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NCLEX-RN Rest and sleep practice questions

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These are original practice items written to the NCLEX-RN blueprint (4 options, no penalty for wrong answers), not actual exam questions. Try each one before you open the answer.

What this topic covers

Rest and sleep sits inside the Basic Care and Comfort category of the NCLEX-RN. Our bank holds 33 verified items tagged to it, and the 4 below are a fixed sample so the page stays the same every time you open it. Each one shows the reasoning, not just the letter.

The topic tag comes from our own items rather than from a published syllabus, so treat it as a map of what we cover. For the official category breakdown see the NCLEX-RN page.

Rest and sleep sample questions

Question 1

A 50-year-old male in a cardiac step-down unit after a myocardial infarction complains of difficulty falling asleep due to noise and anxiety. His vital signs are stable. Which nursing intervention is most appropriate to promote sleep?

  1. A Encourage the client to watch television until sleepy
  2. B Offer a caffeinated beverage to relax before bed
  3. C Administer zolpidem 5 mg at bedtime
  4. D Close the door and dim the lights at 9 PM
Show the answer and explanation

Correct answer: D

Closing the door and dimming the lights reduce noise and light, creating an environment that supports natural sleep. Nonpharmacologic measures are the first step for sleep problems.

Why the other options are wrong:
A: Television light and content are stimulating and can delay sleep.
B: Caffeine is a stimulant that disrupts sleep and can raise the heart rate after an MI.
C: A hypnotic is not first-line and adds fall and next-day sedation risk.

Question 2

A 30-year-old client in the psychiatric unit is being treated for depression and reports difficulty falling asleep and waking frequently during the night. The client's current medications include sertraline 100 mg daily and trazodone 50 mg at bedtime. The nurse observes the client napping for 2 hours in the afternoon. Which nursing action is most appropriate to promote nocturnal sleep?

  1. A Encourage the client to take a warm bath and drink a cup of herbal tea before bedtime.
  2. B Increase the room temperature and provide a back massage after evening medications.
  3. C Wake the client after 30 minutes of napping and engage in a quiet activity.
  4. D Suggest that the client reduce the trazodone dose to 25 mg to avoid daytime sedation.
Show the answer and explanation

Correct answer: C

A 2-hour afternoon nap reduces the body's drive to sleep at night and worsens insomnia. Limiting naps to about 30 minutes and replacing the extra sleep with a quiet activity is a core sleep hygiene measure that helps consolidate nighttime sleep.

Why the other options are wrong:
A: A warm bath and herbal tea support relaxation, but they do not address the long nap that is disrupting nighttime sleep.
B: A warm room tends to impair sleep; a cool environment promotes it.
D: The nurse cannot change a prescribed dose, and lowering the bedtime trazodone would not improve nighttime sleep.

Question 3

A 45-year-old client admitted to the medical unit with pneumonia reports difficulty sleeping because of frequent coughing and the need to use the bedside commode. Which nursing intervention is most likely to promote uninterrupted sleep?

  1. A Place the call light and bedside commode within reach and offer a PRN antitussive before bedtime
  2. B Limit oral fluid intake to 500 mL after 6 PM to reduce nocturnal urinary frequency
  3. C Encourage the client to sleep in a supine position with one flat pillow under the head
  4. D Cluster all care activities, including vital signs and medication administration, at 2-hour intervals
Show the answer and explanation

Correct answer: A

Placing the call light and commode within reach reduces the need to call for assistance, and offering a PRN antitussive before bedtime suppresses the cough reflex, both of which minimize sleep disruptions. Clustering care at 2-hour intervals (the option "Cluster all care activities, including vital signs and medication administration, at 2-hou..." would actually fragment sleep by waking the client frequently. Sleeping supine with a flat pillow (the option "Encourage the client to sleep in a supine position with one flat pillow under the head" can worsen cough and dyspnea in pneumonia; semi-Fowler's position is preferred. Limiting fluids after 6 PM (the option "Limit oral fluid intake to 500 mL after 6 PM to reduce nocturnal urinary frequency" may reduce urinary frequency but risks dehydration and does not address the primary cause of sleep disruption, which is coughing.

Question 4

A 34-year-old client is admitted to the medical-surgical unit with acute asthma exacerbation. The client's oxygen saturation is 91% on 2 L nasal cannula, respiratory rate 26/min, and the client reports difficulty sleeping due to coughing. Which nursing intervention should the nurse implement first?

  1. A Administer the prescribed albuterol nebulizer treatment now.
  2. B Encourage the client to use pursed-lip breathing during coughing episodes.
  3. C Elevate the head of the bed to 45 degrees and apply a cool mist humidifier.
  4. D Request a prescription for a sedative-hypnotic to promote sleep.
Show the answer and explanation

Correct answer: A

Saturation of 91% on oxygen, tachypnea and coughing show ongoing bronchospasm. A short-acting bronchodilator such as albuterol opens the airways, improves oxygenation and reduces the cough that is disrupting sleep.

Why the other options are wrong:
B: Pursed-lip breathing helps air trapping in COPD but does not relieve acute bronchospasm.
C: Elevating the head helps, but cool mist does not treat bronchospasm and can irritate reactive airways.
D: Sedatives can depress breathing in acute asthma and are unsafe.

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