Question 1

A patient is recovering from a minor automobile accident that occurred 1 week ago.He is taking cyclobenzaprine (Flexeril)for muscular pain and goes to physical therapy three times a week.Which nursing diagnosis would be appropriate for him?

A) Risk for injury related to decreased sensorium
B) Risk for addiction related to psychologic dependency
C) Decreased fluid volume related to potential adverse effects
D) Disturbed sleep pattern related to the drug's interference with REM sleep

Accepted Answer

Cyclobenzaprine can cause drowsiness and dizziness, leading to a decreased sensorium, which increases the risk for injury.

Question 2

A patient has experienced insomnia for months,and the physician has prescribed a medication to help with this problem.The nurse expects which drug to be used for long-term treatment of insomnia?&#10;A) Secobarbital (Seconal),a barbiturate&#10;B) Diazepam (Valium),a benzodiazepine&#10;C) Midazolam (Versed),a benzodiazepine&#10;D) Eszopiclone (Lunesta),a nonbenzodiazepine sleep aid

Accepted Answer

Eszopiclone (Lunesta) is a nonbenzodiazepine sleep aid that is commonly used for long-term treatment of insomnia. It has been shown to be effective and safe for extended use, with a low risk of dependence or tolerance. Barbiturates (A) are no longer commonly used due to their high potential for side effects and dependence. Benzodiazepines (B and C) may also be effective for short-term treatment, but can have negative effects on memory and cognitive functioning, and can also lead to dependence with long-term use.

Question 3

A 50-year-old man who has been taking phenobarbital for 1 week is found very lethargic and unable to walk after eating out for dinner.His wife states that he has no other prescriptions and that he did not take an overdose-the correct number of pills is in the bottle.The nurse suspects that which of these may have happened?

A) He took a multivitamin.
B) He drank a glass of wine.
C) He took a dose of aspirin.
D) He developed an allergy to the drug.

He drank a glass of wine.

Accepted Answer

Phenobarbital is a central nervous system depressant and consuming alcohol can enhance its effects leading to increased sedation, confusion, and impaired coordination. Therefore, drinking a glass of wine could have resulted in the patient's symptoms. There is no indication that taking a multivitamin or aspirin or developing an allergy to the drug would have caused the patient's symptoms.

Question 4

A patient is brought to the emergency department for treatment of a suspected overdose.The patient was found with an empty prescription bottle of a barbiturate by his bedside.He is lethargic and barely breathing.The nurse would expect which immediate intervention?

A) Starting an intravenous infusion of diluted bicarbonate solution
B) Administering medications to increase blood pressure
C) Implementing measures to maintain the airway and support respirations
D) Administrating naloxone (Narcan)as an antagonist

Accepted Answer

The patient's lethargy and compromised breathing suggest respiratory depression. The nurse should focus on maintaining the airway and supporting respirations. This may involve suctioning the airway, administering oxygen, and potentially intubating the patient if necessary. The other options are not appropriate for a barbiturate overdose. Intravenous bicarbonate may be used for specific types of drug toxicities, but not for barbiturates. Administering medications to increase blood pressure would not directly address the respiratory depression caused by the overdose. Naloxone is an opioid antagonist and would not be effective for a barbiturate overdose.

Question 5

A patient has been taking temazepam (Restoril)for intermittent insomnia.She calls the nurse to say that when she takes it,she sleeps well,but the next day she feels "so tired." Which explanation by the nurse is correct?

A) "Long-term use of this drug results in a sedative effect."
B) "If you take the drug every night,this hangover effect will be reduced."
C) "These drugs affect the sleep cycle,resulting in daytime sleepiness."
D) "These drugs increase the activity of the central nervous system,making you tired the next day."

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Accepted Answer

Temazepam affects the sleep cycle, causing daytime drowsiness or "hangover" effects. It does not increase the activity of the central nervous system or result in long-term sedation. While taking it every night may reduce the hangover effect, it is not always recommended as it can lead to dependence and tolerance.

Question 6

A patient has been taking phenobarbital for 2 weeks as part of his therapy for epilepsy.He tells the nurse that he feels tense and that "the least little thing" bothers him now.Which is the correct explanation for this problem?

A) These are adverse effects that usually subside after a few weeks.
B) The drug must be stopped immediately because of possible adverse effects.
C) This drug causes the rapid eye movement (REM)sleep period to increase,resulting in nightmares and restlessness.
D) This drug causes deprivation of REM sleep and may cause the inability to deal with normal stress.

Accepted Answer

Phenobarbital causes deprivation of REM sleep and may cause the inability to deal with normal stress, which can result in feelings of tension and irritability. It is important to monitor the patient for these adverse effects and consider adjusting the dosage or switching to a different medication if necessary, but stopping the drug abruptly could have serious consequences for the patient's seizure control. These adverse effects may also subside after a few weeks as the patient's body adjusts to the medication.

Question 7

Ramelteon (Rozerem)is prescribed for a patient with insomnia.The nurse checks the patient's medical history,knowing that this medication is contraindicated in which disorder?&#10;A) Coronary artery disease&#10;B) Renal insufficiency&#10;C) Liver disease&#10;D) Anemia

Accepted Answer

Ramelteon is metabolized by the liver and is contraindicated in patients with severe liver disease.

Question 8

A patient is taking flurazepam (Dalmane)three to four nights a week for sleeplessness.She is concerned that she cannot get to sleep without taking the medication.What nonpharmacologic measures should the nurse suggest to promote sleep for this patient?

A) Providing a quiet environment
B) Exercising before bedtime to become tired
C) Consuming heavy meals in the evening to promote sleepiness
D) Drinking hot tea or coffee just before bedtime

Accepted Answer

Nonpharmacologic approaches to induce sleep include providing a quiet environment, avoiding heavy exercise before bedtime, avoiding heavy meals late in the evening, and drinking warm decaffeinated drinks, such as warm milk, before bedtime.

Question 9

A patient who has received some traumatic news is panicking and asks for some medication to help settle down.The nurse anticipates giving which drug that is most appropriate for this situation?&#10;A) Diazepam (Valium)&#10;B) Zolpidem (Ambien)&#10;C) Phenobarbital&#10;D) Cyclobenzaprine (Flexeril)

Accepted Answer

Diazepam is a benzodiazepine that has anxiolytic properties and can provide relief from symptoms of anxiety and panic. It is rapidly absorbed when taken orally and has a calming effect on the body. Zolpidem is a hypnotic drug used for the short-term treatment of insomnia, whereas Phenobarbital is a barbiturate used as a sedative and anticonvulsant agent. Cyclobenzaprine is a muscle relaxant and is not suitable for managing anxiety and panic. Therefore, the most appropriate drug in this scenario is Diazepam.

Question 10

The nurse notes in the patient's medication history that the patient is taking cyclobenzaprine (Flexeril).Based on this finding,the nurse interprets that the patient has which disorder?&#10;A) A musculoskeletal injury&#10;B) Insomnia&#10;C) Epilepsy&#10;D) Agitation

Accepted Answer

Cyclobenzaprine (Flexeril) is a muscle relaxant typically used for musculoskeletal conditions such as sprains, strains, and other musculoskeletal injuries. It is not used for insomnia, epilepsy, or agitation.

Question 11

A patient tells the nurse that he likes to drink kava herbal tea to help him relax.Which statement by the patient indicates that additional teaching about this herbal product is needed?&#10;A) &#34;I will not drink wine with the kava tea.&#34;&#10;B) &#34;If I notice my skin turning yellow,I will stop taking the tea.&#34;&#10;C) &#34;I will not take sleeping pills if I have this tea in the evening.&#34;&#10;D) &#34;I will be able to drive my car after drinking this tea.&#34;

Accepted Answer

The answer of A patient tells the nurse that he...

Deck 12: Central Nervous System Depressants and Muscle Relaxants