PHYS Exam: Questions & Answers (Straighterline)PHYSICS
The nurse should assess a patient who is taking lorazepam (Ativan) for the development of which of
these adverse effect?
1. Tachypnea
2. Astigmatism
3. Ataxia
4. Euphoria - ANSWER: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: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: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.
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: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: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.
4. Long-term use may increase the risk of adverse effects, create a "sleep debt", and cause rebound
insomnia when stopped. - ANSWER:Answer 4.
Rationale: Long-term use of drugs to treat insomnia is not recommended. They have significant adverse
effects, may cause a "sleep debt" due to effects on the sleep cycle, and may cause rebound insomnia
when discontinued. Option 1, 2, and 3 are incorrect. Many of the drugs used for insomnia have
significant adverse effects and are not used long term. Whereas some drugs in the category may require
concurrent blood counts, this is not required for all drugs in the category.
An 8-year-old boy is evaluated and diagnosed with absence seizures. He is started on ethosuximide
(Zarontin). Which information should the nurse provide the parents?
1. After-school sports activities will need to be stopped because they will increase the risk of seizures.
2. Monitor height and weight to assess that growth is progressing normally.
3. Fractures may occur, so increase the amount of vitamin D and calcium-rosh foods in the diet.
4. Avoid dehydration with activities and increase fluid intake. - ANSWER:Answer 2.
Rationale: Because adverse drug effects such as nausea, anorexia, or abdominal pain may occur with
ethosuximide (Zarontin), the parents should monitor the child's height and weight to assess whether
nutritional intake is sufficient for normal growth and development. Options 1, 3, and 4 are incorrect.
Physical activity does not increase the risk of seizure activity or need to be curtailed, and the drug does
not affect bone growth or require extra vitamin D or calcium in the diet. Dehydration is a condition to be
avoided in all clients, although increasing fluid intake is not necessarily related to the use of
ethosuximide.
The nurse is providing education for a 12-year-old client with partial seizures currently prescribed
valproic acid (Depakene). The nurse will teach the client and the parents to immediately report which
symptom?
1. Increasing or severe abdominal pain
2. Decreased or foul taste in the mouth
3. Pruritis or dry skin
4. Bone and joint pain - ANSWER:Answer 1.
Rationale: Valporic acid may cause life-threatening pancreatitis, and any severe or increasing abdominal
pain should be reported immediately. Options 2, 3, and 4 are incorrect. The drug is not known to cause
dyspepsia (altered sense of taste) or effects on bones or joints. Although pruritus is an adverse effect
associated with vampiric acid, it may be managed with simple therapies, and unless it progresses to a
more serious rash, it does not need to be reported immediately.
The nurse should assess a patient who is taking lorazepam (Ativan) for the development of which of
these adverse effect?
1. Tachypnea
2. Astigmatism
3. Ataxia
4. Euphoria - ANSWER: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: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: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.
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: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: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.
4. Long-term use may increase the risk of adverse effects, create a "sleep debt", and cause rebound
insomnia when stopped. - ANSWER:Answer 4.
Rationale: Long-term use of drugs to treat insomnia is not recommended. They have significant adverse
effects, may cause a "sleep debt" due to effects on the sleep cycle, and may cause rebound insomnia
when discontinued. Option 1, 2, and 3 are incorrect. Many of the drugs used for insomnia have
significant adverse effects and are not used long term. Whereas some drugs in the category may require
concurrent blood counts, this is not required for all drugs in the category.
An 8-year-old boy is evaluated and diagnosed with absence seizures. He is started on ethosuximide
(Zarontin). Which information should the nurse provide the parents?
1. After-school sports activities will need to be stopped because they will increase the risk of seizures.
2. Monitor height and weight to assess that growth is progressing normally.
3. Fractures may occur, so increase the amount of vitamin D and calcium-rosh foods in the diet.
4. Avoid dehydration with activities and increase fluid intake. - ANSWER:Answer 2.
Rationale: Because adverse drug effects such as nausea, anorexia, or abdominal pain may occur with
ethosuximide (Zarontin), the parents should monitor the child's height and weight to assess whether
nutritional intake is sufficient for normal growth and development. Options 1, 3, and 4 are incorrect.
Physical activity does not increase the risk of seizure activity or need to be curtailed, and the drug does
not affect bone growth or require extra vitamin D or calcium in the diet. Dehydration is a condition to be
avoided in all clients, although increasing fluid intake is not necessarily related to the use of
ethosuximide.
The nurse is providing education for a 12-year-old client with partial seizures currently prescribed
valproic acid (Depakene). The nurse will teach the client and the parents to immediately report which
symptom?
1. Increasing or severe abdominal pain
2. Decreased or foul taste in the mouth
3. Pruritis or dry skin
4. Bone and joint pain - ANSWER:Answer 1.
Rationale: Valporic acid may cause life-threatening pancreatitis, and any severe or increasing abdominal
pain should be reported immediately. Options 2, 3, and 4 are incorrect. The drug is not known to cause
dyspepsia (altered sense of taste) or effects on bones or joints. Although pruritus is an adverse effect
associated with vampiric acid, it may be managed with simple therapies, and unless it progresses to a
more serious rash, it does not need to be reported immediately.
