Nokea
A patient tells the nurse that he likes to drink kava herbal tea to help him relax. Which statement by the patient indicates that additional teaching about this herbal product is needed?
- A. I will not drink wine with the kava tea.
- B. If I notice my skin turning yellow, I will stop taking the tea.
- C. I will not take sleeping pills if I have this tea in the evening.
- D. I will be able to drive my car after drinking this tea.
Correct Answer: D
Rationale: Patients should not drive after drinking this tea because it may cause sedation. Kava tea may cause skin discoloration (with long-term use). In addition, it must not be taken with alcohol, barbiturates, and psychoactive drugs.
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A patient has been taking suvorexant for intermittent insomnia. She calls the nurse to say that when she takes it, she sleeps well, but the next day she feels - so tired I Which explanation by the nurse is correct?
- A. Long-term use of this drug results in a sedative effect.
- B. If you take the drug every night, this hangover effect will be reduced.
- C. These drugs affect the sleep cycle, resulting in daytime sleepiness.
- D. These drugs increase the activity of the central nervous system, making you tired the next day.
Correct Answer: C
Rationale: Use of suvorexant results in daytime sleepiness. The other statements are incorrect.
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.
The barbiturate phenobarbital is prescribed for a patient with epilepsy. While assessing the patient's current medications, the nurse recognizes that interactions may occur with which drugs?
- A. Antihistamines
- B. Opioids
- C. Diuretics
- D. Anticoagulants
- E. Oral contraceptives
- F. Insulin
Correct Answer: A,B,D,E
Rationale: The co-administration of barbiturates and alcohol, antihistamines, benzodiazepines, opioids, and tranquilizers may result in additive CNS depression. Co-administration of anticoagulants and barbiturates can result in decreased anticoagulation response and possible clot formation. Co-administration of barbiturates and oral contraceptives can result in accelerated metabolism of the contraceptive drug and possible unintended pregnancy. There are no interactions with diuretics and insulin.
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.
The nurse is preparing to administer a barbiturate. Which conditions or disorders would be a contraindication to the use of these drugs?
- A. Gout
- B. Pregnancy
- C. Epilepsy
- D. Severe chronic obstructive pulmonary disease
- E. Severe liver disease
- F. Diabetes mellitus
Correct Answer: B,D,E
Rationale: Contraindications to barbiturates include pregnancy, significant respiratory difficulties, and severe liver or renal disease. The other disorders are not contraindications.