NCLEX Pharmacology Quiz 22 Anesthetic And Narcotic Drugs

1. During induction of anesthesia. the nurse notes the client becomes hyperactive and physically resists the treatment. The nurse concludes what interventions are needed?

Anesthesia must be discontinued.

An intravenous drug will be given to calm the client.

Anesthesia must be discontinued.

The surgery will need to be rescheduled.

Stage 2 is the stage of excitement and hyperactivity. Medications may be given IV to calm the client.

Explanation

Stage 2 is the stage of excitement and hyperactivity. Medications may be given IV to calm the client.

2. The nurse receives the client in the postanesthesia care unit (PACU) following a procedure requiring general anesthesia. The most important assessment made by the nurse relates to the client's:

Level of consciousness.

Pain.

Vital signs.

Respiratory status.

General anesthesia causes relaxation of all muscles. including respiratory muscles. requiring mechanical ventilation. The client’s respiratory status must be monitored closely following general anesthesia.

Explanation

General anesthesia causes relaxation of all muscles. including respiratory muscles. requiring mechanical ventilation. The client’s respiratory status must be monitored closely following general anesthesia.

3. The client asks the nurse to explain the action of infiltration anesthesia. The nurse's response is based on the knowledge that infiltration anesthesia:

Is applied only to mucous membranes to provide local anesthesia.

Blocks a specific group of nerves in tissues close to the operative area.

Blocks sensation to an entire limb. or a large area of the face.

Produces numbing to large. regional areas such as the lower abdomen and legs.

Infiltration anesthesia blocks a specific group of nerves close to the operative area by diffusion of a drug into the tissues. It is used to anesthetize small areas. Topical anesthetics are applied to mucous membranes. Nerve blocks provide anesthesia to a large surface area. Spinal anesthesia affects large. regional areas.

Explanation

Infiltration anesthesia blocks a specific group of nerves close to the operative area by diffusion of a drug into the tissues. It is used to anesthetize small areas. Topical anesthetics are applied to mucous membranes. Nerve blocks provide anesthesia to a large surface area. Spinal anesthesia affects large. regional areas.

4. The nurse observes a co-worker preparing to administer a solution of lidocaine and epinephrine to a client with multiple premature ventricular contractions. The appropriate action by the nurse is to:

Offer to monitor the client’s heart rhythm.

Notify the supervisor of the error.

Do nothing; the drug choice is correct.

Prevent the administration. and give a plain lidocaine solution.

Solutions of lidocaine containing preservatives or epinephrine are intended for local anesthesia only. and must never be given IV for dysrhythmias.

Explanation

Solutions of lidocaine containing preservatives or epinephrine are intended for local anesthesia only. and must never be given IV for dysrhythmias.

5. The half-life of morphine is:

4 to 6 hours

2 to 4 hours

6 to 8 hours

30 minutes to 1 hour

The half-life of morphine is 2 to 4 hours. Other choices are incorrect because they are either longer or shorter than the true half-life of morphine.

Explanation

The half-life of morphine is 2 to 4 hours. Other choices are incorrect because they are either longer or shorter than the true half-life of morphine.

6. All narcotics. regardless of their origin. reduce pain by:

Stimulating opiate receptors

Promoting the release of excitatory transmitters

Releasing large quantities of endorphin

Blocking the mu receptors

It is the stimulation of cerebral opiate receptors that reduces pain. Excitatory transmitters are not released during administration of morphine. Endorphin release is not associated with narcotic pain relief. The mu receptors mediate analgesia and are not blocked during narcotic administration.

Explanation

It is the stimulation of cerebral opiate receptors that reduces pain. Excitatory transmitters are not released during administration of morphine. Endorphin release is not associated with narcotic pain relief. The mu receptors mediate analgesia and are not blocked during narcotic administration.

7. In addition to analgesia. narcotic effects include:

Euphoria. diarrhea. increased respirations

Euphoria. miosis. nausea and vomiting

Respiratory depression. increased blood pressure

Dependence. seizures. muscle spasms

These are the effects that often occur with administration of narcotics. Constipation (not diarrhea) and decreased respirations (not increased) are noted during administration of narcotics. Decreased blood pressure results from narcotic administration. Narcotics do not cause the effects in choice D at all.

Explanation

These are the effects that often occur with administration of narcotics. Constipation (not diarrhea) and decreased respirations (not increased) are noted during administration of narcotics. Decreased blood pressure results from narcotic administration. Narcotics do not cause the effects in choice D at all.

8. When administering codeine. the nurse should be aware that:

Codeine produces more sedation than other opiates.

Codeine causes diarrhea. so the client must take an additional drug to prevent this.

Codeine is very constipating.

Codeine is an antitussive in high doses.

Codeine is very constipating. so the client’s diet should include foods that fight constipation. such as water. fruits. and vegetables.

Explanation

Codeine is very constipating. so the client’s diet should include foods that fight constipation. such as water. fruits. and vegetables.

9. Nurse Gretchen is discussing the use of cocaine as a local anesthetic with a nursing student. Which statement by the student indicates understanding of this agent?

“Anesthetic effects develop slowly and persist for several hours.”

“Cocaine is a local anesthetic administered by injection.”

“Vasoconstrictors should not be used as adjunct agents with this drug.”

“When abused. cocaine causes physical dependence.”

Cocaine should not be combined with epinephrine or other vasoconstrictors. because it causes vasoconstriction itself. and the combination could precipitate severe hypertension. Cocaine has a rapid onset of effects. which last about 1 hour. It is used only topically for anesthesia. Although subject to widespread abuse with profound psychological dependence. it does not cause substantial physical dependence.

Explanation

Cocaine should not be combined with epinephrine or other vasoconstrictors. because it causes vasoconstriction itself. and the combination could precipitate severe hypertension. Cocaine has a rapid onset of effects. which last about 1 hour. It is used only topically for anesthesia. Although subject to widespread abuse with profound psychological dependence. it does not cause substantial physical dependence.

10. Which of the following statements about morphine is correct?

Morphine is contraindicated in pain relief caused by head injury.

Morphine‘s withdrawal symptoms cannot be relieved by methadone.

Morphine is most effective by parenteral administration.

Morphine quickly enters all body tissues.

Morphine quickly enters all body tissues. Morphine is not contraindicated for head-injured clients. and withdrawal symptoms can be relieved by methadone. Morphine is equally effective by all routes when the proper dose is prescribed.

Explanation

Morphine quickly enters all body tissues. Morphine is not contraindicated for head-injured clients. and withdrawal symptoms can be relieved by methadone. Morphine is equally effective by all routes when the proper dose is prescribed.