Exam (elaborations)
Chapter 20 Anesthetics
- Course
- Pharmacology illustrated
- Institution
- Plaza College
Chapter 20 Anesthetics
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Chapter 20: Anesthetics1. 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 patients 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 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.
6. An extremely anxious patient is beginning to awaken in the postanesthesia care unit. He
or she states that his or her arms and legs feel like tree trunks and that they are hard to move.
He or she also complains that his or her head feels fuzzy and that the right words will not
come to his or her. What is the priority nursing intervention for this patient? A) Provide
analgesic medication for the discomfort.
B) Stay with patient as much as possible and provide reassurance.
C) Provide fluids to increase his or her wakefulness.
D) Encourage the patient to turn from side to side periodically.
Ans: B
Feedback:
Most patients are disoriented and confused when awaking from anesthesia. It would be
most important for the nurse to be with the patient as much as possible and reassure the
patient that everything is as expected. Providing pain medication is important and may
be needed during recovery if the patient reports pain, but would not be useful in treating
the reported symptoms. The nurse would not provide fluids to patients immediately after
surgery until ensuring the swallow reflex has returned and bowel motility has resumed.
The nurse will help the patient turn from side to side, but this is not the priority nursing
action at this time. However, the most effective nursing action for anxious postoperative
patients is for the nurse to stay with them as much as possible.
7. The patient appears awake but is unconscious and has no response to painful stimuli.
What medication does the nurse suspect this patient has received?
A) Thiopental (Pentothal)
B) Midazolam (Generic)
C) Ketamine (Ketalar) D) Propofol (Diprivan)
Ans: C
Feedback:
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