Chapter 17: Antianxiety Drugs

Psychiatric Nursing, 7th Edition by Norman L. Keltner - Debbie Steele

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Chapter 17: Antianxiety Drugs

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

  1. Lorazepam (Ativan) reduces anxiety by:
a. increasing serotonin levels.
b. blocking dopamine receptors.
c. depressing norepinephrine levels.
d. potentiating gamma-aminobutyric acid (GABA).

 

 

ANS:  D

Benzodiazepines enhance the effects of the inhibitory neurotransmitter GABA, slowing neuronal firing. They do not affect dopamine, serotonin, or norepinephrine.

 

DIF:    Cognitive level: Understanding        REF:   p. 184             TOP:   Nursing process: Planning

MSC:  NCLEX: Psychosocial Integrity

 

  1. A patient started diazepam (Valium) 5 mg twice daily 6 months ago. Now, the patient requires 10 mg to achieve the same effect. This phenomenon results from:
a. addiction.
b. tolerance.
c. dependence.
d. disinhibition.

 

 

ANS:  B

Tolerance is the need for increasing amounts of a substance to achieve the same effects. The other terms, defined in the text, do not account for this phenomenon.

 

DIF:    Cognitive level: Understanding        REF:   pp. 187           TOP:   Nursing process: Evaluation

MSC:  NCLEX: Physiologic Integrity

 

  1. A patient diagnosed with agoraphobia took alprazolam (Xanax) 0.5 mg three times daily for 3 months and then discontinued it. The next day the patient called the nurse reporting insomnia, shakiness, and sweating. The nurse’s assessment questions should focus on whether the patient:
a. may have also been drinking alcohol or taking antihistamines.
b. has built up tolerance to alprazolam and needs an increased dose.
c. is having withdrawal symptoms from abrupt discontinuation of the drug.
d. has progressed to panic attacks and needs a non-benzodiazepine medication.

 

 

ANS:  C

The patient’s symptoms suggest benzodiazepine withdrawal. The nurse knows that patients often attempt to manage their own care by discontinuing medication when they begin to feel better. Benzodiazepines should be slowly withdrawn if withdrawal symptoms are to be avoided. Drinking alcohol would result in different symptoms. Development of tolerance and panic attack symptoms would be different from those mentioned.

 

DIF:    Cognitive level: Analyzing              REF:   p. 187

TOP:   Nursing process: Implementation     MSC:  NCLEX: Physiologic Integrity

 

  1. An emergency room patient was very anxious after a serious car accident. Lorazepam (Ativan) 2 mg intramuscularly was administered. One hour later, which finding indicates to the nurse that the medication was effective?
a. Impaired problem-solving skills
b. Increased alertness and attention
c. Increased verbalization and activity
d. Reduced agitation and environmental scanning

 

 

ANS:  D

Benzodiazepines mute incoming stimuli and evoke less reaction. The hyperalertness and environmental scanning that accompany high anxiety are notably decreased when the drug is effective. Impaired problem solving is a negative outcome. Because of its sedating properties, the individual might not be more alert, talkative, or active.

 

DIF:    Cognitive level: Applying                REF:   p. 185-186      TOP:   Nursing process: Evaluation

MSC:  NCLEX: Physiologic Integrity

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