Chapter 34: Sedative-Hypnotic Drugs

Chapter 34: Sedative-Hypnotic Drugs

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

1. A patient is being treated for muscle spasms. A nurse is preparing to administer a prn medication for this patient. The nurse is aware that the only benzodiazepine commonly used to relieve muscle spasm is which of the following?

a.	Diazepam (Valium)
b.	Lorazepam (Ativan)
c.	Estazolam (Prosom)
d.	Clonazepam (Klonopin)

 

 

ANS:   A

A benzodiazepine (diazepam) is used to relive muscle spasm and spasticity.

Lorazepam’s primary indication is as an antianxiety medication or to manage status epileptics.

Estazolam is used primarily to manage sleep disturbances.

Clonazepam is used primarily to manage panic disorders.

 

DIF:    Cognitive Level: Application             REF:    p. 370

TOP:    Nursing Process: Evaluation

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

 

2. A nurse is acting as a preceptor to a graduate nurse. They are discussing the differences between various medications. The nurses understand that, in contrast to the barbiturates, the benzodiazepines have which principal mechanism of action?

a.	They cannot pass the blood-brain barrier.
b.	They have limited central nervous system depression effects.
c.	They are not lipid soluble.
d.	They have more difficulty affecting the central nervous system.

 

 

ANS:   B

The ability of benzodiazepines to depress central nervous system function is low. Because of their high lipid solubility, benzodiazepines readily cross the blood-brain barrier to reach sites in the central nervous system.

Benzodiazepines readily cross the blood-brain barrier.

Benzodiazepines are highly lipid soluble.

Benzodiazepines do not have more difficulty affecting the central nervous system than barbiturates do.

 

DIF:    Cognitive Level: Application             REF:    pp. 368-369

TOP:    Nursing Process: Diagnosis

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

 

3. A nurse is assessing a patient on benzodiazepines who exhibits drowsiness, lethargy, and confusion, and has respirations of 11/minute. The nurse recognizes these signs and symptoms and should prepare to administer which drugs ordered by the prescriber?

a.	Flumazenil (Romazicon)
b.	Naloxone (Narcan)
c.	Epinephrine (adrenaline)
d.	Atropine (AtroPEN)

 

 

ANS:   A

The patient exhibits signs and symptoms of benzodiazepine overdose, therefore the nurse should administer an antagonist such as flumazenil.

Naloxone is indicated for narcotic overdose.

Epinephrine is indicated for anaphylaxis.

Atropine is indicated for cholinergic overdose.

 

DIF:    Cognitive Level: Application             REF:    p. 372

TOP:    Nursing Process: Planning

MSC:   NCLEX Client Needs Category: Physiological Integrity: Reduction of Risk Potential

 

4. A nurse is making patient rounds and determines that one of her patients is having paradoxical symptoms related to the use of benzodiazepines. Which of the following symptoms would the patient manifest?

a.	Insomnia, excitation, euphoria, and rage
b.	Laryngeal edema, hypotension, and wheals
c.	Vasodilation, flushing, and orthostatic hypotension
d.	Confusion, central nervous system depression, and disorientation

 

 

ANS:   A

The paradoxical symptoms manifested by someone using benzodiazepines are insomnia, excitation, euphoria, and rage.

Laryngeal edema, hypotension, and wheals are manifestations of anaphylaxis.

Vasodilation, flushing, and orthostatic hypotension indicate an adverse reaction to the medication.

Confusion, central nervous system depression, and disorientation may be manifestations of a benzodiazepine overdose.

 

DIF:    Cognitive Level: Analysis                  REF:    p. 371

TOP:    Nursing Process: Assessment

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies