Deck 18: General Anesthetics

Question 1

Identify the anesthetic agent that can be used for induction,maintenance,and MAC that does not depress respiratory and cardiovascular function or relax skeletal muscle.

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

Answer 1

Ketamine

Question 2

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.

Answer 2

Succinylcholine has a rapid onset of action and an ultrashort duration of action, making it the paralytic of choice for rapid sequence induction.

Question 3

Differentiate between the available inhaled anesthetics,and select the true statement related to their use.

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) The standard reference for inhaled anesthetics is MAC or median minimum alveolar concentration that keeps 75 percent of the patients from moving in response to a surgical stimulus (e.g., incision).
D) None of these are correct.

Answer 3

Nitrous oxide is not potent enough to maintain Stage III, Plane 3 anesthesia.

Question 4

Using the physiological effects of the injected benzodiazepine and barbiturate anesthetic agents on the respiratory system,select the true statement.

A) Benzodiazepines and barbiturates produce a dose-dependent respiratory depression.
B) Benzodiazepines and barbiturates decrease respiratory rate and tidal volume.
C) Patients with underlying chronic obstructive pulmonary disease are more susceptible to respiratory depression from the use of benzodiazepine and barbiturate anesthetic agents, even at doses that would be considered therapeutic in healthy individuals.
D) All of these are correct.

Question 5

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

A) Ketamine stimulates the sympathetic nervous system, so blood pressure and heart rate may be elevated 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 6

Select the true statement based on the physiological effects of the inhaled anesthetic agents 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 7

Explain the mechanism of action of flumazenil (Romazicon).

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

Question 8

Select the true statement related to the MOA of the antiemetic agent droperidol.

A) Droperidol occupies the postsynaptic GABA receptor so that serotonin accumulates in the synapse. This alters the normal balance between serotonin and dopamine and inhibits chemoreceptor trigger zone transmission to the vomiting center in the brain.
B) Droperidol occupies the postsynaptic GABA receptor so that acetylcholine accumulates in the synapse. This alters the normal balance between acetylcholine and dopamine and inhibits chemoreceptor trigger zone transmission to the vomiting center in the brain.
C) Droperidol occupies the postsynaptic GABA receptor so that dopamine accumulates in the synapse. This alters the normal balance between acetylcholine and dopamine and inhibits chemoreceptor trigger zone transmission to the vomiting center in the brain.
D) None of these are correct

Question 9

Select the statement that best explains the reason why propofol is the preferred agent used 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 contributes to an increase in blood pressure in patients who suffer from hypotension.
D) None of these are correct.

Question 10

Using the physiological effects of the inhaled anesthetic agents on the CNS,select the true statement.

A) All nervous tissue is not depressed by inhalation anesthetics.
B) The inhaled anesthetic agents constrict cerebral blood vessels.
C) The inhaled anesthetic agents might not be a good choice for use in patients who already have increased intracranial pressure from cerebral edema or tumors.
D) None of these are correct.

Question 11

Explain the mechanism of 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 while enhancing the opioid mu receptors.
B) Nitrous oxide, propofol, and ketamine potentiate NMDA receptors, thereby increasing cation movement and hyperpolarization with no effect on the opioid mu receptors.
C) Nitrous oxide, propofol, and ketamine antagonize NMDA receptors, thereby blocking cation movement and depolarization while suppressing the opioid mu receptors.
D) None of these are correct.

Question 12

Describe the physiological effect that results from the administration of an anticholinergic agent prior to the administration of general anesthetic agents.

A) Anticholinergic drugs may be used as preanesthetic medications to prevent hypoxia.
B) Anticholinergic drugs may be used as preanesthetic medications to prevent the increase in salivary and bronchial secretions induced by some anesthetics.
C) Anticholinergic drugs may be used as preanesthetic medications to improve the transfer of oxygen and anesthetic across the lungs.
D) All of these are correct.

Question 13

Compare the volatile liquid anesthetic agents,and select the false statement related to their use.

A) The volatile liquid anesthetic agents include enflurane (Ethrane), desflurane (Suprane), halothane (Fluothane), isoflurane (Forane), and sevoflurane (Ultane).
B) The volatile liquid anesthetic agents must be administered by intravenous injection.
C) The volatile liquid anesthetic agents are delivered to the alveoli and then to the blood for distribution to the tissues.
D) All of these are correct.

Question 14

Describe the therapeutic objective of the use of 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 15

Select the true statement based on the solubility characteristic also known as the blood:gas partition coefficient.

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 because they require more anesthetic to dissolve in the blood before enough drug molecules are available to
C) cross into the brain, where they can modulate neuronal membranes to produce a state of anesthesia.
D) Nitrous oxide, desflurane, and sevoflurane have blood:gas partition coefficients that are less than the blood:gas partition coefficients of halothane and enflurane.
E) All of these are correct.

Question 16

Select the correct statement using facts related to the stages of anesthesia.

A) During Stage I, there is a decreased response to pain (analgesia) and inhibition of spinal reflexes.
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 (analgesia), a feeling of euphoria (well-being or elation), and a loss of consciousness (sleep).
D) None of these are correct.

Question 17

Using the side-effect profile of the general anesthetics,select the anesthetic agent that would have an antiemetic effect on the patient.

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

Question 18

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

A) The volatile anesthetics are easy to administer, have the benefit of not causing PONV, and can be controlled by the anesthesiologist as needed to keep the patient oxygenated and away from medullary depression.
B) The volatile anesthetics are easy to administer, have the benefit of additional skeletal muscle relaxation, and can be controlled by the anesthesiologist as needed to keep the patient oxygenated and away from medullary depression.
C) The volatile anesthetics are easy to administer, have the benefit being antiemetics, and can be controlled by the anesthesiologist as needed to keep the patient oxygenated and away from medullary depression.

Question 19

Using the do's and don'ts that the patient should be made aware of after surgical procedures using anesthesia,select the true statement.

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 20

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