NCLEX Pharmacology Quiz 21 Anesthetic And Narcotic Drugs

1. Mr. Baltazar will be undergoing surgery with general anesthesia. The client should be given which of the following instructions preoperatively?

Eat big breakfast

Expect to be incontinent of urine postoperatively

Double your medication doses

Expect nausea. vomiting. shivering. and pain postoperatively.

These responses should be expected. and the client should be prepared for them. Food is contraindicated before surgery. Urinary retention. not incontinence is likely. Medication is more likely to be held on the day of surgery.

Explanation

These responses should be expected. and the client should be prepared for them. Food is contraindicated before surgery. Urinary retention. not incontinence is likely. Medication is more likely to be held on the day of surgery.

2. A client received lidocaine viscous before a gastroscopy was performed. Following the procedure. the nurse places priority on what assessment?

Return of the gag reflex

Ability to urinate

Abdominal pain

Ability to stand

Because the throat is anesthetized. monitor the client for return of the gag reflex before drinking or eating.

Explanation

Because the throat is anesthetized. monitor the client for return of the gag reflex before drinking or eating.

3. A preoperative patient receives atropine before induction of anesthesia. The nurse caring for this patient understands that this agent is used to prevent:

Anxiety.

Bradycardia.

Dry mouth.

Hypertension.

Atropine. an anticholinergic drug. is used as an adjunct to anesthesia to counter the effects of vagal stimulation. which is caused by surgical manipulations that trigger parasympathetic reflexes. resulting in bradycardia. Atropine is not an anxiolytic. Atropine causes dry mouth and sometimes is used to minimize bronchial secretions.

Explanation

Atropine. an anticholinergic drug. is used as an adjunct to anesthesia to counter the effects of vagal stimulation. which is caused by surgical manipulations that trigger parasympathetic reflexes. resulting in bradycardia. Atropine is not an anxiolytic. Atropine causes dry mouth and sometimes is used to minimize bronchial secretions.

4. General anesthetics potentiate the effects of which of the following drugs?

Depolarizing agents

Skeletal muscle relaxants

Volatile liquids

Inhalation anesthetics

The effects of skeletal muscle relaxants are potentiated with the use of the general anesthetics. Depolarizing agents do not interact with general anesthetics. C and D are general anesthetics.

Explanation

The effects of skeletal muscle relaxants are potentiated with the use of the general anesthetics. Depolarizing agents do not interact with general anesthetics. C and D are general anesthetics.

5. Early signs and symptoms of local anesthetic toxicity include ALL BUT ONE of the following. Indicate the exception:

Tinnitus

Perioral numbness

Dizziness

Hypertension

Manifestations of local anesthetic toxicity typically appear 1-5 minutes after the injection. but onset may range from 30 seconds to as long as 60 minutes. Initial manifestations may also vary widely. Classically. patients experience symptoms of central nervous system (CNS) excitement such as the following: Circumoral and/or tongue numbness. metallic taste. lightheadedness. dizziness. visual and auditory disturbances (difficulty focusing and tinnitus). disorientation and drowsiness.

Explanation

Manifestations of local anesthetic toxicity typically appear 1-5 minutes after the injection. but onset may range from 30 seconds to as long as 60 minutes. Initial manifestations may also vary widely. Classically. patients experience symptoms of central nervous system (CNS) excitement such as the following: Circumoral and/or tongue numbness. metallic taste. lightheadedness. dizziness. visual and auditory disturbances (difficulty focusing and tinnitus). disorientation and drowsiness.

6. During surgery. there is an increased potential for arrhythmias when catecholamines are given with:

Halothane (Fluothane)

Digoxin (Lanoxin)

Bupivacaine (Marcaine)

Lidocaine (Xylocaine)

Arrhythmias are a result of an interaction that can occur with halothane and catecholamines. Other choices do not interact with halothane to cause arrhythmias.

Explanation

Arrhythmias are a result of an interaction that can occur with halothane and catecholamines. Other choices do not interact with halothane to cause arrhythmias.

7. Geneva is reviewing for her upcoming quiz in Pharmacology. She should be aware that local and regional anesthesia act by:

Inhibiting depolarization.

Increasing depolarization.

Producing a semiconscious state.

Inhibiting motor movement.

When local anesthesia is used. sensation is removed and the area anesthetized by inhibition of depolarization. Choice B is incorrect because the opposite is true. Choices C and D do not occur with local anesthesia.

Explanation

When local anesthesia is used. sensation is removed and the area anesthetized by inhibition of depolarization. Choice B is incorrect because the opposite is true. Choices C and D do not occur with local anesthesia.

8. The most dangerous metabolic side effect of general anesthesia that can occur during surgery is:

Hyperglycemia

Hyperthermia

Hypoglycemia

Hypothermia

Malignant hyperthermia is the most dangerous metabolic side effect of general anesthesia.

Explanation

Malignant hyperthermia is the most dangerous metabolic side effect of general anesthesia.

9. Which of the following statements about shivering is correct?

Shivering is a response controlled by the brainstem.

Shivering can occur in the absence of hypothermia.

Shivering is effectively treated with small doses of naloxone.

Shivering is an uncomfortable. though harmless. effect of anesthesia.

Shivering can also appear after surgery. This is known as postanesthetic shivering.

Explanation

Shivering can also appear after surgery. This is known as postanesthetic shivering.

10. The nurse teaching a client who will receive thiopental (Pentothal) as an anesthetic explains that what common adverse effects might occur?

Headache

Emergence delirium

Nausea and vomiting

Paralysis

Emergence delirium could occur postoperatively. and is characterized by hallucinations. confusion. and excitability.

Explanation

Emergence delirium could occur postoperatively. and is characterized by hallucinations. confusion. and excitability.