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18 Cards in this Set

  • Front
  • Back

All of the following are important components of general anesthesia except one. Which one is the exception?

a) Loss of consciousness

b) Respiratory paralysis

c) Skeletal muscle relaxation

d) Loss of pain sensation

e) Good patient control

b) Respiratory Paralysis

The goals of surgical anesthesia are loss of consciousness, adequate muscle relaxation and pain cessation. Respiratory paralysis would result in patient death. REF: p. 128

Which of the following agents would be most effective for the surgical stage of general anesthesia?

a) Midazolam

b) Enflurane

c) Nitrous oxide

d) Levodopan

b) Enflurane

Enflurane is one of the most commonly used volatile liquid general anesthetic agents. Midazolam and nitrous oxide are antiolytic agents and are used adjunctively with general anesthetic agents. Levodopa is used in the treatment of Parkinson's disease. REF: p. 128

Guedel's stages and planes of anesthesia describe changes that occur during anesthesia. Ideally, which stage is passed through very quickly, which can be an uncomfortable time for the patient, when emesis and incontinence may occur?

a) Stage I

b) Stage II

c) Stage III

d) Stage IV

b) Stage II

Stage II is the excitement or delirium stage of general anesthesia, beginning with the loss of consciousness and associated with involuntary movement and sympathetic stimulation. Tachycardia, hypertension, emesis, and incontinence can occur. Thus, for patient comfort, having a rapid and smooth passage through stage II into stage III (i.e., surgical anesthesia) is important. REF: p. 128

Nitrous oxide conscious sedation is popular in dental offices for all of the following reason except one. Which is the exception?

a) Antianxiety

b) Analgesia

c) Long period of onset and recovery

d) short period of onset and recovery

e) Retained consciousness and protective reflexes

c) Long period of onset and recovery

Nitrous oxide has low blood solubility, which allows rapid onset and recovery. It is popular in dental offices because of it's analgesic and anxiolytic properties and the retention of consciousness and protective reflexes. REF: p. 131

The potency of general anesthetic inhalation agents is measured by the blood/gas coefficient. The less soluble the anesthetic is in the body tissues, the more rapid the onset and recovery will be.

a) Both statements are true

b) Both statements are false

c) The first statement is true; the second statement is false

d) the first statement is false; the second statement is true

d) The first statement is false; the second statement is true

The solubility of a general anesthetic is measured by the solubility in the blood. Drugs that are highly soluble in the blood have an increased induction and recovery time. The potency of an anesthetic agent is measured by the minimal alveolar concentration of an anesthetic a 1 atmospheric pressure. REF: pp. 129-130

Diffusion hypoxia at the end of nitrous oxide administration can be prevented by:

a) Increasing the percentage of nitrous oxide to 100% for 5 min.

b) Increasing the percentage of oxygen to 100% for 5 min.

c) Administering two aspirins at the end of treatment

d) Giving an additional cartridge of local anesthetic

b) Increasing the percentage of oxygen to 100% for 5 min.

The patient should be placed on 100% oxygen for at least 5 minutes at the termination of a procedure using nitrous oxide sedation to prevent the phenomena known as diffusion hypoxia. The rapid outflow of nitrous oxide accompanied by oxygen and carbon dioxide can cause severe headache and other adverse effects. REF: p. 131

All the following are benzodiazepines except one. Which is the exception?

a) Chloral hydrate

b) Diazepam

c) Midazolam

d) Triazolam

a) Chloral hydrate

Chloral hydrate is a nonbenzodiazepines-nonbarbiturate sedative hypnotic with a rapid onset and short duration of action. The other agents are all benzodiazepines. REF: p. 138, Table 11-1

Benzodiazepines have all the following pharmacologic actions except one. Which one is the exception?

a) Treatment of insomnia

b) Anticonvulsant

c) Anxiolytic

d) Analgesic

e) Treatment of alcohol withdrawal

d) Analgesic

Benzodiazepines are useful for short-term treatment of anxiety, panic attacks, insomnia, and treatment of alcohol withdrawal, acute treatment of seizures, conscious sedation, and adjunctive use during general anesthesia. They do not have analgesic action. REF: p. 141

The biggest advantage to using benzodiazepines rather than barbiturates is:

a) Less expensive

b) Can be given orally or intervenously

c) Safer

d) Longer lasting

c) Safer

Barbiturates are associated with high abuse rates and cardiovascular and respiratory depression with overdose. Benzodiazepines have a much better safety profile and have almost completely replaced the barbiturates in clinical use for treating anxiety and insomnia. REF: p. 142

Which of the following is a major disadvantage of chloral hydrate?

a) Slow onset

b) Mucosal irritation and aspiration

c) Difficult to administer

d) Cost

b) Mucosal irritation and aspiration

Chloral Hydrate is an inexpensive, orally effective sedative-hypnotic agent with rapid onset. It is highly irritating to the gastric mucosa and can cause aspiration, especially in upset and struggling children. REF: p. 144

What is the primary difference between sedation and hypnosis with the sedative-hypnotic medications?

a) Specific agent

b) Rout of administration

c) Dose

d) Prescription of over-the-counter status

c) Dose

The sedative-hypnotic agents produce different amounts of central nervous system depression based on the dose. In small doses, sedation and anxiolytic effects occur. In large doses, the hypnotic or sleep inducing effect occur. In very large doses, anesthesia, coma and death caused by respiratory failure can occur. REF: p. 137

Which of the following classes of antianxiety agents is most commonly used today?

a) Barbiturates

b) Benzodiazepines

c) Nonbenzodiazepines-nonbarbiturate sedative hypnotics

d) Opioids

b) Benzodiazepines

The benzodiazepines are the most commonly prescribed antianxiety drug used today because of their wide margin of safety. REF: p. 137

All of the following are factors which contribute to the effectiveness of the benzodiazepines except one. Which one is the exception?

a) High lipid solubility

b) Concentration in adipose tissue

c) ability to cross the blood-brain barrier

d) Highly ionized form

d) High ionized form

Benzodiazepines are usually high protein bound, un-ionized, and lipid soluble. They easily cross the blood-brain barrier to produce an effect on the central nervous system and are stored in adipose tissue, prolonging their action. REF: p. 138

The primary mechanism of action for the benzodiazepines is:

a) Serotonin agonist

b) Serotonin antagonist

c) Gamma-aminobutyric acid (GABA) agonist

d) Gamma-aminobutyric acid (GABA) antagonist

c) Gamma-aminobutyric acid (GABA) agonist

The benodiazepines enhance or facilitate (act as an agonist) the action of the neurotransmitter GABA, a major inhibitory transmitter in the central nervous system, reducing symptoms of anxiety. REF: p. 139

Which of the following is the most common adverse drug effect of the benzodiazepines?

a) Muscle spasticity

b) Confulsions

c) Fatigue and drowsiness

d) Nausea and vomiting

e) Increased appetite

c) Fatigue and drowsiness

The most common adverse effect attributed to the benzodiazepines are fatigue, drowsiness, muscle weakness, and ataxia. The patient may also experience lightheadedness, and dizziness. The benzodiazepines are used in treatment of muscle spasticity and confulsions. REF: p. 139

The primary benzodiazepine for intervenous use in conscious sedation today is:

a) Diazepam

b) Flunitrazepam

c) Midazolam

d) Clonazepam

e) Chlordiazepoxide

c) Midazolam

Midazolam is the primary benzodiazepine used intravenously today in conscious sedation, replacing diazepam, because it is metabolized to inactive metabolites and has a much shorter half-life and recovery period. REF: p. 139

All of the following are therapeutic effects of barbiturates except one. Which one is the exception?

a) anxiolysis

b) Sedation

c) Sleep induction

d) Analgesia

e) Anesthesia

d) Analgesia

Barbiturates have no significant analgesic effect. REF: p. 143

The cause of death in barbiturate overdose is:

a) Hypatotoxicity

b) Renal failure

c) Respiratory failure

d) Cardiac arrest

c) Respiratory failure

The cause of death in barbiturate overdose is respiratory failure caused by central nervous system depression; therefore respiratory function must be carefully monitored whenever large doses are given, such as when used adjunctively with other general anesthetic agents. REF: p. 143