Anesthesia Pharmacology

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Sample questions from Anesthesia Pharmacology

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.A client receives IV midazolam before a procedure. Which assessment is the nurse's priority?

   • A.Capillary refill in the toes
   • B.Respiratory rate and oxygen saturation
   • C.Urine color
   • D.Bowel sounds

   Rationale: Midazolam can cause dose-dependent sedation and respiratory depression, especially when combined with opioids, so ventilation and oxygenation are priorities. Bowel sounds, toe perfusion, and urine color do not identify its most immediate potentially life-threatening adverse effect. Continue to monitor level of consciousness and maintain access to airway support.

2. 2.A client is scheduled for general anesthesia and reports taking St. John's wort daily. Which response by the nurse is most appropriate?

   • A.Tell the client to take an extra dose on the morning of surgery.
   • B.Advise the client to stop all prescribed medications immediately.
   • C.Document the supplement and notify the anesthesia team.
   • D.Explain that herbal products do not affect anesthetic drugs.

   Rationale: St. John's wort can alter drug-metabolizing enzymes and transporters, potentially changing anesthetic and other medication effects; the anesthesia team needs this information. Taking an extra dose could increase interaction risk, and herbal products are not pharmacologically inert. The client should not independently stop prescribed medications; medication changes should be directed by the prescriber.

3. 3.The nurse is preparing an older adult for procedural sedation with an opioid and a benzodiazepine. Which actions are appropriate? Select all that apply.

   • A.Ensure that oxygen, suction, and airway-rescue equipment are available.
   • B.Continuously monitor oxygenation and assess ventilation and level of consciousness.
   • C.Administer the usual adult dose rapidly to achieve sedation before monitoring begins.
   • D.Review the client's current medications and substance use.
   • E.Consider that age-related changes may increase sensitivity and prolong drug effects.

   Rationale: Medication and substance-use review can identify additive central nervous system depression and interactions. Rescue equipment and ongoing assessment are necessary because both drug classes can depress ventilation, and older adults may have increased sensitivity or slower clearance. Rapidly administering a routine adult dose before monitoring is unsafe because dosing should be individualized and titrated with monitoring in place.

4. 4.A nurse administers IV fentanyl to a client receiving anesthesia. Which finding requires the most immediate action?

   • A.Mild nausea
   • B.Reports of itching without rash or breathing difficulty
   • C.Small pupils with a respiratory rate of 16/min
   • D.Respiratory rate of 7/min with difficult arousal

   Answer and rationale are in the full material.

5. 5.A client with chronic kidney disease is prescribed an anesthetic adjunct that is primarily eliminated unchanged in urine. Which pharmacokinetic concern should the nurse anticipate?

   • A.Reduced renal clearance may prolong the drug's effect.
   • B.The drug will be cleared more rapidly because urine output is lower.
   • C.Reduced kidney function will always prevent the drug from entering the bloodstream.
   • D.Renal impairment affects absorption but not elimination.

   Answer and rationale are in the full material.