Question

The nurse is reviewing a client’s current drug regimen and notes that the client takes 30 mg flurazepam daily. The nurse should suspect what health problem?

Answer 1

Correct Answers:

Insomnia

Rationale :

▪ Flurazepam is a long-acting benzodiazepine commonly prescribed for insomnia.

▪ It helps initiate and maintain sleep by potentiating GABA, an inhibitory neurotransmitter.

▪ Unlike short-acting anxiolytics, flurazepam’s effect persists into the next day, helpful for sleep maintenance.

▪ Its sedative-hypnotic profile makes it less appropriate for acute anxiety or psychiatric disorders.

▪ It is not used for bipolar or psychosis, as it lacks mood-stabilizing or antipsychotic properties.

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Answer 2

Correct Answers:

try to identify and avoid factors that cause nervousness or insomnia.

Rationale :

💎 Behavioral management of anxiety includes recognizing triggers to reduce reliance on medication.

💎 Non-pharmacologic techniques like relaxation or sleep hygiene increase treatment success.

💎Avoiding caffeine, stressors, and overstimulation at night enhances drug effectiveness.

💎Medications for anxiety should be paired with lifestyle and cognitive interventions.

💎This approach also promotes long-term coping strategies, not just symptomatic relief.

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Answer 3

Correct Answers:

Question the provider about the order.

Rationale :

😊Phenobarbital IV should be administered cautiously, especially at low doses like 6 mg which is unusually small.

😊 Standard IV doses are much higher for acute seizure control, often around 10–20 mg/kg.

😊 The nurse must verify questionable orders to prevent underdosing or medication error.

😊 Safe practice mandates clarification when dosages fall outside accepted parameters.

😊 This safeguards both patient outcome and legal nursing responsibility.

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Answer 4

Correct Answers:

lacks muscle relaxant and sedative effects

Rationale :

◆ Buspirone differs from benzodiazepines in that it does not cause sedation or dependency. ◆ It has no muscle relaxant or hypnotic properties, making it ideal for daytime use. ◆ Effective for generalized anxiety disorder, but not for acute panic or sleep issues. ◆ Does not interact with alcohol, reducing overdose risk. ◆ Takes 2–4 weeks to reach full therapeutic effect, unlike rapid-acting benzodiazepines.

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Answer 5

Correct Answers:

Help the client out of bed to the bathroom and encourage the client to void.

Rationale :

💙 Parenteral benzodiazepines cause sedation, so fall precautions and safety are essential.

💙Voiding before administration reduces risk of incontinence or urinary retention.

💙 Encouraging urination ensures comfort during procedure and avoids bladder overdistention.

💙 Post-dose ambulation could lead to injury due to dizziness.

💙 Nurses must address basic needs before administering sedatives to ensure patient safety.

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Answer 6

Correct Answers:

"This drug will calm me down at around half an hour after | take it."

Rationale :

◆ Alprazolam (Xanax) begins to act within 30–60 minutes after oral administration.

◆ Its peak effect occurs within 1–2 hours, suitable for short-term anxiety relief.

◆ Statements indicating immediate or prolonged action are inaccurate.

◆ Elderly patients should receive lower doses due to increased CNS sensitivity.

◆ Correct understanding reflects appropriate use and expectations.

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Answer 7

Correct Answers:

monitoring for agitation or restlessness

Rationale :

🎯In children, barbiturates can cause paradoxical excitement, not sedation.

🎯Agitation or restlessness may indicate a CNS stimulatory effect in pediatric clients.

🎯 These reactions are important to monitor to adjust dose or discontinue.

🎯Routine reflex or cardiac monitoring is secondary unless symptoms suggest complications.

🎯 Identifying unusual behavior early helps avoid adverse neurological effects

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Answer 8

Correct Answers:

"We should see results in about 10 to 30 minutes."

Rationale :

💙IV phenobarbital typically controls status epilepticus within 10–30 minutes.

💙Longer delays in response may suggest resistance or alternative etiology.

💙 Expecting seizure resolution in under 5 minutes is unrealistic.

💙 Family should be reassured using accurate timelines for medication onset.

💙 Quick seizure control is vital to prevent hypoxia and brain injury.

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Answer 9

Correct Answers:

Document the fact that the client's phenytoin level is therapeutic.

Rationale :

😉Therapeutic range of phenytoin is 10–20 mcg/mL; 16 mcg/mL is within target.

😉 Dose changes are needed unless levels approach toxicity (>20).

😉Monitoring and documentation ensure safe seizure control.

😉 seizure activity occurs despite therapeutic level, consider alternative causes.

😉 Accurate documentation supports safe medication management.

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Answer 10

Correct Answers:

diazepam

Rationale :

😊Diazepam is first-line for seizures during alcohol withdrawal due to its rapid action.

😊 It enhances GABA inhibition, reducing neuronal excitability.

😊 Phenytoin and ethosuximide are ineffective for withdrawal seizures.

😊 Diazepam also alleviates agitation, anxiety, and tremors from withdrawal.

😊 Its longer half-life provides continued CNS suppression

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Pharm Exam 2-Fall~2023

No.

1 :
The nurse is reviewing a client’s current drug regimen and notes that the client takes 30 mg flurazepam daily. The nurse should suspect what health problem?

2 :
A nurse is planning teaching with a client who has had an anti-anxiety medication prescribed. A priority action for would be to:

3 :
A client is experiencing a seizure and the provider prescribes phenobarbital 6 mg IV STAT. What is the nurse’s best action?

4 :
When compared with benzodiazepines, buspirone stands out as unique among antianxiety drugs because of what therapeutic
advantage?

5 :
A nurse is about to administer a parenteral benzodiazepine to a client in the hospital before the performance of an invasive diagnostic procedure. What action should the nurse prioritize before administration of the drug?

6 :
The nurse has provided health education related to the use of alprazolam with a 78-year-old client. What statement best suggests that the client has an accurate understanding of the drug?

7 :
A nurse is caring for a 4-year-old who is receiving a barbiturate. What assessment should the nurse prioritize?

8 :
A client is brought into the emergency department in status epilepticus and the nurse is administering phenobarbital 300 mg IV as prescribed. Family members ask the nurse how long it will take to stop the seizures. What is the nurse's best response?

9 :
The nurse evaluates the client's latest serum phenytoin level which is revealed to be 16 mcg/mL. What is the nurse’s best action?

10 :
A client is brought to the emergency department in the midst of acute alcohol withdrawal accompanied by seizure activity.What drug is most likely to meet this client’s needs?

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Pharm Exam 2-Fall~2023

No.

1 : The nurse is reviewing a client’s current drug regimen and notes that the client takes 30 mg flurazepam daily. The nurse should suspect what health problem?

2 : A nurse is planning teaching with a client who has had an anti-anxiety medication prescribed. A priority action for would be to:

3 : A client is experiencing a seizure and the provider prescribes phenobarbital 6 mg IV STAT. What is the nurse’s best action?

4 : When compared with benzodiazepines, buspirone stands out as unique among antianxiety drugs because of what therapeutic advantage?

5 : A nurse is about to administer a parenteral benzodiazepine to a client in the hospital before the performance of an invasive diagnostic procedure. What action should the nurse prioritize before administration of the drug?

6 : The nurse has provided health education related to the use of alprazolam with a 78-year-old client. What statement best suggests that the client has an accurate understanding of the drug?

7 : A nurse is caring for a 4-year-old who is receiving a barbiturate. What assessment should the nurse prioritize?

8 : A client is brought into the emergency department in status epilepticus and the nurse is administering phenobarbital 300 mg IV as prescribed. Family members ask the nurse how long it will take to stop the seizures. What is the nurse's best response?

9 : The nurse evaluates the client's latest serum phenytoin level which is revealed to be 16 mcg/mL. What is the nurse’s best action?

10 : A client is brought to the emergency department in the midst of acute alcohol withdrawal accompanied by seizure activity.What drug is most likely to meet this client’s needs?

1 :
The nurse is reviewing a client’s current drug regimen and notes that the client takes 30 mg flurazepam daily. The nurse should suspect what health problem?

2 :
A nurse is planning teaching with a client who has had an anti-anxiety medication prescribed. A priority action for would be to:

3 :
A client is experiencing a seizure and the provider prescribes phenobarbital 6 mg IV STAT. What is the nurse’s best action?

4 :
When compared with benzodiazepines, buspirone stands out as unique among antianxiety drugs because of what therapeutic
advantage?

5 :
A nurse is about to administer a parenteral benzodiazepine to a client in the hospital before the performance of an invasive diagnostic procedure. What action should the nurse prioritize before administration of the drug?

6 :
The nurse has provided health education related to the use of alprazolam with a 78-year-old client. What statement best suggests that the client has an accurate understanding of the drug?

7 :
A nurse is caring for a 4-year-old who is receiving a barbiturate. What assessment should the nurse prioritize?

8 :
A client is brought into the emergency department in status epilepticus and the nurse is administering phenobarbital 300 mg IV as prescribed. Family members ask the nurse how long it will take to stop the seizures. What is the nurse's best response?

9 :
The nurse evaluates the client's latest serum phenytoin level which is revealed to be 16 mcg/mL. What is the nurse’s best action?

10 :
A client is brought to the emergency department in the midst of acute alcohol withdrawal accompanied by seizure activity.What drug is most likely to meet this client’s needs?