Chapter 19 – Answers to Review Questions
1. Answer: 1
Rationale: The patient’s throat was anesthetized during gastroscopy with lidocaine viscous. The
patient should be assessed for the return of the gag reflex before being allowed to drink or eat to
prevent aspiration. Options 2, 3, and 4 are incorrect. Leg pain, ability to stand, and ability to
urinate are not assessments related to the procedure or the lidocaine viscous use. If these are
noted as abnormal, other causes should be investigated.
Cognitive Level: Applying.
Nursing Process: Assessment.
Client Need: Physiological Integrity.
2. Answer: 4
Rationale: Solutions of lidocaine containing epinephrine are used for local anesthesia because
the epinephrine will prolong the anesthetic action at the site. Because this is a young patient, that
may be particularly advantageous. Options 1, 2, and 3 are incorrect. Epinephrine causes
vasoconstriction and HTN when given systemically; this drug is being used locally. Epinephrine
will not prevent postsuturing infection and the site should continue to be monitored.
Cognitive Level: Analyzing.
Nursing Process: Implementation.
Client Need: Physiological Integrity.
3. Answer: 3
Rationale: Nitrous oxide suppresses the pain mechanisms within the CNS thereby causing
analgesia. Options 1, 2, and 4 are incorrect. Nitrous oxide does not produce complete loss of
consciousness or the profound relaxation of skeletal muscles as general anesthetics do and the
patient does not perceive pain differently; it is suppressed.
Cognitive Level: Analyzing.
Nursing Process: Implementation.
Client Need: Physiological Integrity.
4. Answer: 1, 4
Rationale: Bradycardia and respiratory depression are common findings with general anesthetics
in the immediate postoperative period due to the CNS depressant effects of the drugs. Options 2,
3, and 5 are incorrect. General anesthetics may cause hypotension or urinary retention and
generally do not cause a severe headache. If it occurs, other causes should be investigated.
Cognitive Level: Analyzing.
Nursing Process: Assessment.
Client Need: Physiological Integrity.
©2017 by Pearson Education, Inc.
Adams/Holland/Urban, Pharmacology for Nurses: A Pathophysiologic Approach, 5th Edition
5. Answer: 4
Rationale: Neuroleptanalgesia drugs such as ketamine do not result in full loss of consciousness
but cause disconnection from events that are occurring. Confusion, anxiety, fear, or panic may
occur in the immediate postprocedure period if sensory stimulation is misinterpreted. Sensory
stimulation should be kept to a minimum during this period for this reason. Options 1, 2, and 3 are
incorrect. Frequent assessments, above those required for patient safety or monitoring, increase
sensory stimulation and may result in extreme reactions by the patient.
Cognitive Level: Applying.
Nursing Process: Implementation.
Client Need: Safe and Effective Care Environment.
6. Answer: 1
Rationale: The combination of succinylcholine (Anectine, Quelicin) and general anesthetics is
known to trigger malignant hyperthermia in some patients. A temperature of 38.9°C (102°F) may
signal the development of malignant hyperthermia and should be immediately reported. Options 2,
3, and 4 are incorrect. General anesthetics depress CNS function, and bradycardia, bradypnea, and
lowered blood pressure or hypotension are not uncommon findings in the immediate postoperative
period. The nurse should compare these patient findings with the baseline assessment to
determine if they are abnormal or a normal expected effect of the general anesthesia.
Cognitive Level: Analyzing.
Nursing Process: Assessment.
Client Need: Physiological Integrity.
©2017 by Pearson Education, Inc.
Adams/Holland/Urban, Pharmacology for Nurses: A Pathophysiologic Approach, 5th Edition