Deck 26: Local Anesthetics

Question 1

A nurse is discussing the use of cocaine as a local anesthetic with a nursing student. Which statement by the student indicates understanding of this agent?

A) "Anesthetic effects develop slowly and persist for several hours."
B) "Cocaine is a local anesthetic administered by injection."
C) "Vasoconstrictors should not be used as adjunct agents with this drug."
D) "When abused, cocaine causes physical dependence."

Answer 1

"Vasoconstrictors should not be used as adjunct agents with this drug."

Question 2

A nurse is preparing a patient to go home from the emergency department after receiving sutures for a laceration on one hand. The provider used lidocaine with epinephrine as a local anesthetic. Which symptom in this patient causes the most concern?

A) Difficulty moving the fingers of the affected hand
B) Inability to feel pressure at the suture site
C) Nervousness and tachycardia
D) Sensation of pain returning to the wound

Answer 2

Nervousness and tachycardia

Question 3

A patient receives an epidural anesthetic during labor and delivery. The nurse caring for the newborn in the immediate postpartum period will observe the infant for:

A) bradycardia.
B) hypoglycemia.
C) jitteriness.
D) tachypnea.

Answer 3

bradycardia.

Question 4

A nurse is assisting the physician during a procedure in which a local anesthetic is administered. Within a few minutes of administration of the anesthetic, the patient has a pulse of 54 beats/min, respirations of 18 breaths per minute, and a blood pressure of 90/42 mm Hg. The nurse should monitor the patient for further signs of:

A) heart block.
B) anaphylaxis.
C) central nervous system excitation.
D) respiratory depression.

Question 5

A nurse is teaching a patient who has a second-degree burn on one arm about the use of a topical anesthetic for pain. Which statement by the patient indicates understanding of the teaching?

A) "I will apply a thin layer of the medication to a small area of skin."
B) "I will cover the burn with a dressing after applying the medication."
C) "I will make sure to apply the medication to the entire burn area."
D) "I will use the medication only on the most painful, blistered areas."

Question 6

A nurse is teaching a group of nursing students about local anesthetics. Which statement by a student reflects an understanding of the teaching?

A) "Local anesthetics affect large myelinated neurons first."
B) "Local anesthetics affect motor and sensory nerves."
C) "Local anesthetics do not block temperature perception."
D) "Local anesthetics do not cause systemic effects."

Question 7

A nurse is assisting a physician who is performing a circumcision on a newborn. The physician asks the nurse to prepare lidocaine and epinephrine for injection to provide anesthesia. What will the nurse do?

A) Ask the provider why an injectable anesthetic is being used for this procedure.
B) Draw up the medication as ordered and prepare the infant for the procedure.
C) Make sure that seizure precautions are in place.
D) Question the use of the epinephrine for this procedure.

Question 8

A nurse is assisting a physician who is preparing to suture a superficial laceration on a patient's leg. The physician asks the nurse to draw up lidocaine with epinephrine. The nurse understands that epinephrine is used with the lidocaine to:

A) allow more systemic absorption to speed up metabolism of the lidocaine.
B) increase the rate of absorption of the lidocaine.
C) improve perfusion by increasing blood flow to the area.
D) prolong anesthetic effects and reduce the risk of systemic toxicity from lidocaine.

Question 9

Vasoconstrictors are combined with local anesthetics for which reasons?

A) To enhance absorption
B) To reduce the risk of toxicity
C) To prevent bradycardia
D) To shorten the duration of action
E) To prolong anesthesia

Question 10

A nurse is caring for a patient in the immediate postoperative period after surgery in which a spinal anesthetic was used. The patient has not voided and complains of headache. The patient has a pulse of 62 beats/min, a respiratory rate of 16 breaths per minute, and a blood pressure of 92/48 mm Hg. Which action by the nurse is appropriate?

A) Contact the anesthetist to request an order for ephedrine.
B) Have the patient sit up to relieve the headache pain.
C) Lower the head of the bed to a 10- to 15-degree head-down position.
D) Obtain an order for a urinary catheter for urinary retention.

Question 11

Which are important considerations when spinal anesthesia is being administered?

A) Encouraging the patient to remain supine after the procedure
B) Having epinephrine available in case of adverse effects
C) Injecting a local anesthetic into the sacral region
D) Placing the agent into the spinal column outside the dura mater
E) Using an anesthetic solution from a single-dose vial