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: PCOS is a multifactorial endocrine disorder characterized by altered LH secretion, insulin resistance, and hyperandrogenism. Insulin resistance contributes to increased androgen production by the ovaries, and elevated LH levels stimulate theca cells, further exacerbating androgen excess. These mechanisms disrupt follicular development and ovulation.
Choice B reason: While thyroid dysfunction and hyperprolactinemia can cause menstrual irregularities, they are not part of the pathogenesis of PCOS. Nonclassical congenital adrenal hyperplasia may mimic PCOS but is a distinct condition.
Choice C reason: Hypothalamic amenorrhea and primary ovarian insufficiency are causes of secondary amenorrhea but are unrelated to the pathogenesis of PCOS. They involve different hormonal profiles and etiologies.
Choice D reason: An androgen-secreting tumor can cause virilization and menstrual disturbances but is a rare and distinct cause of hyperandrogenism. It is not part of the typical pathophysiology of PCOS.
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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