1.

After teaching a group of nursing students about antianxiety drugs, the instructor
determines that the teaching was successful when the students identify which as an
example? Select all that apply.
A) Alprazolam
B) Buspirone
C) Hydroxyzine
D) Chlordiazepoxide
E) Lorazepam
Ans: A, D, E
Feedback:
Alprazolam, chlordiazepoxide, and lorazepam are examples of benzodiazepine
antianxiety drugs. Buspirone and hydroxyzine are considered nonbenzodiazepines.

2. The nurse is reviewing the medication record of a client who is prescribed a

nonbenzodiazepine. Which of the following would the nurse expect to find? Select all
that apply.
A) Alprazolam
B) Buspirone
C) Hydroxyzine
D) Chlordiazepoxide
E) Doxepin
Ans: B, C, E
Feedback:
Buspirone, doxepin, and hydroxyzine are examples of nonbenzodiazepine antianxiety
drugs. Alprazolam and chlordiazepoxide are benzodiazepines.

3. A nurse is administering an antianxiety agent to a client. The nurse understands that

long-term use of which of the following anxiolytics would be most likely to lead to
physical or psychological tolerance? Select all that apply.
A) Alprazolam
B) Buspirone
C) Hydroxyzine
D) Chlordiazepoxide
E) Doxepin
Ans: A, D
Feedback:
Although long-term use of benzodiazepines such as alprazolam and chlordiazepoxide
and nonbenzodiazepines such as buspirone, hydroxyzine, and doxepin can result in
physical or psychological dependence, benzodiazepines are more likely to result in
physical dependence and tolerance.

4. A nurse is administering an antianxiety agent that exerts its anxiolytic effects by

potentiating the effects of gamma-aminobutyric acid (GABA). Which of the following

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 might the nurse be administering? Select all that apply.
A) Alprazolam
B) Buspirone
C) Hydroxyzine
D) Chlordiazepoxide
E) Lorazepam
Ans: A, D, E
Feedback:
Benzodiazepines like alprazolam, chlordiazepoxide, and lorazepam exert their
anxiolytic effects by potentiating the effects of gamma-aminobutyric acid (GABA).
Nonbenzodiazepines exert their effects in different ways.

5. A nurse is preparing to administer an anxiolytic drug. The nurse integrates knowledge of

this group of drugs, understanding that the drugs can be used in the management of
which of the following conditions? Select all that apply.
A) Alcohol withdrawal
B) Diabetic neuropathy
C) Seizures
D) Panic attacks
E) Hypertension
Ans: A, C, D
Feedback:
Anxiolytic drugs can be used in the management of anxiety disorder, panic attacks,
convulsions, seizures, and alcohol withdrawal and for preanesthetic sedation and muscle
relaxation.

6. After administering an anxiolytic, the nurse assesses the client for adverse reactions.
Which of the following would the nurse identify as a common early reaction to this
group of drugs? Select all that apply.
A) Headache
B) Sedation
C) Lightheadedness
D) Dizziness
E) Hypertension
Ans: A, B, C, D
Feedback:
Common early reactions caused by anxiolytics include mild drowsiness, sedation,
lightheadedness, dizziness, and headache.

7. A nurse suspects that a client who is receiving lorazepam may be experiencing

benzodiazepine withdrawal based on assessment of which of the following? Select all
that apply.
A) Anxiety

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B) Tremor
C) Photophobia
D) Insomnia
E) Metallic taste
Ans: A, B, C, E
Feedback:
Symptoms of benzodiazepine withdrawal include increased anxiety, concentration
difficulties, tremor, and sensory disturbances, such as paresthesias, photophobia,
hypersomnia, and metallic taste.

8. A nurse is reviewing the medical record of a client with anxiety who is to receive an
antianxiety agent as part of the treatment. The nurse recognizes that benzodiazepines
would not be used based on which of the following conditions? Select all that apply.
A) Cataracts
B) Acute narrow-angle glaucoma
C) Hypotension
D) Psychoses
E) Pregnancy
Ans: B, D, E
Feedback:
The use of benzodiazepines is contraindicated in clients with known hypersensitivity,
psychoses, acute narrow-angle glaucoma, and pregnancy.

9. The nurse is assessing an infant at a well-child visit and notices that the infant has been
losing weight and is lethargic. The mother is breastfeeding the child. The nurse
questions the mother about any medications that she might be taking. Which of the
following, if being taken by the mother, would alert the nurse to a problem? Select all
that apply.
A) Alprazolam
B) Buspirone
C) Hydroxyzine
D) Chlordiazepoxide
E) Lorazepam
Ans: A, D, E
Feedback:
Benzodiazepines like alprazolam, chlordiazepoxide, and lorazepam taken by a
breastfeeding mother can result in lethargy and weight loss in the infant. Buspirone and
hydroxyzine do not appear to have the same effect.

10. A client is hospitalized and is prescribed diazepam. Before administering the drug,
which of the following information should the nurse obtain? Select all that apply.
A) Complete medical history
B) Mental status exam

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C) Anxiety level
D) Pain assessment
E) Medication history
Ans: A, B, C
Feedback:
Before starting anxiolytic therapy in a hospitalized client, the nurse obtains a complete
medical history, including mental status and anxiety level.

11. A client is prescribed lorazepam. The nurse understands that this drug can be given by
which route? Select all that apply.
A) Intramuscular
B) Oral
C) Transdermal
D) Intravenous
E) Rectal
Ans: A, B, D
Feedback:
Lorazepam can be administered to a client via the oral, IM, and IV routes.

12. During assessment of a client, a nurse suspects that the client is experiencing anxiety.
Which of the following would support the nurse's suspicion? Select all that apply.
A) Facial flushing
B) Tense posture
C) Extreme restlessness
D) Somnolence
E) Facial grimaces
Ans: B, C, E
Feedback:
During the intake history, the nurse observes the client for behavioral signs indicating
anxiety (e.g., inability to focus, extreme restlessness, facial grimaces, tense posture).

13. Before administering a prescribed anxiolytic to a client, which of the following would
the nurse include in the physical assessment of the client? Select all that apply.
A) Blood pressure
B) Blood glucose
C) Pulse
D) Respiratory rate
E) Weight
Ans: A, C, D, E
Feedback:
The nurse's preadministration physical assessment for the administration of an
anxiolytic should include blood pressure, pulse, respiratory rate, and weight.

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 14. A nurse suspects that a client is experiencing anxiety. Which physical assessment
findings would support the nurse's suspicion? Select all that apply.
A) Hypotension
B) Decreased respiratory rate
C) Increased muscle tension
D) Pale skin
E) Bradycardia
Ans: C, D
Feedback:
Physiological manifestations of anxiety can include hypertension, tachycardia, increased
rate and depth of respirations, increased muscle tension, and cool, pale skin.

15. An older adult client is experiencing anxiety. Which anxiolytic drug would the nurse
identify as being relatively safe to administer to this client at a normal dose? Select all
that apply.
A) Buspirone
B) Lorazepam
C) Oxazepam
D) Alprazolam
E) Diazepam
Ans: A, B, C
Feedback:
Lorazepam, oxazepam, and buspirone are relatively safer for older adult clients when
given at normal doses.

16. A nurse is preparing to administer an anxiolytic agent via intramuscular injection.

Which of the following would be most important for the nurse to keep in mind? Select
all that apply.
A) The client should be monitored closely for 3 hours postinjection.
B) Intramuscular injection should be given in chronic states.
C) The client should remain in a lying position for about 30 minutes.
D) The drug should be administered into a large muscle mass.
E) The client should be kept conscious for at least 1 hour after administration.
Ans: A, D
Feedback:
Intramuscular administration of an anxiolytic should be done primarily in an acute state.
The drug should be administered in a large muscle mass, the client should be observed
closely for at least 3 hours, and the client should be kept lying down for 30 minutes to 3
hours after drug administration.

17. A client who is prescribed an anxiolytic tells the nurse that she is constipated. Which of
the following would be most appropriate for the nurse to suggest? Select all that apply.

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A) Stop taking the drug.
B) Increase fluid intake.
C) Increase fiber intake.
D) Ask to have the drug given by injection.
E) Take the drug on an empty stomach.
Ans: B, C
Feedback:
Clients receiving an anxiolytic should be advised to increase fluid and fiber intake to
address constipation. The drug should not be stopped or changed to an injectable form.
Taking the drug on an empty stomach may lead to GI upset.

18. A nurse is preparing a teaching plan for a client who is prescribed an anxiolytic. As part
of the plan, the nurse addresses medications that should be avoided to reduce the risk of
increased CNS depression and sedation. Which of the following would the nurse
include? Select all that apply.
A) Alcohol
B) Analgesics
C) Digoxin
D) Tricyclic antidepressants
E) Antipsychotics
Ans: A, B, D, E
Feedback:
Alcohol, analgesics, tricyclic antidepressants, and antipsychotics should be used with
caution with anxiolytics due to increased CNS depression and increased risk of sedation.

19. A nurse is caring for a client who is receiving alprazolam. The nurse would be alert for
which of the following as an initial adverse reaction with this drug?
A) Heartburn
B) Anorexia
C) Headache
D) Allergy
Ans: C
Feedback:
The nurse should assess for headache as the initial adverse reaction in the client after
administering alprazolam. Heartburn, anorexia, and allergy are adverse reactions
observed in the client after administering salicylates.

20. A client who is prescribed buspirone therapy also is receiving digoxin for heart failure.
The nurse understands that this client would be at increased risk for which of the
following?
A) Sedation
B) Respiratory depression
C) Digitalis toxicity

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D) Central nervous system depression
Ans: C
Feedback:
The client faces an increased risk for digitalis toxicity due to the effect of interaction of
buspirone with digoxin. Increased risk for sedation and respiratory depression are
caused by the interaction of buspirone with tricyclic antidepressants and antipsychotics.
Increased risk for central nervous system depression is caused by the interaction of
buspirone with alcohol.

21. A client with anxiety is prescribed anxiolytic therapy. Before administering the drug, the
nurse assesses the client for symptoms of anxiety. Which of the following would the
nurse expect to find?
A) Increased blood pressure
B) Decreased muscle tension
C) Increased glucose level
D) Decreased pulse rate
Ans: A
Feedback:
Increased blood pressure is a manifestation of anxiety. Additional manifestations include
increased pulse rate and increased muscle tension. Increased glucose levels are not
associated with anxiety.

22. A nurse is assigned to care for a hospitalized client with anxiety. Buspirone is
prescribed. When reviewing the client's history, which of the following, if found, would
the nurse identify as a contraindication for this drug?
A) Cataract
B) Diabetic retinopathy
C) Acute gout
D) Psychoses
Ans: D
Feedback:
The use of buspirone is contraindicated in clients with hypersensitivity, psychoses, and
acute narrow-angle glaucoma. Ethambutol is contraindicated in clients with cataracts
and diabetic retinopathy. Pyrazinamide is contraindicated in clients with acute gout.

23. A client who was receiving a benzodiazepine for treatment of anxiety tells the nurse that
he has decided to discontinue the treatment. Which of the following would the nurse
include in the teaching plan for this client?
A) “Be sure to gradually decrease the dosage over time.”
B) “It's fine to just stop taking the medication.”
C) “You need to first increase the dose and then stop.”
D) “It's important that you continue the medication even if you want to stop.”
Ans: A

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 Feedback:
The nurse should suggest the client gradually decrease the dosage schedule to avoid
withdrawal symptoms. It is not advisable for the nurse to suggest just stopping the
medication, increasing the dosage, or continuing with the medication as prescribed.

24. A client admitted to the health care facility for alcohol withdrawal has been prescribed
an antianxiety medication. The nurse instructs the client about the need for cessation of
alcohol consumption based on the understanding that the client would be at increased
risk for which of the following?
A) Antianxiety drug toxicity
B) Respiratory depression
C) Sedation
D) CNS depression
Ans: D
Feedback:
The nurse should suggest that the client stop consuming alcohol while therapy is going
on because such consumption increases the risk for CNS depression. Increased risk for
digitalis toxicity is identified when the client is taking digoxin for management of
cardiac problems. Increased risk for sedation and respiratory depression is identified
when tricyclic antidepressants or antipsychotics are being used simultaneously with an
antianxiety agent.

25. A client receiving antianxiety drug therapy complains of constipation. The nurse
understands that this is the result of which of the following?
A) Excess fibrous food in the diet
B) Overdose of an antianxiety drug
C) Slowed intestinal transit time
D) Oral administration of the drug
Ans: C
Feedback:
Constipation results from the action of the antianxiety agents, which slow intestinal
transit time. An increased fiber intake would help combat the constipation. Constipation
does not result from an overdose of the drug or from oral administration.

26. A client who experiences panic attacks in social situations has been prescribed an
antianxiety medication. The nurse would assess which of the following before
administering the drug?
A) Temperature
B) Blood pressure
C) Blood sugar
D) Red blood cell count
Ans: B
Feedback:

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 The nurse should check the client's blood pressure before administering the antianxiety
drug because physiologic manifestations of panic attacks can include increased blood
pressure. Temperature, blood sugar, and RBC count are not adversely affected by
antianxiety drugs.

27. A nurse is caring for an older adult client who is prescribed an antianxiety agent
parenterally. Which of the following would be most important for the nurse to do?
A) Arrange for a blood transfusion.
B) Provide fiber-rich food.
C) Provide plenty of fluids.
D) Have resuscitative equipment ready.
Ans: D
Feedback:
The nurse should have resuscitative equipment ready because older adult clients may
experience apnea and cardiac arrest during the treatment. Providing fiber-rich food and
plenty of fluids is appropriate to prevent constipation and is unrelated to the use of the
parenteral route. The need for a blood transfusion would not arise during the treatment.

28. A client is prescribed a benzodiazepine as treatment for anxiety. After administration of

the drug, the client reports dizziness and lightheadedness. Which nursing diagnosis
would the nurse identify as a priority?
A) Impaired Comfort
B) Risk for Injury
C) Ineffective Coping
D) Deficient Knowledge
Ans: B
Feedback:
Dizziness and lightheadedness place the client at risk for falls; therefore, Risk for Injury
would be the priority. Impaired Comfort would be appropriate if the client reported
problems such as dry mouth or constipation. Ineffective Coping would be appropriate if
the client reported continued feelings of anxiety. There is no evidence to suggest that the
client lacks knowledge of the drug therapy.

29. A client is brought to the emergency department with suspected overdose of a

benzodiazepine. Which of the following should the nurse anticipate administering to
counteract the effects of the overdose?
A) Naloxone
B) Naltrexone
C) Flumazenil
D) Diazepam
Ans: C
Feedback:
Flumazenil is the antidote for benzodiazepine toxicity. Naloxone is used to reverse the

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 effects of opioids. Naltrexone is used primarily to treat alcohol dependence and to block
the effects of suspected opioids if they are being used by a person undergoing treatment
for alcohol dependence. Diazepam is a benzodiazepine and would only increase the
client's toxicity.

30. A client who is receiving a benzodiazepine tells the nurse that his mouth feels really dry.
Which of the following would the nurse include in the teaching plan for this client?
A) “Try drinking about 8 ounces of water at least every 2 hours.”
B) “Sucking on hard sugarless candy might help you.”
C) “Make sure you eat a lot of green leafy vegetables.”
D) “Change your position slowly as you get out of bed.”
Ans: B
Feedback:
For dry mouth, the nurse should suggest sucking on hard, sugarless candies or chewing
sugarless gum. Frequent sips of water would also help, but drinking 8 ounces of water
every 2 hours could lead to fluid overload. Eating green leafy vegetables would help
with constipation. Changing positions slowly would be appropriate if the client reported
dizziness or lightheadedness.

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