Principles #3
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Test reviewing the material for Test #3 in principles class.
- 1.You are looking at pressure readings on your vent because you are having to use your tank nitrous oxide. Ten minutes ago the pressure read 750, but now the pressure has just started to decrease. According to our handouts how much volume (approximately) should be left in the tank?
- A.
215 L
- B.
1590 L
- C.
795 L
- D.
530 L
- 2.According to our handout, what is clinical anesthesia?
- A.
A generalized reversible depression of the central nervous system such that perception of all senses is removed.
- B.
Production of an abnormal state that satisfies the requirements for the carrying out of surgical and diagnostic procedures.
- C.
A state characterized by unconsciousness, analgesia, muscle relaxation, and depressed reflexes.
- D.
The period of time from the end of induction to the time of decreasing anesthetic depth to allow awakening.
- 3.Induction of anesthesia is characterized by…. (two answers)
- A.
Rapid Loss of consciousness
- B.
Production of paralysis
- C.
Progression to a light surgical plane of anesthesia
- D.
Progression to a deep surgical plane of anesthesia
- 4.During induction, the level of anesthesia-induced depression which is most dangerous to the patient is…
- A.
Sedated-unconscious
- B.
Light Anesthesia
- C.
Minimal Anesthesia
- D.
Depression- Excitation
- 5.During which level of anesthesia induced depression would your patient experience an increased somatic response and be most susceptible to laryngospasms?
- A.
Depression-Excitation
- B.
Sedated-unconscious
- C.
Deep anesthesia
- D.
Minimal anesthesia
- 6.You are the SRNA for a pt undergoing a minor procedure today. Your preceptor asks you which level of anesthesia induced depression your pt is currently in. You take note that the pt currently has minimal response to stimuli, has depressed respiration that can increase with stimuli, and only a slight cardiac response to major stimuli. Which level is this pt in?
- A.
Deep Anesthesia
- B.
Light Anesthesia
- C.
Minimal Anesthesia
- D.
Sedated- unconscious
- 7.What is the most frequently used method of anesthesia induction in adults?
- A.
Inhalational induction
- B.
IM injection
- C.
Intravenous induction
- D.
Administration of oral agents.
- 8.Is it possible to confirm dentirogenation? If so, How?
- A.
By monitoring the patients O2 saturation.
- B.
By looking at your ETCO2
- C.
By using a colorimetric CO2 analyzer
- D.
By observing the percent O2 present in expired gas using an O2 analyzer.
- 9.What would be an appropriate induction plan for a patient with an anticipated difficult airway?
- A.
Awake intubation under topical anesthesia
- B.
Inhalational induction and plan to mask the entire case
- C.
Rapid sequence induction and having a glide scope ready
- D.
Call the MDA to intubate this patient.
- 10.Which of the following is NOT one the goals during maintenance of anesthesia? (According to handout)
- A.
To maintain stable body temperature
- B.
To maintain an adequate and normal level of stress response
- C.
To provide suitable operating conditions for the surgeon
- D.
To maintain appropriate fluid and electrolyte balances
- 11.During maintenance of anesthesia, where should your arterial BP and heart rate be?
- A.
Maintained at basal levels
- B.
Within 20% of basal levels
- C.
Within 10% of basal levels
- D.
Slightly more than basal levels.
- 12.Which of the following would NOT be respiratory sign that your anesthesia is too light in a patient with controlled ventilation?
- A.
Onset of respiratory efforts
- B.
Changes in peak inspiratory pressure
- C.
Appearance of an end inspiratory pause
- D.
Increase in ETCO2
- 13.When properly placing a BIS monitor on a patient, where should electrode #1 be placed?
- A.
In the center of forehead, 2 inches from bridge of nose
- B.
At the patients temple, level with their eye
- C.
Directly above the patients eyebrow.
- D.
On the right side of the pts face, adjacent to electrode #2
- 14.When properly placing a BIS monitor on a patient, where should electrode #3 be placed?
- A.
In the center of forehead, 2 inches from bridge of nose
- B.
At the patients temple, level with their eye
- C.
Directly above the patients eyebrow.
- D.
On the right side of the pts face, adjacent to electrode #1
- 15.The benefits of using BIS monitoring do NOT include which of the following?
- A.
Reduction in use of anesthetic agent
- B.
Reduction of tourniquet time
- C.
Decreased emergence time
- D.
Decrease in post-op nausea and vomiting
- 16.Which of the following BEST describes the BIS number?
- A.
A single number derived from EG recording using a single signal processing technique, updated every 15 seconds.
- B.
Multiple numbers derived from multiple EEG recordings updated every minute
- C.
A value based on the EEG recordings of the prior minute and derived from multiple signal processing techniques, updated every second.
- 17.What would be an appropriate BIS value to maintain during maintenance of anesthesia?
- A.
100
- B.
30
- C.
70
- D.
50
- 18.At which BIS value would you see an isoelectric EEG?
- A.
0
- B.
20
- C.
30
- D.
40
- 19.If you were to apply a BIS monitor to yourself RIGHT NOW, what would your BIS value most likely be?
- A.
0
- B.
76
- C.
98
- D.
54
- 20.What do you predict will be the effect of intubation on BIS, BP & heart rate?
- A.
Increase BP & HR, BIS may or may not increase
- B.
BIS will not change, BP and HR will increase
- C.
BIS will increase, BP and HR will stay same
- D.
BIS will increase, BP & HR will decrease
- 21.During emergence, the patient will typically become responsive and open their eyes above what BIS level?
- A.
60
- B.
80
- C.
70
- D.
100
- 22.Which of the following will not increase the risk for awareness during surgery?
- A.
Total intravenous anesthesia
- B.
Trauma or emergency surgery
- C.
ASA status 2 or 3
- D.
Chronic Pain Patient
- 23.You are preparing for induction of Mr. Optimus Prime. He is 6’0” and weighs 100 kg. Pick the option below which gives you a proper induction dose for Optimus Prime.
- A.
Propofol 100 mg Sux 10 mg
- B.
Etomidate 20 mg Vec 100 mg
- C.
Propofol 200mg Vec 10 mg
- D.
Etomidate 200 mg Sux 150 mg
- 24.During which stage of anesthesia would the patient experience loss of respiration and be at risk for death?
- A.
Stage 5
- B.
Stage 1
- C.
Stage 3
- D.
Stage 4
- 25.During which stage of anesthesia would a patient be at increased risk for laryngospasm?
- A.
Stage 2
- B.
Stage 1
- C.
Stage 4
- D.
Stage 3
- 26.During general anesthesia, we should try to maintain the patient at what stage of anesthesia?
- A.
Stage 4
- B.
Stage 3
- C.
Stage 2
- D.
Stage 1
- 27.Which of the following will cause an increase in MAC requirements?
- A.
Acute ETOH intoxication
- B.
Pregnancy
- C.
Hyperthermia
- D.
Use of benzo’s
- 28.You are caring for Fat Albert today who has a past history of hypothyroidism. He is having a gastric bypass today. Considering the history of thyroid gland dysfunction, how will this affect your MAC requirements?
- A.
Increase MAC
- B.
Decrease MAC
- C.
I’m just glad Fat Albert is finally seeking help.
- D.
Nothing, thyroid dysfunction does not affect MAC.
- 29.Optimal depth of anesthesia will maintain the BIS Number…
- A.
40-60
- B.
60-70
- C.
80-100
- D.
15-30
- 30.You have just extubated Mr. Woo, and he begins to have a laryngospasm. What should you do?
- A.
Put on a non-rebreather mask with 100% O2 and wheel him to the PACU
- B.
Give 100% O2 via face mask, use the bag to apply some positive pressure, and apply jaw thrust.
- C.
Re-intubate him immediately and then extubate at a higher stage of anesthesia.
- D.
Give an albuterol treatment.
- 31.Today you are caring for Pete, a 34 yr old male with Down’s Syndrome. He has the mental capacities of a 4-5 yr old child, and on top of his mental deficiencies he is also deaf. He is not being cooperative with nurses in pre-op and seems to be confused and frightened. What is your plan for induction of this patient?
- A.
Get a sign language interpreter in to help you explain things to him so that he will let you start an IV.
- B.
Have the nurses held to hold him down so you can start an IV and then tape the hell out of it so he can’t get it out.
- C.
Use a ketamine dart to calm him, then start your IV and induce the pt.
- D.
Wait for him to fall asleep… then gas the hell out of him.
- 32.Which of the following cases would be inappropriate for MAC anesthesia?
- A.
Cataract surgery on an 78 yr old Female
- B.
Pacemaker insertion on 56 yr old male
- C.
Bone marrow biopsy on 5 yr old female
- D.
Open hysterectomy on a 43 yr old female
- 33.What is the Aldrete score for an anesthetized patient, who is paralyzed. This patients Blood pressure is within 15 mm of baseline BP. The skin is warm, dry, and has a normal color to it.
- A.
4
- B.
6
- C.
0
- D.
2
- 34.You are caring for Ms. UglyFoot who is in the OR today having a bunionectomy. She has a local block on her foot and the surgeon is asking you what is the maximum dose of Lidocaine (mixed with epi) that he can give to this patient. Ms. Ugly foot is 5’0”, weighs 50kg, is an ASA 2 patient with past medical history of HTN & DM. The physician asks for 25cc of 1% Lidocaine mixed with Epi 1:100,000. What do you do?
- A.
Question the MD, that's too much Lido
- B.
Question the MD, that's too much Epi
- C.
Question the MD, we don't mix Lido and Epi
- D.
Nothing
- 35.You are giving lidocaine IV prior to administration of propfol on a very small patient who only weighs 30 kg. What is the max dose of lidocane that you could give this patient IV?
- A.
30 mg
- B.
210 mg
- C.
120 mg
- D.
300 mg
- 36.You are going to do a MAC case with propofol infusion on a case today. What would be the most desirable dosing regimen to maintain the patient in therapeutic rage?
- A.
Propofol 10-20mg boluses as needed
- B.
Start with propofol 2mg/kg bolus, then give 10 mg PRN as needed
- C.
Start propofl infusion 60 mcg/kg/min
- D.
Start with propofol bolus 10-20mg then start infusion of 50 mcg/kg/min
- 37.How would you reverse the effects of hypnotic agents?
- A.
Just sit and wait, there is no way to reverse them.
- B.
Flumazenil 0.2 mg IV over 15 seconds, may give up to 1 mg.
- C.
Narcan 2mg IV
- D.
Neostigmine .08 mg/kg given with glycopyrolate
- 38.What should you choose for reversal of benzodiazepine sedation?
- A.
Just sit and wait, there is no way to reverse them.
- B.
Flumazenil 0.2 mg IV over 15 seconds, may give up to 1 mg.
- C.
Narcan 2mg IV
- D.
Neostigmine .08 mg/kg given with glycopyrolate
- 39.You are the SRNA for a 4 yr old female. Where would you expect her spinal cord would end?
- A.
L1
- B.
L5
- C.
L3
- D.
L2
- 40.Where would you expect the spinal canal to end on an adult patient?
- A.
L1-L2
- B.
L3
- C.
L5
- D.
Sacral Hiatus
- 41.Where you expect the Spinal Cord to end on an adult patient?
- A.
L1-L2
- B.
L3
- C.
L5
- D.
Sacral Hiatus
- 42.When performing an epidural on a patient whose ligamentum flavum is not fused, this may result in?
- A.
Dural Headache
- B.
Spinal that works better on one side than other
- C.
Uncal Herniation
- D.
‘Popping’ upon insertion of epidural needle
- 43.At what level should epidural anesthesia be performed?
- A.
At L1
- B.
Below level of L1
- C.
Can be performed at any level
- D.
Identify Tuffiers line an insert there.
- 44.At what level should Spinal Anesthesia be performed?
- A.
Can be performed at any level
- B.
At level of T 12
- C.
At L1
- D.
Below level of L1
- 45.The primary site of action for both spinal and epidural anesthesia is the Nerve Root.
- A.
True
- B.
False
- 46.After performing Spinal anesthesia you have a Sensory blockade at the level of T 8. You would expect to see a sympathetic blockade at the level of _____ and a motor blockade at the level of _____.
- A.
T6, T10
- B.
T 4, T6
- C.
T10, T6
- D.
T10, T12
- 47.You have just performed spinal anesthesia and found you have a sympathetic blockade at the level of T6. Is this safe for your patient?
- A.
No, they are at increases risk for dural puncture headache.
- B.
Yes, this is considered a safe level of sympathetic blockade.
- C.
No, the patient is at risk for profound bradycardia.
- D.
No, the level of blockade is inadequate.
- 48.You have just performed spinal anesthesia and found you have a motor blockade at the level of T6. Is this safe for your patient?
- A.
No, they are at increases risk for dural puncture headache.
- B.
Yes, this is considered a safe level of sympathetic blockade.
- C.
No, the patient is at risk for profound bradycardia.
- D.
No, the level of blockade is inadequate.
- 49.You are performing an epidural on a patient in labor, would you expect this to change your dose of anesthetic used?
- A.
Nope, amount of anesthetic used will stay the same.
- B.
You will require more anesthetic to reach the desired effect.
- C.
This is a contraindication to epidural anesthesia, I would not do the block.
- D.
I would expect to use less anesthetic.
- 50.Which of the following patients is an Absolute contraindication to spinal anesthesia?
- A.
Mrs. A what has severe mitral stenosis.
- B.
Mr. B who has advanced HIV disease
- C.
Mrs. C who weighs 350 pounds.
- D.
Mr. D who suffers from chronic back pain.
- 51.You have just performed spinal anesthesia and find your patient has experienced total spinal anesthesia. What do you do?
- A.
Prepare for the patient to be placed on cardiac bypass due to arrhythmias.
- B.
Intubate the patient and wait it out.
- C.
Deliver neo and glyco to reverse the paralysis.
- D.
Begin delivering pain medication to counteract the headache.
- 52.You are delivering spinal anesthetic to a patient when they begin to complain of feeling light headed and ringing in their ears. What should you do?
- A.
Slow down your rate of injection, and then administer rest of anesthetic.
- B.
Immediately notify MD and prepare pt for cardiac bypass, your plasma concentration is most likely too high now.
- C.
Immediately stop injection, start lipid infusion, monitor patient, your plasma concentration should still be low enough to reverse this.
- D.
Comfort the patient that this is normal to experience and deliver rest of anesthetic quickly.
- 53.
![What portion of the spinal vertebrae are pictured in red? - ProProfs]( "What portion of the spinal vertebrae are pictured in red?")
What portion of the spinal vertebrae are pictured in red?- A.
Thoracic
- B.
Lumbar
- C.
Sacral
- D.
Cervical
- 54.
![What portion of the spinal vertebrae are pictured in green? - ProProfs]( "What portion of the spinal vertebrae are pictured in green?")
What portion of the spinal vertebrae are pictured in green?- A.
Thoracic
- B.
Lumbar
- C.
Sacral
- D.
Cervical
- 55.
![What portion of the spinal vertebrae are pictured in blue? - ProProfs]( "What portion of the spinal vertebrae are pictured in blue?")
What portion of the spinal vertebrae are pictured in blue?- A.
Thoracic
- B.
Lumbar
- C.
Sacral
- D.
Cervical
- 56.You are attemtping to give spinal anesthesia, where do you want to inject your anesthetic?
- A.
Epidural Space
- B.
Pia Mater
- C.
Subarachnoid Space
- D.
Ligamantum Flavum
- 57.You are the SRNA up on the OB floor today and are in the process of giving an epidural to a 34 yr old female in labor. Where do you want to inject your anesthetic?
- A.
SubArachnoid Space
- B.
Ligamentum Flavum
- C.
Pia Mater
- D.
Epidural Space
- 58.Which of the following is an advantage of epidural anesthesia over spinal anesthesia?
- A.
Decreased risk for dural headache
- B.
Less discomfort during placement
- C.
Less time to perform
- D.
More intense sensory & motor blockade
- 59.Which of the following is an advantage of spinal anesthesia over epidural anesthesia?
- A.
Decrease risk of dural headache
- B.
Requires less local anesthetic
- C.
Lower incidence of hypotension
- D.
Greater control over intensity of block achieved.
- 60.
![Identify 1. - ProProfs]( "Identify 1.")
Identify 1.- A.
Interspinous Ligament
- B.
Ligamentum Flavum
- C.
Supraspinous Ligament
- D.
Dura Mater
- 61.
![Identify 2. - ProProfs]( "Identify 2.")
Identify 2.- A.
Supraspinous Ligament
- B.
Ligamentum Flavum
- C.
Dura Mater
- D.
Interspinous Ligament
- 62.
![Identify 3. - ProProfs]( "Identify 3.")
Identify 3.- A.
Ligamentum Flavum
- B.
Supraspinous Ligament
- C.
Intraspinous Ligament
- D.
Dura Mater
- 63.When using the midline technique for application of spinal anesthesia what will be the FIRST ligament your needle encounter as it passes from the skin to the subarachnoid space?
- A.
Inerspinous ligament
- B.
Supraspinous ligament
- C.
Pia Mater
- D.
Ligamentum Flavum
- 64.When using the paramedian technique for application of spinal anesthesia what will be the first ligament your needle encounter as it progresses from the skin toward the subarachnoid space?
- A.
Supraspinous ligament
- B.
Interspinous ligamant
- C.
Ligamentum Flavum
- D.
Pia Mater
- 65.Which layer of of the spinal meninges is most impermeable to drugs?
- A.
Dura Mater
- B.
Pia mater
- C.
Ligamentum flavum
- D.
Arachnoid Membrane
- 66.Which of the following is NOT an absolute contraindication for spinal anesthesia?
- A.
A patient with scoliosis who is on the step-down unit and currently takes medication for back pain.
- B.
A patient with hydrocephalus who is on the 4th floor neuro step-down unit with severe headaches and vision disturbances.
- C.
A. unstable trauma patient who was in a serious MVA and has had large amounts of blood loss.
- D.
A patient who saw the needle to be used and then immediately refused and told you "Absolutely no way in hell am I getting poked with a needle that big!"
- 67.What is the preferred positioning of the patient for administration of spinal & epidural anesthesia?
- A.
Laying supine.
- B.
Spine flexed with pt bent at the waist and bringing the chin toward the chest.
- C.
Laying prone due to ease of performing the procedure in this position.
- 68.Which needle would have the lowest risk of post-dural headache?
- A.
24 gauge bevelled tip needle
- B.
20 gauge bevelled tip needle
- C.
24 gauge pencil point needle
- D.
20 gauge pencil point needle
- 69.The most commonly selected anesthetic solution for spinal anesthetic are....
- A.
Isobaric
- B.
Umm...the one that makes you numb, and yeah... something like that.
- C.
Hypobaric
- D.
Hyperbaric
- 70.What is the primary advantage of adding epinephrine to tetracaine for spinal anesthesia?
- A.
Increased duration of spinal anesthesia.
- B.
Decrease in ICP.
- C.
Decreased risk for neurotoxicity or neurological symptoms.
- D.
Increase in spinal cord blood flow.
- 71.What is the duration of action for lidocaine when used as a spinal anesthetic?
- A.
30-60 minutes
- B.
60-90 minutes
- C.
120- 150 minutes
- D.
10-20 minutes
- 72.Which of the following local anesthetics would be the best choice for a procedure requiring spinal anesthesia of long duration?
- A.
Lidocaine
- B.
Chloroprocaine
- C.
Tetracaine
- D.
Cocaine
- 73.When would you consider using the 'loss of resistance' technique?
- A.
On a TV show like SuperNanny. Just keep punishing the kid until they quit resisting you, and do as they are told.
- B.
When performing spinal anesthesia to assess when you have entered the subarachnoide space.
- C.
This is another name for midline approach which can be used for both spinal and epidural anesthesia.
- D.
When performing epidural anesthesia to assess when you have entered the epidural space.
- 74.When giving spinal anesthesia it is considered ________ to add epinephrine to the lidocaine. When giving epidural anesthesia it is considered ________ to add epinephrine to the lidocaine.
- A.
Unsafe, Safe
- B.
Unsafe, Unsafe
- C.
Safe, Unsafe
- D.
Safe, Safe
- 75.On which of the following patients would you consider using rapid sequence induction?
- A.
A patient have cardiac bypass
- B.
A patient coming in for emergent open cholecystectomy
- C.
A patient with past medical history of psychiatric illness
- D.
A patient with an anticipated difficult airway
- 76.You are asked to do a rapid sequence induction on a burn patient is mildly hyperkalemic, what muscle relaxant agent would you choose for this induction?
- A.
Succinylcholine 1.5 mg/kg
- B.
Vecuronium 0.1 mg/kg
- C.
Rocuronium 1mg/kg
- D.
Atracurium 0.5 mg/kg
- 77.What would be the best choice for induction of a 5 yr male undergoing repair of a broken elbow?
- A.
Intravenous induction with versed and vecuronium
- B.
IM injection with induction agents
- C.
Institute the Vulcan death grip at the base of his neck.
- D.
Inhalational Induction with sevoflurane
- 78.You are the SRNA for Mrs. Green who is having removal of a foriegn object from the bottom of her left foot. Her past medical history includes COPD, Diabetes, and cardiac impairment. What would be the the best choice for this patient?
- A.
Peripheral nerve block
- B.
Spinal Anesthesia
- C.
Epidural anesthesia
- D.
Tell her to stop stepping on sharp rocks.
- 79.During anesthesia what leads would be most appropriate to choose to monitor your pt for cardiac ischemia?
- A.
I & avF
- B.
II & V5
- C.
III & V3
- D.
AvL & I
- 80.Diastolic BP is usually lower with automated devices than with direct arterial measurement.
- A.
True
- B.
False
- 81.CVP monitoring is most frequently used...
- A.
When wide swings in BP are expected
- B.
To measure cardiac output and left venticulat end-diastolic pressures
- C.
To help in assessment of patients intravascular status
- D.
To get a unidimensional view of the myocardium.
- 82.How will administration of methylene blue affect pulse oxymetry?
- A.
Falsely elevate readings
- B.
Falsely decrease readings
- C.
Will not be affected.
- 83.Which of the following would cause an increase in ETCO2?
- A.
Cardiac Arrest
- B.
Pulmonary Embolism
- C.
Hypothermia
- D.
Hypoventilation
- 84.General anesthesia includes all of the following except:
- A.
Paralysis
- B.
Amnesia
- C.
Awareness
- D.
Analgesia
- 85.During Stage I of Anesthesia the patient should experience all of the following except:
- A.
Sedation
- B.
Consciousness
- C.
Paralysis
- D.
Drowsiness
- 86.Why is extubating a patient in Stage II not desirable?
- A.
Increased risk of larynospasm
- B.
Too sedated
- C.
Regular BP & RR
- D.
Not Ready
- 87.What BIS reading would you expect to see in a patient in Stage IV anesthesia?
- A.
100
- B.
> 40
- C.
< 40
- D.
Cannot be determined
- 88.The induction dose of Propofol is?
- A.
1 mg/kg
- B.
4 mg/kg
- C.
2mg/kg
- D.
2.5-3.5mg/kg
- 89.What is the induction dose for Succinylcholine?
- A.
1 - 1.5 mg/kg
- B.
0.1-0.2 mg/kg
- C.
3-5 mg/kg
- D.
0.6-1.2 mg/kg
- 90.What is the induction dose for Rocuronium?
- A.
1-1.5 mg/kg
- B.
0.1-0.2 mg/kg
- C.
3-5 mg/kg
- D.
0.6-1.2mg/kg
- 91.What is the induction dose for Versed?
- A.
1-1.5 mg/kg
- B.
0.1-0.2 mg/kg
- C.
3-5 mg/kg
- D.
0.6-1.2 mg/kg
- 92.According to lecture, why are inhalation anesthetics potentially the most dangerous drugs administered in anesthesia?
- A.
Due to lipid solubility
- B.
Due to unpredictability
- C.
Due to their potency
- D.
Due to steep dose response curve
- 93.Factors that affect Fa (alveolar) include all of the following except :
- A.
Concentration
- B.
Ventilation
- C.
Uptake
- D.
Distribution
- 94.Factors that affect Uptake include all of the following except:
- A.
Blood solubility
- B.
Cardiac Output
- C.
Partial Pressure Gradient
- D.
Hyperventilation
- 95.Which of the following decreases MAC? (more than one answer)
- A.
Hyperthermia
- B.
Chronic ETOH
- C.
Opioids
- D.
Pregnancy
- 96.Some indications for extubating someone deep include all of the following except?
- A.
Required to maintain surgical site
- B.
No risk for aspiration
- C.
Able to maintain own airway
- D.
To keep them asleep while transporting to PACU
- 97.What should be included in your report to the PACU nurse?
- A.
What you did
- B.
What patient did
- C.
How patient is now
- D.
All of the above
- 98.Which of the following drugs would not be appropriate to use during a MAC case?
- A.
Nimbex
- B.
Nitrous Oxide
- C.
Versed
- D.
Fentanyl
- 99.MAC patients should be arousable.
- A.
True
- B.
False
- 100.Studying for all these tests is going to cause me to have a mental snap.
- A.
True
- B.
False
- 101.The main difference between conscious sedation and deep sedation is
- A.
The kind of IV hypnotics used
- B.
Type of airway used
- C.
Ability to maintain protective reflexes
- D.
Ability to return to pre-procedural state
- 102.The Goals of any MAC case in include all of the following except:
- A.
Maintain Safety
- B.
Alleviate pain & minimize discomfort
- C.
Keep them heavily sedated and unarousable
- D.
Amnesia & anxiolysis
- 103.Decreasing consciousness increases safety risk.
- A.
True
- B.
False
- 104.According to lecture, the 3 faces of MAC are all of the following except…
- A.
Sedation & Block
- B.
Local & Sedation
- C.
Sedation Only
- D.
Sedation, Local & Block
- 105.The critical flaws when providing a MAC case is failure to consider which of the following except?
- A.
The surgeon
- B.
The patient
- C.
The procedure
- D.
The family
- 106.Which of the following procedures CAN be performed under MAC?
- A.
Open cholecystectomy
- B.
Breast augmentation
- C.
Kyphoplasty
- D.
Spinal Fusion
- 107.MAC cases are easier than General cases because the patient is conscious and cooperative.
- A.
True
- B.
False
- 108.Which of the following drugs would you be MOST cautious about when performing a MAC case?
- A.
Propofol
- B.
Morphine
- C.
Valium
- D.
Sevoflurane
- 109.The aldrete score of a patient who can move 2 extremities, able to deep breathe, BP < 20% preanesthetic level, arousable and maintains normal skin color.
- A.
10
- B.
8
- C.
6
- D.
4
- 110.The aldrete score is based on which of the following characteristics except?
- A.
Activity
- B.
Respiration
- C.
Circulation
- D.
Orientation
- 111.The aldrete score of a patient who can move all extremities, able to take deep breaths and cough, full pre-anesthetic BP level, awake, talking and normal skin color is
- A.
10
- B.
8
- C.
5
- D.
0
- 112.The aldrete score of a patient who is unable to move any extremities, limited breathing, BP >50 mm Hg from preanesthetic level, pale skin tone, Sats 95% on 3L O2, and arousable is...
- A.
7
- B.
5
- C.
3
- D.
1
- 113.Small controlled boluses of Propofol achieve a more consistent sedation pattern than an infusion does.
- A.
True
- B.
False
- 114.Lidocaine 1% is equivalent to how many milligrams per ml?
- A.
1 mg
- B.
0.1 mg
- C.
10 mg
- D.
100 mg
- 115.What is the max dose of Lidocaine plain?
- A.
4 mg/kg
- B.
7 mg/kg
- C.
2.5 mg/kg
- D.
3.2 mg/kg
- 116.What is the max dose of Bupivicaine with Epi?
- A.
4 mg/kg
- B.
7 mg/kg
- C.
2.5 mg/kg
- D.
3.2 mg/kg
- 117.You are the SRNA for Karianne, who is having her broken finger surgically repaired. The surgeon is doing a peripheral nerve block and is using bupivicaine plain during this case. Karianne weighs approximately 60 kg and the surgeon is asking what is the max dose of bupivicaine he can give to her. What do you say?
- A.
150 mg
- B.
192 mg
- C.
240 mg
- D.
Tell him to give her all he wants.... this is a fun experiment.
- 118.Why can a higher dose of local anesthetics be given when using epinephrine?
- A.
The 2 drugs counteract one another (one is more potent than the other)
- B.
Using 2 drugs minimizes risk of toxicity
- C.
Vasoconstriction effect of Epi, localizes the concentration
- D.
Vasodilation effect of the local is counteracted by Epi
- 119.The posterior or dorsal root ganglion contains:
- A.
Efferent neurons
- B.
Dendrites of motor neurons
- C.
Afferent neurons
- D.
Axons of sensory neurons
- 120.The cauda equina is formed by the:
- A.
The roots of the lower lumbar, sacral and coccygeal nerves
- B.
The roots of the upper lumbar and cervical
- C.
All of the spinal roots: cervical, lumbar, sacral and coccygeal
- D.
The roots of the sacral and coccygeal only
- 121.CSF is found in the:
- A.
Epidural space
- B.
Subdural space
- C.
Subarachnoid space
- 122.The meninge that adheres to the surface of the spinal cord (furtherest from the skin) is the:
- A.
Dura Mater
- B.
Subarachnoid membrane
- C.
Arachnoid membrane
- D.
Pia Mater
- 123.Which of the following statements is false:
- A.
There are 7 pairs of cervical nerve roots
- B.
There are 12 pairs of thoracic nerve roots
- C.
There are 5 pairs of lumbar nerve roots
- D.
There are 5 pairs of sacral nerve roots
- 124.What is the difference when doing a spinal vs epidural?
- A.
The location of injection
- B.
Technique used
- C.
Medications used
- D.
No difference
- 125.Why are spinals inserted at a precise level in the lumbar spine?
- A.
Because 38% of the population have herniated disks
- B.
Because you have better access to CSF
- C.
Because you minimize the risk of the injuring the spinal cord
- D.
Because it minimizes the risk of having a “wet tap”
- 126.Which of the following is one of the MOST important factors that will affect the level of spinal anesthesia?
- A.
Age of pt
- B.
Curvature of pts spine
- C.
Patients Height
- D.
Baricity of Solution
- 127.If you have a hyperbaric solution (compared to CSF) and you place your patient in a trendelenburg to minimize any vasodilating effects, you would except the block to move:
- A.
Caudad
- B.
Cephalad
- C.
No change
- D.
Posterior
- 128.All of the following are factors that affect the level of spinal anesthesia except:
- A.
Patient weight
- B.
Patient height
- C.
Pregnancy
- D.
Site of injection
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