Chapter 49 Drug Therapy With Local Anesthetics


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Chapter 49  Drug Therapy With Local Anesthetics



Complete chapter Questions And Answers

Sample Questions



1. A patient has suffered a severe laceration to his thumb and index finger during a workplace accident, and local anesthetic is to be utilized to facilitate suturing. Which of the patient’s following statements should prompt the nurse to provide further health education?

  1. A)  “I have to admit I’m relieved that they’ll be freezing my hand before they stitch it


  2. B)  “I’m feeling pretty queasy about getting stitches, so I’m glad they’ll be knocking

    me out.”

  3. C)  “They told me that it will take a few hours before I can feel my hand again.”
  4. D)  “If I understand correctly, I won’t be able to move my hand normally for a while

    after getting the anesthesia.”

Ans: B


Local anesthesia is differentiated from general anesthesia in that there is no loss of consciousness. “Freezing” is an accurate description. Normal motor control and sensation return after a period of time.

2. Spinal anesthesia will be used to perform a patient’s scheduled bunionectomy. What should the nurse teach the patient about the administration of this form of anesthesia?

  1. A)  It will cause a significant, but temporary, decrease in level of consciousness.
  2. B)  It will be injected at the level of C7 to T2.
  3. C)  It will be injected between T8 and T9.
  4. D)  It will be injected into the cerebrospinal fluid.

Ans: D
Spinal anesthesia involves injecting the anesthetic agent into the cerebrospinal fluid, usually in the lumbar spine. It does not cause a significant decrease in level of consciousness.

3. Resetting of a patient’s fracture will take place under local anesthetic. These anesthetics reduce movement and sensation by decreasing the permeability of the nerve cell membrane to ions. What is the most important ion that participates in this process?

  1. A)  Calcium
  2. B)  Magnesium
  3. C)  Sodium
  4. D)  Potassium

Ans: C Feedback:

Local anesthetics decrease the permeability of the nerve cell membrane to ions, especially sodium.

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4. A patient who suffered a laceration while doing woodwork in his garage will have his wound treated under local anesthesia achieved using lidocaine and epinephrine. The nurse who will assist with the procedure should recognize that epinephrine performs what function in this situation?

  1. A)  Promoting vasodilation
  2. B)  Prolonging the effects of lidocaine
  3. C)  Preventing adverse effects of lidocaine
  4. D)  Blocking the afferent nerve pathways

Ans: B
Lidocaine has a rapid effect, and, when combined with epinephrine, this effect is prolonged. Epinephrine can promote vasoconstriction, not vasodilation, and it neither prevents adverse effects nor blocks afferent nerve pathways.

5. A patient’s chronic venous ulcer on the lower lateral surface of his leg requires incision and debridement (I & D). The nurse should anticipate that lidocaine will be administered by which of the following routes?

  1. A)  Intravenous
  2. B)  Topical
  3. C)  Injection
  4. D)  Nebulized

Ans: C
Injectable lidocaine is used for infiltration of the skin or subcutaneous administration prior to minor surgical procedures, such as I & D. Nebulized administration of lidocaine is reserved for lung procedures. Topical administration would be insufficient, and IV administration is not warranted.

6. A patient with hand trauma following a gunshot wound currently has bier block anesthesia with lidocaine. What assessment finding should signal the nurse to the possibility that the patient has local anesthetic systemic toxicity (LAST)?

  1. A)  The patient has become intensely anxious and agitated.
  2. B)  The patient has complained of nausea and had an episode of blood-tinged emesis.
  3. C)  The patient’s heart rate has become bradycardic and irregular.
  4. D)  The patient states that he still has sensation in his hand.

Ans: A


Initial symptoms of LAST may include analgesia, circumoral numbness, metallic taste, tinnitus or auditory changes, and agitation. Nausea, dysrhythmias, and continued sensory nerve function do not suggest LAST.

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