The nurse adds a nursing diagnosis of Ineffective Breathing Pattern to a patient’s care plan. Which sleep condition likely caused the nurse to assign this nursing diagnosis?
Narcolepsy
Sleep deprivation
Insomnia
Obstructive sleep apnea
The Correct Answer is D
Choice A reason: Narcolepsy causes sudden sleep attacks and cataplexy but does not typically disrupt breathing patterns during sleep. It affects sleep-wake regulation, not airway mechanics. This condition is unlikely to cause ineffective breathing, as it lacks the respiratory obstruction linked to the nursing diagnosis.
Choice B reason: Sleep deprivation results from insufficient sleep, leading to fatigue and cognitive issues, but it does not directly cause ineffective breathing patterns. It may exacerbate other conditions, but without airway obstruction, it is not the primary cause of the respiratory diagnosis, making this choice incorrect.
Choice C reason: Insomnia involves difficulty falling or staying asleep, causing fatigue and irritability, but it does not typically affect breathing mechanics. It lacks the airway obstruction or hypoventilation associated with ineffective breathing patterns, making it an unlikely cause for the nursing diagnosis.
Choice D reason: Obstructive sleep apnea causes repeated airway collapse during sleep, leading to hypopnea, apnea, and ineffective breathing patterns. This disrupts oxygenation and ventilation, aligning with the nursing diagnosis. The nurse likely identified symptoms like snoring or pauses in breathing, making this the correct condition to monitor.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Short naps (15-20 minutes) are recommended for narcolepsy to manage excessive daytime sleepiness without disrupting nighttime sleep. This aligns with evidence-based management, improving alertness. No intervention is needed, as this practice supports symptom control, enhancing daily function and reducing sleep attacks in narcolepsy patients.
Choice B reason: Taking antidepressants, like SSRIs or SNRIs, is standard for narcolepsy to manage cataplexy or sleep disturbances. This is appropriate and requires no intervention unless misuse occurs. The nurse would ensure proper dosing, as antidepressants support symptom control, improving quality of life without disrupting narcolepsy management strategies.
Choice C reason: Chewing gum regularly is benign and unrelated to narcolepsy management. It may help with alertness but doesn’t warrant intervention. Unlike environmental factors like room temperature, gum has no significant impact on sleep quality or narcolepsy symptoms, making it an irrelevant focus for nursing education or correction.
Choice D reason: Sleeping in a hot, stuffy room disrupts sleep quality, exacerbating narcolepsy symptoms like fragmented sleep or daytime sleepiness. The nurse intervenes to promote a cool, well-ventilated sleep environment, critical for optimizing rest. Poor sleep hygiene worsens narcolepsy, reducing treatment efficacy and increasing risks of sleep attacks or fatigue.
Correct Answer is A
Explanation
Choice A reason: Stage 4 NREM (deep sleep) is characterized by slow delta brain waves, making the patient difficult to awaken. This stage promotes physical restoration, with minimal responsiveness to stimuli. The assessment finding aligns with the physiological state of deep sleep, making it the correct indicator for stage 4 NREM.
Choice B reason: Elevated vital signs are not typical of stage 4 NREM, where metabolic rate and heart rate decrease due to deep relaxation. Elevated vital signs may occur in REM or lighter sleep stages, making this finding inconsistent with the characteristics of deep NREM sleep.
Choice C reason: Easily awakening occurs in lighter NREM stages (1 or 2), not stage 4, which is the deepest sleep phase. Patients in stage 4 require significant stimuli to rouse, so this finding contradicts the expected state of deep sleep, making it incorrect.
Choice D reason: Rapid eye movement is specific to REM sleep, not NREM. Stage 4 NREM involves slow brain waves and no eye movement, focusing on physical restoration. This finding is characteristic of a different sleep phase, making it an incorrect indicator for stage 4 NREM.
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