Chapter 17: Antianxiety Drugs
Steele: Keltner’s Psychiatric Nursing,
MULTIPLE CHOICE
1. By what mechanism does lorazepam reduce anxiety?
a. Increasing serotonin levels
b. Blocking dopamine receptors
c. Depressing norepinephrine levels
d. Potentiating gamma-aminobutyric acid (GABA)
ANS: D
Benzodiazepines enhance the effects of the inhibitory neurotransmitter GABA, slowing
neuronal firing. They do not affect dopamine, serotonin, or norepinephrine.
DIF: Cognitive level: Understanding TOP: Nursing process: Planning
MSC: Client Needs: Psychosocial Integrity
2. A patient started diazepam 5 mg twice daily 6 months ago. Now, the patient requires 10 mg to
achieve the same effect. What phenomenon is responsible for this situation?
a. Addiction
b. Tolerance
c. Dependence
d. Disinhibition
ANS: B
Tolerance is the need for increasing amounts of a substance to achieve the same effects. The
other terms, defined in the text, do not account for this phenomenon.
DIF: Cognitive level: Understanding TOP: Nursing process: Evaluation
, MSC: Client Needs: Physiologic Integrity
3. A patient diagnosed with agoraphobia took alprazolam 0.5 mg three times daily for 3 months and
then discontinued it. The next day the patient called the nurse reporting insomnia, shakiness, and
sweating. What should be the focus of the nurse‘s assessment questions?
a. Whether the patient may have also been drinking alcohol or taking antihistamines.
b. The possibility that the patient has built up tolerance to alprazolam and needs an increased dose.
c. The likelihood that the patient is having withdrawal symptoms from abrupt discontinuation of the
drug.
d. Whether the patient has progressed to panic attacks and needs a nonbenzodiazepine medication.
ANS: C
, The patient‘s symptoms suggest benzodiazepine withdrawal. The nurse knows that patients often
attempt to manage their own care by discontinuing medication when they begin to feel better.
Benzodiazepines should be slowly withdrawn if withdrawal symptoms are to be avoided.
Drinking alcohol would result in different symptoms. Development of tolerance and panic attack
symptoms would be different from those mentioned.
DIF: Cognitive level: Analyzing TOP: Nursing process: Implementation
MSC: Client Needs: Physiologic Integrity
4. An emergency room patient was very anxious after a serious car accident. Lorazepam 2 mg
intramuscularly was administered. One hour later, which finding indicates to the nurse that the
medication was effective?
a. Improved problem-solving skills
b. Increased alertness
c. Increased verbalization
d. Reduced environmental scanning
ANS: D
Benzodiazepines mute incoming stimuli and evoke less reaction. The hyper-alertness and
environmental scanning that accompany high anxiety are notably decreased when the drug is
effective. Impaired problem-solving is a negative outcome. Because of its sedating properties,
the individual might not be more alert, talkative, or active.
DIF: Cognitive level: Applying TOP: Nursing process: Evaluation
MSC: Client Needs: Physiologic Integrity
5. A patient has taken diazepam for 1 week for back spasms. The patient reports ―feeling sleepy
all the time.‖ Which response will best address the patient‘s concern?
a. ―The dosage probably needs to be decreased.‖
b. ―Drowsiness indicates a paradoxical reaction to the drug.‖
c. ―Tolerance to the sedative effect of the drug will develop quickly.‖
d. ―Sleepiness is an unavoidable side effect of nonbenzodiazepine drugs.‖
Steele: Keltner’s Psychiatric Nursing,
MULTIPLE CHOICE
1. By what mechanism does lorazepam reduce anxiety?
a. Increasing serotonin levels
b. Blocking dopamine receptors
c. Depressing norepinephrine levels
d. Potentiating gamma-aminobutyric acid (GABA)
ANS: D
Benzodiazepines enhance the effects of the inhibitory neurotransmitter GABA, slowing
neuronal firing. They do not affect dopamine, serotonin, or norepinephrine.
DIF: Cognitive level: Understanding TOP: Nursing process: Planning
MSC: Client Needs: Psychosocial Integrity
2. A patient started diazepam 5 mg twice daily 6 months ago. Now, the patient requires 10 mg to
achieve the same effect. What phenomenon is responsible for this situation?
a. Addiction
b. Tolerance
c. Dependence
d. Disinhibition
ANS: B
Tolerance is the need for increasing amounts of a substance to achieve the same effects. The
other terms, defined in the text, do not account for this phenomenon.
DIF: Cognitive level: Understanding TOP: Nursing process: Evaluation
, MSC: Client Needs: Physiologic Integrity
3. A patient diagnosed with agoraphobia took alprazolam 0.5 mg three times daily for 3 months and
then discontinued it. The next day the patient called the nurse reporting insomnia, shakiness, and
sweating. What should be the focus of the nurse‘s assessment questions?
a. Whether the patient may have also been drinking alcohol or taking antihistamines.
b. The possibility that the patient has built up tolerance to alprazolam and needs an increased dose.
c. The likelihood that the patient is having withdrawal symptoms from abrupt discontinuation of the
drug.
d. Whether the patient has progressed to panic attacks and needs a nonbenzodiazepine medication.
ANS: C
, The patient‘s symptoms suggest benzodiazepine withdrawal. The nurse knows that patients often
attempt to manage their own care by discontinuing medication when they begin to feel better.
Benzodiazepines should be slowly withdrawn if withdrawal symptoms are to be avoided.
Drinking alcohol would result in different symptoms. Development of tolerance and panic attack
symptoms would be different from those mentioned.
DIF: Cognitive level: Analyzing TOP: Nursing process: Implementation
MSC: Client Needs: Physiologic Integrity
4. An emergency room patient was very anxious after a serious car accident. Lorazepam 2 mg
intramuscularly was administered. One hour later, which finding indicates to the nurse that the
medication was effective?
a. Improved problem-solving skills
b. Increased alertness
c. Increased verbalization
d. Reduced environmental scanning
ANS: D
Benzodiazepines mute incoming stimuli and evoke less reaction. The hyper-alertness and
environmental scanning that accompany high anxiety are notably decreased when the drug is
effective. Impaired problem-solving is a negative outcome. Because of its sedating properties,
the individual might not be more alert, talkative, or active.
DIF: Cognitive level: Applying TOP: Nursing process: Evaluation
MSC: Client Needs: Physiologic Integrity
5. A patient has taken diazepam for 1 week for back spasms. The patient reports ―feeling sleepy
all the time.‖ Which response will best address the patient‘s concern?
a. ―The dosage probably needs to be decreased.‖
b. ―Drowsiness indicates a paradoxical reaction to the drug.‖
c. ―Tolerance to the sedative effect of the drug will develop quickly.‖
d. ―Sleepiness is an unavoidable side effect of nonbenzodiazepine drugs.‖
