Central Nervous System Depressants

A nurse is reviewing medications with a student nurse. The student correctly identifies hypnotics as having which of the following characteristics? a) They cause sleep by producing a more potent CNS depressant effect than sedatives. b) They increase the body's ability to enter REM sleep. c) They stimulate the nervous system to reduce anxiety. d) They only work when combined with benzodiazepines.

Correct Answer: a) They cause sleep by producing a more potent CNS depressant effect than sedatives. Rationale: Hypnotics are a type of CNS depressant that induce sleep through a stronger CNS effect than sedatives.

A patient taking benzodiazepines reports muscle tension. The nurse explains that benzodiazepines have which of the following effects on skeletal muscles? a) They induce relaxation of skeletal muscles. b) They increase muscle tone and rigidity. c) They stimulate the neuromuscular junction to enhance strength. d) They have no effect on muscle relaxation.

Correct Answer: a) They induce relaxation of skeletal muscles. Rationale: Benzodiazepines help relax skeletal muscles by enhancing GABA activity, which reduces muscle tension and promotes relaxation.

A nurse is reviewing sleep cycle effects of benzodiazepines. Compared to barbiturates, benzodiazepines have which of the following effects on REM sleep? a) They produce less REM suppression than barbiturates. b) They completely eliminate REM sleep. c) They increase REM sleep, leading to prolonged dreaming. d) They suppress REM sleep more than barbiturates, leading to deeper sleep.

Correct Answer: a) They produce less REM suppression than barbiturates. Rationale: Benzodiazepines cause less REM suppression compared to barbiturates, which makes them a preferred option for sleep induction with fewer disruptions to the sleep cycle

Which of the following is an example of a short-acting benzodiazepine? a) Triazolam b) Lorazepam c) Diazepam d) Flurazepam

Correct Answer: a) Triazolam. Rationale: Triazolam is classified as a short-acting benzodiazepine, meaning it has a quick onset and shorter duration of action.

A patient is prescribed a sedative-hypnotic. The nurse explains that the drug's effect depends on the dosage. Which statement by the patient indicates understanding? a) "A low dose will help me sleep, while a high dose will only help me feel calm." b) "A low dose will calm me down, while a high dose will put me to sleep." c) "Sedative-hypnotics always cause sleep, no matter the dose." d) "The medication will increase my alertness and energy levels."

Correct Answer: b) "A low dose will calm me down, while a high dose will put me to sleep." Rationale: Sedative-hypnotics have dose-dependent effects—low doses calm the CNS (sedative effect), while high doses induce sleep (hypnotic effect).

A nurse is discussing CNS depressants with a student. Which of the following statements by the student indicates a need for further teaching? a) "CNS depressants can be classified based on their chemical composition." b) "All CNS depressants have the same chemical structure." c) "CNS depressants include barbiturates, benzodiazepines, and miscellaneous drugs." d) "CNS depressants can be misused due to their sedative effects."

Correct Answer: b) "All CNS depressants have the same chemical structure." Rationale: CNS depressants are classified into different groups based on their chemical makeup, meaning they do not all share the same chemical structure.

A patient with anxiety is prescribed an intermediate-acting benzodiazepine. Which of the following medications would the nurse expect the provider to prescribe? a) Zolpidem b) Alprazolam c) Clonazepam d) Triazolam

Correct Answer: b) Alprazolam. Rationale: Intermediate-acting benzodiazepines include alprazolam, lorazepam, and temazepam, which are used for anxiety and sedation.

A nurse is reviewing dietary restrictions with a patient prescribed benzodiazepines. The nurse advises the patient to avoid grapefruit juice because it: a) Increases the metabolism of benzodiazepines, making them less effective b) Alters benzodiazepine metabolism, resulting in prolonged effects and potential toxicity c) Decreases the absorption of benzodiazepines, shortening their duration of action d) Has no known interaction with benzodiazepines

Correct Answer: b) Alters benzodiazepine metabolism, resulting in prolonged effects and potential toxicity. Rationale: Grapefruit juice affects the metabolism of benzodiazepines, leading to prolonged drug effects and an increased risk of toxicity.

A patient taking oral contraceptives is prescribed a barbiturate for seizure prevention. The nurse should educate the patient about which of the following risks? a) Barbiturates can enhance the effectiveness of oral contraceptives. b) Barbiturates can decrease the effectiveness of oral contraceptives. c) Barbiturates have no effect on oral contraceptive metabolism. d) Barbiturates increase the risk of pregnancy complications but not contraceptive failure.

Correct Answer: b) Barbiturates can decrease the effectiveness of oral contraceptives. Rationale: Barbiturates enhance liver enzyme activity, increasing the metabolism of oral contraceptives, which may lead to decreased effectiveness and an increased risk of unintended pregnancy.

A nurse is comparing benzodiazepines with barbiturates. Which of the following statements accurately describes a key difference? a) Benzodiazepines produce greater REM suppression than barbiturates. b) Benzodiazepines do not increase the metabolism of other drugs, unlike barbiturates. c) Benzodiazepines stimulate the CNS more than barbiturates. d) Benzodiazepines increase the metabolism of anticoagulants and oral contraceptives.

Correct Answer: b) Benzodiazepines do not increase the metabolism of other drugs, unlike barbiturates. Rationale: Unlike barbiturates, benzodiazepines do not stimulate liver enzymes that increase drug metabolism, making them a safer option with fewer drug interactions.

Ultrashort-acting barbiturates are used for which of the following purposes? a) Long-term seizure prevention b) Brief surgical procedures, induction of anesthesia, control of seizures, and reducing intracranial pressure c) Treatment of chronic insomnia d) Anxiety management in outpatient settings

Correct Answer: b) Brief surgical procedures, induction of anesthesia, control of seizures, and reducing intracranial pressure. Rationale: Ultrashort-acting barbiturates, such as methohexital and thiopental, are primarily used for short surgical procedures, anesthesia induction, seizure control, and reducing intracranial pressure.

Which of the following drugs is classified as an intermediate-acting barbiturate? a) Pentobarbital b) Butobarbital c) Thiopental d) Phenobarbital

Correct Answer: b) Butobarbital. Rationale: Butobarbital is an intermediate-acting barbiturate used for sedation and seizure control.

A nurse is educating a patient about the long-term use of barbiturates. The nurse correctly explains that prolonged use can have which of the following harmful effects on sleep? a) Increased total sleep duration b) Deprivation of rapid eye movement (REM) sleep c) Decreased non-REM sleep phases d) Enhanced ability to fall asleep naturally

Correct Answer: b) Deprivation of rapid eye movement (REM) sleep. Rationale: Long-term use of barbiturates leads to REM sleep deprivation, which can result in sleep disturbances and daytime fatigue.

CNS depressants are categorized based on their effects. Which classification induces sleep? a) Sedatives b) Hypnotics c) Stimulants d) Analgesics

Correct Answer: b) Hypnotics. Rationale: Hypnotics are a type of CNS depressant that induce sleep, whereas sedatives primarily produce a calming effect without necessarily causing sleep.

A nurse is educating a patient about benzodiazepines. The nurse correctly states that benzodiazepines primarily affect which areas of the brain? a) Cerebral cortex and brainstem b) Hypothalamic, thalamic, and limbic systems c) Cerebellum and spinal cord d) Medulla oblongata and corpus callosum

Correct Answer: b) Hypothalamic, thalamic, and limbic systems. Rationale: Benzodiazepines act on the hypothalamic, thalamic, and limbic systems by enhancing gamma-aminobutyric acid (GABA) receptor activity, leading to CNS depression.

A nurse is discussing the effects of benzodiazepines with a patient. The nurse explains that benzodiazepines reduce excessive sensory stimulation, leading to which of the following effects? a) Increased alertness b) Induced sleep c) Heightened anxiety d) Increased metabolic rate

Correct Answer: b) Induced sleep. Rationale: By reducing excessive sensory stimulation, benzodiazepines help induce sleep and promote relaxation, making them effective for conditions such as insomnia and anxiety.

The nurse is reviewing medication classifications with a student nurse. The student nurse correctly identifies hypnotics as producing which of the following effects? a) Inducing calm b) Inducing sleep c) Increasing alertness d) Stimulating the CNS

Correct Answer: b) Inducing sleep. Rationale: Hypnotics are a class of CNS depressants specifically used to induce sleep. Unlike sedatives, which only produce a calming effect, hypnotics promote sleep in patients with insomnia or other sleep disorders.

Central nervous system (CNS) depressants produce their effects by which of the following mechanisms? a) Stimulating nerve impulse transmission to the CNS b) Inhibiting the transmission of nerve impulses to the CNS c) Increasing neurotransmitter activity in the spinal cord d) Enhancing excitatory signals in the cerebral cortex

Correct Answer: b) Inhibiting the transmission of nerve impulses to the CNS. Rationale: CNS depressants produce a calming effect by reducing the transmission of nerve impulses to the CNS, leading to sedation, relaxation, or sleep induction.

Central nervous system (CNS) depressants are drugs that result in which of the following effects? a) Stimulation of nerve impulses to the CNS b) Inhibition of the transmission of nerve impulses to the CNS c) Increased brain activity and alertness d) Increased nerve conduction and excitability

Correct Answer: b) Inhibition of the transmission of nerve impulses to the CNS. Rationale: CNS depressants work by slowing down brain activity through the inhibition of nerve impulse transmission. This results in a calming effect, sleep induction, or both.

A nurse is reviewing a patient's medication list. The patient is taking a monoamine oxidase inhibitor (MAOI) for depression. How does this medication affect barbiturates? a) It shortens the duration of action of barbiturates. b) It prolongs the duration of action of barbiturates. c) It prevents barbiturates from crossing the blood-brain barrier. d) It increases the excretion of barbiturates from the body.

Correct Answer: b) It prolongs the duration of action of barbiturates. Rationale: Monoamine oxidase inhibitors (MAOIs) result in a longer duration of action of barbiturates, increasing the risk of prolonged sedation and CNS depression.

A nurse is administering a barbiturate intravenously. Which of the following complications can occur with rapid infusion? a) Increased alertness and restlessness b) Life-threatening respiratory or cardiac arrest c) Hypertension and increased heart rate d) Delayed onset of action and prolonged sedation

Correct Answer: b) Life-threatening respiratory or cardiac arrest. Rationale: Rapid infusion of barbiturates can cause severe CNS depression, leading to respiratory or cardiac arrest.

Which statements are correct regarding benzodiazepines? Select all that apply.​ -Clonazepam, diazepam, and flurazepam are short-acting benzodiazepines -Reduce excessive sensory stimulation which induces sleep -Affect the hypothalamic, thalamic, and limbic systems of the brain (gamma-aminobutyric acid [GABA] receptors) -Alprazolam, lorazepam, and temazepam are long-acting benzodiazepines -Produce more rapid eye movement (REM) suppression than barbiturates Induce relaxation of skeletal muscles

-Reduce excessive sensory stimulation which induces sleep -Affect the hypothalamic, thalamic, and limbic systems of the brain (gamma-aminobutyric acid [GABA] receptors) -Produce more rapid eye movement (REM) suppression than barbiturates Induce relaxation of skeletal muscles

Benzodiazepines were once the most prescribed sedative-hypnotic drugs. However, which class of drugs is now prescribed more frequently? a) Barbiturates b) Nonbenzodiazepines c) Opioids d) Tricyclic antidepressants

Correct Answer: b) Nonbenzodiazepines. Rationale: While benzodiazepines were once the most prescribed sedative-hypnotic drugs, nonbenzodiazepines are now prescribed more frequently due to their improved safety profile and lower risk of dependency.

A nurse is educating a patient about potential drug interactions with benzodiazepines. Which of the following medications can increase the effects of benzodiazepines, leading to greater central nervous system (CNS) depression? a) Rifampin b) Olanzapine c) Metformin d) Furosemide

Correct Answer: b) Olanzapine. Rationale: Olanzapine, an antipsychotic, increases the CNS depressant effects of benzodiazepines, leading to enhanced sedation and an increased risk of respiratory depression.

A nurse is educating a patient about the black box warning on benzodiazepines. The nurse explains that the combination of benzodiazepines with which of the following drug classes can cause extreme sleepiness, respiratory depression, coma, and death? a) Antihypertensives b) Opioids c) Nonsteroidal anti-inflammatory drugs (NSAIDs) d) Antacids

Correct Answer: b) Opioids. Rationale: The black box warning for benzodiazepines warns against their combination with opioids due to the risk of severe CNS depression, which can lead to coma or death

A nurse is reviewing the black box warning associated with benzodiazepines. This warning highlights the danger of combining benzodiazepines with which of the following? a) Antihistamines b) Opioids c) Nonsteroidal anti-inflammatory drugs (NSAIDs) d) Diuretics

Correct Answer: b) Opioids. Rationale: The black box warning states that combining benzodiazepines with opioids can cause serious CNS depression, including extreme sleepiness, respiratory depression, coma, and death.

Which long-acting barbiturate is also used to treat hyperbilirubinemia in neonates? a) Pentobarbital b) Phenobarbital c) Secobarbital d) Thiopental

Correct Answer: b) Phenobarbital. Rationale: Phenobarbital, a long-acting barbiturate, is used to treat hyperbilirubinemia in neonates in addition to preventing seizures.

A nurse is reviewing contraindications for barbiturates. Which of the following conditions would be a contraindication for their use? a) Chronic hypertension b) Pregnancy and severe respiratory, kidney, or liver conditions c) Mild anxiety and occasional insomnia d) History of migraines

Correct Answer: b) Pregnancy and severe respiratory, kidney, or liver conditions. Rationale: Barbiturates are contraindicated in pregnancy and in patients with severe respiratory, kidney, or liver conditions due to their enzyme-stimulating action, which leads to the fast metabolism of drugs and a shortened duration of action.

A patient taking benzodiazepines is prescribed rifampin for tuberculosis. What effect should the nurse anticipate? a) Increased metabolism of benzodiazepines, reducing their effectiveness b) Prolonged benzodiazepine effects due to slower metabolism c) No significant interaction between the two drugs d) Severe CNS depression requiring respiratory support

Correct Answer: a) Increased metabolism of benzodiazepines, reducing their effectiveness. Rationale: Rifampin increases the metabolism of benzodiazepines, causing them to be broken down more quickly and reducing their effectiveness.

A healthcare provider is considering prescribing a barbiturate for an older adult patient. The nurse should educate the provider about which of the following risks? a) Increased risk of falling b) Increased energy levels c) Enhanced cognitive function d) Increased appetite

Correct Answer: a) Increased risk of falling. Rationale: Barbiturates can cause CNS depression, leading to drowsiness, dizziness, and impaired coordination, which increases the risk of falls in older adults.

Which of the following drugs are classified as long-acting barbiturates? a) Phenobarbital and mephobarbital b) Pentobarbital and secobarbital c) Methohexital and thiopental d) Butobarbital and pentobarbital

Correct Answer: a) Phenobarbital and mephobarbital. Rationale: Phenobarbital and mephobarbital are long-acting barbiturates used primarily for seizure prevention.

Phenobarbital, a long-acting barbiturate, is used for which of the following purposes? a) Prevention of generalized tonic-clonic seizures and fever-induced convulsions b) Management of hyperactivity disorders c) Treatment of opioid overdose d) Short-term sedation for minor procedures

Correct Answer: a) Prevention of generalized tonic-clonic seizures and fever-induced convulsions. Rationale: Phenobarbital is used to prevent generalized tonic-clonic seizures and fever-induced convulsions but is no longer used as a sedative or hypnotic.

Short-acting barbiturates include which of the following drugs? a) Secobarbital and pentobarbital b) Methohexital and thiopental c) Butobarbital and phenobarbital d) Mephobarbital and thiopental

Correct Answer: a) Secobarbital and pentobarbital. Rationale: Secobarbital and pentobarbital are short-acting barbiturates used for sedation and seizure control.

Short-acting barbiturates are used for which of the following purposes? a) Sedation and control of seizures b) Long-term management of epilepsy c) Treatment of chronic pain d) Increasing alertness in patients with narcolepsy

Correct Answer: a) Sedation and control of seizures. Rationale: Short-acting barbiturates, such as pentobarbital and secobarbital, are used primarily for sedation and seizure control.

Benzodiazepines are classified by their primary use. Which of the following are the two main classifications? a) Sedative-hypnotics and anxiolytics b) Analgesics and anesthetics c) Muscle stimulants and antidepressants d) Anticoagulants and mood stabilizers

Correct Answer: a) Sedative-hypnotics and anxiolytics. Rationale: Benzodiazepines are primarily classified as sedative-hypnotics (used for sleep induction) or anxiolytics (used for anxiety reduction).

A patient with severe muscle spasms is prescribed a benzodiazepine. The nurse recognizes that benzodiazepines are used for which of the following effects? a) Skeletal muscle relaxation b) Appetite stimulation c) Blood pressure regulation d) Mood enhancement

Correct Answer: a) Skeletal muscle relaxation. Rationale: Benzodiazepines help relax skeletal muscles by enhancing gamma-aminobutyric acid (GABA) receptor activity, making them useful for conditions involving muscle spasms.

A nurse is educating a patient about CNS depressants. The classification of these drugs as sedatives, hypnotics, or both is determined by which of the following? a) The dosage and degree of CNS inhibition b) The patient's weight and age c) The route of administration d) The presence of coexisting medical conditions

Correct Answer: a) The dosage and degree of CNS inhibition. Rationale: CNS depressants can act as sedatives at lower doses and as hypnotics at higher doses, depending on the level of CNS inhibition.

A nurse is reviewing the mechanism of action of benzodiazepines. Which of the following brain structures are affected by benzodiazepines? a) The hypothalamic, thalamic, and limbic systems b) The brainstem and spinal cord c) The cerebellum and medulla oblongata d) The cerebral cortex and corpus callosum

Correct Answer: a) The hypothalamic, thalamic, and limbic systems. Rationale: Benzodiazepines affect the hypothalamic, thalamic, and limbic systems of the brain by acting on GABA receptors, leading to relaxation and sedation.

Long-acting barbiturates are used primarily for which of the following purposes? a) The prevention of seizures b) Induction of anesthesia c) Preoperative sedation d) Treatment of chronic anxiety

Correct Answer: a) The prevention of seizures. Rationale: Long-acting barbiturates, such as phenobarbital and mephobarbital, are primarily used for the prevention of seizures.

A patient experiencing alcohol withdrawal symptoms is prescribed diazepam. The nurse understands that benzodiazepines are used for alcohol withdrawal because they: a) Increase metabolism of alcohol to prevent withdrawal symptoms b) Prevent and treat withdrawal symptoms such as agitation and seizures c) Act as a substitute for alcohol to reduce cravings d) Stimulate neurotransmitters to enhance alcohol tolerance

Correct Answer: b) Prevent and treat withdrawal symptoms such as agitation and seizures. Rationale: Benzodiazepines, such as diazepam and chlordiazepoxide, are used in alcohol withdrawal to manage symptoms like agitation and seizures.

A patient taking a sedative-hypnotic for an extended period reports feeling fatigued during the day. The nurse recognizes that this is likely due to which of the following? a) Increased REM sleep b) REM interference c) Increased CNS stimulation d) Decreased need for sleep

Correct Answer: b) REM interference. Rationale: Prolonged use of sedative-hypnotics can disrupt REM sleep, an important phase of the sleep cycle, leading to daytime fatigue.

A patient who recently discontinued a sedative-hypnotic reports experiencing vivid dreams. The nurse explains that this is likely due to which of the following? a) REM suppression b) REM rebound c) CNS overexcitation d) Increased metabolism of the drug

Correct Answer: b) REM rebound. Rationale: When sedative-hypnotics are discontinued, the body may compensate for previous REM suppression by increasing REM sleep, leading to frequent and vivid dreams.

2. Which of the following is a key effect of benzodiazepines? a) Increase sensory stimulation to enhance wakefulness b) Reduce excessive sensory stimulation, which induces sleep c) Suppress deep sleep phases and increase metabolism of other drugs d) Act as a stimulant on the central nervous system

Correct Answer: b) Reduce excessive sensory stimulation, which induces sleep. Rationale: Benzodiazepines promote sleep by reducing excessive sensory stimulation, helping to calm the nervous system.

A nurse is educating a patient about sedatives. The nurse correctly explains that sedatives primarily produce which of the following effects? a) Cause sleep regardless of the dose b) Reduce nervousness, excitability, and irritability without causing sleep at lower doses c) Increase CNS stimulation to promote alertness d) Induce a deeper stage of REM sleep

Correct Answer: b) Reduce nervousness, excitability, and irritability without causing sleep at lower doses. Rationale: Sedatives create a calming effect and reduce nervousness and irritability without necessarily causing sleep unless given in large enough doses.

. A patient presents to the emergency department with symptoms of barbiturate overdose. The nurse anticipates which of the following life-threatening complications? a) Hypertension and tachycardia b) Respiratory arrest, coma, and death c) Increased alertness and hyperactivity d) Gastrointestinal bleeding and metabolic acidosis

Correct Answer: b) Respiratory arrest, coma, and death. Rationale: An overdose of barbiturates can cause severe respiratory depression, leading to respiratory arrest, coma, and death due to CNS suppression.

A nurse is educating a patient about the risk of dependency associated with barbiturates. The patient asks why these drugs are controlled substances. The nurse correctly explains that barbiturates are classified under which of the following controlled substance schedules? a) Schedule I only b) Schedule II-IV c) Schedule V only d) Not classified as controlled substances

Correct Answer: b) Schedule II-IV. Rationale: Barbiturates are controlled substances classified as Schedule II-IV, depending on their potential for abuse and dependence, according to the U.S. Department of Justice.

Which of the following is the primary use of intermediate-acting barbiturates? a) Induction of anesthesia b) Sedation and control of seizures c) Treatment of chronic insomnia d) Management of opioid withdrawal

Correct Answer: b) Sedation and control of seizures. Rationale: Intermediate-acting barbiturates, such as butobarbital, are used primarily for sedation and seizure control.

A nurse is educating a patient about CNS depressants. Which classification of CNS depressants induces calmness? a) Hypnotics b) Sedatives c) Stimulants d) Analgesics

Correct Answer: b) Sedatives. Rationale: Sedatives are CNS depressants that primarily induce a calming effect without necessarily causing sleep. They are often used to reduce anxiety and agitation.

A patient who has been taking benzodiazepines for sleep reports feeling excessively tired during the day. The nurse explains that this is likely due to: a) Increased REM sleep b) Suppression of REM sleep c) Increased deep sleep duration d) Increased energy levels

Correct Answer: b) Suppression of REM sleep. Rationale: Benzodiazepines reduce REM sleep, leading to incomplete restorative sleep and subsequent daytime sleepiness.

A nurse is preparing to manage a patient with a barbiturate overdose. What is the primary treatment approach? a) Administration of an opioid antagonist b) The ABCs (airway, breathing, circulation) with vasopressor support and fluids c) Administration of benzodiazepines to counteract CNS depression d) Inducing vomiting to remove the drug from the stomach

Correct Answer: b) The ABCs (airway, breathing, circulation) with vasopressor support and fluids. Rationale: There is no direct antidote for barbiturate overdose. Treatment focuses on maintaining airway, breathing, and circulation (ABCs), along with vasopressor support and fluids to stabilize blood pressure.

Barbiturates are a subclass of CNS depressants that inhibit nerve impulses by acting on which of the following? a) The spinal cord and cerebellum b) The brainstem and gamma-aminobutyric acid (GABA) receptors c) The hypothalamus and limbic system d) The peripheral nervous system

Correct Answer: b) The brainstem and gamma-aminobutyric acid (GABA) receptors. Rationale: Barbiturates act on the brainstem and GABA receptors, inhibiting nerve impulses in the cerebral cortex, leading to CNS depression.

A nurse is educating a student about barbiturates. The nurse explains that the inhibition of nerve impulses occurs in which part of the brain? a) The hypothalamus b) The cerebral cortex c) The thalamus d) The cerebellum

Correct Answer: b) The cerebral cortex. Rationale: Barbiturates inhibit nerve impulses in the cerebral cortex by acting on the brainstem and GABA receptors, leading to CNS depression.

The nurse is preparing to administer a CNS depressant. The classification of the drug as a sedative, hypnotic, or sedative-hypnotic is based on which factor? a) The chemical composition of the drug b) The degree to which the drug inhibits nerve impulse transmission c) The route of administration d) The patient's weight and age

Correct Answer: b) The degree to which the drug inhibits nerve impulse transmission. Rationale: CNS depressants are classified based on how much they inhibit nerve impulses. Sedatives induce calmness, hypnotics promote sleep, and sedative-hypnotics can do both depending on the level of inhibition they cause.

Barbiturates are classified into three groups based on which of the following factors? a) Their mechanism of action b) The duration of action c) Their route of administration d) Their chemical composition

Correct Answer: b) The duration of action. Rationale: Barbiturates are classified into three groups based on their duration of action, which influences their pharmacokinetics and clinical use.

. A patient taking benzodiazepines is prescribed erythromycin, a macrolide antibiotic. The nurse understands that this combination may result in which of the following? a) Increased elimination of benzodiazepines b) Reduced CNS depressant effects c) Prolonged benzodiazepine action d) No significant drug interaction

Correct Answer: c) Prolonged benzodiazepine action. Rationale: Macrolide antibiotics, such as erythromycin, decrease benzodiazepine metabolism, leading to prolonged drug effects and an increased risk of sedation.

A nurse is educating a patient about the effects of benzodiazepines on sleep. The nurse explains that benzodiazepines suppress which phase of sleep? a) Non-REM sleep b) Light sleep stages c) Rapid eye movement (REM) sleep d) Deep sleep stages

Correct Answer: c) Rapid eye movement (REM) sleep. Rationale: Benzodiazepines suppress REM sleep, which can result in daytime sleepiness and altered sleep patterns.

Pentobarbital, a short-acting barbiturate, was historically used for which of the following purposes but is now used for preoperative anxiety, sedation, withdrawal symptoms, and seizure control? a) Long-term seizure prevention b) Management of hyperbilirubinemia in neonates c) Sedative-hypnotic for insomnia d) Treatment of major depressive disorder

Correct Answer: c) Sedative-hypnotic for insomnia. Rationale: Pentobarbital was previously used as a sedative-hypnotic for insomnia but is now primarily used for preoperative anxiety, sedation, withdrawal symptom management, and seizure control.

A patient presents to the emergency department with suspected benzodiazepine overdose. The nurse should monitor for which life-threatening complication? a) Hypertension b) Increased respiratory rate c) Severe respiratory depression when mixed with alcohol or other CNS depressants d) Hyperactive reflexes

Correct Answer: c) Severe respiratory depression when mixed with alcohol or other CNS depressants. Rationale: Benzodiazepines rarely cause life-threatening effects unless taken in excessive doses or combined with other CNS depressants like alcohol or barbiturates, which can result in severe respiratory depression.

Barbiturates exert their effects primarily by acting on which area of the brain? a) The hypothalamus b) The cerebellum c) The reticular formation area of the brainstem d) The limbic system

Correct Answer: c) The reticular formation area of the brainstem. Rationale: Barbiturates act primarily on the reticular formation area of the brainstem, increasing the effectiveness of gamma-aminobutyric acid (GABA) receptors, which inhibits nerve impulses in the cerebral cortex.

Which of the following describes why benzodiazepines are used in balanced anesthesia? a) They eliminate the need for analgesics and anesthetics. b) They prevent bacterial infections during surgery. c) They reduce anxiety and enhance the effects of anesthetics, analgesics, and neuromuscular blocking drugs. d) They increase oxygenation of tissues during procedures.

Correct Answer: c) They reduce anxiety and enhance the effects of anesthetics, analgesics, and neuromuscular blocking drugs. Rationale: Benzodiazepines are used in balanced anesthesia to provide sedation, reduce anxiety, and enhance the effectiveness of anesthetics, analgesics, and neuromuscular blocking drugs.

CNS depressants are classified into three main groups based on their chemical composition. Which of the following is NOT one of these groups? a) Barbiturates b) Benzodiazepines c) Miscellaneous drugs d) Opioids

Correct Answer: d) Opioids. Rationale: CNS depressants are categorized into barbiturates, benzodiazepines, and miscellaneous drugs. Opioids are a separate class of drugs primarily used for pain relief, although they also have CNS depressant properties.

Benzodiazepines are classified under which schedule of controlled substances? a) Schedule I b) Schedule II c) Schedule III d) Schedule IV

Correct Answer: d) Schedule IV. Rationale: Benzodiazepines are classified as Schedule IV controlled substances due to their potential for abuse and dependence, though they have a lower risk than Schedule I-III substances.

Which of the following substances can further increase CNS depression when taken with benzodiazepines? (Select all that apply) a) Alcohol b) Kava c) Grapefruit juice d) Valerian e) Vitamin C

Correct Answers: a) Alcohol, b) Kava, d) Valerian. Rationale: Alcohol, kava, and valerian are CNS depressants that can enhance the sedative effects of benzodiazepines, increasing the risk of respiratory depression and excessive drowsiness. Grapefruit juice alters metabolism but does not directly cause CNS depression.

A nurse is monitoring a patient for common adverse effects of benzodiazepines. Which of the following symptoms might the patient experience? (Select all that apply) a) Headache b) Drowsiness c) Paradoxical excitement or nervousness d) Cognitive impairment e) Hypertension

Correct Answers: a) Headache, b) Drowsiness, c) Paradoxical excitement or nervousness, d) Cognitive impairment. Rationale: Common side effects of benzodiazepines include headache, drowsiness, paradoxical excitement or nervousness, dizziness or vertigo, cognitive impairment, and lethargy. Hypertension is not a typical adverse effect.

A nurse is caring for a patient who has overdosed on benzodiazepines. Which of the following symptoms would the nurse expect to assess? (Select all that apply) a) Hypotension b) Bradypnea c) Increased reflexes d) Somnolence e) Confusion

Correct Answers: a) Hypotension, b) Bradypnea, d) Somnolence, e) Confusion. Rationale: Overdose symptoms include hypotension, bradypnea (low respiratory rate), excessive sleepiness (somnolence), confusion, coma, and diminished reflexes. Reflexes are diminished rather than increased.

A patient with a history of anxiety is prescribed a benzodiazepine. The nurse should question the order if the patient has which of the following conditions? (Select all that apply) a) Narrow-angle glaucoma b) Pregnancy c) Muscle spasms d) Drug allergy to benzodiazepines e) Insomnia

Correct Answers: a) Narrow-angle glaucoma, b) Pregnancy, d) Drug allergy to benzodiazepines. Rationale: Benzodiazepines are contraindicated in patients with narrow-angle glaucoma, pregnancy (due to the risk of birth defects and neonatal withdrawal), and a known drug allergy to benzodiazepines.

Benzodiazepines carry a black box warning regarding what? -The use of benzodiazepines in clients with a history of depression. -The use of benzodiazepines while driving can cause severe sleepiness. -The combined use of benzodiazepines and opioids can cause extreme central nervous system (CNS) depression.​ -The dosage of benzodiazepines.

The combined use of benzodiazepines and opioids can cause extreme central nervous system (CNS) depression.​ Rationale: There are significant drug-drug interactions with benzodiazepines, especially with opioids, due to the intensity of benzodiazepines and the combined CNS depressant effects. There is a black box warning regarding the combination of all opioids with all benzodiazepines which can cause serious CNS depression (extreme sleepiness, respiratory depression, coma, and death).​

A nurse is educating a patient about benzodiazepine use. The patient asks if they can take the medication long-term. The nurse should respond by stating: a) "Benzodiazepines can be taken indefinitely without risk of adverse effects." b) "Long-term use can lead to dependence and should be avoided." c) "You should double your dose if you feel your medication is not working as well." d) "Benzodiazepines do not affect sleep patterns and can be used without limitations."

b) "Long-term use can lead to dependence and should be avoided."

________affect the hypothalamic, thalamic, and limbic systems of the brain (GABA receptors), reduce excessive sensory stimulation which induces sleep, induce relaxation of skeletal muscles, produce less rapid eye movement (REM) suppression than barbiturates, and do not increase the metabolism of other drugs. a. Barbiturates b. Benzodiazepines

b. Benzodiazepines

__________ cause sleep with a much more potent CNS effect than________

hypnotics sedatives

Central nervous system (CNS) depressants are drugs that result in a calming effect by ________the transmission of nerve impulses to the CNS. ​ a. inhibiting b. activating

inhibiting

__________ can act as either a sedative or a hypnotic depending on the dose and client responsiveness. In low doses, they calm the CNS without causing sleep. In high doses, they calm the CNS and cause sleep.​

sedative-hypnotic

__________produce a sense of calm and reduce nervousness, excitability, and irritability without causing sleep unless given at a large enough dose.

sedatives

A nurse is reviewing a patient's medication list. Which of the following medications, when taken with benzodiazepines, could result in significant central nervous system (CNS) depression? (Select all that apply) a) Opioids b) Antihistamines c) Antifungal medications ending in "-zole" d) Antidepressants e) Macrolide antibiotics

Correct Answers: a) Opioids, b) Antihistamines. Rationale: Benzodiazepines, when combined with other CNS depressants such as opioids and antihistamines, can cause extreme sedation, respiratory depression, coma, and death. Although antifungals and macrolide antibiotics affect benzodiazepine metabolism, they do not directly cause CNS depression.

Which of the following medications can decrease the metabolism of benzodiazepines, leading to prolonged action? (Select all that apply) a) Protease inhibitors (used to treat HIV and hepatitis C) b) Verapamil and diltiazem c) Non-benzodiazepine sleep aids d) Macrolide antibiotics

Correct Answers: a) Protease inhibitors (used to treat HIV and hepatitis C), b) Verapamil and diltiazem, d) Macrolide antibiotics. Rationale: Protease inhibitors, verapamil, diltiazem, and macrolide antibiotics all decrease the metabolism of benzodiazepines, resulting in prolonged effects. NSAIDs and non-benzodiazepine sleep aids do not significantly impact benzodiazepine metabolism.

A patient taking benzodiazepines reports using herbal supplements. Which of the following herbs should the nurse educate the patient about due to their CNS depressant effects? (Select all that apply) a) Ginseng b) Kava c) Valerian d) Echinacea e) St. John's Wort

Correct Answers: b) Kava, c) Valerian. Rationale: Kava and valerian have CNS depressant properties and, when combined with benzodiazepines, can lead to excessive sedation and increased risk of CNS depression.

A nurse is explaining the mechanism of action of barbiturates to a student nurse. Which of the following best describes how barbiturates work? a) They stimulate excitatory neurotransmitters to enhance nerve conduction. b) They increase the effectiveness of gamma-aminobutyric acid (GABA) receptors, leading to CNS depression. c) They primarily act on the limbic system to reduce anxiety. d) They block dopamine receptors to produce sedation.

Correct Answer: b) They increase the effectiveness of gamma-aminobutyric acid (GABA) receptors, leading to CNS depression. Rationale: Barbiturates enhance the effectiveness of GABA receptors, resulting in increased inhibition of nerve impulses in the cerebral cortex, leading to sedation or hypnosis.

A nurse is educating a patient who takes both an anticoagulant and a barbiturate. The nurse explains that barbiturates have which of the following effects on anticoagulants? a) They decrease the metabolism of anticoagulants, increasing the risk of bleeding. b) They increase the metabolism of anticoagulants, decreasing their effectiveness. c) They have no significant effect on anticoagulants. d) They enhance the clot-preventing action of anticoagulants.

Correct Answer: b) They increase the metabolism of anticoagulants, decreasing their effectiveness. Rationale: Barbiturates accelerate the metabolism of anticoagulants, leading to a decreased effect, which increases the risk of clot formation.

A nurse is reviewing a patient's medication history. Which of the following statements best explains why barbiturates cause a shortened duration of action in the body? a) They are metabolized slowly in the kidneys. b) They stimulate liver enzymes, leading to fast metabolism of drugs. c) They decrease the absorption of medications in the intestines. d) They inhibit the breakdown of drugs in the liver.

Correct Answer: b) They stimulate liver enzymes, leading to fast metabolism of drugs. Rationale: Barbiturates stimulate liver enzymes, accelerating the metabolism of drugs and shortening their duration of action.

A nurse is monitoring a patient taking barbiturates. Which of the following are common adverse effects of barbiturates? a) Hypertension and increased alertness b) Vasodilation, hypotension, and respiratory depression c) Increased energy levels and gastrointestinal motility d) Hyperactivity and bradycardia

Correct Answer: b) Vasodilation, hypotension, and respiratory depression. Rationale: Common adverse effects of barbiturates include vasodilation, hypotension, and respiratory depression due to their CNS depressant effects.

A nurse is monitoring a patient taking benzodiazepines along with azole antifungals. What effect should the nurse anticipate? a) Decreased effectiveness of benzodiazepines b) Increased metabolism of benzodiazepines c) Prolonged benzodiazepine action d) Immediate benzodiazepine excretion from the body

Correct Answer: c) Prolonged benzodiazepine action. Rationale: Azole antifungals decrease the metabolism of benzodiazepines, leading to prolonged effects and an increased risk of excessive sedation.

A nurse is reviewing the pharmacological effects of barbiturates. The effect of the drug as a sedative or hypnotic is primarily determined by which factor? a) The specific barbiturate used b) The client's age and weight c) The dosage administered d) The method of drug metabolism

A nurse is reviewing the pharmacological effects of barbiturates. The effect of the drug as a sedative or hypnotic is primarily determined by which factor? a) The specific barbiturate used b) The client's age and weight c) The dosage administered d) The method of drug metabolism Correct Answer: c) The dosage administered. Rationale: All barbiturates have sedative-hypnotic effects, and their specific action depends on the dosage—lower doses produce sedation, while higher doses induce hypnosis (sleep).

________are the subclass of central nervous system (CNS) depressants that inhibit nerve impulses by acting on the brainstem and gamma-aminobutyric acid (GABA) receptors, resulting in the inhibition of nerve impulses in the cerebral cortex. a. Barbiturates b. Benzodiazepines

Barbiturates

Which of the sedative-hypnotic groups carries the highest risk for dependence and is therefore used less? Barbiturates Benzodiazepines Hypnotics Sedative-hypnotics

Barbiturates Rationale: Barbiturates are used much less than in previous years because of the greater safety and efficacy of benzodiazepines, along with a lower risk for dependence. Hypnotics, sedative-hypnotics, and benzodiazepines are not as likely to cause dependence as barbiturates.

A nurse is educating a patient taking barbiturates about potential drug interactions. The nurse correctly states that combining barbiturates with which of the following can increase central nervous system (CNS) depression? a) Alcohol, antihistamines, benzodiazepines, opioids, and tranquilizers b) Stimulants and decongestants c) Nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen d) Beta-blockers and calcium channel blockers

Correct Answer: a) Alcohol, antihistamines, benzodiazepines, opioids, and tranquilizers. Rationale: Barbiturates enhance CNS depression when taken with alcohol, antihistamines, benzodiazepines, opioids, and tranquilizers, increasing the risk of excessive sedation, respiratory depression, and coma.

4. A patient taking benzodiazepines reports experiencing dizziness and vertigo. The nurse explains that these symptoms are: a) Expected side effects of benzodiazepines b) Signs of an allergic reaction requiring immediate medical attention c) Unrelated to benzodiazepine use d) Indicators of drug toxicity

Correct Answer: a) Expected side effects of benzodiazepines. Rationale: Dizziness and vertigo are common adverse effects of benzodiazepines due to their CNS depressant effects.

A pregnant patient is prescribed a benzodiazepine for anxiety. The nurse should question the order because benzodiazepines: a) Increase the risk of birth defects and neonatal withdrawal symptoms. b) Improve fetal circulation and brain development. c) Are ineffective in reducing anxiety during pregnancy. d) Are safer to use than nonbenzodiazepine alternatives during pregnancy.

Correct Answer: a) Increase the risk of birth defects and neonatal withdrawal symptoms. Rationale: Benzodiazepines are contraindicated in pregnancy due to their association with congenital abnormalities and withdrawal symptoms in newborns.

A nurse is reviewing the indications for benzodiazepines. Which of the following is NOT an approved use? a) Sedation and sleep b) Treatment of anxiety and anxiety-related depression c) Prevention of bacterial infections d) Treatment of acute seizure disorders

Correct Answer: c) Prevention of bacterial infections. Rationale: Benzodiazepines are not antibiotics and do not prevent bacterial infections. Their approved uses include sedation, sleep, anxiety treatment, seizure control, and muscle relaxation.

A nurse is educating a patient about the black box warning for benzodiazepines. Which statement by the patient indicates a need for further teaching? a) "Taking benzodiazepines with opioids could make me extremely drowsy." b) "Mixing benzodiazepines with opioids could slow my breathing and be life-threatening." c) "If I take a low dose of both medications, there is no risk of side effects." d) "I should avoid taking opioids while using benzodiazepines unless directed by my doctor."

Correct Answer: c) "If I take a low dose of both medications, there is no risk of side effects." Rationale: Even at low doses, the combination of benzodiazepines and opioids can cause significant CNS depression, including respiratory depression and coma. Patients should be warned of the serious risks associated with this drug interaction.

A nurse is educating a patient about the different classifications of barbiturates. Which statement by the patient indicates a need for further teaching? a) "Ultrashort-acting barbiturates are used for anesthesia induction." b) "Short-acting barbiturates can be used for sedation and seizure control." c) "Long-acting barbiturates are commonly used as sleeping aids." d) "Phenobarbital can be used to prevent seizures."

Correct Answer: c) "Long-acting barbiturates are commonly used as sleeping aids." Rationale: Long-acting barbiturates, such as phenobarbital, are used for seizure prevention and are no longer commonly used as sedatives or hypnotics due to safer alternatives.

A patient taking barbiturates is being counseled on drug interactions. Which statement by the patient indicates a need for further teaching? a) "I should avoid drinking alcohol while taking this medication." b) "If I take an MAOI, my barbiturate dose may last longer." c) "My blood thinner may become stronger when taken with a barbiturate." d) "I may need an additional form of birth control while taking barbiturates."

Correct Answer: c) "My blood thinner may become stronger when taken with a barbiturate." Rationale: Barbiturates increase the metabolism of anticoagulants, leading to decreased effectiveness, which can increase the risk of clot formation, not stronger anticoagulant effects.

A patient asks the nurse about sedative-hypnotics. The nurse correctly explains that these medications produce which of the following effects? a) Only sedation b) Only sleep induction c) A combination of both sedation and sleep induction d) CNS stimulation

Correct Answer: c) A combination of both sedation and sleep induction. Rationale: Sedative-hypnotics have properties of both sedatives (calming effect) and hypnotics (sleep-inducing effect). The effect depends on the dosage—lower doses typically provide sedation, while higher doses induce sleep.7

Which of the following is a key difference between benzodiazepines and barbiturates? a) Benzodiazepines produce more rapid eye movement (REM) suppression than barbiturates. b) Barbiturates do not act on GABA receptors, while benzodiazepines do. c) Benzodiazepines do not increase the metabolism of other drugs, while barbiturates do. d) Barbiturates only induce relaxation of skeletal muscles, while benzodiazepines do not.

Correct Answer: c) Benzodiazepines do not increase the metabolism of other drugs, while barbiturates do. Rationale: Unlike barbiturates, benzodiazepines do not increase the metabolism of other drugs, making them a safer option with fewer drug interactions.

A nurse is educating a patient about barbiturates. Which of the following statements best explains why they are less commonly used today? a) They are ineffective in producing sedation or hypnosis. b) They have a shorter duration of action compared to benzodiazepines. c) Benzodiazepines provide greater safety and efficacy with a lower risk of dependence. d) They are less effective in inhibiting nerve impulses in the cerebral cortex.

Correct Answer: c) Benzodiazepines provide greater safety and efficacy with a lower risk of dependence. Rationale: Barbiturates are used less frequently today because benzodiazepines offer similar sedative-hypnotic effects with a safer profile and a lower risk of dependence.

Which of the following benzodiazepines is classified as long-acting? a) Midazolam b) Temazepam c) Clonazepam d) Triazolam

Correct Answer: c) Clonazepam. Rationale: Long-acting benzodiazepines include clonazepam, diazepam, and flurazepam, which have prolonged effects and are used for conditions such as seizure prevention and anxiety management.

A patient is prescribed a miscellaneous hypnotic drug. The nurse recognizes which of the following medications falls into this category? a) Triazolam b) Alprazolam c) Eszopiclone d) Clonazepam

Correct Answer: c) Eszopiclone. Rationale: Miscellaneous hypnotic drugs, such as eszopiclone, midazolam, ramelteon, zaleplon, and zolpidem, act similarly to short-acting benzodiazepines but are chemically distinct.

A patient taking benzodiazepines asks the nurse why combining them with opioids is dangerous. The nurse correctly explains that this combination can lead to which of the following effects? a) Increased metabolism of both drugs b) CNS stimulation and increased anxiety c) Extreme sleepiness, respiratory depression, coma, and death d) Increased heart rate and hypertension

Correct Answer: c) Extreme sleepiness, respiratory depression, coma, and death. Rationale: The combination of benzodiazepines and opioids can lead to profound CNS depression, resulting in extreme sedation, difficulty breathing, coma, and even death.

Which of the following are examples of ultrashort-acting barbiturates? a) Pentobarbital and secobarbital b) Phenobarbital and mephobarbital c) Methohexital and thiopental d) Butobarbital and phenobarbital

Correct Answer: c) Methohexital and thiopental. Rationale: Methohexital and thiopental are ultrashort-acting barbiturates used primarily for anesthesia induction and reducing intracranial pressure.

A patient taking barbiturates reports experiencing drowsiness and dizziness. The nurse understands that these symptoms are associated with which of the following effects? a) Central nervous system (CNS) stimulation b) Paradoxical reaction c) Normal adverse effects of barbiturates d) Increased metabolism of the drug

Correct Answer: c) Normal adverse effects of barbiturates. Rationale: Barbiturates commonly cause drowsiness, lethargy, dizziness, and a "hangover" effect due to CNS depression.

A nurse is teaching a patient about the risks of combining benzodiazepines with other medications. Which of the following drug classes has a significant interaction with benzodiazepines? a) Antihypertensives b) Antidepressants c) Opioids d) Antacids

Correct Answer: c) Opioids. Rationale: Benzodiazepines have significant drug-drug interactions with opioids due to their combined CNS depressant effects, which can result in extreme sleepiness, respiratory depression, coma, and death.