Sleep Apnea Nclex || Already Passed.
A nurse assesses a client who reports waking up feeling very tired, even after 8 hours of good
sleep. Which action should the nurse take first?
a.
Contact the provider for a prescription for sleep medication.
b.
Tell the client not to drink beverages with caffeine before bed.
c.
Educate the client to sleep upright in a reclining chair.
d.
Ask the client if he or she has ever been evaluated for sleep apnea. correct answers ANS: D
Clients are usually unaware that they have sleep apnea, but it should be suspected in people who
have persistent daytime sleepiness and report waking up tired. Causes of the problem should be
assessed before the client is offered suggestions for treatment.
A nurse is caring for a client who has sleep apnea and is prescribed modafinil (Provigil). The
client asks, "How will this medication help me?" How should the nurse respond?
a.
"This medication will treat your sleep apnea."
b.
"This sedative will help you to sleep at night."
c.
"This medication will promote daytime wakefulness."
d.
"This analgesic will increase comfort while you sleep." correct answers ANS: C
Modafinil is helpful for clients who have narcolepsy (uncontrollable daytime sleep) related to
sleep apnea. This medication promotes daytime wakefulness.
The most effective treatments for sleep apnea include all of the following EXCEPT
a. weight loss.
b. the use of stimulant drugs.
c. the use of a continuous positive airway pressure (CPAP) mask.
d. surgery for breathing obstructions. correct answers b. the use of stimulant drugs.
Sleep apnea would be diagnosed in a patient who has which of these findings?
1. More than 15 apnea episodes per hour of sleep
2. More than 5 apnea episodes per hour over an 8-hour period
3. More than 75% of the apneas are obstructive.
4. More than 75% of the apneas and hypopneas are obstructive.
a. 1, 4
b. 2, 3
c. 2, 3, 4
d. 1, 3, 4 correct answers D
, During a sleep study, obstructive sleep apnea (OSA) is confirmed when either of the following
two conditions exists: 15 or more apneas, hypopneas, or RERAs per hour of sleep (i.e., the AHI
or RDI >15 events/hour) in an asymptomatic patient. More than 75% of the apneas and
hypopneas must be obstructive. Or, 5 or more apneas, hypopneas, or RERAs per hour of sleep
(i.e., the AHI or RDI >5/hour events/hour) in patients with symptoms (e.g., sleepiness, fatigue,
and inattention) or signs of disturbed sleep (e.g., snoring, restless sleep, and respiratory pauses).
More than 75% of the apneas and hypopneas must be obstructive.
Signs and symptoms of sleep apnea include which of the following?
a. Loud snoring
b. Difficulty falling asleep
c. Headache in the evening
d. Nighttime sleepiness correct answers a. Loud snoring
What is the rationale for using CPAP to treat sleep apnea?
A) positive air pressure holds the airway open
B) negative air pressure holds the airway closed
C) delivery of oxygen facilitates respiratory effort
D) alternating waves of air stimulate breathing correct answers A) positive air pressure holds the
airway open
A 32-year-old morbidly obese male complains of excessive fatigue, snoring, and awakening in
the middle of the night, which prevents restorative sleep.
He is sluggish during the day due to the lack of sleep and feels like he is going "fall asleep at the
wheel" when driving to work. Occupation: dishwasher. Medical history includes hypertension
and type 2 diabetes. Current medications include ACE inhibitor and metformin. Denies use of
alcohol, tobacco, or drugs. On physical examination, the patient is afebrile, pulse 88, resps
20/min, BP 178/95. BMI is 45.
These are signs and symptoms of:
A. Obstructive sleep apnea
B. Primary insomnia
C. Heart failure
D. All of the above correct answers ANS: A
With the obesity epidemic, the incidence of obstructive sleep apnea (OSA) is also increasing.
Besides obesity, other predisposing and risk factors include narrowed upper airways,
macroglossia, tonsillar hypertrophy, sleep medicines, alcohol, smoking, nasal obstruction, and
hypothyroidism. It occurs more in middle-aged men. A thorough medication history, respiratory
history, neurologic history, and mental health assessment should be performed. One of the more
common symptoms of OSA is snoring, usually reported by the spouse. The patient may complain
of frequent nighttime awakening, morning drowsiness, headache (caused by carbon dioxide
buildup in the brain), cognitive impairment, as well as impotence and weight gain, which can be
both a cause and an effect. Systemic hypertension is a complication of OSA but often resolves
when the cause of the apnea is corrected.
A 64-year-old obese man is admitted to the hospital for treatment of heart failure secondary to
alcoholism. For which of the following negative consequences should the nurse assess?
