Grant CRNA Local Anesthetics Quiz Review

63 Questions | Total Attempts: 118

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CRNA Quizzes & Trivia

Are you a nurse anesthetist and want to put your knowledge to the test? The Grant CRNA local anesthetics quiz review below is set to help advance and gauge your knowledge. Take it up and see how it goes.


Questions and Answers
  • 1. 
    Nerve conduction is determined mainly by 2 factors: nerve fiber diameter and the degree of ________, which determines conduction velocity.
  • 2. 
    Various concentrations of local anesthetics will provide various types of blocks.  For example: –0.125% Bupivicaine only blocks _______ while 0.5% blocks sensory and motor
  • 3. 
    Which of the following describes the correct order of nerve fiber blockade?
    • A. 

      Autonomic, sensory, then motor.

    • B. 

      Sensory, autonomic, then motor.

    • C. 

      Sensory, motor, then autonomic.

    • D. 

      Motor, autonomic, then sensory.

  • 4. 
    Local anesthetics produce reversible binding at the site of sodium channels in nerves in all of the following states EXCEPT:
    • A. 

      Closed/Resting

    • B. 

      Open

    • C. 

      Inactivated

  • 5. 
    Local anesthetics must bind with at least ______ successive nodes of Ranvier to be effective.
  • 6. 
    The non-ionized form diffuses into the nerve axon while the ionized form binds to receptors on sodium channels when the channel is in the inactivated state.
    • A. 

      True

    • B. 

      False

  • 7. 
    Voltage gated Na+ channels are found only in the nerve’s _____.
    • A. 

      Axon

    • B. 

      Dendrites

    • C. 

      Soma

  • 8. 
    The Cm (minimum blocking concentration) or motor fibers is about ____ that of sensory fibers.
    • A. 

      2x

    • B. 

      1/2

    • C. 

      1/4

    • D. 

      10x

  • 9. 
    }The Cmin for local anesthetics can be defined as the lowest concentration of drug that is needed for blocking impulse propagation.  The Cmin value can very depending on the temperature, pH or _____ concentration of the bathing solution.
  • 10. 
    Chemically, local anesthetics have three characteristic traits:1. An intermediate carbon group separates2. an unsaturated “aromatic” ring system from3. a tertiary amine. The aromatic ring provides lipophilic characteristics, whereas the amine gives hydrophilicity to the molecule.
    • A. 

      True

    • B. 

      False

  • 11. 
    Lipid solubility will ______ potency and duration of action.
    • A. 

      Increase

    • B. 

      Decrease

    • C. 

      Not affect

  • 12. 
    When considering duration of action, the lipid solubility of a drug is more important than its protein binding.
    • A. 

      True

    • B. 

      False

  • 13. 
    Local Anesthetics that have a longer duration of action preferentially bind to the _____ protein chain of the nerve and less to albumin
  • 14. 
    Which of the following local anesthetics is 95% protein bound and has the greatest duration of action?
    • A. 

      Bupivicaine

    • B. 

      Mepivicaine

    • C. 

      Lidocaine

    • D. 

      Chloroprocaine

  • 15. 
    Increased lipid solubility correlates with increased protein binding, increased potency, longer duration of action and a higher tendency for severe _______ (especially cardiac). 
    • A. 

      Toxicity

    • B. 

      Anaphylaxis

    • C. 

      Great outcomes

    • D. 

      Cases of the Monday's

  • 16. 
    If a local anesthetic is injected into venous system, less drug gets to systemic circulation due to uptake by the _____ (first pass uptake).
  • 17. 
    The addition of epinephrine or, less commonly, phenylephrine causes ______ rate of absorption and of peak plasma concentrations.
    • A. 

      Decreased

    • B. 

      Increased

    • C. 

      No change to

  • 18. 
    The addition of epinephrine to bupivacaine, ropivacaine, or etidocaine has which effect on their duration of action?
    • A. 

      Increase

    • B. 

      Decrease

    • C. 

      No change

  • 19. 
    What is the max dose of epinephrine your are able to mix with your local anesthetic?
    • A. 

      200-250 mcg or 3-5 mcg/kg

    • B. 

      100-175 mcg or 1.5-2.5 mcg/kg

    • C. 

      50-100 mcg or 0.5-1 mcg/kg

    • D. 

      250-500 mcg or 5-10 mcg/kg

  • 20. 
    Higher max doses of local anesthetic are allowed with vasoconstrictor added.
    • A. 

      True

    • B. 

      False

  • 21. 
    Which of the following are contraindications to the addition of epi to your LA?
    • A. 

      Unstable angina

    • B. 

      Cardiac dysrhythmias

    • C. 

      Uncontrolled HTN

    • D. 

      Uteroplacental insufficiency

    • E. 

      Areas that lack collateral blood flow such as the fingers/toes

  • 22. 
    Ropivacaine, lidocaine, and cocaine are vasoconsctrictors
    • A. 

      True

    • B. 

      False

  • 23. 
    Cocaine has vasoconstrictive properties because of its ability to block the reuptake of _________.
  • 24. 
    The pKa's of local anesthetics range from 7.6-9.1 with one exception of chloroprocaine which has a really high pKA.  Chloroprocaine still has a very fast onset of action due to being used in high concentrations (3%).
    • A. 

      True

    • B. 

      False

  • 25. 
    How do we increase the pH of a local anesthetic in order to increase the amount of drug in the nonionized form when injected into tissue?
    • A. 

      The addition of sodium bicarbonate

    • B. 

      Hyperventilate the patient

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