A nurse is assisting with teaching a class about physiological changes that occur during sleep. The nurse should include that which of the following changes occur during non-rapid eye movement (NREM) sleep?

Choice A reason : Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity. While the causes of ADHD are not fully understood, current research does not establish childhood obesity as a direct risk factor for developing ADHD. ADHD is thought to be linked to genetic factors and certain environmental exposures during pregnancy.

Choice B reason : Hypotension, or low blood pressure, is generally not associated with childhood obesity. In fact, obesity, especially in the long term, is more commonly linked to hypertension (high blood pressure) due to increased strain on the heart and blood vessels, and not hypotension.

Choice C reason : Rheumatoid arthritis is an autoimmune condition that causes joint inflammation and damage. It is not typically considered a direct complication of childhood obesity. While obesity can contribute to joint problems due to increased mechanical stress, it is not a known cause of autoimmune conditions like rheumatoid arthritis.

Choice D reason : Diabetes mellitus, particularly type 2 diabetes, is a well-documented potential complication of childhood obesity. Obesity increases the risk of developing insulin resistance, which can lead to elevated blood sugar levels and eventually type 2 diabetes. The excess fat, particularly visceral fat, is associated with chronic inflammation and metabolic changes that contribute to the development of diabetes⁴.

Choice A reason : Inability to form healthy relationships is not typically associated with fixation at the oral stage of development. Freud's theory suggests that this issue is more related to the Oedipal conflict during the phallic stage, where the individual's interactions with parental figures shape their future relationships.

Choice B reason : Feelings of shame are generally associated with the anal stage of Freud's psychosexual development, where the child's experiences with toilet training can lead to outcomes that manifest as either excessive orderliness or messiness in adulthood, rather than shame, which is not directly linked to the oral stage.

Choice C reason : Bedwetting is not a condition associated with the oral stage of development. It is more related to the anal stage, where issues of control and independence are central, and bedwetting can be a manifestation of conflicts around toilet training.

Choice D reason : Overeating is a classic example of an oral stage fixation. According to Freud, if an individual's needs are not properly met during the oral stage (0–1 years), they may develop habits such as overeating or smoking to satisfy the residual need for oral stimulation.