Otterbein/Grant CRNA Basics II Quiz 1 Review
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Questions and Answers
- 1.
Lasers depend on _______ to deliver energy.
- A.
Photons
- B.
Pressure
- C.
Electrons
- D.
Magic
Correct Answer
A. PhotonsExplanation
Lasers depend on photons to deliver energy. Photons are particles of light that carry energy. In a laser, photons are generated through a process called stimulated emission, where excited atoms release photons of specific wavelengths. These photons are then amplified and focused into a coherent beam of light. This concentrated beam of photons can be used for various applications, such as cutting, welding, or medical procedures. Therefore, photons are essential for the functioning of lasers as they provide the energy needed for their operation.Rate this question:
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- 2.
All of the following describe laser light characteristics except.....
- A.
Complete visible spectrum
- B.
Coherent
- C.
Monochromatic
- D.
Collimated
Correct Answer
A. Complete visible spectrumExplanation
Laser light is not characterized by a complete visible spectrum because it consists of a single wavelength or a narrow range of wavelengths, which makes it monochromatic. Laser light is also coherent, meaning that the waves are in phase and have a fixed relationship with each other. Additionally, laser light is collimated, meaning that it is highly focused and does not spread out like ordinary light. Therefore, the correct answer is "Complete visible spectrum" because laser light is not composed of a full range of colors.Rate this question:
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- 3.
CO2 lasers have a wavelegth of 10,600 nm, are transmitted through the air, absorbed by water and provide superficial penetration.They are used for: vocal cord ablation, snoring procedures, skin wrinkles, soft tissue excision, and condyloma vaporization.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
CO2 lasers have a wavelength of 10,600 nm, which falls within the infrared range. This wavelength allows the lasers to be transmitted through the air without significant absorption or scattering. However, water molecules readily absorb this wavelength, making CO2 lasers effective for procedures involving water-rich tissues like vocal cords, skin, and soft tissues. The superficial penetration of CO2 lasers makes them suitable for treatments such as vocal cord ablation, snoring procedures, skin wrinkle reduction, soft tissue excision, and condyloma vaporization. Therefore, the statement that CO2 lasers are used for these purposes is true.Rate this question:
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- 4.
The Erbium YAG (yitrium aluminum garment) laser has a wavelength of 2940 nm, is pulsed, and absorbed by water. It provides shallow penetration and is used for skin rejuvenation.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
The explanation for the given correct answer is that the Erbium YAG laser has a specific wavelength of 2940 nm, which makes it highly absorbed by water. This characteristic of the laser allows it to target the water content in the skin, making it effective for skin rejuvenation. Additionally, the laser is pulsed, meaning it delivers energy in short bursts, which further enhances its ability to target specific areas of the skin. The shallow penetration of the laser ensures that it primarily affects the outer layers of the skin, making it ideal for cosmetic procedures such as skin rejuvenation.Rate this question:
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- 5.
The Holmium YAG laser has a wavelength of 2100-2140 nm which is infrared. It utilizes a fiber delivery system and provides shallow penetration. It is transmitted through solutions via a vapor bubble. It can be used for cutting and coagulation. It has been used for treatment of urinary stones, pecutaneous microdiscectomy, and transmyocardial revascularization.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
The explanation for the given correct answer is that the statement accurately describes the characteristics and uses of the Holmium YAG laser. It operates in the infrared range with a wavelength of 2100-2140 nm, and it is delivered through a fiber system, allowing for shallow penetration. The laser's energy is transmitted through solutions via a vapor bubble, making it suitable for cutting and coagulation. Additionally, the Holmium YAG laser has been successfully used in various medical procedures such as the treatment of urinary stones, percutaneous microdiscectomy, and transmyocardial revascularization. Therefore, the statement is true.Rate this question:
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- 6.
The Nd: YAG laser was the 1st YAG laser created. It has a wavelength of 1064 nm and uses a fiber delivery system. It can be transmitted through solutions and also cuts and coagulates. It has been used for colonic, esophageal, bronchial, and bladder tumors as well as tattoo removal and posterior capsulotomy (Q-switch YAG).
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
The explanation for the given correct answer is that the Nd: YAG laser was indeed the first YAG laser created. It operates at a wavelength of 1064 nm and utilizes a fiber delivery system. This laser can be transmitted through solutions and is capable of both cutting and coagulating tissues. It has been widely used in various medical procedures such as treating colonic, esophageal, bronchial, and bladder tumors, as well as for tattoo removal and posterior capsulotomy using Q-switch YAG technology. Therefore, the statement "The Nd: YAG laser was the 1st YAG laser created" is true.Rate this question:
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- 7.
KTP lasers have frequency doubling crystals. They are used for stapedectomies, lysis of adhesions and endometrial implants as well as prostate procedures.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
The statement is true because KTP lasers do indeed have frequency doubling crystals. These crystals allow the laser to emit green light by doubling the frequency of the initial infrared light. KTP lasers are commonly used in various medical procedures such as stapedectomies, lysis of adhesions, endometrial implants, and prostate procedures.Rate this question:
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- 8.
Argon lasers utilize two different wavelengths: 488 nm (blue) and 515 nm (green).
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
Argon lasers are indeed capable of emitting two different wavelengths, 488 nm (blue) and 515 nm (green). This is due to the unique properties of argon gas, which can produce laser light at these specific wavelengths. Therefore, the statement "Argon lasers utilize two different wavelengths: 488 nm (blue) and 515 nm (green)" is true.Rate this question:
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- 9.
Benefits from _______ surgery include: precision, enhanced accessiblity, less bleeding, less pain for select cases, and less recovery time.
- A.
LASER
- B.
Traditional
Correct Answer
A. LASERExplanation
LASER surgery offers several benefits such as precision, enhanced accessibility, less bleeding, less pain for select cases, and shorter recovery time. This is because LASER technology allows for precise and controlled incisions, minimizing damage to surrounding tissues. It also provides better access to hard-to-reach areas. Additionally, LASER surgery typically results in less bleeding and post-operative pain compared to traditional surgery methods. The use of LASER also promotes faster healing and shorter recovery periods.Rate this question:
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- 10.
Part of fire safety with the use of lasers in the airway includes using a laser ETT, filling the balloon with tinted saline, and placing ____ cottonoids around the tube.
- A.
Wet
- B.
Dry
- C.
No
Correct Answer
A. WetExplanation
The correct answer is "Wet" because wet cottonoids around the laser ETT tube are used as a safety measure to prevent fires during laser surgery. Wet cottonoids help to absorb and dissipate heat generated by the laser, reducing the risk of ignition and fire. This ensures the safety of the patient and the medical staff during the procedure.Rate this question:
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- 11.
Which size of mask filtration provides adequate protection against surgical smoke?
- A.
0.1 micron filtration
- B.
5 micron filtration
Correct Answer
A. 0.1 micron filtrationExplanation
Or an N-95Rate this question:
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- 12.
When managing the ventilation of an obese patient, you know that their goal tidal volumes should be based on their ideal body weight.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
PEEP is the only ventilator parameter that can improve respiratory function in obesity.Rate this question:
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- 13.
Hypothermia slows anesthetic elimination, prolongs recovery from anesthesia, impairs coagulation, and increases the chances that the patient will shiver. The elderly have impaired thermoregulation d/t decreased function of the hypothalamus. Hypothermia is more pronounced and lasts longer due to a lower BMR, a high ratio of surface to body area mass, and a less effective peripheral vasoconstrictive response to cold.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
Hypothermia can indeed slow anesthetic elimination, prolong recovery from anesthesia, impair coagulation, and increase the chances of shivering. The elderly, due to decreased function of the hypothalamus, have impaired thermoregulation. This means that hypothermia is more pronounced and lasts longer in the elderly due to factors such as a lower basal metabolic rate (BMR), a higher ratio of surface to body area mass, and a less effective peripheral vasoconstrictive response to cold. Therefore, the statement is true.Rate this question:
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- 14.
Due to high amounts of circulating catecholamines, elderly patients exhibit _____ adrenergic responsiveness.
- A.
Decreased
- B.
Increased
Correct Answer
A. DecreasedExplanation
Elderly patients exhibit decreased adrenergic responsiveness due to high amounts of circulating catecholamines. This can be attributed to age-related changes in the sympathetic nervous system, such as reduced sensitivity of adrenergic receptors and decreased release of neurotransmitters. As a result, elderly individuals may have a diminished response to adrenergic stimulation, leading to decreased adrenergic responsiveness.Rate this question:
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- 15.
In the elderly, there is an increase in afterload and ________ BP resulting in ventricular thickening and prolonged ejection times.
- A.
Systolic
- B.
Diastolic
- C.
Mean arterial
Correct Answer
A. SystolicExplanation
As people age, there is an increase in afterload, which refers to the resistance that the heart has to overcome in order to pump blood out of the ventricles. This increase in afterload leads to an increase in systolic blood pressure, which is the pressure in the arteries when the heart contracts. As a result, the ventricles of the heart thicken in order to pump blood against the higher pressure, and the ejection time, the time it takes for the blood to be pumped out of the heart, becomes prolonged.Rate this question:
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- 16.
MAC is decreased by _% each decade after age 40.
Correct Answer
6 - 17.
In the beach chair position, blood pressure, cerebral blood flow and cerebral function:
- A.
Decrease
- B.
Increase
- C.
Remain the same
Correct Answer
A. DecreaseExplanation
In the beach chair position, the blood pressure, cerebral blood flow, and cerebral function decrease. This is because when a person is in the beach chair position, their upper body is elevated, leading to a redistribution of blood away from the brain and towards the lower extremities. This decrease in blood flow to the brain can result in a decrease in blood pressure, cerebral blood flow, and cerebral function.Rate this question:
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- 18.
Hypotension in the beach chair/sitting position is caused by venous pooling resulting in sympathetic activation which causes vigorous contraction of a poorly filled ventricle.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
Hypotension in the beach chair/sitting position is caused by venous pooling, which means that blood accumulates in the veins instead of being properly circulated. This leads to sympathetic activation, where the sympathetic nervous system is stimulated to compensate for the low blood pressure. As a result, the ventricle, which is responsible for pumping blood out of the heart, contracts forcefully even though it is not adequately filled with blood. Therefore, the statement is true.Rate this question:
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- 19.
Pneumatic tourniquets should always be inflated to 300 mmHg.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
90-100 higher than the pre-induction systolicRate this question:
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- 20.
Fall in core temperature, metabolic acidosis, fall in central venous oxygen, acid metabolites released into systemic circulation, and an increase in etCO2 are associated with the ______ of a pneumatic tourniquet.
- A.
Deflation
- B.
Inflation
Correct Answer
A. DeflationExplanation
Deflation of a pneumatic tourniquet is associated with a fall in core temperature, metabolic acidosis, fall in central venous oxygen, acid metabolites released into systemic circulation, and an increase in etCO2.Rate this question:
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- 21.
Tourniquet pain starts immediately upon inflation.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
45-60 min after inflationRate this question:
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- 22.
Tourniquet pain is progressively demonstrated by hypertension, tachycardia and diaphoresis.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
Immediately resolves with deflationRate this question:
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- 23.
The prone position significantly _______ systemic and pulmonary vascular resistance.
- A.
Increases
- B.
Decreases
Correct Answer
A. IncreasesExplanation
The prone position significantly increases systemic and pulmonary vascular resistance. This means that when a person is lying face down, there is an increase in the resistance to blood flow in both the systemic (throughout the body) and pulmonary (through the lungs) blood vessels. This can have implications for blood pressure and oxygenation in the body.Rate this question:
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- 24.
Regarding the West zones in the prone position...zone II decreases, zone III ________.
- A.
Increases
- B.
Decreases
- C.
Stays the same
Correct Answer
A. IncreasesExplanation
In the prone position, zone II refers to the middle of the chest and zone III refers to the lower chest and abdomen. When in the prone position, the weight of the body is distributed towards the front, causing increased pressure on zone III. This increased pressure leads to an increase in blood flow and oxygenation in zone III, resulting in an increase in this zone. Therefore, the correct answer is "Increases".Rate this question:
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- 25.
The insufflator inflates the abdomen using a pressure of:
- A.
10-15 mmHg
- B.
20-30 mmHg
- C.
0-5 mmHg
- D.
25-50 mmHg
Correct Answer
A. 10-15 mmHgExplanation
The correct answer is 10-15 mmHg. This pressure range is commonly used in laparoscopic surgeries to create a pneumoperitoneum, which is the inflation of the abdomen with carbon dioxide gas. This pressure is sufficient to provide a clear surgical field while minimizing the risk of complications such as gas embolism or trauma to the abdominal organs. Higher pressures may cause discomfort to the patient and increase the risk of complications, while lower pressures may not provide adequate visualization for the surgeon.Rate this question:
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- 26.
This gas is used for insufflation because it is inexpensive, does not support combustion, it is readily absorbed from the vascular system and excreted by the pulmonary system. It is colorless, and physiologically inert.
- A.
CO2
- B.
O2
- C.
Air
- D.
N2O
Correct Answer
A. CO2Explanation
CO2 is the correct answer because it meets all the criteria mentioned in the question. It is inexpensive, does not support combustion, and is readily absorbed and excreted by the body. Additionally, CO2 is colorless and physiologically inert, making it suitable for insufflation purposes.Rate this question:
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- 27.
Gas embolisms during laparoscopy are very rare, they usually occur during initial insufflation or from the Veress needle/Trocar placement entering a vessel. Gas bubbles can cause a "gas lock" due to preventing ______ ventricular outflow.
- A.
Right
- B.
Left
Correct Answer
A. RightExplanation
Signs & Symptoms
Hypotension
Dysrhythmias
Hypoxia
Pulmonary Edema
“mill wheel” murmur
Treatment
Discontinue insufflation
Administer 100% O2
Release pneumoperitoneum
Place in left lateral decubitus position
Place central line to evacuate Air/Co2Rate this question:
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- 28.
Which of the following is associated with more blood loss?
- A.
Partial nephrectomy
- B.
Total nephrectomy
Correct Answer
A. Partial nephrectomyExplanation
Unable to clamp entire blood flow to the kidney.Rate this question:
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- 29.
The lithotomy position is often used for GU surgeries, complications include:Decreased FRC, increased WOB, compartment syndrome, common peroneal nerve injury, and unrecognized _________.
- A.
Hypovolemia
- B.
Tachycardia
- C.
Hypertension
- D.
Death
Correct Answer
A. HypovolemiaExplanation
The lithotomy position is commonly used for genitourinary surgeries, which can lead to complications such as decreased functional residual capacity (FRC) and increased work of breathing (WOB). Additionally, the lithotomy position can cause compartment syndrome and common peroneal nerve injury. However, the most significant and potentially life-threatening complication is hypovolemia, which refers to a decrease in blood volume. This can occur due to blood loss during surgery or fluid shifts within the body. Hypovolemia can lead to hemodynamic instability, organ dysfunction, and ultimately, death if not promptly recognized and treated.Rate this question:
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- 30.
TURP syndrome S/S include: hemolysis, hypotension, hypertension, bradycardia, CHF, pulmonary edema, confusion, N&V, seizures, coma, and death.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
The given statement is true. TURP syndrome refers to a condition that can occur after transurethral resection of the prostate (TURP) surgery. It is characterized by a variety of symptoms including hemolysis (breakdown of red blood cells), hypotension (low blood pressure), hypertension (high blood pressure), bradycardia (slow heart rate), congestive heart failure (CHF), pulmonary edema (fluid accumulation in the lungs), confusion, nausea and vomiting (N&V), seizures, coma, and even death. Therefore, the statement is correct.Rate this question:
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- 31.
TURP syndome is caused by dilutional hyponatremia (hypo-osmolarity) resulting from absorption of irrigating fluid through the prostate sinuses, usually 2L or more is absorbed. Contributing factors include irrigating fluid characteristics and the length of resection time - 20 mL of fluid is absorbed per minute.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
Tx w/3-5% saline @ 100 mL/hr or lessRate this question:
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- 32.
Intraocular pressure and ICP decrease during robotic surgeries.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
Prolonged trendelenburg:
Reduced FRC, neuropathies (pressure), swelling of face, tongue, airway, hypotension, decreased urine output.Rate this question:
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- 33.
Greg:Pneumoperitoneum increases peak inspiratory pressures. MMA instillation (bone cement) causes transitory hypotension. Tx w/alpha agonist, 100% FiO2, and by maximizing blood pressure prior to MMA.Use one size smaller ETT with anterior spine surgery.Minimize fluid administration with robotics until the anastamosis is complete.The shoulder pain associated with insufflation is due to phrenic nerve irritation.The increased CO2 associated with insufflatoin passively increases CBF.Desflurane is the most commonly used inhalation agent for obese patients d/t being the least toxic, and low lipid solubility.Laparascopic procedures increase the risk for PONV.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
The given correct answer is true. The statement is supported by the information provided in the explanation. It states that laparoscopic procedures increase the risk for postoperative nausea and vomiting (PONV).Rate this question:
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