The Nervous System Drugs for Muscle Spasms and Spasiticity

Question 1

The nurse is asked how dantrolene (Dantrium) affects spastic muscles.

Which information should the nurse include in the response?
a) “It blocks calcium release within muscles.”
b) “It increases norepinephrine activity by blocking its synaptic reuptake.”
c) “It inhibits neuronal activity within the brain and spinal cord.”
d) “It depletes dopamine, serotonin, and norepinephrine at nerve terminals.”

Answer 1

a) “It blocks calcium release within muscles.”

Question 2

The nurse is caring for a patient with muscle spasticity from multiple sclerosis (MS).

Which skeletal muscle relaxant should the nurse expect to be prescribed for this patient?
a) Dantrolene (Dantrium)
b) Incobotulinumtoxin A (Xeomin)
c) Baclofen (Lioresal)
d) Onabotulinum A (Botox)

Answer 2

c) Baclofen (Lioresal)

Question 3

A patient is receiving multiple injections of onabotulinumtoxinA (Botox).

Which pharmacologic principle should the nurse consider for this medication?
a) It produces adverse effects when high doses are administered.
b) It can spread beyond the regional area of injection.
c) It is the safest direct-acting muscle relaxant because of its universal dosing.
d) Its duration of action is typically 2-3 weeks.

Answer 3

b) It can spread beyond the regional area of injection.

Question 4

A patient who is prescribed botulinum toxin for upper limb spasticity asks how the medication works.

Which response should the nurse make?
a) “It works in the central nervous system.”
b) “It blocks calcium release within muscles.”
c) “It produces complete muscle paralysis.”
d) “It blocks the nerves to muscle transmission.”

Answer 4

d) “It blocks the nerves to muscle transmission.”

Question 5

A patient prescribed dantrolene (Dantrium) asks why a blood specimen is being drawn.

Which response should the nurse make?
a) “Dantrolene can be toxic to the liver.”
b) “Dantrolene can increase heart enzyme levels.”
c) “Dantrolene can increase the risk for anemia.”
d) “Dantrolene can be toxic to the pancreas.”

Answer 5

a) “Dantrolene can be toxic to the liver.”

Question 6

A patient reports tight, painful leg muscles after exercising at the gym.

From which class should the nurse anticipate a medication being prescribed for this patient?
a) Opioid analgesic
b) Benzodiazepine
c) Nonsteroidal anti-inflammatory drug (NSAID)
d) Corticosteroid

Answer 6

c) Nonsteroidal anti-inflammatory drug (NSAID)

Question 7

A patient is receiving care for a brain and spinal cord injury.

Which centrally acting skeletal muscle relaxant should the nurse expect to be prescribed for this patient?
a) Abobotulinumtoxin A (Dysport)
b) Cyclobenzaprine (Amrix)
c) Dantrolene (Dantrium)
d) Rimabotulinumtoxin B (Myobloc)

Answer 7

b) Cyclobenzaprine (Amrix)

Question 8

A patient who has received a first dose of a muscle relaxant asks why someone else needs to drive the car home.

Which adverse effect of muscle relaxants should the nurse consider when responding to the patient?
a) Muscle rigidity
b) Strabismus
c) Ototoxicity
d) Sedation

Answer 8

d) Sedation

Question 9

A patient experiences muscle cramping of the lower legs.

For which health problem should the nurse assess this patient?
a) Intermittent claudication
b) Stroke
c) History of head injury
d) History of spinal cord trauma

Answer 9

a) Intermittent claudication

Question 10

A patient is prescribed cyclobenzaprine (Amrix).

Which question should the nurse ask when assessing the patient’s tolerance to the medication?
a) Have you experienced insomnia since starting the medication?”
b) “Have you experienced increased salivation since starting the medication?”
c) “Have you experienced bladder pressure since starting the medication?”
d) “Have you experienced increased hair growth since starting the medication?”

Answer 10

c) “Have you experienced bladder pressure since starting the medication?”

Question 11

A patient recovering from a stroke asks how muscle spasticity can be treated.

Which response should the nurse make?
a) “There is no treatment.”
b) “The spasticity can be treated with medication and extensive physical therapy.”
c) “The muscle tissue has to regenerate before the spasticity will improve.”
d) “This type of muscle problem is only treated with surgery.”

Answer 11

b) “The spasticity can be treated with medication and extensive physical therapy.”

Question 12

The nurse discusses the mechanism of action of baclofen (Lioresal) to treat muscle spasms.

Which information should the nurse include?
a) “It directly affects the neuromuscular junction.”
b) “It directly affects involved muscles.”
c) “It reduces inflammation around the injury site.”
d) “It acts on the central nervous system.”

Answer 12

d) “It acts on the central nervous system.”

Question 13

An older patient is prescribed a muscle relaxant.

Which dietary teaching should the nurse provide this patient?
a) “Consume whole grains.”
b) “Consume more seafood.”
c) “Consume electrolyte-replacement drinks.”
d) “Consume less dietary sodium.”

Answer 13

a) “Consume whole grains.”

Question 14

A patient who received general anesthesia develops malignant hyperthermia.

Which medication should the nurse expect to be prescribed for this patient?
a) Clonazepam (Klonopin)
b) Diazepam (Valium)
c) Dantrolene (Revonta)
d) Lorazepam (Ativan)

Answer 14

c) Dantrolene (Revonta)

Question 15

The nurse is asked to explain spasticity.

Which response should the nurse make?
a) “It is caused by muscle strain.”
b) “It is caused by damage to the motor area of the brain that controls movement.”
c) “It usually is caused by an endocrine disorder.”
d) “It is caused by a cardiopulmonary disorder.”

Answer 15

b) “It is caused by damage to the motor area of the brain that controls movement.”

Question 16

The cause for a patient’s muscle spasms cannot be identified after a complete physical examination.

Which electrolytes should the nurse prepare to measure?
a) Phosphorus and magnesium
b) Sodium and magnesium
c) Potassium and phosphorus
d) Calcium and potassium

Answer 16

d) Calcium and potassium

Question 17

A patient is prescribed tizanidine (Zanaflex).

Which patient statement should indicate the need for further teaching?
a) “I am glad this medication won’t cause dry mouth.”
b) “I will notify the healthcare provider if I plan to become pregnant.”
c) “The medication can potentially affect my liver.”
d) “I will monitor my blood pressure while taking the medication.”

Answer 17

a) “I am glad this medication won’t cause dry mouth.”

Question 18

A patient has severe muscle spasms of the head and neck.

Which medication that blocks the release of calcium in the muscles should the nurse expect to be prescribed?
a) Carisoprodol (Soma)
b) Metaxalone (Skelaxin)
c) Dantrolene (Dantrium)
d) Methocarbamol (Robaxin)

Answer 18

c) Dantrolene (Dantrium)

Question 19

A patient is prescribed carisoprodol (Soma).

Which statement should the nurse make to determine the patient’s understanding of the medication?
a) “Explain to me how the medication will work in your body.”
b) “Explain to me the dosing and scheduling of the medication.”
c) “Explain to me some other possible uses of the medication.”
d) “Explain to me what you know about the half-life of the medication.”

Answer 19

b) “Explain to me the dosing and scheduling of the medication.”

Question 20

A patient with muscle spasms is prescribed methocarbamol (Robaxin) and range-of-motion exercises.

Which patient statement should indicate the need for further teaching?
a) “I will stop and rest if I start feeling lightheaded.”
b) “Therapy should help lessen the muscle spasms within 1-2 weeks.”
c) “Decreased muscle tenderness and rigidity indicates therapy is effective.”
d) “I will stop performing range-of-motion exercises when I start feeling severe pain.”

Answer 20

d) “I will stop performing range-of-motion exercises when I start feeling severe pain.”

Question 21

The nurse is caring for a patient with cerebral palsy.

Which finding should the nurse expect to assess in this patient?
a) Spasticity
b) Flaccidity
c) Muscle atrophy
d) Bone pain

Answer 21

a) Spasticity

Question 22

A patient prescribed cyclobenzaprine (Amrix) asks why alcoholic beverages cannot be consumed while taking the medication.

Which response should the nurse make?
a)”Mixing alcohol with cyclobenzaprine can increase blood pressure.”
b) “Alcohol increases the anticholinergic effects of cyclobenzaprine.”
c) “You may become over sedated if you mix cyclobenzaprine with alcohol.”
d) “Alcohol decreases the effectiveness of cyclobenzaprine.”

Answer 22

c) “You may become over sedated if you mix cyclobenzaprine with alcohol.”

Question 23

A patient with muscle spasms does not want to use medication to treat the disorder.

Which nonpharmacologic treatment should the nurse consider for the health problem?
a) Topical capsaicin cream
b) Heat packs
b) Topical capsaicin cream
c) Ice packs
d) Isometric exercises

Answer 23

b) Topical capsaicin cream

Question 24

A patient with a spinal cord injury asks why cyclobenzaprine (Amrix) is not prescribed for the muscle spasms.

Which response should the nurse make?
a) “Cyclobenzaprine acts directly on skeletal muscles and worsens mobility.”
b) “Cyclobenzaprine acts directly on skeletal muscles and delays spinal cord healing.”
c) “Cyclobenzaprine overdose fatalities are higher when administered to a patient with a spinal cord injury.”
d) “Cyclobenzaprine is not effective in treating muscle spasms that result from a spinal cord injury.”

Answer 24

d) “Cyclobenzaprine is not effective in treating muscle spasms that result from a spinal cord injury.”

Question 25

Which of the following represents mechanical dysphasia?
1. Strep pharyngitis
2. Esophageal stricture
3. Parkinson’s disease
4. Paraplegia

Question 26

Which of the following represents muscle spasm due to injury?
1. Muscle spasticity
2. Muscle spasm
3. Tremor
4. Dystonia

Answer 26

1. Muscle spasticity

Question 27

Which of the following muscle relaxers work by depressing the CNS?
1. Cyclobenzaprine
2. Baclofen
3. Methocarbamol
4. Diazepam