Chapter 34: Sedative-Hypnotic Drugs

Chapter 34: Sedative-Hypnotic Drugs

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A nurse is discussing the use of benzodiazepines as sedative-hypnotic agents with a group of nursing students. A student asks about the actions of these drugs in the central nervous system. The nurse makes which correct statement?

a.	“Benzodiazepines affect the hippocampus and the cerebral cortex to cause anterograde amnesia.”
b.	“Benzodiazepines depress neuronal functions by acting at a single site in the brain.”
c.	“Benzodiazepines induce muscle relaxation by acting on sites outside the central nervous system.”
d.	“Benzodiazepines promote sleep through effects on the limbic system.”

 

 

ANS:  A

All beneficial and most adverse effects of benzodiazepines occur from depressant actions in the central nervous system (CNS); the various effects depend on the site of action. Anterograde amnesia is the result of effects in the hippocampus and the cerebral cortex. Benzodiazepines act at multiple sites in the CNS. Muscle relaxant effects are the result of actions on supraspinal motor areas in the CNS. Benzodiazepines promote sleep through effects on cortical areas and on the sleep-wakefulness “clock.”

 

PTS:   1                    DIF:    Cognitive Level: Analysis                REF:   pp. 373-374

TOP:   Nursing Process: Evaluation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

 

2. A patient who has been using secobarbital for several months to treat insomnia tells the nurse that the prescriber has said the prescription will be changed to temazepam [Restoril] because it is safer. The patient asks why this agent is safer. The nurse is correct in telling the patient that temazepam:

a.	does not depress the central nervous system.
b.	shows no respiratory depression, even in toxic doses.
c.	mimics the actions of a central nervous system inhibitory neurotransmitter.
d.	potentiates endogenous gamma-aminobutyric acid (GABA) producing a finite CNS depression.

 

 

ANS:  D

Benzodiazepines potentiate the actions of GABA, and because the amount of GABA in the CNS is finite, these drugs’ depressive effect on the CNS is limited. Benzodiazepines depress the CNS but not to the extent that barbiturates do. Benzodiazepines are weak respiratory depressants at therapeutic doses and moderate respiratory depressants at toxic doses. Barbiturates mimic GABA; therefore, because they produce CNS depression, this effect is limited only by the amount of barbiturate administered.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   pp. 373-374

TOP:   Nursing Process: Implementation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

 

3. A hospitalized patient who is given one dose of flurazepam continues to show drowsiness the next day. A nursing student asks the nurse the reason for this, because the drug’s half-life is only 2 to 3 hours. Which response by the nurse is correct?

a.	“Benzodiazepines commonly cause residual effects lasting into the day after the dose is given.”
b.	“The patient is having a paradoxical reaction to this medication.”
c.	“This patient must have developed a previous tolerance to benzodiazepines.”
d.	“When this drug is metabolized, the resulting compound has longer-lasting effects.”

 

 

ANS:  D

Flurazepam has a half-life of 2 to 3 hours; however, its metabolite has a long half-life, so giving the drug results in long-lasting effects. Barbiturates, not benzodiazepines, are commonly associated with residual, or hangover, effects. A paradoxical reaction to a sedative would manifest as insomnia, euphoria, and excitation, not drowsiness. Tolerance means that the patient would need increased amounts of a drug to get the desired effects and would not have prolonged effects of the medication.

 

PTS:   1                    DIF:    Cognitive Level: Analysis                REF:   pp. 374-376 | pp. 381-382

TOP:   Nursing Process: Evaluation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

 

4. A patient who is experiencing alcohol withdrawal is given a benzodiazepine. The nurse understands that this drug is effective because:

a.	the alcohol does not interact with the benzodiazepine.
b.	the benzodiazepine potentiates alcohol withdrawal symptoms.
c.	the benzodiazepine relieves muscle spasms and spasticity.
d.	the patient has a cross-dependence to the benzodiazepine.

 

 

ANS:  D

Benzodiazepines are given to ease withdrawal from alcohol because of cross-dependence with these drugs and alcohol, enabling the benzodiazepine to suppress withdrawal symptoms. Alcohol and benzodiazepines can potentiate one another. The benzodiazepine does not potentiate withdrawal symptoms. Benzodiazepines relieve muscle spasms, but this is not why they are given for alcohol withdrawal.

 

PTS:   1                    DIF:    Cognitive Level: Analysis                REF:   p. 375

TOP:   Nursing Process: Assessment

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies