Question 1

Which individual is at high risk for an altered response to anaesthesia?&#10;A)The 30-year-old male who has never had surgery before&#10;B)The 45-year-old female who stopped smoking 10 years ago&#10;C)The 20-year-old male who is to have a lymph node removed&#10;D)The 78-year-old female who is to have her gallbladder removed

Accepted Answer

The older adult patient is more affected by anaesthesia because of the effects of aging on the hepatic,cardiac,respiratory,and renal systems.
Young or middle-aged adult patients are not at high risk for an altered response to anaesthesia.

Question 2

While monitoring a patient who had surgery under general anaesthesia 2 hours earlier,the nurse notes a sudden elevation in body temperature.What does this sudden elevation in body temperature indicate?

A)Tachyphylaxis
B)Postoperative infection
C)Malignant hypothermia
D)Malignant hyperthermia

Malignant hyperthermia

Accepted Answer

A sudden elevation in body temperature during the postoperative period may indicate the occurrence of malignant hyperthermia,a life-threatening emergency.

Question 3

During a fishing trip,a patient pierced his finger with a large fish hook.He is now at an emergency room to have it removed.What type of anaesthesia will be used for this procedure?&#10;A)Topical benzocaine spray to the area&#10;B)Spinal anaesthesia with mepivacaine (Carbocaine,Isocaine)&#10;C)Topical prilocaine (EMLA) cream around the site&#10;D)Infiltration of the area with lidocaine

Accepted Answer

Infiltration anaesthesia is commonly used for minor surgical procedures.It involves injecting the local anaesthetic solution intradermally,subcutaneously,or submucosally across the path of nerves supplying the area to be anaesthetized.The local anaesthetic may be administered in a circular pattern around the operative field.

Question 4

A patient has been given succinylcholine (Quelicin)after a severe injury that necessitated controlled ventilation.The physician now wants to reverse the paralysis.The nurse would expect to use which drug to reverse the succinylcholine?

A)diazepam (Valium)
B)Caffeine
C)Neostigmine
D)vecuronium (Norcuron)

Accepted Answer

The antidote for neuromuscular blocking agents (NMBAs)such as succinylcholine is neostigmine or atropine.Both drugs reverse the effects of the NMBAs.

Question 5

A patient is undergoing abdominal surgery and has been anaesthetized for 3 hours.Which of the following nursing diagnoses is appropriate for him?&#10;A)Anxiety related to the use of an anaesthetic&#10;B)Risk for injury related to increased sensorium from general anaesthesia&#10;C)Decreased cardiac output related to systemic effects of local anaesthesia&#10;D)Impaired gas exchange related to central nervous system (CNS)depression produced by general anaesthesia

Accepted Answer

"Impaired gas exchange related to central nervous system (CNS)depression produced by general anaesthesia" is the appropriate nursing diagnosis for this patient.
Because the patient is under anaesthesia,the nurse is unable to assess the patient for anxiety.Risk for injury is related to decreased sensorium,not increased sensorium from general anaesthesia."Decreased cardiac output related to systemic effects of local anaesthesia" is incorrect because local anaesthesia should have very little systemic effect.

Question 6

Which of the following symptoms may occur if a patient is taking ginger and requires an anaesthetic?&#10;A)Decreased blood pressure&#10;B)Increased risk of bleeding&#10;C)Increased risk of stroke&#10;D)Migraine headaches

Accepted Answer

A patient who has been taking the natural health product ginger and requires anaesthesia is at an increased risk of bleeding,especially if the patient is also taking acetylsalicylic acid (Aspirin)or ginkgo.
Decreased blood pressure,increased risk of stroke,and migraine headaches are risks associated when anaesthesia is combined with some natural health products,but not ginger.

Question 7

When administering a neuromuscular drug such as pancuronium,which of the following does the nurse need to remember?&#10;A)It can be used instead of general anaesthesia during surgery.&#10;B)Only skeletal muscles are paralyzed;respiratory muscles remain functional.&#10;C)It causes sedation and pain relief while allowing for lower doses of anaesthetics.&#10;D)Patients will require artificial mechanical ventilation because of paralyzed respiratory muscles.

Accepted Answer

Patients receiving neuromuscular blocking agents (NMBAs)will require artificial mechanical ventilation because of the resultant paralysis of the respiratory muscles.
NMBAs do not cause sedation or pain relief and cannot be used in place of general anaesthesia during surgery.Respiratory muscles are paralyzed by this drug.

Question 8

A patient is being prepared for an oral endoscopy,and the nurse reminds him that he will be awake during the procedure but probably will not remember it.What type of anaesthetic technique is used in this situation?

A)Twilight sleep
B)Moderate sedation
C)Adjunctive anaesthesia
D)Spinal anaesthesia

Accepted Answer

Moderate sedation effectively reduces patient anxiety,sensitivity to pain,and recall of the medical procedure,yet it preserves the patient's ability to maintain his or her own airway and respond to verbal commands.

Question 9

A patient is to receive local anaesthesia for removal of a lymph node from his groin.Why does the physician add epinephrine to the local anaesthetic during the preparation?&#10;A)Epinephrine prevents an anaphylactic reaction from occurring.&#10;B)The anaesthetic enhances the effect of the epinephrine.&#10;C)Epinephrine contributes to a balanced anaesthetic state.&#10;D)Vasoconstrictive effects keep the anaesthetic at its local site of action.

Accepted Answer

Vasoconstrictors such as epinephrine are co-administered with local anaesthetics to keep the anaesthetic at its local site of action and to prevent systemic absorption.

Question 10

MATCHING&#10;When a neuromuscular blocking drug is given,the effects occur in a certain order.Put the following drug effects in the proper order of occurrence,using the choices A through C listed below.&#10;&#10;Occurs first&#10;A)Cessation of respirations due to paralysis of diaphragm and intercostal muscles&#10;B)Total flaccid paralysis&#10;C)Weakness&#10;

Accepted Answer

Weakness occurs first as the initial effect of neuromuscular blocking drugs, followed by total flaccid paralysis, and finally cessation of respirations.

Question 11

MATCHING&#10;When a neuromuscular blocking drug is given,the effects occur in a certain order.Put the following drug effects in the proper order of occurrence,using the choices A through C listed below.&#10;&#10;Occurs last&#10;A)Cessation of respirations due to paralysis of diaphragm and intercostal muscles&#10;B)Total flaccid paralysis&#10;C)Weakness&#10;

Accepted Answer

The answer of MATCHING&#10;When a neuromuscular blocking drug is given,the...

Question 12

During the postoperative recovery period,what should be the nurse's immediate main concern?&#10;A)Pupil responses&#10;B)Return to sensation&#10;C)Level of consciousness&#10;D)Airway,breathing,and circulation

Accepted Answer

The answer of During the postoperative recovery period,what should be...

Question 13

MATCHING&#10;When a neuromuscular blocking drug is given,the effects occur in a certain order.Put the following drug effects in the proper order of occurrence,using the choices A through C listed below.&#10;&#10;Occurs second&#10;A)Cessation of respirations due to paralysis of diaphragm and intercostal muscles&#10;B)Total flaccid paralysis&#10;C)Weakness&#10;

Accepted Answer

The answer of MATCHING&#10;When a neuromuscular blocking drug is given,the...

Deck 12: General and Local Anaesthetics