Deck 11: Neuromuscular, sedative, anesthetic, and Analgesic Agents

Question 1

Respiratory complications of inhaled anesthetics include all of the following except:

A)A decreased depth of respiration.
B)An increased rate of respiration.
C)An increased ventilatory response to falling O₂ levels.
D)An alteration of the ventilatory response to rising CO₂ levels.

Answer 1

An increased ventilatory response to falling O₂ levels.

Question 2

Of the following,which NMBA would provide the longest duration and an onset of less than 5 minutes?

A)Norcuron
B)Mivacron
C)Anectine
D)Pavulon

Answer 2

Pavulon

Question 3

During your intubation rotation,you attend a surgical procedure that requires an NMBA that will last for 40 minutes.The anesthesiologist asks which agent you would select if you wanted to reduce cardiovascular side effects during the 40-minute procedure.Which of the following would you select?

A)Vecuronium
B)Pancuronium
C)Mivacurium
D)Doxacurium

Answer 3

Vecuronium

Question 4

Which of the following drugs would least likely be administered for sedation in the ICU?

A)Phenobarbital
B)Dexmedetomidine
C)Propofol
D)Lorazepam

Question 5

Which of the following factors determine the type of anesthetic medication a patient receives? I.Patient age
II)Medical condition
III)Drug allergy or sensitivity

A)I and II
B)I and III
C)II and III
D)I,II,and III

Question 6

Drugs that result in muscle relaxation by interfering with the reflex nerve pathway in the spinal cord include all of the following except:

A)Flexeril.
B)Parafon Forte.
C)Dantrium.
D)Robaxin.

Question 7

The point at which a nerve cannot accept further electrolyte transfer is known as:

A)Action potential.
B)Depolarization.
C)The refractory period.
D)Repolarization.

Question 8

Which of the following is a depolarizing NMBA?

A)Doxacurium
B)Mivacurium
C)Neostigmine
D)Succinylcholine

Question 9

Which of the following agents can be used to reverse a neuromuscular blockade? I.Succinylcholine
II)Neostigmine
III)Pyridostigmine

A)I and II
B)I and III
C)II and III
D)I,II,and III

Question 10

The drug of choice for a patient experiencing acute back pain would be:

A)Xanax.
B)Robaxin.
C)Diprivan.
D)Versed.

Question 11

The depth of anesthesia preferred during a bronchoscopy is:

A)Stage 1.
B)Stage 2.
C)Stage 3.
D)Stage 4.

Question 12

All of the following statements concerning Precedex are true except:

A)Precedex can be used for sedation of mechanically ventilated patients.
B)Precedex has a lower incidence of delirium.
C)Precedex stimulates central alpha₂ receptors.
D)Precedex has a high incidence of causing hypertension.

Question 13

A local anesthetic commonly used during bronchoscopy is:

A)Benzocaine
B)Ketamine
C)Diazepam
D)Lidocaine

Question 14

Which of the following is the drug of choice for rapid-sequence intubation and provision of paralysis because of its quick onset and short duration?

A)Pancuronium
B)Succinylcholine
C)Propofol
D)Versed

Question 15

All except which of the following drugs can cause loss of airway reflexes?

A)Rozerem
B)Diprivan
C)Lidocaine
D)Ketalar

Question 16

When acetylcholine is released into the synapses of skeletal muscles,contraction can take place only when which of the following is present?

A)Sodium
B)Calcium
C)Potassium
D)Chloride

Question 17

In which of the following stages of anesthesia would the patient progress to a state of complete respiratory depression?

A)Stage 1
B)Stage 2
C)Stage 3
D)Stage 4

Question 18

Local anesthetic medications are divided chemically into which of the following types? I.Caine
II)Amide
III)Ester

A)I and II
B)I and III
C)II and III
D)I,II,and III

Question 19

NMBAs are beneficial during mechanical ventilation for all except which of the following reasons?

A)Increased spontaneous breathing
B)Prevention of movement that can dislodge chest tubes
C)Reduced oxygen consumption
D)Improved patient-ventilator synchrony

Question 20

Successful paralysis with NMBAs is determined by all of the following methods except:

A)Monitoring for lack of patient movement.
B)Lab testing for a deficiency of pseudocholinesterase.
C)The use of a peripheral nerve stimulator.
D)The use of the train-of-four (TOF)technique.

Question 21

A mechanically ventilated patient in multiple system organ failure requires medication to decrease his oxygen consumption and spontaneous work of breathing.Which of the following agents would you recommend? I.Sedative
II)Continuous infusion of a NMBA
III)Opioid analgesic

A)I and II
B)I and III
C)II and III
D)I,II,and III TRUE/FALSE
Write 'T' if the statement is true and 'F' if the statement is false.

Question 22

Side effects of opioid analgesics include which of the following? I.Hallucinations
II)Seizures
III)Respiratory stimulation

A)I and II
B)I and III
C)II and III
D)I,II,and III

Question 23

______ 2.Nerve conduction occurs when there has been a transfer of electrolytes that causes cellular depolarization.

Question 24

______ 8.Inhaled anesthetics work by passing through the alveoli without crossing the blood-brain barrier.

Question 25

______ 5.NMBAs must be pharmacologically reversed when paralysis is no longer needed.

Question 26

______ 6.A side effect of skeletal muscle relaxants is drowsiness.

Question 27

Which of the following anesthetic agents is related to an increased incidence of postoperative nausea and vomiting?

A)Nitrous oxide
B)Lidocaine
C)Propofol
D)Midazolam

Question 28

______ 10.Tolerance is a state of adaptation in which exposure to a drug induces changes that result in diminution of one or more of the drug's effects over time.
FILL-IN-THE-BLANK
Write the word or phrase that best completes each statement.

Question 29

______ 4.NMBAs are used for their CNS effect in several clinical situations.

Question 30

______ 9.Inhaled anesthetics are used to rapidly induce a state of unconsciousness in a predictable way.

Question 31

Reversal of ventilatory depression caused by opioids is accomplished with which of the following?

A)Fentanyl
B)Naloxone
C)Doxapram
D)Protriptyline

Question 32

All except which of the following statements are true about opioids?

A)Morphine sulfate is classified as an opioid.
B)Opioid analgesics are regulated by the FDA.
C)Respiratory depression is not a side effect of opioids.
D)Opioid analgesics can be administered by epidural infusion.

Question 33

Patients suffering with chronic pain related to a decrease in circulating levels of serotonin and norepinephrine benefit from which of the following?

A)Topamax
B)Phenergan
C)Zoloft
D)Elavil

Question 34

Which of the following types of analgesic inhibits the arachidonic acid cascade,resulting in decreased production of leukotrienes and prostaglandins?

A)Opioids
B)Corticosteroids
C)NSAIDs
D)Anxiolytics

Question 35

______ 7.Benzodiazepines can cause loss of airway reflexes if administered at high doses.

Question 36

Vicodin,an effective analgesic,combines acetaminophen with which of the following?

A)Codeine
B)Hydrocodone
C)Morphine
D)Fentanyl

Question 37

______ 1.The portion of the nervous system that is responsible for respiratory muscle activity is the autonomic nervous system.

Question 38

Patients most likely to become addicted to the euphoric effects of opioids are those being treated:

A)During labor and delivery.
B)For malignant pain.
C)For pulmonary edema.
D)For myocardial infarction.

Question 39

______ 3.Agents that inhibit acetylcholinesterase cause increased acetylcholine at the muscle end plate and result in stimulation of the muscle.

Question 40

Medroxyprogesterone is most useful in which of the following conditions to stimulate ventilation?

A)Postanesthesia respiratory depression
B)Weaning from mechanical ventilation
C)Apnea of prematurity
D)Obstructive sleep apnea

Question 41

Describe "neuropathic pain" and give an example of the type of patients who may be affected by this type of pain.

Question 42

________________ can be categorized as sedatives,hypnotics,and anxiolytics.

Question 43

The ability of one drug to suppress the physical withdrawal produced by another drug is referred to as _______________.

Question 44

_______________NBMAs stimulate nonselective cholinergic receptors causing parasympathetic responses.

Question 45

A cell's ________________ refers to the electrical charge at which the cell becomes depolarized.

Question 46

Administration of a/an ________________ inhibitor will reverse neuromuscular blockade.

Question 47

The termination of the effect of an inhaled anesthetic is called the ________________.

Question 48

In order for the contractile proteins actin and myosin to interact _______________ must be available.

Question 49

Central-acting skeletal muscle relaxants decrease muscle tone by acting directly on ________________.

Question 50

Peripheral muscle relaxants work by preventing the release of ________________ at the motor end plate junction.

Question 51

Drugs that reduce CNS arousal are classified as ________________.

Question 52

A local anesthetic works by binding to a membrane site and preventing the neurons from ________________.

Question 53

How do peripheral muscle relaxants result in a decrease of the force of skeletal muscle contraction?

Question 54

Patients receiving NMBAs during mechanical ventilation frequently need to be medicated with ________________ because they can still feel pain and are alert.

Question 55

Explain the difference between nondepolarizing and depolarizing NMBAs.

Question 56

What are the different mechanisms of action for analgesic medications?

Question 57

________________ anesthetics make a specific region of the body insensitive to pain without loss of consciousness.

Question 58

The ________________ pathway is the site of action for analgesics.

Question 59

Why is Versed used during major and minor surgical procedures?

Question 60

Drugs used in combination to decrease the level of consciousness and produce a retrograde amnesia are referred to as ________________.