Test Bank - Focus on Nursing Pharmacology (8th Edition by Karch)
1. To decrease sympathetic stimulation in balanced anesthesia type of what agent
would be used?
a. Antihistamines
b. Antiemetics
c. Narcotics
d. Sedative-hypnotics
Ans: D
Feedback:
Sedative-hypnotics relax the patient, facilitate amnesia, and decrease sympathetic
stimulation. Antihistamines decrease the chance of allergic reaction and help dry
secretions. Antiemetics decrease the nausea and vomiting associated with
gastrointestinal (GI) depression. Narcotics aid in the analgesic and sedative effects.
2. During what stage of anesthesia would the nurse see the patient’s skeletal muscles
relax and return of regular respirations?
a. Stage 1: Analgesia stage
b. Stage 2: Excitement stage
c. Stage 3: Surgical anesthesia stage
d. Stage 4: Medullary paralysis
Ans: C
Feedback:
Stage 3 is surgical anesthesia, which involves relaxation of skeletal muscles and
return of regular respirations. During this stage, eye reflexes and pupil dilation are
progressively lost. Surgery can be safely performed in this stage. Stage 1 refers to the
loss of pain sensation; stage 2 involves a period of excitement with sympathetic
stimulation (e.g., tachycardia, increased respirations, blood pressure changes); and
stage 4 involves deep central nervous system depression with loss of respiratory and
vasomotor center stimuli. Death can occur rapidly at this stage if adequate support is
not supplied.
3. The nurse is developing a plan of care for the patient undergoing general
anesthesia. What is a priority of care for this patient?
a. Encourage clear fluids.
b. Increase oxygen.
c. Reassure the patient that about safety.
, d. Maintain regular repositioning.
Ans: D
Feedback:
The patient would need to be moved or turned periodically to prevent skin breakdown
and the formation of decubitus ulcers if the surgery lasted longer than an hour. Muscle
paralysis resulting from the medications used in general anesthesia would prevent the
patient from shifting himself or herself to relieve increase pressure. A patient
receiving a general anesthetic would be unconscious, require respiratory support, and
be connected to a mechanical ventilator to maintain respirations. Increased oxygen
would not be indicated unless oxygen levels were less than adequate, and the patient
would not receive anything by mouth eliminating option A. Reassurance would not be
necessary for the unconscious patient.
4. A plan of care formulated by an operating room (OR) nurse includes four nursing
diagnoses. Which diagnoses will the nurse include that is directly related to safety?
a. Deficient knowledge regarding drug therapy
b. Disturbed sensory perception (kinesthetic, tactile) related to anesthesia
c. Risk for impaired skin integrity related to immobility
d. Risk for injury related to central nervous system (CNS) depressive effects
of drugs
Ans: D
Feedback:
The nursing diagnosis, which directly relates to safety, is high risk for injury. The
other three options are only indirectly related to safety. While in the OR, the patient
under general anesthetic is unable to express safety concerns and must rely
completely on the surgeon and OR staff for protection.
5. What nursing interventions would help minimize the risk of a headache in a patient
recovering from spinal anesthesia?
a. Administer a triptan intramuscularly.
b. Administer morphine intravenously.
c. Maintain patient in recumbent position.
d. Place patient in Trendelenburg position.
Ans: C
Feedback:
Patients receiving spinal anesthesia should remain in a recumbent position for as long
as 12 hours. Triptan would not be effective because it is indicated for treatment of
migraine headaches. Morphine would treat the headache but would not prevent it.
6. An extremely anxious patient is beginning to awaken in the postanesthesia care
unit. He or she states that his or her arms and legs feel like tree trunks and that they
1. To decrease sympathetic stimulation in balanced anesthesia type of what agent
would be used?
a. Antihistamines
b. Antiemetics
c. Narcotics
d. Sedative-hypnotics
Ans: D
Feedback:
Sedative-hypnotics relax the patient, facilitate amnesia, and decrease sympathetic
stimulation. Antihistamines decrease the chance of allergic reaction and help dry
secretions. Antiemetics decrease the nausea and vomiting associated with
gastrointestinal (GI) depression. Narcotics aid in the analgesic and sedative effects.
2. During what stage of anesthesia would the nurse see the patient’s skeletal muscles
relax and return of regular respirations?
a. Stage 1: Analgesia stage
b. Stage 2: Excitement stage
c. Stage 3: Surgical anesthesia stage
d. Stage 4: Medullary paralysis
Ans: C
Feedback:
Stage 3 is surgical anesthesia, which involves relaxation of skeletal muscles and
return of regular respirations. During this stage, eye reflexes and pupil dilation are
progressively lost. Surgery can be safely performed in this stage. Stage 1 refers to the
loss of pain sensation; stage 2 involves a period of excitement with sympathetic
stimulation (e.g., tachycardia, increased respirations, blood pressure changes); and
stage 4 involves deep central nervous system depression with loss of respiratory and
vasomotor center stimuli. Death can occur rapidly at this stage if adequate support is
not supplied.
3. The nurse is developing a plan of care for the patient undergoing general
anesthesia. What is a priority of care for this patient?
a. Encourage clear fluids.
b. Increase oxygen.
c. Reassure the patient that about safety.
, d. Maintain regular repositioning.
Ans: D
Feedback:
The patient would need to be moved or turned periodically to prevent skin breakdown
and the formation of decubitus ulcers if the surgery lasted longer than an hour. Muscle
paralysis resulting from the medications used in general anesthesia would prevent the
patient from shifting himself or herself to relieve increase pressure. A patient
receiving a general anesthetic would be unconscious, require respiratory support, and
be connected to a mechanical ventilator to maintain respirations. Increased oxygen
would not be indicated unless oxygen levels were less than adequate, and the patient
would not receive anything by mouth eliminating option A. Reassurance would not be
necessary for the unconscious patient.
4. A plan of care formulated by an operating room (OR) nurse includes four nursing
diagnoses. Which diagnoses will the nurse include that is directly related to safety?
a. Deficient knowledge regarding drug therapy
b. Disturbed sensory perception (kinesthetic, tactile) related to anesthesia
c. Risk for impaired skin integrity related to immobility
d. Risk for injury related to central nervous system (CNS) depressive effects
of drugs
Ans: D
Feedback:
The nursing diagnosis, which directly relates to safety, is high risk for injury. The
other three options are only indirectly related to safety. While in the OR, the patient
under general anesthetic is unable to express safety concerns and must rely
completely on the surgeon and OR staff for protection.
5. What nursing interventions would help minimize the risk of a headache in a patient
recovering from spinal anesthesia?
a. Administer a triptan intramuscularly.
b. Administer morphine intravenously.
c. Maintain patient in recumbent position.
d. Place patient in Trendelenburg position.
Ans: C
Feedback:
Patients receiving spinal anesthesia should remain in a recumbent position for as long
as 12 hours. Triptan would not be effective because it is indicated for treatment of
migraine headaches. Morphine would treat the headache but would not prevent it.
6. An extremely anxious patient is beginning to awaken in the postanesthesia care
unit. He or she states that his or her arms and legs feel like tree trunks and that they
