Chapter 20 Anxiolytic and Hypnotic Agents

Chapter 20  Anxiolytic and Hypnotic Agents

Complete Chapter Questions And Answers
 

Sample Questions

1.
The nurse is caring for a patient in a state of hypnosis, which means the patient is in what state?
A)
A state of extreme sedation in which the person no longer senses or reacts to incoming stimuli.
B)
A state of tranquility in which the person can be made to do whatever is suggested by others.
C)
A feeling of tension, nervousness, apprehension, or fear with high levels of awareness.
D)
A state in which the brain is no longer sending out signals to the body.
Ans:
A

Feedback:

Hypnosis is an extreme state of sedation in which the person no longer senses or reacts to incoming stimuli. A state of tranquility is produced through minor tranquilizers by decreasing anxiety. Anxiety is a feeling of tension, nervousness, apprehension, or fear. Sedation is the loss of awareness and reaction to environmental stimuli, which may lead to drowsiness. The state of suggestibility often seen in television programs is not an appropriate definition of hypnosis. If the brain stopped sending signals, the patient would stop breathing and death would follow.

2.
A nurse is caring for a 4-year-old child who is receiving a barbiturate. What common adverse effect would the nurse assess for?
A)
Decrease in respirations
B)
Vomiting
C)
Excitability
D)
Dry mucous membranes
Ans:
C

Feedback:

The barbiturates, being older drugs, have established pediatric dosages. These drugs must be used with caution because of the often unexpected responses. Children must be monitored very closely for central nervous system (CNS) depression and excitability. The most common adverse effects are related to general CNS depression. Other CNS effects may include drowsiness, somnolence, lethargy, ataxia, vertigo, a feeling of a “hangover,” thinking abnormalities, paradoxical excitement, anxiety, and hallucinations. Alteration in respirations and dried mucous membranes are adverse effects of antihistamines, which can be given to calm children or induce sleep. Vomiting could occur with the use of paraldehyde due to the unpleasant taste and odor of the drug.

3.
A nurse is caring for a 9-year-old patient and has received an order for diazepam (Valium) 10 mg given orally q.i.d. What is the nurse’s priority action?
A)
Perform hand hygiene and prepare the drug.
B)
Send the order to the hospital pharmacy.
C)
Determine when to administer the first dose.
D)
Call the physician and question the order.
Ans:
D

Feedback:

The first action of the nurse would be to call the physician and question the order. The normal oral dosage for a pediatric patient is 1 to 2.5 mg t.i.d. or q.i.d. The ordered dose would be unsafe for this patient. If the dosage was changed and the correct amount administered, the nurse would order the medication from the pharmacy if necessary and determine what time to start the medication. She would then wash her hands in preparation for administering the medication, but not until obtaining an appropriate dosage of medication.

4.
A nurse is discussing the use of alprazolam (Xanax) with a 68-year-old patient. What statement indicates that the patient has an understanding of the drug?
A)
“When I stop having panic attacks, I can stop taking the drug.”
B)
“This drug will calm me down in about 30 minutes after I take it.”
C)
“One dose will keep me calm for about 24 hours.”
D)
“I am taking an increased dose because of my age.”
Ans:
B

Feedback:

The onset of alprazolam is about 30 minutes. The drug must be tapered after long-term use and the duration is approximately 4 to 6 hours. Elderly patients usually have a reduced dosage.

5.
A nurse is about to administer a parenteral benzodiazepine to a female patient in the hospital before the performance of a procedure. What is the priority nursing action before administration of the drug?
A)
Make sure that the side rails are up and the bed is in the lowest position.
B)
Close the blinds and ensure appropriate room temperature for the patient.
C)
Help the patient out of bed to the bathroom and encourage her to void.
D)
Ask all visitors to leave the room and remain in the waiting area.
Ans:
C

Feedback:

The priority action would be to help the patient up to void. After the medication is administered the patient should not get out of bed because of possibly injury due to drowsiness. Safety should always be the priority concern. After administration of the drug the nurse would ask visitors to leave before beginning the procedure, make the room conducive to rest and sleep, and make sure that both side rails are up and the bed is in the lowest position.