Deck 26: Anesthetics and Anesthesia Adjuncts

Question 1

The surgical nurse is preparing a novice nurse for the first day in the operating suite.Which comment by the surgical nurse best explains what can be expected when the client is given succinylcholine (Anectine)?

A)"We don't have to worry too much about the client's cardiovascular status on this drug."
B)"The client will rapidly lose consciousness with drug administration."
C)"The client will need assistance with breathing,as it paralyzes the muscles of respiration."
D)"We'll see that the effects of succinylcholine administration are much like those of atropine."

Answer 1

"The client will need assistance with breathing,as it paralyzes the muscles of respiration."

Question 2

A nurse assisting the health care provider with chest tube placement prepares lidocaine for which type of anesthesia administration near the insertion site?

A)A regional nerve block
B)Spinal
C)Epidural
D)Infiltration

Answer 2

Infiltration

Question 3

A client reports that the last time he received nitrous oxide for a procedure he had what felt like a hangover" for days afterward.Which intervention should the nurse plan to help avoid this effect?

A)Prehydrate the client with intravenous normal saline.
B)Report this comment to the anesthesiologist so he will change the agent used.
C)Provide the client with caffeine-containing beverages immediately after the procedure.
D)Have the client breathe 100% oxygen for several minutes following the nitrous oxide.

Answer 3

Have the client breathe 100% oxygen for several minutes following the nitrous oxide.

Question 4

Which is a priority outcome goal for a client who has received local anesthesia related to treatment of a musculoskeletal injury?

A)The client will describe the postoperative course of recovery prior to discharge.
B)The client will maintain adequate nutrition to promote wound healing.
C)The client will have a return of gag reflex prior to ingesting food or fluids.
D)The client will verbalize the need to refrain from activity that could cause injury due to paresthesia.

Question 5

Which assessment would indicate that surgical anesthesia has not been achieved for the client undergoing surgery with a general anesthetic?

A)Muscle rigidity
B)A reduction in heart rate
C)Slowed eye movements
D)Loss of consciousness

Question 6

Balanced anesthesia is the use of a combination of medications to produce general anesthesia.Which drugs may be used in combination?
Select all that apply.

A)Benzodiazepines
B)Neuromuscular blockers
C)Inhaled anesthetics
D)Proton-pump inhibitors
E)Intravenous anesthetics

Question 7

Preoperative adjunct medications are used for which reasons?
Select all that apply.

A)To reduce anxiety and facilitate sedation
B)To facilitate a faster recovery
C)To reduce the risk of aspiration pneumonia
D)To reduce the risk of a postoperative ileus
E)To manage pain

Question 8

The nursing instructor is explaining the drug lidocaine (Xylocaine)to nursing students who are about to enter their surgical rotation.Which information should be included?
Select all that apply.

A)Amides block sodium from entering the cell.
B)Lidocaine has a longer duration of action than many of the esters.
C)Amides have fewer side effects than do esters.
D)Lidocaine is a calcium blocker.
E)Lidocaine and cocaine are from the same drug class.

Question 9

The client is in stage 3 of general anesthesia,known as surgical anesthesia.The nurse anticipates which findings in this client's assessment?

A)Relaxation,stable respiration,and slow eye movements are present.
B)Breathing ceases.
C)Heart rate and breathing become irregular.
D)General sensation is lost.

Question 10

A pregnant woman has a lesion on her leg and will need surgery.She expresses concern about anesthesia.What is the best response by the nurse?

A)"You will most likely have local anesthesia; this will not affect the baby."
B)"You may choose to have an epidural or a spinal block,which will not affect your baby."
C)"There are newer general anesthetics that do not pose a risk to your baby."
D)"Inhalation anesthetics will be used,as they are safest for your baby."

Question 11

Which client effect would the nurse expect when nitrous oxide is administered?

A)Stage 3 anesthesia
B)Suppression of the pain mechanism
C)Total relaxation of skeletal muscles
D)A state of unconsciousness

Question 12

Which statement by the nurse would be part of a "best plan" to teach a client about anesthesia?

A)"An inhaled agent is used to induce sleep,followed by an intravenous agent to promote relaxation."
B)"An inhaled agent needs to be followed by an intravenous agent if the inhaled agent is not adequate."
C)"An intravenous agent will be used first to induce sleep; then an inhaled agent will be used."
D)"An intravenous agent to induce sleep is usually all that is required."

Question 13

For which client would the nurse anticipate the use of a local anesthetic?

A)A client with an umbilical hernia
B)A client scheduled for a laparoscopic cholecystectomy
C)A client scheduled for a repeat cesarean section
D)A client with a scalp laceration

Question 14

Midazolam (Versed)may be administered as part of surgical anesthesia.This drug is recognized as having which effects?
Select all that apply.

A)Producing effects consistent with those observed in administering other benzodiazepines
B)Reducing anxiety and stress associated with surgery
C)Producing central nervous system depression and skeletal muscle relaxation
D)Maintaining stable cardiac and respiratory activity
E)Preventing cardiac dysrhythmias

Question 15

A client has received local anesthesia of lidocaine (Xylocaine)with epinephrine for repair of a laceration.The nurse plans care based on the knowledge of which action of the epinephrine?

A)Constrict the blood vessels in the area to dramatically reduce bleeding,thus enhancing the operative field.
B)Constrict the blood vessels to extend the duration of the drug in the operative area.
C)Constrict the blood vessels to make the wound less distressing to the client and to promote relaxation.
D)Constrict the blood vessels in the area to reduce the transmission of pain signals to the central nervous system.

Question 16

The client is in stage 2 of general anesthesia.What is the priority nursing intervention?

A)Insert a urinary catheter.
B)Maintain a quiet and calm environment in the operating room suite.
C)Administer a surgical scrub to the operative site.
D)Assist the anesthesiologist in positioning the client on the operating room table.

Question 17

The anesthesiologist has listed succinylcholine (Anectine)as part of a client's anesthesia plan.Noting this,the nurse plans which as a priority assessment for this client?

A)Respiratory paralysis
B)Spontaneous bleeding
C)Anaphylactic shock
D)Emergence delirium

Question 18

The anesthesiologist elects to use an opioid as adjunct to anesthesia for pain relief.Because of the use of this drug,the nurse is more alert to monitor the client for which occurrence?

A)Risk for Addiction
B)Risk for Profound Hypotension
C)Risk for Respiratory Depression
D)Risk for Diaphragmatic Paralysis

Question 19

The client asks the nurse during preoperative teaching why he has to "receive so many drugs for such a simple procedure." How should the nurse explain the goal of using multiple agents to achieve general anesthesia?

A)This method decreases the dosages required for the various anesthetic agents.
B)Temporary amnesia can be produced in order for the client not to remember the procedure.
C)Use of multiple drugs reduces the pain the client feels postoperatively.
D)This method maintains a deep state of anesthesia during the procedure.

Question 20

A nurse who works in the operating room monitors clients for a number of effects of inhalation anesthesia.Which is the most dangerous of these effects?

A)Malignant hypertension
B)An increase in intracranial pressure
C)Malignant hyperthermia
D)Ventricular tachycardia

Question 21

A client has just been visited by the anesthesiologist who will provide anesthesia during the client's abdominal surgery the next day.The client says,I think I heard the doctor say something about hypnosis.I don't believe in all of that." How should the nurse respond?
Select all that apply.

A)Hypnosis is a standard method of relaxing the client before anesthesia is started."
B)That just means the drugs are going to make you unaware of what is happening."
C)The doctor needs to block all of your reflexes so the surgeon can do the surgery."
D)This is not the same as the kind of hypnosis you might see on television."
E)The doctors do not want you to remember the pain of your procedure."

Question 22

Which nursing action would be best to help a client clear nitrous oxide anesthesia from the system?

A)Run intravenous fluids at 125 mL/hr for several hours after the procedure.
B)Keep the client NPO for at least 2 hours after the procedure.
C)Have the client deep breathe several times each hour for several hours after the procedure.
D)Monitor urine output every hour for at least 4 hours after the procedure.

Question 23

During review of postoperative medical orders,the nurse notes an order for ondansetron (Zofran)prn.When would the nurse expect to administer this medication?
Select all that apply.

A)If the client has temperature elevation
B)If the client complains of nausea
C)Approximately 30 minutes before the end of the procedure
D)If the client reports breakthrough pain between regular pain medication administration
E)Just before the first dressing change

Question 24

During the admission assessment for a procedure in which propofol (Diprivan)will be administered,the client reports multiple food and drug allergies.Which allergies would be of greatest concern to the nurse?
Select all that apply.

A)Eggs
B)Milk
C)Wheat
D)Soybeans
E)Pineapple

Question 25

A novice nurse says,We want to keep our clients in stage 4 anesthesia during their surgery." How should the supervising nurse interpret this statement?
Select all that apply.

A)The novice nurse has made an error in this statement.
B)Stage 4 anesthesia is avoided.
C)This is a good description of the goal of anesthesia.
D)The novice nurse should have said stage 3 anesthesia.
E)A more accurate statement would be that the client is maintained in anxiolysis anesthesia.

Question 26

A nurse is admitting a client scheduled for a late afternoon procedure for which midazolam (Versed)will be administered.Which client statements should be reported to the anesthesiologist?
Select all that apply.

A)I was afraid I would be nervous and not be able to sleep last night,so I took one of my melatonin capsules."
B)The doctor said I could have a light breakfast.I hope a grapefruit and dry toast is light enough."
C)I didn't put my glaucoma drops in my eyes this morning."
D)When I had my last surgery,they gave me nitrous oxide."
E)I am allergic to eggs."

Question 27

Isoflurane (Forane)was administered as anesthesia for a client who had abdominal surgery.During postanesthesia recovery,the client begins to shiver.What should the nurse do?
Select all that apply.

A)Check the client's temperature.
B)Notify the anesthesiologist immediately.
C)Put warm blankets on the client.
D)Assure the client that shivering is common.
E)Administer prn pain medication.

Question 28

A nurse is interviewing a client who is scheduled for a surgical procedure using nitrous oxide.Which statement by the client is most important for the nurse to communicate to the surgeon?

A)I've never had any type of surgery before this."
B)The last surgery I had was done under spinal anesthesia."
C)I take St.John's wort daily to decrease my tendency toward depression."
D)I have a fear of enclosed spaces."

Question 29

A nurse is assessing a postoperative client who has a family history of malignant hyperthermia.Which findings would be of most concern to the nurse?
Select all that apply.

A)Mild spasms of the client's jaw muscles
B)Dark urine 3 hours after surgery
C)Tachycardia in the first hour after surgery
D)Temperature elevation 3 hours after the procedure
E)Respiratory rate increase to 18 breaths per minute 2 hours after the procedure

Question 30

A client is scheduled to have a procedure under anxiolysis sedation.Which assessment findings would the nurse evaluate as indicating this level of sedation has been reached?
Select all that apply.

A)Client needs airway support.
B)Respiratory effort is adequate.
C)Client can only be aroused with painful stimulation.
D)Cardiovascular function requires support.
E)Client remains responsive.

Question 31

Which clients would the nurse evaluate as unsuitable for the administration of fentanyl as anesthesia?
Select all that apply.

A)A 60-year-old with history of emphysema
B)A 17-year-old who sustained a head injury in a motor vehicle accident
C)A breast-feeding mother
D)A 58-year-old with type 2 diabetes mellitus
E)A 70-year-old with a history of ulcerative colitis

Question 32

Moderate sedation is planned for a client who will undergo a procedure.Which statements by the nurse would help the client understand this level of sedation?
Select all that apply.

A)You will be able to respond to us when we tap you on the shoulder."
B)You will have a breathing tube inserted in your throat through your mouth."
C)We will keep stimulating you to breathe."
D)This level of sedation shouldn't have any effect on your heart."
E)You will definitely be able to respond to us when we call your name."

Question 33

A client has had an unexpected reaction to propofol (Diprivan)and may be developing propofol infusion syndrome (PIF).What assessment findings are important for the nurse to relay to the client's health care provider?
Select all that apply.

A)The client's urinary output has fallen to almost nothing over the last 4 hours.
B)The client's urine is cola-colored.
C)The client's serum potassium level drawn an hour ago is low normal.
D)The client is complaining of right upper quadrant pain.
E)The client has a fever.