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 : Going to bed at the same time every night, even when not feeling tired, can help regulate the body's clock and aid in falling asleep at a regular time. However, lying in bed awake can lead to frustration and should be avoided. If sleep does not come within 20 minutes, it's recommended to get up and do something relaxing until feeling sleepy.

Choice B reason : Exercising can increase alertness and endorphin levels which can make it difficult to fall asleep if done too close to bedtime. Stopping exercise at least 2 hours before bedtime allows the body to wind down and prepare for sleep, making this statement correct and indicative of an understanding of good sleep hygiene practices.

Choice C reason : Watching television or engaging in other stimulating activities in the bedroom can associate the space with wakefulness rather than sleep. The light from screens can also suppress melatonin production, making it harder to fall asleep. Therefore, this statement does not reflect an understanding of the teaching on good sleep practices.

Choice D reason : Taking long naps, especially in the late afternoon or evening, can interfere with nighttime sleep. If naps are necessary, they should be limited to 20-30 minutes and taken earlier in the day. This statement suggests a misunderstanding of the impact of napping on sleep quality at night.

Choice A reason : Prolonged stress can lead to impaired immune function. When a person is stressed, the body's stress response can suppress the immune system, making it less effective at fighting off infections. This is because stress hormones like cortisol can inhibit the production and function of white blood cells, such as lymphocytes, which are crucial for the immune response. Additionally, chronic stress can lead to inflammation and reduce the body's ability to respond to immunological challenges, increasing the risk of illness and infection.

Choice B reason : Decreased blood pressure is not typically a manifestation of prolonged stress. In fact, stress can lead to increased blood pressure due to the release of stress hormones that cause vasoconstriction and an increase in heart rate. Over time, this can contribute to hypertension and cardiovascular problems.

Choice C reason : Hypoglycemia, or low blood sugar, is not a direct manifestation of prolonged stress. However, stress can affect blood sugar levels. For individuals with diabetes, stress can make it harder to control blood sugar as stress hormones can cause blood sugar levels to rise. In non-diabetic individuals, stress typically does not cause hypoglycemia.

Choice D reason : Anemia, a condition characterized by a lack of healthy red blood cells, is not a direct result of prolonged stress. Anemia can be caused by a variety of factors, including nutritional deficiencies, chronic diseases, or genetic conditions, but it is not commonly linked to stress.