1. The following statements about the administration of local anesthetics for regional anesthesia are true, EXCEPT:

a. Bupivacaine and ropivacaine have slow onsets of action and long durations of effect.

b. Procaine and chloroprocaine are used for brief surgical cases.

c. Loss of sensory nerve function is a goal of regional anesthesia.

d. Motor nerve function is maintained after placement of successful regional anesthesia.

2. Causes of local anesthetic toxicity during regional anesthesia administration include:

a. Inadvertent intra-arterial injection of local anesthetic.

b. Rapid absorption of local anesthetic by the venous circulation.

d. All of the above.

3. All of the following are signs of local anesthetic toxicity EXCEPT:

a. Pruritis

b. Circumoral numbness and tingling

c. Tinnitus

d. Seizure activity

e. Bradycardia

4. Which of the following patients is at highest risk for local anesthetic toxicity?

a. A 24 year old healthy male for knee surgery using a femoral nerve block.

b. An 80 year old female with known cardiac disease for shoulder surgery using an interscalene block.

c. A 59 year old female on clonazepam for panic disorder, scheduled for vascular surgery using an ankle block.

d. A 48 year old male with history of thyroid cancer for hand surgery using an infraclavicular block.

5. Nursing assessment in patients that pertains to regional anesthesia include all of the following, EXCEPT:

a. Vital signs, including cardiac rate and rhythm

b. Neurologic status, including mental status

c. Renal status, including current BUN and creatinine

d. Patient’s medical history, including current medications

6. Nursing measures to optimize patient safety during administration of regional anesthesia by the anesthesia provider include:

a. Setting alarm parameters on the cardiac and oxygen saturation monitors.

b. Checking for proper syringe and/or tubing labeling.

c. Measuring blood pressure frequently during and after block placement.

d. Checking for availability of appropriate emergency equipment.

e. All of the above.

7. Mr. Klein is a 50 year old healthy male undergoing an interscalene block in preparation for repair of labral tear in his right shoulder. His pre-procedure vital signs are: blood pressure 126/80, heart rate normal sinus rhythm 64, respiratory rate 15, oxygen saturation 99% on room air. He is given Oxygen 2 l/min via nasal cannula, and presedated with midazolam 1 mg IV. During the placement of the interscalene block he complains of perioral numbness. Immediate nursing measures include:

a. Check blood pressure and heart rhythm.

b. Administer oxygen via facemask.

c. Alert the anesthesia provider to stop administration of the local anesthetic.

d. Prepare lidocaine for IV infusion if ventricular ectopy is noted.

e. All of the above

f. A, B, C only

8. Patients with local anesthetic-related cardiotoxicity may not respond to the usual ACLS approach to resuscitation. Modifications to these standards may include which of the following?

a. IV lipid emulsion, IV vasopressin, and IV amiodarone.

b. Fluid bolus, IV lidocaine, and IV epinephrine.

c. IV calcium channel blockers.

d. None of the above.

9. Lipid Emulsion therapy for local anesthetic-induced cardiotoxicity is thought to be effective due to which mechanism?

a. Lipid emulsion has a direct effect on the defibrillation threshold.

b. Lipid emulsion acts to rapidly bind excess local anesthetic.

c. Lipid emulsion enhances liver metabolism of the anesthetic.

d. Lipid emulsion reverses sensory and motor blockade.

10. Successful treatment of seizure activity after administration of a long-acting local anesthetic will always prevent cardiotoxic adverse effects.

a. TRUE

b. FALSE