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Bioscience I - Quiz 1

128 Questions
Science Quizzes & Trivia

A quiz to review the respiratory material for test 1 in bioscience.

Questions and Answers
  • 1. 
    Which of the following are part of the 5 functions of the respiratory system? (Check all that apply)
    • A. 

      Blood Reservoir

    • B. 

      Acid Base Balance

    • C. 

      Chest Wall Support

    • D. 

      Metabolism

    • E. 

      Phonation

  • 2. 
    The inhalation of air from the atmosphere into the lungs is known as…
    • A. 

      Ventilation

    • B. 

      External Respiration

    • C. 

      Internal Respiration

  • 3. 
    What is Internal Respiration?
    • A. 

      The inspiration and expiration of air from the atmosphere into the lungs.

    • B. 

      The exchange of gases between the blood and the cells

    • C. 

      The exchange of gases between the lungs and the blood

    • D. 

      The production of ATP within the cells

  • 4. 
    What is the proper technique for a nasal intubation?
    • A. 

      While the patient is sedated insert the tube into the left nose applying a firm pressure to rapidly insert the tube past the nares at a downward angle.

    • B. 

      Insert the tube at an upward angle in order to decrease the risk of bleeding, the nare should be pushed inferiorly

    • C. 

      With the nose pushed superiorly insert the tube with steady gentle pressure parallel to the roof of the mouth.

    • D. 

      Insert the tube gently and with a twisting motion to ease past the turbinates. If the tube gets caught temporarily direct upward and apply firm pressure until you are past.

  • 5. 
    Which of the following is a risk associated with prolonged nasal intubations?
    • A. 

      Basal Skull Fracture

    • B. 

      Nasal polyps

    • C. 

      Facial Nerve Palsy

    • D. 

      Intracranial Infection

  • 6. 
    What is the function of the pharynx?
    • A. 

      Serve as a conduit for air and food and to provide a resonating chamber for speech sounds

    • B. 

      To supply the cells of the body with oxygen and remove the carbon dioxide produced by cellular activities

    • C. 

      Humidification and filtering of inspired air

    • D. 

      Provides the chief support for the larynx

  • 7. 
    Which of the following is NOT part of the pharynx?
    • A. 

      Nasopharynx

    • B. 

      Tracheopharynx

    • C. 

      Laryngopharynx

    • D. 

      Oropharynx

  • 8. 
    Why is it that adults need cuffed tubes and children do not?
    • A. 

      Children are less prone to tissue necrosis from large ETT tubes, adults need softer cuffs to prevent tissue necrosis.

    • B. 

      Pediatric cases are generally of a short duration, otherwise a cuffed tube would be used

    • C. 

      Cricoid cartilage can form a seal against an ETT tube in children, making cuffed tubes uneccessary.

    • D. 

      The much wider vocal cords of adults make extubation more likely so the cuff is used to prevent extubation.

  • 9. 
    Which of the following is one of the single cartilage formations of the larynx?
    • A. 

      Arytenoid

    • B. 

      Corniculate

    • C. 

      Cuneiform

    • D. 

      Cricoid

  • 10. 
    When you swallow food, what cartilage of the larynx guards the laryngeal entrance and protects you from aspiration?
    • A. 

      Epiglottis

    • B. 

      Vocal Cords

    • C. 

      Cricoid

    • D. 

      Arytenoid

  • 11. 
    The chief support for the larynx is provided by…
    • A. 

      Pharynx

    • B. 

      Hyoid Bone

    • C. 

      Thyroid Cartilage

    • D. 

      Cricoid Cartilage

  • 12. 
    You are the SRNA for Mr. Becker today. During the middle of the ENT case the surgeon moves the patients head down, so that his chin is to his chest. Your preceptor asks how this will effect your ETT, what do you tell him?
    • A. 

      Aren’t YOU supposed to teach me this stuff?

    • B. 

      The ETT will be pulled upward and the pt is at risk for extubation.

    • C. 

      The ETT will be pushed further into the trachea, pt at risk for tube to hit carina or go into Right mainstem bronchus.

    • D. 

      The ETT should not move, you secured it prior to the procedure.

  • 13. 
    Which Cartilage is attached to the posterior ends of the vocal cords and serves as their focal point for movement?
    • A. 

      Epiglottis

    • B. 

      Periglottic

    • C. 

      Corniculate

    • D. 

      Arytenoid

  • 14. 
    Which laryngeal cartilage corresponds to the beginning of the trachea?
    • A. 

      Cricoid

    • B. 

      Arytenoid

    • C. 

      Thyroid

    • D. 

      Epiglottis

  • 15. 
    Which of the following is true regarding the trachea?
    • A. 

      It is a fixed structure approximately 12 cm in length

    • B. 

      Distance from incisors to carina is roughly 26 cm

    • C. 

      Composed of 120 horizontal complete rings

    • D. 

      Extends from the Epiglottis to the end of the primary bronchi

  • 16. 
    As the bronchial branching becomes more extensive in the bronchial tree the epithelium changes from _______________ to _____________ in the terminal bronchioles.
    • A. 

      Cartilage, smooth muscle

    • B. 

      Simple cuboidal, pseudostratified ciliated

    • C. 

      Pseudostratified ciliated, simple cuboidal

    • D. 

      Cartilage rings, cartilage plates

  • 17. 
    The names of two layers of serous membranes that enclose and protect the lungs are … (Two Answers)               
    • A. 

      Pleural

    • B. 

      Surfactant

    • C. 

      Parietal

    • D. 

      Visceral

  • 18. 
    Which lung contains the greater proportion of lung capacity?
    • A. 

      Right

    • B. 

      Left

    • C. 

      Both are equal

  • 19. 
    The cardiac notch is contained within which lung?
    • A. 

      Right

    • B. 

      Left

    • C. 

      Both

  • 20. 
    Which lung contains a hilus?
    • A. 

      Right

    • B. 

      Left

    • C. 

      Both

  • 21. 
    Due to pulmonary anatomy, a risk associated with inserting subclavian lines is…
    • A. 

      Mediastinitis

    • B. 

      Chylothorax

    • C. 

      Paralysis of nerves which innervate diaphragm

    • D. 

      Pneumothorax

  • 22. 
    What is the function of the alveolar capillary membrane?
    • A. 

      Diffusion of gases

    • B. 

      Protects alveoli from collapsing

    • C. 

      Production of surfactant

    • D. 

      Segmentalization of alveoli

  • 23. 
    Which form of cellular metabolism produces the greatest amount of ATP?
    • A. 

      Internal Respiration

    • B. 

      Aerobic Metabolism

    • C. 

      Glycolysis

    • D. 

      Anaerobic Metabolism

  • 24. 
    General anesthesia will have what effects of cellular metabolism?
    • A. 

      Reducing O2 consumption while increasing CO2 production by ~15% each.

    • B. 

      Increased cerebral O2 consumption

    • C. 

      Reducing both O2 consumption and CO2 production by ~ 15% each.

    • D. 

      Produces hyperthermia which will increase cardiac O2 consumption.

  • 25. 
    What is the primary function of the Tracheobronchial tree?
    • A. 

      To serve as a conduit for air and food and to provide a resonating chamber for speech sounds

    • B. 

      To conduct gas flow to and from the alveoli

    • C. 

      Humidification and filtering of inspired air

    • D. 

      Provides the chief support for the larynx.

  • 26. 
    The Tracheobronchial Tree is composed of how many different dichotomous divisions?
    • A. 

      17

    • B. 

      19

    • C. 

      6

    • D. 

      23

  • 27. 
    At what level of tracheobronchial division does flat epithelium begin to appear?
    • A. 

      17-19

    • B. 

      21-23

    • C. 

      23-26

    • D. 

      11-15

  • 28. 
    Which of the following is true regarding Aleveoli?
    • A. 

      The largest alveoli are found at the bases of the lungs while in upright position.

    • B. 

      Size of alveoli is a function of gravity and lung volume.

    • C. 

      Walls are symmetrical to allow for maximal gas exchange.

    • D. 

      The larger alveoli will have more surfactant than smaller alveoli.

  • 29. 
    Why are Cervical injuries above the level of C5 incompatible with spontaneous ventilation?
    • A. 

      Due to interruption of bronchial circulation to the lungs.

    • B. 

      Due to interruption of sympathetic activity while stimulating vagal activity

    • C. 

      Due to both phrenic and intercostals nerves being disrupted.

    • D. 

      Due to increased likelihood of tension pneumothorax

  • 30. 
    Vagal Activity in the lungs is responsible for  Broncho_______ and it ______ secretions.
    • A. 

      Constriction, decreases

    • B. 

      Dilation, decreases

    • C. 

      Dilation, Increases

    • D. 

      Constriction, Increases

  • 31. 
    During spontaneous ventilation the gradients for gas exchange are created by…
    • A. 

      Changes in intrathoracic pressure

    • B. 

      God.

    • C. 

      Intermittent positive pressure in the airway

    • D. 

      Diaphragmatic relaxation

  • 32. 
    Inhalational agents affect the respiratory pattern by resulting in slow, deep breaths during anesthesia.
    • A. 

      True

    • B. 

      False

  • 33. 
    In the supine position, abdominal breathing predominates.
    • A. 

      True

    • B. 

      False

  • 34. 
    During general anesthesia Expiration will become…
    • A. 

      Passive

    • B. 

      Active

    • C. 

      Dependent

    • D. 

      Shortened

  • 35. 
    The Chest wall has a tendency to _____, while the lungs have a tendency to _____.
    • A. 

      Expand, Expand

    • B. 

      Collapse, Expand

    • C. 

      Expand, Collapse

    • D. 

      Collapse, Collapse

  • 36. 
    Alveoli collapse is directly proportional to…
    • A. 

      Alveolar size

    • B. 

      Amount of Surfactant

    • C. 

      Patient height

    • D. 

      Surface Tension

  • 37. 
    What substance within the alveoli serves to decrease surface tension?
    • A. 

      Surfactant

    • B. 

      Angiotensin Converting Enzyme

    • C. 

      Carbon Dioxide

    • D. 

      Pleural WD40

  • 38. 
    The ease at which the lungs and thoracic wall can be expanded is known as what?
    • A. 

      Elastic Recoil

    • B. 

      Compliance

    • C. 

      Diaphragmatic Excursion

    • D. 

      Surfactant

  • 39. 
    Which of the following is not true regarding functional residual capacity?
    • A. 

      Defined as the lung volume at the end of NORMAL exhalation.

    • B. 

      About 2300 ml in normal adult.

    • C. 

      Composed of Expiratory reserve volume + Inspiratory reserve volume

    • D. 

      Directly related to patient height

  • 40. 
    What is Closing Capacity?
    • A. 

      Composed of Expiratory Reserve Volume + Residual Volume

    • B. 

      Volume of gas that can be exhaled following Maximal inspiration

    • C. 

      The mean volume of total lung capacity

    • D. 

      Volume at which small airways close in dependent parts of lungs

  • 41. 
    You are assessing lung volumes on a patient today. You ask your patient to take a very deep breath (as much as he can) and then to promptly exhale as much as he can. What are you measuring?
    • A. 

      Vital Capacity

    • B. 

      Total Lung Capacity

    • C. 

      Functional Residual Capacity

    • D. 

      Zero Long Volume

  • 42. 
    Vital Capacity is NOT dependent on which of the following?
    • A. 

      Body habitus

    • B. 

      Gender

    • C. 

      Respiratory muscle strength

    • D. 

      Chest-Lung Compliance

  • 43. 
    What would be a normal Vital Capacity for a female who is 5’4” and 60 kg?
    • A. 

      2400 ml

    • B. 

      6000 ml

    • C. 

      3600 ml

    • D. 

      3000 ml

  • 44. 
    Gas flow in the lungs is…
    • A. 

      Laminar

    • B. 

      Turbulent

    • C. 

      Transitional

    • D. 

      A mix of laminar and turbulent

  • 45. 
    The work of breathing is performed primarily by what?
    • A. 

      Diaphragm

    • B. 

      Intercostal muscles

    • C. 

      Abdominal muscles

    • D. 

      Accessory muscles

  • 46. 
    Patients with increased airflow resistance will have a rapid, shallow breathing pattern.
    • A. 

      True

    • B. 

      False

  • 47. 
    After inducing a patient for general anesthesia you can expect that their FRC will be…
    • A. 

      Increased

    • B. 

      Decreased

    • C. 

      Unchanged

  • 48. 
    What is the minute volume for a patient breathing  12 breaths per minutes at 450 ml tidal volume?               
    • A. 

      4.5 L

    • B. 

      6 L

    • C. 

      5.4 L

    • D. 

      3.8 L

  • 49. 
    Gases in non-respiratory airways are known as what?
    • A. 

      Physiologic Dead Space

    • B. 

      Alveolar Dead Space

    • C. 

      Ventilatory Dead Space

    • D. 

      Anatomic Dead Space

  • 50. 
    How will systemic vasoconstriction effect pulmonary blood volume?
    • A. 

      Will increase pulmonary blood volume

    • B. 

      Will decrease pulmonary blood volume

    • C. 

      Will have no effect

  • 51. 
    Which of the following will decrease Pulmonary blood volume?
    • A. 

      Placing the pt in Lithotomy position

    • B. 

      Placing pt in upright position

    • C. 

      Placing pt in Trendelenburg

    • D. 

      Administering Ephedrine

  • 52. 
    Which protective pulmonary mechanism diverts blood flow away from poorly ventilated or atelectic areas to minimize pulmonary shunting?
    • A. 

      Systemic Capacitance

    • B. 

      Perfusion Reflex

    • C. 

      Hypoxic Pulmonary Vasoconstriction

    • D. 

      Baroreceptor reflex

  • 53. 
    A VQ ratio of 0.3 on a patient would indicate what?
    • A. 

      Normal function of lungs

    • B. 

      Decreased Perfusion

    • C. 

      Pulm Emboli

    • D. 

      Decreased Ventilation

  • 54. 
    A VQ ratio of 0.8 would indicate what?
    • A. 

      Normal function of lungs

    • B. 

      Decreased Perfusion

    • C. 

      Hypoxic Pulmonary Vasoconstriction

    • D. 

      Decreased Ventilation

  • 55. 
    An intrapulmonary shunt is characterized by perfusion with no ventilation.
    • A. 

      True

    • B. 

      False

  • 56. 
    Which of the following is NOT an effect of anesthesia on Gas Exchange?
    • A. 

      Increased Dead Space

    • B. 

      Increased FRC

    • C. 

      Hypoventilation

    • D. 

      Increased Pulm Shunting

  • 57. 
    How will anemia effect oxygen delivery to tissues?
    • A. 

      Decrease delivery

    • B. 

      Increase delivery

    • C. 

      Unaffected due to compensatory mechanisms

  • 58. 
    You are caring for a patient whose ABG is:  pH 7.29  PaO2 82  PaCO2 60  HCO3 25. Would this have any effect on the oxygen-hemoglobin dissociation curve?
    • A. 

      Shift to Left and increase affinity of Hgb for O2

    • B. 

      Shift to Left and decrease affinity of Hgb for O2

    • C. 

      Shift to Right and decrease affinity of Hgb for O2

    • D. 

      Shift to Right and increase affinity of Hgb for O2

  • 59. 
    Which of the following will NOT shift the oxyhemoglobin dissociation curve to the Left?
    • A. 

      Carbon Monoxide Poisoning

    • B. 

      Fetal Hemoglobin

    • C. 

      PH 7.50

    • D. 

      Increased 2,3-DPG levels

  • 60. 
    The vast majority of oxygen stores in adults is contained where?
    • A. 

      O2 remaining in lungs

    • B. 

      O2 bound to Hgb

    • C. 

      O2 dissolved in body fluid

    • D. 

      O2 within tissues

  • 61. 
    Why do we pre-oxygenate a patient prior to induction?
    • A. 

      To blow off excess CO2

    • B. 

      To increase oxygen stores

    • C. 

      To shift oxygen hemoglobin dissociation curve to the left.

    • D. 

      To increase FRC

  • 62. 
    Following acute changes in ventilation the rate of fall in arterial CO2 tension is slower than it’s rise.
    • A. 

      True

    • B. 

      False

  • 63. 
    Which area of the brain is responsible for control of basic respiratory rhythm?
    • A. 

      Pontine Area

    • B. 

      Central Chemoreceptors

    • C. 

      Medulla

    • D. 

      MidBrain

  • 64. 
    What is the Hering-Breuer Reflex?
    • A. 

      A protective reflex which diverts blood flow away from poorly ventilated or atelectic areas to minimize pulmonary shunting.

    • B. 

      Compensates for decreased O2 affinity for Hgb in a Right shift by producing more RBC’s.

    • C. 

      Responds to arterial changes in O2, CO2, and H concentrations to change respiratory rate.

    • D. 

      Senses distention in lungs to prevent overinflation.

  • 65. 
    Which of the following is NOT a metabolic function of the lungs?
    • A. 

      Inhibition of Phosphodiesterase

    • B. 

      Surfactant Synthesis

    • C. 

      Conversion of Angiotensin 1 to Angiotensin 2

    • D. 

      Infection Control

  • 66. 
    The ______ the degree of pre-op pulmonary impairment the ________ the risk of pulmonary complications intra-op and post-op.
    • A. 

      Greater, lower

    • B. 

      Greater, Greater

    • C. 

      Lower, Greater

    • D. 

      None of above

  • 67. 
    Which of the following would have the GREATEST risk for post-op pulmonary complications?
    • A. 

      Mrs. Kuehm who has been a smoker for 15 yrs, 1 pack per day, but currently has no pulmonary disease

    • B. 

      Mr. Dent who is 78 yr old obese diabetic having a minor procedure

    • C. 

      Mrs. Vayo who is having open heart surgery today.

    • D. 

      Mr. Brachle who is having ankle and knee reconstructions following an MVA. Procedure predicted to take >3 hours.

  • 68. 
    Which of the following is not a predictor of post-op pulm complications?
    • A. 

      Preexisting Pulmonary Conditions

    • B. 

      Thoracic or Upper Abdominal Surgery

    • C. 

      Prolonged General Anesthesia

    • D. 

      Prone or Lateral Decubitus Position

  • 69. 
    What would be the hallmark of a patient with COPD?
    • A. 

      Decreased FEV1/FVC ratio and resistance to airflow

    • B. 

      Lung volumes decreased with normal FEV1/FVC ratio

    • C. 

      Manifested as sudden trachypnea, chest pain or hemoptysis

    • D. 

      Both A & B

  • 70. 
    You are taking care of Ms. Weezy, who came into the ER today. When she first came in she stated she had asthma and was displaying expiratory wheezing. A short while later she had both inspiratory and expiratory wheezing. She was given some aspirin for a headache prior to a respiratory treatment, after which she stopped wheezing. She is still using accessory muscle and appears to have trouble speaking, but the wheezes are now gone. What do you think about this?
    • A. 

      Great! She is improving, this is a good sign.

    • B. 

      Crap, the obstruction has become severe, she is getting worse.

    • C. 

      Not enough information to determine her status.

  • 71. 
    What symptoms would you expect to see in a patient with Asthma?
    • A. 

      The presence of a chronic productive cough most days of the month.

    • B. 

      Increases in FRC, RV, and TLC as well as pursed lip breathing.

    • C. 

      Insidious onset, chronic inflammation of alveolar walls and progressive pulmonary fibrosis.

    • D. 

      Recurrent episodes of wheezing, breathlessness, chest tightness, and cough.

  • 72. 
    During an asthma attack there is resistance to gas flow where?
    • A. 

      At all levels of Lower Airway

    • B. 

      Only in the alveoli and terminal bronchioles

    • C. 

      At all levels of the upper airway

    • D. 

      In the main stem bronchi

  • 73. 
    You are SRNA for Mr. Teesh who is a 31 yr old male and has a PMH of Asthma. He has not been hospitalized within the last 2 years but he has been to the ER several times. He takes daily medication to control his asthma and brought his inhaler with him. You auscultate his lungs and hear slight expiratory wheezes. He is having a minor outpatient procedure today, What should you do?
    • A. 

      Cancel the procedure until the patient is stabilized

    • B. 

      Give the patient a respiratory treatment prior to surgery, the monitor closely during surgery

    • C. 

      Induce the patient and then give treatment if symptoms occur

    • D. 

      Induce with Propofol & Atracurium to reduce possibility of bronchospasm.

  • 74. 
    You are in the middle of a hernia repair on a patient with a PMH of Asthma. During  the procedure you notice and increase in your PIP, decreased exhaled volume, an rising capnograph. You ausculatate the patients lungs and hear wheezing. His vital signs are currently stable. What should you do now?
    • A. 

      Inform the surgeon the patient is showing signs of malignant hyperthermia and to close up.

    • B. 

      Administer an albuterol treatment to the patient.

    • C. 

      Turn your Sevo up to deepen anesthetic depth.

    • D. 

      Give IV hydrocortisone & glyco.

  • 75. 
    Chronic Bronchitis is characterized by what?
    • A. 

      The presence of a chronic productive cough most days of the month.

    • B. 

      Increases in FRC, RV, and TLC as well as pursed lip breathing.

    • C. 

      Insidious onset, chronic inflammation of alveolar walls and progressive pulmonary fibrosis.

    • D. 

      Recurrent episodes of wheezing, breathlessness, chest tightness, and cough.

  • 76. 
    Emphysema is characterized by…
    • A. 

      The presence of a chronic productive cough most days of the month.

    • B. 

      Increases in FRC, RV, and TLC as well as pursed lip breathing.

    • C. 

      Insidious onset, chronic inflammation of alveolar walls and progressive pulmonary fibrosis.

    • D. 

      Recurrent episodes of wheezing, breathlessness, chest tightness, and cough.

  • 77. 
    You need to be cautious when administering which of the following to a COPD patient due to the possibility of knocking out their respiratory drive?
    • A. 

      Beta Adrenergic Agonists

    • B. 

      Broad spectrum antibiotics

    • C. 

      Anticholinergics

    • D. 

      Oxygen

  • 78. 
    You are caring for a patient with severe COPD, Pulm HTN, and Cor Pulmonale.  During the surgery you notice the patient  has an increase in their CVP, CI and PAP pressures. The patient is also beginning to develop peripheral edema.  What should be your first intervention?
    • A. 

      Give Lasix, pt is hypervolemic

    • B. 

      Give vasodilators, RV failure is worsening

    • C. 

      Give albumin to help prevent third spacing

    • D. 

      Give Inotropic agents to increase the CI

  • 79. 
    Smoking should be discontinued how many weeks prior to surgery?
    • A. 

      2-4

    • B. 

      6-8

    • C. 

      10-12

    • D. 

      1-2

  • 80. 
    Elevated levels of carboxyhemoglobin and methemoglobin are directly related to…
    • A. 

      COPD

    • B. 

      Emphysema

    • C. 

      Smoking

    • D. 

      Age

  • 81. 
    Which of the following is not true regarding management of a pt with COPD?
    • A. 

      Nitrous oxide should be avoided in those with pulmonary HTN.

    • B. 

      Ventilation should be controlled with small to moderate tidal volumes and slow rates

    • C. 

      Pre-op interventions may decrease the incidence of post-op complications

    • D. 

      Pre-oxygenation should be avoided due to the hypoxic respiratory drive of the COPD patient.

  • 82. 
    How is the respiratory drive of a COPD pt different from that of a normal person?
    • A. 

      Hypoxia is main respiratory drive

    • B. 

      Respiratory drive initiated by PCO2

    • C. 

      Intrinsic respiratory rate will be much more rapid

    • D. 

      HPV reflex is absent.

  • 83. 
    How will an increase in dead space effect your end tidal CO2?
    • A. 

      Increase ETCO2

    • B. 

      Decrease ETCO2

    • C. 

      No effect on ETCO2

  • 84. 
    Restrictive Pulmonary disease is characterized by…
    • A. 

      The presence of a chronic productive cough most days of the month.

    • B. 

      Increases in FRC, RV, and TLC as well as pursed lip breathing.

    • C. 

      Decreased lung compliance and lung volumes but a normal FEV1/FVC ratio

    • D. 

      Recurrent episodes of wheezing, breathlessness, chest tightness, and cough.

  • 85. 
    Which of the following would not be an Acute Intrinsic Pulmonary Disease?
    • A. 

      ARDS

    • B. 

      Pulmonary Edema

    • C. 

      Pneumonia

    • D. 

      Asthma

  • 86. 
    In ARDS, reduced lung compliance is primarily due to…
    • A. 

      Increased lung permeability and fluid in lungs

    • B. 

      Fibrosis of pulmonary tissue

    • C. 

      Increased dead space cause by air trapping

    • D. 

      Lack of surfactant leading to collapsed alveoli

  • 87. 
    You are SRNA for a patient from the unit coming for a procedure. This patient has ARDS. The patient is 5’5” and weighs 60 kg. What would be an appropriate tidal volume and resp rate for this pt?
    • A. 

      Vt 600 RR 14

    • B. 

      Vt 360 RR 16

    • C. 

      Vt 420 RR 10

    • D. 

      Vt 550 RR 12

  • 88. 
    Chronic Intrinsic Pulmonary disorders are characterized by…
    • A. 

      The presence of a chronic productive cough most days of the month.

    • B. 

      Increases in FRC, RV, and TLC as well as pursed lip breathing.

    • C. 

      Insidious onset, chronic inflammation of alveolar walls and progressive pulmonary fibrosis.

    • D. 

      Recurrent episodes of wheezing, breathlessness, chest tightness, and cough.

  • 89. 
    You are the SRNA for Mr. Troner today, who is an oncology patient. He has recently had radiation and chemotherapy with bleomycin. He was recently diagnosed with radiation pneumonitis. What special considerations do you need to take during surgery?
    • A. 

      Patient will have high levels of methemoglobin

    • B. 

      Patient should be placed on 100% O2 during the procedure

    • C. 

      Patient will be more susceptible to Pulmonary Embolism

    • D. 

      Inspired FiO2 should kept to a minimum (30%) or less.

  • 90. 
    You are caring for Ms. Garo today. She came in with a hip and femur fracture following an MVA 2 days ago and has been on bedrest.  She has a PMH of childhood asthma, no attacks for 10 years. She is trying to get comfortable in the bed when she suddenly complains of chest pain and shortness of breath. Her respiratory rate is now 36, when it has been 16. She looks very distressed, what do you think is wrong?               
    • A. 

      Pulmonary Embolism

    • B. 

      Acute Asthma Attack

    • C. 

      Pulmonary Edema

    • D. 

      Pnuemonia

  • 91. 
    Which of the following would you not expect to see on a patient with an intra-op pulmonary embolism?               
    • A. 

      Increased Pulmonary shunting

    • B. 

      Increased ETCO2

    • C. 

      Low V/Q ratio

    • D. 

      Elevated CVP & hypotension

  • 92. 
    You are doing a pre-op on a patient with a PMH of asthma. What important questions should you ask?               
    • A. 

      Do you take medication to control your asthma and how often?

    • B. 

      Have you been hospitalized within the last 2 yrs for asthma related problems?

    • C. 

      When was your last attack? About how often do you have attacks?

    • D. 

      All the above

  • 93. 
    A person with asthma may have PERMANENT changes in airway anatomy. 
    • A. 

      True

    • B. 

      False

  • 94. 
    Which of the following would be considered safe to give to an asthmatic patient?
    • A. 

      Aspirin

    • B. 

      Morphine

    • C. 

      Fentanyl

    • D. 

      Atracurium

  • 95. 
    The enlargement of the airways distal to the terminal bronchioles associated with emphysema is usually reversible. 
    • A. 

      True

    • B. 

      False

  • 96. 
    Use of regional anesthesia for orthopedic procedures will decrease the risk of DVT and PE.
    • A. 

      True

    • B. 

      False

  • 97. 
    Which of the following ABG’s would you expect to see on a patient who has an acute pulmonary embolism?
    • A. 

      PH 7.27 PaCO2 58 PaO2 60 HCO3 26

    • B. 

      PH 7.45 PaCO2 49 PaO2 86 HCO3 31

    • C. 

      PH 7.38 PaCO2 38 PaO2 90 HCO3 24

    • D. 

      PH 7.52 PaCO2 22 PaO2 70 HCO3 25

  • 98. 
    Which of the following is not likely to cause respiratory acidosis?
    • A. 

      Diabetic Acidosis

    • B. 

      COPD

    • C. 

      Neuromuscular abnormalities

    • D. 

      Cardiopulmonary arrest

  • 99. 
    Which of the following is not likely to cause respiratory alkalosis?
    • A. 

      Pulmonary embolism

    • B. 

      Pulmonary edema

    • C. 

      Pneumothorax

    • D. 

      Fever

  • 100. 
    Which of the following is not likely to cause metabolic alkalosis?
    • A. 

      NG suctioning

    • B. 

      Diuretic Therapy

    • C. 

      Severe Diarrhea

    • D. 

      Severe vomiting

  • 101. 
    Which of the following is not likely to cause metabolic acidosis?
    • A. 

      Shock

    • B. 

      Renal failure

    • C. 

      Diabetic Acidosis

    • D. 

      Cushings Disease

  • 102. 
    Which of the following ABG’s would you expect to see on a patient with a CNS injury?
    • A. 

      PH 7.54 CO2 28 HCO3 22

    • B. 

      PH 7.20 CO2 60 HCO3 26

    • C. 

      PH 7.62 CO2 45 HCO3 33

    • D. 

      PH 7.18 CO2 35 HCO3 15

  • 103. 
    Which of the following ABG’s would you expect to see on a patient with severe pneumonia?
    • A. 

      PH 7.54 CO2 28 HCO3 22

    • B. 

      PH 7.20 CO2 60 HCO3 26

    • C. 

      PH 7.62 CO2 45 HCO3 33

    • D. 

      PH 7.18 CO2 35 HCO3 15

  • 104. 
    Which of the following ABG’s would expect to see on a pt with severe vomiting who has been NG suctioned for 3 days?
    • A. 

      PH 7.54 CO2 28 HCO3 22

    • B. 

      PH 7.20 CO2 60 HCO3 26

    • C. 

      PH 7.62 CO2 45 HCO3 33

    • D. 

      PH 7.18 CO2 35 HCO3 15

  • 105. 
    Which of the following ABG’s would you expect to see on a patient in septic shock?
    • A. 

      PH 7.54 CO2 28 HCO3 22

    • B. 

      PH 7.20 CO2 60 HCO3 26

    • C. 

      PH 7.62 CO2 45 HCO3 33

    • D. 

      PH 7.18 CO2 35 HCO3 15

  • 106. 
    Interpret this ABG:  pH  7.35   CO2    54     HCO3    30
    • A. 

      Partially Compensated Metabolic Acidosis

    • B. 

      Compensated Respiratory Acidosis

    • C. 

      Compensated Metabolic Alkalosis

    • D. 

      Partially compensated respiratory alkalosis

  • 107. 
    Interpret this ABG:  pH  7. 49    CO2   30     HCO3   18
    • A. 

      Partially Compensated Metabolic Acidosis

    • B. 

      Compensated metabolic alkalosis

    • C. 

      Partially compensated respiratory alkalosis

    • D. 

      Compensated respiratory acidosis

  • 108. 
    Interpret this ABG: pH  7.45   CO2  55    HCO3   32
    • A. 

      Partially Compensated Metabolic Acidosis

    • B. 

      Compensated metabolic alkalosis

    • C. 

      Partially compensated respiratory alkalosis

    • D. 

      Compensated respiratory acidosis

  • 109. 
    Interpret this ABG:   pH  7.24   CO2  31     HCO3 19
    • A. 

      Partially Compensated Metabolic Acidosis

    • B. 

      Compensated metabolic alkalosis

    • C. 

      Partially compensated respiratory alkalosis

    • D. 

      Compensated respiratory acidosis

  • 110. 
    Interpret the following ABG:   pH 7.19   CO2   58    HCO3 24
    • A. 

      Respiratory Acidosis

    • B. 

      Respiratory Alkalosis

    • C. 

      Metabolic Acidosis

    • D. 

      Metabolic Alkalosis

    • E. 

      Normal ABG

  • 111. 
    Interpret the following ABG:  pH  7. 53   CO2   26     HCO3   23
    • A. 

      Respiratory Acidosis

    • B. 

      Respiratory Alkalosis

    • C. 

      Metabolic Acidosis

    • D. 

      Metabolic Alkalosis

    • E. 

      Normal ABG

  • 112. 
    Interpret the following ABG:  pH   7.28    CO2  41    HCO3  19
    • A. 

      Respiratory Acidosis

    • B. 

      Respiratory Alkalosis

    • C. 

      Metabolic Acidosis

    • D. 

      Metabolic Alkalosis

    • E. 

      Normal ABG

  • 113. 
    Interpret the following ABG:  pH  7.51    CO2 44   HCO3   32
    • A. 

      Respiratory Acidosis

    • B. 

      Respiratory Alkalosis

    • C. 

      Metabolic Acidosis

    • D. 

      Metabolic Alkalosis

    • E. 

      Normal ABG

  • 114. 
    Interpret the following ABG:  pH 7.37  CO2 44  HCO3  25
    • A. 

      Respiratory Acidosis

    • B. 

      Respiratory Alkalosis

    • C. 

      Metabolic Acidosis

    • D. 

      Metabolic Alkalosis

    • E. 

      Normal ABG

  • 115. 
    FEV1 and FVC are effort  _______ while forced midexpiratory flow is effort ________.
    • A. 

      Dependent, independent

    • B. 

      Independent, dependent

    • C. 

      Dependent, dependent

    • D. 

      Independent, independent

  • 116. 
    The normal FEV1/FVC ratio is greater than or equal to what?
    • A. 

      70%

    • B. 

      80%

    • C. 

      90%

    • D. 

      50%

  • 117. 
    A patient with cystic fibrosis is likely to have all of the following except:
    • A. 

      Low forced midexpiratory flow

    • B. 

      Reduced FEV1/FVC ratio

    • C. 

      Decreased lung compliance

    • D. 

      Increased airway resistance

  • 118. 
    A patient with ARDS is likely to have all of the following except:
    • A. 

      Normal Forced midexpiratory flow

    • B. 

      Normal FEV1/FVC ratio

    • C. 

      Decreased FEV1 & FVC

    • D. 

      Increased airway resistance

  • 119. 
    COMIC RELIEF:http://www.youtube.com/watch?v=Usm9SpnHYJQ&feature=related
    • A. 

      Dear god, did that giraffe cuss?

    • B. 

      Laura, we are seriously beginning to questions your mental stability.

    • C. 

      HA HA HA HA

    • D. 

      All the above

  • 120. 
    Which regional anesthesia used for eye surgeries  is associated with the greatest incidence of complications?
    • A. 

      Peribulbar block

    • B. 

      Subtenon block

    • C. 

      Retrobulbar block

    • D. 

      Topical anesthesia

  • 121. 
    Why is the use of succhinylcholine contraindicated within 20 minutes of forced duction testing?
    • A. 

      Succhinylcholine may be used within 20 minutes of forced duction testing as long as pretreatment with a nondepolarizer is used

    • B. 

      Succhinylcholine causes increased intraocular pressure due to contraction of intraocular muscles, causing a false forced duction result

    • C. 

      The increase in potassium associated with the use of succhinylcholine may produce transient blindness if used during forced duction testing

    • D. 

      Succhinylcholine may potentiate the oculocardiac reflex and is thus contraindicated during forced duction testing

  • 122. 
    Which of the following reduces the risk of stimulation of the oculocardiac reflex during ocular surgery?
    • A. 

      Asking the surgeon to create more traction on the extraocular muscles

    • B. 

      Utilizing sevoflurane rather than desflurane during maintenance

    • C. 

      Utilizing vecuronium rather than rocuronium to paralyze the patient

    • D. 

      Using atropine 0.02 mg/kg IV preoperatively

  • 123. 
    Patient G.K. presents with sharp pains to right lower abdomen. Patient complains of nausea and vomiting, loss of appetite, and fever. G.K is diagnosed with appendicitis and is en route to the OR for an appendectomy. Which airway management is best for this patient?
    • A. 

      General Endotrachial Intubation Anesthesia (GETA) – Appendectomy necessitates patient paralysis throughout the procedure.

    • B. 

      LMA – pt will not be paralyzed, which allows for spontaneous ventilation.

    • C. 

      RSI with endotrachial intubation – appendectomy usually an emergency procedure, and these patients must be treated as a full stomach

    • D. 

      Mask ventilation – procedure is relatively short and can be managed with inhalational anesthetics via mask ventilation

  • 124. 
    Which of the following is not a valid reason for inserting a nasogastric tube in a patient undergoing an appendectomy?
    • A. 

      Insertion of an NGT allows decompression of the stomach, decreasing the risk of aspiration

    • B. 

      According to AANA’s standards, all patients under general anesthesia must have an NGT inserted.

    • C. 

      Appendectomy is usually an emergent procedure, and patients undergoing this surgery are usually treated as a full stomach

    • D. 

      All of the above are correct

  • 125. 
    Concerns related to an appendectomy may include:
    • A. 

      Fluid and electrolyte replacement secondary to concomitant vomiting, fever, and decreased oral intake.

    • B. 

      Administration of antibiotics, especially if there possible perforation and contamination into the abdominal cavity.

    • C. 

      Lateral decubitus positioning – pressure points must be padded, arms supported by pillow and armboard, axilla roll in place to prevent brachial plexus injury.

    • D. 

      Both a & b

  • 126. 
    During an ORIF of the wrist, After the tourniquet is released from the arm the patient will
    • A. 

      Become tachycardic and hypertensive

    • B. 

      Become tachycardic and hypotensive

    • C. 

      Become bradycardic and hypertensive

    • D. 

      Become bradycardic and hypotensive

  • 127. 
    2)  It is extremely important preoperative to a wrist ORIF to….
    • A. 

      To obtain a full set of labs including, CBC, BMP, PT/INR. EKG, & CXR

    • B. 

      To ensure the patient was NPO for a minimum of 4 hours.

    • C. 

      To make the surgeon wait an extra 30 minutes because you don’t like him

    • D. 

      Note any pre-existing sensory or motor defects

  • 128. 
    Which of the following is not correct regarding a wrist ORIF?
    • A. 

      ORIF is required for closed unstable fractures unable to improve with conservative therapy

    • B. 

      Most commonly seen in young, healthy individuals.

    • C. 

      EBL is moderate

    • D. 

      Can use a combination of regional and general anesthesia

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