Deck 16: Drugs That Block Nicotinic Cholinergic Transmission: Neuromuscular Blocking Agents

Question 1

While preparing a patient for a second esophageal dilation procedure, the nurse explains that succinylcholine [Anectine] will be used for muscle relaxation. The patient is anxious and reports not being able to swallow for several hours after the previous procedure. What will the nurse do?

A) Be prepared to provide mechanical ventilation after the procedure.
B) Have dantrolene available, because this patient is at increased risk for side effects.
C) Reassure the patient that this is expected after neuromuscular blockade.
D) Request an order for a pseudocholinesterase level.

Answer 1

Request an order for a pseudocholinesterase level.

Question 2

A patient receives a neuromuscular blocking agent before a procedure. The patient's eyes close. The nurse knows this is a sign that the patient:

A) has fallen asleep.
B) has received a toxic dose of the medication.
C) is beginning to feel the drug's effects.
D) may need mechanical ventilation.

Answer 2

is beginning to feel the drug's effects.

Question 3

A patient who will undergo electroconvulsive therapy to treat severe depression will be given succinylcholine just prior to the procedure. When teaching the patient about the procedure the nurse will explain that the succinylcholine is given for what purpose?

A) To minimize the amount of electroshock treatment required
B) To prevent harm caused by electroshock-induced convulsions
C) To prolong the therapeutic electroshock-induced convulsions
D) To stop the electroshock-induced convulsions once therapeutic effects have occurred

Answer 3

To prevent harm caused by electroshock-induced convulsions

Question 4

A nurse is reviewing nursing actions for emergency treatment of malignant hyperthermia with a group of nursing students. Which statement by a student indicates a need for further teaching?

A) "Analgesics should be given to help with muscle pain."
B) "Dantrolene helps to slow the metabolic activity in skeletal muscles."
C) "If malignant hyperthermia occurs, the succinylcholine must be stopped immediately."
D) "The patient may need an intravenous infusion of cold saline."

Question 5

A nurse is teaching a group of nursing students about neuromuscular blocking agents. For what may these agents be used?

A) Analgesia
B) Electroshock therapy
C) Malignant hyperthermia
D) Mechanical ventilation
E) Surgery

Question 6

A patient with hepatitis requires endotracheal intubation. Which agent does the nurse expect to be administered to facilitate this procedure?

A) Atropine
B) Cisatracurium [Nimbex]
C) Rocuronium [Zemuron]
D) Vecuronium [Norcuron]

Question 7

A nurse is caring for an intubated patient who is receiving pancuronium for neuromuscular blockade. The patient's eyes are closed, and the patient is not moving any extremities. The heart rate is 76 beats/min, and the blood pressure is 110/70 mm Hg. The nurse caring for this patient will do what?

A) Request an order for an antihistamine to prevent a further drop in blood pressure.
B) Request an order for serum electrolytes to evaluate for hyperkalemia.
C) Review the patient's chart for a history of myasthenia gravis (MG).
D) Talk to the patient while giving care and explain all procedures.

Question 8

While preparing a patient for a procedure in which a neuromuscular blocking agent will be used, the nurse reviews the patient's preprocedure laboratory values. Which abnormality would cause the most concern?

A) Hyponatremia
B) Hypercalcemia
C) Hypomagnesemia
D) Hypokalemia

Question 9

Which areas of the body show the effects of neuromuscular blockers last?

A) Levator muscle of the eyelids and the muscles of mastication
B) Muscles in the lower extremities
C) Muscles controlling the glottis
D) Muscles of respiration and the diaphragm

Question 10

A patient will receive atracurium [Tracrium] during surgery for neuromuscular blockade. The nurse caring for this patient will correctly perform which of the following actions?

A) Assess the patient for signs of CNS depression.
B) Ensure that dantrolene is available in case of a serious adverse reaction.
C) Monitor the patient's blood pressure closely.
D) Review the preprocedure laboratory values related to renal and hepatic function.