You are assisting a physician who is preparing to suture a superficial laceration on a patient's leg. The physician asks you to draw up lidocaine with epinephrine. You understand that epinephrine is used with the lidocaine to:
Improve perfusion by increasing blood flow to the area
Prolong anesthetic effects and reduce the risk of systemic toxicity from lidocaine.
Increase the rate of absorption of the lidocaine
Allow more systemic absorption to speed up metabolism of the lidocaine
The Correct Answer is B
A. Epinephrine is a vasoconstrictor, meaning it narrows blood vessels at the injection site. This leads to decreased blood flow rather than increased perfusion. Although this helps reduce bleeding, the statement is incorrect because it describes the opposite effect.
B. Epinephrine causes localized vasoconstriction, which slows the absorption of lidocaine into the bloodstream. This allows the anesthetic to remain at the site longer, thereby prolonging its effect. At the same time, reduced systemic absorption lowers the risk of toxicity, such as central nervous system or cardiovascular complications.
C. Epinephrine decreases, not increases, the rate of absorption of lidocaine. Slower absorption is essential for maintaining the drug’s local effect and preventing it from rapidly entering systemic circulation.
D. Increasing systemic absorption would raise blood levels of lidocaine and increase the risk of toxicity. The purpose of adding epinephrine is to limit systemic exposure, not enhance it.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Ketamine does not allow patients to remember their surgical experience. On the contrary, it produces amnesia, so patients typically have little to no recollection of the procedure. This amnesic effect is an important component of its anesthetic action.
B. Ketamine is not simply a paralytic. While it may reduce movement, it provides both anesthesia and analgesia, meaning it relieves pain as well as inducing a trance-like, unconscious state. It is not a drug that merely immobilizes the patient.
C. Ketamine is classified as a dissociative anesthetic, which means it induces a trance-like state in which the patient feels detached from their body and environment. This dissociation allows surgical procedures to be performed while the patient is unaware of pain and has a sense of separation from what is happening. Unlike some other anesthetics, ketamine maintains protective airway reflexes, spontaneous breathing, and cardiovascular stability, making it especially useful in emergency settings, pediatric procedures, or in patients with unstable cardiovascular status. The unique dissociative properties also make it useful for short procedures and sedation outside of the operating room.
D. Ketamine does not allow patients to move freely in a controlled manner during surgery. While some reflexive movementsmay occur, the patient is generally unresponsive to painful stimuliand unaware of the procedure due to the dissociative anesthesia and analgesia.
Correct Answer is D
Explanation
A. Propranolol does not significantly increase insulin requirements through receptor blocking. While beta-blockers affect adrenergic receptors, they do not directly cause a predictable increase in insulin dosage needs.
B. Beta-blockers are not primarily associated with causing insulin resistance. Their main concern in diabetic patients is related to hypoglycemia awareness rather than altering insulin sensitivity.
C. The combination of insulin and propranolol does not directly increase the risk of diabetic ketoacidosis. Ketoacidosis is typically related to insufficient insulin, infection, or stress, not beta-blocker use.
D. Propranolol is a nonselective beta-blockerthat can mask the adrenergic warning signs of hypoglycemia, such as tachycardia, tremors, and anxiety. This makes it more difficult for the patient to recognize low blood glucose levels early. Although sweating may still occur, the absence of typical warning signs increases the risk of severe hypoglycemia.
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