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Nurse Practitioner:
doi: 10.1097/01.NPR.0000371297.05995.27
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Managing sleep disorders in the elderly

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INSTRUCTIONS Managing sleep disorders in the elderly

TEST INSTRUCTIONS

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* You will receive your CE certificate of earned contact hours and an answer key to review your results.There is no minimum passing grade.

* Registration deadline is May 31, 2012.

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PROVIDER ACCREDITATION

Lippincott Williams & Wilkins, publisher of The Nurse Practitioner journal, will award 2.1 contact hours for this continuing nursing education activity.

Lippincott Williams & Wilkins is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

This activity is also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for 2.1 contact hours. Lippincott Williams & Wilkins is also an approved provider of continuing nursing education by the District of Columbia and Florida #FBN2454.

Your certificate is valid in all states. This activity has been assigned 1.0 pharmacologic credit hour.

The ANCC's accreditation status of Lippincott Williams & Wilkins Department of Continuing Education refers only to its continuing nursing educational activities and does not imply Commission on Accreditation approval or endorsement of any commercial product.

Managing sleep disorders in the elderly

General Purpose: To provide the NP with a review of sleep disorders and their management in the elderly. Learning Objectives: After reading the preceding article and taking the following test, the nurse will be able to: 1. Describe sleep physiology. 2. Identify common causes of sleep disorders in the elderly. 3. Discuss the management of sleep disorders in the elderly.

1. How many hours of sleep a night do adults need for normal physiologic processes?

a. 6 to 6.4

b. 6.5 to 6.9

c. 7 to 8.4

d. 8.5 to 8.9

2. What percentage of elderly persons may experience chronic insomnia?

a. 30%

b. 40%

c. 50%

d. 60%

3. During REM sleep, which physiologic change occurs?

a. breathing slows

b. BP decreases

c. body temperature drops

d. brain replenishes neurotransmitters

4. Older adults spend less time in which stage of sleep?

a. earlier non-REM

b. later non-REM

c. earlier REM

d. later REM

5. To be clinically significant, insomnia must cause distress or impairment for at least

a. 1 month.

b. 2 months.

c. 3 months.

d. 6 months.

6. Clinical studies suggest, one major risk factor for insomnia is

a. daytime sleepiness.

b. alcohol use.

c. depression.

d. disability.

7. Which elderly patient is most at risk for OSA?

a. a female with diabetes

b. an underweight female

c. a male who smokes

d. an obese male

8. RLS may be precipitated or caused by taking

a. sedatives.

b. opioids.

c. beta blockers.

d. calcium channel blockers.

9. Which nonpharmacologic intervention before bedtime may help combat insomnia?

a. limiting fluid intake

b. reading

c. an alcoholic beverage

d. mild exercise

10. Pharmacologic treatment for sleep disorders in the elderly must be

a. started after referral to sleep specialist.

b. limited to OTC medications.

c. initiated with a long-acting benzodiazepine.

d. managed with caution due to problems with polypharmacy.

11. The patient taking ramelteon can expect to fall asleep within

a. 30 minutes.

b. 60 minutes.

c. 90 minutes.

d. 120 minutes.

12. Which drug induces sleep easily and may be safe for long-term use?

a. estazolam

b. flurazepam

c. eszopiclone

d. temazepam

13. Which sleep aid should be avoided in the elderly?

a. zolpidem

b. extended-release zolpidem

c. zaleplon

d. melatonin

14. Antidepressants have been shown effective for insomnia related to

a. RLS.

b. Alzheimer disease.

c. a history of substance abuse.

d. obstructive sleep apnea.

15. Which supplement may help elderly patients with mild-to-moderate symptoms of RLS?

a. magnesium

b. calcium

c. vitamin D

d. zinc

16. Which is the pharmacologic treatment of choice for RLS?

a. anticonvulsants

b. opioids

c. benzodiazepines

d. dopaminergics

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