Pharmacology Quiz 1 NUR 340 Practice Questions and Correct Answers
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Course
NUR 340
Institution
NUR 340
The circulating nurse explains to a nursing student that thiopental sodium (Pentothal) is commonly administered to a surgical patient during induction of anesthesia. Why is this drug considered to be a mainstay of anesthesia induction? (select all that apply) - causes a smaller drop in blood pressu...
Pharmacology Quiz 1 NUR 340 Practice
Questions and Correct Answers
The circulating nurse explains to a nursing student that thiopental sodium (Pentothal) is
commonly administered to a surgical patient during induction of anesthesia. Why is this
drug considered to be a mainstay of anesthesia induction? (select all that apply)
- causes a smaller drop in blood pressure than other agents
-unconsciousness results within 60 - 80 seconds
-recovery from drug's effects occurs within about 10 minutes
- has a rapid onset and short duration of action
- effects include amnesia, analgesia, and muscle relaxation ✅-causes smaller drop in
blood pressure than other agents
- recovery from drug's effect occur within about 10 minutes
- has a rapid onset and short duration of action
Rationale: Thiopental sodium is a short-acting barbiturate taking effect in 10 - 20
seconds. The effects last only about 10 minutes making this drug particularly useful for
induction of anesthesia. Although it may cause cardiovascular and respiratory
depression, thiopental causes a smaller drop in BP, making it a preferred drug for
geriatric, cardiovascular, and neurosurgical patients. Short-acting benzodiazepines like
midazolam (versed) or diazepam (Valium) can also be used to induce anesthesia.
However, these drugs take longer to work; 60 - 80 seconds in contrast to the fast-acting
barbiturates. Benzodiazepines are used in conjunction with analgesics to create
conscious sedation or monitored-care anesthesia (MAC). The effects of MAC are
amnesia, analgesia, sedation, and decreased anxiety. See Lehne pg. 269-271.
A patient receives local anesthesia by injection with lidocaine (Xylocaine) and
epinephrine during the surgical repair of an ankle injury. The patient develops
palpitations and tachycardia shortly after the procedure. The nurse understands that
these symptoms would most likely occur as the result of which situation?
- lack of analgesic medication
- systemic absorption of epinephrine
-sensory and motor neuron blockade
- peripheral vasodilation effect of lidocaine ✅- systemic absorption of epinephrine
Rationale: Epinephrine is a vasoconstrictor given to prolong the effects of a local
anesthetic such as lidocaine. However, the drug can be absorbed systemically and
produce symptoms of palpitations, tachycardia, nervousness, and hypertension. Similar
severe systemic effects may also occur following injection of a local anesthetic such as
lidocaine. See Lehne, pg 257 - 258, 261
Which nursing diagnosis would be most appropriate for a post-operative patient who is
receiving a centrally acting opioid analgesic on a scheduled basis?
, - Risk for injury
- Fatigue
- Impaired physical mobility
- Risk for activity intolerance ✅- risk for injury
A patient is receiving an opioid analgesic for post-operative pain. Although arousable,
the patient drifts off to sleep and is unable to maintain a conversation. According to the
Pasero Opioid-induced Sedation Scale (POSS), what is the most appropriate nursing
response?
- locate Naloxone (Narcan) and respiratory support equipment.
- monitor the respiratory rate and sedation level until stable.
- take no action at this time; opioid dose may be increased if needed.
- stop the opioid and call the health care provider. ✅- monitor the respiratory and
sedation level until stable
Rationale: This patient's sedation level is unacceptable. The patient should be
monitored closely until the sedation level improves. In addition, the nurse should
monitor the respiratory status, decrease the next dose of medication by 25 - 50% and
consider administration of a non-opioid analgesic. If the patient is receiving patient-
controlled analgesia, the physician should be notified and new orders requested. The
use of Narcan is anticipated if the patient has minimal to no response to stimulation.
See class notes and Lewis pg 139.
Intravenous benzodiazepines produce a loss of which functions?
- all sensation and consciousness
- memory surrounding a procedure
- painful sensations
- skeletal muscle contraction ✅- memory surrounding a procedure
Rationale: Intravenous benzodiazepines, depending on the dosage, produce amnesia
and/or unconsciousness and reduce anxiety. Benzodiazepines do not affect sensation.
A loss of all sensations and consciousness is produced by inhaled general anesthetics.
Analgesics selectively cause loss of painful sensations. Neuromuscular blockers relax
skeletal muscles. See Lehne chapter 27 and pg 270.
During general anesthesia a patient is noted to have hypoxemia, tachycardia, muscle
stiffness, and a markedly elevated temperature. The nurse's interventions are based on
the knowledge that these symptoms may be the result of combining an inhalation
anesthetic with which of the following adjunctive medications?
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