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A patient has experienced insomnia for months, and the physician has prescribed a medication to help with this problem. The nurse expects which drug to be used for long-term treatment of insomnia?
- A. Secobarbital, a barbiturate
- B. Diazepam, a benzodiazepine
- C. Midazolam, a benzodiazepine
- D. Eszopiclone, a nonbenzodiazepine sleep aid
Correct Answer: D
Rationale: Eszopiclone is one of the newest prescription hypnotics to be approved for long-term use in treatment of insomnia. Barbiturates and benzodiazepines are not appropriate for long-term treatment of insomnia: midazolam is used for procedural (moderate) sedation.
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The nurse notes in the patient's medication history that the patient is taking cyclobenzaprine. Based on this finding, the nurse interprets that the patient has which disorder?
- A. A musculoskeletal injury
- B. Insomnia
- C. Epilepsy
- D. Agitation
Correct Answer: A
Rationale: Cyclobenzaprine is the muscle relaxant most commonly used to reduce spasms following musculoskeletal injuries. It is not appropriate for insomnia, epilepsy, or agitation.
Ramelteon is prescribed for a patient with insomnia. The nurse checks the patient's medical history, knowing that this medication is contraindicated in which disorder?
- A. Coronary artery disease
- B. Renal insufficiency
- C. Liver disease
- D. Anemia
Correct Answer: C
Rationale: Ramelteon is contraindicated in cases of severe liver dysfunction. The other conditions are not contraindications.
A patient is brought to the emergency department for treatment of a suspected overdose. The patient was found with an empty prescription bottle of a barbiturate by his bedside. He is lethargic and barely breathing. The nurse would expect which immediate intervention?
- A. Starting an intravenous infusion of diluted bicarbonate solution
- B. Administering medications to increase blood pressure
- C. Implementing measures to maintain the airway and support respirations
- D. Administering naloxone (Narcan) as an antagonist
Correct Answer: C
Rationale: There are no antagonists/antidotes for barbiturates. Treatment supports respirations and maintains the airway. The other interventions are not appropriate.
A patient who has received some traumatic news is panicking and asks for some medication to help settle down. The nurse anticipates giving which drug that is most appropriate for this situation?
- A. Diazepam
- B. Zolpidem
- C. Phenobarbital
- D. Cyclobenzaprine
Correct Answer: A
Rationale: Benzodiazepines such as diazepam are used as anxiolytics, or sedatives. Zolpidem is used as a hypnotic for sleep. Phenobarbital is not used as an anxiolytic but is used for seizure control. Cyclobenzaprine is a muscle relaxant and is not used to reduce anxiety.
A patient is taking flurazepam three to four nights a week for sleeplessness. She is concerned that she cannot get to sleep without taking the medication. What nonpharmacologic measures should the nurse suggest to promote sleep for this patient?
- A. Providing a quiet environment
- B. Exercising before bedtime to become tired
- C. Consuming heavy meals in the evening to promote sleepiness
- D. Drinking hot tea or coffee just before bedtime
Correct Answer: A
Rationale: Nonpharmacologic approaches to induce sleep include providing a quiet environment, avoiding heavy exercise before bedtime, avoiding heavy meals late in the evening, and drinking warm decaffeinated drinks, such as warm milk, before bedtime.