A nurse is reviewing the plan of care for a client who was admitted with insomnia and recent weight gain. Which of the following is a benefit a increased sleep that could help prevent further weight gain for the client?

Increased ghrelin production

Increased leptin production

Decreased hypocretin levels

Decreased melatonin levels

Answer and Explanation

The Correct Answer is B

A. Ghrelin is a hormone produced by the stomach that stimulates appetite. Higher ghrelin levels are associated with increased hunger and caloric intake. Sleep deprivation increases ghrelin, which can contribute to weight gain. Therefore, increasing sleep would decrease ghrelin, not increase it, and help reduce weight gain.

B. Leptin is a hormone secreted by adipose (fat) tissue that signals satiety to the brain and suppresses appetite. Adequate sleep helps maintain normal leptin levels, which can reduce overeating and help prevent weight gain. This makes increased leptin production a beneficial effect of improving sleep for clients with insomnia and recent weight gain.

C. Hypocretin (also called orexin) is a neuropeptide that promotes wakefulness and alertness. While excessive wakefulness can contribute to sleep problems, decreasing hypocretin is not a primary mechanism for controlling weight gain. Disrupting hypocretin can actually cause sleepiness and may have other metabolic consequences.

D. Melatonin is a hormone produced by the pineal gland that regulates sleep-wake cycles. Sleep increases melatonin secretion rather than decreasing it. Reduced melatonin is associated with insomnia and circadian rhythm disruption. Therefore, decreased melatonin would not be beneficial for sleep or weight control.

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Correct Answer is B

Explanation

A. A cool shower may actually be stimulating and reduce the body’s natural drop in core temperature, which is necessary to initiate sleep. A warm shower or bath is recommended because it promotes relaxation and a gradual decline in body temperature that facilitates sleep onset.

B. Going to bed only when sleepy and leaving the bed if unable to fall asleep (to engage in relaxing activities such as listening to soft music) helps prevent negative associations with the bed and promotes healthy sleep hygiene. This approach is consistent with cognitive-behavioral therapy for insomnia (CBT-I) techniques and encourages the client to associate the bed with sleep rather than frustration or wakefulness.

C. Limiting daytime naps to 20–30 minutes is recommended to avoid interference with nighttime sleep. Naps longer than 30 minutes, even if limited to 1 hour, can reduce sleep drive and make it harder to fall asleep at night.

D. Exercising too close to bedtime, especially vigorous activity within 1–2 hours of sleep, can be stimulating and delay sleep onset. Moderate exercise is beneficial for sleep but should be done earlier in the day to avoid interference with the natural sleep-wake cycle.

A. Hypersomnia B. Narcolepsy (NT2) C. Narcolepsy (NT1) D. Insomnia

Correct Answer is C

Explanation

A. Hypersomnia is characterized by excessive daytime sleepiness but does not include cataplexy (sudden loss of muscle tone triggered by strong emotions). Clients with hypersomnia may sleep for long periods but maintain normal muscle control.

B. Narcolepsy type 2 involves excessive daytime sleepiness without cataplexy. While clients may struggle to stay awake, they do not experience the sudden muscle weakness episodes seen in NT1.

C. Narcolepsy type 1 (NT1) is defined by excessive daytime sleepiness plus cataplexy (sudden, temporary loss of muscle tone often triggered by laughter, anger, or surprise). Other NT1 manifestations can include sleep paralysis and hypnagogic hallucinations. The client’s report of involuntary muscle tone loss along with daytime sleepiness aligns directly with NT1.

D. Insomnia involves difficulty falling asleep, staying asleep, or waking too early. It does not cause cataplexy or sudden loss of muscle tone and therefore does not fit the client’s symptoms.

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A nurse is reviewing the plan of care for a client who was admitted with insomnia and recent weight gain. Which of the following is a benefit a increased sleep that could help prevent further weight gain for the client?

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Naxlex Comprehensive Predictor Exams

An employee health nurse is providing teaching about sleep promotion to a group of newly licensed nurses. Which of the following statements should the nurse include?

Correct Answer is B

Explanation

A nurse is assessing a client who reports difficulty staying awake during the day and experiencing involuntary episodes of lost muscle tone. The nurse should identify that these are manifestations of which of the following conditions?

Correct Answer is C

Explanation

A nurse is reviewing the plan of care for a client who was admitted with insomnia and recent weight gain. Which of the following is a benefit a increased sleep that could help prevent further weight gain for the client?

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