Ch 54

Supplementation of which hormones has been used in the treatment of insomnia due to jet lag? a. Estrogen b. Melatonin c. Testosterone d. Progestin

Melatonin

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

respiratory depression

The nurse is caring for a client who experiences anxiety and insomnia and is prescribed lorazepam. When developing the plan of care, what would be an appropriate nursing conclusion related to potential adverse effects of the drug? a. fear related to rebound effects following therapy b. chronic confusion related to decreased arousal c. risk for injury related to central nervous system (CNS) effects d. ineffective tissue perfusion related to vasoconstriction

risk for injury related to central nervous system (CNS) effects

A nurse emphasizes the need to avoid caffeine and caffeinated beverages with a client undergoing treatment for insomnia based on which known caffeine effect? a. Restlessness b. Delirium c. Wakefulness d. Depression

Wakefulness

A client has received a benzodiazepine for sedation before a diagnostic procedure. Which agent would the nurse expect the client to receive to reverse the sedative effects? a. Temazepam b. Flumazenil c. Triazolam d. Promethazine

Flumazenil

A client is prescribed flurazepam. When explaining the drug to the client, the nurse would include which actions as its effect? a. Decreased stress b. Induction of sleep c. Improvement in circulation d. Easing of pain

Induction of sleep

A client is prescribed flurazepam. When explaining the drug to the client, the nurse would include which actions as its effect? a. Induction of sleep b. Decreased stress c. Improvement in circulation d. Easing of pain

Induction of sleep

What medication is thought to play a role in maintenance of the circadian rhythm? a. Sonata b. Rozerem c. Kava d. Ambien

Rozerem

A client is prescribed an anxiolytic agent. What would be most important for the nurse to include in the teaching? a. "Try other measures to help you relax, too." b. "Be sure not to stop the drug abruptly." c. "Increase the amount of fiber in your diet." d. "Take the drug with meals if necessary."

"Be sure not to stop the drug abruptly."

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? a. "I will likely experience hyperactivity when taking this medication." b. "I may be a little drowsy at first when I start taking this medication." c. "I may suffer from a mild rash when taking this medication." d. "Occasional seizures may occur when starting this new medication."

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

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? a. Place the call light within reach b. Dim the lights c. Having the client walk to the bathroom d. Raise the side rails

Having the client walk to the bathroom

A 70-year-old male client asks why he is receiving a lower dose of zaleplon than his son. As part of the nurse's teaching plan, which explanation will the nurse give this client? a. "Older adults metabolize the drug at the same speed as younger adults; I will check the dosage with your health care provider." b. "Older adults metabolize the drug more quickly, but due to renal dysfunction, the medication must be reduced." c. "Older adults do not need as much of the medication for the desired effect as a younger adult does." d. "Older adults metabolize the drug more slowly, and half-lives are longer than in younger adults."

"Older adults metabolize the drug more slowly, and half-lives are longer than in younger adults."

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

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

A nurse is caring for a client who is receiving alprazolam. The nurse would be alert for which symptom as an initial adverse reaction with this drug? a. Headache b. Heartburn c. Anxiety d. Anorexia

Headache

A client who is prescribed a hypnotic asks the nurse, "About how long will I be taking this medication?" Which time frame would the nurse most likely include in the response? a. 2 weeks b. 8 weeks c. 6 weeks d. 4 weeks

2 weeks

A male client is prescribed zaleplon for short-term treatment of his insomnia. He states that it only works once in a while. Upon review of his evening habits, the nurse discovers he is engaging in which behavior that may interfere with the absorption of his prescription? a. A late, heavy meal before bedtime b. Fasting before bedtime c. Exercise before bedtime d. Doing paperwork before bedtime

A late, heavy meal before bedtime

A 35-year-old female client is recently divorced and having difficulty coping. She visits her health care provider, and he diagnoses her with situational anxiety. She is fearful that the anxiety she feels will become chronic. The nurse gives the client what information concerning situational anxiety? a. A feeling that will go away on its own b. A method of coping with the divorce c. A normal response to a stressful situation d. An abnormal response to a stressful situation

A normal response to a stressful situation

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

Falls

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

Abnormal anxiety is prolonged and impairs normal function.

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? a. Sedative toxicity b. Antihypertensive toxicity c. Benzodiazepine toxicity d. Analgesic toxicity

Benzodiazepine toxicity

A nurse obtains a health history from a client who has been prescribed temazepam. Which finding would require immediate follow-up by the nurse? a. Client has history of one spontaneous miscarriage. b. Client has a history of bladder infection in the last year. c. Client recently quit drinking one alcoholic beverage per day. d. Client is diagnosed with hepatitis C.

Client is diagnosed with hepatitis C.

An older adult client is prescribed a sedative for the treatment of insomnia. The nurse would suspect that the client is experiencing an adverse reaction to the drug based on assessment of which of the following? a. Stress b. Headache c. Confusion d. Anxiety

Confusion

The nurse works on a busy floor giving multiple sedatives and hypnotics. What priority concern should the nurse carefully assess for when administering a sedative or hypnotic? a. Depressed respiratory function b. Confusion c. Decreased peristalsis d. Ataxia

Depressed respiratory function

A group of nursing students answers correctly if they identify which medication as the prototype benzodiazepine? a. Lorazepam b. Diazepam c. Clonazepam d. Alprazolam

Diazepam

Ms. Buller is a 28-year-old patient who has been admitted to the hospital for abdominal pain. She puts on her call light because she is having difficulty breathing, palpitations, and increasing sweating. As the nurse caring for Ms. Buller, you complete a physical assessment, and you note her blood pressure, pulse, and respirations are elevated. You inquire about her symptoms; she states that she is afraid to be in the hospital because something bad will happen to her. What is Ms. Buller most likely suffering from? a. Panic attack b. Insomnia c. Impaired coping d. General anxiety disorder

Panic attack

After reviewing the various drugs that are classified as barbiturates, a student demonstrates understanding when identifying which as the prototype? a. Pentobarbital b. Phenobarbital c. Amobarbital d. Secobarbital

Phenobarbital

A client admitted for insomnia related to stress is prescribed a sedative. Which actions would the nurse include in the plan of care to promote the effectiveness of the drug? a. Encourage plenty of fluids. b. Offer fiber-rich food. c. Provide back rubs. d. Give the client coffee or tea.

Provide back rubs.

A nurse is preparing to administer buspirone to a client with anxiety. The nurse should question this order if which disorder is noted in the client's past history? a. Cataract b. Psychoses c. Diabetic retinopathy d. Acute gout

Psychoses

A nurse determines the possibility of benzodiazepine toxicity based on assessment of which adverse effect? a. Respiratory depression b. Abdominal pain c. Severe headache d. Muscle pain

Respiratory depression

A nurse is preparing to call a prescriber about a client who would like to sleep through the night. The nurse is clarifying with the client the need of a medication to fall asleep, which would be hypnotic, or a medication to relax them like a sedative. What are the differences between sedatives and hypnotics? Select all that apply. a. Sedative drugs assist with sleeping. b. Hypnotic drugs induce drowsiness or sleep. c. Hypnotic drugs are given prior to surgery to aid in the relaxation of the client. d. Hypnotic drugs are usually given during daytime hours. e. Sedative drugs aid in the healing process by assistance with sleep.

Sedative drugs assist with sleeping. Hypnotic drugs induce drowsiness or sleep. Sedative drugs aid in the healing process by assistance with sleep.

A client reports taking kava for stress relief. What should the nurse teach the client about the supplement? a. Research supports that herbal supplements are generally safer to use than drugs. b. The Food and Drug Administration (FDA) warns that kava may cause severe liver toxicity. c. Its effectiveness hasn't been confirmed, but it has few adverse effects. d. Kava use can cause increasing hyperactivity, excessive talking, and nervousness.

The Food and Drug Administration (FDA) warns that kava may cause severe liver toxicity.

While reviewing a client record, the nurse sees that the client has a history of chronic insomnia. What assumption can the nurse have regarding the client? a. The client has periods of alternating deep and light sleep. b. The client is experiencing an underlying serious illness. c. The client has been experiencing dysfunctional sleep for more than 1 month. d. The client needs pharmacological assistance to go to sleep.

The client has been experiencing dysfunctional sleep for more than 1 month.

The nurse administers promethazine to the client before sending the client to the preoperative holding area. What outcome demonstrates therapeutic effects? a. The client is conscious but drowsy. b. The client is asleep. c. The client's blood pressure is below 130/80 mm Hg. d. The client is unresponsive to verbal and physical stimuli.

The client is conscious but drowsy.

The client reports using an over-the-counter (OTC) drug to treat insomnia. What classification of OTC medications is often used for this purpose? a. salicylates b. antihistamines c. nonsteroidal anti-inflammatory drugs d. antitussives

antihistamines