Pharmacological Aspects Of Nursing Care 8th Edition By Broyles Reiss Evans – Test Bank

CHAPTER 11: ANESTHETICS

TRUE/FALSE

1. Malignant hyperthermia decreases the metabolic rate and oxygen consumption of muscle cells.

ANS: F

Feedback
Correct Malignant hyperthermia increases metabolic rate and oxygen consumption of muscle cells.
Incorrect

PTS: 1 REF: p. 316 OBJ: Cognitive Level: Knowledge

2. Regional anesthetics do not pass through the placenta; therefore, there is no risk to the fetus.

ANS: F

Feedback
Correct Regional anesthetics can pass through the placenta and cause bradycardia in the fetus.
Incorrect

PTS: 1 REF: p. 318 OBJ: Cognitive Level: Knowledge

3. Because of their action on the central nervous system, many gaseous anesthetics may produce nausea and vomiting.

ANS: T PTS: 1 REF: p. 302 OBJ: Cognitive Level: Knowledge

4. Most lengthy surgeries are performed at stage 3 of general anesthesia.

ANS: T PTS: 1 REF: p. 303 OBJ: Cognitive Level: Knowledge

5. A major disadvantage of intravenous anesthetics is the difficulty of controlling their adverse effects once introduced into the bloodstream.

ANS: T PTS: 1 REF: p. 304
OBJ: Cognitive Level: Comprehension

MULTIPLE CHOICE

A client is brought to the postanesthesia care unit (PACU) following a cholecystectomy. In the operating room, the client received a mixture of nitrous oxide and oxygen as a primary anesthetic, and anesthesia was induced with ketamine (Ketalar). The nurse receives a report from the anesthetist and begins to care for the client. The following questions refer to this situation and to background knowledge required for working in the PACU.

1. The client is in a stage of anesthesia known as analgesia. This stage is:
a. stage 1. c. stage 3.
b. stage 2. d. stage 4.

ANS: A

Feedback
A Correct: Stage 1 is the stage of analgesia.
B Incorrect: Stage 2 is the stage of excitation.
C Incorrect: Stage 3 is the stage of surgical anesthesia.
D Incorrect: Stage 4 is the stage of medullary paralysis.

PTS: 1 REF: p. 303, Table 11-1 OBJ: Cognitive Level: Knowledge

2. Fentanyl (Innovar) is used in surgery primarily as a(n):
a. sedative-hypnotic. c. analgesic.
b. local anesthetic. d. anticholinergic.

ANS: C

Feedback
A Incorrect: Fentanyl will produce sedation, but is not classified as a sedative-hypnotic.
B Incorrect: Fentanyl is not a local anesthetic.
C Correct: Fentanyl is classified as an opioid analgesic.
D Incorrect: Fentanyl is not an anticholinergic.

PTS: 1 REF: p. 308 OBJ: Cognitive Level: Knowledge

3. Droperidol (Inapsine) is used as a preanesthetic medication primarily because of its ability to act as a(n):
a. opioid analgesic. c. anticholinergic.
b. antiemetic. d. muscle relaxant.

ANS: B

Feedback
A Incorrect: It is not an opiod analgesic.
B Correct: It is an anti-anxiety and antiemetic agent.
C Incorrect: It is not an anticholinergic.
D Incorrect: It is not a muscle relaxant.

PTS: 1 REF: p. 309, Table 11-4 OBJ: Cognitive Level: Knowledge

4. A drug that is often administered with regional anesthetics in order to prolong their effect is:
a. diazepam (Valium). c. meperidine (Demerol).
b. mepivacaine HCl. d. epinephrine.

ANS: D

Feedback
A Incorrect: Diazepam is not used for this purpose.
B Incorrect: Mepivacaine HCl is a regional anesthetic agent.
C Incorrect: This is not a purpose for meperidine.
D Correct: Epinephrine causes vasoconstriction to delay absorption of regional anesthetic agents.

PTS: 1 REF: p. 312 OBJ: Cognitive Level: Comprehension

5. Malignant hyperthermia is believed to be the result of:
a. stress and an inherited susceptibility to develop the disorder.
b. operating rooms that are kept too warm.
c. the use of spinal anesthesia, rather than general anesthesia.
d. the lights and heavy drapes used in operating rooms.

ANS: A

Feedback
A Correct: Stress and inherited susceptibility is believed to cause this response to general anesthesia, especially succinylcholine.
B Incorrect: Operating rooms are kept cool.
C Incorrect: This is not associated with spinal anesthesia.
D Incorrect: These do not predispose a client to malignant hyperthermia.

PTS: 1 REF: p. 316 OBJ: Cognitive Level: Comprehension

6. The client who becomes flushed and also may experience excitement and urinary retention following administration of anticholinergic preanesthetic medications is probably experiencing:
a. an allergic reaction to the drug.
b. a normal reaction to anticholinergics.
c. a reaction that will cause the postponement of the procedure.
d. malignant hyperthermia.

ANS: B

Feedback
A Incorrect: This does not represent an allergic reaction.
B Correct: These manifestations are normal responses to anticholinergic medications.
C Incorrect: These are normal manifestations.
D Incorrect: These are not manifestations of malignant hyperthermia.

PTS: 1 REF: p. 315 OBJ: Cognitive Level: Comprehension

7. The last sense to disappear and the first to reappear in an unconscious person is:
a. sight. c. smell.
b. hearing. d. taste.

ANS: B

Feedback
A Incorrect: Sight is not the last sense to disappear.
B Correct: Hearing is the last sense to disappear and the first to reappear.
C Incorrect: Smell is not the last sense to disappear.
D Incorrect: Taste is not the last sense to disappear.

PTS: 1 REF: p. 317 OBJ: Cognitive Level: Knowledge

8. For clients who have received general anesthesia the usual assessment that indicates that the artificial airway can be removed is:
a. they begin to move around.
b. they open their eyes.
c. they first reach the recovery room.
d. the gag and swallowing reflexes return.

ANS: D

Feedback
A Incorrect: This does not provide sufficient or appropriate information.
B Incorrect: This does not provide sufficient or appropriate information.
C Incorrect: This does not provide sufficient or appropriate information.
D Correct: When the client’s gag and swallow reflex return, they usually will displace the artificial airway themselves and usually it can be removed.

PTS: 1 REF: p. 317 OBJ: Cognitive Level: Evaluation

9. Two problems that clients frequently experience in the recovery room are:
a. pain and shivering. c. nausea and hypertension.
b. confusion and anger. d. serious bleeding and anxiety.

ANS: A

Feedback
A Correct: These are two of the most commonly experienced problems clients experience in PACU.
B Incorrect: These are not commonly problems.
C Incorrect: These are not commonly problems.
D Incorrect: These are not commonly problems.

PTS: 1 REF: p. 317 OBJ: Cognitive Level: Knowledge

10. Emergence reactions requiring special nursing care occur most frequently following the use of:
a. lidocaine. c. cyclopropane.
b. ketamine. d. halothane.

ANS: B

Feedback
A Incorrect: This does not cause emergence reactions.
B Correct: This is characteristic of ketamine.
C Incorrect: This is not characteristic of cyclopropane.
D Incorrect: This is not characteristic of halothane.

PTS: 1 REF: p. 317 OBJ: Cognitive Level: Knowledge