Deck 14: Drugs for Anxiety and Insomnia

Question 1

The client 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?

A) "The limbic system and hypothalamus."
B) "The frontal lobes and limbic system."
C) "The thalamus and reticular activating system."
D) "The limbic system and reticular activating system."

Answer 1

"The limbic system and reticular activating system."

Question 2

The client has been taking lorazepam (Ativan) for the treatment, of generalized anxiety, he asks the nurse what is the normal adult dosage? The nurse replies.

A) "What did your doctor prescribe you?"
B) "2 -4 mgs. po. b.i.d"
C) "2 -6 mg/day in divided doses to a max of 10mg/day"
D) "2mg, orally, up to 6 times per day"

Answer 2

"2 -6 mg/day in divided doses to a max of 10mg/day"

Question 3

The client 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? Select all that apply.

A) "You will be taking medications known as sedative -hypnotics."
B) "You will be taking medications known as paraldehydes."
C) "You will be taking medications known as benzodiazepines."
D) "You will be taking medications known as barbiturates."
E) "You will be taking medications known as antidepressants."

Answer 3

"You will be taking medications known as sedative -hypnotics."
"You will be taking medications known as benzodiazepines."
"You will be taking medications known as antidepressants."

Question 4

The client has been receiving escitalopram (Cipralex) for treatment of obsessive -compulsive disorder. Unknown to the nurse, the client has also been self -medicating with St. John's wort. The client comes to the office with symptoms of hyperthermia and diaphoresis. Which statement best describes the result of the nurse's assessment?

A) The client is experiencing symptoms of St. John's wort toxicity, as the medication was most likely outdated.
B) The client has contracted a viral infection. Escitalopram (Cipralex) and St. John's wort are safe to take together.
C) The client has combined two antidepressant medications and is experiencing serotonin syndrome.
D) The client has not been taking escitalopram (Cipralex) and is experiencing withdrawal.

Question 5

The client 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?

A) "This is called panic disorder; I'll get your medication for you."
B) "You have posttraumatic stress disorder (PTSD), and it is time for your therapy session."
C) "This sounds like social anxiety. You need to calm down and you'll be fine."
D) "You have generalized anxiety; I will teach you some relaxation techniques."

Question 6

The client is receiving Zopiclone (imovane) for treatment of short -term insomnia. What is the primary safety concern of the nurse when the client takes this medication?

A) nausea and gastrointestinal (GI) distress
B) dizziness and daytime sedation
C) sleepwalking
D) nausea and diarrhea

Question 7

The client has been treated by the same physician for two years and has had insomnia the entire time. Many different medications have been tried with limited success. What should be the nurse's primary assessment at this time?

A) Assess if the client has been selling his medications to addicts.
B) Assess for a primary sleep disorder such as sleep apnea.
C) Assess if the client has an addictive personality disorder.
D) Assess the client for a primary personality disorder.

Question 8

The nurse works with a physician who frequently prescribes benzodiazepines. The use of benzodiazepines in which client would cause the nurse the most concern?

A) A 9 -year -old child with panic attacks.
B) An 87 -year -old client who uses a cane for ambulation.
C) A 42 -year -old businessman who travels internationally.
D) A 32 -year -old mother of two preschool children.

Question 9

The client has been taking lorazepam (Ativan) for two years. The client stopped this medication after a neighbour said the drug manufacturer's plant was contaminated with rat droppings. What best describes the nurse's assessment of the client when seen three days after stopping his medication?

A) Nothing different; it is safe to abruptly stop lorazepam (Ativan).
B) Pinpoint pupils, constipation, and urinary retention.
C) A sense of calmness and lack of anxiety.
D) Increased heart rate, fever, and muscle cramps.

Question 10

The client has generalized anxiety disorder. He asks the nurse "Will I need medication for this? My neighbour is very nervous and he takes medication." What is the best response by the nurse?

A) "Medication is necessary when anxiety interferes with your quality of life."
B) "Probably not, but you shouldn't compare yourself to your neighbour."
C) "Medication is necessary initially; later we will try therapy."
D) "Medications are a way of life for clients with anxiety disorders."

Question 11

The nurse has completed group education for clients with anxiety disorders. The education is evaluated as successful when the clients make which statements? Select all that apply.

A) "We need therapy to learn where this anxiety comes from."
B) "We need different medicines for anxiety, and for difficulty in sleeping."
C) "Relaxation techniques will often decrease anxiety."
D) "Antianxiety medicine should be used until our anxiety is gone."
E) "Antianxiety medicine should not be used indefinitely."

Question 12

The nurse has completed medication education for the anxious client who is receiving buspirone (BuSpar) The nurse determines that the client needs additional instruction when the client makes which statement?

A) "I can take this medication when I feel anxious and it will relax me."
B) "I don't need to worry about becoming dependent on this medication."
C) "I have to take this medicine on a regular basis for it to help me."
D) "Side effects I might experience include dizziness, headache, and drowsiness."

Question 13

The client is receiving clonazepam (Apo -Clonazepam) for the treatment of panic attacks. What is an important medication outcome for this client as it relates to safety?

A) The client will verbalize the signs of developing Stevens -Johnson rash.
B) The client will verbalize the consequences of stopping the drug abruptly.
C) The client will verbalize the importance of diet restrictions related to this drug.
D) The client will verbalize the importance of having routine blood work done.

Question 14

The client is scheduled to have an EEG to confirm the presence of a sleep disorder. The client asks the nurse to describe Stage IV NREM sleep. What is the best response by the nurse?

A) "Dreaming occurs here; without dreams you will be irritable and paranoid."
B) "This is the deepest stage of sleep; without it you will be tired and depressed."
C) "This is the lightest stage of sleep, and is profoundly affected by anxiety.
D) "This stage comprises the greatest amount of sleep time, and is important."

Question 15

The client is receiving escitalopram (Cipralex) for treatment of generalized anxiety disorder. The client asks the nurse "I am just nervous, not depressed. Why am I taking an antidepressant medicine?" What is the best response by the nurse?

A) "The same brain chemicals are involved with anxiety as well as depression, and these medications are very safe."
B) "Your doctor thinks that this is the best treatment for your anxiety, and these medications are safer than benzodiazepines."
C) "The two disorders go together, and if you treat depression, the anxiety goes away."
D) "You are really depressed; it is just manifested as anxiety. These medications are safer than benzodiazepines."