Chapter 13: Central Nervous System Depressants and Muscle Relaxants
Sealock: Lilley’s Pharmacology for Canadian Health Care Practice
MULTIPLE CHOICE
1. Which is a true statement about sedatives and hypnotics?
a. The two terms mean the same thing. b. A hypnotic causes sleep.
c. Low doses of sedatives will cause sleep.
d. Compared with sedatives, hypnotics have a less potent effect on the central nervous system.
ANS: B
A sedative reduces nervousness, excitability, and irritability without causing sleep, whereas a hypnotic
causes sleep.
DIF: Cognitive Level: Knowledge
2. A patient who has been taking phenobarbital for 2 weeks as part of therapy for epilepsy reports
feeling tense and that the “least
little thing” is a bother now. What is the nurse’s best explanation to the patient?
a. These adverse effects will often subside after a few weeks.
b. The drug should be stopped immediately because of possible adverse effects.
c. This drug causes the rapid eye movement (REM) sleep period to increase, resulting in nightmares
and restlessness.
d. This drug causes deprivation of REM sleep and may cause the patient’s inability to deal with normal
stress.
ANS: D
Barbiturates deprive people of REM sleep, which can result in agitation and an inability to deal with
normal stress. A rebound phenomenon occurs when the drug is stopped, and the proportion of REM
sleep increases, sometimes resulting in nightmares.
DIF: Cognitive Level: Application
, 3. A 50-year-old male who has been taking a benzodiazepine for 1 week is found unresponsive. His wife
states that he takes no other prescription drugs and that he did not take an overdose—the correct
number of pills is in the bottle. What might have happened?
a. He took a multivitamin.
b. He drank a glass of wine. c. He took a dose of Aspirin.
d. He developed an allergy to the drug.
ANS: B
Potential drug interactions with the benzodiazepines are significant because of their intensity,
particularly when they involve other central nervous system (CNS) depressants (e.g., alcohol, opioids,
muscle relaxants).
DIF: Cognitive Level: Analysis
4. A patient has been taking temazepam (Restoril®) for intermittent insomnia. She tells the nurse that
when she takes it, she sleeps well, but the next day she feels “so tired.” What is the nurse’s best
explanation to the patient?
a. Long-term use results in a sedative effect.
b. She should take the drug every night to reduce this hangover effect.
c. Benzodiazepines affect the sleep cycle, thus causing a hangover effect.
d. Benzodiazepines increase CNS activity, thus causing tiredness the next day.
ANS: C
Benzodiazepines suppress rapid eye movement REM sleep to a degree (though not as much as
barbiturates) and thus result in a hangover effect.
DIF: Cognitive Level: Application
5. A patient who is recovering from a minor automobile accident that occurred 1 week ago is taking
cyclobenzaprine
(Novo-Cycloprine®) for muscular pain and goes to physical therapy three times a week. Which nursing
diagnosis would be appropriate for him?
a. Risk for falls related to decreased sensorium
b. Risk for addiction related to psychological dependency c. Excess fluid volume related to potential
adverse effects
Sealock: Lilley’s Pharmacology for Canadian Health Care Practice
MULTIPLE CHOICE
1. Which is a true statement about sedatives and hypnotics?
a. The two terms mean the same thing. b. A hypnotic causes sleep.
c. Low doses of sedatives will cause sleep.
d. Compared with sedatives, hypnotics have a less potent effect on the central nervous system.
ANS: B
A sedative reduces nervousness, excitability, and irritability without causing sleep, whereas a hypnotic
causes sleep.
DIF: Cognitive Level: Knowledge
2. A patient who has been taking phenobarbital for 2 weeks as part of therapy for epilepsy reports
feeling tense and that the “least
little thing” is a bother now. What is the nurse’s best explanation to the patient?
a. These adverse effects will often subside after a few weeks.
b. The drug should be stopped immediately because of possible adverse effects.
c. This drug causes the rapid eye movement (REM) sleep period to increase, resulting in nightmares
and restlessness.
d. This drug causes deprivation of REM sleep and may cause the patient’s inability to deal with normal
stress.
ANS: D
Barbiturates deprive people of REM sleep, which can result in agitation and an inability to deal with
normal stress. A rebound phenomenon occurs when the drug is stopped, and the proportion of REM
sleep increases, sometimes resulting in nightmares.
DIF: Cognitive Level: Application
, 3. A 50-year-old male who has been taking a benzodiazepine for 1 week is found unresponsive. His wife
states that he takes no other prescription drugs and that he did not take an overdose—the correct
number of pills is in the bottle. What might have happened?
a. He took a multivitamin.
b. He drank a glass of wine. c. He took a dose of Aspirin.
d. He developed an allergy to the drug.
ANS: B
Potential drug interactions with the benzodiazepines are significant because of their intensity,
particularly when they involve other central nervous system (CNS) depressants (e.g., alcohol, opioids,
muscle relaxants).
DIF: Cognitive Level: Analysis
4. A patient has been taking temazepam (Restoril®) for intermittent insomnia. She tells the nurse that
when she takes it, she sleeps well, but the next day she feels “so tired.” What is the nurse’s best
explanation to the patient?
a. Long-term use results in a sedative effect.
b. She should take the drug every night to reduce this hangover effect.
c. Benzodiazepines affect the sleep cycle, thus causing a hangover effect.
d. Benzodiazepines increase CNS activity, thus causing tiredness the next day.
ANS: C
Benzodiazepines suppress rapid eye movement REM sleep to a degree (though not as much as
barbiturates) and thus result in a hangover effect.
DIF: Cognitive Level: Application
5. A patient who is recovering from a minor automobile accident that occurred 1 week ago is taking
cyclobenzaprine
(Novo-Cycloprine®) for muscular pain and goes to physical therapy three times a week. Which nursing
diagnosis would be appropriate for him?
a. Risk for falls related to decreased sensorium
b. Risk for addiction related to psychological dependency c. Excess fluid volume related to potential
adverse effects
