ATI RN
Central Nervous System Stimulants and Related Drugs NCLEX Style Questions Questions
Question 1 of 5
A physician has a choice in benzodiazepines to prescribe for patients. A particular patient (a 53-year-old man with anxiety) has a difficult time with compliance to medications. The physician is concerned about the patient going into withdrawal because of abrupt discontinuation of the antianxiety medication. Which of the following medications would have the least severe withdrawal reaction?
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Question 2 of 5
A 21-year-old male has recently begun pimozide therapy for Tourette's disorder. His parents bring him to the emergency department. They describe that he has been having “different appearing tics†than before, such as prolonged contraction of the facial muscles. While being examined, he experiences opsichotomus (type of extrapyramidal spasm of the body in which the head and heels are bent backward and the body is bowed forward). Which of the following drugs would be beneficial in reducing these symptoms?
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Question 3 of 5
Benzodiazepines produce their actions on CNS by:
Correct Answer: B
Rationale: Benzodiazepines (e.g., diazepam, lorazepam) are CNS depressants used for anxiety, seizures, and insomnia. They exert effects by binding to a specific allosteric site on the GABAa receptor, enhancing GABA's inhibitory action. GABA, the primary inhibitory neurotransmitter, opens chloride (Clâ») channels, hyperpolarizing neurons and reducing excitability. Benzodiazepines increase the frequency of channel opening, potentiating this effect, leading to sedation and anxiolysis. Blocking Clâ» channels (choice A) would oppose inhibition, contrary to their purpose. Acting as direct agonists (choice C) is incorrect—they don't activate the receptor alone but amplify GABA's action. Antagonizing GABAb receptors (choice D) is irrelevant, as benzodiazepines target GABAa specifically. This potentiation mechanism underlies their therapeutic utility and risks like tolerance. Understanding this is key to distinguishing benzodiazepines from other CNS drugs and managing their clinical use effectively.
Question 4 of 5
Pharmacologic actions of acetylsalicylic acid include all of the following EXCEPT:
Correct Answer: C
Rationale: Acetylsalicylic acid (aspirin) inhibits COX enzymes, reducing prostaglandin synthesis (choice D), yielding analgesic (choice A) and antipyretic (choice B) effects by decreasing pain mediators and hypothalamic heat regulation, respectively. However, it inhibits, not promotes, platelet aggregation (choice C) by blocking thromboxane A2 production, a pro-aggregatory prostaglandin, making it antiplatelet, used in cardiovascular prophylaxis. Promotion of aggregation would contradict its mechanism. This exception tests understanding of aspirin's unique antiplatelet action among NSAIDs, critical for its clinical applications.
Question 5 of 5
Trichloroethanol is the active metabolite of:
Correct Answer: D
Rationale: Chloral hydrate (choice D) is metabolized to trichloroethanol, which depresses the CNS, inducing sedation. Morphine (choice A) metabolizes to active compounds like morphine-6-glucuronide, not trichloroethanol. Clorazepate (choice B) becomes desmethyldiazepam, a benzodiazepine. Phenobarbitone (choice C) is a barbiturate, not metabolized to trichloroethanol. This identifies Chloral hydrate's metabolic pathway, key for its hypnotic use.