Ch. 34 - Sedative-Hypnotic Drugs

How do benzodiazepines help in withdrawal from alcohol? a. They increase the incidence of vomiting when a person takes a drink. b. They suppress symptoms brought on by alcohol abstinence. c. They block alcohol receptors in the brain. d. They decrease the desire for alcohol.

They suppress symptoms brought on by alcohol abstinence

The healthcare provider ordered lorazepam [Ativan] 0.5 mg IV every 6 hours for anxiety. The medication available is lorazepam [Ativan] 2 mg/mL. How many mL will the nurse administer? a. 0.25 b. 0.5 c. 1 d. 4

0.25

Zolpidem 10 mg as needed at hs is prescribed. Available are 5 mg immedite release tablets. How many tablets would be administered in one dose? ________ tablets

2

A patient has been taking alprazolam (Xanax) for panic disorder. The primary health care provider discontinues the medication. For how long does the nurse expect to monitor this patient for a recurrence of the original symptoms? a. 3 days b. 1 week c. 2 weeks d. 3 weeks

3 weeks

What type of meal should be avoided by a person taking zaleplon (Sonata) as a sleep aid? a. A high-fat diet b. A high-CHO diet c. A high-protein diet d. A low glycemic diet

A high-fat diet

What substance should the nurse advise patients to avoid when taking benzodiazepines? a. Coffee b. Alcohol c. Tea d. Milk

Alcohol

A patient taking benzodiazepines calls the office to report experiencing lethargy and confusion. What is the nurse's best response? a. You need to take syrup of ipecac to induce vomiting b. The symptoms you are experiencing are normal and will decrease over time c. Did you take more than your regular dose, or are you taking something with the prescribed medication d. The symptoms you are experiencing are related to your dosage being too low; you need to increase the amount of medication you are taking

Did you take more than your regular dose, or are you taking something with the prescribed medication

A patient is taking a benzodiazepine for anxiety disorder and tells her nurse that she wants to have a baby. What is the nurse's best response to her concern? a. You can take the medication only after the first trimester of pregnancy. b. you can continue to take your benzodiazepine because it will not affect the pregnancy. c. Decrease the amount of medication you are taking because this can affect the baby at high doses d. Discontinue the medication because it can increase the risk of congenital malformations

Discontinue the medication because it can increase the risk of congenital malformations

What might the nurse expect to give to a person experiencing toxicity from an intravenous dose of benzodiazepines? a. Naloxone b. Flumazenil c. Morphine d. Codeine

Flumazenil

The nurse in the emergency department is caring for a patient with a suspected overdose of diazepam [Valium]. Which agent is most likely to be administered to reverse the effects of diazepam? a. Naloxone [Narcan] b. Flumazenil [Romazicon] c. Acetylcysteine [Mucomyst] d. Vitamin K

Flumazenil [Romazicon]

Alprazolam [Xanax] is prescribed for an adult with panic attacks. The nurse recognizes that this drug exerts its therapeutic effect by interacting with which neurotransmitter? a. Norepinephrine b. Acetylcholine c. Serotonin (5-HT) d. Gamma-aminobutyric acid (GABA)

Gamma-aminobutyric acid (GABA)

The nurse recognizes which symptom as an adverse effect of benzodiazepines? a. long-term memory loss b. Short-term memory loss c. Inability to remember events before taking the medication d. Inability to remember events after taking the medication

Inability to remember events after taking the medication

The nurse is caring for a patient with a seizure disorder who takes phenobarbital at bedtime each night to control seizures. Which symptom, if present, would most likely indicate an adverse effect of this drug? a. Morning sedation b. A respiratory rate of 30 breaths per minute c. Constipation d. A blood pressure of 160/88 mm Hg

Morning sedation

The nurse is caring for a group of patients who have been prescribed sedative-hypnotic agents. Which agent has the greatest abuse potential? a. Diazepam [Valium] b. Triazolam [Halcion] c. Zolpidem [Ambien] d. Phenobarbital [Luminal Sodium]

Phenobarbital [Luminal Sodium]

A patient is taking eszopiclone (Lunesta) and reports experiencing dry mouth after use of the medication. What is the nurse's best response? a. This is a common adverse effect of the medication b. This is a major adverse reaction. Discontinue the medication immediately. c. This is because you are not drinking enough fluid when taking the medication d. Take the medication with food to decrease the incidence of dry mouth

This is a common adverse effect of the medication

The nurse is teaching a patient with a new prescription for alprazolam [Xanax]. Which statement is the most appropriate to include in the teaching plan? a. "When it is time to discontinue this drug, you will need to taper it off slowly." b. "Protect your skin from the sun to prevent rash and exaggerated sunburn." c. "Increase your intake of fluid and high-fiber foods to prevent constipation." d. "Take this medication on an empty stomach at least 2 hours after meals."

When it is time to discontinue this drug, you will need to taper it off slowly

Which agent is most likely to be prescribed today for short-term management of insomnia? a. Secobarbital [Seconal Sodium] b. Meprobamate [Miltown] c. Zolpidem [Ambien] d. Flumazenil [Romazicon]

Zolpidem [Ambien]

What symptoms of physical dependence might the nurse find in a patient being withdrawn from long-term, high-dose therapy of benzodiazepines? (Select all that apply.) a. Panic episodes b. Delirium c. Hypotension d. Convulsions e. Myocardial infarction

a, b, d

When comparing benzodiazepines to barbiturates, the nurse identifies which statements about benzodiazepines as true? (Select all that apply.) a. Benzodiazepines have a high safety profile. b. Benzodiazepines have a significant ability to depress central nervous system (CNS) function. c. Benzodiazepines are associated with a high suicide potential. d. Benzodiazepines have a low ability to cause tolerance. e. Benzodiazepines have a low abuse potential.

a, d, e

A patient asks for a sleeping pill at 2200. She states that she can fall asleep but awakens during the night and has difficulty getting back to sleep. The medication administration record (MAR) lists triazolam (Halcion) at 0.125 mg at hour of sleep (hs) as needed. What should the nurse do? a. administer the triazolam b. administer the triazolam and communicate the need to assess for effectiveness during shift report c. contact the prescriber and discuss the need for a slower onset hypnotic d. hold the triazolam because it is not effective in this situation

administer the triazolam and communicate the need to assess for effectiveness during shift report

the nurse is caring for a hospitalized patient who states that he has difficulty falling asleep when away from home. Which intervention should the nurse employ first? a. assess for a possible reason for insomnia b. discuss the benefits of melatonin for insomnia c. medicate with prescribed as-needed zolpidem (Ambien) d. offer a backrub

assess for a possible reason for insomnia

a patient falls asleep without difficulty but frequently awakens during the night. The nurse would consult the prescriber if which drug was prescribed for sleep? (Select all that apply) a. Eszopiclone (Lunesta) b. Ramelton (Rozerem) c. Temazepam (Restoril) d. Zaleplon (Sonata) e. Zolpidem (Ambien CR)

b, c, d

patients with depression sometimes experience insomnia. The nurse recognizes that in addition to being a symptom of the disorder, insomnia is an adverse effect of some antidepressants. Which antidepressants are effective in treating depression associated insomnia? (select all that apply) a. Bupropion (Wellbutrin) b. Doxepin (Silenor) c. Fluoxetine (Prozac) d. Fluvoxamine (Luvox) e. Trazodone (Desyrel)

b, e

which statement(s) are true regarding use of melatonin for insomnia? (select all that apply) a. research suggests melatonin is effective but may cause difficulty awakening b. melatonin is a dietary supplement and is not closely regulated c. melatonin relieved insomnia in a blinded study of insomniacs d. studies have shown that melatonin is effective in preventing jet lag e. there is no guarantee that the product contains the amount of melatonin as listed on the label

b, e

the nurse should assess for which symptoms in a patient with a suspected barbiturate overdose? a. apnea and hyperthermia b. bradypnea and constricted pupils c. hypertension and hypothermia d. hypotension and dilated pupils

bradypnea and constricted pupils

Which statements about zaleplon [Sonata] does the nurse identify as true? (Select all that apply.) a. Zaleplon [Sonata] is a benzodiazepine. b. Zaleplon [Sonata] is indicated for long-term management of insomnia. c. Zaleplon [Sonata] is used to maintain sleep throughout the night. d. Zaleplon [Sonata] should not be administered with cimetidine [Tagamet]. e. Zaleplon [Sonata] interacts with the neurotransmitter GABA.

d, e

what does the lipid-solubility of benzodiazepines do? (select all that apply) a. causes induction of hepatic metabolizing enzymes b. decreases the risk that the drug will cause genital defects c. extends plasma half-life d. increases absorption e. improves distribution to the CNS

d, e

a child who received a severe head injury is in a barbiturate-induced coma. The child's parents ask the nurse why he is being kept unconscious. They want the drug to be stopped so they can see if he will respond. The best explanation is that this therapy a. decreases the brain's need for oxygen and glucose b. produces amnesia so the child will not remember the accident c. relaxes skeletal muscle so the patient is not uncomfortable d. stabilizes the patient's blood pressure and pulse

decreases the brain's need for oxygen and glucose

when caring in the morning for a patient who has received zolpidem (Ambien) for sleep the night before, the nurse would monitor for symptoms of which common adverse effect? a. dizziness b. hypertension c. sweating d. tremors

dizziness

Benzodiazepine-like can cause significant rebound insomnia if suddenly discontinued a. true b. false

false

Benzodiazepine-like drugs are used to prevent seizures a. true b. false

false

Benzodiazepine-like drugs produce moderate muscle relaxation a. true b. false

false

Benzodiazepine-like reduce REM sleep a. true b. false

false

An older adult patient occasionally uses diphenhydramine (Sominex) for insomnia. What should the nurse include in patient education to prevent a very common adverse effect? a. increase fiber in the diet b. limit fluid intake c. eat a low-fat diet d. take the medication with food

increase fiber in the diet

The nurse in the emergency department administers progressive doses of flumazenil (Romazicon) to a patient who has overdosed on a benzodiazepine and alcohol. What is the nursing priority in this situation? a. ensuring adequate fluids b. monitoring breathing c. reducing anxiety d. monitoring renal function

monitoring breathing

barbiturates are contraindicated for a patient with porphyria. What do symptoms of porphyria include? a. confusion, disorientation, and weakness b. hypotension, bradycardia, and bradypnea c. nausea, abdominal colic, and behavioral and neuromuscular disturbances d. restlessness, insomnia, and hyperthermia

nausea, abdominal colic, and behavioral and neuromuscular disturbances

tolerance to barbiturates does not produce cross tolerance to which substance? a. alcohol b. benzodiazepines c. general anesthetics d. opiates

opiates

what is the nursing priority when administering a long-acting benzodiazepine as prescribed? a. gastric distress b. potential for abuse c. respiratory depression d. safety

potential for abuse

what does the nurse know about most benzodiazepines? a. they are absorbed from the GI tract very slowly b. they direct GABA agonists c. they prolong prodrugs d. they are short-acting

they prolong prodrugs

Benzodiazepine-like drugs are metabolized into an inactive compound a. true b. false

true

Benzodiazepine-like drugs can intensify the effects of alcohol a. true b. false

true

Benzodiazepine-like drugs prolong periods of uninterrupted sleep a. true b. false

true

Benzodiazepine-like drugs promote falling asleep a. true b. false

true

Benzodiazepine-like have a rapid onset a. true b. false

true

Benzodiazepine-like require reduced doses for people with liver impairment a. true b. false

true

The lowest prescribed dose of doxepin (Sinequan) for depression is approximately how many times greater than the highest dose of doxepin (Silenor) prescribed for insomnia? a. two b. three c. twelve d. twenty

twelve

A nursing priority for a patient during immediate care after overdose on a barbiturate is to monitor what? a. bowel sounds b. deep tendon reflexes c. peripheral pulses d. urine output

urine output

The nurse is caring for a patient with insomnia. The patient asks if there are medications for sleep that are not controlled substances. Which statement by the nurse is correct? a. "Yes, there is a medication that works with your body's melatonin and is not a controlled substance." b. "No, all of the sleep medications are controlled substances." c. "There are some over-the-counter medications, and you can take those without discussing them with your healthcare provider." d. "Yes, but it is not for chronic insomnia."

yes, there is a medication that works with your body's melatonin and is not a controlled substance