Chapter 27: General Anesthetics

Chapter 27: General Anesthetics

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A postoperative patient is reporting pain as a 7 on a scale from 1 to 10, with 10 being the worst pain. The nurse caring for the patient assesses vital signs of HR, 76; RR, 16; and BP, 110/70. The patient has vomited twice. Which postoperative medications will the nurse expect to administer?

ANS:  C

This patient is experiencing postoperative symptoms of moderate to severe pain and nausea and vomiting. Morphine is used postoperatively for this degree of pain, and ondansetron is one of the most effective antiemetics. Atropine is an anticholinergic drug and usually is given preoperatively or perioperatively to prevent bradycardia. Bethanechol is a muscarinic agonist that is used to counter postoperative abdominal distention and urinary retention. Ibuprofen can be used, but it is effective only for mild postoperative pain. Promethazine is less effective as an antiemetic and can be used, but clonidine, marketed as Catapres, is used for postoperative hypertension.

PTS:   1                    DIF:    Cognitive Level: Application           REF:   pp. 253-254

TOP:   Nursing Process: Diagnosis

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

2. A nurse is teaching nursing students about inhalation anesthesia and asks, “What is balanced anesthesia?” Which response by a student is correct?

ANS:  D

Balanced anesthesia is the use of a combination of drugs, along with an inhaled anesthetic, to produce effects that cannot safely be accomplished with inhalation anesthesia alone. These adjunct drugs are used to help induce anesthesia, provide muscle relaxation, and increase analgesia so that a lower and safer dose of the inhalation anesthetic can be used. The other three options describe characteristics of an ideal anesthetic, which does not exist; to get these effects, a combination of other drugs must be used.

PTS:   1                    DIF:    Cognitive Level: Analysis                REF:   pp. 251-252

TOP:   Nursing Process: Implementation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

3. A surgical patient is receiving succinylcholine [Anectine] with an inhalation anesthetic. The patient is intubated, has an indwelling urinary catheter, and has ongoing monitoring of vital signs. Which symptom during the perioperative period is cause for concern?

ANS:  A

Combining succinylcholine (a skeletal muscle relaxant) with an inhalation anesthetic increases the risk of malignant hyperthermia. The mechanism is not understood. Temperature elevation can be profound, and cooling measures must be initiated or the condition can be fatal. A decrease in urine output would be a sign of hypotension. Muscle paralysis and lack of response to pain are desired effects of anesthesia.

PTS:   1                    DIF:    Cognitive Level: Application           REF:   p. 253

TOP:   Nursing Process: Evaluation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential

4. A nurse administers atropine to a patient before induction of anesthesia for a surgical procedure. When evaluating the effects of this medication, the nurse will:

ANS:  C

Anticholinergic drugs, such as atropine [Sal-Tropine], may be given to reduce the risk of bradycardia during surgery. Atropine can alter bronchial secretions, but the effect would be to reduce them, not increase them. It is not used to reduce anxiety. It does not cause muscle paralysis.

PTS:   1                    DIF:    Cognitive Level: Application           REF:   pp. 253-254

TOP:   Nursing Process: Evaluation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies