Question 1

A client complains of frequent awakenings during the night with an inability to return to sleep.The client does not have difficulty falling asleep initially.Which medication would the nurse anticipate preparing?

Accepted Answer

Eszopiclone (Lunesta) is a medication that is specifically indicated for difficulty returning to sleep after waking up in the middle of the night. It has a longer half-life than other benzodiazepine receptor agonists, which makes it effective for helping patients stay asleep throughout the night. Estazolam (ProSom) and Temazepam (Restoril) are both benzodiazepines that are better suited for difficulty falling asleep initially. Ramelteon (Rozerem) is a melatonin agonist that is also better suited for difficulty falling asleep initially.

Question 2

A client,who experienced shortness of breath,tachycardia,profuse diaphoresis,and trembling learns that all cardiac diagnostic tests are negative for an acute myocardial infarction.During the assessment,the nurse is told about a major problem that has caused the client great concern over the last two months.The nurse interprets this information as being consistent with which anxiety disorder?

Accepted Answer

The client's symptoms of shortness of breath, tachycardia, profuse diaphoresis, and trembling are consistent with a panic attack. The mention of a major problem causing great concern over the last two months also suggests that the client may be experiencing generalized anxiety disorder; however, the acute nature of the symptoms described points more towards panic disorder. Social anxiety disorder would involve fear and avoidance of social situations, while obsessive-compulsive disorder would involve recurrent thoughts or obsessions that lead to compulsive behaviors.

Question 3

It is important for the nurse to obtain a thorough history from a client who is experiencing anxiety.What can the nurse distinguish through the history? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

Accepted Answer

A,B,E

Question 4

Signals routed through the amygdala ultimately connect with the hypothalamus,an important center responsible for modulating the fight-or-flight response of the autonomic nervous system.Which are emotional states associated with this connection? Note: Credit will be given only if all choices and no incorrect choices are selected.Standard Text: Select all that apply.

Accepted Answer

The answer of Signals routed through the amygdala ultimately connect...

Question 5

A client who is complaining of anxiety and difficulty sleeping has asked what prescription medications would assist in getting to sleep.What would be appropriate responses? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

Accepted Answer

The answer of A client who is complaining of anxiety...

Question 6

The client is diagnosed with post-traumatic stress disorder (PTSD).What will the nurse assess in this client? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

Accepted Answer

The answer of The client is diagnosed with post-traumatic stress...

Question 7

A client comes to the emergency department with shortness of breath,difficulty breathing,pressure in the chest,and a feeling of impending doom.After diagnostic tests and an electrocardiogram,the findings are not consistent with an acute myocardial infarction.What should the nurse do next?

Accepted Answer

The symptoms described by the client are consistent with a panic attack or anxiety disorder. Therefore, obtaining a history of recent events that might trigger anxiety or drug abuse is an appropriate next step to further evaluate the client's condition. Assessing the gastrointestinal system or prescribing pain medication would not address the client's symptoms. Discharging the client without further evaluation or treatment would be inappropriate and could lead to potentially serious consequences.

Question 8

A client with anxiety and insomnia has been taking alprazolam (Xanax)for five days.What is the priority for the nurse to assess in this client?

Accepted Answer

The priority for the nurse to assess in a client taking alprazolam (Xanax) is the presence of suicidal thoughts or ideations. Xanax is a benzodiazepine that can cause depressive symptoms, including suicidal thoughts or behaviors. Therefore, it is essential to monitor clients closely for the development of depressive symptoms, especially in the early stages of treatment. The other options are also important to assess, but they are not the priority compared to suicidal thoughts or ideations.

Question 9

A client is taking verapamil for hypertension,Glucotrol for management of type II diabetes,and melatonin for sleep.Which the nurse ask about these medications?

Accepted Answer

The answer of A client is taking verapamil for hypertension,Glucotrol...

Question 10

The nurse distinguishes medications used in general surgery as either hypnotic or sedative,or sedative-hypnotic.The nurse can anticipate the anesthesiologist using which sedative-hypnotic for induction of anesthesia?

Accepted Answer

Thiopental sodium (Pentobarbital) is commonly used in general anesthesia for induction due to its fast onset and rapid recovery. Clorazepate, alprazolam, and temazepam are benzodiazepines which are primarily used for their sedative and anxiolytic properties, and may be used as adjuncts during surgery or for preoperative medication.

Question 11

A client diagnosed with generalized anxiety disorder is prescribed a tricyclic antidepressant,Doxepin (Sinequan).Which statement indicates that the client understands the actions of this medication?

Accepted Answer

The statement "I might need to suck on sugar-free hard candy for my dry mouth" indicates that the client understands one of the common side effects of Doxepin (Sinequan) which is dry mouth. Option A indicates a misunderstanding of the medication's actions as it is not immediate and takes time to work. Option B is incorrect as all medications have the potential for side effects. Option C is partially correct as long-term use of tricyclic antidepressants can lead to drug dependency, but it is important to note that this is not a medication that is typically abused or addictive in nature.

Question 12

A client whose spouse recently died is having difficulty falling asleep and does not want to take any prescription medications to induce sleep.Which response by the nurse is the most appropriate? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

Accepted Answer

A) Exercise, especially in the morning, can help regulate the body's natural sleep-wake cycle, improving sleep quality.B) Yoga, meditation, and massage therapy are recognized alternative methods that can help reduce stress and improve sleep without the need for medication.D) Caffeinated beverages, nicotine, and alcohol can interfere with the ability to fall asleep and the quality of sleep, so avoiding them before bedtime is beneficial for someone experiencing insomnia.

Question 13

A client diagnosed with insomnia,triggered by anxiety,is prescribed paroxetine (Paxil).When the client asks the nurse why an antidepressant has been prescribed,which response by the nurse is the most appropriate?

Accepted Answer

Option B is the most appropriate response because it accurately explains that there is a link between insomnia and anxiety, and many antidepressants that are effective for treating anxiety are also given to treat insomnia. This explanation offers a clear and concise reason for why Paxil was prescribed. Option A is incorrect because Paxil is not a sedative-hypnotic, and Option C is incorrect because there are no studies that indicate that antidepressants are inherently safer than other medications used to induce sleep. Option D is incorrect because antidepressants do not act immediately; it often takes 2-4 weeks for the full therapeutic effect of the medication to be reached.

Question 14

A client who recently returned from duty in Iraq is diagnosed with post-traumatic stress disorder (PTSD).The client's family questions what this means.How should the nurse respond to the family?

Accepted Answer

This choice defines PTSD by listing common symptoms associated with the disorder, including nightmares, hallucinations, and flashbacks, which are often accompanied by physical symptoms such as a racing heart, sweating, shortness of breath, and trembling. It is important for the family to understand the severity of the disorder in order to support their loved one's treatment and recovery. Choices A, B, and D describe symptoms related to other anxiety disorders but do not fully capture the complexity of PTSD.

Question 15

The spouse of a client tells the nurse about the client's twitching and jerking shortly after lying down and says it stops after the client goes into a deep sleep.Which response is the most appropriate from the nurse?

Accepted Answer

Twitching and jerking shortly after lying down might be normal body movements during the transition from wakefulness to sleep. Since the symptoms stop after the client goes into a deep sleep, it is unlikely to be a pathological condition like restless leg syndrome. Hence, reassuring the spouse that it might be a part of the normal sleep cycle would be an appropriate response from the nurse.

Question 16

A client diagnosed with narcolepsy,sleepwalking,and cataplexy is prescribed a selective serotonin reuptake inhibitor (SSRI).Which explanation regarding this medication is the most accurate?

Accepted Answer

The answer of A client diagnosed with narcolepsy,sleepwalking,and cataplexy is...

Question 17

A client is complaining of irritability,difficulty with memory,constant fatigue,and an inability to fall asleep.The client averages 3 hours of sleep each night,has been following a restricted calorie evening meal as part of a weight loss plan,and exercises every evening.Instead of food,the client drinks no-calorie caffeinated sodas.What should the nurse suggest to this client?

Accepted Answer

The client's symptoms suggest a disruption in NREM sleep, which can be caused by exercising late in the evening and drinking caffeine close to bedtime. Additionally, the restricted calorie evening meal may not be providing enough nutrients to facilitate a better sleep. Suggesting a larger meal later in the evening may cause discomfort and disrupt sleep even further. An MRI is unnecessary at this point as the client's symptoms are likely caused by lifestyle factors that can be addressed without extensive testing. Simply acknowledging that dieting can cause difficulty sleeping may not fully address the client's specific behaviors and symptoms.

Question 18

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.What 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.Standard Text: Select all that apply.

Accepted Answer

The answer of A client has been in the intensive...

Question 19

A client who recently experienced the loss of a spouse asks the nurse if there are any over-the-counter herbs or nonprescription medications that can be used to improve insomnia.Which response by the nurse is the most appropriate? Standard Text: Select all that apply.

Accepted Answer

- Diphenhydramine (Benadryl) and doxylamine are over-the-counter medications that are sometimes used to induce drowsiness and can help with sleep. Valerian and melatonin are natural supplements that are commonly used to improve sleep. Ginger root and Ginkgo are not primarily used for sleep improvement, and while Kava has been used for relaxation and sleep, it has safety concerns including potential liver damage.

Question 20

A client is being assessed for complaints of difficulty getting to and staying asleep,chronic fatigue,and difficulty staying awake during daytime hours.A sleep study has been ordered.Which medication should the nurse teach the client to avoid prior to the sleep study?

Accepted Answer

Buspirone is a medication that can affect sleep patterns and should be avoided prior to a sleep study. Fosinopril and Calan SR have no known effects on sleep and folic acid is a vitamin supplement that would not affect sleep.

Quiz 18: Pharmacotherapy of Anxiety and Sleep Disorders

A client complains of frequent awakenings during the night with an inability to return to sleep.The client does not have difficulty falling asleep initially.Which medication would the nurse anticipate preparing?

It is important for the nurse to obtain a thorough history from a client who is experiencing anxiety.What can the nurse distinguish through the history? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

The client is diagnosed with post-traumatic stress disorder (PTSD) .What will the nurse assess in this client? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A client comes to the emergency department with shortness of breath,difficulty breathing,pressure in the chest,and a feeling of impending doom.After diagnostic tests and an electrocardiogram,the findings are not consistent with an acute myocardial infarction.What should the nurse do next?

A client with anxiety and insomnia has been taking alprazolam (Xanax) for five days.What is the priority for the nurse to assess in this client?

A client is taking verapamil for hypertension,Glucotrol for management of type II diabetes,and melatonin for sleep.Which the nurse ask about these medications?

The nurse distinguishes medications used in general surgery as either hypnotic or sedative,or sedative-hypnotic.The nurse can anticipate the anesthesiologist using which sedative-hypnotic for induction of anesthesia?

A client diagnosed with generalized anxiety disorder is prescribed a tricyclic antidepressant,Doxepin (Sinequan) .Which statement indicates that the client understands the actions of this medication?

A client diagnosed with insomnia,triggered by anxiety,is prescribed paroxetine (Paxil) .When the client asks the nurse why an antidepressant has been prescribed,which response by the nurse is the most appropriate?

A client who recently returned from duty in Iraq is diagnosed with post-traumatic stress disorder (PTSD) .The client's family questions what this means.How should the nurse respond to the family?

The spouse of a client tells the nurse about the client's twitching and jerking shortly after lying down and says it stops after the client goes into a deep sleep.Which response is the most appropriate from the nurse?

A client diagnosed with narcolepsy,sleepwalking,and cataplexy is prescribed a selective serotonin reuptake inhibitor (SSRI) .Which explanation regarding this medication is the most accurate?

A client who recently experienced the loss of a spouse asks the nurse if there are any over-the-counter herbs or nonprescription medications that can be used to improve insomnia.Which response by the nurse is the most appropriate? Standard Text: Select all that apply.

A client is being assessed for complaints of difficulty getting to and staying asleep,chronic fatigue,and difficulty staying awake during daytime hours.A sleep study has been ordered.Which medication should the nurse teach the client to avoid prior to the sleep study?