Deck 19: Drugs for Local and General Anesthesia

Question 1

The nurse is preparing to assess a client in Stage 3 of general anesthesia. Which assessment findings should the nurse anticipate?

A) Irregular heart and respiratory rate
B) Loss of general sensation during consciousness
C) Temporary smooth muscle paralysis
D) Respiratory stabilization and slow eye movements

Answer 1

Respiratory stabilization and slow eye movements

Question 2

The nurse is preparing to assist a healthcare provider suture a laceration on a 2-year-old child. Prior to the procedure, which initial intervention should the nurse anticipate?

A) Wrapping the child in a blanket for restraint and safety during suturing
B) Applying a topical anesthetic prior to administering a local anesthetic with a needle
C) Administering a small dose of lorazepam (Ativan)
D) Requesting the parents to leave the room prior to the procedure

Answer 2

Applying a topical anesthetic prior to administering a local anesthetic with a needle

Question 3

Which is the priority nursing assessment for the client that has received succinylcholine (Anectine)?

A) Spontaneous bleeding
B) Respiratory paralysis
C) Anaphylactic shock
D) Delirium

Answer 3

Respiratory paralysis

Question 4

The nurse asks the educator how local anesthetics work. Which response should the educator provide the nurse?

A) Enhancing the influx of calcium into the cell
B) Occupy potassium receptors
C) Increase nerve impulse transmission
D) Block the sodium channels

Question 5

The nurse is preparing to assist with the repair of a laceration on a client with a history of a cardiovascular disorder. Which anesthesia should the nurse anticipate prescribed?

A) Benzocaine
B) Lidocaine
C) Lidocaine gel
D) Lidocaine with epinephrine

Question 6

A client with gastroesophageal reflux disease receives lidocaine viscous prior to an endoscopy. Which is the nurse's priority assessment after the procedure?

A) Assess for a return of the gag reflex.
B) Assess for nausea and vomiting.
C) Assess for any damage to the teeth or gums.
D) Assess for a headache.

Question 7

The nurse is caring for a client in Stage 2 of general anesthesia. Which is a priority nursing intervention?

A) Assist the anesthesiologist in repositioning the client.
B) Complete the surgical scrub.
C) Keep the environment quiet and calm.
D) Insert the indwelling urinary catheter.

Question 8

The nurse has provided education for a client prescribed a topical anesthetic. Which statements made by the client indicate an understanding of the information? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "This lotion should only be used on small areas of skin."
B) "I will wear gloves when I apply the lotion."
C) "This lotion will work well on cuts too."
D) "I will wash my hands before touching my eyes."
E) "I will be mindful of the expiration date on the prescription."

Question 9

The educator is preparing to discuss the classifications of local anesthetics. Which should the educator include when discussing amides? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Amides have fewer side effects than esters.
B) Amides block potassium entry into the cell.
C) Amides are similar in structure to cocaine.
D) Amides tend to last longer than esters.
E) Amides block calcium entry into the cell.

Question 10

A client asks the nurse why he or she will receive IV anesthesia before inhaled anesthesia. Which response should the nurse provide?

A) "The IV anesthesia will produce a rapid unconsciousness."
B) "The IV anesthesia is easier to reverse if adverse effects occur."
C) "The IV is used to administer large amounts of solutions required by the anesthesia."
D) "The IV is used to administer a volatile liquid that will help maintain a deep sleep."

Question 11

Which local anesthetic agent should the nurse recognize has the lowest rate of adverse effects?

A) Tetracaine (Pontocaine)
B) Procaine (Novocain)
C) Lidocaine (Xylocaine)
D) Chloroprocaine (Nesacaine)

Question 12

Which type of local anesthesia should the nurse anticipate will be administered to a laboring client?

A) Nerve block
B) Topical
C) Infiltration
D) Epidural

Question 13

The nurse understands that which client description is most desirable after the administration of general anesthesia prior to a surgical procedure?

A) The client is unconscious, with arm and leg movement.
B) The client is unresponsive to pain and is unable to breath spontaneously.
C) The client is unconscious with slow eye movements.
D) The client loses sensation, but remains awake.

Question 14

Which should the nurse understand is the purpose of the epinephrine added to local anesthetics?

A) Extension of the duration of the action of the local anesthetic
B) Decrease the amount of pain experienced
C) Promotion of patient relaxation
D) Promotion of blood flow to the area

Question 15

Which characteristics of sedation describe a client that has been administered general anesthesia?

A) A sleeping state that can be awakened easily
B) An unconscious state, without analgesia
C) A total loss of body movements
D) A conscious but sleepy state of being

Question 16

The nurse is preparing education for a client who will receive anesthesia for a surgical procedure. Which statement should the nurse include in the teaching?

A) "If the inhaled agent is ineffective, an intravenous agent will be administered."
B) "An inhaled agent is used to induce sleep, followed by an intravenous agent for relaxation."
C) "Usually all that is required is an intravenous agent to induce sleep."
D) "An intravenous agent will be initially administered to induce sleep followed by an inhaled agent."

Question 17

Which should the nurse monitor the client for who has received a volatile liquid inhalation anesthesia?

A) Hypertension
B) Pneumonia
C) Malignant hyperthermia
D) Increased intracranial pressure

Question 18

A pregnant client requiring a skin biopsy expresses concern about the anesthesia that will be administered. Which response should the nurse provide?

A) "You will most likely have an epidural so there is no risk to your baby."
B) "There are newer general anesthetics available that are safe for your baby."
C) "You will most likely receive local anesthesia so this will not affect your baby."
D) "Inhalation anesthetics are safe because they remain in your lungs and will not affect the baby."

Question 19

The educator is preparing to discuss the actions of succinylcholine (Anectine) with a nurse. Which information should the educator include?

A) "It causes the patient to rapidly lose consciousness."
B) "It increases cardiac output by raising the heart rate."
C) "It interferes with impulse transmission, resulting in total anesthesia from the pain of surgery."
D) "It reduces the amount of general anesthetic needed for procedures."

Question 20

For which client receiving an inhalation anesthesia should the nurse be most concerned?

A) A 15-year-old with diabetes mellitus
B) A 6-year-old with no chronic health problems
C) A 79-year-old with arteriosclerosis
D) A 55-year-old with a serious neck injury

Question 21

The nurse has provided teaching for a client prescribed viscous lidocaine for oral ulcerations. Which statement made by the client indicates further teaching is necessary?

A) "I can use a mouthwash after the use of the prescription."
B) "I will not chew or eat anything until I regain feeling."
C) "I will swish the prescription around my mouth before spitting it out."
D) "I can drink some water after I swallow the prescription."

Question 22

The nurse is reviewing the prescription history for a client scheduled for an operative procedure that will require the administration of succinylcholine (Anectine). Which prescription should the nurse find most concerning?

A) St. John's wort
B) Diazepam
C) Furosemide
D) Citalopram

Question 23

Which effects associated with the prescription of midazolam (Versed) should the nurse anticipate when administered as part of surgical anesthesia? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Effects consistent with those observed with other benzodiazepines
B) Reduction of anxiety and stress associated with surgery
C) Central nervous system depression and skeletal muscle relaxation
D) Maintenance of stable cardiac and respiratory activity
E) Absent cardiac dysrhythmias

Question 24

A client asks the nurse why he or she is receiving preoperative prescriptions. Which information should the nurse include in the education? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Reduce anxiety and facilitate sedation
B) Facilitation of a faster recovery
C) Reduce the risk of aspiration pneumonia
D) Reduce the risk of a postoperative ileus
E) Manage pain

Question 25

Which statements made by a client scheduled for an operative procedure for which isoflurane (Forane) will be administered should the nurse immediately report to the healthcare provider? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "I stopped taking my vitamin C supplement last week because it upset my stomach."
B) "I don't think my St. John's wort is helping my depression."
C) "I have not eaten anything since before my CT scan yesterday."
D) "My brother ran a high fever and had seizures after his surgery."
E) "My last dose of levodopa was yesterday."

Question 26

A client who has a history of severe arteriosclerosis requires a repair of a laceration. Which property contained in a local anesthetic should the nurse recognize is safe to administer to the client?

A) Epinephrine
B) Sodium bicarbonate
C) Benzocaine
D) Proparacaine (Alcaine)

Question 27

Which reflects the primary reason a neuromuscular blocking agent is used for a client receiving general anesthesia?

A) Potentiate analgesic effects
B) Prevent adverse effects associated with inhaled gases
C) Induce total skeletal muscle relaxation
D) Induce unconsciousness

Question 28

Which anatomical areas should be avoided when administering lidocaine with epinephrine? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Cheek
B) Earlobe
C) Tip of the nose
D) Top of the foot
E) Fingertip

Question 29

A client is suspected to have been overdosed with Propofol (diprivan). Which immediate nursing actions are indicated? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Increase the intravenous fluid rate.
B) Monitor the client for development of an allergic skin reaction.
C) Monitor the client for respiratory depression.
D) Obtain serum calcium levels.
E) Administer a benzodiazepine.

Question 30

Which prescriptions should the nurse anticipate to be included in balanced anesthesia? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Benzodiazepines
B) Neuromuscular blockers
C) Inhaled anesthetics
D) Proton-pump inhibitors
E) Intravenous anesthetics