Chapter 14 Pharmacology For Nurses A Pathophysiologic Approach 5th Edition

Chapter 14 Pharmacology For Nurses A Pathophysiologic Approach 5th Edition

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Question 1

Type: MCSA

The patient tells the nurse he worries about everything all day, feels confused, restless, and just can’t stop worrying. What is the best response by the nurse?

1. “You have generalized anxiety; I will teach you some relaxation techniques.”
2. “This sounds like social anxiety. You need to calm down and you’ll be fine.”
3. “You have posttraumatic stress disorder (PTSD), and it is time for your therapy session.”
4. “This is called panic disorder; I’ll get your medication for you.”

Correct Answer: 1

Rationale 1: Generalized anxiety disorder is characterized by excessive anxiety but not to panic levels. Other symptoms include restlessness, muscle tension, and loss of focus and ability to concentrate. Relaxation techniques are effective in reducing anxiety.

Rationale 2: Social anxiety disorder is characterized by “performance anxiety,” (i.e., extreme fear when a patient is in a social situation); there is no information to support that this is what the patient is experiencing. Also, telling the patient to “calm down” is non-therapeutic.

Rationale 3: Posttraumatic stress disorder is situational anxiety that develops in response to re-experiencing a previous traumatic life event; there is no information that the patient has experienced a trauma.

Rationale 4: Panic disorder is characterized by intense feelings of apprehension, terror, and impending doom and increased autonomic nervous system anxiety; the patient does not have these symptoms.

Global Rationale: Generalized anxiety disorder is characterized by excessive anxiety but not to panic levels. Other symptoms include restlessness, muscle tension, and loss of focus and ability to concentrate. Relaxation techniques are effective in reducing anxiety. Panic disorder is characterized by intense feelings of apprehension, terror, and impending doom and increased autonomic nervous system anxiety; the patient does not have these symptoms. Posttraumatic stress disorder is situational anxiety that develops in response to re-experiencing a previous traumatic life event; there is no information that the patient has experienced a trauma. Social anxiety disorder is characterized by “performance anxiety,” (i.e., extreme fear when a patient is in a social situation); there is no information to support that this is what the patient is experiencing. Also, telling the patient to “calm down” is non-therapeutic.

 

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.1 Explain the interrelationships among theory, practice, and research.

NLN Competencies: Knowledge and Science: Relationships between knowledge and science and quality and safe patient care.

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 14-1 Identify the major types of anxiety disorders.

MNL Learning Outcome: 3.4.1 Examine the etiology, pathophysiology and clinical manifestations.

Page Number: 162

 

 

Question 2

Type: MCMA

The nurse has completed group education for patients with anxiety disorders. The education is evaluated as successful when the patients make which statements?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. “Relaxation techniques will often decrease anxiety.”
2. “Antianxiety medicine should be used until anxiety is gone.”
3. “Antianxiety medicine should not be used indefinitely.”
4. “Therapy may help identify where this anxiety comes from.”
5. “Different medications are required for treating anxiety than for treating difficulty sleeping.”

Correct Answer: 1,3,4

Rationale 1: Nonpharmacological techniques such as relaxation techniques are effective in reducing some levels of anxiety.

Rationale 2: Absence of anxiety is an unrealistic goal because all individuals will have some level of anxiety during their lifetime.

Rationale 3: For most patients, anti-anxiety medication is intended for short-term use.

Rationale 4: Patients with anxiety disorders should be encouraged to uncover the cause of the anxiety through cognitive-behavioral therapy or other counseling techniques.

Rationale 5: Often, the same medication can be used for anxiety as well as insomnia.

Global Rationale: Patients with anxiety disorders should be encouraged to uncover the cause of the anxiety through cognitive-behavioral therapy or other counseling techniques. Nonpharmacological techniques such as relaxation techniques are effective in reducing some levels of anxiety. For most patients, anti-anxiety medication is intended for short-term use. Absence of anxiety is an unrealistic goal because all individuals will have some level of anxiety during their lifetime. Often, the same medication can be used for anxiety as well as insomnia.

 

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

QSEN Competencies: I.B.3 Provide patient-centered care with sensitivity and respect for the diversity of human experience.

AACN Essentials Competencies: VII.4 Use behavioral change techniques to promote health and manage illness.

NLN Competencies: Knowledge and Science: Relationships between knowledge and science and quality and safe patient care.

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 14-3 Discuss factors contributing to anxiety and explain some nonpharmacologic therapies used to cope with this disorder.

MNL Learning Outcome: 3.4.1 Examine the etiology, pathophysiology and clinical manifestations.

Page Number: 164

 

Question 3

Type: MCSA

The patient tells the nurse that she is interested in the human brain and questions which parts of the brain control anxiety and insomnia. What is the best reply by the nurse?

1. “The limbic system and reticular activating system control anxiety and insomnia.”
2. “The frontal lobes and limbic system control anxiety and insomnia.”
3. “The thalamus and reticular activating system control anxiety and insomnia.”
4. “The limbic system and hypothalamus control anxiety and insomnia.”

Correct Answer: 1

Rationale 1: Neural systems associated with anxiety and restlessness include the limbic system and the reticular activating system. The reticular activating system is responsible for sleeping and wakefulness and performs an alerting function for the entire cerebral cortex.

Rationale 2: The frontal lobes are not responsible for anxiety and sleep.

Rationale 3: The thalamus is not responsible for anxiety and sleep.

Rationale 4: The hypothalamus is not responsible for anxiety and sleep.

Global Rationale: Neural systems associated with anxiety and restlessness include the limbic system and the reticular activating system. The reticular activating system is responsible for sleeping and wakefulness and performs an alerting function for the entire cerebral cortex. The limbic system and the reticular activating system, not the hypothalamus, are responsible for anxiety and sleep. The limbic system and the reticular activating system, not the frontal lobes, are responsible for anxiety and sleep. The limbic system and the reticular activating system, not the thalamus, are responsible for anxiety and sleep.

 

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: I.2 Synthesize theories and concepts from liberal education to build an understanding of the human experience.

NLN Competencies: Knowledge and Science: Relationships between knowledge and science and quality and safe patient care.

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 14-2 Identify the regions of the brain associated with anxiety, sleep, and wakefulness.

MNL Learning Outcome: 3.4.1 Examine the etiology, pathophysiology and clinical manifestations.

Page Number: 162

 

Question 4

Type: MCMA

The patient tells the nurse, “I am really confused after talking to my doctor. He said I would be taking different kinds of medications for my anxiety and insomnia. Will you please explain it?” What is the best response by the nurse?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. “You will be taking medications known as sedative-hypnotics.”
2. “You will be taking medications known as antidepressants.”
3. “You will be taking a medication known as paraldehyde.”
4. “You will be taking medications known as barbiturates.”
5. “You will be taking medications known as benzodiazepines.”

Correct Answer: 1,2,5

Rationale 1: The three categories of medications used to treat anxiety and sleep disorders include the sedative-hypnotics.

Rationale 2: The three categories of medications used to treat anxiety and sleep disorders include the antidepressants.

Rationale 3: Paraldehyde is no longer used for anxiety or insomnia because of significant side effects and the availability of more effective medications.

Rationale 4: Barbiturates are no longer used for anxiety or insomnia because of significant side effects and the availability of more effective medications.

Rationale 5: The three categories of medications used to treat anxiety and sleep disorders include the benzodiazepines.

Global Rationale: The three categories of medications used to treat anxiety and sleep disorders include the benzodiazepines, antidepressants, and sedative-hypnotics. Barbiturates are no longer used for anxiety or insomnia because of significant side effects and the availability of more effective medications. Paraldehyde is no longer used for anxiety or insomnia because of significant side effects and the availability of more effective medications.

 

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.1 Explain the interrelationships among theory, practice, and research.

NLN Competencies: Knowledge and Science: Relationships between knowledge and science and quality and safe patient care.

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 14-4 Identify the three classes of medications used to treat anxiety and sleep disorders.

MNL Learning Outcome: 3.4.2 Compare the classes of medication used in pharmacologic management.

Page Number: 167