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NCLEX-Style Questions (20 Total)

Total questions: 20

Worksheet time: 10mins

Name
Class
Date
1.

An 82-year-old reports “waking up many times at night” and “not feeling rested.” Which age-related sleep change does the nurse recognize?

a)

Increased REM sleep

b)

Increased deep sleep (N3)

c)

Decreased sleep efficiency

d)

Longer total sleep time

2.

An older adult states, “I fall asleep early but wake up at 3 AM every night.” The nurse interprets this as:

a)

REM behavior disorder

b)

Advanced sleep phase syndrome

c)

Sleep apnea

d)

Narcolepsy

3.

A nurse teaches sleep hygiene to an older adult with chronic insomnia. Which statement indicates understanding?

a)

“I will avoid exercising during the day.”

b)

“I should take two long naps to restore energy.”

c)

“I will limit caffeine intake in the afternoon.”

d)

“I’ll drink wine before bed to help me sleep.”

4.

Which older adult is at highest risk for obstructive sleep apnea (OSA)?

a)

BMI 21, non-smoker

b)

Uses diuretics daily

c)

Obesity and loud snoring

d)

Sleeps only 5 hours per night

5.

During sleep assessment, which finding is abnormal in older adults?

a)

Increased nighttime awakenings

b)

Decreased REM sleep

c)

Pauses in breathing lasting 20 seconds

d)

Short daytime naps

6.

An older adult complains of “crawling sensations in my legs at night.” The nurse suspects:

a)

REM behavior disorder

b)

Restless leg syndrome

c)

Circadian rhythm disorder

d)

Sleep paralysis

7.

Which intervention is most effective for chronic insomnia in older adults?

a)

Benzodiazepines

b)

High-protein evening snack

c)

Cognitive Behavioral Therapy for Insomnia (CBT-I)

d)

Warm milk and herbal supplements

8.

Which nursing recommendation best promotes sleep for a long-term care resident?

a)

Encourage daytime sleeping

b)

Administer sedatives to maintain a sleep cycle

c)

Maintain consistent bedtime routines

d)

Restrict physical activity during the day

9.

A nurse reviews the stages of sleep. Which statement is correct?

a)

Stage N3 (deep sleep) increases with age

b)

REM sleep increases significantly in older adults

c)

Older adults spend more time in lighter sleep stages

d)

Older adults have longer sleep cycles

10.

When assessing activity patterns in older adults, the nurse’s priority focus is:

a)

Preventing cold exposure

b)

Increasing balance and strength

c)

Avoiding all strenuous activity

d)

Promoting sedentary rest to prevent fatigue

11.

The nurse identifies which factors as common contributors to insomnia in older adults? (Select all that apply.)

a)

Chronic pain

b)

Depression

c)

Nocturia

d)

High-protein diet

e)

Loud nighttime environment

12.

Which interventions promote healthy sleep in older adults? (Select all that apply.)

a)

Maintain a consistent bedtime

b)

Increase daytime physical activity

c)

Drink caffeinated beverages before bed

d)

Reduce screen exposure in the evening

e)

Limit naps to < 30 minutes

13.

Which assessment findings suggest obstructive sleep apnea? (Select all that apply.)

a)

Morning headaches

b)

Loud snoring

c)

Slow, steady respiratory rate

d)

Pauses in breathing during sleep

e)

Excessive daytime sleepiness

14.

Which are expected age-related sleep changes? (Select all that apply.)

a)

Longer time to fall asleep

b)

Increased deep (N3) sleep

c)

More nighttime awakenings

d)

Earlier sleep/wake times

e)

Increased REM sleep cycles

15.

An older adult with dementia has difficulty sleeping. Which nursing strategies are appropriate? (Select all that apply.)

a)

Provide daytime sunlight exposure

b)

Offer a calming bedtime routine

c)

Use benzodiazepines nightly

d)

Reduce environmental noise

e)

Promote daytime activity

16.

A patient with sleep apnea refuses to use the CPAP at night. What is the nurse’s priority action?

a)

Document noncompliance

b)

Ask about discomfort or barrier with CPAP

c)

Turn up oxygen flow

d)

Provide sedative-hypnotics

17.

A nurse notices an older adult is napping more frequently and appears confused in the afternoon. What action is most appropriate?

a)

Encourage longer daytime naps

b)

Assess for infection or delirium

c)

Increase caffeine intake

d)

Restrict fluids completely

18.

An older adult reports “acting out dreams” and accidentally hitting their spouse during sleep. The nurse suspects:

a)

Advanced sleep phase syndrome

b)

OSA

c)

REM sleep behavior disorder

d)

Restless legs syndrome

19.

A 90-year-old resident reports chronic insomnia. Which intervention is most appropriate?

a)

Start diazepam (Valium) nightly

b)

Evaluate for depression, pain, and medications

c)

Encourage patient to sleep in late mornings

d)

Restrict all daytime movement

20.

To promote healthy activity patterns in an older adult, the nurse should:

a)

Encourage daily walking tailored to ability

b)

Avoid resistance training

c)

Tell patient to exercise only once weekly

d)

Recommend activity only when the patient feels energetic