Nursing Pharmacology Chapter 15: Local Anesthetics Questions
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Question # 1 (Multiple Answer) Advantage(s) of 5% lidocaine (Xylocaine)-prilocaine (Citanest) cream (eutectic mixture)
(A) no local irritation
(B) even absorption
(C) no systemic toxicity
Question # 2 (Multiple Choice) Local anesthetic used in greater than 50% of rhinolaryngologic cases:
Answer: (B) cocaine
Question # 3 (Multiple Choice) Mechanism(s) of local anesthetic action in epidural anesthesia:
Answer: (C) both
Question # 4 (Multiple Answer) Rationale for adding epinephrine to a local anesthetic solution:
(A) reduced local anesthetic systemic absorption
(B) increased anesthetic concentration near nerve fibers
Question # 5 (Multiple Choice) Zone of differential motor blockade may average up to four segments below the sensory level
Answer: (A) epidural
Question # 6 (Multiple Choice) Duration of sensory anesthesia is likely to be extended for abdominal regional anesthesia
Answer: (B) false
Question # 7 (Multiple Choice) Primary side effect/toxicities associated with local anesthetic use:
Answer: (C) both
Question # 8 (Multiple Answer) Factors enhancing bupivacaine (Marcaine) toxicity
(A) pregnancy
(B) presence of calcium channel blockers
(C) arterial hypoxemia
(D) acidosis
(E) hypercarbia
Question # 9 (Multiple Answer) Agents added to local anesthetics that prolonged local anesthetic duration of action
(A) epinephrine
(B) phenylephrine (Neo-Synephrine)
(C) dextran
Question # 10 (Multiple Choice) typically a zone of differential sympathetic nervous system blockade
Answer: (B) spinal
Question # 11 (Multiple Answer) Preferred local anesthetics for local infiltration:
(A) lidocaine (Xylocaine)
(B) ropivacaine (Naropin)
(C) bupivacaine (Marcaine)
Question # 12 (Multiple Choice) Neurotoxicity associate with local anesthesia: sensory anesthesia, bowell & bladder sphincter dysfunction, paraplegia -- may because by nonhomogeneous local anesthetic distribution
Answer: (B) cauda equina syndrome
Question # 13 (Multiple Choice) Neurotoxicity -- moderate/severe lower back, buttocks, posterior side pain
Answer: (B) transient radicular irritation
Question # 14 (Multiple Answer) Factors that influence lidocaine (Xylocaine) metabolism:
(A) pregnancy-induced hypertension
(B) hepatic disease
(C) reduced liver blood flow
(D) volatile anesthetics
Question # 15 (Multiple Choice) Most common cause of toxic plasma local anesthetic concentrations
Answer: (B) accidental direct intravascular injection during peripheral or block or epidural anesthesia
Question # 16 (Multiple Choice) Common eutectic mixture of local anesthetics (EMLA)
Answer: (E) lidocaine (Xylocaine) and prilocaine (Citanest)
Question # 17 (Multiple Choice) Most frequent local anesthetic clinical use:
Answer: (D) regional anesthetia
Question # 18 (Multiple Choice) Lidocaine (Xylocaine) effect on ventilation response to hypoxia
Answer: (B) depressed response
Question # 19 (Multiple Answer) Clinical use(s) of EMLA applications:
(A) arterial cannulation
(B) venipuncture
(C) myringotomy
(D) lumbar puncture
Question # 20 (Multiple Answer) Allergic reactions to local anesthetics:
(B) high-risk with ester-type agents which are metabolized to p-aminobenzoic acid-related compounds
(D) intradermal testing for possible allergy to local anesthetics should use preservative-free drug
Question # 21 (Multiple Answer) Factors which increase local anesthetic CNS toxicities:
(B) rate of injection
(C) patient receiving mexiletine (Mexitil) when lidocaine (Xylocaine) is used
(D) high PaCO2 (reduced local anesthetic seizure threshold)
Question # 22 (Multiple Choice) Least likely to exhibit cross-sensitivity with amide or ester local anesthetics.
Answer: (E) dyclonine (Dyclone)
dyclonine (Dyclone) -- ketone structure BACK
Question # 23 (Multiple Answer) Factor(s) that reduce lidocaine (Xylocaine) seizure threshold.
(A) hypoxemia
(B) hyperkalemia
(C) acidosis
Question # 24 (Multiple Choice) Local anesthetic which produces localized vasoconstriction and anesthesia
Answer: (C) cocaine
Question # 25 (Multiple Choice) Agents not recommended for Bier block:
Answer: (D) all the above
Question # 26 (Multiple Answer) Manifestation of systemic toxicity
(A) CNS toxicity
(B) cardiovascular toxicity
(C) neurological symptoms
Question # 27 (Multiple Choice) Most commonly used local anesthetic for rhinolaryngologic cases
Answer: (D) cocaine
Question # 28 (Multiple Answer) Commonly use local anesthetics for topical/surface application:
(B) lidocaine (Xylocaine)
(C) tetracaine (pontocaine)
(D) cocaine
Question # 29 (Multiple Answer) Clinical presentations suggestive of local anesthetic allergies:
(A) rash
(B) laryngeal edema
(C) bronchospasm
(D) urticaria
(E) possibly hypotension
Question # 30 (Multiple Choice) Local anesthetic most likely to cause cyanosis secondary to reduced oxygen transport:
Answer: (D) prilocaine (Citanest)
Question # 31 (Multiple Choice) This amide-type local anesthetic is used to assess the possible presence of atypical cholinesterase
Answer: (C) dibucaine (Nupercainal, generic)
Question # 32 (Multiple Choice) Toxicities associated with systemic epinephrine absorption following local anesthetic use with epinephrine included in the local anesthetic solution
Answer: (C) both
Question # 33 (Multiple Choice) ropivacaine (Naropin):less cardiotoxic then bupivacaine (Marcaine)
Answer: (A) true
pure S-enantiomer BACK
Question # 34 (Multiple Answer) Factor(s) which determine extent of systemic local anesthetic absorption:
(A) initial dose
(B) injection site vascularity
(C) intrinsic drug properties
(D) whether or not epinephrine was used to provide local vasoconstriction
Question # 35 (Multiple Answer) Lidocaine (Xylocaine) cardiotoxicity -- electrophysiological characteristics
(A) ECG -PR interval prolongation
(C) reduced phase 4 depolarization
(D) reduced automaticity
Question # 36 (Multiple Choice) Local anesthetic lipophilicity and effectiveness of epinephrine on local anesthesia:
Answer: (B) more lipophilic anesthetics benef ileast by epinephrine in addition to local anesthetic solutions
Question # 37 (Multiple Choice) Neurotoxicity following local anesthesia: lower extremity paresis-- predisposing conditions may include advanced age and peripheral vascular disease
Answer: (C) anterior spinal artery syndrome
Question # 38 (Multiple Choice) Local anesthetic not recommended for peripheral nerve blockade:
Answer: (D) tetracaine (pontocaine)
slow onset/systemic toxicity BACK
Question # 39 (Multiple Answer) Frequently used amide-type local anesthetic for Bier block
(B) prilocaine (Citanest)