Question 1

The client is diagnosed with post-traumatic stress disorder (PTSD).What will the nurse assess in this client?
Select all that apply.

Accepted Answer

PTSD is characterized by symptoms such as tachycardia, extreme nervousness or panic attacks, and re-experiencing the traumatic event through hallucinations, nightmares, or flashbacks. Fear of crowds or germs is not typically associated with PTSD.

Question 2

A client,who experienced shortness of breath,tachycardia,profuse diaphoresis,and trembling learns that all cardiac diagnostic tests are negative for an acute myocardial infarction.During the assessment,the nurse is told about a major problem that has caused the client great concern over the last two months.The nurse interprets this information as being consistent with which anxiety disorder?

Accepted Answer

The symptoms described in the scenario are consistent with a panic attack, which is a hallmark feature of panic disorder. The client's negative cardiac tests suggest that the symptoms are not related to a heart condition, further supporting the diagnosis of panic disorder. The mention of a major problem causing concern for the last two months is also typical of generalized anxiety disorder, but the acute presentation of symptoms is more suggestive of panic disorder. Social anxiety disorder and obsessive-compulsive disorder do not typically present with the physical symptoms described in the scenario.

Question 3

A client with anxiety and insomnia has been taking alprazolam (Xanax)for five days.What is the priority for the nurse to assess in this client?

Accepted Answer

The priority for the nurse to assess in a client taking alprazolam (Xanax) is thoughts of suicide. Benzodiazepines like alprazolam can increase the risk of suicidal ideation or behavior, especially in people with a history of depression or suicidal thoughts. It is important for the nurse to ask the client about their mood, any suicidal thoughts or plans, and any changes in mood or behavior while taking the medication.

Question 4

A client diagnosed with generalized anxiety disorder is prescribed a tricyclic antidepressant,Doxepin (Sinequan).Which statement indicates that the client understands the actions of this medication?

Accepted Answer

Dry mouth is a common side effect of tricyclic antidepressants such as Doxepin (Sinequan). Sucking on sugar-free hard candy or chewing gum can help alleviate this symptom. Option A is incorrect because tricyclic antidepressants do not work immediately and may take several weeks to produce therapeutic effects. Option B is also incorrect because all medications can have side effects, and tricyclic antidepressants are known to cause various adverse reactions. Option C is inaccurate because tricyclic antidepressants do not produce drug dependency, although sudden discontinuation of these medications can cause withdrawal symptoms.

Question 5

A client is complaining of irritability,difficulty with memory,constant fatigue,and an inability to fall asleep.The client averages 3 hours of sleep each night,has been following a restricted calorie evening meal as part of a weight loss plan,and exercises every evening.Instead of food,the client drinks no-calorie caffeinated sodas.What should the nurse suggest to this client?

Accepted Answer

The symptoms of irritability, difficulty with memory, constant fatigue, and an inability to fall asleep are all associated with disruptions in the different stages of sleep, particularly the non-rapid eye movement (NREM) phase. Late-night caffeine intake and exercising can cause hormonal changes that can disrupt this stage of sleep, leading to the reported symptoms. It is important for the client to minimize caffeine intake and exercise earlier in the evening. Additionally, the nurse should encourage the client to discuss any dietary restrictions and plans with their healthcare provider to ensure appropriateness for their needs.

Question 6

A client complains of frequent awakenings during the night with an inability to return to sleep.The client does not have difficulty falling asleep initially.Which medication would the nurse anticipate preparing?

Accepted Answer

Eszopiclone is a medication used for insomnia that helps individuals stay asleep throughout the night. It does not have an immediate release component and is instead formulated to provide a longer duration of sleep. This makes it a good choice for individuals who have no trouble falling asleep initially but wake up frequently during the night.

Question 7

A client has been in the intensive care unit for a week receiving various procedures throughout the day and night.Currently the client,though physiologically stable,is irritable and paranoid and complains of vivid dreams when dozing off to sleep.What are the best actions for the nurse to take at this time?
Select all that apply.

Accepted Answer

The answer of A client has been in the intensive...

Question 8

A client who is complaining of anxiety and difficulty sleeping has asked what prescription medications would assist in getting to sleep.What would be appropriate responses?
Select all that apply.

Accepted Answer

Ramelteon (Rozerem), flurazepam (Dalmane), and zolpidem (Ambien) are all prescription medications that are used to treat insomnia.

Question 9

A client diagnosed with narcolepsy,sleepwalking,and cataplexy is prescribed a selective serotonin reuptake inhibitor (SSRI).Which explanation regarding this medication is the most accurate?

Accepted Answer

SSRIs can help manage cataplexy, which is characterized by sudden muscle weakness, by modulating serotonin levels, thereby reducing episodes of slurred speech, sagging of the jaw, and head nodding.

Question 10

A client who recently returned from duty in Iraq is diagnosed with post-traumatic stress disorder (PTSD).The client's family questions what this means.How should the nurse respond to the family?

Accepted Answer

PTSD symptoms can include nightmares, hallucinations, or flashbacks, which can be accompanied by physical symptoms such as sweating, increased heart rate, shortness of breath, and trembling. It is important for the family to understand the potential symptoms of PTSD so that they can offer support and seek appropriate treatment for the client.

Question 11

A client is being assessed for complaints of difficulty getting to and staying asleep,chronic fatigue,and difficulty staying awake during daytime hours.A sleep study has been ordered.Which medication should the nurse teach the client to avoid prior to the sleep study?

Accepted Answer

Buspirone is a medication that is commonly used to treat anxiety, and it can interfere with the accuracy of a sleep study. Therefore, the nurse should teach the client to avoid taking buspirone prior to the sleep study. The other medications listed are unlikely to interfere with the sleep study and do not need to be avoided.

Question 12

A client whose spouse recently died is having difficulty falling asleep and does not want to take any prescription medications to induce sleep.Which response by the nurse is the most appropriate?
Select all that apply.

Accepted Answer

A) Exercise, especially in the morning, can help regulate the body's natural sleep-wake cycle, improving sleep quality.B) Yoga, meditation, and massage therapy are recognized alternative methods that can help reduce stress and improve sleep without the need for medication.D) Caffeinated beverages, nicotine, and alcohol can interfere with the ability to fall asleep and the quality of sleep, so avoiding them before bedtime is beneficial for someone experiencing insomnia.

Question 13

A client who recently experienced the loss of a spouse asks the nurse if there are any over-the-counter herbs or nonprescription medications that can be used to improve insomnia.Which response by the nurse is the most appropriate?
Standard Text: Select all that apply.

Accepted Answer

- Diphenhydramine (Benadryl) and doxylamine are over-the-counter medications that are sometimes used to induce drowsiness and can help with sleep. Valerian and melatonin are natural supplements that are commonly used to improve sleep. Ginger root and Ginkgo are not primarily used for sleep improvement, and while Kava has been used for relaxation and sleep, it has safety concerns including potential liver damage.

Question 14

The nurse distinguishes medications used in general surgery as either hypnotic or sedative,or sedative-hypnotic.The nurse can anticipate the anesthesiologist using which sedative-hypnotic for induction of anesthesia?

Accepted Answer

Thiopental sodium is a commonly used sedative-hypnotic for induction of anesthesia in general surgery. Clorazepate, alprazolam, and temazepam are examples of sedative or hypnotic medications but are not typically used for induction of anesthesia.

Question 15

A client is taking verapamil for hypertension,Glucotrol for management of type II diabetes,and melatonin for sleep.Which should the nurse ask about these medications?

Accepted Answer

The answer of A client is taking verapamil for hypertension,Glucotrol...

Question 16

Signals routed through the amygdala ultimately connect with the hypothalamus,an important center responsible for modulating the fight-or-flight response of the autonomic nervous system.Which are emotional states associated with this connection?
Note: Credit will be given only if all choices and no incorrect choices are selected.Select all that apply.

Accepted Answer

The answer of Signals routed through the amygdala ultimately connect...

Question 17

It is important for the nurse to obtain a thorough history from a client who is experiencing anxiety.What can the nurse distinguish through the history?
Select all that apply.

Accepted Answer

The answer of It is important for the nurse to...

Question 18

A client comes to the emergency department with shortness of breath,difficulty breathing,pressure in the chest,and a feeling of impending doom.After diagnostic tests and an electrocardiogram,the findings are not consistent with an acute myocardial infarction.What should the nurse do next?

Accepted Answer

The symptoms described by the client are consistent with a panic attack, which can be triggered by anxiety or drug use. Obtaining a history of recent events that might trigger anxiety or that might indicate drug abuse can help identify the cause of the symptoms and determine the appropriate treatment. Assessing the gastrointestinal system or prescribing pain medication is not indicated based on the given information. Discharging the client without proper assessment and treatment is also not appropriate.

Question 19

A client diagnosed with insomnia,triggered by anxiety,is prescribed paroxetine (Paxil).When the client asks the nurse why an antidepressant has been prescribed,which response by the nurse is the most appropriate?

Accepted Answer

Many antidepressants are also effective for treating anxiety, and there is a link between anxiety and insomnia. Therefore, prescribing an antidepressant like Paxil can help with both conditions. It is not necessarily a sedative-hypnotic, and it may not act immediately, but it can still be effective in treating the client's insomnia. The other options are not accurate or complete explanations.

Question 20

The spouse of a client tells the nurse about the client's twitching and jerking shortly after lying down and says it stops after the client goes into a deep sleep.Which response is the most appropriate from the nurse?

Accepted Answer

Twitching and jerking movements after lying down may be a normal part of the sleep cycle and is commonly known as hypnic jerks. It is reassuring for the spouse to know that it stops after the client falls into a deep sleep. Therefore, the most appropriate response is to reassure the spouse that this might be a part of the normal sleep cycle. Option A is not warranted as the client's symptoms are not indicative of restless leg syndrome. Option C is not relevant to the client's symptoms. Option D is also not relevant to the client's symptoms.

Quiz 18: Pharmacotherapy of Anxiety and Sleep Disorders

The client is diagnosed with post-traumatic stress disorder (PTSD) .What will the nurse assess in this client? Select all that apply.

A client with anxiety and insomnia has been taking alprazolam (Xanax) for five days.What is the priority for the nurse to assess in this client?

A client diagnosed with generalized anxiety disorder is prescribed a tricyclic antidepressant,Doxepin (Sinequan) .Which statement indicates that the client understands the actions of this medication?

A client complains of frequent awakenings during the night with an inability to return to sleep.The client does not have difficulty falling asleep initially.Which medication would the nurse anticipate preparing?

A client who is complaining of anxiety and difficulty sleeping has asked what prescription medications would assist in getting to sleep.What would be appropriate responses? Select all that apply.

A client diagnosed with narcolepsy,sleepwalking,and cataplexy is prescribed a selective serotonin reuptake inhibitor (SSRI) .Which explanation regarding this medication is the most accurate?

A client who recently returned from duty in Iraq is diagnosed with post-traumatic stress disorder (PTSD) .The client's family questions what this means.How should the nurse respond to the family?

A client is being assessed for complaints of difficulty getting to and staying asleep,chronic fatigue,and difficulty staying awake during daytime hours.A sleep study has been ordered.Which medication should the nurse teach the client to avoid prior to the sleep study?

A client whose spouse recently died is having difficulty falling asleep and does not want to take any prescription medications to induce sleep.Which response by the nurse is the most appropriate? Select all that apply.

A client who recently experienced the loss of a spouse asks the nurse if there are any over-the-counter herbs or nonprescription medications that can be used to improve insomnia.Which response by the nurse is the most appropriate? Standard Text: Select all that apply.

The nurse distinguishes medications used in general surgery as either hypnotic or sedative,or sedative-hypnotic.The nurse can anticipate the anesthesiologist using which sedative-hypnotic for induction of anesthesia?

A client is taking verapamil for hypertension,Glucotrol for management of type II diabetes,and melatonin for sleep.Which should the nurse ask about these medications?

It is important for the nurse to obtain a thorough history from a client who is experiencing anxiety.What can the nurse distinguish through the history? Select all that apply.

A client comes to the emergency department with shortness of breath,difficulty breathing,pressure in the chest,and a feeling of impending doom.After diagnostic tests and an electrocardiogram,the findings are not consistent with an acute myocardial infarction.What should the nurse do next?

A client diagnosed with insomnia,triggered by anxiety,is prescribed paroxetine (Paxil) .When the client asks the nurse why an antidepressant has been prescribed,which response by the nurse is the most appropriate?

The spouse of a client tells the nurse about the client's twitching and jerking shortly after lying down and says it stops after the client goes into a deep sleep.Which response is the most appropriate from the nurse?