NUR 141 Pharma Test 2, Questions & Answers
With Rationales
The nurse is providing education to a client who has been scheduled to receive spinal anesthesia.
What anatomical location will the nurse identify as the site of administration?
A) Mucous membrane
B) Epidural space
C) Nerve ganglion
D) Lumbar region - D) Lumbar region
Rationale:
Spinal anesthesia involves injecting the anesthetic agent into the cerebrospinal fluid, usually in
the lumbar spine. Epidural anesthesia involves the injection of an anesthetic into the epidural
space. Nerve block anesthesia blocks a group of nerves, called a plexus or ganglion, to a specific
area of the body. Topical anesthesia involves the application of a local anesthetic on the skin or
mucous membranes.
The induction of a local anesthetic would decrease the permeability of the nerve cell membrane
to which element?
A) Sodium
B) Glucose
C) Bicarbonate
D) Phosphorus - A) Sodium
Rationale:
Local anesthetics decrease the permeability of the nerve cell membrane to ions, especially
sodium.
NCLEX: What medical diagnosis is likely to be managed with the daily administration of a 5%
to 20% topical benzocaine solution?
A) Psoriasis
B) Hemorrhoids
C) Stomatitis
D) Chronic pain - B) Hemorrhoids
Rationale:
Application of the 5% to 20% topical solution of benzocaine relieves hemorrhoid pain. This
solution is not indicated in the treatment of psoriasis, chronic pain, or stomatitis.
Which medication used for local and regional anesthesia has the longest duration of action?
A) Mepivacaine
B) Procaine
C) Bupivacaine
,D) Lidocaine - C) Bupivacaine
Rationale:
Bupivacaine is used for local, regional, and spinal anesthesia for diagnostic and therapeutic
procedures. The drug is more potent and has a longer duration of action than lidocaine, procaine,
or mepivacaine.
For what client is intravenous (IV) administration of 2% lidocaine most likely indicated?
A) A client who requires a bolus of IV normal saline to restore vascular volume
B) A client whose lower limb pain has not responded to opioids
C) A client who is scheduled to receive an IV dose of propofol
D) A client who has just had a peripherally inserted central catheter (PICC) inserted - C) A client
who is scheduled to receive an IV dose of propofol
Rationale:
A 2% lidocaine solution may be administered intravenously preceding administration of a
painful IV medication such as propofol in the surgical arena. Bolus IV fluids, recent PICC
insertion, and limb pain do not warrant IV administration of lidocaine.
A client with a history that suggests a possible hypersensitivity to chloroprocaine requires
administration of the drug. Following administration, what assessment should the nurse
prioritize?
A) Musculoskeletal
B) Integumentary
C) Respiratory
D) Neurological - C) Respiratory
Rationale:
Excessive doses of chloroprocaine can result in respiratory depression; respiratory assessment is
consequently indicated. It is less important to assess the client's temperature, neurologic function,
or musculoskeletal status. To determine therapeutic effects, it is necessary to assess for
cutaneous sensation in the client's integumentary system.
A primiparous woman who has been in the first stage of labor for 2 hours will receive an
anesthetic. What would the perinatal nurse anticipate being the anesthetic of choice?
A) Intravenous anesthesia
B) Spinal anesthesia
C) Epidural anesthesia
D) Topical anesthesia - C) Epidural anesthesia
Rationale:
Epidural anesthesia involves injecting the anesthetic into the epidural space. It is used most often
in obstetrics during labor and birth. Topical, intravenous, and spinal anesthesia are unlikely
choices for this client.
,The nurse is providing education to a client who will receive an injection of chloroprocaine. The
nurse should instruct the client that sensation is likely to return how long after the injection?
A) 60 minutes
B) 10 minutes
C) 20 minutes
D) 3 hours - A) 60 minutes
Rationale:
Chloroprocaine is absorbed rapidly at the injection site. The onset of action is 6 to 12 minutes,
with a duration of 1 hour.
The nurse has just completed administration of an oral local anesthetic mouthwash to a client.
What undesired outcome is the nurse preventing by withholding food and fluids following
administration?
A) Gastroesophageal reflux
B) Dysphagia
C) Gastritis
D) Aspiration - D) Aspiration
Rationale:
Clients should not drink fluids or eat after gargling with oral anesthetics due to the risk of
aspiration. This intervention does not prevent gastritis, reflux, or dysphagia.
While assisting the health care provider with a minor procedure involving a local anesthetic, the
nurse monitors the client for a systemic toxicity event. What is the usual trigger for such an
event?
A) A genetic predisposition toward incomplete metabolism of the anesthetic
B) A type II hypersensitivity response to the anesthetic
C) A type I hypersensitivity response to the anesthetic
D) Systemic absorption of a local anesthetic - D) Systemic absorption of a local anesthetic
Rationale:
LAST occurs when the local anesthetic is absorbed systemically, resulting in extreme central
nervous system (CNS) excitation followed by cardiovascular excitation and cardiovascular
collapse. LAST is not a hypersensitivity reaction or a result of incomplete metabolism.
A client has been prescribed oral lidocaine solution prior to a bronchoscopy. What instruction
should the nurse provide?
A) ''Hold this solution under your tongue for a minute before swallowing it.''
B) ''Hold this solution in your mouth for a few seconds and then spit it out.''
C) ''Swish the solution around your mouth for a few seconds and then spit it into this basin.''
D) ''Gargle with the solution for 30 seconds and then swallow it.'' - D) ''Gargle with the solution
for 30 seconds and then swallow it.''
Rationale:
, When pharyngeal anesthesia is needed, such as prior to a bronchoscopy, the client gargles and
then swallows the oral lidocaine. This process best effects the local anesthetic of the medication.
The other described actions will result in a lesser anesthetic effect.
The nurse is preparing to insert a peripheral intravenous catheter into a school-age client. What
local anesthetic is the nurse likely to apply prior to insertion?
A) Tetracaine hydrochloride
B) Cocaine hydrochloride ointment
C) Eutectic mixture of local anesthetics (EMLA) cream
D) Benzocaine cream - C) Eutectic mixture of local anesthetics (EMLA) cream
Rationale:
Eutectic mixture of local anesthetics (EMLA) is a cream-based mixture of lidocaine and
prilocaine applied to intact skin. The cream is applied at an injection site with an occlusive
dressing at least 60 minutes before the vaccination or venipuncture. Tetracaine, cocaine, and
benzocaine are not used for this purpose.
A client is scheduled for a colonoscopy involving sedation with propofol. Prior to the procedure,
the nurse should assess the client for what possible allergy? Select all that apply.
1) Nuts
2) Soybeans
3) Shellfish
4) Eggs
5) Dairy products
A) 1,2,3
B) 2,4
C) 3,5
D) 1,4
E) None are
F) All are - B) 2,4
Rationale:
Clients who are allergic to soybean or soy products, or eggs or egg products, should not receive
propofol. Allergies involving nuts, shellfish, and dairy products are not contraindications.
What medication belongs to the category of inhaled anesthetics?
A) Etomidate
B) Desflurane
C) Propofol
D) Atracurium - B) Desflurane
Rationale:
