Deck 11: General and Local Anesthetics

Question 1

During the immediate postoperative period, the Post Anesthesia Care Unit nurse is assessing a patient who had hip surgery. The patient is experiencing tachycardia, tachypnea, and muscle rigidity, and his temperature is 103° F ( 39.4° C ). The nurse will prepare for what immediate treatment?

A) naltrexone hydrochloride ( Narcan ) injection, an opioid reversal drug
B) dantrolene ( Dantrium ) injection, a skeletal muscle relaxant
C) An anticholinesterase drug, such as neostigmine
D) Cardiopulmonary resuscitation ( CPR ) and intubation

Answer 1

dantrolene ( Dantrium ) injection, a skeletal muscle relaxant

Question 2

MATCHING
When a neuromuscular blocking drug is given, the effects occur in a certain order. Put the drug effects in the correct order, using the choices A through C listed below.

A) Cessation of respirations due to paralysis of diaphragm and intercostal muscles
B) Total flaccid paralysis
C) Weakness

Answer 2

Total flaccid paralysis

Question 3

When administering a neuromuscular blocking drug such as pancuronium (Pavulon), the nurse needs to remember which principle?

A) It is used instead of general anesthesia during surgery.
B) Only skeletal muscles are paralyzed; respiratory muscles remain functional.
C) It causes sedation and pain relief while allowing for lower doses of anesthetics.
D) Artificial mechanical ventilation is required because of paralyzed respiratory muscles.

Answer 3

Artificial mechanical ventilation is required because of paralyzed respiratory muscles.

Question 4

A patient is to receive midazolam (Versed) 2 mg IV push over 2 minutes just before an endoscopy procedure. The medication is available in a strength of 5 mg/mL. How many milliliters of medication will the nurse draw up into the syringe for this dose?

Question 5

While monitoring a patient who had surgery under general anesthesia 2 hours ago, the nurse notes a sudden elevation in body temperature. This finding may be an indication of which problem?

A) Tachyphylaxis
B) Postoperative infection
C) Malignant hypertension
D) Malignant hyperthermia

Question 6

The nurse is preparing to administer dexmedetomidine (Precedex) to a patient. Which is an appropriate indication for dexmedetomidine? (Select all that apply.)

A) Procedural sedation
B) Surgeries of short duration
C) Surgeries of long duration
D) Postoperative anxiety
E) Sedation of mechanically ventilated patients

Question 7

During a fishing trip, a patient pierced his finger with a large fishhook. He is now in the emergency department to have it removed. The nurse anticipates that which type of anesthesia will be used for this procedure?

A) No anesthesia
B) Topical benzocaine spray on the area
C) Topical prilocaine ( EMLA ) cream around the site
D) Infiltration of the puncture wound with lidocaine

Question 8

MATCHING
When a neuromuscular blocking drug is given, the effects occur in a certain order. Put the drug effects in the correct order, using the choices A through C listed below.

A) Cessation of respirations due to paralysis of diaphragm and intercostal muscles
B) Total flaccid paralysis
C) Weakness

Question 9

MATCHING
When a neuromuscular blocking drug is given, the effects occur in a certain order. Put the drug effects in the correct order, using the choices

A) Cessation of respirations due to paralysis of diaphragm and intercostal muscles
B) Total flaccid paralysis
C) Weakness

Question 10

When assessing patients in the preoperative area, the nurse knows that which patient is at a higher risk for an altered response to anesthesia?

A) The 30-year-old patient who has never had surgery before
B) The 45-year-old patient who stopped smoking 10 years ago
C) The 21-year-old patient who is to have a kidney stone removed
D) The 78-year-old patient who is to have gallbladder removal

Question 11

A patient has been given succinylcholine (Anectine) after a severe injury that necessitated controlled ventilation. The physician now wants to reverse the paralysis. The nurse would expect to use which drug to reverse the succinylcholine?

A) valium (Diazepam)
B) caffeine
C) neostigmine (Prostigmin)
D) vecuronium (Norcuron)

Question 12

A patient is to receive local anesthesia for removal of a lymph node from his armpit. The physician asks for a solution of premixed lidocaine and epinephrine. The nurse knows that the epinephrine is used for which reason?

A) It prevents an anaphylactic reaction from occurring.
B) The anesthetic enhances the effect of the epinephrine.
C) Epinephrine contributes to a balanced anesthetic state.
D) It keeps the anesthetic at its local site of action and decreases incisional bleeding.

Question 13

During the immediate postoperative recovery period, what is the nurse's priority assessment?

A) Pupil responses
B) Return to sensation
C) Level of consciousness
D) Airway, breathing, and circulation

Question 14

A patient is undergoing abdominal surgery and has been anesthetized for 3 hours. Which nursing diagnosis would be appropriate for this patient?

A) Anxiety related to the use of an anesthetic
B) Risk for injury related to increased sensorium from general anesthesia
C) Decreased cardiac output related to systemic effects of local anesthesia
D) Impaired gas exchange related to central nervous system depression produced by general anesthesia

Question 15

A patient is being prepared for an oral endoscopy, and the nurse anesthetist reminds him that he will be awake during the procedure but probably will not remember it. What type of anesthetic technique is used in this situation?

A) Local anesthesia
B) Moderate sedation
C) Topical anesthesia
D) Spinal anesthesia