A 49-Year-Old Registered Nurse Comes to the Office Due to Sleep

question 1310

Multiple Choice

A 49-year-old registered nurse comes to the office due to sleep difficulties since receiving a promotion to an administrative position in the hospital several weeks ago.  She finds her new job and its many responsibilities stressful.  Her sleep schedule changed when she took the new position; she used to work the 4:00 PM-12:00 AM shift and had no sleep difficulties.  Now she has to be at the hospital by 7:30 AM.  The patient cannot fall asleep until 2:00-3:00 AM.  She then awakens by alarm at 6:15 AM to get to work on time.  She is exhausted all the time and has trouble concentrating and staying awake during meetings.  The patient is increasingly frustrated by her sleep problems, which have occurred in the past with jobs or schooling requiring early start times.  The patient has the same difficulty initiating sleep before 2:00-3:00 AM on weekends but feels better then as she is able to sleep without interruption until 11:00 AM.  She does not use tobacco or alcohol.  Which of the following is the most likely cause of her sleep difficulties?

• A)Advanced sleep-wake phase disorder
• B)Delayed sleep-wake phase disorder
• C)Melatonin deficiency
• D)Poor sleep hygiene
• E)Shift work disorder

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Definitions:

Demand-Side Economics

An economic theory focused on increasing demand for goods and services as a pathway to economic growth and full employment.

Fiscal Policy

The use of government spending and taxation to stabilize the economy.

Economic Indicators

Statistical metrics that help assess the overall health and direction of an economy, guiding investment and policy decisions.

Consumer Price Index

A measure that examines the weighted average of prices of a basket of consumer goods and services, such as transportation, food, and medical care, used to estimate inflation.