NUR207 Chapter 14 Review
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NUR207 Chapter 14 Review questions and
answers latest 2024
The nurse should assess a patient who is taking lorazepam (Ativan) for the development of
which of this adverse effect?
1. Tachypnea
2. Astigmatism
3. Ataxia
4. Euphoria
Answer 3.
Rationale: Adverse CNS effects for lorazepam (Ativan) include ataxia, amnesia, weakness,
disorientation, blurred vision, diplopia, nausea, and vomiting. Option 1, 2, and 4 are incorrect.
Lorazepam is not known to cause tachycardia, astigmatism, or euphoria. If these symptoms
occur, the patient should be assessed for other causative factors.
A patient is receiving temazepam (Restoril). Which of these responses should a nurse expert
the patient to have if the medication is achieving the desired effects?
1. The patient sleeps in 3-hours intervals, awakens for a short time, and then falls back to
sleep.
2. The patient reports feeling less anxiety during activities of daily living.
3. The patient reports having fewer episodes of panic attacks when stressed.
4. The patient reports sleeping 7 hours without awakening.
Answer 4.
Rationale: Temazepma (Restoril) is a benzodiazepine ordered for insomnia. Therefore, the
patient should be experiencing relief from insomnia and reporting feeling rested when
awakening. Options 1, 2, and 3 are incorrect. Sleeping 3 hours or less would indicate less than
therapeutic effects. Whereas some benzodiazepines are used in the treatment of anxiety or
panic disorders, temazepam's primary use is in the treatment of insomnia.
A 32-year-old female patient has been taking lorazepam (Ativan) for her anxiety and is
brought into the emergency department after taking 30-days' worth at one time. What
antagonist for benzodiazepines may be used in this case?
1. Epinephrine
2. Atropine
3. Flumazenil
4. Naloxone
Answer 3.
Rationale: The competitive antagonist drug used in cases of benzodiazepine overdose is
flumazenil (Romazicon). Option 1, 2, and 4 are incorrect. Epinephirne, an adrenergic agonist, is
not an antagonist to the benzodiazepines. Atropine is an anticholinergic, and naloxone is a
competitive antagonist to opioid (narcotic) drugs.
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A 17-year-old patient has been prescribed escitalopram (Lexapro) for increasing anxiety
uncontrolled by other treatment measures. Because of this patient's age, the nurse will
ensure that the patient and parents are taught what important information?
1. Cigarette smoking will counteract the effects of the drug.
2. Signs of increasing depression or thoughts of suicide should be reported immediately.
3. The drug causes dizziness and alternative schooling arrangements may be needed for the
first two months of use.
4. Anxiety and excitability may increase during the first two weeks of use but then will have
significant improvement.
Answer 2.
Rationale: Escitalopram (Lexapro) is an antidepressant in the SSRI class. The drug carries a black
box warning of increased risk of suicidal thinking and behavior in children, adolescents, and
young adults. Signs of increasing depression or suicidal thoughts should be reported
immediately. Options 1, 3, and 4 are incorrect. Smoking has no direct effects on escitalopram.
Although dizziness may occur, it should not be significant enough to warrant a change in
schooling needs. Escitalopram should not cause increased anxiety or excitability in the first few
weeks of use, and other causes should be investigated should these occur.
Zolpidem (Ambien) has been ordered for a client for the treatment of insomnia. What
information will the nurse provide for this client? (Select all that apply.)
1. Be cautious when performing morning activities because it may cause a significant
"hungover" effect with drowsiness and dizziness.
2. Take the drug with food; this enhances the absorption for quicker effects.
3. Take the drug immediately before going to bed; it has a quick onset of action.
4. If the insomnia is long-lasting, this drug may be safely used for up to a year.
5. Alcohol and other drugs that cause CNS depression should be avoided while taking this
drug.
Answer 3 and 5.
Rationale: Zolpidem (Ambien, Intermezzo) has a rapid onset, approximately 7 to 27 minutes,
and should be taken immediately before going to bed. It should not be taken with alcohol or
other drugs that cause CNS depression because of increased sedation and CNS depression.
Option 1, 2, and 4 are incorrect.. Taking the drug with food will significantly impair its
absorption and the onset of action may be delayed. Zolpidem has a duration of action of
approximately 6 to 8 hours. Depending on when the drug is taken the night before, significant
"hangover" effects such as sedation are not likely to occur as with other drugs in the category.
The drug is approved for short-term treatment of insomnia only.
Education given to clients about the use of all drugs to treat insomnia should include an
emphasis on what important issue?
1. They will be required long-term to achieve long-lasting effects.
2. They require frequent blood counts to avoid adverse effects.
3. They are among the safest drugs available and have few adverse effects.
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