17 Anesthetic Drugs

A client scheduled for surgery has to undergo insertion of an endotracheal tube. The nurse understands that which of the following drugs for general anesthesia would most likely be ordered for this client? A) Benzodiazepines B) Barbiturates C) Opioid analgesics D) Skeletal muscle relaxants

Ans: D Feedback: Skeletal muscle relaxants help produce relaxation of skeletal muscles during certain types of surgeries involving the chest or abdomen and are used to facilitate the insertion of an endotracheal tube. Barbiturates are used for the induction of anesthesia. Benzodiazepines are used to relieve anxiety, induce anesthesia, and consciously sedate the client before minor procedures. Opioid analgesics are used to produce neuroleptanalgesia characterized by general quietness, reduced motor activity, and profound analgesia.

A nurse is assigned to care for a 53-year-old client who is to receive glycopyrrolate as a preanesthetic drug. The nurse reviews the client's history for which of the following that would contraindicate the use of this drug? A) Diabetes B) Hypotension C) Respiratory problems D) Myocardial ischemia

Ans: D Feedback: The nurse should confirm that the 53-year-old client does not have myocardial ischemia to ensure that the use of glycopyrrolate is not contraindicated. The other conditions that contraindicate the drug's use include prostatic hypertrophy and glaucoma. Diabetes, hypotension, or respiratory problems are not contraindications for the use of glycopyrrolate.

A nurse working in an outpatient surgical setting may see which of the following volatile liquids used in general anesthesia? A) Sevoflurane B) Desflurane C) Isoflurane D) Methoxyflurane E) Halothane

Ans: A Feedback: A nurse working in an outpatient surgical setting may see sevoflurane used in outpatient general anesthesia.

A client is to receive atropine as a preanesthetic. The nurse would inform the client that this drug is given for which reason? A) Decrease secretions B) Relieve anxiety C) Promote sedation D) Promote relaxation

Ans: A Feedback: Atropine is a cholinergic blocker that is given to dry secretions in the upper respiratory tract. An opioid or antianxiety drug may be given to relax or sedate the client.

A client is prescribed preanesthetic drugs prior to surgery. Which of the following nursing interventions should the nurse perform when caring for this client before the administration of preanesthetic drugs? A) Explain postoperative client activities. B) Check the client every 5 to 15 minutes. C) Assess the respiratory status of the client. D) Admit the client to an appropriate unit.

Ans: A Feedback: When caring for a client prescribed preanesthetic drugs, the nurse should demonstrate, describe, and explain postoperative client activities, such as deep breathing, coughing, and leg exercises. The nurse should check the client every 5 to 15 minutes for emergence from anesthesia, but this is done after the administration of anesthesia, not before. Assessing the respiratory status of the client and admitting the client to an appropriate unit are both postoperative interventions that a nurse should perform. Therefore, these are not performed before the administration of preanesthetic drugs and anesthesia.

A nurse is reviewing the medical record of a client scheduled for surgery and notes that the client will be receiving general anesthesia. Which factor would the nurse identify as affecting the choice of general anesthesia medication used in a particular client? Select all that apply. A) Client's general physical condition B) Area of the planned surgery C) Anticipated length of the surgery D) Client's weight E) Client's temperature

Ans: A, B, C Feedback: The choice of anesthetic drug depends on many factors, including general physical condition of the client; area, organ, or system being operated on; and anticipated length of the surgical procedure. The client's weight may affect the dose of the drug to be given. The client's temperature is unrelated to the choice of anesthetic.

A client is scheduled for surgery. Before surgery, the nurse would be responsible for which of the following? Select all that apply. A) Describing the preparation for surgery ordered by the physician B) Assessing the physical status of the client C) Describing postoperative care D) Demonstrating postoperative client activities E) Demonstrating the use of a PCA pump

Ans: A, B, C, D, E Feedback: The nurse is responsible for describing the preparation for surgery ordered by the physician, assessing the physical status of the client, describing postoperative care, demonstrating postoperative client activities, and demonstrating the use of a PCA pump.

A nurse is working in the PACU. Which of the following would be most important for the nurse to do? Select all that apply. A) Checking airway patency B) Positioning the client to prevent aspiration of secretions C) Reviewing the client's surgical and anesthesia records D) Checking the client every 15 to 30 minutes for emergence from anesthesia E) Checking the client's vital signs

Ans: A, B, C, E Feedback: Checking airway patency, positioning the client to prevent aspiration of secretions, reviewing the client's surgical and anesthesia records, checking the client every 5 to 15 minutes for emergence from anesthesia, and checking the client's vital signs, IV lines, catheters, drainage tubes, surgical dressings, and casts represent the nurse's responsibilities to a client in the PACU.

Which of the following are responsibilities of the nurse when local injectable anesthesia is to be administered to a client? A) Taking the client's allergy history B) Explaining how the anesthetic will be administered C) Preparing the area to be anesthetized D) Administering the anesthetic E) Applying a dressing to the area if appropriate

Ans: A, B, C, E Feedback: The nurse is responsible for taking the client's allergy history, explaining how the anesthetic will be administered, preparing the area to be anesthetized, and applying a dressing to the area if appropriate. The physician administers the local injectable anesthetic.

When reviewing information about general anesthetics, a group of students read about volatile liquids used as inhaled general anesthetics. The students demonstrate understanding of the information when they identify which of the following as a volatile liquid? Select all that apply. A) Halothane B) Desflurane C) Nitrous oxide D) Enflurane E) Cyclopropane

Ans: A, B, D Feedback: Halothane, desflurane, and enflurane are examples of volatile liquids used as inhaled anesthetics. Examples of gas anesthetics are nitrous oxide and cyclopropane.

When clients receive the rapid-acting general anesthetic ketamine, they would exhibit which of the following? Select all that apply. A) Analgesia B) Cardiovascular stimulation C) Reduced skeletal muscle tone D) Respiratory depression E) Respiratory stimulation

Ans: A, B, E Feedback: Clients administered the rapid-acting general anesthetic ketamine (Ketalar) will exhibit profound analgesia, cardiovascular stimulation, respiratory stimulation, and enhanced skeletal muscle tone.

A nurse working on the labor and delivery unit will most likely see which of the following used during the birthing process? Select all that apply. A) Epidural block B) Brachial plexus block C) Transsacral block D) Local infiltration anesthesia E) General anesthesia

Ans: A, C Feedback: Epidural and transsacral blocks are often used in obstetrics during the birthing process.

1. A group of nursing students are reviewing the different types of anesthesia. The students demonstrate understanding of the information when they identify which of the following as a type of local anesthesia? Select all that apply. A) Topical anesthesia B) General anesthesia C) Local infiltration anesthesia D) Regional anesthesia E) Spinal anesthesia

Ans: A, C, D, E Feedback: Local anesthesia includes topical, local infiltration, and regional anesthesia (spinal anesthesia and conduction block are types of regional anesthesia).

For which area on the body would the nurse identify that the use of epinephrine with a local injectable drug would be contraindicated? Select all that apply. A) Use on a toe B) Use on the scalp C) Use on the face D) Use on the abdomen E) Use on a finger

Ans: A, E Feedback: When the local anesthetic is used on an extremity (such as a toe or finger), the use of epinephrine with a local injectable drug is contraindicated.

The nurse is reviewing the medical record of a client who has returned from surgery. The client received a volatile liquid that required administration with a special vaporizer because delivery to the client without a vaporizer can result in irritation of the client's respiratory tract. Which of the following would the nurse identify as being administered? Select all that apply. A) Sevoflurane B) Desflurane C) Isoflurane D) Methoxyflurane E) Halothane

Ans: B Feedback: Desflurane is a volatile liquid that must be administered with a special vaporizer because delivery to the client without a vaporizer can result in irritation of the client's respiratory tract.

A nurse is reviewing the anesthesia record of a client who has returned to the unit after abdominal surgery. Which of the following might the nurse note as being used for the induction of anesthesia? Select all that apply. A) Lidocaine B) Prilocaine C) Methohexital D) Etomidate E) Propofol

Ans: C, D, E Feedback: Methohexital, propofol, and etomidate are examples of medications used for the induction of anesthesia. Lidocaine and prilocaine are local anesthetics.

A nursing student is reviewing the stages of general anesthesia. Which pairing if identified by the student demonstrates understanding? Select all that apply. A) Stage Iódelirium B) Stage IIIórespiratory paralysis C) Stage IIódelirium D) Stage IVórespiratory paralysis E) Stage Ióanalgesia

Ans: C, D, E Feedback: The stages of anesthesia are as follows: stage Ióanalgesia; stage IIódelirium; stage IIIósurgical anesthesia; and stage IVórespiratory paralysis.

After teaching an in-service presentation for nurses about general anesthetics, the instructor determines that the teaching was successful when the nurses identify which of the following as an example of a gas anesthetic? Select all that apply. A) Halothane B) Desflurane C) Nitrous oxide D) Enflurane E) Cyclopropane

Ans: C, E Feedback: Nitrous oxide and cyclopropane are examples of gas anesthetics. Halothane, desflurane, and enflurane are examples of volatile liquids used as inhaled anesthetics.

A client visits a dental health care clinic for a tooth extraction. Which type of anesthesia would most likely be used? A) Regional anesthesia B) General anesthesia C) Topical anesthesia D) Local infiltration anesthesia

Ans: D Feedback: Local infiltration anesthesia is often used for dental procedures. Regional anesthesia covers a larger area than that covered by local infiltration anesthesia, so it is not used for minor surgeries like that of a tooth extraction. General anesthesia is used to achieve a pain-free state for the entire body and is not the most appropriate type of anesthesia for a tooth extraction. Similarly, topical anesthesia is used to desensitize skin or mucous membranes for injection of a deeper local anesthetic.

A client admitted to a local health care facility is to undergo surgery with spinal anesthesia. Which of the following is the nurse most likely to observe when caring for this client? A) Moderate muscle relaxation B) Loss of feeling in the lower abdomen C) Hypotension as anesthesia deepens D) Increase in the client's heart rate

Ans: B Feedback: Spinal anesthesia involves the injection of a local anesthetic drug into the subarachnoid space of the spinal cord. There is a loss of feeling (anesthesia) and movement in the lower extremities, lower abdomen, and perineum. Spinal anesthesia is not known to increase a client's heart rate. Spinal anesthesia also does not cause hypotension or moderate muscle relaxation. Enflurane is a volatile liquid anesthetic that causes hypotension once it deepens. Halothane, which is a volatile liquid anesthetic, produces moderate muscle relaxation. Both halothane and enflurane are drugs used for general anesthesia.

After teaching a group of students about the stages of general anesthesia, the instructor determines that the teaching was successful when the students identify which of the following as characteristic of the first stage? A) Delirium B) Analgesia C) Respiratory paralysis D) Excitement

Ans: B Feedback: Stage I is characterized by analgesia; stage II is the stage of delirium and excitement; stage III is the stage of surgical analgesia; and stage IV is the stage of respiratory paralysis.

A group of nursing students are reviewing information about general anesthesia. The students demonstrate understanding of the information when they identify which of the following as a factor that would influence the selection of the general anesthesia for the client? A) Age of the client B) Length of surgical procedure C) Preanesthetic drug prescribed D) Postoperative care involved

Ans: B Feedback: The choice of general anesthesia depends on factors that include the general physical condition of the client; the area, organ, or system being operated on; and the anticipated length of the surgical procedure. The selection of general anesthesia does not depend on the age of the client, the preanesthetic drug prescribed for the client, or the postoperative care involved.

A nursing instructor is describing the classes of drugs that are commonly used as preanesthetics. The instructor determines that the teaching was successful when the students identify which as an example? Select all that apply. A) Antihypertensives B) Opioid agonists C) Antianxiety agents D) Antiemetics E) Cholinergic antagonists

Ans: B, C, D, E Feedback: Opioid agonists, antianxiety agents, antiemetics, and cholinergic antagonists represent classes of drugs commonly used as preanesthetics.

A nurse is researching the actions of the drug midazolam. Which of the following would the nurse expect to find about this drug's use as an anesthetic? Select all that apply. A) A common preanesthetic antiemetic drug B) Appropriate for induction of anesthesia C) Often for conscious sedation prior to minor procedures D) Limited for use with general anesthesia E) Supplementation to nitrous oxide and oxygen for short surgical procedures

Ans: B, C, E Feedback: Midazolam, a short-acting benzodiazepine CNS depressant, is used as a preanesthetic drug to relieve anxiety (not prevent vomiting); for induction of anesthesia; for conscious sedation before minor procedures, such as endoscopy; and to supplement nitrous oxide and oxygen for short surgical procedures.

A nurse is reviewing the methods for general anesthesia administration. The nurse would expect which route to be used most commonly for this type of anesthesia? Select all that apply. A) Oral B) Inhalation C) Topical D) IV E) IM

Ans: B, D Feedback: General anesthesia is most commonly achieved when the anesthetic vapors are inhaled or the drug is administered IV.

The nurse reviews a client's medical record and finds that the client received Innovar. The nurse understands that this drug results in neuroleptanalgesia and is a combination of which of the following drugs? Select all that apply. A) Lidocaine B) Fentanyl C) Etomidate D) Droperidol E) Methohexital

Ans: B, D Feedback: The drug Innovar is a combination drug consisting of fentanyl and droperidol.

The nurse should inform a client receiving spinal anesthesia to expect a loss of feeling and movement in which of the following? Select all that apply. A) Arms B) Legs C) Face D) Lower abdomen E) Hands

Ans: B, D Feedback: The nurse should inform a client receiving spinal anesthesia to expect a loss of feeling and movement in the lower extremities, lower abdomen, and perineum.

A client admitted for surgery is to receive general anesthesia. Prior to administering the prescribed preanesthetic, which of the following would the nurse do? A) Review the client's surgical and anesthesia records. B) Position the client to prevent aspiration of vomitus and secretions. C) Check the chart for any abnormal laboratory test results. D) Check the airway for patency and assess the respiratory status.

Ans: C Feedback: Before surgery and administering the preanesthetic, the nurse should check the client's chart for any abnormal laboratory test results. Reviewing the client's surgical and anesthesia records, positioning the client to prevent aspiration of vomitus and secretions, checking the airway for patency, and assessing the respiratory status are the postoperative responsibilities of the nurse.

A client admitted to a health care facility for an appendectomy receives methohexital as a general anesthetic. Which of the following would most likely occur as a result of this medication? A) Skeletal muscle relaxation B) Profound analgesia C) CNS depression D) Neuroleptanalgesia

Ans: C Feedback: Methohexital is an ultrashort-acting barbiturate that depresses the CNS to produce hypnosis and anesthesia, but it does not produce analgesia. Skeletal muscle relaxation is caused by skeletal muscle relaxants, halothane, and enflurane. An anesthetic state characterized by profound analgesia is produced by ketamine, which is a rapid-acting general anesthetic. Neuroleptanalgesia is caused by a combination of fentanyl and droperidol.

A client is admitted to a local health care facility for minor surgery to be performed with regional anesthesia. The nurse knows that regional anesthesia would be injected around which of the following regions in the body? A) The veins B) The arteries C) The nerves D) The capillaries

Ans: C Feedback: Regional anesthesia involves injection around the client's nerves. Doing so prevents these nerves from sending pain signals to the brain. Regional anesthesia is never injected into the veins, arteries, or capillaries.

To assist with the insertion of an endotracheal tube, the nurse would expect the client to receive which of the following to facilitate its insertion? Select all that apply. A) Hydroxyzine B) Glycopyrrolate C) Atracurium D) Doxacurium E) Meperidine

Ans: C, D Feedback: Atracurium and doxacurium are muscle relaxants used during general anesthesia to facilitate the insertion of an endotracheal tube.