SATA 1

Question 1

1. A patient is admitted to the same day surgery unit for liver biopsy. Which of the following laboratory tests assesses coagulation? Select all that apply.
2. Partial thromboplastin time.
3. Prothrombin time.
4. Platelet count.
5. Hemoglobin
6. Complete Blood Count
7. White Blood Cell Count

Answer 1

1. Answer: 1, 2, and3
2. Partial thromboplastin time.
3. Prothrombin time.
4. Platelet count.

Prothrombin time, partial thromboplastin time, and platelet count are all included in coagulation studies. The hemoglobin level, though important information prior to an invasive procedure like liver biopsy, does not assess coagulation.

Question 2

2. A patient is admitted to the hospital with suspected polycythemia vera. Which of the following symptoms is consistent with the diagnosis? Select all that apply.
3. Weight loss.
4. Increased clotting time.
5. Hypertension.
6. Headaches.

Answer 2

2. Answer: 2, 3, and4
3. Increased clotting time.
4. Hypertension.
5. Headaches.

Polycythemia vera is a condition in which the bone marrow produces too many red blood cells. This causes an increase in hematocrit and viscosity of the blood. Patients can experience headaches, dizziness, and visual disturbances. Cardiovascular effects include increased blood pressure and delayed clotting time. Weight loss is not a manifestation of polycythemia vera.

Question 3

3. The nurse is teaching the client how to use a metered dose inhaler (MDI) to administer a Corticosteroid drug. Which of the following client actions indicates that heisusing the MDI correctly? Select all that apply.
4. The inhaler is held upright.
5. Head is tilted down while inhaling the medication
6. Client waits 5 minutes between puffs.
7. Mouth is rinsed with water following administration
8. Client lies supine for 15 minutes following administration.

Answer 3

3. Answer: 1 and 4.
4. The inhaler is held upright.
5. Mouth is rinsed with water following administration

Question 4

4. The nurse is teaching a client with polycythemia vera about potential complications from this disease. Which manifestations would the nurse include in the client’s teaching plan? Select all that apply.
5. Hearing loss
6. Visual disturbance
7. Headache
8. Orthopnea
9. Gout
10. Weight loss

Answer 4

4. Answers: 2, 3, 4and 5.
5. Visual disturbance
6. Headache
7. Orthopnea
8. Gout

Polycythemia vera, a condition in which too many RBCs are produced in the blood serum, can lead to an increase in the hematocrit and hypervolemia, hyperviscosity, and hypertension. Subsequently, the client can experience dizziness, tinnitus, visual disturbances, headaches, or a feeling of fullness in the head. The client may also experience cardiovascular symptoms such as heart failure (shortness of breath and orthopnea) and increased clotting time or symptoms of an increased uric acid level such as painful swollen joints (usually the big toe). Hearing loss and weight loss are not manifestations associated with polycythemia vera.

Question 5

5. Which of the following would be priority assessment data to gather from a client who has been diagnosed with pneumonia? Select all that apply.
6. Auscultation of breath sounds
7. Auscultation of bowel sounds
8. Presence of chest pain.
9. Presence of peripheral edema
10. Color of nail beds

Answer 5

5. Answer: 1, 3, 5.
6. Auscultation of breath sounds
7. Presence of chest pain.
8. Color of nail beds

A respiratory assessment, which includes auscultation of breath sounds and assessing the color of the nail beds, is a priority for clients with pneumonia. Assessing for the presence of chest pain is also an important respiratory assessment as chest pain can interfere with the client’s ability to breathe deeply. Auscultating bowel sounds and assessing for peripheral edema may be appropriate assessments, but these are not priority assessments for the patient with pneumonia.

Question 6

6. The nurse is teaching a client who has been diagnosed with TB how to avoid spreading the disease to family members. Which statement(s) by the client indicate(s) that he has understood the nurses instructions? Select all that apply.
7. “I will need to dispose of my old clothing when I return home.”
8. “I should always cover my mouth and nose when sneezing.”
9. “It is important that I isolate myself from family when possible.”
10. “I should use paper tissues to cough in and dispose of them properly.”
11. “I can use regular plate and utensils whenever I eat.”

Answer 6

6.Answer: 2, 4, 5.

2. “I should always cover my mouth and nose when sneezing.”
3. “I should use paper tissues to cough in and dispose of them properly.”
4. “I can use regular plate and utensils whenever I eat.”

Question 7

7. The nurse is admitting a client with hypoglycemia. Identify the signs and symptoms the nurse should expect. Select all that apply.
8. Thirst
9. Palpitations
10. Diaphoresis
11. Slurred speech
12. Hyperventilation

Answer 7

7. Answer: 2, 3, 4.
8. Palpitations
9. Diaphoresis
10. Slurred speech

Palpitations, an adrenergic symptom, occur as the glucose levels fall; the sympathetic nervous system is activated and epinephrine and norepinephrine are secreted causing this response. Diaphoresis is a sympathetic nervous system response that occurs as epinephrine and norepinephrine are released. Slurred speech is a neuroglycopenic symptom; as the brain receives insufficient glucose, the activity of the CNS becomes depressed.
8.Answer: 2, 4.

Question 8

8. Which adaptations should the nurse caring for a client with diabetic ketoacidosis expect the client to exhibit? Select all that apply:
9. Sweating
10. Low PCO2
11. Retinopathy
12. Acetone breath
13. Elevated serum bicarbonate

Answer 8

8. Answer: 2, 4.
9. Low PCO2
10. Acetone breath

Metabolic acidosis initiates respiratory compensation in the form of Kussmaul respirations to counteract the effects of ketone buildup, resulting in a lowered PCO2. A fruity odor to the breath (acetone breath) occurs when the ketone level is elevated in ketoacidosis.

Question 9

9. When planning care for a client with ulcerative colitis who is experiencing symptoms, which client care activities can the nurse appropriately delegate to a unlicensed assistant? Select all that apply.
10. Assessing the client’s bowel sounds
11. Providing skin care following bowel movements
12. Evaluating the client’s response to antidiarrheal medications
13. Maintaining intake and output records
14. Obtaining the client’s weight.

Answer 9

9.Answer: 2, 4, and 5.
The nurse can delegate the following basic care activities to the unlicensed assistant: providing skin care following bowel movements, maintaining intake and output records, and obtaining the client’s weight. Assessing the client’s bowel sounds and evaluating the client’s response to medication are registered nurse activities that cannot be delegated.

Question 10

10. Which of the following nursing diagnoses would be appropriate for a client with heart failure? Select all that apply.
11. Ineffective tissue perfusionrelated todecreased peripheral blood flow secondary to decreased cardiac output.
12. Activity intolerancerelated toincreased cardiac output.
13. Decreased cardiac outputrelated tostructural and functional changes.
14. Impaired gas exchangerelated todecreased sympathetic nervous system activity.

Answer 10

10. Answer: 1 and 3.
11. Ineffective tissue perfusion related to decreased peripheral blood flow secondary to decreased cardiac output.
12. Decreased cardiac output related to structural and functional changes.

HF is a result of structural and functional abnormalities of the heart tissue muscle. The heart muscle becomes weak and does not adequately pump the blood out of the chambers. As a result, blood pools in the left ventricle and backs up into the left atrium, and eventually into the lungs. Therefore, greater amounts of blood remain in the ventricle after contraction thereby decreasing cardiac output. In addition, this pooling leads to thrombus formation and ineffective tissue perfusion because of the decrease in blood flow to the other organs and tissues of the body. Typically, these clients have an ejection fraction of less than 50% and poorly tolerate activity. Activity intolerance is related to a decrease, not increase, in cardiac output. Gas exchange is impaired. However, the decrease in cardiac output triggers compensatory mechanisms, such as an increase in sympathetic nervous system activity.

Question 11

11. When caring for a client with a central venous line, which of the following nursing actions should be implemented in the plan of care for chemotherapy administration? Select all that apply.
12. Verify patency of the line by the presence of a blood return at regular intervals.
13. Inspect the insertion site for swelling, erythema, or drainage.
14. Administer a cytotoxic agent to keep the regimen on schedule even if blood return is not present.
15. If unable to aspirate blood, reposition the client and encourage the client to cough.
16. Contact the health care provider about verifying placement if the status is questionable.

Answer 11

11. Answer: 1, 2, 4, 5.
12. Verify patency of the line by the presence of a blood return at regular intervals.
13. Inspect the insertion site for swelling, erythema, or drainage.
14. If unable to aspirate blood, reposition the client and encourage the client to cough.
15. Contact the health care provider about verifying placement if the status is questionable.

A major concern with intravenous administration of cytotoxic agents is vessel irritation or extravasation. The Oncology Nursing Society and hospital guidelines require frequent evaluation of blood return when administering vesicant or non vesicant chemotherapy due to the risk of extravasation. These guidelines apply to peripheral and central venous lines. In addition, central venous lines may be long-term venous access devices. Thus, difficulty drawing or aspirating blood may indicate the line is against the vessel wall or may indicate the line has occlusion. Having the client cough or move position may change the status of the line if it is temporarily against a vessel wall. Occlusion warrants more thorough evaluation via x-ray study to verify placement if the status is questionable and may require a declotting regimen.

Question 12

12. A 20-year old college student has been brought to the psychiatric hospital by her parents. Her admitting diagnosis is borderline personality disorder. When talking with the parents, which information would the nurse expect to be included in the client’s history? Select all that apply.
13. Impulsiveness
14. Lability of mood
15. Ritualistic behavior
16. psychomotor retardation
17. Self-destructive behavior

Answer 12

12. Answer: 1, 2, 5.
13. Impulsiveness
14. Lability of mood
15. Self-destructive behavior

Question 13

13. When assessing a client diagnosed with impulse control disorder, the nurse observes violent, aggressive, and assaultive behavior. Which of the following assessment data is the nurse also likely to find? Select all that apply.
14. The client functions well in other areas of his life.
15. The degree of aggressiveness is out of proportion to the stressor.
16. The violent behavior is most often justified by the stressor.
17. The client has a history of parental alcoholism and chaotic, abusive family life.
18. The client has no remorse about the inability to control his anger.

Answer 13

13. Answer: 1, 2, 4.
14. The client functions well in other areas of his life.
15. The degree of aggressiveness is out of proportion to the stressor.
16. The client has a history of parental alcoholism and chaotic, abusive family life.

A client with an impulse control disorder who displays violent, aggressive, and assaultive behavior generally functions well in other areas of his life. The degree of aggressiveness is typically out of proportion with the stressor. Such a client commonly has a history of parental alcoholism and a chaotic family life, and often verbalizes sincere remorse and guilt for the aggressive behavior.

Question 14

14. Which of the following nursing interventions are written correctly? (Select all that apply.)
15. Apply continuous passive motion machine during day.
16. Perform neurovascular checks.
17. Elevate head of bed 30 degrees before meals.
18. Change dressing once a shift.

Answer 14

14. Answer: 3.
15. Elevate head of bed 30 degrees before meals.

It is specific in what to do and when.

Question 15

15. The nurse is monitoring a client receiving peritoneal dialysis and nurse notes that a client’s outflow is less than the inflow. Select actions that the nurse should take.
16. Place the client in good body alignment
17. Check the level of the drainage bag
18. Contact the physician
19. Check the peritoneal dialysis system for kinks
20. Reposition the client to his or her side.

Answer 15

15. Answer: 1, 2, 4, 5.
16. Place the client in good body alignment
17. Check the level of the drainage bag
18. Check the peritoneal dialysis system for kinks
19. Reposition the client to his or her side.

If outflow drainage is inadequate, the nurse attempts to stimulate outflow by changing the client’s position. Turning the client to the other side or making sure that the client is in good body alignment may assist with outflow drainage. The drainage bag needs to be lower than the client’s abdomen to enhance gravity drainage. The connecting tubing and the peritoneal dialysis system is also checked for kinks or twisting and the clamps on the system are checked to ensure that they are open. There is no reason to contact the physician.

Question 16

16. The nurse is caring for a hospitalized client who has chronic renal failure. Which of the following nursing diagnoses are most appropriate for this client? Select all that apply.
17. Excess Fluid Volume
18. Imbalanced Nutrition; Less than Body Requirements
19. Activity Intolerance
20. Impaired Gas Exchange
21. Pain.

Answer 16

16. Answer: 1, 2, 3.
17. Excess Fluid Volume
18. Imbalanced Nutrition; Less than Body Requirements
19. Activity Intolerance

Appropriate nursing diagnoses for clients with chronic renal failure include excess fluid volume related to fluid and sodium retention; imbalanced nutrition, less than body requirements related to anorexia, nausea, and vomiting; and activity intolerance related to fatigue. The nursing diagnoses of impaired gas exchange and pain are not commonly related to chronic renal failure.

Question 17

17. The nurse is assessing a child diagnosed with a brain tumor. Which of the following signs and symptoms would the nurse expect the child to demonstrate? Select all that apply.
18. Head tilt
19. Vomiting
20. Polydipsia
21. Lethargy
22. Increased appetite
23. Increased pulse

Answer 17

17. Answer: 1, 2, 4.
18. Head tilt
19. Vomiting
20. Lethargy

Head tilt, vomiting, and lethargy are classic signs assessed in a child with a brain tumor. Clinical manifestations are the result of location and size of the tumor.

Question 18

18. The nurse is caring for a client with a T5 complete spinal cord injury. Upon assessment, the nurse notes flushed skin, diaphoresis above the T5, and a blood pressure of 162/96. The client reports a severe, pounding headache. Which of the following nursing interventions would be appropriate for this client? Select all that apply.
19. Elevate the HOB to 90 degrees
20. Loosen constrictive clothing
21. Use a fan to reduce diaphoresis
22. Assess for bladder distention and bowel impaction
23. Administer antihypertensive medication
24. Place the client in a supine position with legs elevated

Answer 18

18. Answer: 1, 2, 4, 5.
19. Elevate the HOB to 90 degrees
20. Loosen constrictive clothing
21. Assess for bladder distention and bowel impaction
22. Administer antihypertensive medication

The client has signs and symptoms of autonomic dysreflexia. The potentially life-threatening condition is caused by an uninhibited response from the sympathetic nervous system resulting from a lack of control over the autonomic nervous system. The nurse should immediately elevate the HOB to 90 degrees and place extremities dependently to decrease venous return to the heart and increase venous return from the brain. Because tactile stimuli can trigger autonomic dysreflexia, any constrictive clothing should be loosened. The nurse should also assess for distended bladder and bowel impaction, which may trigger autonomic dysreflexia, and correct any problems. Elevated blood pressure is the most life-threatening complication of autonomic dysreflexia because it can cause stroke, MI, or seizures. If removing the triggering event doesn’t reduce the client’s blood pressure, IV antihypertensives should be administered. A fan shouldn’t be used because cold drafts may trigger autonomic dysreflexia.

Question 19

19. The nurse is evaluating the discharge teaching for a client who has an ileal conduit. Which of the following statements indicates that the client has correctly understood the teaching? Select all that apply.
20. “If I limit my fluid intake I will not have to empty my ostomy pouch as often.”
21. “I can place an aspirin tablet in my pouch to decrease odor.”
22. “I can usually keep my ostomy pouch on for 3 to 7 days before changing it.”
23. “I must use a skin barrier to protect my skin from urine.”
24. “I should empty my ostomy pouch of urine when it is full.”

Answer 19

19. Answer: 3, 4.
20. “I can usually keep my ostomy pouch on for 3 to 7 days before changing it.”
21. “I must use a skin barrier to protect my skin from urine.”

The client with an ileal conduit must learn self-care activities related to care of the stoma and ostomy appliances. The client should be taught to increase fluid intake to about 3,000 ml per day and should not limit intake. Adequate fluid intake helps to flush mucus from the ileal conduit. The ostomy appliance should be changed approximately every 3 to 7 days and whenever a leak develops. A skin barrier is essential to protecting the skin from the irritation of the urine. An aspirin should not be used as a method of odor control because it can be an irritant to the stoma and lead to ulceration. The ostomy pouch should be emptied when it is one-third to one-half full to prevent the weight from pulling the appliance away from the skin.

Question 20

20. A nurse is assisting in performing an assessment on a client who suspects that she is pregnant and is checking the client for probable signs of pregnancy.Selectallprobablesigns of pregnancy.
21. Uterine enlargement
22. Fetal heart rate detected by nonelectric device
23. Outline of the fetus via radiography or ultrasound
24. Chadwick’s sign
25. Braxton Hicks contractions
26. Ballottement

Answer 20

20. Answers:1, 4, 5, and 6.
21. Uterine enlargement
22. Chadwick’s sign
23. Braxton Hicks contractions
24. Ballottement

Theprobablesigns of pregnancy include:
Uterine Enlargement
Hegar’s sign or softening and thinning of the uterine segment that occurs at week 6.
Goodell’s sign or softening of the cervix that occurs at the beginning of the 2nd month
Chadwick’s sign or bluish coloration of the mucous membranes of the cervix, vagina and vulva. Occurs at week 6.
Ballottement or rebounding of the fetus against the examiner’s fingers of palpation
Braxton-Hicks contractions
Positive pregnancy test measuring for hCG.
Positive signs of pregnancy include:
Fetal Heart Rate detected by electronic device (doppler) at 10-12 weeks
Fetal Heart rate detected by nonelectronic device (fetoscope) at 20 weeks AOG
Active fetal movement palpable by the examiners
Outline of the fetus via radiography or ultrasound

Question 21

21. A nurse is monitoring a pregnant client with pregnancy induced hypertension who is at risk for Preeclampsia. The nurse checks the client for which specific signs of Preeclampsia (select all that apply)?
22. Elevated blood pressure
23. Negative urinary protein
24. Facial edema
25. Increased respirations

Answer 21

21. Answer:1 and 3.
22. Elevated blood pressure
23. Facial edema

The three classic signs of preeclampsia are hypertension, generalized edema, and proteinuria. Increased respirations are not a sign of preeclampsia.

Question 22

22. A nurse is caring for a pregnant client with severe preeclampsia who is receiving IV magnesium sulfate. Selectallnursing interventions that apply in the care for the client.
23. Monitor maternal vital signs every 2 hours
24. Notify the physician if respirations are less than 18 per minute.
25. Monitor renal function and cardiac function closely
26. Keep calcium gluconate on hand in case of a magnesium sulfate overdose
27. Monitor deep tendon reflexes hourly
28. Monitor I and O’s hourly
29. Notify the physician if urinary output is less than 30 ml per hour.

Answer 22

22. Answers:3, 4, 5, 6, and 7.
23. Monitor renal function and cardiac function closely
24. Keep calcium gluconate on hand in case of a magnesium sulfate overdose
25. Monitor deep tendon reflexes hourly
26. Monitor I and O’s hourly
27. Notify the physician if urinary output is less than 30 ml per hour.

When caring for a client receiving magnesium sulfate therapy, the nurse would monitor maternal vital signs, especially respirations, every 30-60 minutes and notify the physician if respirations are less than 12, because this would indicate respiratory depression. Calcium gluconate is kept on hand in case of magnesium sulfate overdose, because calcium gluconate is the antidote for magnesium sulfate toxicity. Deep tendon reflexes are assessed hourly. Cardiac and renal function is monitored closely. The urine output should be maintained at 30 ml per hour because the medication is eliminated through the kidneys.

Question 23

23. When interpreting an ECG, the nurse would keep in mind which of the following about the P wave? Select all that apply.
24. Reflects electrical impulse beginning at the SA node
25. Indicated electrical impulse beginning at the AV node
26. Reflects atrial muscle depolarization
27. Identifies ventricular muscle depolarization
28. Has duration of normally 0.11 seconds or less.

Answer 23

23. Answer: 1, 3, 5.
24. Reflects electrical impulse beginning at the SA node
25. Reflects atrial muscle depolarization
26. Has duration of normally 0.11 seconds or less.

In a client who has had an ECG, the P wave represents the activation of the electrical impulse in the SA node, which is then transmitted to the AV node. In addition, the P wave represents atrial muscle depolarization, not ventricular depolarization. The normal duration of the P wave is 0.11 seconds or less in duration and 2.5 mm or more in height.

Question 24

24. When caring for a client with a central venous line, which of the following nursing actions should be implemented in the plan of care for chemotherapy administration? Select all that apply.
25. Verify patency of the line by the presence of a blood return at regular intervals.
26. Inspect the insertion site for swelling, erythema, or drainage.
27. Administer a cytotoxic agent to keep the regimen on schedule even if blood return is not present.
28. If unable to aspirate blood, reposition the client and encourage the client to cough.
29. Contact the health care provider about verifying placement if the status is questionable.

Answer 24

24. Answer: 1, 2, 4, 5.
25. Verify patency of the line by the presence of a blood return at regular intervals.
26. Inspect the insertion site for swelling, erythema, or drainage.
27. If unable to aspirate blood, reposition the client and encourage the client to cough.
28. Contact the health care provider about verifying placement if the status is questionable.

A major concern with intravenous administration of cytotoxic agents is vessel irritation or extravasation. The Oncology Nursing Society and hospital guidelines require frequent evaluation of blood return when administering vesicant or non vesicant chemotherapy due to the risk of extravasation. These guidelines apply to peripheral and central venous lines. In addition, central venous lines may be long-term venous access devices. Thus, difficulty drawing or aspirating blood may indicate the line is against the vessel wall or may indicate the line has occlusion. Having the client cough or move position may change the status of the line if it is temporarily against a vessel wall. Occlusion warrants more thorough evaluation via x-ray study to verify placement if the status is questionable and may require a declotting regimen.

Question 25

25. To assist an adult client to sleep better the nurse recommends which of the following? (Select all that apply.)
26. Drinking a glass of wine just before retiring to bed
27. Eating a large meal 1 hour before bedtime
28. Consuming a small glass of warm milk at bedtime
29. Performing mild exercises 30 minutes before going to bed

Answer 25

25. Answer: 3.
26. Consuming a small glass of warm milk at bedtime

A small glass of milk relaxes the body and promotes sleep.

Question 26

26. The nurse recognizes that a client is experiencing insomnia when the client reports (select all that apply):
27. Extended time to fall asleep
28. Falling asleep at inappropriate times
29. Difficulty staying asleep
30. Feeling tired after a night’s sleep

Answer 26

26. Answer: 1, 3, and 4.
27. Extended time to fall asleep
28. Difficulty staying asleep
29. Feeling tired after a night’s sleep

These symptoms are often reported by clients with insomnia. Clients report nonrestorative sleep. Arising once at night to urinate (nocturia) is not in and of itself insomnia.

Question 27

27. The nurse teaches the mother of a newborn that in order to prevent sudden infant death syndrome (SIDS) the best position to place the baby after nursing is (select all that apply):
28. Prone
29. Side-lying
30. Supine
31. Fowler’s

Answer 27

27. Answer: 2and 3.
28. Side-lying
29. Supine

Research demonstrate that the occurrence of SIDS is reduced with these two positions.

Question 28

28. A client has a diagnosis of primary insomnia. Before assessing this client, the nurse recalls the numerous causes of this disorder. Select all that apply:
29. Chronic stress
30. Severe anxiety
31. Generalized pain
32. Excessive caffeine
33. Chronic depression
34. Environmental noise

Answer 28

28. Answer: 1, 4, and 6.
29. Chronic stress
30. Excessive caffeine
31. Environmental noise

Acute or primary insomnia is caused by emotional or physical discomfort not caused by the direct physiologic effects of a substance or a medical condition. Excessive caffeine intake is an example of disruptive sleep hygiene; caffeine is a stimulant that inhibits sleep. Environmental noise causes physical and/or emotional and therefore is related to primary insomnia.

Question 29

29. Select all that apply to the use of barbiturates in treating insomnia:
30. Barbiturates deprive people of NREM sleep
31. Barbiturates deprive people of REM sleep
32. When the barbiturates are discontinued, the NREM sleep increases.
33. When the barbiturates are discontinued, the REM sleep increases.
34. Nightmares are often an adverse effect when discontinuing barbiturates.

Answer 29

29. Answer: 2, 4, and 5.
30. Barbiturates deprive people of REM sleep
31. When the barbiturates are discontinued, the REM sleep increases.
32. Nightmares are often an adverse effect when discontinuing barbiturates.

Barbiturates deprive people of REM sleep. When the barbiturate is stopped and REM sleep once again occurs, a rebound phenomenon occurs. During this phenomenon, the persons dream time constitutes a larger percentage of the total sleep pattern, and the dreams are often nightmares.

Question 30

30. Select all that apply that is appropriate when there is a benzodiazepine overdose:
31. Administration of syrup of ipecac
32. Gastric lavage
33. Activated charcoal and a saline cathartic
34. Hemodialysis
35. Administration of Flumazenil

Answer 30

30. Answer: 2, 3, and 5.
31. Gastric lavage
32. Activated charcoal and a saline cathartic
33. Administration of Flumazenil

If ingestion is recent, decontamination of the GI system is indicated. The administration of syrup of ipecac is contraindicated because of aspiration risks related to sedation. Gastric lavage is generally the best and most effective means of gastric decontamination. Activated charcoal and a saline cathartic may be administered to remove any remaining drug. Hemodialysis is not useful in the treatment of benzodiazepine overdose. Flumazenil can be used to acutely reverse the sedative effects of benzodiazepines, though this is normally done only in cases of extreme overdose or sedation.