Question 1

The nurse is assessing a patient who is being evaluated in an outpatient clinic for complaints of back pain. The patient reports taking diphenhydramine for insomnia related to job stress. Which statement by the nurse is accurate regarding this medication?

A) "This medication should only be taken for 1 week."
B) "This medication can cause nausea."
C) "The medication should not be taken after eating a high-fat meal."
D) "This is an herbal medication that has been used for hundreds of years."

"This medication should only be taken for 1 week."

Accepted Answer

&#34;This medication should only be taken for 1 week.&#34;

Question 2

Which two phases make up normal sleep?&#10;A) Hypnogogic and hypnopompic&#10;B) REM and non-REM&#10;C) Alpha and beta&#10;D) Delta and theta

Accepted Answer

REM (rapid eye movement) and non-REM (non-rapid eye movement) are the two phases of normal sleep. Non-REM is further divided into three stages (N1, N2, and N3), while REM sleep is a separate phase characterized by rapid eye movements, high brain activity, and vivid dreaming.

Question 3

Why are benzodiazepines often preferred over barbiturates? (Select all that apply.)&#10;A) They have selective action at specific receptor sites.&#10;B) There is a wide range of safety between therapeutic and lethal levels.&#10;C) REM sleep is decreased to a lesser extent.&#10;D) Accidental overdoses are well tolerated.&#10;E) There are no hypotensive episodes when rising to a sitting position.

Accepted Answer

Benzodiazepines are often preferred over barbiturates because they have a selective action at specific receptor sites, making them more effective for anxiety and insomnia with fewer side effects. They have a wider safety margin between therapeutic and lethal doses, reducing the risk of fatal overdose. REM sleep is less affected, preserving more natural sleep patterns. Additionally, accidental overdoses are generally better tolerated due to their high therapeutic index.

Question 4

The nurse finds that a patient is extremely agitated, yelling out frequently, and attempting to get out of bed without assistance. What is the nurse's initial action?&#10;A) Administer zolpidem after taking the patient's vital signs.&#10;B) Close the patient's door for privacy after administering Tylenol.&#10;C) Administer benzodiazepine before calling the health care provider.&#10;D) Spend uninterrupted time listening to the patient.

Accepted Answer

Spending uninterrupted time listening to the patient is the best initial action to assess the cause of the agitation and address any underlying concerns. Administering medication without first assessing the patient's condition and identifying the cause of the behavior can be harmful and is not appropriate.

Question 5

Which are common adverse effects of barbiturates? (Select all that apply.)&#10;A) Residual daytime sedation&#10;B) Headache&#10;C) Hyperactivity&#10;D) Blurred vision&#10;E) Impaired coordination

Accepted Answer

The answer of Which are common adverse effects of barbiturates?...

Question 6

A patient receiving diazepam (Valium) is complaining of nausea and vomiting and is becoming jaundiced. Which type of blood work will be performed?&#10;A) Renal function tests&#10;B) Liver function tests&#10;C) Clotting times&#10;D) Electrolyte panels

Accepted Answer

Diazepam is metabolized by the liver, and nausea, vomiting, and jaundice can indicate liver dysfunction. Therefore, liver function tests would be the appropriate blood work to perform.

Question 7

An older adult patient received a hypnotic agent at 9:00 PM. At 2:00 AM, the nurse discovers that the patient has removed her gown and is attempting to get out of bed without assistance. What type of medication effect is the patient exhibiting?

A) Allergic
B) Hypersensitivity
C) Paradoxical
D) Therapeutic

Accepted Answer

The patient is exhibiting a paradoxical effect, which occurs when a medication has the opposite effect of what was intended. In this case, the hypnotic agent was meant to induce sleep, but instead, the patient is showing increased activity and agitation. Allergic and hypersensitivity reactions typically involve physical symptoms such as rash, itching, or swelling, which are not present in this scenario. Therapeutic effects refer to the desired and intended effects of the medication, which are not being demonstrated by the patient in this case.

Question 8

The nurse is explaining the use of medications to a patient with insomnia. Which statement about sedatives is true?&#10;A) A sedative will produce sleep.&#10;B) Sedatives increase the total time in REM sleep.&#10;C) Increased relaxation occurs with sedatives.&#10;D) Sedatives are more potent than hypnotics.

Accepted Answer

Sedatives do not necessarily produce sleep, but they do promote relaxation and can make falling asleep easier. They may also decrease the amount of time spent in REM sleep. Hypnotics are typically more potent than sedatives and are used to induce and maintain sleep.

Question 9

A patient has been prescribed lorazepam (Ativan), a benzodiazepine used to treat insomnia. Which action will the nurse take?&#10;A) Advise the patient to take the medication with food.&#10;B) Assess the patient's blood pressure in sitting and lying positions.&#10;C) Inform the patient to discontinue the medication once sleep improves.&#10;D) Instruct the patient to lie down before taking the medication.

Accepted Answer

The answer of A patient has been prescribed lorazepam (Ativan),...

Question 10

Which sleep pattern stage diminishes as an effect of aging?&#10;A) Stage I&#10;B) Stage II&#10;C) Stage III&#10;D) Stage IV

Accepted Answer

Stage IV, also known as deep sleep, diminishes as an effect of aging. This is because as we age, our bodies produce less growth hormone, which is essential for deep sleep. As a result, older adults may experience more restless sleep and wake up more frequently during the night.

Question 11

In addition to facilitating sleep, what is another benefit of sedatives?&#10;A) Increased pain control postoperatively&#10;B) Reduced bronchial secretions&#10;C) Decreased patient anxiety&#10;D) Increased patient alertness

Accepted Answer

The answer of In addition to facilitating sleep, what is...

Question 12

Which disease is associated with insufficient sleep?&#10;A) Cancer&#10;B) Glaucoma&#10;C) Myocardial infarction&#10;D) Renal failure

Accepted Answer

The answer of Which disease is associated with insufficient sleep?&#10;A)...

Question 13

For what conditions are benzodiazepines prescribed?&#10;A) Chronic amnesia&#10;B) Chronic insomnia&#10;C) Preoperative sedation&#10;D) Psychotic episodes

Accepted Answer

The answer of For what conditions are benzodiazepines prescribed?&#10;A) Chronic...

Question 14

What can occur as a result of rapid withdrawal from long-term use of barbiturate therapy? (Select all that apply.)&#10;A) Anxiety&#10;B) Delirium&#10;C) Weakness&#10;D) Grand mal seizures&#10;E) Severe pain

Accepted Answer

The answer of What can occur as a result of...

Question 15

The nurse is caring for an older patient recently admitted to an assisted living center who is experiencing insomnia associated with the recent relocation. At bedtime, which nursing action will assist the patient to sleep?

A) Offering the patient hot tea
B) Encouraging the patient to ambulate in the hallway
C) Performing back massage
D) Administering an analgesic

Accepted Answer

The answer of The nurse is caring for an older...

Deck 14: Sedative-Hypnotics