Deck 14: Drugs for Anxiety and Insomnia

Question 1

The nurse has provided teaching for a client prescribed clonazepam (Klonopin). Which is an important outcome when evaluating the client's understanding of the teaching?

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

Answer 1

The client will verbalize the consequences of abruptly stopping the drug.

Question 2

The nurse has completed group education for clients with anxiety disorders. Which statement made be a client indicates an understanding of the education? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "Relaxation techniques will often decrease anxiety."
B) "Antianxiety medicine should be used until anxiety is gone."
C) "Antianxiety medicine should not be used indefinitely."
D) "Therapy may help identify where this anxiety comes from."
E) "Different medications are required for treating anxiety than for treating difficulty sleeping."

Answer 2

"Relaxation techniques will often decrease anxiety."
"Antianxiety medicine should not be used indefinitely."
"Therapy may help identify where this anxiety comes from."

Question 3

A client tells the nurse that he or she worries about everything all day, feels confused, restless. Which should the nurse suspect the client is experiencing?

A) Generalized anxiety
B) Social anxiety
C) Post-traumatic stress disorder (PTSD)
D) Panic disorder

Answer 3

Generalized anxiety

Question 4

A client experiencing nervousness asks the nurse why escitalopram was prescribed. Which response should the nurse provide the client?

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

Question 5

Which condition is a client most likely experiencing who tells the nurse he or she is having difficulty sleeping because he or she has two final exams approaching?

A) Situational anxiety
B) Social anxiety
C) Obsessive-compulsive disorder
D) Performance anxiety

Question 6

A client presents to the emergency department suspected of overdosing on lorazepam (Ativan). Which prescription should the nurse prepare to administer?

A) Pralidoxime (Protopam)
B) Naloxone (Narcan)
C) Flumazenil (Romazicon)
D) Nalmefene (Revex)

Question 7

A client is prescribed zolpidem (Ambien) for treatment of short-term insomnia. Which is the primary safety concern of the nurse?

A) Dizziness and daytime sedation
B) Nausea
C) Diarrhea
D) Sleepwalking

Question 8

A client asks the nurse to describe NREM stage 3 sleep. Which response should the nurse provide the client?

A) "This is the lightest stage of sleep and is profoundly affected by anxiety."
B) "Dreaming occurs here; without dreams you will be irritable and paranoid."
C) "This is the deepest stage of sleep; without it you will be tired and depressed."
D) "This is also called paradoxical sleep."

Question 9

A client with a generalized anxiety disorder asks the nurse if he or she will need medication for treatment. Which response should the nurse provide the client?

A) "A prescription is a common treatment for clients with anxiety disorders."
B) "A prescription is necessary initially; followed by therapy."
C) "You most likely will not require a prescription."
D) "A prescription is necessary when anxiety interferes with your quality of life."

Question 10

Which client should the nurse be most concerned with taking benzodiazepines?

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

Question 11

A client asks the nurse why he or she is prescribed different types of medications for his or her anxiety and insomnia. Which response should the nurse provide the client? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

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

Question 12

A client has taken different prescriptions over the past two years that have been unsuccessful in treating his or her insomnia. Which condition should the nurse suspect the client may be experiencing?

A) Sleep apnea
B) Anxiety disorder
C) Addiction
D) Personality disorder

Question 13

Which drug category can be used for treating anxiety?

A) Antitussives
B) Anticoagulants
C) Seizure drugs
D) Antibiotics

Question 14

A client presents to the clinic with symptoms of hyperthermia and diaphoresis. The client's prescription history includes escitalopram (Lexapro), St. John's wort, levothyroxine, and acetaminophen. Which should the nurse suspect has occurred?

A) The patient may be experiencing serotonin syndrome.
B) The patient may have contracted a virus.
C) The patient may be experiencing withdrawal.
D) The patient may be experiencing thyroid toxicosis.

Question 15

Which should the nurse recommend to a client as a primary approach to managing stress?

A) A combined approach using a prescription and nonpharmacological strategies
B) The use of an anxiolytic
C) The practice of meditation
D) To determine the cause of the anxiety

Question 16

Which area of the brain is primarily responsible for maintaining sleep and wakefulness?

A) Reticular activating system
B) Cerebral cortex
C) Limbic system
D) Cerebellum

Question 17

A client with anxiety and insomnia asks the nurse about the benefits of treatment with a benzodiazepine. Which response should the nurse provide the client?

A) "Benzodiazepines are the most effective."
B) "Benzodiazepines have the lowest risk of dependency and tolerance."
C) "Benzodiazepines are most likely to be covered under insurance premiums."
D) "Benzodiazepines are most affordable."

Question 18

A client ask the nurse which part of the brain controls anxiety and insomnia. Which response should the nurse provide?

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

Question 19

The nurse has completed the education for a client prescribed buspirone (BuSpar). Which statement made by the client indicates further teaching is required?

A) "The side effects I might experience include dizziness, headache, and drowsiness."
B) "I can take this prescription when I feel anxious and it will relax me."
C) "This prescription should be taken on a regular basis for it to help me."
D) "I don't need to worry about becoming dependent on this prescription."

Question 20

A client who has been taking lorazepam (Ativan) for 2 years presents to the clinic and tells the nurse that he or she stopped taking his or her medication 3 days prior. Which assessment findings should the nurse anticipate?

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

Question 21

Which nonpharmacological interventions should the nurse recommend for a client who is having difficulty sleeping? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "Make certain your bedroom is nice and warm."
B) "There are alternative methods to treat insomnia, such as yoga, meditation, and massage therapy."
C) "Eating a large meal at bedtime will help induce sleep."
D) "Avoid caffeinated beverages, nicotine, and alcohol immediately prior to bedtime."
E) "Play your favorite type of music when you go to sleep."

Question 22

A client asks the nurse if there are any over-the-counter herbs or nonprescription medications that can be used to improve insomnia. Which response should the nurse provide the client? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "Ginger root is commonly taken to improve sleep."
B) "Ginkgo is an herb commonly taken to improve sleep."
C) "Diphenhydramine (Benadryl) and doxylamine are over-the-counter meds sometimes taken to produce drowsiness."
D) "Valerian and melatonin are herbs commonly taken to improve sleep."
E) "Kava is an herb taken to improve sleep."

Question 23

A client asks the nurse which prescriptions are commonly used to treat insomnia. Which pharmacological agents should the nurse discuss with the client? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Diphenhydramine (Benadryl)
B) Valerian root
C) Ramelteon (Rozerem)
D) Flurazepam (Dalmane)
E) Zolpidem (Ambien)

Question 24

Which statement regarding the use of zolpidem (Ambien) for insomnia is accurate?

A) Clients using Ambien should avoid foods that contain tyramine.
B) Ambien will take longer to produce an effect when taken with food.
C) Ambien is contraindicated during pregnancy but can be taken by breastfeeding mothers.
D) Ambien is classified as a benzodiazepine.

Question 25

Which information should the nurse include in the teaching for a client prescribed ramelteon?

A) Daytime drowsiness is common.
B) There is an increased risk of physical dependence.
C) Relatively short onset of action.
D) The primary action is to induce a deep sleep state.

Question 26

Which should the nurse recognize is a benefit of obtaining a thorough history from a client who is experiencing anxiety?

A) Pharmacotherapy can be prescribed.
B) The type of counseling can be prescribed based on the history.
C) The category of anxiety disorder can be identified.
D) The treatment plan can be created.

Question 27

Which explanation best explains why barbiturates are rarely used to treat anxiety and insomnia?

A) They have a greater associated cost.
B) They have a high risk of producing an allergic response.
C) They are seldom effective.
D) They produce many serious adverse effects.

Question 28

The nurse is preparing the education for a client prescribed a selective serotonin reuptake inhibitors (SSRI). Which adverse effects should the nurse include in the teaching?

A) Drowsiness and coma
B) Weight gain and sexual dysfunction
C) Headache and nausea
D) Dry mouth and urine retention

Question 29

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. Which are the best actions for the nurse to take at this time? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Check the client's oxygen status.
B) Request a prescription for a sleep hypnotic.
C) Assess the client's vital signs.
D) Turn down the lights at night and reduce noise to a minimum.
E) Schedule all tests and procedures before 9 p.m. or after 7 a.m.

Question 30

Which assessment findings should the nurse anticipate if a client is diagnosed with post-traumatic stress disorder? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Tachycardia
B) Panic attacks
C) Inability to focus
D) A fear of exposure to germs
E) Hallucinations