Anxiety and Insomnia Medications: Pharmacology for Nurses

Question 1

Which of the following medications is NOT a benzodiazepine used to treat anxiety?

Accepted Answer

Buspirone

Answer

Alprazolam

Answer

Lorazepam

Question 2

Which of the following best describes the primary mechanism of action for benzodiazepines?

Accepted Answer

Blocking the effects of GABA at its receptors

Answer

Increasing the levels of serotonin in the brain

Answer

Stimulating dopamine receptors in the reward pathway

Answer

Reducing the release of acetylcholine at the synapse

Question 3

Which neurotransmitter is mainly involved in promoting sleep?

Accepted Answer

GABA

Answer

Serotonin

Answer

Dopamine

Answer

Epinephrine

Question 4

What is the generally recommended duration of treatment with benzodiazepines for anxiety disorders?

Accepted Answer

2-4 weeks

Answer

Less than 2 weeks

Answer

4-6 weeks

Answer

Indefinite use is acceptable

Question 5

Which type of anxiety disorder is the most prevalent?

Accepted Answer

Generalized anxiety disorder

Answer

Panic disorder

Answer

Social anxiety disorder

Answer

Obsessive-compulsive disorder

Question 6

Benzodiazepines primarily exert their anxiolytic effects by:

Accepted Answer

Enhancing GABAergic neurotransmission

Answer

Inhibiting serotonin reuptake

Answer

Stimulating dopamine receptors

Answer

Antagonizing glutamate receptors

Question 7

Which adverse effect is commonly associated with benzodiazepines?

Accepted Answer

Drowsiness

Answer

Increased appetite

Answer

Tachycardia

Answer

Seizures

Question 8

When administering nonbenzodiazepine anxiolytics, which nursing consideration is essential?

Accepted Answer

Educate patients about potential interactions with alcohol

Answer

Monitor for seizures

Answer

Assess for respiratory depression

Answer

Check blood pressure before each dose

Question 9

For generalized anxiety disorder, which nonbenzodiazepine anxiolytic is commonly used?

Accepted Answer

Buspirone

Answer

Gabapentin

Answer

Pregabalin

Answer

Clonidine

Question 10

The primary distinction between benzodiazepines and nonbenzodiazepine anxiolytics lies in their:

Accepted Answer

Mechanism of action

Answer

Side effect profile

Answer

Contraindications

Answer

Route of administration

Question 11

For insomnia, which sedative-hypnotic drug is frequently prescribed?

Accepted Answer

Zolpidem

Answer

Risperidone

Answer

Valproic acid

Answer

Carbamazepine

Question 12

What is the primary mechanism of action of benzodiazepines?

Accepted Answer

Activation of GABA-A receptors

Answer

Inhibition of NMDA receptors

Answer

Reuptake inhibition of serotonin

Answer

Stimulation of alpha-1 adrenergic receptors

Question 13

Which of the following is NOT a common adverse effect associated with benzodiazepines?

Accepted Answer

Elevated blood pressure

Answer

Drowsiness

Answer

Cognitive impairment

Answer

Respiratory depression

Question 14

Which of the following drugs is a non-benzodiazepine anxiolytic?

Accepted Answer

Buspirone

Answer

Sertraline

Answer

Zolpidem

Answer

Diazepam

Question 15

What is a significant advantage of non-benzodiazepine anxiolytics over benzodiazepines?

Accepted Answer

Reduced risk of misuse

Answer

Faster onset of action

Answer

Enhanced efficacy in severe anxiety

Answer

Fewer drug interactions

Question 16

Which drug is a sedative-hypnotic structurally related to benzodiazepines?

Accepted Answer

Zaleplon

Answer

Trazadone

Answer

Gabapentin

Answer

Melatonin

Question 17

What is a key nursing intervention when administering sedative-hypnotics for insomnia?

Accepted Answer

Monitoring for respiratory depression

Answer

Encouraging physical activity before bedtime

Answer

Providing a stimulating environment

Answer

Restricting fluid intake before bedtime

Question 18

When administering non-benzodiazepine anxiolytics to patients with hepatic impairment, which nursing intervention is crucial?

Accepted Answer

Monitor for signs of liver damage.

Answer

Administer non-benzodiazepine anxiolytics with food.

Answer

Increase the dosage of non-benzodiazepine anxiolytics in patients with hepatic impairment.

Answer

Avoid administering non-benzodiazepine anxiolytics with other medications.

Question 19

Which action is the primary mechanism of benzodiazepines?

Accepted Answer

Blocking GABA reuptake

Answer

Increasing serotonin release

Answer

Preventing NMDA receptor activation

Answer

Stimulating adrenergic receptors

Question 20

Which anxiety disorder involves excessive, often unrealistic worry and fear?

Accepted Answer

Generalized Anxiety Disorder

Answer

Social Anxiety Disorder

Answer

Panic Disorder

Answer

Obsessive-Compulsive Disorder

Question 21

Which medication is a non-benzodiazepine anxiolytic?

Accepted Answer

Buspirone

Answer

Alprazolam

Answer

Lorazepam

Answer

Clonazepam

Question 22

Which is a known adverse effect of benzodiazepines?

Accepted Answer

Sedation

Answer

Euphoria

Answer

Enhanced alertness

Answer

Improved memory

Question 23

When administering benzodiazepines, which nursing consideration is crucial?

Accepted Answer

Monitoring for respiratory depression signs

Answer

Encouraging alcohol consumption

Answer

Abruptly discontinuing the medication without tapering

Answer

Permitting heavy machinery operation

Question 24

Which of the following medications is a commonly used benzodiazepine anxiolytic?

Accepted Answer

Diazepam

Answer

Phenobarbital

Answer

Buspirone

Answer

Valproic acid

Question 25

Which non-benzodiazepine hypnotic is commonly used for short-term insomnia?

Accepted Answer

Zaleplon

Answer

Lorazepam

Answer

Alprazolam

Answer

Temazepam

Question 26

What is a common potential adverse effect associated with long-term benzodiazepine use?

Accepted Answer

Tolerance and dependence

Answer

Insomnia

Answer

Hypertension

Answer

Bradycardia

Question 27

Which neurotransmitter system do benzodiazepines interact with?

Accepted Answer

GABA

Answer

Serotonin

Answer

Dopamine

Answer

Noradrenaline

Question 28

What is a contraindication for the use of zaleplon?

Accepted Answer

Severe sleep apnea

Answer

History of drug or alcohol abuse

Answer

Hepatic impairment

Answer

Renal impairment

Question 29

In addition to medication, which non-drug approach is often used as a complementary therapy for treating anxiety disorders?

Accepted Answer

Cognitive behavioral therapy

Answer

Electroconvulsive therapy

Answer

Massage therapy

Question 30

What is the mechanism of action by which benzodiazepines exert their anxiolytic effects?

Accepted Answer

Inhibition of GABA reuptake in the central nervous system (CNS)

Answer

Activation of NMDA receptors

Answer

Antagonism of dopamine receptors

Answer

Stimulation of postsynaptic adrenergic receptors

Question 31

Which medication is frequently used to treat generalized anxiety disorder (GAD)?

Accepted Answer

Buspirone

Answer

Diazepam

Answer

Zolpidem

Answer

Trazodone

Question 32

Which of the following is NOT a common adverse effect associated with benzodiazepines?

Accepted Answer

Increased appetite

Answer

Drowsiness

Answer

Impaired coordination

Answer

Cognitive impairment

Question 33

Which of the following medications is classified as a non-benzodiazepine anxiolytic?

Accepted Answer

Buspirone

Answer

Alprazolam

Answer

Clonazepam

Answer

Lorazepam

Question 34

Which class of drugs is commonly employed in the treatment of insomnia?

Accepted Answer

Benzodiazepines

Answer

Selective serotonin reuptake inhibitors (SSRIs)

Answer

Nonsteroidal anti-inflammatory drugs (NSAIDs)

Answer

Corticosteroids

Question 35

Which of the following medications is not recommended for long-term treatment of insomnia?

Accepted Answer

Alprazolam

Answer

Zolpidem

Answer

Zaleplon

Answer

Ramelteon

Question 36

In managing benzodiazepine withdrawal syndrome, which of the following interventions is NOT recommended?

Accepted Answer

Administering anticonvulsants to prevent seizures

Answer

Tapering medication gradually over several weeks

Answer

Providing supportive care and counseling

Answer

Monitoring individuals closely for signs of complications

Question 37

When prescribing benzodiazepines or non-benzodiazepine anxiolytics to pregnant women, which ethical principle should be prioritized?

Accepted Answer

Minimize potential risks to the fetus

Answer

Respect patient autonomy

Answer

Ensure cost-effectiveness

Answer

Maximize patient convenience

Question 38

How do non-pharmacological interventions, like cognitive-behavioral therapy, contribute to managing anxiety disorders?

Accepted Answer

They can help patients cope and potentially reduce medication use.

Answer

They are less effective than medication.

Answer

They should replace medication entirely.

Answer

They have no side effects.

Question 39

The primary mechanism of action of benzodiazepines is:

Accepted Answer

Enhancing GABA activity

Answer

Blocking NMDA receptors

Answer

Inhibiting acetylcholine release

Answer

Stimulating dopamine receptors

Question 40

The medication indicated for the treatment of generalized anxiety disorder (GAD) is:

Accepted Answer

Buspirone

Answer

Alprazolam

Answer

Zolpidem

Answer

Trazodone

Question 41

The recommended route of administration for lorazepam is:

Accepted Answer

Oral

Answer

Intravenous

Answer

Intramuscular

Answer

Subcutaneous

Question 42

Which of the following is a common adverse effect associated with benzodiazepine use?

Accepted Answer

Drowsiness

Answer

Increased heart rate

Answer

Hypertension

Answer

Dry mouth

Question 43

What is the primary mechanism of action of nonbenzodiazepine anxiolytics?

Accepted Answer

Enhancement of GABA activity

Answer

Blockade of NMDA receptors

Answer

Stimulation of dopamine release

Answer

Inhibition of serotonin reuptake

Question 44

Which of the following drugs is an example of a nonbenzodiazepine anxiolytic?

Accepted Answer

Buspirone

Answer

Diazepam

Answer

Chlorpromazine

Answer

Phenobarbital

Question 45

Which hypnotic drug has a relatively short half-life and duration of action, making it suitable for managing transient insomnia episodes?

Accepted Answer

Zolpidem

Answer

Temazepam

Answer

Diphenhydramine

Answer

Eszopiclone

Question 46

What is a potential adverse effect of using sedative-hypnotics for insomnia?

Accepted Answer

Impaired cognitive function during daytime hours

Answer

Weight gain

Answer

Increased appetite

Answer

Dry mouth

Question 47

Which type of insomnia is characterized by difficulty initiating and maintaining sleep, often with early morning awakenings?

Accepted Answer

Sleep onset and maintenance insomnia

Answer

Situational insomnia

Answer

Paradoxical insomnia

Answer

Psychophysiological insomnia

Question 48

A patient is prescribed alprazolam (Xanax) for generalized anxiety disorder. What is the most important nursing instruction to emphasize regarding this medication?

Accepted Answer

Avoid alcohol and other central nervous system depressants while taking alprazolam.

Answer

Increase fluid intake to prevent dehydration.

Answer

Take alprazolam with food to minimize gastrointestinal upset.

Question 49

A patient with insomnia is prescribed zolpidem (Ambien). Which of the following is a common side effect of this medication?

Accepted Answer

Drowsiness the following morning (hangover effect)

Answer

Elevated heart rate

Answer

Increased appetite

Answer

Gastrointestinal upset

Question 50

A patient reports experiencing tremors and insomnia after abruptly discontinuing alprazolam. What is the most likely cause of these symptoms?

Accepted Answer

Benzodiazepine withdrawal syndrome

Answer

Development of a new medical condition

Answer

Underlying anxiety disorder worsening

Answer

Adverse reaction to alprazolam

Question 51

A patient is prescribed escitalopram (Lexapro) for generalized anxiety disorder. What nursing intervention is appropriate to address a potential side effect of this medication?

Accepted Answer

Monitoring for sexual dysfunction, a common side effect of SSRIs.

Answer

Assessing for signs of withdrawal if the medication is discontinued abruptly (more relevant to benzodiazepines).

Answer

Educating the patient about the risk of dependence (not relevant to SSRIs).

Answer

Administering the medication with food (not a primary concern with escitalopram).

Question 52

A patient taking a benzodiazepine for anxiety is also prescribed a medication for insomnia. Which of the following would be the most appropriate choice for insomnia in this patient?

Accepted Answer

A non-benzodiazepine hypnotic like zolpidem (Ambien) to minimize the risk of additive CNS depression.

Answer

An over-the-counter sleep aid (may not be effective and could interact with the benzodiazepine).

Answer

Another benzodiazepine with a longer half-life (would increase the risk of sedation and potential for dependence).

Question 53

A patient with anxiety and insomnia is prescribed a beta-blocker for both conditions. How do beta-blockers help manage anxiety?

Accepted Answer

Beta-blockers reduce physical symptoms of anxiety by blocking the effects of adrenaline on the sympathetic nervous system.

Answer

Increasing serotonin levels in the brain, reducing anxiety (mechanism of action for SSRIs).

Question 54

A patient with anxiety is prescribed a selective serotonin reuptake inhibitor (SSRI). What accurately reflects the expected therapeutic effects of SSRIs?

Accepted Answer

SSRIs take several weeks to achieve maximum therapeutic effect, so patients should be advised to continue taking the medication as prescribed.

Answer

SSRIs provide immediate relief from anxiety symptoms (not true, they take time to build up therapeutic levels).

Question 55

A patient is being discharged on a long-term regimen of an anxiolytic medication. What nursing intervention is crucial to ensure medication adherence?

Accepted Answer

Providing the patient with comprehensive information about the medication, including potential side effects, and emphasizing the importance of taking it as prescribed.

Answer

Encouraging the patient to seek immediate medical attention for any side effects (important, but not the most crucial for adherence).