A nurse suspects that a client who is receiving lorazepam may be experiencing benzodiazepine withdrawal based on assessment of which of the following? Select all that apply.
- A. Anxiety
- B. Tremor
- C. Photophobia
- D. Insomnia
- E. Metallic taste
Correct Answer: A,B,C,E
Rationale: Symptoms of benzodiazepine withdrawal include increased anxiety, concentration difficulties, tremor, and sensory disturbances, such as paresthesias, photophobia, hypersomnia, and metallic taste.
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The nurse is assessing an infant at a well-child visit and notices that the infant has been losing weight and is lethargic. The mother is breastfeeding the child. The nurse questions the mother about any medications that she might be taking. Which of the following, if being taken by the mother, would alert the nurse to a problem? Select all that apply.
- A. Alprazolam
- B. Buspirone
- C. Hydroxyzine
- D. Chlordiazepoxide
- E. Lorazepam
Correct Answer: A,D,E
Rationale: Benzodiazepines like alprazolam, chlordiazepoxide, and lorazepam taken by a breastfeeding mother can result in lethargy and weight loss in the infant. Buspirone and hydroxyzine do not appear to have the same effect.
A nurse is administering an antianxiety agent to a client. The nurse understands that long-term use of which of the following anxiolytics would be most likely to lead to physical or psychological tolerance? Select all that apply.
- A. Alprazolam
- B. Buspirone
- C. Hydroxyzine
- D. Chlordiazepoxide
- E. Doxepin
Correct Answer: A,D
Rationale: Although long-term use of benzodiazepines such as alprazolam and chlordiazepoxide and nonbenzodiazepines such as buspirone, hydroxyzine, and doxepin can result in physical or psychological dependence, benzodiazepines are more likely to result in physical dependence and tolerance.
A client who experiences panic attacks in social situations has been prescribed an antianxiety medication. The nurse would assess which of the following before administering the drug?
- A. Temperature
- B. Blood pressure
- C. Blood sugar
- D. Red blood cell count
Correct Answer: B
Rationale: The nurse should check the client's blood pressure before administering the antianxiety drug because physiologic manifestations of panic attacks can include increased blood pressure. Temperature, blood sugar, and RBC count are not adversely affected by antianxiety drugs.
A nurse is assigned to care for a hospitalized client with anxiety. Buspirone is prescribed. When reviewing the client's history, which of the following, if found, would the nurse identify as a contraindication for this drug?
- A. Cataract
- B. Diabetic retinopathy
- C. Acute gout
- D. Psychoses
Correct Answer: D
Rationale: The use of buspirone is contraindicated in clients with hypersensitivity, psychoses, and acute narrow-angle glaucoma. Ethambutol is contraindicated in clients with cataracts and diabetic retinopathy. Pyrazinamide is contraindicated in clients with acute gout.
A nurse is preparing to administer an anxiolytic agent via intramuscular injection. Which of the following would be most important for the nurse to keep in mind? Select all that apply.
- A. The client should be monitored closely for 3 hours postinjection.
- B. Intramuscular injection should be given in chronic states.
- C. The client should remain in a lying position for about 30 minutes.
- D. The drug should be administered into a large muscle mass.
- E. The client should be kept conscious for at least 1 hour after administration.
Correct Answer: A,D
Rationale: Intramuscular administration of an anxiolytic should be done primarily in an acute state. The drug should be administered in a large muscle mass, the client should be observed closely for at least 3 hours, and the client should be kept lying down for 30 minutes to 3 hours after drug administration.
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