NGR 6172 Quiz 6 The University of West Florida
Questions with 100% Verified Answers Latest Update
Question: A patient states that the dose of oxycodone he currently receives does not
provide the same pain relief as it used to. The nurse understands that the patient has
developed what?
A. Physical dependence
B. Tolerance
C. Withdrawal syndrome
D. An addiction
Answer:
Answer: B
Rationale: Tolerance occurs with regular drug use and is a state in which a particular dose
elicits a smaller response than it did with prior use.
Question: A patient is in treatment for alcohol addiction and has relapsed since his last visit.
The nurse knows this does not mean treatment has failed. Why?
A. Relapse indicates pharmacologic treatments are working.
B. Addiction is a chronic, relapsing disease that takes time to treat.
C. Alcohol addiction is particularly difficult to treat.
D. Patients often relapse during initial treatment.
Answer:
Answer: B
Rationale: Addiction is a complex phenomenon that will have causes and consequences
unique to each individual's experience of the disease. Additionally, neurological remodeling
that occurs during treatment takes time.
Question: Which of the following best explains why local anesthetics are preferred over
general anesthetics for minor procedures?
A) They cause generalized nervous system depression
B) They block pain without affecting consciousness
C) They have a longer duration of action
D) They always require intravenous administration
Answer:
Answer: B Rationale: Local anesthetics block nerve impulse conduction locally, suppressing
pain without causing generalized depression of the entire nervous system, unlike general
anesthetics.
Question: Lidocaine is classified as which type of local anesthetic?
A) Ester-type
B) Amide-type
C) Both ester and amide
D) Neither
, Answer:
Answer: B Rationale: Lidocaine contains an amide linkage and is metabolized by hepatic
enzymes; it has a very low incidence of allergic reactions compared to ester-type agents.
Question: Which property of a local anesthetic primarily determines its onset of action?
A) Molecular size
B) Lipid solubility
C) Degree of ionization at physiological pH
D) All of the above
Answer:
Answer: D Rationale: Onset depends on molecular size, lipid solubility, and ionization
degree, which affect the drug's ability to penetrate nerve membranes quickly.
Question: The addition of epinephrine to a local anesthetic primarily:
A) Increases systemic toxicity
B) Prolongs the duration of anesthesia
C) Causes immediate systemic absorption
D) Is contraindicated in all patients
Answer:
Answer: B Rationale: Epinephrine causes vasoconstriction, reducing blood flow to the site,
delaying systemic absorption, prolonging anesthesia, and reducing toxicity risk.
Question: Which local anesthetic is most likely to cause allergic reactions?
A) Lidocaine
B) Procaine
C) Bupivacaine
D) Ropivacaine
Answer:
Answer: B Rationale: Procaine is an ester-type anesthetic, which has a higher incidence of
allergic reactions than amide-type agents like lidocaine.
Question: Select all adverse effects associated with systemic toxicity of local anesthetics:
A) Seizures
B) Bradycardia
C) Hypertension
D) Respiratory depression
E) Hyperglycemia
Answer:
Answer: A, B, D Rationale: Systemic toxicity can cause CNS excitation (seizures), followed
by depression (respiratory depression), and cardiovascular depression (bradycardia).
Hypertension and hyperglycemia are not typical direct effects.
Question: Which of the following are true regarding cocaine as a local anesthetic? (Select
,that apply)
A) It causes vasoconstriction
B) It is an amide-type anesthetic
C) It can cause significant CNS stimulation
D) It is safe for use in patients with cardiovascular disease
Answer:
Answer: A, C Rationale: Cocaine is an ester-type anesthetic that causes intense
vasoconstriction by blocking norepinephrine reuptake, leading to CNS stimulation. It is risky
in cardiovascular disease due to tachycardia and hypertension risk.
Question: Which factors increase systemic absorption of topical local anesthetics? (Select
that apply)
A) Application to broken skin
B) Use over small areas
C) Increased skin temperature
D) Wrapping or heating the application site
Answer:
Answer: A, C, D Rationale: Broken skin, increased temperature, and wrapping increase
blood flow or permeability, enhancing absorption and toxicity risk.
Question: Select all correct statements about ester-type local anesthetics:
A) Metabolized by plasma esterases
B) Cross-reactivity with amide-type anesthetics is common
C) More likely to cause allergic reactions than amides
D) Procaine is an example
Answer:
Answer: A, C, D Rationale: Ester anesthetics are metabolized by plasma esterases, have a
higher allergy risk, and procaine is a prototype. Cross-reactivity with amides does not occur.
Question: Which monitoring parameters are essential after injection of a local anesthetic?
(Select all that apply)
A) Blood pressure
B) Respiratory rate
C) Level of consciousness
D) Liver function tests
Answer:
Answer: A, B, C Rationale: Cardiovascular and CNS toxicity require close monitoring of blood
pressure, respiratory function, and consciousness; liver function tests are not immediately
relevant post-injection.
Question: True or False: Local anesthetics selectively block pain fibers while sparing motor
fibers.
, Answer:
Answer: False Rationale: Local anesthetics block all nerve fibers they reach, including motor
neurons, but small, nonmyelinated pain fibers are blocked more rapidly.
Question: True or False: Topical benzocaine is contraindicated in children younger than 2
years due to risk of methemoglobinemia.
Answer:
Answer: True Rationale: Benzocaine can cause methemoglobinemia, particularly dangerous
in young children.
Question: True or False: Epinephrine should be avoided in local anesthetics administered to
fingers or toes due to risk of ischemia.
Answer:
Answer: True Rationale: Vasoconstriction from epinephrine can cause ischemic necrosis in
end-artery areas like digits.
Question: True or False: Allergic reactions to amide local anesthetics are common.
Answer:
Answer: False Rationale: Allergic reactions to amide anesthetics are very rare compared to
ester types.
Question: True or False: Cocaine is no longer used clinically due to its high abuse potential
and toxicity.
Answer:
Answer: False Rationale: Cocaine is still used topically in ENT procedures for its potent
vasoconstrictive and anesthetic effects despite abuse potential.
Question: A 45-year-old patient undergoing dental extraction reports a history of allergy to
procaine. Which local anesthetic is safest to use?
A) Lidocaine
B) Procaine
C) Benzocaine
D) Cocaine
Answer:
Answer: A Rationale: Lidocaine is an amide-type and does not cross-react with ester
allergies, making it safe for this patient.
Question: A patient develops seizures shortly after administration of lidocaine for nerve
block. What is the most appropriate immediate intervention?
A) Administer intravenous benzodiazepines
B) Provide mechanical ventilation with oxygen
Questions with 100% Verified Answers Latest Update
Question: A patient states that the dose of oxycodone he currently receives does not
provide the same pain relief as it used to. The nurse understands that the patient has
developed what?
A. Physical dependence
B. Tolerance
C. Withdrawal syndrome
D. An addiction
Answer:
Answer: B
Rationale: Tolerance occurs with regular drug use and is a state in which a particular dose
elicits a smaller response than it did with prior use.
Question: A patient is in treatment for alcohol addiction and has relapsed since his last visit.
The nurse knows this does not mean treatment has failed. Why?
A. Relapse indicates pharmacologic treatments are working.
B. Addiction is a chronic, relapsing disease that takes time to treat.
C. Alcohol addiction is particularly difficult to treat.
D. Patients often relapse during initial treatment.
Answer:
Answer: B
Rationale: Addiction is a complex phenomenon that will have causes and consequences
unique to each individual's experience of the disease. Additionally, neurological remodeling
that occurs during treatment takes time.
Question: Which of the following best explains why local anesthetics are preferred over
general anesthetics for minor procedures?
A) They cause generalized nervous system depression
B) They block pain without affecting consciousness
C) They have a longer duration of action
D) They always require intravenous administration
Answer:
Answer: B Rationale: Local anesthetics block nerve impulse conduction locally, suppressing
pain without causing generalized depression of the entire nervous system, unlike general
anesthetics.
Question: Lidocaine is classified as which type of local anesthetic?
A) Ester-type
B) Amide-type
C) Both ester and amide
D) Neither
, Answer:
Answer: B Rationale: Lidocaine contains an amide linkage and is metabolized by hepatic
enzymes; it has a very low incidence of allergic reactions compared to ester-type agents.
Question: Which property of a local anesthetic primarily determines its onset of action?
A) Molecular size
B) Lipid solubility
C) Degree of ionization at physiological pH
D) All of the above
Answer:
Answer: D Rationale: Onset depends on molecular size, lipid solubility, and ionization
degree, which affect the drug's ability to penetrate nerve membranes quickly.
Question: The addition of epinephrine to a local anesthetic primarily:
A) Increases systemic toxicity
B) Prolongs the duration of anesthesia
C) Causes immediate systemic absorption
D) Is contraindicated in all patients
Answer:
Answer: B Rationale: Epinephrine causes vasoconstriction, reducing blood flow to the site,
delaying systemic absorption, prolonging anesthesia, and reducing toxicity risk.
Question: Which local anesthetic is most likely to cause allergic reactions?
A) Lidocaine
B) Procaine
C) Bupivacaine
D) Ropivacaine
Answer:
Answer: B Rationale: Procaine is an ester-type anesthetic, which has a higher incidence of
allergic reactions than amide-type agents like lidocaine.
Question: Select all adverse effects associated with systemic toxicity of local anesthetics:
A) Seizures
B) Bradycardia
C) Hypertension
D) Respiratory depression
E) Hyperglycemia
Answer:
Answer: A, B, D Rationale: Systemic toxicity can cause CNS excitation (seizures), followed
by depression (respiratory depression), and cardiovascular depression (bradycardia).
Hypertension and hyperglycemia are not typical direct effects.
Question: Which of the following are true regarding cocaine as a local anesthetic? (Select
,that apply)
A) It causes vasoconstriction
B) It is an amide-type anesthetic
C) It can cause significant CNS stimulation
D) It is safe for use in patients with cardiovascular disease
Answer:
Answer: A, C Rationale: Cocaine is an ester-type anesthetic that causes intense
vasoconstriction by blocking norepinephrine reuptake, leading to CNS stimulation. It is risky
in cardiovascular disease due to tachycardia and hypertension risk.
Question: Which factors increase systemic absorption of topical local anesthetics? (Select
that apply)
A) Application to broken skin
B) Use over small areas
C) Increased skin temperature
D) Wrapping or heating the application site
Answer:
Answer: A, C, D Rationale: Broken skin, increased temperature, and wrapping increase
blood flow or permeability, enhancing absorption and toxicity risk.
Question: Select all correct statements about ester-type local anesthetics:
A) Metabolized by plasma esterases
B) Cross-reactivity with amide-type anesthetics is common
C) More likely to cause allergic reactions than amides
D) Procaine is an example
Answer:
Answer: A, C, D Rationale: Ester anesthetics are metabolized by plasma esterases, have a
higher allergy risk, and procaine is a prototype. Cross-reactivity with amides does not occur.
Question: Which monitoring parameters are essential after injection of a local anesthetic?
(Select all that apply)
A) Blood pressure
B) Respiratory rate
C) Level of consciousness
D) Liver function tests
Answer:
Answer: A, B, C Rationale: Cardiovascular and CNS toxicity require close monitoring of blood
pressure, respiratory function, and consciousness; liver function tests are not immediately
relevant post-injection.
Question: True or False: Local anesthetics selectively block pain fibers while sparing motor
fibers.
, Answer:
Answer: False Rationale: Local anesthetics block all nerve fibers they reach, including motor
neurons, but small, nonmyelinated pain fibers are blocked more rapidly.
Question: True or False: Topical benzocaine is contraindicated in children younger than 2
years due to risk of methemoglobinemia.
Answer:
Answer: True Rationale: Benzocaine can cause methemoglobinemia, particularly dangerous
in young children.
Question: True or False: Epinephrine should be avoided in local anesthetics administered to
fingers or toes due to risk of ischemia.
Answer:
Answer: True Rationale: Vasoconstriction from epinephrine can cause ischemic necrosis in
end-artery areas like digits.
Question: True or False: Allergic reactions to amide local anesthetics are common.
Answer:
Answer: False Rationale: Allergic reactions to amide anesthetics are very rare compared to
ester types.
Question: True or False: Cocaine is no longer used clinically due to its high abuse potential
and toxicity.
Answer:
Answer: False Rationale: Cocaine is still used topically in ENT procedures for its potent
vasoconstrictive and anesthetic effects despite abuse potential.
Question: A 45-year-old patient undergoing dental extraction reports a history of allergy to
procaine. Which local anesthetic is safest to use?
A) Lidocaine
B) Procaine
C) Benzocaine
D) Cocaine
Answer:
Answer: A Rationale: Lidocaine is an amide-type and does not cross-react with ester
allergies, making it safe for this patient.
Question: A patient develops seizures shortly after administration of lidocaine for nerve
block. What is the most appropriate immediate intervention?
A) Administer intravenous benzodiazepines
B) Provide mechanical ventilation with oxygen
