Principles #3
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
Correct Answer
A. 215 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.
Correct Answer
B. Production of an abnormal state that satisfies the requirements for the carrying out of surgical and diagnostic procedures. -
- 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
Correct Answer(s)
A. Rapid Loss of consciousness
C. Progression to a light 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
Correct Answer
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
Correct Answer
A. Depression-Excitation -
- 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
Correct Answer
B. Light Anesthesia -
- 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.
Correct Answer
C. Intravenous induction -
- 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.
Correct Answer
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.
Correct Answer
A. Awake intubation under topical anesthesia -
- 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
Correct Answer
B. To maintain an adequate and normal level of stress response -
- 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.
Correct Answer
C. Within 10% of 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
Correct Answer
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
Correct Answer
A. In the center of forehead, 2 inches from bridge of nose -
- 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
Correct Answer
B. At the patients temple, level with their eye -
- 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
Correct Answer
B. Reduction of tourniquet time -
- 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.
Correct Answer
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
Correct Answer
D. 50 -
- 18.
At which BIS value would you see an isoelectric EEG?
- A.
0
- B.
20
- C.
30
- D.
40
Correct Answer
A. 0 -
- 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
Correct Answer
C. 98 -
- 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
Correct Answer
A. Increase BP & HR, BIS may or may not increase -
- 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
Correct Answer
B. 80 -
- 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
Correct Answer
C. ASA status 2 or 3 -
- 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
Correct Answer
C. Propofol 200mg Vec 10 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
Correct Answer
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
Correct Answer
A. Stage 2 -
- 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
Correct Answer
B. Stage 3 -
- 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
Correct Answer
C. Hyperthermia -
- 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.
Correct Answer
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
Correct Answer
A. 40-60 -
- 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.
Correct Answer
B. Give 100% O2 via face mask, use the bag to apply some positive pressure, and apply jaw thrust. -
- 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.
Correct Answer
C. Use a ketamine dart to calm him, then start your IV and induce the pt. -
- 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
Correct Answer
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
Correct Answer
A. 4 -
- 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
Correct Answer
D. NothingExplanation
max lido mixed w/ epi is 7mg/kg or 350mg, 1% Lido is 10mg/ml x 25mL is 250mg, well below the max dose.Rate this question:
-
- 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
Correct Answer
A. 30 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
Correct Answer
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
Correct Answer
A. Just sit and wait, there is no way to reverse them. -
- 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
Correct Answer
B. Flumazenil 0.2 mg IV over 15 seconds, may give up to 1 mg. -
- 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
Correct Answer
C. L3 -
- 40.
Where would you expect the spinal canal to end on an adult patient?
- A.
L1-L2
- B.
L3
- C.
L5
- D.
Sacral Hiatus
Correct Answer
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
Correct Answer
A. L1-L2 -
- 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
Correct Answer
B. Spinal that works better on one side than other -
- 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.
Correct Answer
C. Can be performed at any level -
- 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
Correct Answer
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
Correct Answer
A. True -
- 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
Correct Answer
A. T6, T10 -
- 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.
Correct Answer
B. Yes, this is considered a safe level of sympathetic blockade. -
- 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.
Correct Answer
C. No, the patient is at risk for profound bradycardia. -
- 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.
Correct Answer
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.
Correct Answer
A. Mrs. A what has severe mitral stenosis. -
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Dec 14, 2012Quiz Edited by
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