NURSING 6005 CHAPTER 34: SEDATIVE-HYPNOTIC DRUGS
Test Bank
MULTIPLE CHOICE
1. A nurse is discussing the use of benzodiazepines as sedative-hypnotic agents with a group of
nursing students. A student asks about the actions of these drugs in the central nervous
system. The nurse makes which correct statement?
a. “Benzodiazepines affect the hippocampus and the cerebral cortex to cause
anterograde amnesia.”
b. “Benzodiazepines depress neuronal functions by acting at a single site in the
brain.”
c. “Benzodiazepines induce muscle relaxation by acting on sites outside the central
nervous system.”
d. “Benzodiazepines promote sleep through effects on the limbic system.”
ANS: A
All beneficial and most adverse effects of benzodiazepines occur from depressant actions in
the central nervous system (CNS); the various effects depend on the site of action.
Anterograde amnesia is the result of effects in the hippocampus and the cerebral cortex.
Benzodiazepines act at multiple sites in the CNS. Muscle relaxant effects are the result of
actions on supraspinal motor areas in the CNS. Benzodiazepines promote sleep through
effects on cortical areas and on the sleep-wakefulness “clock.”
DIF: Cognitive Level: Analysis
REF: Benzodiazepines | Overview of Pharmacologic Effects | Central Nervous System
TOP: Nursing Process: Evaluation
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
2. A patient who has been using secobarbital for several months to treat insomnia tells the nurse
that the prescriber has said the prescription will be changed to temazepam (Restoril) because it
is safer. The patient asks why this agent is safer. The nurse is correct in telling the patient that
temazepam:
a. does not depress the central nervous system.
b. shows no respiratory depression, even in toxic doses.
c. mimics the actions of a central nervous system inhibitory neurotransmitter.
d. only potentiates the action of endogenous gamma-aminobutyric acid (GABA).
ANS: D
Benzodiazepines potentiate the actions of GABA, and because the amount of GABA in the
CNS is finite, these drugs’ depressive effect on the CNS is limited. Benzodiazepines depress
the CNS but not to the extent that barbiturates do. Benzodiazepines are weak respiratory
depressants at therapeutic doses and moderate respiratory depressants at toxic doses.
Barbiturates mimic GABA; therefore, because they produce CNS depression, this effect is
limited only by the amount of barbiturate administered.
DIF: Cognitive Level: Application
REF: Benzodiazepines | Overview of Pharmacologic Effects | Central Nervous System | Respiratory
System | Molecular Mechanism of Action
TOP: Nursing Process: Implementation
, MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
3. A hospitalized patient who is given one dose of flurazepam continues to show drowsiness the
next day. A nursing student asks the nurse the reason for this, because the drug’s half-life is
only 2 to 3 hours. Which response by the nurse is correct?
a. “Benzodiazepines commonly cause residual effects lasting into the day after the
dose is given.”
b. “The patient is having a paradoxical reaction to this medication.”
c. “This patient must have developed a previous tolerance to benzodiazepines.”
d. “When this drug is metabolized, the resulting compound has longer lasting
effects.”
ANS: D
Flurazepam has a half-life of 2 to 3 hours; however, its metabolite has a long half-life, so
giving the drug results in long-lasting effects. Barbiturates, not benzodiazepines, are
commonly associated with residual, or hangover, effects. A paradoxical reaction to a sedative
would manifest as insomnia, euphoria, and excitation, not drowsiness. Tolerance means that
the patient would need increased amounts of a drug to get the desired effects and would not
have prolonged effects of the medication.
DIF: Cognitive Level: Application
REF: Benzodiazepines | Pharmacokinetics | Adverse Effects | Paradoxical Effects | Tolerance |
Barbiturates | Adverse Effects | Hangover TOP: Nursing Process: Evaluation
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
4. A nursing student asks a nurse what criteria are used to determine which benzodiazepine is
prescribed in different situations. The nurse correctly states that selection is based on
differences in the onset and duration of effects, as well as on:
a. differences in sites of action in the central nervous system.
b. marketing decisions of pharmaceutical companies.
c. relative differences in abuse potential.
d. variations in adverse effects and drug interactions.
ANS: B
The principal factors determining the applications of a particular benzodiazepine are the
pharmacokinetic properties having to do with absorption, metabolism, and excretion and the
research and marketing decisions of the drug makers. All of the benzodiazepines produce a
similar spectrum of responses, and all act at various sites in the CNS. All benzodiazepines
have a lower abuse potential than barbiturates. Drug effects and drug interactions are similar
for all benzodiazepines.
DIF: Cognitive Level: Analysis
REF: Benzodiazepines | Pharmacokinetics | Therapeutic Uses | Adverse Effects
TOP: Nursing Process: Assessment
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
5. A patient takes temazepam (Restoril) for insomnia. The patient tells the nurse that a recent
telephone bill lists several calls to friends that the patient does not remember making. What
will the nurse do?
a. Ask the patient about any alcohol consumption in conjunction with the
benzodiazepine.
Test Bank
MULTIPLE CHOICE
1. A nurse is discussing the use of benzodiazepines as sedative-hypnotic agents with a group of
nursing students. A student asks about the actions of these drugs in the central nervous
system. The nurse makes which correct statement?
a. “Benzodiazepines affect the hippocampus and the cerebral cortex to cause
anterograde amnesia.”
b. “Benzodiazepines depress neuronal functions by acting at a single site in the
brain.”
c. “Benzodiazepines induce muscle relaxation by acting on sites outside the central
nervous system.”
d. “Benzodiazepines promote sleep through effects on the limbic system.”
ANS: A
All beneficial and most adverse effects of benzodiazepines occur from depressant actions in
the central nervous system (CNS); the various effects depend on the site of action.
Anterograde amnesia is the result of effects in the hippocampus and the cerebral cortex.
Benzodiazepines act at multiple sites in the CNS. Muscle relaxant effects are the result of
actions on supraspinal motor areas in the CNS. Benzodiazepines promote sleep through
effects on cortical areas and on the sleep-wakefulness “clock.”
DIF: Cognitive Level: Analysis
REF: Benzodiazepines | Overview of Pharmacologic Effects | Central Nervous System
TOP: Nursing Process: Evaluation
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
2. A patient who has been using secobarbital for several months to treat insomnia tells the nurse
that the prescriber has said the prescription will be changed to temazepam (Restoril) because it
is safer. The patient asks why this agent is safer. The nurse is correct in telling the patient that
temazepam:
a. does not depress the central nervous system.
b. shows no respiratory depression, even in toxic doses.
c. mimics the actions of a central nervous system inhibitory neurotransmitter.
d. only potentiates the action of endogenous gamma-aminobutyric acid (GABA).
ANS: D
Benzodiazepines potentiate the actions of GABA, and because the amount of GABA in the
CNS is finite, these drugs’ depressive effect on the CNS is limited. Benzodiazepines depress
the CNS but not to the extent that barbiturates do. Benzodiazepines are weak respiratory
depressants at therapeutic doses and moderate respiratory depressants at toxic doses.
Barbiturates mimic GABA; therefore, because they produce CNS depression, this effect is
limited only by the amount of barbiturate administered.
DIF: Cognitive Level: Application
REF: Benzodiazepines | Overview of Pharmacologic Effects | Central Nervous System | Respiratory
System | Molecular Mechanism of Action
TOP: Nursing Process: Implementation
, MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
3. A hospitalized patient who is given one dose of flurazepam continues to show drowsiness the
next day. A nursing student asks the nurse the reason for this, because the drug’s half-life is
only 2 to 3 hours. Which response by the nurse is correct?
a. “Benzodiazepines commonly cause residual effects lasting into the day after the
dose is given.”
b. “The patient is having a paradoxical reaction to this medication.”
c. “This patient must have developed a previous tolerance to benzodiazepines.”
d. “When this drug is metabolized, the resulting compound has longer lasting
effects.”
ANS: D
Flurazepam has a half-life of 2 to 3 hours; however, its metabolite has a long half-life, so
giving the drug results in long-lasting effects. Barbiturates, not benzodiazepines, are
commonly associated with residual, or hangover, effects. A paradoxical reaction to a sedative
would manifest as insomnia, euphoria, and excitation, not drowsiness. Tolerance means that
the patient would need increased amounts of a drug to get the desired effects and would not
have prolonged effects of the medication.
DIF: Cognitive Level: Application
REF: Benzodiazepines | Pharmacokinetics | Adverse Effects | Paradoxical Effects | Tolerance |
Barbiturates | Adverse Effects | Hangover TOP: Nursing Process: Evaluation
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
4. A nursing student asks a nurse what criteria are used to determine which benzodiazepine is
prescribed in different situations. The nurse correctly states that selection is based on
differences in the onset and duration of effects, as well as on:
a. differences in sites of action in the central nervous system.
b. marketing decisions of pharmaceutical companies.
c. relative differences in abuse potential.
d. variations in adverse effects and drug interactions.
ANS: B
The principal factors determining the applications of a particular benzodiazepine are the
pharmacokinetic properties having to do with absorption, metabolism, and excretion and the
research and marketing decisions of the drug makers. All of the benzodiazepines produce a
similar spectrum of responses, and all act at various sites in the CNS. All benzodiazepines
have a lower abuse potential than barbiturates. Drug effects and drug interactions are similar
for all benzodiazepines.
DIF: Cognitive Level: Analysis
REF: Benzodiazepines | Pharmacokinetics | Therapeutic Uses | Adverse Effects
TOP: Nursing Process: Assessment
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
5. A patient takes temazepam (Restoril) for insomnia. The patient tells the nurse that a recent
telephone bill lists several calls to friends that the patient does not remember making. What
will the nurse do?
a. Ask the patient about any alcohol consumption in conjunction with the
benzodiazepine.
