Ch 20 antianxiety

A client who has claustrophobia is scheduled for an magnetic resonance imaging (MRI) for the investigation of an abdominal mass. The nurse should anticipate what pre-medication order? Eszopiclone 1 mg PO Ramelteon 8 mg PO Suvorexant 10 mg PO Lorazepam 2 mg PO

Lorazepam 2 mg PO

A client who has taken diazepam for several months has developed physical dependence. The nurse has set up a schedule to taper drug doses to avoid a withdrawal syndrome. Which symptom would indicate that a withdrawal syndrome has occurred? Select all that apply. Constipation Dry skin Headache Increased anxiety Tremor

tremor increased anxiety headache

The home care nurse is following up with a client discharged from the hospital with a prescription for diazepam. On the initial visit what is the nurse's priority related to this medication? teaching about herbal therapies that may be a safe and effective alternative ensuring the client knows how to contact the provider if needed the importance of taking medications for insomnia only occasionally warning signs that may indicate serious adverse effects

warning signs that may indicate serious adverse effects

Diazepam (Valium) is prescribed for a client. What are some possible adverse effects of diazepam? Select all that apply. Sedation Hypothyroidism Restlessness Increased salivation Disorientation

Sedation Restlessness Disorientation

The nurse should include which instruction about antianxiety medications and drug interactions in the teaching plan? "Avoid driving or operating heavy machinery when taking tricyclic antidepressants and starting antianxiety drugs." "Consult your healthcare provider about increasing the dose of digoxin while taking antianxiety drugs." "One to three alcoholic beverages a day may help you feel more relaxed while taking antianxiety drugs." "If taking pain medications, you may need to increase the doses for effective pain relief while taking antianxiety medications."

"Avoid driving or operating heavy machinery when taking tricyclic antidepressants and starting antianxiety drugs."

The healthcare provider has prescribed alprazolam (Xanax) for a client. After the nurse has taught the client about this medication. The nurse confirms that the client understands the drug's action when the client makes which statement? "I may suffer from a mild rash when taking this medication." "I will likely experience hyperactivity when taking this medication." "Occasional seizures may occur when starting this new medication." "I may be a little drowsy at first when I start taking this medication."

"I may be a little drowsy at first when I start taking this medication."

A client is taking a benzodiazepine. The nurse evaluates teaching as effective when the client makes which statement? "I can only take the medication with meals." "I should not stop this drug without talking to my health care provider first." "I should not take aspirin with this medication." "I should avoid grapefruit juice for the duration of treatment."

"I should not stop this drug without talking to my health care provider first."

The nurse is caring for a client who has been prescribed oxazepam. What statement by the client would suggest an increased risk of CNS depression to the nurse? "I take an over-the-counter antihistamine each day for my allergies." "If I get constipated, I sometimes take a stool softener for a couple of days." "I'm also taking baby Aspirin each day for my heart." "I'm almost finished my course of antibiotics for this sinus infection."

"I take an over-the-counter antihistamine each day for my allergies."

The nurse is caring for a client who has been prescribed oxazepam. What statement by the client would suggest an increased risk of CNS depression to the nurse? "If I get constipated, I sometimes take a stool softener for a couple of days." "I'm also taking baby Aspirin each day for my heart." "I take an over-the-counter antihistamine each day for my allergies." "I'm almost finished my course of antibiotics for this sinus infection."

"I take an over-the-counter antihistamine each day for my allergies."

A client has been prescribed alprazolam 0.5 mg PO t.i.d. for the treatment of anxiety. What statement by the client demonstrates an accurate understanding of the drug regimen? "I will make sure not to stop the drug abruptly." "I must take the drug on an empty stomach." "I should temporarily decrease the amount of fiber in my diet." "I can take an OTC antihistamine if I'm still feeling anxious."

"I will make sure not to stop the drug abruptly."

A client's medication regimen for treatment of anxiety has been changed from a benzodiazepine to buspirone (BuSpar). The client asks the nurse what makes this medication safer than the benzodiazepine the client has taken. What is the nurse's best response? "It will not produce sedation like benzodiazepines." "It produces anticonvulsant action to prevent convulsions." "It produces muscle relaxant effects to decrease back pain." "It provides you with a sleep additive to decrease insomnia."

"It will not produce sedation like benzodiazepines."

A client's medication regimen for treatment of anxiety has been changed from a benzodiazepine. The client asks the nurse what likely prompted the health care provider to change the medication. What is the nurse's best response? "Your provider may have been concerned about causing depression." "Your provider may have been worried about the possibility of convulsions." "Long-term use of benzodiazepines can result in dependency." "Long-term use of benzodiazepines can cause insomnia."

"Long-term use of benzodiazepines can result in dependency."

The health care provider has ordered for a client eszopiclone 1 mg PO daily as needed. What education should the nurse provide to the client beginning this medication? "If you're still feeling anxious after taking the drug for the first week, tell your provider." "Some clients experience drowsiness after taking this medication, so avoid driving." "Make sure that you go to bed immediately or very shortly after taking the pill." "Ensure that you don't take this medication more than three nights consecutively."

"Make sure that you go to bed immediately or very shortly after taking the pill."

The health care provider has ordered for a client eszopiclone 1 mg PO daily as needed. What education should the nurse provide to the client beginning this medication? "Make sure that you go to bed immediately or very shortly after taking the pill." "If you're still feeling anxious after taking the drug for the first week, tell your provider." "Some clients experience drowsiness after taking this medication, so avoid driving." "Ensure that you don't take this medication more than three nights consecutively."

"Make sure that you go to bed immediately or very shortly after taking the pill."

A hospitalized client asks the nurse why the health care provider prescribed an anxiolytic medication. What is the nurse's best response? "An anxiolytic, such as alprazolam, is usually prescribed for long-term anxiety disorders." "This type of medication is typically prescribed to treat excess anxiety that interferes with daily activities." "Anxiolytics are prescribed to treat anxiety and can be purchased without a prescription after discharge." "Anxiolytic drugs are different from antianxiety drugs, because they work without a tranquilizing effect."

"This type of medication is typically prescribed to treat excess anxiety that interferes with daily activities."

What assessment question would be most appropriate when providing care for a client newly prescribed chlordiazepoxide? "What is motivating you to stop drinking alcohol?" "How has your alcohol use affected your quality of life?" "How much alcohol have you ingested in the last 8 hours?" "When did you have your last drink of alcohol?"

"When did you have your last drink of alcohol?"

How should the nurse explain the major difference between normal and abnormal anxiety? Abnormal anxiety is generally unresponsive to treatment. Abnormal anxiety is prolonged and impairs normal function. Abnormal anxiety is a brief response to situational stress. Normal anxiety often triggers reports of insomnia.

Abnormal anxiety is prolonged and impairs normal function.

A client informs the nurse that he plans on discontinuing the prescribed lorazepam (Ativan) he has been taking for the past four months. What is the nurse's best action in response to this client's statement? Document the client's plan to discontinue the drug in the client's medical record. Instruct the client to take the remaining medication in the prescription bottle, then discontinue the drug. Advise the client to contact his healthcare provider about tapering off the medication. Warn the client to watch for withdrawal symptoms six to eight weeks after discontinuing the drug.

Advise the client to contact his healthcare provider about tapering off the medication.

A nurse is caring for a client who is receiving flumazenil to combat benzodiazepine toxicity. Which adverse effect can be caused by flumazenil? Cerebral hemorrhage and dystonia Hypertension and renal insufficiency Agitation, confusion, and seizures Hypotension, arrhythmias, and cardiac arrest

Agitation, confusion, and seizures

The nurse is caring for an older adult in the long-term care facility who has begun to display signs of anxiety and insomnia. What is the priority nursing action? Assess the client for physical problems. Call the provider and request an antianxiety drug order. Increase the client's social time, encouraging interaction with others. Suggest the family visit more often to reduce the resident's stress level.

Assess the client for physical problems.

A client presents at the emergency department with respiratory depression and excessive sedation. The family tells the nurse that the client has been taking medication throughout the evening. What would the nurse suspect? Hypnotic overdose Sedative overdose Anti-anxiety overdose Benzodiazepine overdose

Benzodiazepine overdose

A 75-year-old client is brought to the emergency department by the family. The family relates that the client has confusion, seizures, and abnormal perception of movement. When the nurse looks at the medication that the family has brought to the ED, the nurse discovers that twice the number of tablets are missing from the vial as there should be if the prescription orders were being followed. What should the nurse suspect is wrong with this client? Benzodiazepine toxicity Antihypertensive toxicity Sedative toxicity Analgesic toxicity

Benzodiazepine toxicity

The nurse is doing a physical assessment on admission of a client diagnosed with elevated blood pressure due to anxiety. What are the most important physical assessments for a nurse to perform? Select all that apply. Blood pressure Bowel sounds Respiratory rate Skin temperature and color Hair texture

Blood pressure Respiratory rate Skin temperature and color

Which drug used to treat anxiety would be appropriate for a client who is a school teacher and is concerned about feeling sedated at work? Alprazolam Buspirone Diazepam Lorazepam

Buspirone

Many anti-anxiety drugs pose risks for abuse and physical dependence. The nurse knows that which of the following drugs has the least risk for physical dependence? Chlordiazepoxide (Librium) Buspirone (BuSpar) Lorazepam (Ativan) Clorazepate (Tranxene)

Buspirone (BuSpar)

A 25-year-old client is being prescribed buspirone (BuSpar) for a general anxiety disorder. The client asks why she cannot take Ativan, which was prescribed to her last year for this disorder. What statement would provide the best explanation to the client? Ativan is used only for short-term treatment of anxiety. Buspirone has been shown not to cause withdrawal when the medication is stopped. Buspirone will be more effective than Ativan at treating the symptoms of anxiety. Buspirone will start to relieve the symptoms of anxiety after the first dose.

Buspirone has been shown not to cause withdrawal when the medication is stopped.

The nurse and the client are discussing various drugs for management of anxiety. The client asks, "How do these drugs work?" The nurse knows that interaction with the central nervous system neurotransmitter gamma-aminobutyric acid (GABA) is the mechanism of which drug? Diazepam (Valium) Doxepin (Sinequan) Hydroxyzine (Vistaril) Meprobamate (Equanil, Miltown)

Diazepam (Valium)

The nurse is teaching the client about preventing constipation while on alprazolam (Xanax). What is the nurse's best response? Decrease water intake. Increase the intake of citrus fruit juices. Eliminate daily jogging routine. Eat high-fiber foods.

Eat high-fiber foods.

A nurse is caring for a client with complaints of constipation after the administration of antianxiety drugs. Which would be appropriate for the nurse to include in the client's plan of care? Select all that apply. Offer meals rich in fiber Suggest use of antacid Reduce the dosage Encourage increased fluid intake Increase the intake of fruits

Encourage increased fluid intake Increase the intake of fruits Offer meals rich in fiber

The nurse administers an anxiolytic to the client. The nurse recognizes the family needs further teaching on the effects of the medication when the family initiates what action? Raises the side rails and puts the bed in the low position Places the call light within reach and instructs the client to call if they need anything Encourages the client to walk to the bathroom independently Dims the lights, pulls the curtains closed, and turns the volume down on the TV

Encourages the client to walk to the bathroom independently

The nurse is caring for a client suspected of experiencing benzodiazepine toxicity. Which medication does the nurse expect the health care provider to prescribe? Olmesartan medoxomil Pancrelipase Pamidronate disodium Flumazenil

Flumazenil

Benzodiazepines can cause severe respiratory depression but is not common. When it does the nurse knows that this reaction can be reversed by which specific benzodiazepine antagonist? Hydroxyzine (Vistaril) Doxepin (Sinequan) Flumazenil (Romazicon) Lorazepam (Ativan)

Flumazenil (Romazicon)

Which action by the new nurse would alert the charge nurse that more education is needed for the new nurse, after administering an anxiolytic to a client? Having the client walk to the bathroom Raise the side rails Place the call light within reach Dim the lights

Having the client walk to the bathroom

The etiology of anxiety involves which physiologic process? Stimulation of the parasympathetic nervous system Stimulating effects of somatotropin Increased activation of the autonomic nervous system Adrenocortical suppression

Increased activation of the autonomic nervous system

The nurse is reviewing the medication chart of an 82-year-old man who has recently moved to a long-term care facility. The record reveals that the man takes 1 to 2 mg of lorazepam bid prn. The nurse should recognize what consequence of this resident's drug regimen? Cold intolerance Increased risk for falls Risk for paradoxical aggression Anorexia

Increased risk for falls

A client with a known seizure disorder is admitted to the intensive care unit with a diagnosis of septic shock. The client is being sedated with midazolam (Versed). Following discontinuation of the medication, the client remains sedated for several days. Based on the client's history, what is the rationale for not treating with flumazenil (Romazicon)? Increased risk of hypertension Increased risk of seizures Decreased sedation will result Decreased level of agitation

Increased risk of seizures

A client asks a nurse about herbal remedies that can be used to help with anxiety and stress. Which would the nurse include in the response? Ginger Kava Black cohosh Feverfew

Kava

Which of the following herbal products is thought to treat anxiety, relieve stress and promote sleep? (Choose one) Ginger Black cohosh Kava Fever few

Kava

A client is prescribed hydroxyzine. The nurse would be alert for the development of which effect early on? Inflamed mucous membranes Abdominal cramping Mild drowsiness Inflammation of the mouth

Mild drowsiness

Diazepam (Valium) is prescribed for a patient. The nurse knows that contraindications to administration of benzodiazepines such as diazepam include which of the following? Select all that apply. Narrow-angle glaucoma Pregnancy Lactation Acute alcohol withdrawal Hypertension

Narrow-angle glaucoma Pregnancy Lactation

Three days after discontinuing diazepam with medical guidance, an older adult continues to demonstrate impaired memory and confusion. The nurse should consider what possible explanation for the client's current status? Benzodiazepines can occasionally cause permanent alterations in personality and level of consciousness. The client may have decreased liver function. The client may have been experiencing a hypersensitivity to the drug, rather than an adverse effect. The adverse effects of benzodiazepines can persist for several days after stopping the drug.

The adverse effects of benzodiazepines can persist for several days after stopping the drug.

Which client should the nurse expect to receive a lower-than-usual dose of benzodiazepines? a client whose anxiety is due to pain caused by gallstones a client with alcoholic liver disease a client who has irritable bowel syndrome a client who is 6 months post-gastrectomy

a client with alcoholic liver disease

A truck driver has been diagnosed with a generalized anxiety disorder (GAD) and lorazepam has been prescribed. The client asked the nurse how this medication will affect his job. The nurse would advise him how? avoid driving until he is aware of the adverse effects. change his profession, because the drug has long-term effects after cessation of therapy. avoid driving at night, because lorazepam affects the wake-sleep cycle and can lead to drowsiness. drive only 2 hours after consuming the drug and stop when it's time for the subsequent dose.

avoid driving until he is aware of the adverse effects.

After teaching a group of nursing students about antianxiety drugs, the instructor determines that the teaching was successful when the students identify which as an example of a nonbenzodiazepine? Select all that apply. buspirone doxepin diazepam hydroxyzine lorazepam

buspirone doxepin hydroxyzine

In addition to relieving agitation and anxiety, what is a rationale for using benzodiazepines in the treatment of a critically ill client? Increased diffusion and perfusion Decreased cardiac workload Increased level of consciousness Decreased blood pH

decreased cardiac worklaod

The nurse is providing health education for a client who has been prescribed a benzodiazepine. What adverse effect should the nurse discuss in the teaching? dependence suicide personality changes persistent insomnia TAKE ANOTHER QUIZ

dependence

Clients taking benzodiazepines, especially older adult clients, are at high risk for which effect? Constipation Heart failure Hepatic failure Falls

falls

A client is taking diazepam (Valium) and asks how the drug works. The nurse knows that the mechanism of action of diazepam is augmentation of: gamma-aminobutyric acid (GABA) neurotransmission. serotonin (5HT) neurotransmission. dopamine (DA) neurotransmission. acetylcholine (Ach) neurotransmission.

gamma-aminobutyric acid (GABA) neurotransmission.

A review of a client's history reveals that the client uses kava for stress relief. When teaching the client about this herb, the nurse would include a discussion about which as a serious consequence associated with its use? Liver failure Kidney failure Heart failure Stroke

liver failure

After teaching a class on antianxiety drugs, the instructor determines that the teaching was successful when the class identifies which as a controlled substance by DEA regulations? Lorazepam Buspirone Doxepin Hydroxyzineloraepa

lorazepam

A nurse is administering a prescribed dose of chlordiazepoxide to a client. The nurse should closely assess the client for what adverse reaction? idiopathic thrombocytopenic purpura (ITP) respiratory depression esophageal bleeding urinary retention

respiratory depression