Chapter 21: Central Nervous System Depressants Nursing School Test Banks

Kee: Pharmacology, 7th Edition

Chapter 21: Central Nervous System Depressants

Test Bank

MULTIPLE CHOICE

1. A nurse is teaching a client measures to help relieve sleeplessness. Which would be the highest priority teaching point during the instructional session?

a.

Avoid caffeine-containing beverages before sleep.

b.

Perform strenuous exercise before bedtime.

c.

Drink lots of fluids before bedtime.

d.

Eat a heavy meal before bedtime.

ANS: A

Sleep is likely to be induced by the avoidance of beverages containing caffeine before sleep.

DIF: Cognitive Level: Application REF: p. 295

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Health Promotion and Maintenance

2. A client tells the nurse that she no longer wants to take hypnotic agents prescribed to help her sleep. The nurses instructions are based on the premise that abruptly discontinuing a high dose of hypnotic taken over a long period may lead to which issue?

a.

Drug dependence

b.

Drug tolerance

c.

Withdrawal symptoms

d.

Hypnotic rebound

ANS: C

Withdrawal symptoms occur following hypnotic use.

DIF: Cognitive Level: Application REF: pp. 295-296

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

3. A client who takes an intermediate- or long-acting hypnotic agent complains to the nurse of experiencing residual drowsiness and impaired reaction time on awakening. The nurse recognizes that the client is most likely experiencing which issue?

a.

Hangover

b.

Dependence

c.

Tolerance

d.

Depression

ANS: A

Hangover occurs when the client is experiencing residual drowsiness and impaired reaction time upon awakening after taking hypnotic agents for a period of time.

DIF: Cognitive Level: Application REF: pp. 295-296

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

4. A client takes hypnotics over 4 weeks. The client is informed by the nurse that long-term use may lead to rapid eye movement (REM) rebound. The nurse defines REM rebound for the client as:

a.

the return of dreaming to normal levels using prolonged hypnotic therapy.

b.

the suppression of dreaming in clients taking hypnotics.

c.

nightmares or vivid dreaming when the hypnotic is stopped after prolonged use.

d.

the decreased efficacy that occurs after 2 weeks of hypnotic use.

ANS: C

REM rebound may occur after using hypnotics for 3 to 4 weeks and may be manifested with vivid dreams and nightmares.

DIF: Cognitive Level: Application REF: p. 296

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

5. A client is ordered a preoperative medication for preanesthesia and sedation. The nurse anticipates that the healthcare provider will order:

a.

secobarbital (Seconal).

b.

mephobarbital (Mebaral).

c.

ramelteon (Rozerem).

d.

flurazepam (Dalmane).

ANS: A

Seconal is a short-acting barbiturate that is indicated preoperatively for preanesthesia and sedation.

DIF: Cognitive Level: Application REF: pp. 296-297

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

6. A client is ordered to receive temazepam (Restoril). The nurse is preparing an instructional session for the client on the medication. When instructing the client on the action of the medication, the nurse tells her that this medication is known as a(n):

a.

barbiturate.

b.

piperazinedione.

c.

benzodiazepine.

d.

anorexiant.

ANS: C

Benzodiazepine is the class of temazepam (Restoril).

DIF: Cognitive Level: Application REF: pp. 297-298

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

7. The nurse should instruct clients taking a hypnotic for several weeks that hypnotic use should be gradually withdrawn because:

a.

increased drowsiness may result.

b.

withdrawal symptoms may be avoided.

c.

mental depression may be avoided.

d.

gastric irritation may be avoided.

ANS: B

Withdrawal symptoms may result from long-term use of hypnotic agents.

DIF: Cognitive Level: Application REF: p. 296

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

8. A client is ordered to receive benzodiazepine hypnotics. Client teaching for clients taking benzodiazepine hypnotics includes which instruction?

a.

Avoid taking alcohol and antidepressants with a benzodiazepine hypnotic.

b.

Avoid taking cardiac glycosides such as digoxin with the hypnotic.

c.

Take the drug during nocturnal awakenings.

d.

Take the drug immediately after the evening meal.

ANS: A

Alcohol and antidepressants may cause a significant drug interaction with a benzodiazepine hypnotic. The medication should be taken 1 hour before the expected bedtime, not directly after dinner or during nighttime awakenings.

DIF: Cognitive Level: Application REF: p. 302

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

9. What does the rationale for use of balanced anesthesia with a client include?

a.

A desire for a slow induction of anesthesia to maintain the anesthetic state

b.

A reduction in the amount of drug to maintain the desired state of anesthesia

c.

The need to minimize adverse reactions through maximizing side effect

d.

The need for increased respiratory depression during the surgical period

ANS: B

This is the rationale for balanced anesthesia.

DIF: Cognitive Level: Comprehension REF: p. 302

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

10. The client has been ordered an intravenous anesthetic as part of inducing anesthesia. The nurse recognizes that this type of anesthetic is selected because of its _____ onset and _____ duration of action.

a.

rapid; short

b.

slow; short

c.

rapid; long

d.

slow; long

ANS: A

IV anesthetics are rapid in their onset and have a short duration of action. This allows for rapid reversal of anesthesia effects in the recovery room.

DIF: Cognitive Level: Application REF: p. 304

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

11. A client is to receive lidocaine (Xylocaine). The nurse is aware that lidocaine is frequently used as _____ anesthesia.

a.

spinal

b.

intravenous

c.

local

d.

general

ANS: C

Lidocaine is frequently used as a local anesthetic.

DIF: Cognitive Level: Application REF: pp. 303, 305

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

12. The nurse instructs a client prescribed pentobarbital (Nembutal) to avoid taking which herbal preparation?

a.

Chamomile

b.

Kava kava

c.

Ginger

d.

Goldenseal

ANS: B

Kava kava should not be taken in combination with CNS depressants such as the barbiturate pentobarbital, as it may increase sedative effects.

DIF: Cognitive Level: Application REF: p. 297

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

13. After spinal anesthesia, what is the highest priority action of the nurse?

a.

Elevate the head of the bed immediately when the client returns from surgery.

b.

Ambulate the client as soon as possible to aid in the excretion of the spinal anesthetic.

c.

Have the client change positions hourly to increase the spinal fluid loss.

d.

Instruct the client to remain flat for 6 to 8 hours to decrease the loss of spinal fluid.

ANS: D

This will prevent a headache related to leakage of cerebrospinal fluid following spinal surgery.

DIF: Cognitive Level: Application REF: pp. 305-306

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

14. A client is ordered to receive zolpidem tartrate (Ambien) as a hypnotic agent before surgery. Because of the impact of food on the absorption of this medication, the nurse is aware that the medication should be administered _____ dinner.

a.

1 hour before

b.

during

c.

1 hour after

d.

3 hours after

ANS: D

Food hampers absorption; therefore, Ambien should be given on an empty stomach.

DIF: Cognitive Level: Analysis REF: p. 300

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

15. A client is ordered to receive zolpidem tartrate (Ambien) the night before her surgery. The client asks why this is necessary. What is the nurses response?

a.

Clients typically dont sleep well the night before a major surgery.

b.

It will dry up the secretions in your mouth before surgery.

c.

It will help you get the rest you need before your surgery.

d.

It is considered anesthesia and is necessary for your surgery.

ANS: C

This option best describes the benefits of sleep before surgery and attends to the needs and concerns of the patient.

DIF: Cognitive Level: Analysis REF: p. 300

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

16. The client is started on Seconal Sodium. He complains to the nurse of dizziness. The highest priority action on the part of the nurse is to call the:

a.

pharmacist to clarify the dosage and administer the dosage as ordered.

b.

physician; the client is experiencing a side effect of the medication.

c.

physician; the client is experiencing a life-threatening reaction.

d.

pharmacist for clarification and hold the drug until orders are received.

ANS: B

Dizziness is a nonlife-threatening side effect of Seconal Sodium.

DIF: Cognitive Level: Analysis REF: p. 297

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

17. The client has been started on Halcion and tells the nurse that she is concerned about developing a tolerance for the drug. What is the nurses highest priority instruction to the client?

a.

Do not use the medication for longer than 7 to 10 days at a time.

b.

Do not stop the medication for any reason.

c.

Do not use the medication for longer than 6 weeks.

d.

Do not take any other medication when taking this drug.

ANS: A

Using the drug for a shorter period of time decreases the chance for tolerance.

DIF: Cognitive Level: Analysis REF: pp. 297-300

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

ESSAY

1. A client is ordered to receive naloxone (Narcan). The client weighs 20 kg and is ordered to receive 0.01 mg/kg. The medication is available as 400 mcg/mL. How much should the nurse administer?

ANS:

0.5 mL

20 kg 0.01 mg/kg = 0.2 mg = 200 mcg 400 mcg = 0.5 mL.

X 1 mL

DIF: Cognitive Level: Analysis REF: p. 302

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

Copyright 2012, 2009, 2006, 2003 by Saunders, an imprint of Elsevier Inc.

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