Deck 18: General Anesthetics

Question 1

Identify the part of the brain that influences mood,motivation,and the ability to perceive pain.

A) Hypothalamus
B) Thalamus
C) Medulla oblongata
D) Cerebral cortex

Answer 1

Hypothalamus

Question 2

Which of the following statements is true of the use of anticholinergic drugs as preanesthetic medications?

A) Anticholinergic drugs may be used to prevent hypoxia.
B) Anticholinergic drugs may be used to prevent the increase in salivary and bronchial secretions along the respiratory tracts.
C) Anticholinergic drugs may be used to improve the transfer of oxygen and anesthetic across the lungs.
D) All of these are correct.

Answer 2

All of these are correct.

Question 3

Which of the following statements is true of the action of the anesthetic agents nitrous oxide,propofol,and ketamine?

A) Nitrous oxide, propofol, and ketamine antagonize NMDA receptors, thereby blocking cation movement and depolarization.
B) Nitrous oxide, propofol, and ketamine bind to NMDA receptors and facilitate the movement of potassium ions out of a cell.
C) Nitrous oxide, propofol, and ketamine hyperpolarize the lipid membrane and open the chloride ion channel.
D) None of these are correct.

Answer 3

Nitrous oxide, propofol, and ketamine antagonize NMDA receptors, thereby blocking cation movement and depolarization.

Question 4

Which of the following anesthetics has an antiemetic effect on the patient?

A) Propofol
B) Methohexital
C) Ketamine
D) Etomidate

Question 5

Explain the mechanism of action of flumazenil.

A) Flumazenil inhibits glutamate, the excitatory neurotransmitter, in the brain.
B) Flumazenil depresses the neuronal nicotinic acetylcholine (ACH) receptors.
C) Flumazenil competitively inhibits the activity at the benzodiazepine recognition site on the GABA receptor.
D) None of these are correct

Question 6

Which of the following statements is true of the use of droperidol?

A) It produces the best antiemetic effect when it is administered at the start of a surgical procedure.
B) Its use has declined since its association with respiratory problems.
C) It is not administered to patients predisposed to developing cardiac arrhythmia
D) None of these are correct

Question 7

Which of the following statements is true of the effects of inhalation anesthetics on the cardiovascular system?

A) Desflurane, sevoflurane, and isoflurane do not cause a reduction in cardiac output.
B) Isoflurane and desflurane can cause transient bradycardia and hypotension through suppression of the sympathetic nervous system.
C) Desflurane, sevoflurane, and isoflurane cause a reduction in cardiac output.
D) Desflurane, sevoflurane, and isoflurane stimulate the peripheral vasculature to increase blood pressure.

Question 8

Select the correct statement about the stages of anesthesia.

A) During Stage I, the hypothalamus assumes control of body functions.
B) During Stage I, there is an inhibition of spinal reflexes and relaxation of skeletal muscle.
C) During Stage I, there is a decreased response to pain, a feeling of euphoria, and a loss of consciousness.
D) None of these are correct.

Question 9

Select the statement that best explains the reason why volatile anesthetics are the preferred agents for maintaining anesthesia in the operating room.

A) They do not affect the skeletal muscles.
B) They can be controlled to keep the patient oxygenated.
C) They have an antiemetic effect.
D) They have low blood:gas partition coefficients.

Question 10

Which of the following statements best explains the difference between induction of general anesthesia and maintenance of general anesthesia?

A) Induction of general anesthesia is the time required to take a patient from consciousness to Stage III of anesthesia, whereas maintenance of general anesthesia is the ability to keep a patient safely in Stage III of anesthesia.
B) Induction of general anesthesia is the time required to take a patient from Stage I to Stage III of anesthesia, whereas maintenance of general anesthesia is the ability to keep a patient safely in Stage III of anesthesia.
C) Induction of general anesthesia is the time required to take a patient from consciousness to Stage IV of anesthesia, whereas maintenance of general anesthesia is the ability to keep a patient safely in Stage IV of anesthesia.
D) Induction of general anesthesia is the time required to take a patient from Stage I to Stage IV of anesthesia, whereas maintenance of general anesthesia is the ability to keep a patient safely in Stage IV of anesthesia.

Question 11

Which of the following statements about volatile liquid anesthetics is false?

A) Most volatile liquid anesthetics stimulate mucus secretion.
B) Volatile liquid anesthetics must be administered intravenously.
C) Volatile liquid anesthetics relax bronchiolar smooth muscles.
D) Most volatile liquid anesthetics irritate the respiratory lining.

Question 12

Which of the following statements is true of the effect of benzodiazepines and barbiturates?

A) They produce a dose-dependent respiratory depression.
B) They decrease respiratory rate and tidal volume.
C) They may lead to a fatality that is secondary to respiratory depression when the patient overdoses.
D) All of these are correct.

Question 13

Select the primary reason why the use of ketamine would be contraindicated in patients with a history of hypertension.

A) Ketamine stimulates the sympathetic nervous system, leading to elevated blood pressure and heart rate during the anesthesia.
B) Ketamine competitively inhibits the activity at the benzodiazepine recognition site on the GABA receptor, leading to elevated blood pressure and heart rate.
C) Ketamine activates the alpha₂ adrenergic receptors in the CNS and inhibits sympathetic activity, resulting in increased blood pressure and heart rate.
D) None of these are correct.

Question 14

Identify the anesthetic agent that can be used for induction,maintenance,and MAC that produces very little respiratory and cardiovascular depression and increases blood pressure.

A) Propofol
B) Thiopental
C) Ketamine
D) Nitrous oxide

Question 15

Which of the following patients are most likely to be at risk if administered with inhalation general anesthetics?

A) A patient who is suffering from bronchitis
B) A patient who has a history of hypoxia
C) A patient who has increased intracranial pressure due to cerebral edema
D) A patient who has poor renal blood flow due to kidney disease

Question 16

Describe the objective of using anesthesia during surgical procedures.

A) Rapid, smooth induction and maintenance of the patient in Stage IV
B) Rapid, smooth induction and maintenance of the patient in Stage III
C) Rapid, smooth induction and maintenance of the patient in Stage II
D) None of these are correct.

Question 17

Select the true statement about the solubility characteristics of drugs.

A) The higher the blood:gas partition coefficient, the more soluble the drug is in the blood.
B) The more soluble anesthetics have a longer onset of action.
C) Volatile liquids have higher blood:gas partition coefficients.
D) All of these are correct.

Question 18

Which of the following instructions should be given to a patient after administering anesthesia?

A) Don't rely on memory for spoken instructions; follow written instructions.
B) Don't leave the health care facility unless accompanied by a responsible adult.
C) Don't operate complex equipment for at least 24 hours.
D) All of these are correct

Question 19

Select the statement that best explains the reason why propofol is the preferred agent for the induction and maintenance of anesthesia.

A) Propofol does not lead to the development of nausea and vomiting, nor does it accumulate in the tissues.
B) Propofol does not depress cardiovascular and respiratory activity.
C) Propofol does not fully depress the medulla, even in large doses.
D) None of these are correct.

Question 20

Select the reason why the neuromuscular blocking agent succinylcholine is the drug of choice for rapid sequence induction in adults.

A) Succinylcholine has a slow onset of action and a short duration of action, making it the paralytic of choice for rapid sequence induction.
B) Succinylcholine has a rapid onset of action and a long duration of action, making it the paralytic of choice for rapid sequence induction.
C) Succinylcholine has a rapid onset of action and an ultrashort duration of action, making it the paralytic of choice for rapid sequence induction.
D) None of these are correct.

Question 21

Francisca,an anesthesiologist,is assisting with a surgical procedure.The drug she chooses should induce anesthesia quickly and allow the patient to recover quickly.Francisca decides to use methohexital.Which of the following statements,if true,supports Francisca's choice?

A) The patient is undergoing neurosurgery.
B) The patient is susceptible to postoperative nausea and vomiting.
C) The patient is susceptible to laryngospasms.
D) The patient is undergoing a cardiac procedure.

Question 22

Which of the following anesthetics increases blood pressure?

A) Ketamine
B) Midazolam
C) Propofol
D) Methohexital

Question 23

A doctor is scheduled to perform an endoscopic procedure on a child.The anesthetic should have a rapid onset of action as the child is agitated.Which of the following anesthetics is the best choice in this scenario?

A) Midazolam
B) Diazepam
C) Propofol
D) Methohexital

Question 24

_____ is selected for patients with coronary artery disease or cardiomyopathy due to its cardiostability.

A) Etomidate
B) Desflurane
C) Ketamine
D) Midazolam

Question 25

_____ can be safely used in asthmatic patients.

A) Propofol
B) Methohexital
C) Midazolam
D) Ketamine

Question 26

Michelle,an anesthesiologist,is required to sedate a patient and limit the depressant effect of the anesthetic on the heart.She decides to use etomidate.Which of the following statements,if true,would make etomidate a poor choice?

A) The patient is undergoing liver transplantation.
B) The patient is susceptible to postoperative nausea and vomiting (PONV).
C) The patient is susceptible to cerebral ischemia.
D) The patient is undergoing a renal procedure.

Question 27

_____ is characterized by movement disorders such as akathasia,dystonia,and parkinsonism caused by antipsychotic drug therapy.

A) Extrapyramidal syndrome
B) Neuroleptic malignant syndrome
C) Reye's syndrome
D) Gardner's syndrome

Question 28

Select the true statement related to the use of the available inhaled anesthetics.

A) All of the inhalation anesthetics produce all stages of general anesthesia.
B) Nitrous oxide is not potent enough to maintain Stage III, Plane 3 anesthesia.
C) Nitrous oxide loses its analgesic effect when incorporated with other anesthetics.
D) None of these are correct.

Question 29

_____ is the anesthetic of choice for induction with an inhalation agent because it lacks pungency and does not promote secretion production.

A) Sevoflurane
B) Isoflurane
C) Propofol
D) Ketamine

Question 30

Air must be included in the anesthetic mixture when inhalation anesthetics are used to ensure that patients do not develop _____.

A) hypoxia
B) hypertension
C) hemoglobinuria
D) hyperglycemia

Question 31

_____ is the most pungent,strong airway irritant in conscious patients.

A) Desflurane
B) Sevoflurane
C) Droperidol
D) Dexmedetomidine

Question 32

The use of droperidol as a tranquilizer sedative has declined due to its association with _____.

A) cardiac arrhythmia
B) liver cirrhosis
C) bronchospasms
D) renal failure

Question 33

Saul is an anesthesiologist who is required to choose an inhalation anesthetic.The anesthetic must not have an irritating effect on the respiratory system of the patient.Saul decides to use sevoflurane.Which of the following statements explains the reason for his choice?

A) The patient's mucus secretions are to be suppressed during the surgical procedure.
B) The patient's blood pressure is to be decreased during the surgical procedure.
C) The patient is suffering from asthma.
D) The patient is suffering from hepatitis.

Question 34

Mark is administered an anesthesia for a surgical procedure.After the surgery,he experiences lethargy,fever,and nausea.His doctor tests for antibodies to trifluoroacetate bound to hepatocyte protein.If the doctor discovers the antibodies,the anesthetic used during the surgical procedure is _____.

A) desflurane
B) sevoflurane
C) etomidate
D) propofol

Question 35

Ketorolac is contraindicated in patients with a history of GI bleeding because it:

A) inhibits platelet function.
B) reduces RBC count.
C) increases intracranial pressure.
D) leads to cerebral ischemia.