Nokea
When administering a neuromuscular blocking drug, the nurse needs to remember which principle?
- A. It is used instead of general anesthesia 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 anesthetics.
- D. Artificial mechanical ventilation is required because of paralyzed respiratory muscles.
Correct Answer: D
Rationale: Neuromuscular blocking drugs paralyze all skeletal muscles, including respiratory muscles, requiring mechanical ventilation. They do not provide sedation or pain relief and are used with, not instead of, general anesthesia.
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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/lidocaine (EMLA) cream around the site
- D. Infiltration of the puncture wound with lidocaine
Correct Answer: D
Rationale: Infiltration anesthesia with lidocaine is appropriate for minor surgical procedures like fishhook removal, as it involves injecting anesthetic around the wound to block local nerves. No anesthesia is impractical due to pain, and topical agents like benzocaine or EMLA are less effective for deeper wounds.
A patient is to receive midazolam 2 mg IV push over 2 minutes just before an endoscopy procedure. The medication is available in a strength of 1 mg/mL. Identify how many milliliters of medication will the nurse draw up into the syringe for this dose.
Correct Answer: 2 mL
Rationale: To calculate: 1 mg/1 mL = 2 mg/x mL. Cross-multiply: (1 * x) = (1 * 2); x = 2 mL.
A patient is being prepared for an oral endoscopy, and the nurse anesthetist reminds him that he will be awake during the procedure but probably will not remember it. What type of anesthetic technique is used in this situation?
- A. Local anesthesia
- B. Moderate sedation
- C. Topical anesthesia
- D. Spinal anesthesia
Correct Answer: B
Rationale: Moderate sedation reduces anxiety, pain, and recall while allowing the patient to maintain their airway and respond to commands, ideal for procedures like oral endoscopy. Local and topical anesthesia do not affect recall, and spinal anesthesia is used for lower body procedures.
While monitoring a patient who had surgery under general anesthesia 1 hour 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
Correct Answer: D
Rationale: Malignant hyperthermia is a life-threatening condition associated with general anesthesia, characterized by a sudden rise in body temperature. Tachyphylaxis refers to reduced drug response, postoperative infection develops more slowly, and malignant hypertension primarily involves blood pressure elevation.
During the immediate postoperative period, the Post Anesthesia Care Unit nurse is assessing a patient who had hip surgery. The patient is experiencing tachycardia, tachypnea, and muscle rigidity, and his temperature is 103?°F. These findings indicate which condition?
- A. Tachyphylaxis
- B. Postoperative infection
- C. Malignant hypertension
- D. Malignant hyperthermia
Correct Answer: D
Rationale: Tachycardia, tachypnea, muscle rigidity, and elevated temperature (103?°F) are classic signs of malignant hyperthermia, a rare but serious complication of general anesthesia. Tachyphylaxis involves reduced drug response, infections develop more slowly, and malignant hypertension primarily affects blood pressure.