (electroencephalogram or EEG), eye movements (electrooculogram or EOG), muscle activity (electromyogram or EMG), heart rate (electrocardiogram or ECG), breathing patterns, and body position. It is considered the gold standard for diagnosing sleep disorders and provides valuable data about sleep stages, sleep-related breathing disorders, and other sleep-related issues.
Choice D rationale:
Sleep history involves collecting information about an individual's sleep patterns, habits, and behaviors over time. While it provides important insights into sleep-related problems, it doesn't directly involve monitoring physiological parameters during sleep like PSG does. Sleep history is typically obtained through interviews and questionnaires.
Correct Answer is ["B","C"]
Explanation
Choice A rationale:
Genetic factors. Restless legs syndrome (RLS) does have a genetic component, but it's not a major contributing factor on its own. While there might be a family history, it's not a primary cause of RLS.
Choice B rationale:
Iron deficiency anemia. This is a correct choice. Iron deficiency is strongly associated with restless legs syndrome (RLS). Iron is crucial for dopamine production and function, and dopamine dysregulation is thought to play a role in RLS. Treatment of iron deficiency can often alleviate RLS symptoms.
Choice C rationale:
Excessive caffeine consumption. This is a correct choice. Caffeine is a stimulant that can worsen symptoms of RLS. It can exacerbate the restlessness and discomfort in the legs that are characteristic of the disorder.
Choice D rationale:
Pregnancy. Pregnancy can trigger or worsen RLS symptoms, but it is not a primary cause of RLS. The hormonal changes and increased blood volume during pregnancy can lead to RLS symptoms, but these symptoms typically resolve after pregnancy.
Choice E rationale:
Chronic stress. Chronic stress can worsen RLS symptoms, but it is not a direct cause. Stress can exacerbate the discomfort and restlessness in the legs, making the symptoms more pronounced.
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