Deck 30: Anesthetics and Anesthesia Adjuncts

Question 1

The student nurse asks the instructor how succinylcholine (Anectine)works.Which of the following would be the best response?
1)"The client's cardiac muscle is impacted, as are the respiratory muscles."
2)"The client will need assistance with breathing, as it paralyzes the muscles of respiration."
3)"The client will rapidly lose consciousness with drug administration."
4)"The client will require continuous electronic cardiac rhythm monitoring."

Answer 1

2

Question 2

Following spinal administration, which of the following adverse effects is a common occurrence?
1)Hemorrhage
2)Headache
3)Hypertension
4)Delayed healing

Answer 2

2

Question 3

The purpose of nitrous oxide for the surgical patient is to:
1)Provide total relaxation of skeletal muscles.
2)Induce a state of unconsciousness.
3)Cause analgesia by suppressing the pain mechanism in the central nervous system.
4)Induce stage 3 anesthesia in preparation for surgical procedure.

Answer 3

3

Question 4

A pregnant client is dilated to 7 centimeters, and requests an epidural anesthetic.The nurse understands the primary risk of epidurally administered anesthetic for this patient is:
1)Infection.
2)Spinal headache.
3)Hypotension.
4)Inadequate pain relief.

Question 5

Which assessment would indicate that surgical anesthesia has not been achieved for the client undergoing a general surgery?
1)Muscle rigidity
2)Loss of consciousness
3)A reduction in heart rate
4)Slowed eye movements

Question 6

A potential adverse side effect of using opioids as an adjunct to anesthesia is related to:
1)Risk for addiction.
2)Risk for respiratory depression.
3)Risk for profound hypotension.
4)Risk for diaphragmatic paralysis.

Question 7

The client is now in stage 2 of general anesthesia.What is the priority nursing intervention at this time?
1)Assist the anesthesiologist in positioning the patient on the operating room table.
2)Insert a Foley catheter.
3)Administer a surgical scrub to the operative site.
4)Maintain an environment of quiet and calm in the operating room suite.

Question 8

Balanced anesthesia is the use of a combination of medications to produce general anesthesia.Which of the following may be used in combination? Select all that apply.
1)Neuromuscular blockers
2)Benzodiazepines
3)Short-acting barbiturates
4)Inhaled anesthetics
5)Intravenous anesthetics

Question 9

The client asks the nurse during preoperative teaching why he has to "receive so many drugs for such a simple procedure." The nurse explains that the goal of using multiple agents to achieve general anesthesia is to:
1)Produce temporary amnesia in order for the patient not to remember the procedure.
2)Decrease the dosages required for the various anesthetic agents.
3)Reduce the pain the patient feels postoperatively.
4)Maintain a deep state of anesthesia during the procedure.

Question 10

Preoperative adjunct medications are used for which of the following? Select all that apply.
1)To reduce the risk of aspiration pneumonia
2)To reduce anxiety and facilitate sedation
3)To facilitate a faster recovery
4)To reduce the risk of a postoperative ileus

Question 11

A pregnant woman has a malignant melanoma on her leg, and will need surgery.She is concerned about anesthesia.What is the best response by the nurse?
1)"You will most likely have local anesthesia; this will not affect the baby."
2)"There are newer general anesthetics that do not pose a risk to your baby."
3)"You may choose to have an epidural or a spinal block, which will not affect your baby."
4)"Inhalation anesthetics will be used, as they are safest for your baby."

Question 12

Which client is most likely to experience an adverse reaction to inhalation anesthesia?
1)A 15-year-old with diabetes mellitus
2)A 6-year-old with no chronic health problems
3)A 55-year-old with a serious neck injury
4)A 79-year-old with arteriosclerosis

Question 13

The client is scheduled for a surgical procedure.The nurse plans to teach the patient about anesthesia.Which statement included by the nurse would be part of a "best plan?"
1)"An intravenous agent will be used first to induce sleep; then an inhaled agent will be used."
2)"An intravenous agent to induce sleep is usually all that is required."
3)"An inhaled agent is used to induce sleep, followed by an intravenous agent to promote relaxation."
4)"An inhaled agent needs to be followed by an intravenous agent if the inhaled agent is not adequate."

Question 14

For which client would the nurse anticipate the use of a topical anesthetic?
1)A client with a scalp laceration
2)A client with an umbilical hernia
3)A client scheduled for a repeat cesarean section
4)A client scheduled for a laparoscopic cholecystectomy

Question 15

Midazolam (Versed)may be administered as part of surgical anesthesia.This drug is recognized as having which of the following effects? Select all that apply.
1)Reducing anxiety and stress associated with surgery
2)Preventing cardiac dysrhythmias
3)Maintaining stable cardiac and respiratory activity
4)Producing central nervous system depression and skeletal muscle relaxation
5)Producing effects consistent with those observed in administering other benzodiazepines

Question 16

The client is now in stage 3 of general anesthesia, known as surgical anesthesia.What will the best assessment by the nurse reveal?
1)Relaxation, stable respiration, and slow eye movements
2)Heart rate and breathing become irregular.
3)The medulla region of the brain is paralyzed.
4)Eye movements are slow, and general sensation is lost.

Question 17

Identify a priority outcome goal for a client who has received local anesthesia related to treatment of a musculoskeletal injury.
1)Client will have a return of gag reflex prior to ingesting food or fluids.
2)Client will maintain adequate nutrition to promote wound healing.
3)Client will refrain from activity that could cause injury due to paresthesia.
4)Client will describe the postoperative course of recovery prior to discharge.

Question 18

The nursing instructor teaches the nursing students about the advantages of newer local anesthetics.While teaching the nursing students about lidocaine (Xylocaine), the instructor would include which of the following? Select all that apply.
1)Amides block potassium from entering the cell.
2)Amides are similar in construction to cocaine.
3)Amides have fewer side effects than do esters.
4)Amides tend to last longer than do esters.
5)Amides block calcium from entering the cell.

Question 19

As a nurse working in the operating room, what is the most dangerous effect of inhalation anesthesia for which you must constantly be alert?
1)Ventricular tachycardia
2)An increase in intracranial pressure
3)Malignant hypertension
4)Malignant hyperthermia

Question 20

The nurse assisting with chest tube placement notes the physician injecting lidocaine near the insertion site.This technique of anesthesia administration is known as:
1)A regional nerve block.
2)Epidural.
3)Spinal.
4)Infiltration.

Question 21

The client is administered succinylcholine (Anectine).The nurse's priority assessment would be:
1)Spontaneous bleeding.
2)Emergence delirium.
3)Anaphylactic shock.
4)Respiratory paralysis.

Question 22

A client is being treated for a serious laceration of his forearm.He has received local anesthesia of lidocaine (Xylocaine)with epinephrine.The purpose of the epinephrine in this situation is to:
1)Constrict the blood vessels in the area to dramatically reduce bleeding, thus enhancing the operative field.
2)Constrict the blood vessels in the area to reduce the transmission of pain signals to the central nervous system.
3)Constrict the blood vessels to extend the duration of the drug in the operative area.
4)Constrict the blood vessels to make the wound less distressing to the patient and to promote relaxation.

Question 23

The nurse determines the client can safely apply a topical anesthetic to treat a skin condition when the client makes which of the following statement(s)? Select all that apply.
1)"I must wash my hands after application to remove any remaining topical anesthetic."
2)"If my skin doesn't get better and the area enlarges, I will need to call my doctor."
3)"If I cut myself, I can apply this lotion to decrease the pain."
4)"I can use this lotion until it is completely gone, even if the expiration date is past."
5)"I need to wear gloves when I apply this medication, or I can wrap my hand in clear plastic wrap if I don't have gloves."