Deck 19: Drugs for Local and General Anesthesia

Question 1

Local anesthetics work by
1)enhancing the influx of calcium into the cell.
2)occupying potassium receptors.
3)increasing nerve impulse transmission.
4)blocking sodium channels.

Answer 1

4

Question 2

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

Answer 2

4

Question 3

Which of the following correctly identifies the initial use for an IV in a patient undergoing a lengthy abdominal surgery that requires general anesthesia?
1)To administer agents that will produce rapid unconsciousness
2)To administer reversal agents or other medications used to treat the adverse effects associated with general anesthesia
3)To administer large amounts of colloid solutions following surgical blood loss
4)To administer a volatile liquid that will keep the patient asleep

Answer 3

1

Question 4

Which clinical technique for administering anesthesia is common for pregnant women during labor and delivery?
1)Nerve block
2)Topical
3)Infiltration
4)Epidural

Question 5

The patient has gastroesophageal reflux disease and receives lidocaine viscous prior to an endoscopy.What will the best assessment of the nurse include immediately after the procedure?
1)Assess for a return of the gag reflex.
2)Assess for nausea and vomiting.
3)Assess for any damage to the teeth or gums.
4)Assess for a headache.

Question 6

Which of the following correctly identifies a state of general anesthesia desirable for surgery?
1)The patient is unconscious,with arm and leg movement.
2)The patient is not responsive to pain,and has no spontaneous breathing.
3)The patient is unconscious with slow eye movements.
4)The patient loses sensation,but is awake.

Question 7

The patient has a serious laceration to the arm.The patient receives a local anesthetic mixed with epinephrine prior to suturing.What does the nurse recognize as the rationale for the epinephrine?
1)Constricted blood vessels will extend the duration of action of the drug.
2)Constricted blood vessels will decrease the amount of pain experienced.
3)Constricted blood vessels will promote relaxation of the patient.
4)Constricted blood vessels will result in decreased bleeding.

Question 8

The 2-year-old child comes to the emergency department with a laceration to the lower leg.The physician plans to use a local anesthetic,but the child screams at the sight of the needle.What is the best action by the nurse?
1)Wrap the child in a blanket to restrain him and ensure safety during suturing.
2)Rub a local anesthetic cream on the skin so the child will not feel the needle.
3)Administer a small dose of a medication such as lorazepam (Ativan).
4)Ask the parents to leave the room so the child will quiet down.

Question 9

The patient receives succinylcholine (Anectine).What will be a priority assessment by the nurse?
1)Spontaneous bleeding
2)Respiratory paralysis
3)Anaphylactic shock
4)Delirium

Question 10

Which of the following local anesthetic agents would be considered first due to its lower rate of adverse effects?
1)Tetracaine (Pontocaine)
2)Procaine (Novocain)
3)Lidocaine (Xylocaine)
4)Chloroprocaine (Nesacaine)

Question 11

What does the nurse recognize as the most dangerous adverse effect of inhalation anesthesia?
1)Hypertension
2)Ventricular tachycardia
3)Malignant hyperthermia
4)Increased intracranial pressure

Question 12

The student nurse does an operating room rotation and notes that many patients receive succinylcholine (Anectine).The student nurse asks the nursing instructor how the drug works.What is the best response by the nursing instructor?
1)"The patient will rapidly lose consciousness when this drug is administered."
2)"The patient's cardiac muscle will be impacted as well as the respiratory muscles."
3)"The patient will need to be monitored with an electrocardiogram (ECG)."
4)"The patient will need assistance with breathing;it paralyzes respiratory muscles."

Question 13

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 probably have an epidural,and this won't harm your baby."
2)"There are newer general anesthetics available that are safe for your baby."
3)"You will most likely have local anesthesia;this will not affect your baby."
4)"Inhalation anesthetics are safe because they remain in your lungs."

Question 14

The nursing instructor teaches the nursing students about the advantages of the newer local anesthetics,such as lidocaine (Xylocaine).What will the best plan of the nursing instructor include? Credit will be given only if all correct choices and no incorrect choices are selected.
1)Amides have fewer side effects than esters.
2)Amides block potassium entry into the cell.
3)Amides are similar in structure to cocaine.
4)Amides tend to last longer than esters.
5)Amides block calcium entry into the cell.

Question 15

Which statement correctly identifies why epinephrine is used with local anesthetic agents?
1)Epinephrine use produces higher analgesia levels.
2)Epinephrine use prolongs surgical time.
3)Epinephrine use lowers the risk of bacterial infection.
4)Epinephrine use reduces the occurrence of hypertension.

Question 16

Which patient 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 79-year-old with arteriosclerosis
4)A 55-year-old with a serious neck injury

Question 17

The nurse teaches the patient about the correct use of a topical anesthetic for a skin condition.The nurse determines that learning has occurred when the patient makes which statement(s)? Credit will be given only if all correct choices and no incorrect choices are selected.
1)"This lotion should only be used on small areas of skin."
2)"I must wear gloves when I apply the lotion."
3)"This lotion works well on cuts too."
4)"I must wash my hands before touching my eyes."
5)"It's all right to use a lotion after the expiration date."

Question 18

Which of the following correctly identifies a sign of general anesthesia?
1)A sleeping state that can be awakened easily
2)An unconscious state,without analgesia
3)A total loss of body movements
4)A conscious but sleepy state of being

Question 19

The patient is scheduled for a surgical procedure.The nurse plans to teach the patient about anesthesia.Which statement would be included in the best plan of the nurse?
1)"An inhaled agent needs to be followed by an intravenous (IV)agent if it is ineffective."
2)"An inhaled agent is used to induce sleep,followed by an intravenous (IV)agent for relaxation."
3)"An intravenous (IV)agent to induce sleep is usually all that is required."
4)"An intravenous (IV)agent will be used first to induce sleep;then,an inhaled agent will be used."

Question 20

The patient is in Stage 2 of general anesthesia.What are the priority nursing interventions at this time?
1)Assist the anesthesiologist in repositioning the patient.
2)Complete the surgical scrub.
3)Keep the environment quiet and calm.
4)Insert the Foley catheter.

Question 21

Midazolam (Versed)may be administered as part of surgical anesthesia.This drug is recognized as having which effects? Credit will be given only if all correct choices and no incorrect choices are selected.
1)Producing effects consistent with those observed in administering other benzodiazepines
2)Reducing anxiety and stress associated with surgery
3)Producing central nervous system depression and skeletal muscle relaxation
4)Maintaining stable cardiac and respiratory activity
5)Preventing cardiac dysrhythmias

Question 22

A patient undergoing surgery is receiving general anesthesia as well as a neuromuscular blocking agent.Which statement best indicates the primary reason for the neuromuscular blocking agent?
1)To potentiate analgesic effects
2)To prevent adverse effects associated with inhaled gases
3)To cause total skeletal muscle relaxation
4)To induce unconsciousness

Question 23

A novice nurse says,"We want to keep our patients in Stage 4 anesthesia during their surgery." How should the supervising nurse interpret this statement? Credit will be given only if all correct choices and no incorrect choices are selected.
1)The novice nurse has made an error in this statement.
2)Stage 4 anesthesia is avoided.
3)This is a good description of the goal of anesthesia.
4)The novice nurse should have said Stage 3 anesthesia.
5)A more accurate statement would be that the patient is maintained in anxiolysis anesthesia.

Question 24

A nurse is assessing a postoperative patient who has a family history of malignant hyperthermia.Which findings would be of most concern to the nurse? Credit will be given only if all correct choices and no incorrect choices are selected.
1)Mild spasms of the patient's jaw muscles
2)Dark urine 3 hours after surgery
3)Tachycardia in the first hour after surgery
4)Temperature elevation 3 hours after the procedure
5)Respiratory rate increase to 18 breaths per minute 2 hours after the procedure

Question 25

A patient has just been visited by the anesthesiologist who will provide anesthesia during the patient's abdominal surgery the next day.The patient says,"I think I heard the doctor say something about hypnosis.I don't believe in all of that." How should the nurse respond? Credit will be given only if all correct choices and no incorrect choices are selected.
1)"Hypnosis is a standard method of relaxing the patient before anesthesia is started."
2)"That just means the drugs are going to make you unaware of what is happening."
3)"The doctor needs to block all of your reflexes so the surgeon can do the surgery."
4)"This is not the same as the kind of hypnosis you might see on television."
5)"The doctors do not want you to remember the pain of your procedure."

Question 26

Preoperative adjunct medications are used for which reasons? Credit will be given only if all correct choices and no incorrect choices are selected.
1)To reduce anxiety and facilitate sedation
2)To facilitate a faster recovery
3)To reduce the risk of aspiration pneumonia
4)To reduce the risk of a postoperative ileus
5)To manage pain

Question 27

Balanced anesthesia is the use of a combination of medications to produce general anesthesia.Which drugs may be used in combination? Credit will be given only if all correct choices and no incorrect choices are selected.
1)Benzodiazepines
2)Neuromuscular blockers
3)Inhaled anesthetics
4)Proton-pump inhibitors
5)Intravenous anesthetics