A nurse is assessing the status of a patient who is sleeping.
Which assessment data indicate that the patient is most likely in stage 3 of non-rapid eye movement (NREM) sleep?

Choice A rationale:

Excessive NREM sleep does not cause periodic pauses in breathing. NREM (Non-Rapid Eye Movement) sleep consists of stages 1 through 4 and is characterized by a decrease in physiological activity, including a decrease in muscle tone. There is no direct association with breathing interruptions in NREM sleep.

Choice B rationale:

Insomnia is a sleep disorder characterized by difficulty falling asleep or staying asleep, but it does not involve periodic pauses in breathing. It is unrelated to the symptoms described in the question.

Choice C rationale:

Narcolepsy is a sleep disorder characterized by excessive daytime sleepiness and sudden episodes of muscle weakness (cataplexy). It is not associated with periodic pauses in breathing, as described in the question.

Choice D rationale:

Sleep apnea is the correct answer. Sleep apnea is a sleep disorder characterized by repeated episodes of paused or shallow breathing during sleep. The patient may stop breathing for brief periods, then start breathing again. This pattern is consistent with the symptoms described in the question. Sleep apnea can have serious health implications and is important to recognize and address.

Choice A rationale:

Some older adults may indeed have concerns about taking pain medication, but this is not a primary reason for their hesitance to express pain. The fear of taking medication is not a universal characteristic of older adults.

Choice B rationale:

While older adults may be reluctant to bother nursing staff, this is not the primary reason for their reluctance to express pain. It is a consideration but not the main factor.

Choice C rationale:

The unawareness of discomfort is not a common reason for older adults to avoid expressing pain. Most older adults are aware of their discomfort but may not express it for other reasons.

Choice D rationale:

Older adults may have been culturally trained not to complain about pain or discomfort. In some cultures, stoicism and not burdening others with one's pain are highly valued. This cultural training can lead older adults to underreport their pain.

Choice E rationale:

Believing pain is a natural consequence of aging is a misconception, but it is not the primary reason why older adults may not express their pain. They may believe this, but cultural and societal factors have a more significant impact.