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?

Accepted Answer

Tachycardia, tachypnea, muscle rigidity, and raised temperature are symptoms of malignant hyperthermia, which is treated with cardiorespiratory supportive care as needed to stabilize heart and lung function as well as with immediate treatment with the skeletal muscle relaxant dantrolene. CPR is not immediately needed because the patient still has a pulse and respirations. Naltrexone and anticholinesterase drugs are not appropriate in this situation.

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.

Accepted Answer

B

Question 3

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

Accepted Answer

Patients receiving neuromuscular blocking drugs require artificial mechanical ventilation because of the resultant paralysis of the respiratory muscles. In addition, they do not cause sedation or pain relief. They are used along with, not instead of, general anesthesia during surgery.

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?

Accepted Answer

The answer of A patient is to receive midazolam (Versed)...

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?

Accepted Answer

A sudden elevation in body temperature during the postoperative period may indicate the occurrence of malignant hyperthermia, a life-threatening emergency. The elevated temperature does not reflect the other problems listed.

Question 6

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

Accepted Answer

Dexmedetomidine (Precedex) is used for procedural sedation and for surgeries of short duration, and it is also used in the intensive care setting for sedation of mechanically ventilated patients. The other options are incorrect.

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?

Accepted Answer

Infiltration anesthesia is commonly used for minor surgical procedures. It involves injecting the local anesthetic solution intradermally, subcutaneously, or submucosally across the path of nerves supplying the area to be anesthetized. The local anesthetic may be administered in a circular pattern around the operative field. The other types are not appropriate for this injury. This is a painful procedure; therefore, the option of "no anesthesia" is incorrect.

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.

Accepted Answer

The answer of MATCHING
-When a neuromuscular blocking drug is given,...

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

Accepted Answer

B  A  The correct order of effects when a neuromuscular blocking drug is given is: first, weakness occurs (C), followed by total flaccid paralysis (B), and finally, cessation of respirations due to paralysis of the diaphragm and intercostal muscles (A).

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?

Accepted Answer

The elderly patient is more affected by anesthesia than the young or middle-aged adult patient because of the effects of aging on the hepatic, cardiac, respiratory, and renal systems.

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?

Accepted Answer

The antidote for neuromuscular blocking drugs is an anticholinesterase drug, such as neostigmine. Neostigmine reverses the effects of neuromuscular blocking drugs. The other drugs listed are not antidotes for neuromuscular blocking drugs.

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?

Accepted Answer

Vasoconstrictors such as epinephrine are coadministered with local anesthetics to keep the anesthetic at its local site of action and to prevent systemic absorption. The other options are not correct rationales for using this medication.

Question 13

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

Accepted Answer

After surgery and the termination of general anesthesia, the priority assessment is the patient's airway, breathing, and circulation status. The other assessments are important but are not the immediate concern.

Question 14

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

Accepted Answer

The nursing diagnosis of impaired gas exchange is appropriately worded for this patient. Anxiety would not be appropriate while the patient is in surgery. Sensorium would be decreased during surgery, not increased. Cardiac output is affected by general anesthesia, not local 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?

Accepted Answer

Moderate sedation effectively reduces patient anxiety, sensitivity to pain, and recall of the medical procedure, yet it preserves a patient's ability to maintain his or her own airway and respond to verbal commands. The other options are incorrect.

Quiz 11: General and Local Anesthetics

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?

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.

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