Question 1

A patient will receive isoflurane (Forane) as an anesthetic for a surgical procedure. The nurse caring for this patient during the perioperative period knows that, unlike halothane, this agent will not cause:

A) myocardial depression.
B) muscle relaxation.
C) rapid induction.
D) respiratory depression.

myocardial depression.

Accepted Answer

Isoflurane does not cause myocardial depression and does not reduce cardiac output. Isoflurane actually produces more muscle relaxation than halothane. Induction with isoflurane is rapid. Isoflurane causes respiratory depression, as do all inhalation anesthetics.

Question 2

A patient will receive intravenous midazolam (Versed) combined with fentanyl while undergoing an endoscopic procedure. The nurse is explaining the reasons for this to a nursing student before the procedure. Which statement by the student indicates understanding of the teaching?

A) "The patient may appear anxious and restless during the procedure."
B) "The patient will be unconscious during the procedure."
C) "The patient will not need cardiorespiratory support during the procedure."
D) "The patient will not remember the procedure."

"The patient will not remember the procedure."

Accepted Answer

Midazolam, combined with an opioid analgesic, is used for conscious sedation for minor surgeries and endoscopic procedures. It does not cause anesthesia during this state, which is characterized by sedation, analgesia, amnesia, and lack of anxiety. The patient will not remember the events even though the person will be able to respond to commands during the procedure. The patient will appear unperturbed and passive and not anxious or restless. The patient is sedated, not unconscious. Midazolam can cause dangerous cardiorespiratory effects, including respiratory depression and respiratory and cardiac arrest.

Question 3

An anesthesiologist completes preoperative teaching for a patient the night before surgery. The patient asks the nurse to clarify the reason thiopental sodium will be given as an adjunct to the anesthetic. Which statement by the patient indicates understanding?

A) "Pentothal allows a larger amount of inhaled anesthetic to be used without increased side effects."
B) "Pentothal is given to enhance the analgesic and muscle relaxation effects of the inhaled anesthetic."
C) "Pentothal is used to produce rapid unconsciousness before administration of the inhaled anesthetic."
D) "Pentothal is used to reduce cardiovascular and respiratory depression caused by the inhaled anesthetic.

Accepted Answer

Thiopental sodium, a short-acting barbiturate, is given intravenously for induction of anesthesia. It has a rapid onset and short duration and must be followed immediately by an inhalation anesthetic. It does not alter the side effects of inhalation anesthetics. Most adjuncts to inhalation anesthetics are given so that lower doses of the anesthetic may be used. Thiopental sodium has very weak analgesic and muscle relaxation effects. Thiopental sodium causes cardiovascular and respiratory depression.

Question 4

A surgical patient is receiving succinylcholine (Anectine) with an inhalation anesthetic. The patient is intubated, has an indwelling urinary catheter, and has ongoing monitoring of vital signs. Which symptom during the perioperative period is cause for concern?

A) Elevated temperature
B) Increased urine output
C) Muscle paralysis
D) No response to painful stimuli

Accepted Answer

Combining succinylcholine (a skeletal muscle relaxant) with an inhalation anesthetic increases the risk of malignant hyperthermia. The mechanism is not understood. Temperature elevation can be profound, and cooling measures must be initiated or the condition can be fatal. A decrease in urine output would be a sign of hypotension. Muscle paralysis and lack of response to pain are desired effects of anesthesia.

Question 5

A postoperative patient is reporting pain as a 7 on a scale from 1 to 10, with 10 being the worst pain. The nurse caring for the patient assesses vital signs of HR, 76; RR, 16; and BP, 110/70. The patient has vomited twice. Which postoperative medications will the nurse expect to administer?

A) Atropine and morphine
B) Bethanechol and ibuprofen
C) Morphine and ondansetron (Zofran)
D) Promethazine and clonidine (Catapres)

Accepted Answer

This patient is experiencing postoperative symptoms of moderate to severe pain and nausea and vomiting. Morphine is used postoperatively for this degree of pain, and ondansetron is one of the most effective antiemetics. Atropine is an anticholinergic drug and usually is given preoperatively or perioperatively to prevent bradycardia. Bethanechol is a muscarinic agonist that is used to counter postoperative abdominal distention and urinary retention. Ibuprofen can be used, but it is effective only for mild postoperative pain. Promethazine is less effective as an antiemetic and can be used, but clonidine, marketed as Catapres, is used for postoperative hypertension.

Question 6

A nurse administers atropine to a patient before induction of anesthesia for a surgical procedure. When evaluating the effects of this medication, the nurse will:&#10;A) assess for excessive bronchial secretions.&#10;B) expect a reduction in the patient's anxiety.&#10;C) monitor the patient's heart rate.&#10;D) observe for muscle paralysis.

Accepted Answer

Anticholinergic drugs, such as atropine (Sal-Tropine), may be given to reduce the risk of bradycardia during surgery. Atropine can alter bronchial secretions, but the effect would be to reduce them, not increase them. It is not used to reduce anxiety. It does not cause muscle paralysis.

Question 7

A patient in the postanesthesia recovery unit received ketamine (Ketalar) for right open reduction internal fixation surgery. What drug would be beneficial as a premedication to help minimize adverse reactions?

A) Thiopental sodium (Pentothal)
B) Sevoflurane (Ultane)
C) Atropine (Sal-Tropine)
D) Diazepam (Valium)

Accepted Answer

To minimize the effects of ketamine, the patient should be premedicated with diazepam or midazolam to reduce the risk of an adverse reaction. Thiopental sodium would further sedate the patient. Sevoflurane would further complicate sedation and would not be indicated. Atropine would not reduce the risk of an adverse reaction.

Question 8

A postoperative patient complains of abdominal bloating and discomfort. The nurse caring for this patient will contact the provider to request which medication?&#10;A) Bethanechol&#10;B) Droperidol&#10;C) Promethazine&#10;D) Ondansetron

Accepted Answer

Bethanechol is a muscarinic agonist that is used to treat abdominal distention and urinary retention. The other three agents are antiemetics and would not be useful in this situation.

Question 9

A patient is given nitrous oxide, along with another inhalation anesthetic. The nurse knows that the benefits of nitrous oxide include what? (Select all that apply.)&#10;A) It is a potent analgesic.&#10;B) It has high anesthetic potency.&#10;C) It is less likely to cause nausea and vomiting.&#10;D) It is less likely to precipitate malignant hyperthermia.&#10;E) It can significantly reduce the dose of inhalation anesthetic.

Accepted Answer

Nitrous oxide is an inhalation agent with high analgesic potency. It is not likely to precipitate malignant hyperthermia. It can significantly reduce the dose of the primary anesthetic by as much as 50% or more. It does not have high anesthetic potency, so it cannot be used alone to induce anesthesia. It is more likely to cause postoperative nausea and vomiting.

Question 10

A preoperative patient receives atropine before induction of anesthesia. The nurse caring for this patient understands that this agent is used to prevent:&#10;A) anxiety.&#10;B) bradycardia.&#10;C) dry mouth.&#10;D) hypertension.

Accepted Answer

Atropine, an anticholinergic drug, is used as an adjunct to anesthesia to counter the effects of vagal stimulation, which is caused by surgical manipulations that trigger parasympathetic reflexes, resulting in bradycardia. Atropine is not an anxiolytic. Atropine causes dry mouth and sometimes is used to minimize bronchial secretions when irritating inhalation anesthetics are used. It is not used as an antihypertensive agent.

Question 11

A patient receives a neuromuscular blocking agent as an adjunct to inhalation anesthesia. When caring for this patient, it is important for the nurse to remember that neuromuscular blocking agents:&#10;A) cause vagal slowing of the heart.&#10;B) increase the required dose of inhalation anesthetics.&#10;C) increase the depth of unconsciousness.&#10;D) prevent contraction of the diaphragm.

Accepted Answer

The answer of A patient receives a neuromuscular blocking agent...

Question 12

A nurse is teaching nursing students about inhalation anesthesia and asks, &#34;What is balanced anesthesia?&#34; Which response by a student is correct?&#10;A) &#34;An anesthesia that has a brief induction period with a rapid emergence from its effects.&#34;&#10;B) &#34;An inhalation anesthesia that produces both muscle relaxation and unconsciousness.&#34;&#10;C) &#34;An anesthesia that provides maximum analgesia with minimal respiratory side effects.&#34;&#10;D) &#34;An anesthesia that combines other drugs with inhalation anesthesia to produce the desired effects.&#34;

Accepted Answer

The answer of A nurse is teaching nursing students about...

Deck 27: General Anesthetics