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Homework answers / question archive / Charter College, Anchorage - NURSING NU1005 Chapter 28: Drug Therapy for Insomnia Workman & LaCharity: Understanding Pharmacology: Essentials for Medication Safety, 2nd Edition MULTIPLE CHOICE BASIC CONCEPTS 1)Which drug for insomnia can cause amnesia? Amitriptyline (Elavil) Diphenhydramine (Benadryl) Temazepam (Restoril) Trazodone (Desyrel)     Which problems are the two most common side effects of drugs for insomnia? Increased bleeding and reduced sense of taste Inability to fall asleep and stay asleep Dry mouth and drowsiness Hiccoughs and diarrhea     In which drug category for insomnia does zaleplon (Sonata) belong? Antihistamines Benzodiazepines Sedating antidepressants Benzodiazepine receptor agonists     Which drug can increase the risk for seizures in a patient who has epilepsy? Pentobarbital (Nembutal)   Romazicon (Flumazenil) Secobarbital (Seconal) Triazolam (Halcion)     Which class of drugs used to treat insomnia has the lowest likelihood to be habit forming or addictive? Barbiturates Benzodiazepines Sedating antidepressants Benzodiazepine receptor agonists     ADVANCED CONCEPTS   What is the most important precaution to teach a patient who is prescribed a drug for insomnia? “Avoid drinking fluids with caffeine before bedtime

Charter College, Anchorage - NURSING NU1005 Chapter 28: Drug Therapy for Insomnia Workman & LaCharity: Understanding Pharmacology: Essentials for Medication Safety, 2nd Edition MULTIPLE CHOICE BASIC CONCEPTS 1)Which drug for insomnia can cause amnesia? Amitriptyline (Elavil) Diphenhydramine (Benadryl) Temazepam (Restoril) Trazodone (Desyrel)     Which problems are the two most common side effects of drugs for insomnia? Increased bleeding and reduced sense of taste Inability to fall asleep and stay asleep Dry mouth and drowsiness Hiccoughs and diarrhea     In which drug category for insomnia does zaleplon (Sonata) belong? Antihistamines Benzodiazepines Sedating antidepressants Benzodiazepine receptor agonists     Which drug can increase the risk for seizures in a patient who has epilepsy? Pentobarbital (Nembutal)   Romazicon (Flumazenil) Secobarbital (Seconal) Triazolam (Halcion)     Which class of drugs used to treat insomnia has the lowest likelihood to be habit forming or addictive? Barbiturates Benzodiazepines Sedating antidepressants Benzodiazepine receptor agonists     ADVANCED CONCEPTS   What is the most important precaution to teach a patient who is prescribed a drug for insomnia? “Avoid drinking fluids with caffeine before bedtime

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Charter College, Anchorage - NURSING NU1005

Chapter 28: Drug Therapy for Insomnia

Workman & LaCharity: Understanding Pharmacology: Essentials for Medication Safety, 2nd Edition

MULTIPLE CHOICE

BASIC CONCEPTS

1)Which drug for insomnia can cause amnesia?

    1. Amitriptyline (Elavil)
    2. Diphenhydramine (Benadryl)
    3. Temazepam (Restoril)
    4. Trazodone (Desyrel)

 

 

  1. Which problems are the two most common side effects of drugs for insomnia?
    1. Increased bleeding and reduced sense of taste
    2. Inability to fall asleep and stay asleep
    3. Dry mouth and drowsiness
    4. Hiccoughs and diarrhea

 

 

  1. In which drug category for insomnia does zaleplon (Sonata) belong?
    1. Antihistamines
    2. Benzodiazepines
    3. Sedating antidepressants
    4. Benzodiazepine receptor agonists

 

 

  1. Which drug can increase the risk for seizures in a patient who has epilepsy?
    1. Pentobarbital (Nembutal)

 

    1. Romazicon (Flumazenil)
    2. Secobarbital (Seconal)
    3. Triazolam (Halcion)

 

 

  1. Which class of drugs used to treat insomnia has the lowest likelihood to be habit forming or addictive?
    1. Barbiturates
    2. Benzodiazepines
    3. Sedating antidepressants
    4. Benzodiazepine receptor agonists

 

 

ADVANCED CONCEPTS

 

  1. What is the most important precaution to teach a patient who is prescribed a drug for insomnia?
    1. “Avoid drinking fluids with caffeine before bedtime.”
    2. “Rinse your mouth frequently with water or saline.”
    3. “Avoid driving within 8 hours of taking this drug.”
    4. “Do not take this drug for more than 1 week.”

 

 

  1. A patient who has been taking flurazepam (Dalmane) for insomnia is now prescribed zolpidem (Ambien) instead. The patient asks why the prescription was changed. What is your best response?
    1. “Zolpidem (Ambien) is a first-line drug for the treatment of insomnia.”
    2. “Flurazepam (Dalmane) is a benzodiazepine drug that can be habit-forming.”
    3. “Zolpidem (Ambien) is also used to treat any anxiety or stress that may contribute to your insomnia.”
    4. “Flurazepam (Dalmane) has both hypnotic and sedative effects that are less

 

effective in the treatment of insomnia.”

 

 

  1. What is the most important assessment to perform before giving the first dose of any drug to treat insomnia?
    1. The patient’s self-reported score on a pain scale
    2. Heart rate and rhythm
    3. Level of consciousness
    4. Deep tendon reflexes

 

 

  1. How do benzodiazepines depress the central nervous system and induce sleep?
    1. Raising the seizure threshold
    2. Reducing the number of neurotransmitter receptors in the brain
    3. Decreasing the amount of excitatory neurotransmitters in the brain
    4. Increasing the amount of gamma amino butyric acid present in the brain

 

 

  1. A patient taking a drug for insomnia reports becoming sunburned even when only minimally exposed to the sun. What is your best action?
    1. Ask the patient whether he or she usually burns when exposed to the sun.
    2. Instruct the patient to stop the drug and notify the prescriber immediately.
    3. Teach the patient to use sunscreen and wear protective clothing when outdoors.
    4. Document the report as the only action and reassure the patient that this problem is temporary.

 

 

 

  1. Why should women avoid using benzodiazepine receptor agonists during lactation?
    1. The mother could become so sleepy that she endangers her infant.
    2. The sedating effects also occur in the infant.
    3. The infant’s teeth will be discolored.
    4. The infant may have a seizure.

 

 

  1. What adjustment should you expect to be made for an 82-year-old patient who is newly prescribed chloral hydrate for insomnia?
    1. Seizure precautions should be implemented.
    2. The first dose should be given with a meal or a substantial snack.
    3. The initial dose should be lower than that for a younger adult.
    4. The patient should have continuous electrocardiography monitoring.

 

 

  1. What precaution is needed in managing the care of a patient with insomnia who also has liver disease?
    1. Monitor carefully for increased side effects and adverse effects.
    2. Teach the patient that a higher dose is needed for effective action.
    3. Check the patient’s electrolytes before administering the drug.
    4. Assess the patient’s gag reflex every hour.

 

 

  1. Why is more than one dose of Flumazenil (Romazicon) often needed to reverse a benzodiazepine overdose?
    1. It must be administered only by the intravenous route.

 

    1. It depresses the drug metabolizing effects of the liver.
    2. It has a shorter duration of action than most benzodiazepines.
    3. It must be given in low doses to avoid respiratory depression.

 

 

  1. Which unusual side effect should you teach patients and families to monitor for when eszopiclone (Lunesta) is prescribed for insomnia?
    1. Dizziness
    2. Drowsiness
    3. Somnambulism
    4. Headache

 

 

  1. What is the most important information that should be included when teaching a patient who has been prescribed zaleplon (Sonata) about the action of this drug?
    1. “This drug may take from 30 minutes to an hour to work.”
    2. “Go to bed immediately after taking a dose of this drug.”
    3. “Be sure to report any side effects to your prescriber.”
    4. “This drug can make glaucoma worse.”

 

 

  1. A patient is scheduled for a procedure to test mental function at 6 a.m. At 3 a.m. the patient requests something for sleep. What is your best response?
    1. “I’ll call your prescriber and request an order for something to help you sleep.”
    2. “Your prescriber has ordered temazepam (Restoril). I will give you a dose now.”
    3. “I’m sorry, but there is not enough time for sleep now before your procedure.”
    4. “I’m sorry, but you already received a dose of temazepam last evening at 9.”

 

 

MULTIPLE RESPONSE BASIC CONCEPTS

  1. Which symptoms are expected to be seen in a patient with insomnia? (select all that apply)
    1. Difficulty falling asleep
    2. Sleeping too much
    3. Waking often during the night
    4. Feeling unrested after sleep
    5. Uncontrollable urge to sleep
    6. Sleepwalking at least once per week
    7. Nightmares most of the night

 

 

  1. Which drugs used to treat insomnia belong to the benzodiazepine class? (select all that apply)
    1. Chloral hydrate (Somnote)
    2. Estazolam (ProSom)
    3. Eszopiclone (Lunesta)
    4. Flurazepam (Dalmane)
    5. Secobarbital (Seconal)
    6. Triazolam (Halcion)
    7. Zaleplon (Sonata)
    8. Zolpidem (Ambien)

 

 

COMPLETION

 

ADVANCED CONCEPTS

 

  1. An adult patient is prescribed 0.5 mg of triazolam (Halcion) as a one-time order. The available drug is triazolam 0.125 mg/tablet. How many tablets should be given?

 

 

 

 

  1. A child who weighs 56 lb is prescribed to receive chloral hydrate 40 mg/kg. The available drug is 250 mg/5 mL. How many milliliters should you give for the correct dose?

 

 

 

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