Pharmacology

Question 1

Which statement below is INCORRECT about Barbiturates?*
A. “Barbiturates are not as commonly prescribed today for conditions like anxiety or insomnia. Instead they’ve been replaced by the Benzodiazepines which have a lower risk of toxicity.”
B. “Barbiturates have a low therapeutic index.”
C. “Barbiturates decrease the effects of GABA.”
D. “Barbiturates are a central nervous system depressant.”

Answer 1

C. “Barbiturates decrease the effects of GABA.”

Question 2

Select all the medications below that are classified as a Barbiturate:*
A. Midazolam
B. Phenobarbital
C. Primidone
D. Lorazepam

Answer 2

B. Phenobarbital
C. Primidone

Question 3

Which Barbiturate below can be prescribed for migraines and is used in combination with Acetaminophen and/or Caffeine?*
A. Secobarbital
B. Diazepam
C. Butalbital
D. Temazepam

Answer 3

C. Butalbital

Question 4

Barbiturates affect ____________ receptors in the CNS. These receptors are considered _______________ receptors and consist of ___ subunits.*
A. GABAB; ligand-gated; 4
B. GABAB; g protein coupled; 5
C. GABAA; g protein coupled; 5
D. GABAA; ligand-gated; 5

Answer 4

D. GABAA; ligand-gated; 5

Question 5

Barbiturates cause what type of ions to flow into the cell and hyperpolarize it, hence leading to a decrease in firing potential of the neuron?*
A. Potassium
B. Chlorate
C. Sodium
D. Chloride

Answer 5

D. Chloride

Question 6

Barbiturates influence the receptor’s ion channel to perform what action?*
A. stay open longer
B. open more often
C. shorten opening time
D. open less often

Answer 6

A. stay open longer

Question 7

Which statements below are true statements about how Barbiturates differ from Benzodiazepines?*
A. “High doses of Barbiturates can influence the receptor without the help of the neurotransmitter GABA.”
B. “Barbiturates have largely replaced Benzodiazepines for the management of conditions like anxiety and insomnia.”
C. “The antidote used to treat Barbiturate overdose is Flumazenil.”
D. “Barbiturates have a low therapeutic index.”

Answer 7

A. “High doses of Barbiturates can influence the receptor without the help of the neurotransmitter GABA.”

D. “Barbiturates have a low therapeutic index.”

Question 8

Your patient takes Phenobarbital for the treatment of seizures. The dose has been increased. Which findings during your assessment require you to notify the physician immediately? Select all that apply:*
A. The patient has a history of tonic-clonic seizures.
B. The patient’s drug serum level for Phenobarbital is 55 mcg/mL.
C. The patient has a deep tendon reflex of 2+.
D. The patient’s respiratory rate is 6.

Answer 8

B. The patient’s drug serum level for Phenobarbital is 55 mcg/mL.

normal level is 15-40mcg/mL

D. The patient’s respiratory rate is 6.

Question 9

You are collecting the health history on a patient. Upon examining the patient’s electronic health record, you note that the patient has a history of seizures and was prescribed to take a Barbiturate to manage the seizures during the last hospitalization. The patient is unable to communicate the last time she took this prescribed medication. As the nurse you will make it priority to monitor for what findings below that could indicate the patient is experiencing withdrawal?*
A. Elevated temperature
B. Restlessness
C. Convulsions
D. Vomiting and nausea
E. Sleep problems
F. Agitation

Answer 9

A. Elevated temperature
B. Restlessness
C. Convulsions
D. Vomiting and nausea
E. Sleep problems
F. Agitation

Question 10

TRUE OR FALSE: Tolerance is less likely to develop with long-term Barbiturate usage

Answer 10

False

Question 11

Barbituates are classified as:

Question 12

Neurotransmitter are either:

Answer 12

Excitatory (increase signals) or Inhibitory (decrease signals)

Question 13

Barbituates suppress the:

1. PNS
2. PSNS
3. CNS
4. SNS

Answer 13

CNS

Question 14

Barbiturates suppress the CNS by:

a. decreases the neurotransmitter GABA
b. increasing the neurotransmitter epinephrine
c. decreases the neurotransmitter epinephrine
d. increases the neurotransmitter GABA

Answer 14

d. increases the neurotransmitter GABA

Question 15

GABA is what type of neurotransmitter:

a. excitatory
b. inhibitory

Answer 15

b. inhibitory

Question 16

A patient is prescribed a barbiturate for their seizures, when evaluating the prescribed dose, the nurse remembers a critical component of barbituates:

a. they have a high therapeutic index
b. they cannot be prescribed for seizures
c. they have a low therapeutic index
d. overdose cannot occur

Answer 16

c. they have a low therapeutic index

Question 17

The therapeutic index describes:

a. the level of drug in blood serum to be therapeutic
b. the space between therapeutics levels and toxic levels

Answer 17

b. the space between therapeutics levels and toxic levels

Question 18

The nurse accidentally prescribed the wrong amount of a barbiturate, the patient is now in respiratory distress. The nurse remembers that the antidote to a barbiturate overdose is:

a. vitamin K
b. morphine
c. epinephrine
d. there is no antidote

Answer 18

d. there is no antidote

Question 19

What barbitural is commonly used for seizures?

a. phenobarbital
b. pentobarbital
c. primidone
d. amobarbital

Answer 19

c. primidone

Question 20

What are barbiturates used to treat:

a. seizures, insomnia
b. presurgery anxiety
c. ICP, migraines
d. all of the above

Answer 20

d. all of the above

Question 21

Chronic Barbituate use can lead to:

a. seizures
b. tachycardia
c. increased tolerance
d. A and B

Answer 21

c. increased tolerance

Question 22

Long-term barbiturate use can increase risk for:

a. addictions
b. abuse
c. A & B
d. none of these

Answer 22

c. A & B

Question 23

The nurse is reviewing a chart for a patient who recently survived a barbiturate overdose. The nurse remembers supportive measures for barbiturate overdose include:

a. mechanical ventilation, dialysis, activated charcoal
b. D5W & epinephrine
c. epinephrine & activated charcoal
d. elevating HOB to 30 degrees, acetaminophen, zofran

Answer 23

a. mechanical ventilation, dialysis, activated charcoal

Question 24

Patient education regarding barbiturate use should include teaching the patient to avoid using:

a. NSAIDs
b. anything that suppresses the CNS
c. SSRI
d. mannitol

Answer 24

b. anything that suppresses the CNS

Question 25

Signs and Symptoms of Barbiturate overdose:

(LETHAL)

Answer 25

Level of consciousness

Eye pupils are pinpoint

Tachycardia that is weak

Have cool, diaphoretic skin

Absent reflexes

Low/shallow respirations

Question 26

The nurse is caring for a patient who has been prescribed a barbiturate. The nurse remembers that barbiturates are a hypnotic, therefore the nurse will take the following safety measures:

a. setting bed alarm with q4h safety checks
b. turn on the bathroom light to prevent falls and open windows to let in light.
c. ensure the bedrails are up and assist with ambulation
d. keep the patient on bedrest

Answer 26

c. ensure the bedrails are up and assist with ambulation

Question 27

A patient presents to the emergency department with the following symptoms, restlessness, agitation, and sleep problems. Following a thorough health history that includes barbiturate use, the nurse remembers that withdrawal symptoms include:

a. the symptoms presented + tachypnea, cool, diaphoretic skin
b. the symptoms presented + orthopnea
c. the symptoms presented + convulsion, vomiting/nausea, elevated temp
d. the symptoms presented are not due to a barbiturate withdrawal

Answer 27

c. the symptoms presented + convulsion, vomiting/nausea, elevated temp

Question 28

TRUE or FALSE

The nurse should educate a patient who was newly prescribed a barbiturate for the following risks:

Risk of accidental OD (take exactly as prescribed)

Risk for addiction

Risk for Increased Tolerance

Risk for withdrawal symptoms (do not stop taking abruptly)

Answer 28

TRUE