Nokea
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.
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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.
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.
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 man who has been taking phenobarbital for 1 week is found very lethargic and unable to walk after eating out for dinner. His wife states that he has no other prescriptions and that he did not take an overdose-the correct number of pills is in the bottle. The nurse suspects that which of these may have happened?
- A. He took a multivitamin.
- B. He drank a glass of wine.
- C. He took a dose of aspirin.
- D. He developed an allergy to the drug.
Correct Answer: B
Rationale: Alcohol has an additive effect when combined with barbiturates and causes central nervous system (CNS) depression. Multivitamins and aspirin do not interact with barbiturates, and this situation does not illustrate an allergic reaction.
A patient is about to receive pentobarbital 100 mg IV as preoperative sedation. The medication is available in a concentration of 50 mg/mL. How many milliliters will the patient receive for this dose?
Correct Answer: 2 mL
Rationale: 50 mg : 1 mL :: 100 mg : x mL; (50 * x) = (1 * 100); 50x = 100; x = 2 mL.