The patient has been treated by the same physician for 2 years and has had insomnia the entire time. Many different medications have been tried with limited success. What should be the nurse's primary assessment at this time?
1. Assess for a primary sleep disorder such as sleep apnea.
2. Assess if the patient has been selling his medications to addicts.
3. Assess if the patient has an addictive personality disorder.
4. Assess the patient for a primary personality disorder.
Correct Answer: 1
Rationale: If the patient has a primary sleep disorder such as sleep apnea, this must be treated to relieve the insomnia. Also, medications such as benzodiazepines depress respiratory drive and would aggravate the sleep apnea. There is no information that the patient might have a personality disorder. If he did, the nurse would most likely recognize this after 2 years of treatment. While it is remotely possible that the patient is selling his medication; it is not likely for a patient with an anxiety disorder to do this. There is no information that the patient might have an addictive personality disorder. If he did, the nurse would know this after 2 years of treatment.
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