ATI RN
Psychobiologic Disorders Questions
Question 1 of 5
A person is prescribed lorazepam (Ativan) 2 mg po bid prn for anxiety. When the person takes this medication, which change in sleep is anticipated? The patient will:
Correct Answer: B
Rationale: In this scenario, the correct answer is B) have less slow-wave sleep. Lorazepam (Ativan) is a benzodiazepine commonly prescribed for anxiety. It works by enhancing the effects of gamma-aminobutyric acid (GABA) in the brain, leading to sedative and anxiolytic effects. One of the known effects of benzodiazepines like lorazepam is a reduction in slow-wave sleep, which is the deepest stage of non-REM sleep. This means that individuals taking lorazepam may experience less restorative and deep sleep, potentially impacting their overall sleep quality. Now, let's analyze why the other options are incorrect: A) Having fewer dreams is not a typical effect of lorazepam. While some individuals may report changes in dream patterns with benzodiazepines, this is not the most anticipated change in sleep for someone taking lorazepam. C) Experiencing extended sleep latency (difficulty falling asleep) is not a common effect of lorazepam. In fact, lorazepam is known to have a sedative effect that can help individuals fall asleep more easily. D) Entering sleep through rapid eye movement (REM) sleep is not a direct effect of lorazepam. Benzodiazepines are more likely to affect non-REM sleep stages, particularly reducing slow-wave sleep as mentioned earlier. Educational Context: Understanding the effects of medications on sleep is crucial in the management of psychobiologic disorders. Educating healthcare providers and patients about the potential impact of medications like lorazepam on sleep architecture can help in setting appropriate expectations and managing sleep-related issues that may arise during treatment.
Question 2 of 5
A patient reports, Nearly every night I awaken feeling frightened after a bad dream. The dream usually involves being hunted by people trying to hurt me. It usually happens between 4 and 5 AM. The nurse assesses this disorder as most consistent with criteria for which problem?
Correct Answer: B
Rationale: Nightmares are long, frightening dreams from which people awaken in a frightened state. They occur during REM sleep late in the night. Night terror disorder occurs as arousal in the first third of the night during nonREM sleep and is accompanied by feelings of panic. REM sleep behavior disorder involves acting out a violent dream during REM sleep. Nightmare disorder may lead to sleep deprivation.
Question 3 of 5
A patient tells the nurse, Everyone says we should sleep 8 hours a night. I can only sleep 6 hours, no matter how hard I try. Am I doing harm to my body? Select the nurses best response.
Correct Answer: D
Rationale: The correct answer is D) "If you function well with 6 hours of sleep, you are a short sleeper. That's normal for some people." This response is the best because it reassures the patient that their sleep pattern is normal for them as an individual. It validates their experience and helps alleviate any unnecessary worry about potential harm to their body. Option A) "Tell me about strategies you have tried to increase your total sleep hours" is not the best response as it focuses more on attempting to change the patient's behavior rather than accepting their unique sleep needs. Option B) "Lack of sleep acts as a stressor on the body and can cause physical changes" is incorrect as it may unnecessarily alarm the patient by implying that their 6-hour sleep pattern is harmful without considering individual differences in sleep requirements. Option C) "If you have really tried to sleep more, maybe you should consult your health care provider" could be seen as premature since the patient may not necessarily need medical intervention just because they sleep 6 hours instead of 8. In an educational context, it's important for healthcare providers to understand that individuals have varying sleep needs, and what might be considered normal for one person could be inadequate or excessive for another. By acknowledging and respecting these differences, nurses can provide patient-centered care that promotes overall well-being and addresses individual needs effectively.
Question 4 of 5
A night shift worker reports, Im having trouble getting to sleep after a nights work. I have a hearty breakfast with coffee, read the paper, do my exercises, and then go to bed. However, I just lie awake until it is nearly time to get up to be with my family for dinner. What changes should the nurse suggest? Select one that does not apply..
Correct Answer: C
Rationale: Sleep can be disrupted by caffeine, a central nervous system stimulant, exercise performed just before trying to sleep, and eating a heavy meal before retiring. Reading the newspaper is not likely to be so stimulating that it disrupts the patients ability to sleep. Television will be disruptive to sleep.
Question 5 of 5
An adult experienced a myocardial infarction six months ago. At a follow-up visit, this adult says, I havent had much interest in sex since my heart attack. I finished my rehabilitation program, but having sex strains my heart. I dont know if my heart is strong enough. Which nursing diagnosis applies?
Correct Answer: A
Rationale: Patients who have had a myocardial infarction often believe sexual intercourse will cause another heart attack. The patient has completed the rehabilitation, but education is needed regarding sexual activity. These patients should receive information about when sexual activity may begin, positions that conserve energy, and so forth. The scenario does not suggest self-concept or body image disturbance.