Pharm ch20
The nurse administers promethazine (Phenergan) to the patient before sending the patient to the preoperative holding area. What is the rationale for administration of this drug? A) Sedation B) Oral secretions C) Hypotension and bradycardia D) Confusion
A
The nurse is caring for a newborn who was delivered from a woman who took benzodiazepines for anxiety during the last 2 months of her pregnancy after her husband was killed in war. What will the nurse assess for in this newborn? A) Newborn withdrawal syndrome B) Hepatic dysfunction C) Failure to thrive D) Learning deficiencies
A
The nurse is caring for a patient who is taking a benzodiazepine. The nurse knows that caution should be used when administering a benzodiazepine to the elderly because of what possible adverse effect? A) Acute renal failure B) Unpredictable reactions C) Paranoia D) Hallucinations
B
The nurse is caring for a resident in a long-term care facility who is African American with a history of an anxiety disorder. The patient is receiving oral lorazepam (Ativan) 2 mg t.i.d. When developing this patient's plan of care, what priority assessment will the nurse include? A) Depression B) Extreme sedation C) Phlebitis D) Nightmares
B
What anxiolytic drugs would be given to a premenopausal patient who is a registered nurse planning to return to work at the hospital after anxiety is controlled? A) Alprazolam (Xanax) B) Buspirone (BuSpar) C) Diazepam (Valium) D) Clorazepate (Tranxene)
B
A 75-year-old patient is brought to the emergency department by his family. The family relates that the patient is complaining of confusion, seizures, and abnormal perception of movement. The nurse reviews all of the medication bottles found in the house and suspects the patient overdosed on what medication? A) Benzodiazepine B) Antihypertensive C) Sedative D) Analgesic
A
The nurse is caring for a patient in a state of hypnosis, which means the patient is in what state? A) A state of extreme sedation in which the person no longer senses or reacts to incoming stimuli. B) A state of tranquility in which the person can be made to do whatever is suggested by others. C) A feeling of tension, nervousness, apprehension, or fear with high levels of awareness. D) A state in which the brain is no longer sending out signals to the body.
A
The nurse is caring for a patient treated with flumazenil (Anexate) for benzodiazepine toxicity. After administering flumazenil what will the nurse carefully assess for? A) Agitation, confusion, and seizures B) Cerebral hemorrhage and dystonia C) Hypertension and renal insufficiency D) Hypotension, dysrhythmias, and cardiac arrest
A
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? A) Assess the patient for physical problems. B) Call the provider and request an antianxiety drug order. C) Increase the patient's social time, encouraging interaction with others. D) Suggest the family visit more often to reduce the resident's stress level.
A
The nurse assesses the patient who had an abrupt withdrawal of benzodiazepines for withdrawal syndrome and would recognize what symptoms as part of the syndrome? (Select all that apply.) A) Headache B) Nightmares C) Malaise D) Bradycardia E) Hypotension
A,B,C
The nurse is caring for a patient who received a new diagnosis of cancer. The patient exhibits signs of a sympathetic stress reaction. What signs and symptoms will the nurse assess in this patient consistent with an acute reaction to stress? (Select all that apply.) A) Profuse sweating B) Fast heart rate C) Rapid breathing D) Hypotension E) Inability to interact with others
A,B,C
The nurse is teaching a class for nurses working in prenatal clinics about the danger associated with use of benzodiazepines during pregnancy and explains that what fetal anomalies result from maternal use of benzodiazepines during the first trimester of pregnancy? (Select all that apply.) A) Cleft lip or palate B) Inguinal hernia C) Cardiac defects D) Microencephaly E) Gastroschises
A,B,C,D
What reasons can the nurse give for why barbiturates are no longer considered the mainstay for treatment of anxiety? (Select all that apply.) A) Adverse effects are more severe. B) There is an increased risk of physical tolerance. C) There is an increased risk of psychological dependence. D) The most common adverse effects are related to cardiac arrhythmias. E) Hypersensitivity reactions can sometimes be fatal.
A,B,C,E
The nurse is caring for a patient who has a sedative hypnotic ordered. The nurse would consider this drug contraindicated if the patient had what disorder? A) Neurological diseases B) Liver failure C) Endocrine disorders D) Heart disease
B
A nurse is discussing the use of alprazolam (Xanax) with a 68-year-old patient. What statement indicates that the patient has an understanding of the drug? A) "When I stop having panic attacks, I can stop taking the drug." B) "This drug will calm me down in about 30 minutes after I take it." C) "One dose will keep me calm for about 24 hours." D) "I am taking an increased dose because of my age."
B
An elderly patient has been taking zolpidem (Ambien) as a sleep aid for the past 2 months. On admission to the assisted-living facility, it is determined that the drug is no longer needed. What is an important nursing consideration concerning this drug? A) Hallucinations are common. B) The drug needs to be withdrawn gradually. C) Another anxiolytic will need to be substituted. D) Sundowning is common with withdrawal from this drug.
B
The nurse evaluates teaching as effective when a patient taking a benzodiazepine states, A) "I should always take the medication with meals." B) "I should not stop taking this drug without talking to my health care provider first." C) "I cannot take aspirin with this medication." D) "I will have to take this medication for the rest of my life."
B
The nurse is caring for a patient in intensive care unit receiving IV lorazepam (Ativan) to reduce anxiety related to mechanical ventilation. While injecting the medication the nurse notes a decrease in blood pressure and bradycardia. What is the nurse's priority action? A) Discontinue drug administration. B) Give the IV drug more slowly. C) Notify the patient's health care provider. D) Document the reaction to the drug.
B
When compared with benzodiazepines, buspirone (BuSpar) stands out as unique among antianxiety drugs because of what factor? A) Increases the central nervous system (CNS) depression of alcohol and other drugs. B) Lacks muscle relaxant and anticonvulsant effects. C) Causes significant physical and psychological dependence. D) Rapidly absorbed from the gastrointestinal (GI) tract and metabolized in the liver.
B
Why would the nurse expect the patient with liver disease to receive a smaller dose of benzodiazepines? A) Excretion of the drug relies on liver function. B) The drugs are metabolized extensively in the liver. C) They are lipid soluble and well distributed throughout the body. D) The drugs are well absorbed from the gastrointestinal tract.
B
A nurse is about to administer a parenteral benzodiazepine to a female patient in the hospital before the performance of a procedure. What is the priority nursing action before administration of the drug? A) Make sure that the side rails are up and the bed is in the lowest position. B) Close the blinds and ensure appropriate room temperature for the patient. C) Help the patient out of bed to the bathroom and encourage her to void. D) Ask all visitors to leave the room and remain in the waiting area.
C
A nurse is caring for a 4-year-old child who is receiving a barbiturate. What common adverse effect would the nurse assess for? A) Decrease in respirations B) Vomiting C) Excitability D) Dry mucous membranes
C
A patient arrives at the emergency room after attempting suicide by taking an entire bottle of diazepam. What antidote will the nurse most likely administer? A) Phenobarbital (Luminal) B) Dexmedetomidine (Precedex) C) Flumazenil (Romazicon) D) Ramelteon (Rozerem)
C
A patient presents at the free clinic complaining of nervousness, worrying about everything, and feeling very tense. What diagnose would the nurse suspect? A) Neurosis B) Psychosis C) Anxiety D) Depression
C
The nurse is caring for a 36-year-old man who experienced a seizure 30 minutes before coming into the emergency room, where he begins to have another. What barbiturate has the fastest onset and would be most appropriate to give to the patient to quickly stop the seizure? A) Amobarbital (Amytal Sodium) B) Mephobarbital (Mebaral) C) Phenobarbital (Luminal) D) Secobarbital (Seconal)
C
The nurse is caring for a patient who experiences anxiety and insomnia and is prescribed benzodiazepines. When developing the plan of care, what would be an appropriate nursing diagnosis related to potential adverse effects of the drug? A) Provide patient teaching about drug therapy. B) Anxiety related to drug therapy. C) Risk for injury related to central nervous system (CNS) effects. D) Avoid preventable adverse effects, including abuse and dependence.
C
What would the nurse assess for when benzodiazepines are abruptly stopped? A) Urinary retention and change in sexual functioning B) Dry mouth, constipation, nausea, and vomiting C) Nausea, headache, vertigo, malaise, and nightmares D) In most cases nothing significant
C
A 72-year-old patient presents at the emergency department with respiratory depression and excessive sedation. The family tells the nurse that the patient has been taking medication throughout the evening. The nurse suspects benzodiazepine overdose and would expect what drug to be ordered? A) Valium B) Phenergan C) Hydroxyzine D) Flumazenil
D
A nurse is caring for a 9-year-old patient and has received an order for diazepam (Valium) 10 mg given orally q.i.d. What is the nurse's priority action? A) Perform hand hygiene and prepare the drug. B) Send the order to the hospital pharmacy. C) Determine when to administer the first dose. D) Call the physician and question the order.
D
A patient is being discharged home from the hospital after receiving treatment for pneumonia. The patient is going home and continuing to take the same drugs he or she was taking before he or she was hospitalized. These drugs include an antianxiety medication and a medication for insomnia. The home care nurse is following this patient. On the initial visit what is the nurse's priority teaching point? A) The names and purposes of medications prescribed B) How to contact the provider if needed C) The importance of taking medications for insomnia only occasionally D) Warning signs that may indicate serious adverse effects
D
A patient presents at the emergency department with respiratory depression and excessive sedation. The family tells the nurse that the patient has been taking medication throughout the evening and gives the nurse an almost empty bottle of benzodiazepines. What other adverse effects would the nurse assess this patient for? A) Seizures B) Tachycardia C) Headache D) Coma
D
An older adult African American patient comes to the clinic and is diagnosed with generalized anxiety disorder (GAD). The physician orders oral flurazepam 30 mg. What is the nurse's priority action? A) Teach the patient about the prescribed medication. B) Administer the first dose of medication. C) Tell patient to take first dosage after driving home. D) Talk to the physician about the dosage.
D
For what purpose would the nurse choose to administer a hypnotic instead of another classification of antianxiety drug? A) Treating insomnia B) Treating seizure disorder C) Treating panic attach D) Treating confusion and agitation
D
Hypnotic drugs are used to aid people in falling asleep. What physiological system does a hypnotic act on to be effective in helping a patient to sleep? A) Limbic system B) Sympathetic nervous system C) Reticular activating system D) Lymph system
D
The nurse is caring for a patient who has not been able to sleep. The physician orders a barbiturate medication for this patient. What adverse effect should the nurse teach the patient about? A) Double vision B) Paranoia C) Tinnitus D) Thinking abnormalities
D