Chapter 26-CNS sedatives and hypnotics

Question 1

A client asks the nurse why she develops vertigo, dizziness, nausea, and vomiting after taking phenobarbital. The nurse’s best response would be:

Answer 1

“Barbiturates can cause a ‘hangover’ effect resulting in these manifestations.”

Question 2

The nurse is caring for a client receiving IV midazolam for conscious sedation for a procedure. The nurse should:

Answer 2

monitor closely for respiratory depression.

Respiratory depression can occur with IV administration.

Question 3

When teaching clients, the nurse explains that the most common ingredient in nonprescription sleep aids is

Answer 3

diphenhydramine.- is an antihistamine that causes drowsiness and is the most common ingredient in nonprescription sleep aids.

Question 4

The nurse is aware that particular attention is warranted for the client who is prescribed phenobarbital, particularly when the client also takes:

Answer 4

warfarin. Oral anticoagulant levels are decreased with the use of phenobarbital.

Question 5

Which of the following clients receiving benzodiazepines as hypnotics are at greatest risk for complications?

Answer 5

clients who are depressed or suicidal

Question 6

A client is prescribed 15 mg of flurazepam for sleep, which could be repeated if the client were unable to sleep. At 0100, the client complains of inability to sleep. Should the night nurse give the client a second dose of flurazepam?

Answer 6

Yes, after trying to determine why the client is unable to sleep
If there are no other factors that can be modified to help the client sleep, administer the second dose.

Question 7

After administering triazolam to a hospitalized client the nurse should:

Answer 7

raise the client’s side rails.

Question 8

Which of the following would be the most supportive nursing measures to assist clients with sleep needs?

Answer 8

Unmanaged pain is one of the most common causes of clients’ inability to rest and sleep.

Question 9

When teaching a client who is prescribed zolpidem tartrate, the most appropriate statement by the nurse is:

Answer 9

“Avoid driving your car after you have taken this medication.

Question 10

The nurse understands which of the following about chloral hydrate?

Answer 10

short duration of action, rarely produces a hangover feeling

Question 11

When discussing the use of nonprescription sleep aids, the nurse should instruct clients that:

Answer 11

talk with your doctor if insomnia lasts longer than 2 weeks.

Question 12

When used as hypnotics, some barbiturates lose their effectiveness after ____ of regular use.

Answer 12

2 week-According to research, 2 weeks is the maximum effectiveness for some barbiturates.

Question 13

The client receiving parenteral pentobarbital should be monitored for:

Answer 13

infiltration causing tissue necrosis

Question 14

A client benefit of using benzodiazepines as preprocedural or conscious sedation is:

Answer 14

they produce amnesia for the event.

Question 15

Which of the following statement does the nurse understands is true of alcohol?

Answer 15

It is a potent central nervous system (CNS) depressant.

Question 16

A nurse suspects barbiturate toxicity in assessing which of the following client manifestations?

Answer 16

sustained pupillary constriction
Pupillary constriction is a manifestation of barbiturate toxicity, followed by sustained pupil dilation in the final stages.

Question 17

Which of the following comments by the client indicates his understanding of the teaching concerning his prescription for zolpidem tartrate?

Answer 17

“I need to have a follow-up visit with my doctor in a week.”

Question 18

When evaluating a client receiving 75 mg of trazodone each night for sleep, the client tells the nurse that she is experiencing insomnia again in spite of taking the trazodone. The nurse anticipates that the health care provider will

Answer 18

increase the dose of trazodone to 100 mg each night
Increasing the dosage at 25 mg increments is appropriate, because the client probably has developed tolerance to the 75 mg dose.

Question 19

When instructing a client using nonprescription sleep aids, the nurse should instruct the client to:

Answer 19

avoid alcohol. This drug can cause paradoxical psychiatric reactions.

Question 20

The nurse should question a prescription for triazolam for which client?

Answer 20

a psychiatric client

Question 21

The client who abruptly discontinues using triazolam should be monitored for:

Answer 21

rebound insomnia-If abruptly discontinued, this drug can cause insomnia worse than before treatment.

Question 22

A child is scheduled for a liver biopsy, and midazolam is to be administered prior to the procedure. The recommended safe dose for a child is 0.1 to 0.15 mg/kg. The child weighs 55 pounds. What is the maximum dose this child can receive?

Answer 22

55 pounds divided by 2.2 = 25 kg; multiplied by 0.15 mg = 3.75 mg.

Question 23

The nurse understands that the nonbenzodiazepam medications are limited to use in clients:

Answer 23

who are 18 years old or older.

Question 24

Which of the following statements made by the nurse recruit is NOT true concerning Rozerem?

Answer 24

The medication is best absorbed if taken immediately following a high-fat meal.

Question 25

The nurse recruit is questioned about knowledge of clients taking benzodiazepines. Which of the following statements indicates a need for further teaching?

Answer 25

“IV benzodiazepines are compatible in the same syringe with other drugs.”

Question 26

Which of the following is NOT an adverse effect of trazodone HCl?

Answer 26

hypertension-Orthostatic hypotension, not hypertension, is an adverse effect of trazodone HCl.

Question 27

The nurse is aware that which of the following may be administered intravenously? Select all that apply.

Answer 27

a. diazepam
c. lorazepam
d. midazolam

Question 28

A client asks a nurse if there are some interventions he can take to promote sleep. Which of the following would be included in the nurse’s reply? Select all that apply

Answer 28

b. consistent time for retiring and rising
d. reading a book or magazine
e. relief of hunger
f. exercising during the day

Question 29

Your client has a new prescription for Lunesta. Which of the following statements should the nurse include in client teaching? Select all that apply.

Answer 29

a. Unpleasant taste may be an adverse effect.
b. Do not discontinue the medication abruptly.
c. Take the medication with a full glass of water on an empty stomach.
d. Do not crush or break the tablet.
f. OTC medications should be avoided.

Question 30

Which of the following are nursing implications for diazepam? Select all that apply.

Answer 30

a. In full-term infants, elimination half-life is 30 hours.
c. It is used with caution with children.
d. IV route is preferred for use during seizure activity.
e. IM route should be avoided due to pain caused by the injection.