When asked about quality of sleep, a client responds that he falls asleep later than desired and wakes up later than desired. What circadian rhythm sleep-wake disorder subtype is characterized by falling asleep and waking later than desired?
Advanced sleep phase type
Irregular sleep-wake type
Delayed sleep phase type
Non-24 sleep-wake type
The Correct Answer is C
Choice A reason: Advanced sleep phase type is characterized by falling asleep and waking up earlier than desired. Individuals with this disorder tend to feel sleepy in the early evening and wake up very early in the morning, which is the opposite of the scenario described.
Choice B reason: Irregular sleep-wake type involves a lack of a clearly defined sleep-wake cycle. People with this disorder have fragmented sleep patterns with multiple naps throughout the 24-hour period, not a consistent delay in sleep and wake times.
Choice C reason: Delayed sleep phase type is defined by a consistent pattern of falling asleep and waking up later than desired. This disorder is common in adolescents and young adults and matches the client’s report of delayed sleep onset and waking.
Choice D reason: Non-24 sleep-wake type is typically seen in individuals who are blind and lack light perception. Their circadian rhythm does not align with the 24-hour day, leading to progressively shifting sleep times. This does not match the client’s stable but delayed sleep pattern.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Minocycline is a tetracycline antibiotic and has not been established as a treatment for autonomic dysreflexia. While it has neuroprotective and anti-inflammatory properties in experimental models, it is not part of the clinical management protocol for autonomic dysreflexia.
Choice B reason: OnabotulinumtoxinA (Botox) has been used in patients with neurogenic bladder or spasticity, which can contribute to autonomic dysreflexia. It helps reduce bladder overactivity and prevent triggering episodes.
Choice C reason: Nifedipine, a calcium channel blocker, is commonly used to manage acute hypertension in autonomic dysreflexia. It reduces blood pressure quickly and is considered a first-line agent in emergent settings.
Choice D reason: Lidocaine may be used to suppress afferent stimuli during procedures such as catheterization, which can trigger autonomic dysreflexia. It helps block nociceptive input and prevent reflex sympathetic discharge.
Correct Answer is D
Explanation
Choice A reason: Bizarre delusions are implausible and not understandable within the context of cultural norms, such as believing aliens implanted a device in one's brain. The belief in an internal rash is not bizarre—it is medically conceivable, though unfounded.
Choice B reason: Referential delusions involve the belief that external events, objects, or people have special meaning or are directed at the individual. This does not apply to the patient's belief about having a rash.
Choice C reason: Nihilistic delusions involve beliefs that one is dead, does not exist, or that the world is ending. These are often seen in severe depression or psychotic states but are unrelated to somatic complaints.
Choice D reason: Somatic delusions involve false beliefs about bodily functions or sensations. The patient’s belief that he has a rash “on the inside” despite no physical evidence is a classic example of a somatic delusion.
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