Holland/Adams/Brice, Core Concepts in Pharmacology 5th Edition Test Bank
Chapter 16

Question 1

Type: MCMA

A client is admitted to the hospital for surgery. The nurse is explaining major routes of applying local anesthesia to the client. Which routes should be included in the teaching? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Spinal
2. Topical
3. Epidural
4. Tendon block
5. Infiltration

Cognitive Level: Understanding

Client Need: Physiological Integrity

Page Number: 243

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 16-1 Compare and contrast the five major routes for administering local anesthetics.

Question 2

Type: MCSA

The client asks the nurse how local anesthetics work. Which response by the nurse is most appropriate?

1. They numb the skin.
2. They block calcium channels.
3. They block sodium channels.
4. They increase sensation.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 244

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 16-1 Compare and contrast the five major routes for administering local anesthetics.

Question 3

Type: MCSA

The nurse educator asks a group of students what occurs when sensation is lost to a limited part of the body without loss of consciousness. Which answer by the student is correct?

1. General anesthesia
2. Surgical anesthesia
3. Local anesthesia
4. Total anesthesia

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 243

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 16-1 Compare and contrast the five major routes for administering local anesthetics.

Question 4

Type: MCSA

A nurse educator is instructing students about the history of anesthetics. Which type of anesthetic was the ester of choice for dental procedures from the mid-1900s to the 1960s?

1. Cocaine
2. Benzocaine (Solarcaine)
3. Procaine (Novocain)
4. Lidocaine (Xylocaine)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 246

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 16-3 Describe differences between the two major chemical classes of local anesthetics and explain their adverse effects.

Question 5

Type: MCSA

Which medication is NOT an ester?

1. Chloroprocaine (Nesacaine)
2. Bupivicaine (Marcaine)
3. Benzocaine (Americaine)
4. Tetracaine (Pontocaine)

Cognitive Level: Remembering

Client Need: Physiological Integrity

Page Number: 245

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 16-3 Describe differences between the two major chemical classes of local anesthetics and explain their adverse effects.

Question 6

Type: MCSA

A client is receiving a local anesthetic. What instruction is most appropriate by the nurse prior to administering the medication?

1. Never take at home.
2. Take only when drowsiness is present.
3. Report any unusual heart palpitations, lightheadedness, drowsiness, or confusion.
4. Allow family members to use as needed.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 247

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 16-3 Describe differences between the two major chemical classes of local anesthetics and explain their adverse effects.

Question 7

Type: MCSA

When explaining a surgical procedure to a client, the nurse tells the client that a small amount of which drug is sometimes added to the anesthetic solution to lengthen the duration of action of the anesthetic?

1. Epinephrine (Adrenaline)
2. Midazolam (Versed)
3. Diphenhydramine (Benadryl)
4. Lidocaine (Xylocaine)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 244

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 16-2 Explain the mechanism of action of local anesthetics, and explain why additives are sometimes included in the anesthetic solution.

Question 8

Type: MCSA

A client is having surgery tomorrow and the nurse is discussing the plan of care for surgery. Which statement by the client indicates understanding of the preoperative teaching?

1. “I will probably feel pain during the procedure.”
2. “I won’t feel a thing because I will be asleep.”
3. “I will lose consciousness, movement, and memory.”
4. “I will retain all memory of my procedure.”

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 248

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 16-4 Identify the primary actions of general anesthetics within the central nervous system, and identify the four stages of general anesthesia.

Question 9

Type: MCSA

A client having an abdominal resection also has a history of myasthenia gravis. Due to the risk of nitrous oxide, what does the nurse anticipate this client to be at a greater risk for developing?

1. Increased heart rate and respiratory depression
2. Nausea and vomiting during surgery
3. Decreased intracranial pressure and diuresis
4. Respiratory depression and prolonged hypnotic effects

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 250

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 16-5 Explain how general anesthesia is achieved, and categorize drugs for general anesthesia based on their classifications and actions in the body.

Question 10

Type: MCSA

Which is an inhaled anesthetic?

1. Dibucaine (Nupercaine)
2. Dyclonine (Dyclone)
3. Pramoxine (Tronothane)
4. Nitrous oxide

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 250

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 16-5 Explain how general anesthesia is achieved, and categorize drugs for general anesthesia based on their classifications and actions in the body.

Question 11

Type: MCSA

An OR nurse is quizzing a group of students who are observing in the surgical suite. The nurse asks the students how many stages of anesthesia there are. Which answer by the students is correct?

1. Two
2. Four
3. Three
4. One

Cognitive Level: Remembering

Client Need: Physiological Integrity

Page Number: 249

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 16-4 Identify the primary actions of general anesthetics within the central nervous system, and identify the four stages of general anesthesia.

Question 12

Type: MCSA

How many medications are used to rapidly cause unconsciousness and muscle relaxation and to maintain deep anesthesia?

1. Five medications
2. A single medication
3. Always two medications
4. Multiple medications

Cognitive Level: Understanding

Client Need: Physiological Integrity

Page Number: 248

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 16-4 Identify the primary actions of general anesthetics within the central nervous system, and identify the four stages of general anesthesia.

Question 13

Type: MCSA

What is the appropriate term for the third stage of anesthesia?

1. Topical anesthesia
2. Local anesthesia
3. Surgical anesthesia
4. Balanced anesthesia

Cognitive Level: Remembering

Client Need: Physiological Integrity

Page Number: 249

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 16-4 Identify the primary actions of general anesthetics within the central nervous system, and identify the four stages of general anesthesia.

Question 14

Type: MCSA

The nurse prepares to administer succinylcholine (Anectine) as per the medication order. What does the nurse expect after the medication has been administered?

1. Loss of consciousness
2. Light sedation
3. Prevention of muscle contractions
4. Total skeletal muscle relaxation

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 253

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 16-6 For each of the adjunctive drug classes, identify representative drugs and explain their roles before, during, and after surgery.

Question 15

Type: MCSA

The client asks the nurse about the uses of nitrous oxide. Which statement is the most appropriate by the nurse?

1. Nitrous oxide is rarely used in any setting.
2. Nitrous oxide is used for local anesthesia.
3. Nitrous oxide is used for dental procedures.
4. Nitrous oxide is used for general anesthesia.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 250

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 16-5 Explain how general anesthesia is achieved, and categorize drugs for general anesthesia based on their classifications and actions in the body.

Question 16

Type: MCSA

The nurse educator is teaching a group of students about inhaled anesthetics and intravenous anesthetics. Which is an intravenous anesthetic?

1. Methoxyflurane (Penthrane)
2. Isoflurane (Forane)
3. Propofol (Diprivan)
4. Halothane (Fluothane)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 249

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 16-6 For each of the adjunctive drug classes, identify representative drugs and explain their roles before, during, and after surgery.

Question 17

Type: MCSA

The nurse is preparing to administer ketamine (Ketalar) to a client. Which route of administration is correct?

1. Oral
2. Intravenous
3. Inhaled
4. Topical

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 249

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 16-6 For each of the adjunctive drug classes, identify representative drugs and explain their roles before, during, and after surgery.