Chapter 12: General and Local Anaesthetics

Question 1

After piercing a finger with a fish hook during a fishing trip, a patient is now at an emergency
department to have the hook removed. What type of anaesthesia will be used for this
procedure?
a. Topical benzocaine spray to the area
b. Spinal anaesthesia with mepivacaine hydrochloride
c. Topical prilocaine cream (EMLA®) around the site
d. Infiltration of the area with tetracaine hydrochloride

Answer 1

d. Infiltration of the area with tetracaine hydrochloride

Question 2

A patient is to receive local anaesthesia for removal of a lymph node from the groin. Why
does the physician add epinephrine to the local anaesthetic during the preparation?
a. Epinephrine prevents an anaphylactic reaction from occurring.
b. The anaesthetic enhances the effect of the epinephrine.
c. Epinephrine contributes to a balanced anaesthetic state.
d. Vasoconstrictive effects keep the anaesthetic at its local site of action.

Answer 2

d. Vasoconstrictive effects keep the anaesthetic at its local site of action.

Question 3

During the postoperative recovery period, what should be the nurse’s immediate main
concern?
a. Pupil responses
b. Return to sensation
c. Level of consciousness

d. Airway, breathing, and circulation

Answer 3

d. Airway, breathing, and circulation

Question 4

While monitoring a patient who had surgery under general anaesthesia 2 hours earlier, the
nurse notes a sudden elevation in body temperature. What does this sudden elevation in body
temperature indicate?

a. Tachyphylaxis
b. Postoperative infection
c. Malignant hypothermia
d. Malignant hyperthermia

Answer 4

d. Malignant hyperthermia

Question 5

Which individual is at high risk for an altered response to anaesthesia?

a. A 30-year-old male who has never had surgery before
b. A 45-year-old female who stopped smoking 10 years ago
c. A 20-year-old male who is to have a lymph node removed
d. A 78-year-old female who is to have her gallbladder removed

Answer 5

A 78-year-old female who is to have her gallbladder removed

Question 6

A patient is undergoing abdominal surgery and has been anaesthetized for 3 hours. Which
nursing diagnosis is appropriate for him?
a. Anxiety related to the use of an anaesthetic
b. Risk for injury related to increased sensorium from general anaesthesia
c. Decreased cardiac output related to systemic effects of local anaesthesia
d. Impaired gas exchange related to central nervous system (CNS) depression
produced by general anaesthesia

Answer 6

d. Impaired gas exchange related to central nervous system (CNS) depression
produced by general anaesthesia

Question 7

When administering a neuromuscular drug such as pancuronium, what does the nurse need to
remember?
a. It can be used instead of general anaesthesia during surgery.
b. Only skeletal muscles are paralyzed; respiratory muscles remain functional.
c. It causes sedation and pain relief while allowing for lower doses of anaesthetics.
d. Patients will require artificial mechanical ventilation because of paralyzed
respiratory muscles.

Answer 7

d. Patients will require artificial mechanical ventilation because of paralyzed
respiratory muscles.

Question 8

A patient has been given succinylcholine (Quelicin®) after a severe injury that necessitated
controlled ventilation. The physician now wants to reverse the paralysis. The nurse would
expect to use which drug to reverse the succinylcholine?
a. diazepam (Valium®)
b. caffeine
c. neostigmine methylsulphate
d. vecuronium bromide (Norcuron®)

Answer 8

c. neostigmine methylsulphate

Question 9

A patient is being prepared for an oral endoscopy, and the nurse reminds him that he will be
awake during the procedure but probably will not remember it. What type of anaesthetic
technique is used in this situation?
a. Twilight sleep
b. Procedural sedation
c. Adjunctive anaesthesia
d. Spinal anaesthesia

Answer 9

b. Procedural sedation

Question 10

Which symptom may occur if a patient is taking ginger and requires an anaesthetic?

a. Decreased blood pressure
b. Increased risk of bleeding
c. Increased risk of stroke
d. Migraine headaches

Answer 10

b. Increased risk of bleeding

Question 11

When a neuromuscular blocking drug is given, the effects occur in a certain order. Put the
following drug effects in the proper order of occurrence, using the choices A through C listed
below. Express your answer with small letters followed by a comma and a space (e.g. a, b, c).
a. Cessation of respirations due to paralysis of diaphragm and intercostal muscles
b. Total flaccid paralysis
c. Weakness

Answer 11

c. Weakness
b. Total flaccid paralysis
a. Cessation of respirations due to paralysis of diaphragm and intercostal muscles