Chapter 11: General and Local Anesthetics

Chapter 11: General and Local Anesthetics

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. During a fishing trip, a patient pierced his finger with a large fishhook. He is now in the emergency department to have it removed. The nurse anticipates that which type of anesthesia will be used for this procedure?

a.	No anesthesia
b.	Topical benzocaine spray on the area
c.	Topical prilocaine (EMLA) cream around the site
d.	Infiltration of the puncture wound with lidocaine

 

 

ANS:  D

Infiltration anesthesia is commonly used for minor surgical procedures. It involves injecting the local anesthetic solution intradermally, subcutaneously, or submucosally across the path of nerves supplying the area to be anesthetized. The local anesthetic may be administered in a circular pattern around the operative field. The other types are not appropriate for this injury. This is a painful procedure; therefore, the option of “no anesthesia” is incorrect.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   p. 176

TOP:   NURSING PROCESS: Planning

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

2. While monitoring a patient who had surgery under general anesthesia 2 hours ago, the nurse notes a sudden elevation in body temperature. This finding may be an indication of which problem?

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

 

 

ANS:  D

A sudden elevation in body temperature during the postoperative period may indicate the occurrence of malignant hyperthermia, a life-threatening emergency. The elevated temperature does not reflect the other problems listed.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   p. 174

TOP:   NURSING PROCESS: Assessment

MSC:  NCLEX: Safe and Effective Care Environment: Management of Care

 

3. When assessing patients in the preoperative area, the nurse knows that which patient is at a higher risk for an altered response to anesthesia?

a.	The 21-year-old patient who has never had surgery before
b.	The 35-year-old patient who stopped smoking 8 years ago
c.	The 40-year-old patient who is to have a kidney stone removed
d.	The 82-year-old patient who is to have gallbladder removal

 

 

ANS:  D

The elderly patient is more affected by anesthesia than the young or middle-aged adult patient because of the effects of aging on the hepatic, cardiac, respiratory, and renal systems.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   p. 173

TOP:   NURSING PROCESS: Assessment

MSC:  NCLEX: Physiological Integrity: Reduction of Risk Potential

 

4. A patient is undergoing abdominal surgery and has been anesthetized for 3 hours. Which nursing diagnosis would be appropriate for this patient?

a.	Anxiety related to the use of an anesthetic
b.	Risk for injury related to increased sensorium from general anesthesia
c.	Decreased cardiac output related to systemic effects of local anesthesia
d.	Impaired gas exchange related to central nervous system depression produced by general anesthesia

 

 

ANS:  D

The nursing diagnosis of impaired gas exchange is appropriately worded for this patient. Anxiety would not be appropriate while the patient is in surgery. Sensorium would be decreased during surgery, not increased. Cardiac output is affected by general anesthesia, not local anesthesia.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   p. 183

TOP:   NURSING PROCESS: Nursing Diagnosis

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies