Chapter 25: Drugs for Muscle Spasm and Spasticity

Chapter 25: Drugs for Muscle Spasm and Spasticity

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A nurse is admitting a patient to the hospital. The patient reports taking oral baclofen [Lioresal] but stopped taking the drug the day before admission. The nurse would be correct to anticipate which adverse effects?

a.	Weakness and dizziness
b.	Fatigue and drowsiness
c.	Seizures and hallucinations
d.	Respiratory depression and coma

 

 

ANS:  C

Abrupt discontinuation of baclofen is associated with visual hallucinations, paranoid ideation, and seizures. Central nervous system effects of baclofen include weakness, dizziness, fatigue, and drowsiness. Respiratory depression is a result of overdose of baclofen.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   p. 241

TOP:   Nursing Process: Diagnosis

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

 

2. A patient who has a lower back injury exhibits muscle spasms. The provider orders cyclobenzaprine [Flexeril] 10 mg three times a day. What will the nurse include when teaching this patient about this drug?

a.	“This drug carries some risk of developing hallucinations and psychotic symptoms.”
b.	“This medication may cause your urine to turn brown, black, or dark green.”
c.	“You may experience blurred vision, dry mouth, or constipation.”
d.	“You will need to have liver function tests performed while taking this medication.”

 

 

ANS:  C

Cyclobenzaprine has significant anticholinergic effects and patients should be warned about dry mouth, blurred vision, and constipation. Tizanidine can cause hallucinations and psychotic symptoms. Methocarbamol may turn urine brown, black, or green, which is a harmless side effect. Tizanidine and metaxalone can cause liver toxicity and require monitoring.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   p. 241

TOP:   Nursing Process: Implementation

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

 

3. A nurse is caring for a patient receiving intrathecal baclofen [Lioresal]. The patient is unresponsive. After asking a coworker to contact the provider, the nurse anticipates performing which intervention?

a.	Preparing to support respirations
b.	Administering an antidote to baclofen
c.	Administering diazepam to prevent seizures
d.	Obtaining an electrocardiogram

 

 

ANS:  A

An overdose of baclofen can produce coma and respiratory depression, so the nurse would be correct to suspect overdose in this patient. Respiratory support is essential to prevent a fatal outcome. There is no antidote for baclofen overdose. Diazepam would not be indicated, because seizures are not a result of baclofen overdose and may further depress respirations. An electrocardiogram is not indicated for this patient.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   p. 241

TOP:   Nursing Process: Implementation

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

 

4. A patient has localized muscle spasms after an injury. The prescriber has ordered tizanidine [Zanaflex] to alleviate the spasms. When obtaining the patient’s health history, the nurse should be concerned about which possible reason for considering another drug?

a.	Concomitant use of aspirin
b.	A history of hepatitis
c.	A history of malignant hyperthermia
d.	Occasional use of alcohol

 

 

ANS:  B

Hepatotoxicity is a serious potential problem in a patient receiving tizanidine, because the drug can cause liver damage. Baseline liver enzymes should be obtained before dosing and periodically thereafter. Analgesic anti-inflammatory drugs commonly are used in conjunction with centrally acting muscle relaxants, so using aspirin is not a concern. This drug does not contribute to malignant hyperthermia. Patients should be advised to avoid alcohol when taking this drug, but a history of occasional alcohol use is not a contraindication.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   p. 241

TOP:   Nursing Process: Diagnosis

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