Question 1 of 9
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A nurse is educating a patient who is diagnosed with insomnia. Which patient statement indicates further education is needed?
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- “I know I need enough sleep to function correctly.”Sufficient sleep is needed daily to restore energy levels and promote optimal mental and physical functioning.
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- “I’m just a little sleep-deprived, but it doesn’t affect my ability to function at my highest ability.”When sleep is insufficient for adequate rest, all aspects of functioning are affected.
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- “Without the required hours of sleep, it can affect my ability to fully learn, remember, and concentrate.”Areas of obvious impairment from insomnia include learning, remembering, concentration, judgment, reaction time, coordination, and general social interactions.
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- “I know I’m irritable without enough sleep.”People who suffer from sleep deprivation may feel irritable, impatient, and unable to concentrate.
Question 2 of 9
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Which outcome best describes the result of a sedative prescribed at a high dose?
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- An enhanced response to stimulation is experienced by the patient.A sedative is a drug that does reduces a response to stimulation and can result from both lower and higher doses.
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- A calming effect is experienced by the patient.While a sedative does provide a calming effect, this happens at lower doses.
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- The patient is relaxed.A sedative prescribed at a lower dose will relax the patient.
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- The patient falls asleep.At higher doses, a sedative will cause sleep.
Question 3 of 9
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Which drug class would be prescribed for a patient who requires longer sleep but is afraid of drug dependence?
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- AnxiolyticsAn anxiolytic reduces anxiety and decreases muscle tension. Benzodiazepines are recommended primarily for short-term use, such as during a panic attack, during alcohol withdrawal, or before surgery. They can cause drug dependence when taken for long periods of time.
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- Selective serotonin reuptake inhibitors (SSRIs)SSRIs are used for patients with depression, premenstrual dysphoric disorder, posttraumatic stress disorder, obsessive-compulsive disorder, and general anxiety disorder. SSRIs are not typically given for sleep.
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- Monoamine oxidase (MAO) inhibitorsMAO inhibitors are used for severe depression that is not controlled with other categories of antidepressants. MAO inhibitors are not typically given for sleep.
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- Benzodiazepine agonistsA benzodiazepine agonist acts in the same ways as benzodiazepines to initiate sleep and promote longer sleep with less risk for drug dependence.
Question 4 of 9
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Which side effect or adverse effect is related to the use of benzodiazepines (BNZs)? Select all that apply. One, some, or all responses may be correct.
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- Potential memory lossBenzodiazepines can cause mild daytime drowsiness and some memory loss.
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- Renal impairmentRenal impairment is not an expected side effect or adverse effect of benzodiazepine therapy.
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- Risk of dependenceBenzodiazepines have a higher risk of addiction and dependency than do BNZ agonists.
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- Central nervous system (CNS) depressionBenzodiazepines carry a black box warning for CNS depression.
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- High risk of birth defectsBenzodiazepines have a high risk of birth defects, among other adverse effects.
Question 5 of 9
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Which drug or drug class increases the action of benzodiazepines (BNZs) and BNZ agonists? Select all that apply. One, some, or all responses may be correct.
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- CimetidineCimetidine is known to increase the effects of BNZs and BNZ agonists.
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- FlumazenilThe drug flumazenil is a BNZ receptor antagonist and is used as an antidote to reverse an overdose of a BNZ or a BNZ agonist. It is given intravenously for rapid reversal of sedation.
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- Fluoroquinolone antibioticsFluoroquinolone antibiotics are known to increase the action of BNZs and BNZ agonists.
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- LorazepamLorazepam is a benzodiazepine, so it would not increase the action of BNZs or BNZ agonists.
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- Some oral contraceptivesSome oral contraceptives are known to increase the action of the BNZs and the BNZ agonists.
Question 6 of 9
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Which statement indicates patient understanding related to the use of benzodiazepines (BNZs)?
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- “I should not take these for longer than two to three weeks to avoid dependency.”The patient understands that these drugs should be taken for no longer than two to three weeks and only when needed to avoid physical or psychological dependency.
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- “Even though I only have 4 hours of time available for sleep, I can take my prescribed BNZ.”A patient should take a BNZ for sleep only if they have at least 5 to 6 hours immediately available to sleep to avoid excessive drowsiness when they are supposed to be awake.
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- “I can drive while taking these.”Patients should be instructed not to drive, operate dangerous equipment, or make important decisions while under the influence of BNZs.
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- “I can drink alcohol while taking my prescription.”Instruct patients to not take a BNZ with alcohol or any other drug that depresses the central nervous system to prevent severe side effects, coma, and death.
Question 7 of 9
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Which anxiolytic reduces anxiety without the risk for physical dependence?
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- EstazolamEstazolam is a benzodiazepine prescribed for sleep and is highly addictive.
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- FlurazepamFlurazepam is a benzodiazepine prescribed for sleep and has a high risk for dependency.
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- BuspironeA newer drug from the BNZ agonist class, buspirone, reduces anxiety through a variety of actions that affect the serotonin and dopamine neurotransmitters. This drug can reduce anxiety without the risk of physical dependence and the sedation that is often associated with BNZ drugs.
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- EszopicloneEszopiclone is a benzodiazepine agonist is a drug prescribed for sleep that has a high risk for dependency.
Question 8 of 9
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Which patient should avoid taking anxiolytics? Select all that apply. One, some, or all responses may be correct.
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- A 72-year-old healthy patientPatients over the age of 65 should not be given benzodiazepines due to the risk of dizziness, confusion and/or hypotension.
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- An 18-year-old patient diagnosed with anxietyAnxiolytics are used for patients who have anxiety. Cognitive impairment, liver disorder or impairment, age 65 and older, and history of falls would be reasons to avoid therapy with anxiolytics.
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- A 52-year-old patient with cognitive impairmentPatients who have a cognitive impairment, regardless of age, should not be given anxiolytics due to potential adverse reactions such as confusion, apnea, and seizures.
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- A 40-year-old patient who reports panic attacksAnxiolytics are used for patients with panic attacks. Cognitive impairment, liver disorder or impairment, age 65 and older, and history of falls would be reasons to avoid therapy with anxiolytics.
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- A 25-year-old with a history of fallsA patient with a history of falls, regardless of age, should not be given anxiolytics due to potential side effects, such as dizziness.
Question 9 of 9
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Which patient statement indicates the need for further instruction when the nurse is teaching the patient about anxiolytics?
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- “I should not use this drug if I am pregnant.”Patients should be instructed not to use this drug if pregnant or breast-feeding because the effects can be passed to the fetus or infant.
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- “Grapefruit is off limits if I am taking this drug.”Patients should be instructed to avoid drinking grapefruit juice while taking these drugs because doing so could cause an increase in effect.
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- “I can stop taking this drug at any time.”Patients should be instructed to take this drug exactly as prescribed. Withdrawal symptoms can occur if the drug has been used for longer than 2 to 4 weeks; in that case, the patient should contact the healthcare provider because they will need to taper the dosage.
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- “I should avoid driving when I first take this drug.”Instruct patients to avoid driving, operating hazardous machinery, or performing activities that require alertness until response to the drug has been determined.