Principles Of Pediatric Anesthesia And care! Trivia Quiz

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  • 1/102 Questions

    A healthy pediatric patient with no pre-existing congenital anomalies does not need any preop lab tests if the procedure is expected to have minimal blood loss.

    • True
    • False
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About This Quiz

Review of material for Principles II quiz 2 on pediatric anesthesia.

Principles Of Pediatric Anesthesia And care! Trivia Quiz - Quiz

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  • 2. 

    Halothane causes more myocardial depression than any of the other inhlational agents and increases risk of arrhythmia associated with epinephrine by 4 times.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    Halothane is an inhalational anesthetic that is known to cause more depression of the heart muscle compared to other inhalational agents. This means that it can negatively affect the functioning of the heart. Additionally, halothane increases the risk of arrhythmias, or abnormal heart rhythms, when used in combination with epinephrine. The combination of halothane and epinephrine increases the risk of arrhythmias by four times compared to using epinephrine alone. Therefore, the statement that halothane causes more myocardial depression than other inhalational agents and increases the risk of arrhythmia associated with epinephrine is true.

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  • 3. 

    The majority of pediatric cardiac arrests occur when?

    • Induction

    • Maintenance

    • Emergence

    • Rates are equal during all 3 phases

    Correct Answer
    A. Induction
    Explanation
    Pediatric cardiac arrests mainly occur during the induction phase. This is the initial stage of anesthesia where the patient is being prepared for surgery and anesthesia is administered. During this phase, there are various factors that can contribute to cardiac arrest, such as the administration of medications, airway manipulation, and the stress response to surgery. The maintenance and emergence phases are relatively stable and less likely to result in cardiac arrest. Therefore, the majority of pediatric cardiac arrests occur during the induction phase.

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  • 4. 

    Which of the following disease states is associated with an increased risk of Malignant hyperthermia?

    • Cystic Fibrosis

    • Muscular Dystrophy

    • Sickle Cell Anemia

    • Latex Allergy

    Correct Answer
    A. Muscular Dystrophy
    Explanation
    Muscular Dystrophy is associated with an increased risk of Malignant Hyperthermia. Muscular Dystrophy is a group of genetic disorders that cause progressive muscle weakness and degeneration. Malignant Hyperthermia is a potentially life-threatening reaction to certain medications used during general anesthesia, characterized by a rapid increase in body temperature and muscle rigidity. While individuals with any disease state may be at risk for Malignant Hyperthermia, Muscular Dystrophy patients are particularly susceptible due to their already compromised muscle function. Therefore, Muscular Dystrophy is the correct answer.

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  • 5. 

    The best way to administer an IV fluid bolus to an infant is through use of a pressure bag to administer fluid quickly.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    Administering an IV fluid bolus to an infant through the use of a pressure bag is not the best way to do so. Infants have delicate veins that can easily be damaged by the high pressure from a pressure bag. The best way to administer an IV fluid bolus to an infant is by using a syringe pump or a gravity drip system, which allows for a slower and more controlled infusion of fluids.

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  • 6. 

    Which of the following properly describes the most common preceding events to a pediatric cardiac arrest?

    • Tachypnea, Tachycardia, Tachyphylaxis

    • Hypotension, Tachycardia, Muscle rigidity

    • Hypoxia, tachypnea, wheezing, tachycardia

    • Hypotension, Bradycardia, Low O2 sat

    Correct Answer
    A. Hypotension, Bradycardia, Low O2 sat
  • 7. 

    Which of the following would not be an appropriate way to reduce intra-op heat loss in the pediatric patient?

    • Use of an overhead radiant heating unit

    • Use of a water mattress, with circulating warm water

    • Use cloths dipped in 40o C water and place onto child’s head during procedure

    • Use a Bair hugger placed on the child’s body

    Correct Answer
    A. Use cloths dipped in 40o C water and place onto child’s head during procedure
    Explanation
    Using cloths dipped in 40o C water and placing them onto a child's head during a procedure would not be an appropriate way to reduce intra-op heat loss in a pediatric patient. This method could potentially cause hypothermia and increase the risk of complications. The other options mentioned, such as using an overhead radiant heating unit, a water mattress with circulating warm water, or a Bair hugger placed on the child's body, are all effective ways to reduce heat loss and maintain the patient's body temperature during surgery.

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  • 8. 

    When doing a pedi drug set up, it is recommended to draw up your drugs in ‘unit dose’ syringes.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    Drawing up drugs in 'unit dose' syringes during a pedi drug set up is recommended because it ensures accurate dosing and reduces the risk of medication errors. Unit dose syringes contain a pre-measured amount of medication, which eliminates the need for manual calculations and reduces the chances of administering the wrong dose. This practice is particularly important when dealing with pediatric patients who require precise and individualized medication doses based on their weight and age. By using unit dose syringes, healthcare professionals can enhance patient safety and minimize the potential for dosing errors.

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  • 9. 

    For a normal inhalational induction your N2O should be at ______ and your O2 should be at ________ to start out with.

    • 70%, 30%

    • 50%, 50%

    • 40%, 60%

    • 0 %, 100 %

    Correct Answer
    A. 70%, 30%
    Explanation
    For a normal inhalational induction, the correct ratio of N2O to O2 should be 70% N2O and 30% O2. This is because N2O acts as a potent analgesic and anxiolytic, helping to reduce pain and anxiety during the induction process. On the other hand, O2 is necessary to maintain adequate oxygenation and prevent hypoxia. Therefore, a higher concentration of N2O is required compared to O2 for a successful inhalational induction.

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  • 10. 

    Which of the following will not trigger Malignant Hyperthermia?

    • Desflurane

    • Succinylcholine

    • Isoflurane

    • Vecuronium

    Correct Answer
    A. Vecuronium
    Explanation
    Vecuronium is a non-depolarizing neuromuscular blocking agent that does not trigger Malignant Hyperthermia (MH). MH is a potentially fatal reaction to certain medications used during general anesthesia, characterized by a rapid increase in body temperature and muscle rigidity. The other options listed, Desflurane, Succinylcholine, and Isoflurane, are all known triggers of MH.

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  • 11. 

    COMIC RELIEF: 911 Fail

    • A warthog? Where the heck would you run across those

    • Ha ha ha!! Spelling is a wonderful thing

    • Sooo.... he picked up his injured wife and dragged a couple streets over?

    • All the above

    Correct Answer
    A. All the above
    Explanation
    The given answer "All the above" is correct because all of the statements mentioned in the question are examples of comic relief. The first statement mentions a warthog, which is unexpected and humorous. The second statement highlights a spelling mistake, which adds humor. The third statement presents a ridiculous scenario of someone dragging their injured wife a couple of streets over, which is also humorous. Therefore, all of the statements contribute to comic relief in the given context.

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  • 12. 

    What side effect is commonly associated with fentanyl that we are concerned about during anesthesia?

    • Myocardial depression

    • Chest Wall Rigidity

    • Renal Toxicity

    • Cytochrome P450 induction

    Correct Answer
    A. Chest Wall Rigidity
    Explanation
    During anesthesia, fentanyl is commonly associated with a side effect called chest wall rigidity. This refers to the tightening or stiffness of the muscles in the chest wall, which can make it difficult for the patient to breathe. This side effect is concerning because it can lead to respiratory distress or even respiratory arrest if not promptly recognized and managed by the anesthesia team. Therefore, it is important for anesthesia providers to be aware of this potential side effect and be prepared to intervene if necessary.

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  • 13. 

    You are assessing 4 yr old Madelyn prior to her going in for enucleation of her left eye. When you see her in pre-op she appears to be a little under the weather. She is sneezing and has yellow mucus coming her nose. You listen to her lungs and hear a slight wheeze while her mom says she began to run a temperature late last night. She appears fine and is watching and giggling at a children’s show on a portable DVD player her mother brought to calm her.  What do you do for this patient?

    • Give a dose of Tylenol and a respiratory treatement pre-op before continuing with procedure.

    • It is only an eye surgery, not thoracic so she will be fine.

    • Talk to the surgeon regarding possibly cancelling the surgery

    • That depends entirely upon whether Madelyn was a premature baby or has any other coexisting diseases.

    Correct Answer
    A. Talk to the surgeon regarding possibly cancelling the surgery
    Explanation
    Based on the given information, the patient, Madelyn, is showing symptoms of being sick, such as sneezing, yellow mucus, and a slight wheeze. Additionally, her mother mentions that she had a fever the previous night. These symptoms indicate that Madelyn may have an underlying respiratory infection, which can increase the risk of complications during surgery. Therefore, the appropriate action would be to talk to the surgeon about the possibility of cancelling the surgery to ensure Madelyn's safety and well-being.

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  • 14. 

    What is the most important componenent of the physical exam for down syndrome patients?

    • Airway examination and neck stability

    • Assessing degree of mental retardation

    • Obtaining history from parents regarding any heart conditions

    • Assessing for reflux and sings of URI

    Correct Answer
    A. Airway examination and neck stability
    Explanation
    The most important component of the physical exam for Down syndrome patients is airway examination and neck stability. This is because individuals with Down syndrome often have anatomical abnormalities that can affect their airway and neck stability, such as a small or blocked airway, weak neck muscles, or a high risk of atlantoaxial instability. Therefore, assessing the airway and neck stability is crucial in order to ensure the safety and well-being of these patients.

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  • 15. 

    Which of the following is not a sign of latex allergy?

    • Bradycardia and arrhythmias

    • Laryngeal Edema

    • Pruritis

    • Bronchospasm

    Correct Answer
    A. Bradycardia and arrhythmias
    Explanation
    Bradycardia and arrhythmias are not typically associated with latex allergy. Latex allergy is an immune response to latex proteins, which can cause symptoms such as skin itching (pruritis), swelling of the larynx (laryngeal edema), and constriction of the airways (bronchospasm). However, bradycardia and arrhythmias are not commonly observed as symptoms of latex allergy.

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  • 16. 

    Which of the following is the most common reason for cancellation of pediatric procedures?

    • Asthma Exacerbation

    • Upper Respiratory Infections

    • Non-compliance with NPO requirements

    • Instability due to illness

    Correct Answer
    A. Upper Respiratory Infections
    Explanation
    Upper respiratory infections are the most common reason for cancellation of pediatric procedures. This is because these infections can cause symptoms such as coughing, sneezing, and congestion, which can make it difficult for the child to breathe and cooperate during the procedure. Additionally, there is an increased risk of complications and infection spread during the procedure if the child has an active respiratory infection. Therefore, it is common practice to cancel pediatric procedures when a child has an upper respiratory infection to ensure their safety and minimize the risk of complications.

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  • 17. 

    A 7 yr old child must not eat solid food for how many hours prior to procedure?

    • 6 hours

    • 8 hours

    • 3 hours

    • 4 hours

    Correct Answer
    A. 8 hours
    Explanation
    Prior to a medical procedure, it is generally recommended that a 7-year-old child refrains from consuming solid food for a period of 8 hours. This is important to ensure that the child's stomach is empty, reducing the risk of complications during the procedure such as aspiration or vomiting. By abstaining from solid food for 8 hours, the child's digestive system has sufficient time to process and empty any previously consumed food, resulting in a safer and more successful procedure.

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  • 18. 

    Why is it not safe to use an adult semi-closed system on an infant who weighs less than 10 kg?

    • Too much pressure, risk of barotrauma

    • Too large, circuit will not fit the pedi ETT properly

    • Too much dead space, and increased work of breathing

    • Absorber acts to remove almost all gases due to small tidal volume and pt will be undermedicated

    Correct Answer
    A. Too much dead space, and increased work of breathing
    Explanation
    Using an adult semi-closed system on an infant who weighs less than 10 kg is not safe because it would result in too much dead space and increased work of breathing. Dead space refers to the portion of the respiratory system that does not participate in gas exchange, and in this case, the system would be too large for the infant, leading to an inefficient exchange of gases. This would require the infant to exert more effort to breathe, potentially causing respiratory distress.

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  • 19. 

    Which of the following is not part of stage 2 PACU’s standard monitoring?

    • Heart Rate

    • Fluid Balance

    • O2 Sat

    • Blood pressure

    Correct Answer
    A. Fluid Balance
    Explanation
    Stage 2 PACU's standard monitoring includes heart rate, O2 sat, and blood pressure. Fluid balance is not part of stage 2 PACU's standard monitoring. This means that monitoring the patient's fluid balance, such as intake and output, is not a standard practice in this stage of post-anesthesia care.

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  • 20. 

    When placing a nerve stimulator on a child with cerebral palsy, which of the following is true?

    • The nerve stimulator should be placed on a spastic extremity as these are best indicators of childs TRUE response to NMB

    • Placing stimulator on spastic extremity will cause falsely low readings and may lead to underdosing of NMB

    • Placing stimulator on a spastic extremity may cause falsely high readings and may lead to overdosing of NMB’s

    • Children with CP do not need nerve stimulators due to their condition.

    Correct Answer
    A. Placing stimulator on a spastic extremity may cause falsely high readings and may lead to overdosing of NMB’s
    Explanation
    Placing a nerve stimulator on a spastic extremity in a child with cerebral palsy may cause falsely high readings and may lead to overdosing of neuromuscular blockers (NMBs). This is because the spastic extremity may already have increased muscle tone and resistance, which can result in an exaggerated response to the NMB. Therefore, placing the stimulator on a spastic extremity may not accurately reflect the child's true response to NMBs and may lead to administering higher doses than necessary, potentially causing adverse effects.

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  • 21. 

    What IM emergency drugs should you always have available for pediatric inhalation induction (assuming child has no IV access)? TWO ANSWERS

    • Sux 5 mg/kg

    • Ephedrine 750 mcg/kg

    • Lidocaine 1.5 mg/kg

    • Atropine 0.02 mg/kg

    Correct Answer(s)
    A. Sux 5 mg/kg
    A. Atropine 0.02 mg/kg
    Explanation
    The correct answer is Sux 5 mg/kg and Atropine 0.02 mg/kg. These drugs are essential for pediatric inhalation induction when the child does not have IV access. Suxamethonium (Sux) is a neuromuscular blocking agent used to facilitate intubation. Atropine is a medication that increases heart rate and is used to counteract bradycardia, which can occur during induction. These drugs are crucial in ensuring a smooth and safe induction process for the pediatric patient.

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  • 22. 

    The preferred combination of narcotics and inhalational agents, commonly the “bread and butter” of many ped anesthetists is ______  & _________.

    • 1-2 mcg/kg Fentanyl & O.5 MAC isoflurane

    • 2-4 mcg/kg fentanyl & propfol gtt

    • 0.25-0.5 mcg/kg Dilaudid and 0.3 MAC sevoflurane

    • 1-2 mg/kg dialudid and .6 MAC desflurane

    Correct Answer
    A. 1-2 mcg/kg Fentanyl & O.5 MAC isoflurane
    Explanation
    The preferred combination of narcotics and inhalational agents commonly used by pediatric anesthetists is 1-2 mcg/kg Fentanyl and O.5 MAC isoflurane. This combination provides effective pain relief and anesthesia during pediatric surgeries. Fentanyl is a potent opioid analgesic that helps manage pain, while isoflurane is an inhalational anesthetic that induces and maintains anesthesia. The dosage range specified ensures appropriate pain control and anesthesia without causing excessive sedation or respiratory depression in pediatric patients.

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  • 23. 

    Approximately what percentage of children with down syndrome will have associated cardiac anomalies?

    • 5-15%

    • 65-75%

    • 40-60%

    • 80-95%

    Correct Answer
    A. 40-60%
    Explanation
    Approximately 40-60% of children with Down syndrome will have associated cardiac anomalies. This means that a significant proportion of children with Down syndrome will have heart-related issues. These anomalies can range from mild to severe and may require medical intervention or surgery. It is important for healthcare professionals to be aware of this high prevalence and closely monitor the cardiac health of children with Down syndrome.

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  • 24. 

    What would be an appropriate sized ETT for a 3 yr old child weighing 18 kg?

    • 4.5

    • 4

    • 3.5

    • 3

    Correct Answer
    A. 4.5
    Explanation
    An appropriate sized ETT for a 3-year-old child weighing 18 kg would be 4.5. The size of the endotracheal tube (ETT) is determined based on the weight and age of the child. In this case, a 4.5 ETT would be suitable for a 3-year-old child weighing 18 kg.

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  • 25. 

    Which of the following children would be at an increased risk Latex Allergy

    • Nika who is allergic to Egg yolk

    • Tyler, whose mom is a nurse

    • Charlie who has muscular dystrophy

    • Olivia who has spina bifida

    Correct Answer
    A. Olivia who has spina bifida
    Explanation
    Children with spina bifida are at an increased risk of developing latex allergy. This is because spina bifida is often associated with repeated exposure to latex during medical procedures and surgeries. Latex is commonly used in healthcare settings, such as hospitals, and individuals with spina bifida often require frequent medical interventions. Prolonged and repeated exposure to latex can sensitize the immune system, leading to the development of an allergic reaction to latex proteins. Therefore, Olivia, who has spina bifida, would be at an increased risk of latex allergy compared to the other children mentioned.

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  • 26. 

    You are going to do a pre-op on a 6 yr old patient about to undergo a Left nephrectomy to remove a tumor.You walk into the room and find a very nervous little boy clutching a bear and hiding under the covers, the father also looks very upset and nervous. What should your approach be to do this pre-op?

    • Approach the parent and attempt to calm him first

    • Come back later when both are feeling a bit better

    • Approach the child, and attempt to calm him first.

    • Give the child some versed.

    Correct Answer
    A. Approach the parent and attempt to calm him first
    Explanation
    In this scenario, the best approach would be to first address the parent's concerns and attempt to calm them down. By doing so, it will create a more relaxed environment for both the child and the parent, which will ultimately help in calming the child as well. It is important to prioritize the emotional well-being of both the child and the parent before proceeding with the pre-op preparations.

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  • 27. 

    How is the pediatric airway different from that of adults?

    • Airway has smaller tongue and very stiff epiglottis making visualization difficult

    • Airway is more superior and has a more acute angulation between plane of tongue and epiglottis

    • Narrowest portion of airway is the vocal cords, making passage of the ETT much more difficult

    • None of above

    Correct Answer
    A. Airway is more superior and has a more acute angulation between plane of tongue and epiglottis
    Explanation
    The pediatric airway is different from that of adults because it is more superior and has a more acute angulation between the plane of the tongue and the epiglottis. This anatomical difference can make visualization of the airway more challenging during procedures such as intubation.

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  • 28. 

    What response will infants typically have to exogenously administered catecholamines such as ephedrine?

    • Exagerrated response and risk for subdural hemorrhage

    • Infants and kids respond in same manner as adults would

    • Blunted response due to lower catecholamine stores

    • More prone to allergic and anaphylactic responses

    Correct Answer
    A. Blunted response due to lower catecholamine stores
    Explanation
    Infants typically have a blunted response to exogenously administered catecholamines such as ephedrine because they have lower catecholamine stores. Catecholamines are hormones that play a role in the body's response to stress and are involved in various physiological processes. In infants, the levels of catecholamines are lower compared to adults, which results in a diminished response to drugs that stimulate the release or mimic the actions of catecholamines. This blunted response can affect the effectiveness of the medication and may require different dosing strategies for infants compared to adults.

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  • 29. 

    Which of the following is not a risk factor associated with cardiac arrests in the pediatric patient?

    • Emergency Surgery

    • ASA 3-5

    • Congenital Airway Deformities

    • Children 1-4 yrs old

    Correct Answer
    A. Children 1-4 yrs old
    Explanation
    Children 1-4 years old are not a risk factor associated with cardiac arrests in pediatric patients. While emergency surgery, ASA 3-5 (American Society of Anesthesiologists physical status classification), and congenital airway deformities are all known risk factors, being in the age range of 1-4 years old does not increase the risk of cardiac arrests in pediatric patients.

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  • 30. 

    During an inhalational induction, once your pediatric patient is tubed your first priority should be…

    • Inserting the precordial stethoscope

    • Applying nerve monitor to assess paralysis

    • Starting an IV

    • Turning up the sevo higher

    Correct Answer
    A. Starting an IV
    Explanation
    Starting an IV is the first priority during an inhalational induction in a pediatric patient after intubation. This is because an IV provides access to administer medications, fluids, and emergency drugs if needed. It also allows for the administration of anesthesia and other necessary interventions during the procedure. Starting an IV early ensures that the patient has a secure and reliable route for medication administration and fluid management throughout the induction process.

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  • 31. 

    Inhalational induction should not be done on children with asthma due to increased risk of bronchospasm. 

    • True

    • False

    Correct Answer
    A. False
    Explanation
    Inhalational induction should not be done on children with asthma due to the increased risk of bronchospasm. However, the given answer states "False," which implies that inhalational induction can be done on children with asthma. This contradicts the statement provided and is incorrect.

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  • 32. 

    At how much pressure should you observe an air leak in pediatric ETT’s?

    • No air leak should be observed

    • Air leak obersved at 5-10 cm H2O

    • Air leak observed at 15-20 cm H2O

    • Air leak observed at 25-30 cm H2O

    Correct Answer
    A. Air leak observed at 15-20 cm H2O
    Explanation
    An air leak should be observed at a pressure of 15-20 cm H2O in pediatric ETT's. This is because a small amount of air leak is necessary to ensure that the tube is properly sealed and to prevent excessive pressure buildup in the lungs. If there is no air leak, it may indicate that the tube is not properly sealed and could lead to complications such as inadequate ventilation or aspiration. On the other hand, if the air leak is too large (observed at higher pressures), it may indicate a loose or dislodged tube, which also requires immediate attention.

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  • 33. 

    What is an appropriate hourly maintenance fluid rate for a child weighing 15 kg?

    • 60 ml

    • 50 ml

    • 25 ml

    • 15 ml

    Correct Answer
    A. 50 ml
    Explanation
    An appropriate hourly maintenance fluid rate for a child weighing 15 kg is 50 ml. This is because the maintenance fluid rate is typically calculated based on the child's weight, and a common formula used is 4-2-1. According to this formula, the first 10 kg of body weight requires 4 ml of fluid per kg per hour, the next 10 kg requires 2 ml per kg per hour, and any additional weight requires 1 ml per kg per hour. In this case, the child weighs 15 kg, so the calculation would be: (10 kg x 4 ml) + (5 kg x 2 ml) = 40 ml + 10 ml = 50 ml.

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  • 34. 

    Most pediatric arrests are due to ________ causes in children.

    • Cardiac

    • Respiratory

    • Congenital defects

    • Circulatory collapse

    Correct Answer
    A. Respiratory
    Explanation
    Most pediatric arrests are due to respiratory causes in children. This is because children have smaller airways compared to adults, making them more susceptible to respiratory issues such as asthma, bronchiolitis, and pneumonia. Additionally, children may not have fully developed respiratory muscles, making it harder for them to breathe during respiratory distress. Respiratory causes can lead to inadequate oxygenation and ventilation, resulting in cardiac arrest if not promptly addressed. Therefore, respiratory causes are the most common reason for pediatric arrests.

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  • 35. 

    You are the SRNA for a 2 week old child undergoing repair of a patent PDA. Which of the following is not true regarding proper monitor placement?

    • A precordial stethoscope should be used to evaluate heart tone, rate, and murmurs.

    • O2 sat probe should be placed on the left hand for the procedure

    • Twitch monitor should be placed along ulnar nerve at the wrist

    • The only change to ECG monitoring is the use of pediatric ECG leads and changing alarm limits.

    Correct Answer
    A. O2 sat probe should be placed on the left hand for the procedure
    Explanation
    The O2 sat probe should be placed on the right hand for the procedure, not the left hand. This is because the right hand is the standard site for pulse oximetry monitoring in pediatric patients.

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  • 36. 

    You are going to do a pre-op on 5 yr old Trevor who is going in today for a repair of an inguinal hernia. When you go to assess him pre-op you see he is sniffly. His mother says he has seasonal allergies and has a constant runny nose. You go to look at Trevor and indeed his little nose is red and he has clear mucus coming from his nose, but no fever or wheezes. He does not appear to be otherwise ill and in fact is playing with his stuffed dinosaur. Is it safe to proceed with the procedure?

    • Not enough information to decide at this time.

    • No, he is displaying signs of an upper respiratory infection.

    • Only safe to proceed if pt is given a respiratory treatment and an arterial line inserted to closely monitor hemodynamic stability.

    • Yeah, he’s fine. We can proceed!

    Correct Answer
    A. Yeah, he’s fine. We can proceed!
    Explanation
    Based on the given information, Trevor is only displaying symptoms of seasonal allergies such as a runny nose with clear mucus, but he does not have a fever or wheezes. He appears to be otherwise healthy and is even playing with his stuffed dinosaur. Therefore, it is safe to proceed with the procedure as his symptoms do not indicate an upper respiratory infection or any other serious illness.

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  • 37. 

    What would be an appropriate dose of pre-op versed for a 6 yr old child weighing 24 kg?

    • 24 mg IV

    • 6 mg PO

    • 12 mg PO

    • 48 mg PO

    Correct Answer
    A. 12 mg PO
    Explanation
    An appropriate dose of pre-op versed for a 6-year-old child weighing 24 kg would be 12 mg PO (by mouth). This dosage is determined based on the weight of the child and the route of administration, which in this case is oral. It is important to consider the weight of the child when determining the appropriate dosage to ensure safety and effectiveness of the medication.

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  • 38. 

    You are the SRNA for a 6 yr old child coming in from the ER for an emergent appendectomy. Which of the following is the best choice for induction?  

    • Inhalational induction as patient Is not likely to cooperate with IV placement

    • IV must be placed prior to procedure for safe induction.

    • IM induction with ketamine

    • None of above are appropriate

    Correct Answer
    A. IV must be placed prior to procedure for safe induction.
    Explanation
    The best choice for induction in this scenario is to place an IV prior to the procedure for safe induction. This is because an emergent appendectomy requires a reliable and immediate access to administer medications and fluids during the surgery. Inhalational induction may not be feasible as the patient is not likely to cooperate with IV placement, and IM induction with ketamine may not provide the necessary level of control and safety during the procedure. Therefore, the safest option is to ensure IV access before induction.

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  • 39. 

    High dose opioid therapy during maintenance of anesthesia may be appropriate for which of the following?

    • Child with cardiac instability who requires surgical intervention

    • Pt who will be extubated after surgery and requires pain control

    • A healthy 2 yr old who is no longer at risk for post-op apnea

    • A child with respiratory insufficiency who may not have sufficient gas exchange for inhalational agents.

    Correct Answer
    A. Child with cardiac instability who requires surgical intervention
    Explanation
    High dose opioid therapy during maintenance of anesthesia may be appropriate for a child with cardiac instability who requires surgical intervention. Opioids can provide effective analgesia and help stabilize hemodynamics in this patient population. The high dose may be necessary to adequately control pain and prevent further cardiovascular instability during the procedure. However, it is important to carefully monitor the patient's respiratory status and titrate the dose to avoid respiratory depression.

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  • 40. 

    You are the SRNa for 11 yr old Shaheem who has a PMH of asthma. Immediately after induction and intubation you hear wheezing develop. What should be your first action?

    • Deliver 100% FiO2

    • Administer hydrocortisone 5-7mg/kg IV to relieve wheezing

    • Turn off anesthetic and start propofol gtt to maintain anesthesia

    • Give B2 agonist such as albuterol 4-8 puffs through ETT

    Correct Answer
    A. Give B2 agonist such as albuterol 4-8 puffs through ETT
    Explanation
    The correct answer is to give a B2 agonist such as albuterol 4-8 puffs through the endotracheal tube (ETT). Wheezing after induction and intubation in a patient with a history of asthma indicates bronchospasm. Administering a B2 agonist directly into the airway through the ETT helps to relieve the wheezing and bronchospasm quickly. This is the most appropriate first action to take in this situation.

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  • 41. 

    Which of the following is not true regarding management of a patient with hemophilia?

    • Nasal intubations are contraindicated

    • Regional anesthesia is contraindicated

    • IM injection is preferred since IV sticks may cause bleeding

    • Transfusions should be done immediately preceding surgery

    Correct Answer
    A. IM injection is preferred since IV sticks may cause bleeding
    Explanation
    IM injection is not preferred over IV sticks because they may cause bleeding in patients with hemophilia. Patients with hemophilia have a deficiency in clotting factors, making them prone to excessive bleeding. Therefore, IV access is preferred over IM injection to minimize the risk of bleeding. Nasal intubations may be contraindicated due to the risk of bleeding, regional anesthesia may also be contraindicated depending on the specific case, and transfusions should be done prior to surgery to optimize clotting factors.

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  • 42. 

    When monitoring the pediatric patient, where should the precordial stethoscope be placed?

    • Left sternal border 2nd or 3rd intercostals space

    • Right sterna border 2nd or 3rd intercostals space

    • Left midclavicular line 5th intercostals space

    • Depends upon what you are trying to monitor

    Correct Answer
    A. Left sternal border 2nd or 3rd intercostals space
    Explanation
    The correct answer is left sternal border 2nd or 3rd intercostals space. This is the ideal placement for the precordial stethoscope when monitoring a pediatric patient. This location allows for optimal auscultation of the heart sounds and allows the healthcare provider to assess any abnormalities or irregularities in the heart rhythm. Placing the stethoscope in this position ensures accurate and reliable monitoring of the pediatric patient's cardiac status.

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  • 43. 

    You are nearing the end of surgery for 13 yr old Kami who started wheezing part way through her surgery. You gave albuterol and started her on steroid therapy but she is still wheezing. Her O2 sats are good and she is breathing adequate tidal volumes. What should you do?

    • Do not extubate, take her to PACU and they can extubate when wheezing goes away

    • Extubate deep to help prevent laryngospasm

    • Deliver another albuterol treatment and extubate fully awake

    • Give Fentanyl 1-2mcg/kg IV to help smooth out extubation

    Correct Answer
    A. Do not extubate, take her to PACU and they can extubate when wheezing goes away
  • 44. 

    What would be appropriate pre-op medication for a child with a latex allergy?

    • Benadryl 1mg/kg PO

    • Prednisone 1 mg/kg PO

    • Zantac 1-2mg/kg PO

    • All the above

    Correct Answer
    A. All the above
    Explanation
    All the above options would be appropriate pre-op medications for a child with a latex allergy. Benadryl is an antihistamine that can help reduce allergic symptoms such as itching and hives. Prednisone is a corticosteroid that can help reduce inflammation and allergic reactions. Zantac is an H2 blocker that can help reduce stomach acid production, which can be beneficial before surgery. Using all of these medications together can provide comprehensive relief for a child with a latex allergy before undergoing surgery.

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  • 45. 

    In the pediatric population, the greatest amount of heat loss during surgery comes from…

    • Conduction

    • Radiation

    • Convection

    • All above are equal contributors to heat loss.

    Correct Answer
    A. Radiation
    Explanation
    Radiation is the process by which heat is transferred through electromagnetic waves. In the pediatric population, the greatest amount of heat loss during surgery comes from radiation. This is because children have a larger surface area to body mass ratio compared to adults, making them more susceptible to heat loss through radiation. Conduction and convection also contribute to heat loss, but radiation is the primary mechanism in this population.

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  • 46. 

    What is the overall incidence of cardiac arrest in the pediatric population?

    • 1.4 per 10,000

    • 2.7 per 100,000

    • 0.5 per 1,000

    • 16 per 1,000,000

    Correct Answer
    A. 1.4 per 10,000
    Explanation
    The overall incidence of cardiac arrest in the pediatric population is 1.4 per 10,000. This means that for every 10,000 children, 1.4 of them experience a cardiac arrest.

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  • 47. 

    In children, ETCO2 is particularly important to monitor because of which of the following reasons?

    • Will give you earliest indication of MH

    • Will detect hypoxia which is most common cause of pediatric arrest

    • Allows to asses adequacy of your ventilation

    • All the above

    Correct Answer
    A. All the above
    Explanation
    ETCO2 monitoring is particularly important in children because it provides multiple benefits. Firstly, it can give the earliest indication of malignant hyperthermia (MH), a potentially life-threatening condition. Secondly, it helps detect hypoxia, which is the most common cause of pediatric arrest. Lastly, monitoring ETCO2 allows healthcare providers to assess the adequacy of ventilation, ensuring that the child is receiving sufficient oxygen and that their respiratory function is optimal. Therefore, all of the given reasons are valid explanations for why ETCO2 monitoring is important in children.

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  • 48. 

    What would be an appropriate size ETT for a 9 yr old child weighing  33 kg?

    • 5

    • 6

    • 4.5

    • 7

    Correct Answer
    A. 6
    Explanation
    An appropriate size endotracheal tube (ETT) for a 9-year-old child weighing 33 kg would be 6. This size is determined based on the weight and age of the child, as well as other factors such as the size of the child's airway and the intended use of the ETT. It is important to select the correct size ETT to ensure proper ventilation and oxygenation during medical procedures.

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  • 49. 

    You are auscultating heart sounds on a 7 yr old child and hear a short, soft, systolic murmur.  How would you classify this murmur?

    • Pathologic

    • Detrimental

    • Innocent

    • None of above

    Correct Answer
    A. Innocent
    Explanation
    The given correct answer is "Innocent." In this scenario, the short, soft, systolic murmur heard in a 7-year-old child is likely to be innocent or benign. Innocent murmurs are common in children and are usually harmless. They are often soft, brief, and heard during systole. They are not associated with any structural heart abnormalities or symptoms. It is important to differentiate innocent murmurs from pathologic murmurs that may indicate underlying heart conditions. However, based on the given information, the murmur is most likely innocent.

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Quiz Review Timeline (Updated): Oct 11, 2024 +

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  • Oct 11, 2024
    Quiz Edited by
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  • Feb 28, 2009
    Quiz Created by
    Scottishduffy
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