McKenna's Pharmacology for Nursing, 2e

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C H A P T E R 2 0 Anxiolytic and hypnotic agents

8. A child is prescribed phenobarbitone preoperatively to relieve anxiety and produce sedation. After giving the injection, you should assess the child for: a. acute Stevens–Johnson syndrome.

3. Barbiturates cause liver enzyme induction, which could lead to: a. rapid metabolism and loss of effectiveness of other drugs metabolised by those enzymes. b. increased bile production. c. CNS depression. d. the need to periodically lower the barbiturate dose to avoid toxicity. 4. A person who could benefit from an anxiolytic drug for short-term treatment of insomnia would not be prescribed: a. zolpidem. b. chloral hydrate. c. buspirone. d. zopiclone. 5. Anxiolytic drugs block the awareness of and reaction to the environment. This effect would not be beneficial: a. to relieve extreme fear. b. to moderate anxiety related to unknown causes. c. in treating a person who must drive a vehicle for a living. d. in treating a person who is experiencing a stress reaction. 6. Mr Jones is the chief executive officer of a large company and has been experiencing acute anxiety attacks. His physical examination was normal and he was diagnosed with anxiety. Considering his occupation and his need to be alert and present to large groups on a regular basis, the following anxiolytic would be a drug of choice for Mr Jones: a. phenobarbitone. b. diazepam. c. oxazepam. d. buspirone. 7. The benzodiazepines react with: a. GABA-receptor sites in the RAS to cause inhibition of neural arousal. b. noradrenaline-receptor sites in the sympathetic nervous system. c. acetylcholine-receptor sites in the parasympathetic nervous system. d. monoamine oxidase to increase noradrenaline breakdown.

b. bone marrow depression. c. paradoxical excitement. d. withdrawal syndrome.

MULTIPLE RESPONSE Select all that apply.

1. In assessing a person who is experiencing anxiety, the nurse or midwife would expect to find which of the following?

a. rapid breathing b. rapid heart rate c. fear and apprehension d. constricted pupils e. decreased abdominal sounds f. hypotension

2. A woman has a long history of anxiety and has always responded well to diazepam. She has just learned that she is pregnant and feels very anxious. She would like a prescription for diazepam to get her through her early anxiety. What rationale would the nurse or midwife use in explaining why this is not recommended? a. This drug is known to cause a predictable syndrome of birth defects, including cleft lip and pyloric stenosis. b. Babies born to mothers taking benzodiazepines may progress through a neonatal withdrawal syndrome. c. Cardiac defects and small brain development may occur if this drug is taken in the first trimester. d. This drug almost always causes loss of the pregnancy. e. The hormones the body produces during pregnancy will make you unresponsive to diazepam. f. This drug could have adverse effects on your baby; we should explore non-drug measures to help you deal with the anxiety.