Question 1

A client is prescribed a medication that will inhibit the function of the reticular activating system.What will the nurse assess as effects of this medication?
Select all that apply.

Accepted Answer

Inhibiting the reticular activating system will likely cause drowsiness and sleeping due to the role of this system in regulating wakefulness and arousal. Alertness may be decreased as well. Dilated pupils and elevated blood pressure are not typically associated with the reticular activating system, so they are not likely to be affected by this medication.

Question 2

During a medical history,a client tells the nurse about waiting several hours before falling asleep and waking up repeatedly during the night only to wait again to fall asleep.The nurse would document this client's symptoms as being which types of insomnia?
Select all that apply.

Accepted Answer

Sleep-onset insomnia refers to difficulty falling asleep at the beginning of the night, which matches the client's experience of waiting several hours before falling asleep. Sleep-maintenance insomnia involves difficulty staying asleep or waking up frequently during the night, aligning with the client's report of waking up repeatedly.

Question 3

The nurse notes that a client is prescribed zolpidem (Ambien)at a dose smaller than is recommended.What would the nurse review to determine the reason for the reduced dose?
Select all that apply.

Accepted Answer

The answer of The nurse notes that a client is...

Question 4

A client is prescribed a medication for anxiety that will affect the limbic system.When instructing the client,the nurse explains that this medication will affect which areas?
Select all that apply.

Accepted Answer

The limbic system is primarily involved in emotions, behavior, and memory. It plays a significant role in emotional responses and the formation of long-term memories.

Question 5

The nurse is providing discharge instructions to a client who has been started on a monoamine oxidase inhibitor (MAOI).Which statement indicates that the client needs further teaching?

Accepted Answer

MAOIs interact with tyramine in foods such as aged cheese, cured meats, and some alcoholic beverages, which can lead to a dangerous increase in blood pressure. Pizza can contain several of these ingredients, so the client should avoid it. Options A, B, and D are all appropriate considerations for a client on an MAOI, as these medications can cause hypotension and hypoglycemia, and caffeine should be limited. Slowing down when rising from a lying or sitting position also reduces the risk of orthostatic hypotension.

Question 6

A client with anxiety reports difficulty sleeping and waking up several times throughout the night.The nurse is concerned that the client can develop imbalances in which neurotransmitters?
Select all that apply.

Accepted Answer

The answer of A client with anxiety reports difficulty sleeping...

Question 7

The nurse is preparing to administer intravenous lorazepam (Ativan)to a client.Which nursing intervention is a priority following the parenteral administration of this medication?

Accepted Answer

Lorazepam is a benzodiazepine medication that can cause respiratory depression, especially when combined with other CNS depressants. Therefore, monitoring for changes in respirations is a priority nursing intervention following parenteral administration of this medication. Although assessing for drug interactions and seizure activity as well as instructing the client to change positions slowly are also important, they are not the highest priority in this situation.

Question 8

The nurse's client is prescribed medication for anxiety and sleep,and the nurse is providing instruction on lifestyle changes.What would be included in this teaching?
Select all that apply.

Accepted Answer

The nurse should instruct the client to avoid caffeine, smoking, and limit alcohol intake as they can all contribute to anxiety and disrupt sleep. Exercise should be done earlier in the day, rather than before bedtime, to promote better sleep. There is no evidence to suggest that green leafy vegetables should be limited in this scenario.

Question 9

A client recovering from surgery is prescribed zolpidem (Ambien)for sleep.The client is scheduled for physical therapy at 8 p.m.What should the nurse do when providing the client with this medication?

Accepted Answer

Zolpidem is a sedative/hypnotic medication that is commonly used for insomnia. It is best administered immediately prior to expected sleep as it takes 30-60 minutes to produce effects. Crushing or providing the medication with food should be avoided as it affects its absorption and may alter the time it takes to produce its effects. Administering the medication prior to physical therapy may cause drowsiness or affect the client's ability to participate effectively, and therefore should also be avoided.

Question 10

The nurse is coaching a client on nonpharmacologic interventions to improve sleep.What would be included in these instructions?
Select all that apply.

Accepted Answer

Nonpharmacologic interventions to improve sleep include techniques that help relax the mind and body without the use of medication. Meditation, guided imagery, and deep breathing are relaxation techniques that can help reduce stress and promote sleep. Drinking chamomile tea is a natural remedy that has been associated with inducing sleepiness and improving sleep quality due to its calming effects. Keeping a light on is not recommended as it can interfere with the body's circadian rhythm and inhibit the production of melatonin, a hormone that regulates sleep.

Question 11

A client being treated for an anxiety disorder is prescribed medication for sleep to be provided every evening.Why is the client prescribed sleeping medication?
Select all that apply.

Accepted Answer

A) Anxiety and sleep issues often coexist, with anxiety leading to sleep disturbances and poor sleep exacerbating anxiety. B) Improving sleep can have a positive impact on anxiety disorders, as adequate rest can help reduce overall anxiety levels. E) Worrying about not getting enough sleep can itself be a source of anxiety, so addressing sleep issues can help break this cycle.

Question 12

A client experiencing hyperventilation,diaphoresis,and difficulty breathing with chest tightness was diagnosed with panic attacks after a negative cardiac workup.What action should the nurse implement first?

Accepted Answer

Moving the client from the waiting area to a private ED cubicle would provide the client with the privacy and quiet necessary for relaxation techniques and decrease external stimuli that could exacerbate symptoms. It also allows for a more thorough assessment and monitoring. The other actions may be appropriate but are not the priority at this time.

Question 13

Since long-term use of phenobarbital can lead to osteomalacia,a client is instructed to consume foods high in vitamin D,vitamin K,and folic acid.Which statement indicates the client understands these instructions?

Accepted Answer

Fish, green vegetables, and milk are all good sources of vitamin D. Additionally, green vegetables contain vitamin K, and milk contains folic acid. Therefore, this statement indicates that the client understands the instructions given to them. The other answer choices do not include all of the recommended vitamins and minerals.

Question 14

During a health history,a client expresses concern to the nurse about finances and the health of older parents.What will the nurse assess to determine whether this client is experiencing generalized anxiety disorder?
Standard Text: Select all that apply.

Accepted Answer

The answer of During a health history,a client expresses concern...

Question 15

A hospitalized client who is not prescribed medication for sleep tells the nurse about using a sedative to sleep for years." What will the nurse most likely assess in this client?
Select all that apply.

Accepted Answer

Clients who have used sedatives for sleep for an extended period may experience withdrawal symptoms when the medication is stopped, leading to sleeplessness and anxiety. Additionally, long-term use of sedatives can cause daytime drowsiness as a side effect. Dizziness and blurred vision are less directly related to the cessation of sedative use for sleep.

Question 16

A client is prescribed duloxetine (Cymbalta)for fibromyalgia.When teaching the client about this medication,the nurse will include which adverse or side effects?
Select all that apply.

Accepted Answer

Duloxetine can cause constipation, weight loss, and headaches as side effects. It is not associated with increased sexual desire or specifically treating social anxiety disorder.

Question 17

A client receiving phenobarbital for seizure control has a temperature of 102°F,periorbital and oral edema,and an erythematous rash over the entire body.Which action by the nurse is the priority?

Accepted Answer

The client's symptoms indicate a possible allergic reaction to the phenobarbital. Holding the medication and notifying the healthcare provider is the priority action to prevent further harm to the client. Giving the medication could potentially exacerbate the symptoms and lead to a more severe reaction. Inquiring about the symptoms' previous occurrence is important information, but it can be done after the immediate concern is addressed.

Quiz 18: Pharmacotherapy of Anxiety and Sleep Disorders

A client is prescribed a medication that will inhibit the function of the reticular activating system.What will the nurse assess as effects of this medication? Select all that apply.

During a medical history,a client tells the nurse about waiting several hours before falling asleep and waking up repeatedly during the night only to wait again to fall asleep.The nurse would document this client's symptoms as being which types of insomnia? Select all that apply.

The nurse notes that a client is prescribed zolpidem (Ambien) at a dose smaller than is recommended.What would the nurse review to determine the reason for the reduced dose? Select all that apply.

A client is prescribed a medication for anxiety that will affect the limbic system.When instructing the client,the nurse explains that this medication will affect which areas? Select all that apply.

The nurse is providing discharge instructions to a client who has been started on a monoamine oxidase inhibitor (MAOI) .Which statement indicates that the client needs further teaching?

A client with anxiety reports difficulty sleeping and waking up several times throughout the night.The nurse is concerned that the client can develop imbalances in which neurotransmitters? Select all that apply.

The nurse is preparing to administer intravenous lorazepam (Ativan) to a client.Which nursing intervention is a priority following the parenteral administration of this medication?

The nurse's client is prescribed medication for anxiety and sleep,and the nurse is providing instruction on lifestyle changes.What would be included in this teaching? Select all that apply.

A client recovering from surgery is prescribed zolpidem (Ambien) for sleep.The client is scheduled for physical therapy at 8 p.m.What should the nurse do when providing the client with this medication?

The nurse is coaching a client on nonpharmacologic interventions to improve sleep.What would be included in these instructions? Select all that apply.

A client being treated for an anxiety disorder is prescribed medication for sleep to be provided every evening.Why is the client prescribed sleeping medication? Select all that apply.

A client experiencing hyperventilation,diaphoresis,and difficulty breathing with chest tightness was diagnosed with panic attacks after a negative cardiac workup.What action should the nurse implement first?

Since long-term use of phenobarbital can lead to osteomalacia,a client is instructed to consume foods high in vitamin D,vitamin K,and folic acid.Which statement indicates the client understands these instructions?

During a health history,a client expresses concern to the nurse about finances and the health of older parents.What will the nurse assess to determine whether this client is experiencing generalized anxiety disorder? Standard Text: Select all that apply.

A hospitalized client who is not prescribed medication for sleep tells the nurse about using a sedative to sleep for years." What will the nurse most likely assess in this client? Select all that apply.

A client is prescribed duloxetine (Cymbalta) for fibromyalgia.When teaching the client about this medication,the nurse will include which adverse or side effects? Select all that apply.

A client receiving phenobarbital for seizure control has a temperature of 102°F,periorbital and oral edema,and an erythematous rash over the entire body.Which action by the nurse is the priority?