Chapter 27  General and Local Anesthetic Agents

Chapter 27  General and Local Anesthetic Agents

Complete Chapter Questions And Answers
 

Sample Questions

1. To decrease sympathetic stimulation in balanced anesthesia type of what agent would be used?

A) Antihistamines

B) Antiemetics

C) Narcotics

D) Sedative-hypnotics

Ans: D

Feedback:

Sedative-hypnotics relax the patient, facilitate amnesia, and decrease sympathetic stimulation.
Antihistamines decrease the chance of allergic reaction and help dry secretions. Antiemetics decrease
the nausea and vomiting associated with gastrointestinal (GI) depression. Narcotics aid in the analgesic
and sedative effects.

2. During what stage of anesthesia would the nurse see the patient’s skeletal muscles relax and return of
regular respirations?

A) Stage 1: Analgesia stage

B) Stage 2: Excitement stage

C) Stage 3: Surgical anesthesia stage

D) Stage 4: Medullary paralysis

Ans: C

Feedback:

Stage 3 is surgical anesthesia, which involves relaxation of skeletal muscles and return of regular
respirations. During this stage, eye reflexes and pupil dilation are progressively lost. Surgery can be
safely performed in this stage. Stage 1 refers to the loss of pain sensation; stage 2 involves a period of
excitement with sympathetic stimulation (e.g., tachycardia, increased respirations, blood pressure
changes); and stage 4 involves deep central nervous system depression with loss of respiratory and
vasomotor center stimuli. Death can occur rapidly at this stage if adequate support is not supplied.

3. The nurse is developing a plan of care for the patient undergoing general anesthesia. What is a priority

Test Bank – Focus on Nursing Pharmacology (7th Edition by Amy Karch) 437

of care for this patient?

A) Encourage clear fluids.

B) Increase oxygen.

C) Reassure the patient that about safety.

D) Maintain regular repositioning.

Ans: D

Feedback:

The patient would need to be moved or turned periodically to prevent skin breakdown and the
formation of decubitus ulcers if the surgery lasted longer than an hour. Muscle paralysis resulting from
the medications used in general anesthesia would prevent the patient from shifting himself or herself to
relieve increase pressure. A patient receiving a general anesthetic would be unconscious, require
respiratory support, and be connected to a mechanical ventilator to maintain respirations. Increased
oxygen would not be indicated unless oxygen levels were less than adequate, and the patient would not
receive anything by mouth eliminating option A. Reassurance would not be necessary for the
unconscious patient.

4. A plan of care formulated by an operating room (OR) nurse includes four nursing diagnoses. Which
diagnoses will the nurse include that is directly related to safety?

A) Deficient knowledge regarding drug therapy

B) Disturbed sensory perception (kinesthetic, tactile) related to anesthesia

C) Risk for impaired skin integrity related to immobility

D) Risk for injury related to central nervous system (CNS) depressive effects of drugs

Ans: D

Feedback:

The nursing diagnosis, which directly relates to safety, is high risk for injury. The other three options
are only indirectly related to safety. While in the OR, the patient under general anesthetic is unable to
express safety concerns and must rely completely on the surgeon and OR staff for protection.

5. What nursing interventions would help minimize the risk of a headache in a patient recovering from
spinal anesthesia?

A) Administer a triptan intramuscularly.

B) Administer morphine intravenously.

C) Maintain patient in recumbent position.

D) Place patient in Trendelenburg position.

Ans: C

Feedback:

Patients receiving spinal anesthesia should remain in a recumbent position for as long as 12 hours.
Triptan would not be effective because it is indicated for treatment of migraine headaches. Morphine
would treat the headache but would not prevent it.