Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 4/E Chapter 14

Question 1 Type: MCSA The patient tells the nurse he worries about everything all day, feels confused, restless, and just can't stop worrying. What is the best response by the nurse 1. !"ou have generali#ed an$iety% & will teach you so'e rela$ation techni(ues.! 2. !This sounds li)e social an$iety. "ou need to cal' down and you'll be fine.! 3. !"ou have posttrau'atic stress disorder *+TS,-, and it is ti'e for your therapy session.! 4. !This is called panic disorder% &'ll get your 'edication for you.! Correct Answer: . Rationa e 1/ 0enerali#ed an$iety disorder is characteri#ed by e$cessive an$iety, but not to panic levels. 1ther sy'pto's include restlessness, 'uscle tension, and loss of focus and ability to concentrate. 2ela$ation techni(ues are effective in reducing an$iety. +anic disorder is characteri#ed by intense feelings of apprehension, terror, and i'pending doo', and increased autono'ic nervous syste' an$iety% the patient does not have these sy'pto's. +osttrau'atic stress disorder is situational an$iety that develops in response to re3e$periencing a previous trau'atic life event% there is no infor'ation that the patient has e$perienced a trau'a. Social an$iety disorder is characteri#ed by !perfor'ance an$iety,! i.e., e$tre'e fear when a patient is in a social situation% there is no infor'ation to support that this is what the patient is e$periencing. Also, telling the patient to !cal' down! is non3 therapeutic. Rationa e 2/ 0enerali#ed an$iety disorder is characteri#ed by e$cessive an$iety, but not to panic levels. 1ther sy'pto's include restlessness, 'uscle tension, and loss of focus and ability to concentrate. 2ela$ation techni(ues are effective in reducing an$iety. +anic disorder is characteri#ed by intense feelings of apprehension, terror, and i'pending doo', and increased autono'ic nervous syste' an$iety% the patient does not have these sy'pto's. +osttrau'atic stress disorder is situational an$iety that develops in response to re3e$periencing a previous trau'atic life event% there is no infor'ation that the patient has e$perienced a trau'a. Social an$iety disorder is characteri#ed by !perfor'ance an$iety,! i.e., e$tre'e fear when a patient is in a social situation% there is no infor'ation to support that this is what the patient is e$periencing. Also, telling the patient to !cal' down! is non3 therapeutic. Rationa e 3/ 0enerali#ed an$iety disorder is characteri#ed by e$cessive an$iety, but not to panic levels. 1ther sy'pto's include restlessness, 'uscle tension, and loss of focus and ability to concentrate. 2ela$ation techni(ues are effective in reducing an$iety. +anic disorder is characteri#ed by intense feelings of apprehension, terror, and i'pending doo', and increased autono'ic nervous syste' an$iety% the patient does not have these sy'pto's. +osttrau'atic stress disorder is situational an$iety that develops in response to re3e$periencing a previous trau'atic life event% there is no infor'ation that the patient has e$perienced a trau'a. Social an$iety disorder is characteri#ed by !perfor'ance an$iety,! i.e., e$tre'e fear when a patient is in a social situation% there is no
Ada's, Pharmacology for Nurse: A Pathophysiologic Approach, 456 Copyright 78.4 by +earson 6ducation, &nc.

infor'ation to support that this is what the patient is e$periencing. Also, telling the patient to !cal' down! is non3 therapeutic. Rationa e 4/ 0enerali#ed an$iety disorder is characteri#ed by e$cessive an$iety, but not to panic levels. 1ther sy'pto's include restlessness, 'uscle tension, and loss of focus and ability to concentrate. 2ela$ation techni(ues are effective in reducing an$iety. +anic disorder is characteri#ed by intense feelings of apprehension, terror, and i'pending doo', and increased autono'ic nervous syste' an$iety% the patient does not have these sy'pto's. +osttrau'atic stress disorder is situational an$iety that develops in response to re3e$periencing a previous trau'atic life event% there is no infor'ation that the patient has e$perienced a trau'a. Social an$iety disorder is characteri#ed by !perfor'ance an$iety,! i.e., e$tre'e fear when a patient is in a social situation% there is no infor'ation to support that this is what the patient is e$periencing. Also, telling the patient to !cal' down! is non3 therapeutic. ! o"a Rationa e: Co#niti$e %e$e : Applying C ient &eed: +hysiological &ntegrity C ient &eed 'u": &ursin#/(nte#rated Concepts: 9ursing +rocess/ &'ple'entation %earnin# )utcome: .43. Question 2 Type: MCMA The nurse has co'pleted group education for patients with an$iety disorders. The education is evaluated as successful when the patients 'a)e which state'ents Note: Credit will be given only if all correct choices and no incorrect choices are selected. 'tandard Te*t: Select all that apply. 1. !2ela$ation techni(ues will often decrease an$iety.! 2. !Antian$iety 'edicine should be used until our an$iety is gone.! 3. !Antian$iety 'edicine should not be used indefinitely.! 4. !We need therapy to learn where this an$iety co'es fro'.! +. !We need different 'edicines for an$iety, and for difficulty in sleeping.! Correct Answer: .,:,4 Rationa e 1/ +atients with an$iety disorders should be encouraged to uncover the cause of the an$iety through cognitive3behavioral therapy or other counseling techni(ues. 9onphar'acological techni(ues such as rela$ation techni(ues are effective in reducing so'e levels of an$iety. ;or 'ost patients, anti3an$iety 'edication is intended
Ada's, Pharmacology for Nurse: A Pathophysiologic Approach, 456 Copyright 78.4 by +earson 6ducation, &nc.

for short3ter' use. Absence of an$iety is an unrealistic goal because all individuals will have so'e level of an$iety during their lifeti'e. 1ften, the sa'e 'edication can be used for an$iety as well as inso'nia. Rationa e 2/ +atients with an$iety disorders should be encouraged to uncover the cause of the an$iety through cognitive3behavioral therapy or other counseling techni(ues. 9onphar'acological techni(ues such as rela$ation techni(ues are effective in reducing so'e levels of an$iety. ;or 'ost patients, anti3an$iety 'edication is intended for short3ter' use. Absence of an$iety is an unrealistic goal because all individuals will have so'e level of an$iety during their lifeti'e. 1ften, the sa'e 'edication can be used for an$iety as well as inso'nia. Rationa e 3/ +atients with an$iety disorders should be encouraged to uncover the cause of the an$iety through cognitive3behavioral therapy or other counseling techni(ues. 9onphar'acological techni(ues such as rela$ation techni(ues are effective in reducing so'e levels of an$iety. ;or 'ost patients, anti3an$iety 'edication is intended for short3ter' use. Absence of an$iety is an unrealistic goal because all individuals will have so'e level of an$iety during their lifeti'e. 1ften, the sa'e 'edication can be used for an$iety as well as inso'nia. Rationa e 4/ +atients with an$iety disorders should be encouraged to uncover the cause of the an$iety through cognitive3behavioral therapy or other counseling techni(ues. 9onphar'acological techni(ues such as rela$ation techni(ues are effective in reducing so'e levels of an$iety. ;or 'ost patients, anti3an$iety 'edication is intended for short3ter' use. Absence of an$iety is an unrealistic goal because all individuals will have so'e level of an$iety during their lifeti'e. 1ften, the sa'e 'edication can be used for an$iety as well as inso'nia. Rationa e +/ +atients with an$iety disorders should be encouraged to uncover the cause of the an$iety through cognitive3behavioral therapy or other counseling techni(ues. 9onphar'acological techni(ues such as rela$ation techni(ues are effective in reducing so'e levels of an$iety. ;or 'ost patients, anti3an$iety 'edication is intended for short3ter' use. Absence of an$iety is an unrealistic goal because all individuals will have so'e level of an$iety during their lifeti'e. 1ften, the sa'e 'edication can be used for an$iety as well as inso'nia. ! o"a Rationa e: Co#niti$e %e$e : Applying C ient &eed: +hysiological &ntegrity C ient &eed 'u": &ursin#/(nte#rated Concepts: 9ursing +rocess/ 6valuation %earnin# )utcome: .437 Question 3 Type: MCSA The patient tells the nurse that she is interested in the hu'an brain, and (uestions which parts of the brain control an$iety and inso'nia. What is the best reply by the nurse 1. !The li'bic syste' and reticular activating syste' control an$iety and inso'nia.! 2. !The frontal lobes and li'bic syste' control an$iety and inso'nia.! 3. !The thala'us and reticular activating syste' control an$iety and inso'nia.! 4. !The li'bic syste' and hypothala'us control an$iety and inso'nia.!
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Correct Answer: . Rationa e 1/ 9eural syste's associated with an$iety and restlessness includes the li'bic syste' and the reticular activating syste'. The reticular activating syste' is responsible for sleeping and wa)efulness and perfor's an alerting function for the entire cerebral corte$. The li'bic syste' and the reticular activating syste', not the hypothala'us, are responsible for an$iety and sleep. The li'bic syste' and the reticular activating syste', not the frontal lobes, are responsible for an$iety and sleep. The li'bic syste' and the reticular activating syste', not the thala'us, are responsible for an$iety and sleep. Rationa e 2/ 9eural syste's associated with an$iety and restlessness includes the li'bic syste' and the reticular activating syste'. The reticular activating syste' is responsible for sleeping and wa)efulness and perfor's an alerting function for the entire cerebral corte$. The li'bic syste' and the reticular activating syste', not the hypothala'us, are responsible for an$iety and sleep. The li'bic syste' and the reticular activating syste', not the frontal lobes, are responsible for an$iety and sleep. The li'bic syste' and the reticular activating syste', not the thala'us, are responsible for an$iety and sleep. Rationa e 3/ 9eural syste's associated with an$iety and restlessness includes the li'bic syste' and the reticular activating syste'. The reticular activating syste' is responsible for sleeping and wa)efulness and perfor's an alerting function for the entire cerebral corte$. The li'bic syste' and the reticular activating syste', not the hypothala'us, are responsible for an$iety and sleep. The li'bic syste' and the reticular activating syste', not the frontal lobes, are responsible for an$iety and sleep. The li'bic syste' and the reticular activating syste', not the thala'us, are responsible for an$iety and sleep. Rationa e 4/ 9eural syste's associated with an$iety and restlessness includes the li'bic syste' and the reticular activating syste'. The reticular activating syste' is responsible for sleeping and wa)efulness and perfor's an alerting function for the entire cerebral corte$. The li'bic syste' and the reticular activating syste', not the hypothala'us, are responsible for an$iety and sleep. The li'bic syste' and the reticular activating syste', not the frontal lobes, are responsible for an$iety and sleep. The li'bic syste' and the reticular activating syste', not the thala'us, are responsible for an$iety and sleep. ! o"a Rationa e: Co#niti$e %e$e : Applying C ient &eed: +hysiological &ntegrity C ient &eed 'u": &ursin#/(nte#rated Concepts: 9ursing +rocess/ &'ple'entation %earnin# )utcome: .43: Question 4 Type: MCMA The patient tells the nurse, !& a' really confused after tal)ing to 'y doctor. <e said & would be ta)ing different )inds of 'edications for 'y an$iety and inso'nia. Will you please e$plain it ! What is the best response by the nurse Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Ada's, Pharmacology for Nurse: A Pathophysiologic Approach, 456 Copyright 78.4 by +earson 6ducation, &nc.

'tandard Te*t: Select all that apply. 1. !"ou will be ta)ing 'edications )nown as sedative3hypnotics.! 2. !"ou will be ta)ing 'edications )nown as antidepressants.! 3. !"ou will be ta)ing a 'edication )nown as paraldehyde.! 4. !"ou will be ta)ing 'edications )nown as barbiturates.! +. !"ou will be ta)ing 'edications )nown as ben#odia#epines.! Correct Answer: .,7,= Rationa e 1/ The three categories of 'edications used to treat an$iety and sleep disorders include the ben#odia#epines, antidepressants, and sedative3hypnotics. >arbiturates are no longer used for an$iety or inso'nia because of significant side effects and the availability of 'ore effective 'edications. +araldehyde is no longer used for an$iety or inso'nia because of significant side effects and the availability of 'ore effective 'edications. Rationa e 2/ The three categories of 'edications used to treat an$iety and sleep disorders include the ben#odia#epines, antidepressants, and sedative3hypnotics. >arbiturates are no longer used for an$iety or inso'nia because of significant side effects and the availability of 'ore effective 'edications. +araldehyde is no longer used for an$iety or inso'nia because of significant side effects and the availability of 'ore effective 'edications. Rationa e 3/ The three categories of 'edications used to treat an$iety and sleep disorders include the ben#odia#epines, antidepressants, and sedative3hypnotics. >arbiturates are no longer used for an$iety or inso'nia because of significant side effects and the availability of 'ore effective 'edications. +araldehyde is no longer used for an$iety or inso'nia because of significant side effects and the availability of 'ore effective 'edications. Rationa e 4/ The three categories of 'edications used to treat an$iety and sleep disorders include the ben#odia#epines, antidepressants, and sedative3hypnotics. >arbiturates are no longer used for an$iety or inso'nia because of significant side effects and the availability of 'ore effective 'edications. +araldehyde is no longer used for an$iety or inso'nia because of significant side effects and the availability of 'ore effective 'edications. Rationa e +/ The three categories of 'edications used to treat an$iety and sleep disorders include the ben#odia#epines, antidepressants, and sedative3hypnotics. >arbiturates are no longer used for an$iety or inso'nia because of significant side effects and the availability of 'ore effective 'edications. +araldehyde is no longer used for an$iety or inso'nia because of significant side effects and the availability of 'ore effective 'edications. ! o"a Rationa e: Co#niti$e %e$e : Applying C ient &eed: +hysiological &ntegrity C ient &eed 'u": &ursin#/(nte#rated Concepts: 9ursing +rocess/ &'ple'entation %earnin# )utcome: .434 Question +
Ada's, Pharmacology for Nurse: A Pathophysiologic Approach, 456 Copyright 78.4 by +earson 6ducation, &nc.

Type: MCSA The patient has generali#ed an$iety disorder. <e as)s the nurse, !Will & need 'edication for this My neighbor is very nervous and he ta)es 'edication.! What is the best response by the nurse 1. !Medications are a way of life for patients with an$iety disorders.! 2. !Medication is necessary initially% later we will try therapy.! 3. !+robably not, but you shouldn't co'pare yourself to your neighbor.! 4. !Medication is necessary when an$iety interferes with your (uality of life.! Correct Answer: 4 Rationa e 1/ &t is 'ore productive to identify and treat the cause of an$iety than to use 'edications. When an$iety beco'es severe enough to significantly interfere with the patient's (uality of life, phar'acotherapy is indicated. Medications are not considered !a way of life! for patients with an$iety disorders% 'any patients can 'anage an$iety without 'edications. The nurse does not have enough infor'ation to tell the patient that 'edications will probably not be necessary. Medication co'bined with therapy is considered the best approach for treat'ent of an$iety disorders. Rationa e 2/ &t is 'ore productive to identify and treat the cause of an$iety than to use 'edications. When an$iety beco'es severe enough to significantly interfere with the patient's (uality of life, phar'acotherapy is indicated. Medications are not considered !a way of life! for patients with an$iety disorders% 'any patients can 'anage an$iety without 'edications. The nurse does not have enough infor'ation to tell the patient that 'edications will probably not be necessary. Medication co'bined with therapy is considered the best approach for treat'ent of an$iety disorders. Rationa e 3/ &t is 'ore productive to identify and treat the cause of an$iety than to use 'edications. When an$iety beco'es severe enough to significantly interfere with the patient's (uality of life, phar'acotherapy is indicated. Medications are not considered !a way of life! for patients with an$iety disorders% 'any patients can 'anage an$iety without 'edications. The nurse does not have enough infor'ation to tell the patient that 'edications will probably not be necessary. Medication co'bined with therapy is considered the best approach for treat'ent of an$iety disorders. Rationa e 4/ &t is 'ore productive to identify and treat the cause of an$iety than to use 'edications. When an$iety beco'es severe enough to significantly interfere with the patient's (uality of life, phar'acotherapy is indicated. Medications are not considered !a way of life! for patients with an$iety disorders% 'any patients can 'anage an$iety without 'edications. The nurse does not have enough infor'ation to tell the patient that 'edications will probably not be necessary. Medication co'bined with therapy is considered the best approach for treat'ent of an$iety disorders. ! o"a Rationa e: Co#niti$e %e$e : Applying C ient &eed: +hysiological &ntegrity C ient &eed 'u":
Ada's, Pharmacology for Nurse: A Pathophysiologic Approach, 456 Copyright 78.4 by +earson 6ducation, &nc.

&ursin#/(nte#rated Concepts: 9ursing +rocess/ &'ple'entation %earnin# )utcome: .43= Question , Type: MCSA The patient has been treated by the sa'e physician for 7 years and has had inso'nia the entire ti'e. Many different 'edications have been tried with li'ited success. What should be the nurse's pri'ary assess'ent at this ti'e 1. Assess for a pri'ary sleep disorder such as sleep apnea. 2. Assess if the patient has been selling his 'edications to addicts. 3. Assess if the patient has an addictive personality disorder. 4. Assess the patient for a pri'ary personality disorder. Correct Answer: . Rationa e 1/ &f the patient has a pri'ary sleep disorder such as sleep apnea, this 'ust be treated to relieve the inso'nia. Also, 'edications such as ben#odia#epines depress respiratory drive and would aggravate the sleep apnea. There is no infor'ation that the patient 'ight have a personality disorder. &f he did, the nurse would 'ost li)ely recogni#e this after 7 years of treat'ent. While it is re'otely possible that the patient is selling his 'edication% it is not li)ely for a patient with an an$iety disorder to do this. There is no infor'ation that the patient 'ight have an addictive personality disorder. &f he did, the nurse would )now this after 7 years of treat'ent. Rationa e 2/ &f the patient has a pri'ary sleep disorder such as sleep apnea, this 'ust be treated to relieve the inso'nia. Also, 'edications such as ben#odia#epines depress respiratory drive and would aggravate the sleep apnea. There is no infor'ation that the patient 'ight have a personality disorder. &f he did, the nurse would 'ost li)ely recogni#e this after 7 years of treat'ent. While it is re'otely possible that the patient is selling his 'edication% it is not li)ely for a patient with an an$iety disorder to do this. There is no infor'ation that the patient 'ight have an addictive personality disorder. &f he did, the nurse would )now this after 7 years of treat'ent. Rationa e 3/ &f the patient has a pri'ary sleep disorder such as sleep apnea, this 'ust be treated to relieve the inso'nia. Also, 'edications such as ben#odia#epines depress respiratory drive and would aggravate the sleep apnea. There is no infor'ation that the patient 'ight have a personality disorder. &f he did, the nurse would 'ost li)ely recogni#e this after 7 years of treat'ent. While it is re'otely possible that the patient is selling his 'edication% it is not li)ely for a patient with an an$iety disorder to do this. There is no infor'ation that the patient 'ight have an addictive personality disorder. &f he did, the nurse would )now this after 7 years of treat'ent. Rationa e 4/ &f the patient has a pri'ary sleep disorder such as sleep apnea, this 'ust be treated to relieve the inso'nia. Also, 'edications such as ben#odia#epines depress respiratory drive and would aggravate the sleep apnea. There is no infor'ation that the patient 'ight have a personality disorder. &f he did, the nurse would 'ost li)ely recogni#e this after 7 years of treat'ent. While it is re'otely possible that the patient is selling his 'edication% it is not li)ely for a patient with an an$iety disorder to do this. There is no infor'ation that the patient 'ight have an addictive personality disorder. &f he did, the nurse would )now this after 7 years of treat'ent.
Ada's, Pharmacology for Nurse: A Pathophysiologic Approach, 456 Copyright 78.4 by +earson 6ducation, &nc.

! o"a Rationa e: Co#niti$e %e$e : Applying C ient &eed: +hysiological &ntegrity C ient &eed 'u": &ursin#/(nte#rated Concepts: 9ursing +rocess/ Assess'ent %earnin# )utcome: .43? Question Type: MCSA The patient is scheduled to have an 660 to confir' the presence of a sleep disorder. The patient as)s the nurse to describe Stage &@ 926M sleep. What is the best response by the nurse 1. !This is the lightest stage of sleep, and is profoundly affected by an$iety.! 2. !,rea'ing occurs here% without drea's you will be irritable and paranoid.! 3. !This is the deepest stage of sleep% without it you will be tired and depressed.! 4. !This stage co'prises the greatest a'ount of sleep ti'e, and is i'portant.! Correct Answer: : Rationa e 1/ Stage &@ 926M sleep is the deepest stage of sleep. +atients who are deprived of it e$perience depression and a feeling of apathy and fatigue. ,rea'ing occurs in 26M sleep, not 926M sleep. Stage &@ 926M sleep is the deepest stage of sleep, not the lightest stage of sleep. Stage && 926M sleep, not Stage &@ 926M sleep, co'prises the greatest a'ount of total sleep ti'e. Rationa e 2/ Stage &@ 926M sleep is the deepest stage of sleep. +atients who are deprived of it e$perience depression and a feeling of apathy and fatigue. ,rea'ing occurs in 26M sleep, not 926M sleep. Stage &@ 926M sleep is the deepest stage of sleep, not the lightest stage of sleep. Stage && 926M sleep, not Stage &@ 926M sleep, co'prises the greatest a'ount of total sleep ti'e. Rationa e 3/ Stage &@ 926M sleep is the deepest stage of sleep. +atients who are deprived of it e$perience depression and a feeling of apathy and fatigue. ,rea'ing occurs in 26M sleep, not 926M sleep. Stage &@ 926M sleep is the deepest stage of sleep, not the lightest stage of sleep. Stage && 926M sleep, not Stage &@ 926M sleep, co'prises the greatest a'ount of total sleep ti'e. Rationa e 4/ Stage &@ 926M sleep is the deepest stage of sleep. +atients who are deprived of it e$perience depression and a feeling of apathy and fatigue. ,rea'ing occurs in 26M sleep, not 926M sleep. Stage &@ 926M sleep is the deepest stage of sleep, not the lightest stage of sleep. Stage && 926M sleep, not Stage &@ 926M sleep, co'prises the greatest a'ount of total sleep ti'e. ! o"a Rationa e: Co#niti$e %e$e : Applying
Ada's, Pharmacology for Nurse: A Pathophysiologic Approach, 456 Copyright 78.4 by +earson 6ducation, &nc.

C ient &eed: +hysiological &ntegrity C ient &eed 'u": &ursin#/(nte#rated Concepts: 9ursing +rocess/ &'ple'entation %earnin# )utcome: .43A Question . Type: MCSA The patient has been ta)ing lora#epa' *Ativan- for 7 years. The patient stopped this 'edication after a neighbor said the drug 'anufacturer's plant was conta'inated with rat droppings. What best describes the nurse's assess'ent of the patient when seen : days after stopping his 'edication 1. &ncreased heart rate, fever, and 'uscle cra'ps 2. 9othing different% it is safe to abruptly stop lora#epa' *Ativan3. +inpoint pupils, constipation, and urinary retention 4. A sense of cal'ness and lac) of an$iety Correct Answer: . Rationa e 1/ Many central nervous syste' *C9S- depressants can cause physical and psychological dependence. The withdrawal syndro'e for so'e central nervous syste' *C9S- depressants can include fever, sei#ures, increased pulse, anore$ia, 'uscle cra'ps, disorientation, etc. &t is not safe to abruptly stop lora#epa' *Ativan-% withdrawal sy'pto's will occur. +inpoint pupils, constipation, and urinary retention are signs of opioid use. The patient would be an$ious, not cal', during ben#odia#epine withdrawal. Rationa e 2/ Many central nervous syste' *C9S- depressants can cause physical and psychological dependence. The withdrawal syndro'e for so'e central nervous syste' *C9S- depressants can include fever, sei#ures, increased pulse, anore$ia, 'uscle cra'ps, disorientation, etc. &t is not safe to abruptly stop lora#epa' *Ativan-% withdrawal sy'pto's will occur. +inpoint pupils, constipation, and urinary retention are signs of opioid use. The patient would be an$ious, not cal', during ben#odia#epine withdrawal. Rationa e 3/ Many central nervous syste' *C9S- depressants can cause physical and psychological dependence. The withdrawal syndro'e for so'e central nervous syste' *C9S- depressants can include fever, sei#ures, increased pulse, anore$ia, 'uscle cra'ps, disorientation, etc. &t is not safe to abruptly stop lora#epa' *Ativan-% withdrawal sy'pto's will occur. +inpoint pupils, constipation, and urinary retention are signs of opioid use. The patient would be an$ious, not cal', during ben#odia#epine withdrawal. Rationa e 4/ Many central nervous syste' *C9S- depressants can cause physical and psychological dependence. The withdrawal syndro'e for so'e central nervous syste' *C9S- depressants can include fever, sei#ures, increased pulse, anore$ia, 'uscle cra'ps, disorientation, etc. &t is not safe to abruptly stop lora#epa' *Ativan-% withdrawal sy'pto's will occur. +inpoint pupils, constipation, and urinary retention are signs of opioid use. The patient would be an$ious, not cal', during ben#odia#epine withdrawal. ! o"a Rationa e:
Ada's, Pharmacology for Nurse: A Pathophysiologic Approach, 456 Copyright 78.4 by +earson 6ducation, &nc.

Co#niti$e %e$e : Applying C ient &eed: +hysiological &ntegrity C ient &eed 'u": &ursin#/(nte#rated Concepts: 9ursing +rocess/ Assess'ent %earnin# )utcome: .43B Question / Type: MCSA The patient co'es to the e'ergency depart'ent after an overdose of lora#epa' *Ativan-. The nurse will plan to ad'inister which 'edication 1. +ralido$i'e *+rotopa'2. 9alo$one *9arcan3. ;lu'a#enil *2o'a#icon4. 9al'efene *2eve$Correct Answer: : Rationa e 1/ Should an overdose of ben#odia#epines occur, flu'a#enil *2o'a#icon- is a specific ben#odia#epine receptor antagonist that can be ad'inistered to reverse central nervous syste' *C9S- depression. 9alo$one *9arcan- is indicated for treat'ent of opiate overdose. 9al'efene *2eve$- is indicated for treat'ent of opiate overdose. +ralido$i'e *+rotopa'- is indicated for treat'ent of organophosphate poisoning. Rationa e 2/ Should an overdose of ben#odia#epines occur, flu'a#enil *2o'a#icon- is a specific ben#odia#epine receptor antagonist that can be ad'inistered to reverse central nervous syste' *C9S- depression. 9alo$one *9arcan- is indicated for treat'ent of opiate overdose. 9al'efene *2eve$- is indicated for treat'ent of opiate overdose. +ralido$i'e *+rotopa'- is indicated for treat'ent of organophosphate poisoning. Rationa e 3/ Should an overdose of ben#odia#epines occur, flu'a#enil *2o'a#icon- is a specific ben#odia#epine receptor antagonist that can be ad'inistered to reverse central nervous syste' *C9S- depression. 9alo$one *9arcan- is indicated for treat'ent of opiate overdose. 9al'efene *2eve$- is indicated for treat'ent of opiate overdose. +ralido$i'e *+rotopa'- is indicated for treat'ent of organophosphate poisoning. Rationa e 4/ Should an overdose of ben#odia#epines occur, flu'a#enil *2o'a#icon- is a specific ben#odia#epine receptor antagonist that can be ad'inistered to reverse central nervous syste' *C9S- depression. 9alo$one *9arcan- is indicated for treat'ent of opiate overdose. 9al'efene *2eve$- is indicated for treat'ent of opiate overdose. +ralido$i'e *+rotopa'- is indicated for treat'ent of organophosphate poisoning. ! o"a Rationa e: Co#niti$e %e$e : Applying C ient &eed: +hysiological &ntegrity C ient &eed 'u":
Ada's, Pharmacology for Nurse: A Pathophysiologic Approach, 456 Copyright 78.4 by +earson 6ducation, &nc.

&ursin#/(nte#rated Concepts: 9ursing +rocess/ +lanning %earnin# )utcome: .43C Question 10 Type: MCSA The nurse wor)s with a physician who fre(uently prescribes ben#odia#epines. The use of ben#odia#epines in which patient would cause the nurse the 'ost concern 1. An CA3year3old patient who uses a cane for a'bulation 2. A B3year3old child with panic attac)s 3. A 473year3old business'an who travels internationally 4. A :73year3old 'other of two preschool children Correct Answer: . Rationa e 1/ >en#odia#epines should be used with caution in elderly patients. 6lderly patients are at highest ris) because their 'etabolis' and e$cretion is slowed% and there is a higher potential for overdose and sedation. There have been few studies of ben#odia#epine use in the pediatric population% ben#odia#epines 'ust be used with caution, but these patients are not at as high ris) as the elderly population. There is 'ini'al concern with ben#odia#epine use in a :73year3old patient. There is 'ini'al concern with ben#odia#epine use in a 473year3old patient. Rationa e 2/ >en#odia#epines should be used with caution in elderly patients. 6lderly patients are at highest ris) because their 'etabolis' and e$cretion is slowed% and there is a higher potential for overdose and sedation. There have been few studies of ben#odia#epine use in the pediatric population% ben#odia#epines 'ust be used with caution, but these patients are not at as high ris) as the elderly population. There is 'ini'al concern with ben#odia#epine use in a :73year3old patient. There is 'ini'al concern with ben#odia#epine use in a 473year3old patient. Rationa e 3/ >en#odia#epines should be used with caution in elderly patients. 6lderly patients are at highest ris) because their 'etabolis' and e$cretion is slowed% and there is a higher potential for overdose and sedation. There have been few studies of ben#odia#epine use in the pediatric population% ben#odia#epines 'ust be used with caution, but these patients are not at as high ris) as the elderly population. There is 'ini'al concern with ben#odia#epine use in a :73year3old patient. There is 'ini'al concern with ben#odia#epine use in a 473year3old patient. Rationa e 4/ >en#odia#epines should be used with caution in elderly patients. 6lderly patients are at highest ris) because their 'etabolis' and e$cretion is slowed% and there is a higher potential for overdose and sedation. There have been few studies of ben#odia#epine use in the pediatric population% ben#odia#epines 'ust be used with caution, but these patients are not at as high ris) as the elderly population. There is 'ini'al concern with ben#odia#epine use in a :73year3old patient. There is 'ini'al concern with ben#odia#epine use in a 473year3old patient. ! o"a Rationa e:
Ada's, Pharmacology for Nurse: A Pathophysiologic Approach, 456 Copyright 78.4 by +earson 6ducation, &nc.

Co#niti$e %e$e : Applying C ient &eed: +hysiological &ntegrity C ient &eed 'u": &ursin#/(nte#rated Concepts: 9ursing +rocess/ Assess'ent %earnin# )utcome: .43B Question 11 Type: MCSA The nurse has co'pleted 'edication education for the an$ious patient who is receiving buspirone *>uSpar-. The nurse deter'ines that the patient needs additional instruction when the patient 'a)es which state'ent 1. !Side effects & 'ight e$perience include di##iness, headache, and drowsiness.! 2. !& can ta)e this 'edication when & feel an$ious and it will rela$ 'e.! 3. !& have to ta)e this 'edicine on a regular basis for it to help 'e.! 4. !& don't need to worry about beco'ing dependent on this 'edication.! Correct Answer: 7 Rationa e 1/ >uspirone *>uSpar- wor)s by altering levels of neurotrans'itters and ta)es a few wee)s to achieve opti'al an$iety reduction. &t cannot be used as an !as needed! *prn- 'edication. Side effects of buspirone *>uSpar- include di##iness, headache, and drowsiness. ,ependence and withdrawal are less of a concern with buspirone *>uSpar- than with so'e other antian$iety drugs. >uspirone *>uSpar- wor)s by altering levels of neurotrans'itters and ta)es a few wee)s to achieve opti'al an$iety reduction. The drug 'ust be ta)en consistently for this to occur. Rationa e 2/ >uspirone *>uSpar- wor)s by altering levels of neurotrans'itters and ta)es a few wee)s to achieve opti'al an$iety reduction. &t cannot be used as an !as needed! *prn- 'edication. Side effects of buspirone *>uSpar- include di##iness, headache, and drowsiness. ,ependence and withdrawal are less of a concern with buspirone *>uSpar- than with so'e other antian$iety drugs. >uspirone *>uSpar- wor)s by altering levels of neurotrans'itters and ta)es a few wee)s to achieve opti'al an$iety reduction. The drug 'ust be ta)en consistently for this to occur. Rationa e 3/ >uspirone *>uSpar- wor)s by altering levels of neurotrans'itters and ta)es a few wee)s to achieve opti'al an$iety reduction. &t cannot be used as an !as needed! *prn- 'edication. Side effects of buspirone *>uSpar- include di##iness, headache, and drowsiness. ,ependence and withdrawal are less of a concern with buspirone *>uSpar- than with so'e other antian$iety drugs. >uspirone *>uSpar- wor)s by altering levels of neurotrans'itters and ta)es a few wee)s to achieve opti'al an$iety reduction. The drug 'ust be ta)en consistently for this to occur. Rationa e 4/ >uspirone *>uSpar- wor)s by altering levels of neurotrans'itters and ta)es a few wee)s to achieve opti'al an$iety reduction. &t cannot be used as an !as needed! *prn- 'edication. Side effects of buspirone *>uSpar- include di##iness, headache, and drowsiness. ,ependence and withdrawal are less of a concern with buspirone *>uSpar- than with so'e other antian$iety drugs. >uspirone *>uSpar- wor)s by altering levels of
Ada's, Pharmacology for Nurse: A Pathophysiologic Approach, 456 Copyright 78.4 by +earson 6ducation, &nc.

neurotrans'itters and ta)es a few wee)s to achieve opti'al an$iety reduction. The drug 'ust be ta)en consistently for this to occur. ! o"a Rationa e: Co#niti$e %e$e : Applying C ient &eed: +hysiological &ntegrity C ient &eed 'u": &ursin#/(nte#rated Concepts: 9ursing +rocess/ 6valuation %earnin# )utcome: .43C Question 12 Type: MCSA The patient is receiving #olpide' *A'bien- for treat'ent of short3ter' inso'nia. What is the pri'ary safety concern of the nurse when the patient ta)es this 'edication 1. ,i##iness and dayti'e sedation 2. 9ausea and diarrhea 3. 9ausea and gastrointestinal *0&- distress 4. Sleepwal)ing Correct Answer: 4 Rationa e 1/ ,uring sleepwal)ing, a patient 'ay leave the ho'e and cause injury to self. 9ausea and gastrointestinal *0&- distress are co''on side effects of #olpide' *A'bien-, and usually subside after a few days on the 'edication. ,i##iness and dayti'e sedation are co''on side effects of #olpide' *A'bien-, and usually subside after a few days on the 'edication. 9ausea and diarrhea are co''on side effects of #olpide' *A'bien-, and usually subside after a few days on the 'edication. Rationa e 2/ ,uring sleepwal)ing, a patient 'ay leave the ho'e and cause injury to self. 9ausea and gastrointestinal *0&- distress are co''on side effects of #olpide' *A'bien-, and usually subside after a few days on the 'edication. ,i##iness and dayti'e sedation are co''on side effects of #olpide' *A'bien-, and usually subside after a few days on the 'edication. 9ausea and diarrhea are co''on side effects of #olpide' *A'bien-, and usually subside after a few days on the 'edication. Rationa e 3/ ,uring sleepwal)ing, a patient 'ay leave the ho'e and cause injury to self. 9ausea and gastrointestinal *0&- distress are co''on side effects of #olpide' *A'bien-, and usually subside after a few days on the 'edication. ,i##iness and dayti'e sedation are co''on side effects of #olpide' *A'bien-, and usually subside after a few days on the 'edication. 9ausea and diarrhea are co''on side effects of #olpide' *A'bien-, and usually subside after a few days on the 'edication. Rationa e 4/ ,uring sleepwal)ing, a patient 'ay leave the ho'e and cause injury to self. 9ausea and gastrointestinal *0&- distress are co''on side effects of #olpide' *A'bien-, and usually subside after a few days on the 'edication. ,i##iness and dayti'e sedation are co''on side effects of #olpide' *A'bien-, and usually
Ada's, Pharmacology for Nurse: A Pathophysiologic Approach, 456 Copyright 78.4 by +earson 6ducation, &nc.

subside after a few days on the 'edication. 9ausea and diarrhea are co''on side effects of #olpide' *A'bien-, and usually subside after a few days on the 'edication. ! o"a Rationa e: Co#niti$e %e$e : Applying C ient &eed: +hysiological &ntegrity C ient &eed 'u": &ursin#/(nte#rated Concepts: 9ursing +rocess/ Assess'ent %earnin# )utcome: .43B Question 13 Type: MCSA The patient is receiving escitalopra' *De$apro- for treat'ent of generali#ed an$iety disorder. The patient as)s the nurse, !& a' just nervous, not depressed. Why a' & ta)ing an antidepressant 'edicine ! What is the best response by the nurse 1. !The sa'e brain che'icals are involved with an$iety as well as depression, and these 'edications are very safe.! 2. !"ou are really depressed% it is just 'anifested as an$iety. These 'edications are safer than ben#odia#epines.! 3. !"our doctor thin)s that this is the best treat'ent for your an$iety, and these 'edications are safer than ben#odia#epines.! 4. !The two disorders go together, and if you treat depression, the an$iety goes away.! Correct Answer: . Rationa e 1/ Antidepressants are fre(uently used to treat sy'pto's of an$iety. They reduce an$iety by altering levels of norepinephrine and serotonin. These neurotrans'itters are also involved in depression. Selective serotonin reupta)e inhibitors *SS2&s- are safer than ben#odia#epines, but depression and an$iety are two separate disorders. The patient is being treated for generali#ed an$iety, this is different fro' depression. Telling the patient that the doctor )nows best is a condescending reply, and does not answer the patient's (uestion. Rationa e 2/ Antidepressants are fre(uently used to treat sy'pto's of an$iety. They reduce an$iety by altering levels of norepinephrine and serotonin. These neurotrans'itters are also involved in depression. Selective serotonin reupta)e inhibitors *SS2&s- are safer than ben#odia#epines, but depression and an$iety are two separate disorders. The patient is being treated for generali#ed an$iety, this is different fro' depression. Telling the patient that the doctor )nows best is a condescending reply, and does not answer the patient's (uestion. Rationa e 3/ Antidepressants are fre(uently used to treat sy'pto's of an$iety. They reduce an$iety by altering levels of norepinephrine and serotonin. These neurotrans'itters are also involved in depression. Selective serotonin reupta)e inhibitors *SS2&s- are safer than ben#odia#epines, but depression and an$iety are two separate disorders. The patient is being treated for generali#ed an$iety, this is different fro' depression. Telling the patient that the doctor )nows best is a condescending reply, and does not answer the patient's (uestion.
Ada's, Pharmacology for Nurse: A Pathophysiologic Approach, 456 Copyright 78.4 by +earson 6ducation, &nc.

Rationa e 4/ Antidepressants are fre(uently used to treat sy'pto's of an$iety. They reduce an$iety by altering levels of norepinephrine and serotonin. These neurotrans'itters are also involved in depression. Selective serotonin reupta)e inhibitors *SS2&s- are safer than ben#odia#epines, but depression and an$iety are two separate disorders. The patient is being treated for generali#ed an$iety, this is different fro' depression. Telling the patient that the doctor )nows best is a condescending reply, and does not answer the patient's (uestion. ! o"a Rationa e: Co#niti$e %e$e : Applying C ient &eed: +hysiological &ntegrity C ient &eed 'u": &ursin#/(nte#rated Concepts: 9ursing +rocess/ &'ple'entation %earnin# )utcome: .43.8 Question 14 Type: MCSA The patient has been receiving escitalopra' *De$apro- for treat'ent of obsessive3co'pulsive disorder. En)nown to the nurse, the patient has also been self3'edicating with St. Fohn's wort. The patient co'es to the office with sy'pto's of hyperther'ia and diaphoresis. Which state'ent best describes the result of the nurse's assess'ent 1. The patient is e$periencing sy'pto's of St. Fohn's wort to$icity, as the 'edication was 'ost li)ely outdated. 2. The patient has contracted a viral infection. 6scitalopra' *De$apro- and St. Fohn's wort are safe to ta)e together. 3. The patient has not been ta)ing escitalopra' *De$apro- and is e$periencing withdrawal. 4. The patient has co'bined two antidepressant 'edications and is e$periencing serotonin syndro'e. Correct Answer: 4 Rationa e 1/ Ese caution with herbal supple'ents such as St. Fohn's wort, which 'ay increase the effects of escitalopra' *De$apro- and cause serotonin syndro'e. The patient's sy'pto's are consistent with serotonin syndro'e, and there is no evidence that the patient has not been ta)ing the escitalopra' *De$apro-. The patient's sy'pto's are consistent with serotonin syndro'e, and there is no evidence that the patient's St. Fohn's wort is outdated. The patient's sy'pto's are consistent with serotonin syndro'e. &t is not considered safe to co'bine escitalopra' *De$apro- and St. Fohn's wort. Rationa e 2/ Ese caution with herbal supple'ents such as St. Fohn's wort, which 'ay increase the effects of escitalopra' *De$apro- and cause serotonin syndro'e. The patient's sy'pto's are consistent with serotonin syndro'e, and there is no evidence that the patient has not been ta)ing the escitalopra' *De$apro-. The patient's sy'pto's are consistent with serotonin syndro'e, and there is no evidence that the patient's St. Fohn's wort is outdated. The patient's sy'pto's are consistent with serotonin syndro'e. &t is not considered safe to co'bine escitalopra' *De$apro- and St. Fohn's wort.

Ada's, Pharmacology for Nurse: A Pathophysiologic Approach, 456 Copyright 78.4 by +earson 6ducation, &nc.

Rationa e 3/ Ese caution with herbal supple'ents such as St. Fohn's wort, which 'ay increase the effects of escitalopra' *De$apro- and cause serotonin syndro'e. The patient's sy'pto's are consistent with serotonin syndro'e, and there is no evidence that the patient has not been ta)ing the escitalopra' *De$apro-. The patient's sy'pto's are consistent with serotonin syndro'e, and there is no evidence that the patient's St. Fohn's wort is outdated. The patient's sy'pto's are consistent with serotonin syndro'e. &t is not considered safe to co'bine escitalopra' *De$apro- and St. Fohn's wort. Rationa e 4/ Ese caution with herbal supple'ents such as St. Fohn's wort, which 'ay increase the effects of escitalopra' *De$apro- and cause serotonin syndro'e. The patient's sy'pto's are consistent with serotonin syndro'e, and there is no evidence that the patient has not been ta)ing the escitalopra' *De$apro-. The patient's sy'pto's are consistent with serotonin syndro'e, and there is no evidence that the patient's St. Fohn's wort is outdated. The patient's sy'pto's are consistent with serotonin syndro'e. &t is not considered safe to co'bine escitalopra' *De$apro- and St. Fohn's wort. ! o"a Rationa e: Co#niti$e %e$e : Applying C ient &eed: +hysiological &ntegrity C ient &eed 'u": &ursin#/(nte#rated Concepts: 9ursing +rocess/ Assess'ent %earnin# )utcome: .43B Question 1+ Type: MCSA The patient is receiving clona#epa' *Glonopin- for the treat'ent of panic attac)s. What is an i'portant 'edication outco'e for this patient as it relates to safety 1. The patient will verbali#e the signs of developing Stevens3Fohnson rash. 2. The patient will verbali#e the i'portance of diet restrictions related to this drug. 3. The patient will verbali#e the i'portance of having routine blood wor) done. 4. The patient will verbali#e the conse(uences of stopping the drug abruptly. Correct Answer: 4 Rationa e 1/ Abrupt discontinuation of clona#epa' *Glonopin- can result in serious withdrawal sy'pto's. There aren't any diet restrictions with the use of clona#epa' *Glonopin-. 2outine blood wor) is not re(uired with the use of clona#epa' *Glonopin-. Stevens3Fohnson rash is not a side effect of clona#epa' *Glonopin-. Rationa e 2/ Abrupt discontinuation of clona#epa' *Glonopin- can result in serious withdrawal sy'pto's. There aren't any diet restrictions with the use of clona#epa' *Glonopin-. 2outine blood wor) is not re(uired with the use of clona#epa' *Glonopin-. Stevens3Fohnson rash is not a side effect of clona#epa' *Glonopin-.

Ada's, Pharmacology for Nurse: A Pathophysiologic Approach, 456 Copyright 78.4 by +earson 6ducation, &nc.

Rationa e 3/ Abrupt discontinuation of clona#epa' *Glonopin- can result in serious withdrawal sy'pto's. There aren't any diet restrictions with the use of clona#epa' *Glonopin-. 2outine blood wor) is not re(uired with the use of clona#epa' *Glonopin-. Stevens3Fohnson rash is not a side effect of clona#epa' *Glonopin-. Rationa e 4/ Abrupt discontinuation of clona#epa' *Glonopin- can result in serious withdrawal sy'pto's. There aren't any diet restrictions with the use of clona#epa' *Glonopin-. 2outine blood wor) is not re(uired with the use of clona#epa' *Glonopin-. Stevens3Fohnson rash is not a side effect of clona#epa' *Glonopin-. ! o"a Rationa e: Co#niti$e %e$e : Applying C ient &eed: +hysiological &ntegrity C ient &eed 'u": &ursin#/(nte#rated Concepts: 9ursing +rocess/ +lanning %earnin# )utcome: .43B Question 1, Type: MCSA An individual who has difficulty sleeping due to two final e$a'inations scheduled for the sa'e day later in the wee) 'ost li)ely would be suffering fro' 1. situational an$iety. 2. social an$iety. 3. obsessive3co'pulsive disorder. 4. perfor'ance an$iety. Correct Answer: . Rationa e 1/ The final e$a'ination is a te'porary event that is the cause of the an$iety. 1nce the e$a'ination is over, it is li)ely that the situational an$iety will end. Social an$iety is a fear of crowds. +erfor'ance an$iety is fre(uently referred to as stage fright. Although the situation presented re(uired the student to perfor' on the e$a', it is best defined as situational an$iety. Rationa e 2/ The final e$a'ination is a te'porary event that is the cause of the an$iety. 1nce the e$a'ination is over, it is li)ely that the situational an$iety will end. Social an$iety is a fear of crowds. +erfor'ance an$iety is fre(uently referred to as stage fright. Although the situation presented re(uired the student to perfor' on the e$a', it is best defined as situational an$iety. Rationa e 3/ The final e$a'ination is a te'porary event that is the cause of the an$iety. 1nce the e$a'ination is over, it is li)ely that the situational an$iety will end. Social an$iety is a fear of crowds. +erfor'ance an$iety is fre(uently referred to as stage fright. Although the situation presented re(uired the student to perfor' on the e$a', it is best defined as situational an$iety.
Ada's, Pharmacology for Nurse: A Pathophysiologic Approach, 456 Copyright 78.4 by +earson 6ducation, &nc.

Rationa e 4/ The final e$a'ination is a te'porary event that is the cause of the an$iety. 1nce the e$a'ination is over, it is li)ely that the situational an$iety will end. Social an$iety is a fear of crowds. +erfor'ance an$iety is fre(uently referred to as stage fright. Although the situation presented re(uired the student to perfor' on the e$a', it is best defined as situational an$iety. ! o"a Rationa e: Co#niti$e %e$e : Enderstanding C ient &eed: <ealth +ro'otion and Maintenance C ient &eed 'u": &ursin#/(nte#rated Concepts: 9ursing +rocess/ Assess'ent %earnin# )utcome: .43. Question 1Type: MCSA The 'ost productive way of 'anaging stress would be to 1. use a co'bined approach *drug use and nonphar'acological strategies-. 2. use an$iolytics. 3. practice 'editation. 4. deter'ine the cause and address it accordingly. Correct Answer: 4 Rationa e 1/ Stress is generally a sy'pto' of an underlying disorder. &t is 'ore productive to uncover and address the cause than to treat the sy'pto's. Rationa e 2/ Stress is generally a sy'pto' of an underlying disorder. &t is 'ore productive to uncover and address the cause than to treat the sy'pto's. Rationa e 3/ Stress is generally a sy'pto' of an underlying disorder. &t is 'ore productive to uncover and address the cause than to treat the sy'pto's. Rationa e 4/ Stress is generally a sy'pto' of an underlying disorder. &t is 'ore productive to uncover and address the cause than to treat the sy'pto's. ! o"a Rationa e: Co#niti$e %e$e : Enderstanding C ient &eed: <ealth +ro'otion and Maintenance C ient &eed 'u": &ursin#/(nte#rated Concepts: 9ursing +rocess/ +lanning %earnin# )utcome: .437
Ada's, Pharmacology for Nurse: A Pathophysiologic Approach, 456 Copyright 78.4 by +earson 6ducation, &nc.

Question 1. Type: MCSA Which area of the brain is pri'arily responsible for 'aintaining sleep and wa)efulness 1. 2eticular activating syste' 2. Cerebral corte$ 3. Di'bic syste' 4. Cerebellu' Correct Answer: . Rationa e 1/ The reticular activating syste' is responsible for sleeping and wa)efulness. The li'bic syste' is responsible for e'otional e$pression, learning, and 'e'ory. The pri'ary functions of the cerebral corte$ and cerebellu' do not include sleep and wa)efulness. Rationa e 2/ The reticular activating syste' is responsible for sleeping and wa)efulness. The li'bic syste' is responsible for e'otional e$pression, learning, and 'e'ory. The pri'ary functions of the cerebral corte$ and cerebellu' do not include sleep and wa)efulness. Rationa e 3/ The reticular activating syste' is responsible for sleeping and wa)efulness. The li'bic syste' is responsible for e'otional e$pression, learning, and 'e'ory. The pri'ary functions of the cerebral corte$ and cerebellu' do not include sleep and wa)efulness. Rationa e 4/ The reticular activating syste' is responsible for sleeping and wa)efulness. The li'bic syste' is responsible for e'otional e$pression, learning, and 'e'ory. The pri'ary functions of the cerebral corte$ and cerebellu' do not include sleep and wa)efulness. ! o"a Rationa e: Co#niti$e %e$e : 2e'e'bering C ient &eed: +hysiological &ntegrity C ient &eed 'u": &ursin#/(nte#rated Concepts: 9ursing +rocess/ Assess'ent %earnin# )utcome: .43: Question 1/ Type: MCSA Which drug category can be used for treating an$iety 1. Antitussives
Ada's, Pharmacology for Nurse: A Pathophysiologic Approach, 456 Copyright 78.4 by +earson 6ducation, &nc.

2. Anticoagulants 3. Sei#ure drugs 4. Antibiotics Correct Answer: : Rationa e 1/ &n addition to antidepressants, several other drug classes are used to treat an$iety, including sei#ure drugs. Antibiotics are used pri'arily for bacterial infections. Antitussives are used as cough suppressants. Anticoagulants are used to prevent blood clots fro' for'ing. Rationa e 2/ &n addition to antidepressants, several other drug classes are used to treat an$iety, including sei#ure drugs. Antibiotics are used pri'arily for bacterial infections. Antitussives are used as cough suppressants. Anticoagulants are used to prevent blood clots fro' for'ing. Rationa e 3/ &n addition to antidepressants, several other drug classes are used to treat an$iety, including sei#ure drugs. Antibiotics are used pri'arily for bacterial infections. Antitussives are used as cough suppressants. Anticoagulants are used to prevent blood clots fro' for'ing. Rationa e 4/ &n addition to antidepressants, several other drug classes are used to treat an$iety, including sei#ure drugs. Antibiotics are used pri'arily for bacterial infections. Antitussives are used as cough suppressants. Anticoagulants are used to prevent blood clots fro' for'ing. ! o"a Rationa e: Co#niti$e %e$e : 2e'e'bering C ient &eed: +hysiological &ntegrity C ient &eed 'u": &ursin#/(nte#rated Concepts: 9ursing +rocess/ +lanning %earnin# )utcome: .434 Question 20 Type: MCSA >en#odia#epines are often the drug of choice for 'anaging an$iety and inso'nia. Which state'ent best e$plains why 1. >en#odia#epines are the 'ost effective. 2. >en#odia#epines have the lowest ris) of dependency and tolerance. 3. >en#odia#epines are 'ost li)ely to be covered under insurance pre'iu's. 4. >en#odia#epines are the 'ost affordable. Correct Answer: 7
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Rationa e 1/ >en#odia#epines have a lower ris) of dependency and tolerance than do other drugs used for an$iety and inso'nia *such as the barbiturates-. They are not necessarily 'ore effective, affordable, or li)ely to be covered under insurance pre'iu's. Although econo'ics is an i'portant factor in phar'acology, drug safety is essential for widespread use. Rationa e 2/ >en#odia#epines have a lower ris) of dependency and tolerance than do other drugs used for an$iety and inso'nia *such as the barbiturates-. They are not necessarily 'ore effective, affordable, or li)ely to be covered under insurance pre'iu's. Although econo'ics is an i'portant factor in phar'acology, drug safety is essential for widespread use. Rationa e 3/ >en#odia#epines have a lower ris) of dependency and tolerance than do other drugs used for an$iety and inso'nia *such as the barbiturates-. They are not necessarily 'ore effective, affordable, or li)ely to be covered under insurance pre'iu's. Although econo'ics is an i'portant factor in phar'acology, drug safety is essential for widespread use. Rationa e 4/ >en#odia#epines have a lower ris) of dependency and tolerance than do other drugs used for an$iety and inso'nia *such as the barbiturates-. They are not necessarily 'ore effective, affordable, or li)ely to be covered under insurance pre'iu's. Although econo'ics is an i'portant factor in phar'acology, drug safety is essential for widespread use. ! o"a Rationa e: Co#niti$e %e$e : Enderstanding C ient &eed: +sychosocial &ntegrity C ient &eed 'u": &ursin#/(nte#rated Concepts: 9ursing +rocess/ +lanning %earnin# )utcome: .43= Question 21 Type: MCSA Which of the following co''on adverse effects of selective serotonin reupta)e inhibitors *SS2&s- would be stressed by the nurse during patient discharge 1. ,rowsiness and co'a 2. Weight gain and se$ual dysfunction 3. <eadache and nausea 4. ,ry 'outh and urine retention Correct Answer: 7 Rationa e 1/ Although anticholinergic effects such as dry 'outh and urine retention could occur, they are not as co''on as weight gain or se$ual dysfunction. <eadache is not a co''on adverse effect, and neither is drowsiness or co'a. 1verdoses will cause an$iety and restlessness *not drowsiness-.
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Rationa e 2/ Although anticholinergic effects such as dry 'outh and urine retention could occur, they are not as co''on as weight gain or se$ual dysfunction. <eadache is not a co''on adverse effect, and neither is drowsiness or co'a. 1verdoses will cause an$iety and restlessness *not drowsiness-. Rationa e 3/ Although anticholinergic effects such as dry 'outh and urine retention could occur, they are not as co''on as weight gain or se$ual dysfunction. <eadache is not a co''on adverse effect, and neither is drowsiness or co'a. 1verdoses will cause an$iety and restlessness *not drowsiness-. Rationa e 4/ Although anticholinergic effects such as dry 'outh and urine retention could occur, they are not as co''on as weight gain or se$ual dysfunction. <eadache is not a co''on adverse effect, and neither is drowsiness or co'a. 1verdoses will cause an$iety and restlessness *not drowsiness-. ! o"a Rationa e: Co#niti$e %e$e : Applying C ient &eed: +hysiological &ntegrity C ient &eed 'u": &ursin#/(nte#rated Concepts: 9ursing +rocess/ &'ple'entation %earnin# )utcome: .43? Question 22 Type: MCSA Which sleep stage accounts for about one3half of total sleep 1. 926M sleep stage . 2. 926M sleep stage : 3. 926M sleep stage 7 4. 926M sleep stage 4 Correct Answer: : Rationa e 1/ 926M sleep stage 7 accounts for 4=H==I of total sleep. The other stages are considerably less than half. Rationa e 2/ 926M sleep stage 7 accounts for 4=H==I of total sleep. The other stages are considerably less than half. Rationa e 3/ 926M sleep stage 7 accounts for 4=H==I of total sleep. The other stages are considerably less than half. Rationa e 4/ 926M sleep stage 7 accounts for 4=H==I of total sleep. The other stages are considerably less than half. ! o"a Rationa e:
Ada's, Pharmacology for Nurse: A Pathophysiologic Approach, 456 Copyright 78.4 by +earson 6ducation, &nc.

Co#niti$e %e$e : 2e'e'bering C ient &eed: +hysiological &ntegrity C ient &eed 'u": &ursin#/(nte#rated Concepts: 9ursing +rocess/ Assess'ent %earnin# )utcome: .43A Question 23 Type: MCSA A patient ta)ing which of the following 'edications should avoid foods high in tyra'ine 1. MA1&s 2. SS2&s 3. >eta bloc)ers 4. >en#odia#epines Correct Answer: . Rationa e 1/ MA1&s and foods high in tyra'ine can produce a hypertensive crisis, and therefore should not be ta)en together. Rationa e 2/ MA1&s and foods high in tyra'ine can produce a hypertensive crisis, and therefore should not be ta)en together. Rationa e 3/ MA1&s and foods high in tyra'ine can produce a hypertensive crisis, and therefore should not be ta)en together. Rationa e 4/ MA1&s and foods high in tyra'ine can produce a hypertensive crisis, and therefore should not be ta)en together. ! o"a Rationa e: Co#niti$e %e$e : 2e'e'bering C ient &eed: +hysiological &ntegrity C ient &eed 'u": &ursin#/(nte#rated Concepts: 9ursing +rocess/ +lanning %earnin# )utcome: .43? Question 24 Type: MCSA Which state'ent regarding the use of #olpide' *A'bien- for inso'nia is accurate
Ada's, Pharmacology for Nurse: A Pathophysiologic Approach, 456 Copyright 78.4 by +earson 6ducation, &nc.

1. +atients using A'bien should avoid foods that contain tyra'ine. 2. A'bien will ta)e longer to produce an effect when ta)en with food. 3. A'bien is contraindicated during pregnancy, but can be ta)en by breastfeeding 'others. 4. A'bien is classified as a ben#odia#epine. Correct Answer: 7 Rationa e 1/ The absorption of A'bien is slowed when ta)en with food. &t is classified as a nonben#odia#epine C9S depressant. &t is classified as pregnancy category >, and should be avoided by breastfeeding 'others. +atients using MA1&s *not A'bien- should avoid foods high in tyra'ine. Rationa e 2/ The absorption of A'bien is slowed when ta)en with food. &t is classified as a nonben#odia#epine C9S depressant. &t is classified as pregnancy category >, and should be avoided by breastfeeding 'others. +atients using MA1&s *not A'bien- should avoid foods high in tyra'ine. Rationa e 3/ The absorption of A'bien is slowed when ta)en with food. &t is classified as a nonben#odia#epine C9S depressant. &t is classified as pregnancy category >, and should be avoided by breastfeeding 'others. +atients using MA1&s *not A'bien- should avoid foods high in tyra'ine. Rationa e 4/ The absorption of A'bien is slowed when ta)en with food. &t is classified as a nonben#odia#epine C9S depressant. &t is classified as pregnancy category >, and should be avoided by breastfeeding 'others. +atients using MA1&s *not A'bien- should avoid foods high in tyra'ine. ! o"a Rationa e: Co#niti$e %e$e : Enderstanding C ient &eed: +sychosocial &ntegrity C ient &eed 'u": &ursin#/(nte#rated Concepts: 9ursing +rocess/ 6valuation %earnin# )utcome: .43C Question 2+ Type: MCSA Which e$planation best indicates why barbiturates are rarely used to treat an$iety and inso'nia 1. They have a greater associated cost. 2. They have a high ris) of producing an allergic response. 3. They are seldo' effective. 4. They produce 'any serious adverse effects. Correct Answer: 4
Ada's, Pharmacology for Nurse: A Pathophysiologic Approach, 456 Copyright 78.4 by +earson 6ducation, &nc.

Rationa e 1/ >arbiturates were the drug of choice for an$iety and inso'nia prior to the discovery of safer drug alternatives. They can be effective, and are not necessarily 'ore e$pensive. Allergic reactions can occur, but are rare, and are not a pri'ary reason they are no longer used for an$iety and5or inso'nia. Rationa e 2/ >arbiturates were the drug of choice for an$iety and inso'nia prior to the discovery of safer drug alternatives. They can be effective, and are not necessarily 'ore e$pensive. Allergic reactions can occur, but are rare, and are not a pri'ary reason they are no longer used for an$iety and5or inso'nia. Rationa e 3/ >arbiturates were the drug of choice for an$iety and inso'nia prior to the discovery of safer drug alternatives. They can be effective, and are not necessarily 'ore e$pensive. Allergic reactions can occur, but are rare, and are not a pri'ary reason they are no longer used for an$iety and5or inso'nia. Rationa e 4/ >arbiturates were the drug of choice for an$iety and inso'nia prior to the discovery of safer drug alternatives. They can be effective, and are not necessarily 'ore e$pensive. Allergic reactions can occur, but are rare, and are not a pri'ary reason they are no longer used for an$iety and5or inso'nia. ! o"a Rationa e: Co#niti$e %e$e : Enderstanding C ient &eed: +hysiological &ntegrity C ient &eed 'u": &ursin#/(nte#rated Concepts: 9ursing +rocess/ 6valuation %earnin# )utcome: .43B Question 2, Type: MCMA &t is i'portant for the nurse to obtain a thorough history fro' a patient who is e$periencing an$iety. This history will help to distinguish Note: Credit will be given only if all correct choices and no incorrect choices are selected. 'tandard Te*t: Select all that apply. 1. the best 'ethod of phar'acotherapy. 2. whether the patient 'ight benefit fro' individual or group therapy. 3. the category of an$iety disorder. 4. the region of the brain that is causing the an$iety disorder. +. substances that 'ight worsen an$iety. Correct Answer: .,7,=

Ada's, Pharmacology for Nurse: A Pathophysiologic Approach, 456 Copyright 78.4 by +earson 6ducation, &nc.

Rationa e 1/ The health care provider 'ust accurately diagnose the an$iety disorder, because treat'ent differs a'ong the various types of an$iety disorders. So'e an$iety disorders are debilitating and re(uire effective phar'acotherapy. Rationa e 2/ So'e patients benefit fro' individual or group psychotherapy, which can help the' identify and overco'e the root causes of their worry and fear. Rationa e 3/ A thorough health history is not used to deter'ine the category of an$iety disorder. Rationa e 4/ A thorough health history is not used to deter'ine the region of the brain that is causing the an$iety disorder. Rationa e +/ When obtaining a co'prehensive 'edication history during the initial patient assess'ent, the nurse should observe any substances the patient is ta)ing that 'ight worsen or cause an$iety sy'pto's. So'eti'es discontinuing or substituting an alternate drug for these !an$iety3pro'oting! 'edications can lessen patient sy'pto's. ! o"a Rationa e: Co#niti$e %e$e : Analy#ing C ient &eed: +sychosocial &ntegrity C ient &eed 'u": &ursin#/(nte#rated Concepts: 9ursing +rocess/ Assess'ent %earnin# )utcome: .43. Question 2Type: MCMA The patient is diagnosed with post3trau'atic stress disorder. What will the nurse assess in this patient Note: Credit will be given only if all correct choices and no incorrect choices are selected. 'tandard Te*t: Select all that apply. 1. Tachycardia 2. 6$tre'e nervousness or panic attac)s 3. A fear of crowds 4. A fear of e$posure to ger's +. <allucinations, night'ares, or flashbac)s Correct Answer: .,7,= Rationa e 1/ Tachycardia is a sy'pto' of post3trau'atic stress disorder.
Ada's, Pharmacology for Nurse: A Pathophysiologic Approach, 456 Copyright 78.4 by +earson 6ducation, &nc.

Rationa e 2/ 6$tre'e nervousness or panic attac)s are sy'pto's of post3trau'atic stress disorder. Rationa e 3/ A fear of crowds is typical in social an$iety disorder. Rationa e 4/ A fear of e$posure to ger's is typical of obsessive3co'pulsive disorder. Rationa e +/ &n post3trau'atic stress disorder the person re3e$periences trau'atic events, which can ta)e the for' of night'ares, hallucinations, or flashbac)s. ! o"a Rationa e: Co#niti$e %e$e : Analy#ing C ient &eed: +sychosocial &ntegrity C ient &eed 'u": &ursin#/(nte#rated Concepts: 9ursing +rocess/ Assess'ent %earnin# )utcome: .437 Question 2. Type: MCMA A patient has been in the intensive care unit for a wee) receiving various procedures throughout the day and night. Currently the patient, though physiologically stable, is irritable and paranoid and co'plains of vivid drea's when do#ing off to sleep. What are the best actions for the nurse to ta)e at this ti'e Note: Credit will be given only if all correct choices and no incorrect choices are selected. 'tandard Te*t: Select all that apply. 1. Chec) the patient's o$ygen status. 2. 2e(uest an order for sleep 'edication. 3. Assess the patient's vital signs. 4. Turn down the lights at night and reduce noise to a 'ini'u'. +. Schedule all tests and procedures before B p.'. or after A a.'. Correct Answer: 7,4,= Rationa e 1/ The patient is physiologically stable. Rationa e 2/ Since it is i'portant for the patient to get rest, an order for sleep 'edication would be appropriate. Rationa e 3/ &t is not necessary to assess the patient's vital signs, since the patient is physiologically stable.

Ada's, Pharmacology for Nurse: A Pathophysiologic Approach, 456 Copyright 78.4 by +earson 6ducation, &nc.

Rationa e 4/ When deprived of 26M sleep, people e$perience a sleep debt and beco'e frightened, irritable, paranoid, and even e'otionally disturbed. &t is speculated that to 'a)e up for their lac) of drea'ing, these persons e$perience far 'ore daydrea'ing and fantasi#ing throughout the day. &t is i'portant to institute 'easures that pro'ote restful sleep. Rationa e +/ When deprived of 26M sleep, people e$perience a sleep debt and beco'e frightened, irritable, paranoid, and even e'otionally disturbed. &t is i'portant to institute 'easures that pro'ote restful sleep, which would include scheduling tests and procedures so as to not disturb the patient's sleep. ! o"a Rationa e: Co#niti$e %e$e : Applying C ient &eed: +hysiological &ntegrity C ient &eed 'u": +hysiological Adaptation &ursin#/(nte#rated Concepts: 9ursing +rocess/ &'ple'entation %earnin# )utcome: .434 Question 2/ Type: MCMA A patient whose spouse recently died is having difficulty falling asleep and does not want to ta)e any prescription 'edications to induce sleep. <ow should the nurse respond Note: Credit will be given only if all correct choices and no incorrect choices are selected. 'tandard Te*t: Select all that apply. 1. !Wal)ing 7J : 'iles or engaging in so'e other e$ercise every 'orning can enhance sleep.! 2. !There are alternative 'ethods to treat inso'nia, such as yoga, 'editation, and 'assage therapy.! 3. !6ating a large 'eal at bedti'e will help induce sleep.! 4. !Avoid caffeinated beverages, nicotine, and alcohol i''ediately prior to bedti'e.! +. !Count sheep after lying down in order to enhance sleep.! Correct Answer: .,7,4 Rationa e 1/ 6$ercise therapy *e$cept just prior to sleeping-, nutrition therapy, and deep breathing are alternative treat'ents for inso'nia. Rationa e 2/ Acupuncture, aro'atherapy, yoga, prayer, 'assage, 'editation, biofeedbac) therapy, hypnosis, guided i'agery, and 'usic therapy are alternative treat'ents for an$iety and inso'nia. Rationa e 3/ 6ating a large 'eal prior to bedti'e is a secondary cause of inso'nia.
Ada's, Pharmacology for Nurse: A Pathophysiologic Approach, 456 Copyright 78.4 by +earson 6ducation, &nc.

Rationa e 4/ A'pheta'ines, cocaine, caffeinated beverages, corticosteroids, sy'patho'i'etics, antidepressants, alcohol use, nicotine, and tobacco use are secondary causes of inso'nia. Rationa e +/ There is no evidence that counting sheep at bedti'e helps to induce sleep. ! o"a Rationa e: Co#niti$e %e$e : Applying C ient &eed: +hysiological &ntegrity C ient &eed 'u": +hysiological Adaptation &ursin#/(nte#rated Concepts: Teaching and Dearning %earnin# )utcome: .43A Question 30 Type: MCMA A patient who has recently e$perienced the loss of a spouse as)s the nurse if there are any over3the3counter herbs or nonprescription 'edications that can be used to i'prove inso'nia. <ow should the nurse respond to this patient Note: Credit will be given only if all correct choices and no incorrect choices are selected. 'tandard Te*t: Select all that apply. 1. !0inger root is co''only ta)en to i'prove sleep.! 2. !0in)go is an herb co''only ta)en to i'prove sleep.! 3. !,iphenhydra'ine *>enadryl- and do$yla'ine are over3the3counter 'eds so'eti'es ta)en to produce drowsiness.! 4. !@alerian and 'elatonin are herbs co''only ta)en to i'prove sleep.! +. !Gava is an herb ta)en to i'prove sleep.! Correct Answer: :,4 Rationa e 1/ 0inger root is not used to i'prove sleep. Rationa e 2/ 0in)go is not used to i'prove sleep. Rationa e 3/ ,iphenhydra'ine and do$yla'ine are two antihista'ines fre(uently used to produce drowsiness. Rationa e 4/ An herbal product with de'onstrated efficacy in pro'oting rela$ation is valerian root. Supple'ental 'elatonin, 8.=J :.8 'g at bedti'e, is alleged to decrease the ti'e re(uired to fall asleep and to produce a deep and restful sleep.
Ada's, Pharmacology for Nurse: A Pathophysiologic Approach, 456 Copyright 78.4 by +earson 6ducation, &nc.

Rationa e +/ <igh doses of )ava can da'age the liver and should not be used unless reco''ended by a health care provider. ! o"a Rationa e: Co#niti$e %e$e : Applying C ient &eed: +hysiological &ntegrity C ient &eed 'u": +hysiological Adaptation &ursin#/(nte#rated Concepts: Teaching and Dearning %earnin# )utcome: .43A Question 31 Type: MCMA A patient who is co'plaining of an$iety and difficulty sleeping has as)ed what prescription 'edications would assist in getting to sleep. What would be appropriate responses Note: Credit will be given only if all correct choices and no incorrect choices are selected. 'tandard Te*t: Select all that apply. 1. ,iphenhydra'ine *>enadryl2. @alerian root 3. 2a'elteon *2o#ere'4. ;lura#epa' *,al'ane+. Kolpide' *A'bienCorrect Answer: :,4,= Rationa e 1/ ,iphenhydra'ine *>enadryl- can be obtained over the counter and does not need a prescription to obtain. &t does pro'ote getting to sleep. Rationa e 2/ @alerian is an herbal product that does not need a prescription to obtain. &t does pro'ote getting to sleep. Rationa e 3/ 2o#ere' is a newer, nonben#odia#epine hypnotic approved to treat chronic inso'nia in people who have proble's falling asleep. Rationa e 4/ >en#odia#epines are drugs of choice for generali#ed an$iety disorder and the short3ter' therapy of inso'nia. ;lura#epa' *,al'ane- should be ta)en at bedti'e because it (uic)ly produces significant drowsiness. Rationa e +/ A'bien is a sedative3hypnotic approved for short3ter' treat'ent of inso'nia.
Ada's, Pharmacology for Nurse: A Pathophysiologic Approach, 456 Copyright 78.4 by +earson 6ducation, &nc.

! o"a Rationa e: Co#niti$e %e$e : Applying C ient &eed: +hysiological &ntegrity C ient &eed 'u": +har'acological and +arenteral Therapies &ursin#/(nte#rated Concepts: 9ursing +rocess/ &'ple'entation %earnin# )utcome: .43C

Ada's, Pharmacology for Nurse: A Pathophysiologic Approach, 456 Copyright 78.4 by +earson 6ducation, &nc.