Self-Assessment Questions (SAQs) for Study Session 16

Now that you have completed this study session, you can assess how well you have achieved its Learning Outcomes by answering these questions. Write your answers in your Study Diary and discuss them with your Tutor at the next Study Support Meeting. You can check your answers with the Notes on the Self-Assessment Questions at the end of this Module.

SAQ 16.1 (tests Learning Outcomes 16.1, 16.3 and 16.4)

Which of the following statements is false? In each case explain why it is incorrect.

A  Sleep hygiene means making sure that a person is clean before they go to sleep.

B  Problem solving involves telling a person how to solve their problems.

C  Sedative medication is good for people who can’t sleep.

D  In post-traumatic stress disorder the person keeps remembering the bad event that happened to them.

E  Avoiding drinking coffee after lunchtime can help to improve sleep problems.


A is false. Sleep hygiene does not have anything to do with personal hygiene. It is the term used to describe good sleeping habits.

B is false. Instead of telling the person how to solve their problems, problem-solving means helping the person to find their own solutions to their problems.

C is false. In general, sedative medication is not the solution for people who have chronic sleep difficulties because of the risk that they will get addicted to the medicine.

D is true. A person with post-traumatic stress disorder typically has the following symptoms: (1) horrible memories or nightmares about the bad event; (2) not being able to relax because they are expecting more bad things to happen; (3) avoiding anything that reminds them of the bad event.

E is true. Coffee can disturb a person’s sleep if drunk too late in the day.

Read the case study below and answer the questions that follow.

Case Study 16.3  Mr Ato Debela the farmer

Mr Ato Debela has always been somebody who tends to worry about things more than other people. But since his father died a year ago, his worry has increased. Mostly he worries about how he is going to manage to provide for his wife and three children. He has lots of aches and pains in his muscles, especially in his head and neck. His hands shake and he sweats a lot. He also feels his heart beating faster than usual and sometimes feels as though he can’t breathe properly. At night time he finds it difficult to sleep because he is thinking so much about different things. At the health centre he was given some vitamin tablets but they haven’t helped. He is unable to work properly because of his condition.

SAQ 16.2 (tests Learning Outcomes 16.3, 16.4)

  • a.Identify the possible symptoms of anxiety.
  • b.What advice could you give Mr Ato Debela to help improve his sleep?
  • c.How could you help him with his anxiety?


  • a.Mr Ato Debela has the following symptoms of anxiety: worrying without good reason, tense muscles, racing heart, tremor, sweating, shortness of breath and disturbed sleep.
  • b.Check for possible causes of sleep problems and try to correct them. For example, a person with anxiety may use alcohol to try to make them feel calmer but this will disturb their sleep. You can explain the importance of sleep hygiene (Table 16.2).
  • c.Problem solving could help Mr Ato Debela. He is worrying about lots of different things. You can encourage him to focus on just one problem at a time (see Box 16.2).

SAQ 16.3 (tests Learning Outcome 16.2)

One of the nurses working in the nearby health centre tells you about a patient who keeps coming to the clinic with different complaints – one week they have abdominal pain, another week they complain of headaches, the next week they say they feel dizzy. The patient has had a proper examination and all investigations are normal. The nurse asks whether you can help.

  • a.What do you think the problem could be?
  • b.What extra information would you like to find out from the patient?
  • c.Can you suggest how you could work together with the health centre nurse to help this patient?


  • a.The person has a physical complaint without an identifiable medical cause. It could be due to an undetected physical problem, depression, anxiety and/or somatisation.
  • b.You should screen for depression and anxiety. It would also be useful to find out whether the person has any social difficulties that could be leading to somatisation.
  • c.Assuming that the person has somatisation, it is important to work with the health centre staff to try to stop the person having unnecessary investigations and treatments.

SAQ 16.4 (tests Learning Outcomes 16.5 and 16.6)

Look back at Case Study 16.2. How could you help Mrs Alemtsehay?


As we discussed earlier, Mrs Alemtsehay seems to have a level of depression that needs urgent treatment. You should refer her to the next level health facility which is able to provide mental healthcare. You can also provide her with confidential support and try to encourage her to speak to a family member or community elder about the problem with her husband. You may also be able to put her in touch with local organisations that could help her.

Summary of Study Session 16