CNS depressants (before midterm)

Question 1

Which is a true statement about sedatives and hypnotics? a. The two terms mean the same thing.
Ob. A hypnotic causes sleep.
c. Low doses of sedatives will cause sleep.
d. Compared with sedatives, hypnotics have a less potent effect on the central
nervous system.

Answer 1

ANS: B
A sedative reduces nervousness, excitability, and irritability without causing sleep, whereas a hypnotic causes sleep.

Question 2

A patient who has been taking phenobarbital for 2 weeks as part of therapy for epilepsy reports feeling tense and that the “least little thing” is a bother now. What is the nurse’s best explanation to the patient?
a. These adverse effects will often subside after a few weeks.
b. The drug should 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.
Od. This drug causes deprivati

Answer 2

ANS: D
Barbiturates deprive people of REM sleep, which can result in agitation and an inability to deal with normal stress. A rebound phenomenon occurs when the drug is stopped, and the proportion of REM sleep increases, sometimes resulting in nightmares

Question 3

A 50-year-old male who has been taking a benzodiazepine for 1 week is found unresponsive. His wife states that he takes no other prescription drugs and that he did not take an overdose—the correct number of pills is in the bottle. What might have happened? a. He took a multivitamin.
Ob. He drank a glass of wine.
c. He took a dose of Aspirin.
d. He developed an allergy to the drug.

Answer 3

ANS: B
Potential drug interactions with the benzodiazepines are significant because of their intensity, particularly when they involve other central nervous system (CNS) depressants (e.g., alcohol, opioids, muscle relaxants).

Question 4

A patient has been taking temazepam (Restoril®) for intermittent insomnia. She tells the nurse that when she takes it, she sleeps well, but the next day she feels “so tired.” What is the nurse’s best explanation to the patient?
a. Long-term use results in a sedative effect.
b. She should take the drug every night to reduce this hangover effect.
Oc. Benzodiazepines affect the sleep cycle, thus causing a hangover effect.
d. Benzodiazepines increase CNS activity, thus causing tiredness the next day.

Answer 4

ANS: C
Benzodiazepines suppress rapid eye movement REM sleep to a degree (though not as much as barbiturates) and thus result in a hangover effect.

Question 5

A patient who is recovering from a minor automobile accident that occurred 1 week ago is taking cyclobenzaprine (Novo-Cycloprine®) for muscular pain and goes to physical therapy three times a week. Which nursing diagnosis would be appropriate for him?
Oa. Risk for falls related to decreased sensorium
b. Risk for addiction related to psychological dependency
c. Excess fluid volume related to potential adverse effects
d. Disturbed sleep pattern related to the drug’s interference with REM sleep

Answer 5

ANS: A
Musculoskeletal relaxants have a depressant effect on the CNS; lightheadedness, dizziness, drowsiness, and fatigue can occur, thus putting the patient at risk for falls. The patient should be taught the importance of taking measures to minimize self-injury and falls related to decreased sensorium.

Question 6

A patient is taking flurazepam (Apo-Flurazepam®) 3 to 4 nights a week for sleeplessness. She is concerned that she cannot get to sleep without taking the medication. What measures are appropriate for this patient?
a. Trying to establish set sleep patterns
b. Exercising before bedtime to become tired
c. Consuming heavy meals in the evening to promote sleepiness
d. Drinking warm beverages, such as tea or coffee, just before bedtime

Answer 6

ANS: A
Nonpharmacological approaches to induce sleep include establishing set sleep patterns. The patient should avoid heavy exercise before bedtime, avoid heavy meals late in the evening, and should drink warm decaffeinated drinks, such as warm milk, before bedtime.

Question 7

Which is the best treatment of an acute overdose of diazepam?
a. Infusion with diluted bicarbonate solution
b. Administration of medications to decrease blood pressure
c. Administration of flumazenil
d. Administration of nalbuphine as an antagonist

Answer 7

ANS: C
Flumazenil, a benzodiazepine antidote, can be used to acutely reverse the sedative effects of benzodiazepines. Flumazenil antagonizes the action of benzodiazepines on the CNS by directly competing with them for binding at the receptors. Flumazenil is used in cases of oral overdose or excessive intravenous sedation. Infusion with diluted bicarbonate solution and the administration of medications to decrease blood pressure are not appropriate treatments. There are no antagonists for barbiturates.

Question 8

A 45-year-old female has been taking dantrolene as part of the treatment for multiple sclerosis. Which laboratory value should the nurse monitor while the patient receives dantrolene?
a. Creatinine
b. Sedimentation rate
c. Liver function studies
d. Hemoglobin and hematocrit

Answer 8

ANS: C
Dantrolene can cause liver damage; therefore, liver function studies should be performed during therapy.

Question 9

What is an adverse effect of barbiturate administration? a. Vasoconstriction
b. Thrombocytopenia
c. Hypertension
d. Excitement

Answer 9

ANS: B
An adverse effect of barbiturate use is thrombocytopenia. Some other effects include hypotension, vasodilation, and drowsiness and lethargy.

Question 10

Which natural health product is used by some people to promote sleep and to relieve anxiety and restlessness? a. Kava
b. Garlic c. Ginger d. Ginkgo

Answer 10

ANS: A
Kava may be used to promote sleep and for relief of anxiety and restlessness.