Module 1 Prof. TAING SOVANNA (11)

1. Which of the following side effects can be the result of residual neuromuscular blockade?

c. Increased mechanical ventilation hours

a. Decreased risk of aspiration

b. Increased response to hypoxia

d. Decreased length of stay in the intensive care unit

2. Which of the following is a rationale for use of neuromuscular blocking agents (NMBAs) during surgery?

d. Decreases risk of laryngeal trauma during intubation

a. Decreases muscular relaxation to facilitate intubation

c. Increases intracranial pressures

b. Increases overall oxygen demand

3. What can increase the likelihood that a patient may develop residual neuromuscular blockade?

a. Renal impairment

b. Short surgical procedures

c. Fasting before surgery

d. Oral rather than intravenous administration

4. Which of the following statements is true regarding the neuromuscular junction?

d. Acetylcholinesterase is the enzyme that causes muscle contraction

a. A stimulated skeletal nerve muscle releases nicotinic acid from the terminal end to the synaptic space.

b. Acetylcholine binds permanently to nicotinic receptors.

c. Nicotinic receptors open the sodium channels that then produce muscular contraction.

5. Which of the following are potential clinical problems produced by blockade of the muscarine receptors in the heart and lungs during neuromuscular blockade?

b. Bronchospasm and cardiac dysrhythmias

a. Bronchospasm and blood pressure changes

c. Increased secretions and cardiac dysrhythmias

d. Increased secretions and blood pressure changes

6. Which of the following patient conditions would cause the nurse to question the administration of acetylcholinesterase inhibitors to reverse NMBAs?

d. Cardiac dysrhythmias and asthma

a. Acute renal failure and asthma

b. Asthma and myasthenia gravis

c. Cardiac dysrhythmias and acute renal failure

7. Which of the following is a disadvantage of using NMBA reversal in surgical patients?

c. Causes less predictable onset of effect if patient must have neuromuscular blockade reestablished

a. Allows prompt extubation at the end of the case

b. Shortens time in the operating room

d. Leads to decreased secretions and tachycardia

8. The patient is unable to hold his head up off the pillow for 5 seconds after surgery. The nurse suspects this is due to what percentage of neuromuscular receptor blockage?

d. 35%

a. 1%

b. 4%

c. 20%

9. Successful reversal of neuromuscular blockade would be demonstrated by which of the following train-of-4 reactions?

c. 4 of 4 twitches displayed

a. 0 of 4 twitches displayed

b. 1 of 4 twitches displayed

d. A noticeable fade is present

10. Which of the following is a long-acting NMBA?

a. Pancuronium

b. Atracurium

c. Cisatracurium

d. Rocuronium

11. Which of the following can increase the duration of neuromuscular blockade?

d. Decreased calcium levels

a. Increased sodium levels

b. Increased potassium levels

c. Decreased magnesium levels