A 76-year-old man tells the nurse at the sleep disorder clinic, I ...

[EAugust]

A 76-year-old man tells the nurse at the sleep disorder clinic, I awaken almost nightly in the midst of violent dreams in which I am defending myself against multiple attackers. Then I realize I have been hitting and kicking my wife.
 
  She has bruises.. Which health problem is most likely? a. Sleep paralysis
  b. Night terror disorder
  c. Sleep-related bruxism
  d. REM sleep behavior disorder

Question 2

A patient with degenerative arthritis complains, For the past month I have been having a lot of trouble sleeping. I cannot seem to fall asleep. When I finally do get to sleep, I wake up over and over during the night..
 
  Which information should the nurse seek initially? a. What have you done to try to improve your sleep?
  b. What would be a good sleep pattern for you?
  c. How much exercise are you getting?
  d. Do you have pain at night?

[Fayaz00962]

Answer to Question 1

D
The scenario describes REM sleep behavior disorder in which the patient engages in violent and complex behaviors during REM sleep as though acting out his dreams. Older men have a higher incidence of this problem. Sleep paralysis refers to the sudden inability to perform voluntary movement at either sleep onset or awakening from sleep. Bruxism refers to grinding teeth during stage 2 sleep. Night terror disorder occurs as arousal in the first third of the night during non-REM sleep, accompanied by feelings of panic.

Answer to Question 2

D
Patients with diseases such as arthritis may have sleep disturbance related to nightly pain. Because the pain is chronic, the patient may fail to realize it is the reason for the inability to sleep. The other options do not follow the patient's lead or begin problem solving without an adequate database.

[EAugust]

Excellent

[jojobee318]

TYSM