Principles Of Pediatric Anesthesia Quiz! Trivia
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- 1.What should be your first action when preparing to do a pre-op assessment on a 3 yr old child?
- A.
Review the chart
- B.
Introduce yourself to the child’s parents and obtain a thorough history
- C.
Introduce yourself to child, and attempt to play a game or comfort them
- D.
Get your blow gun ready, and load it with a ketamine dart.
- 2.Which of the following is the most common reason for the cancellation of pediatric procedures?
- A.
Asthma Exacerbation
- B.
Upper Respiratory Infections
- C.
Non-compliance with NPO requirements
- D.
Instability due to illness
- 3.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 to 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?
- A.
Give a dose of Tylenol and a respiratory treatement pre-op before continuing with procedure.
- B.
It is only an eye surgery, not thoracic so she will be fine.
- C.
Talk to the surgeon regarding possibly cancelling the surgery
- D.
That depends entirely upon whether Madelyn was a premature baby or has any other coexisting diseases.
- 4.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?
- A.
Not enough information to decide at this time.
- B.
No, he is displaying signs of an upper respiratory infection.
- C.
Only safe to proceed if pt is given a respiratory treatment and an arterial line inserted to closely monitor hemodynamic stability.
- D.
Yeah, he’s fine. We can proceed!
- 5.A 7 yr old child must not eat solid food for how many hours prior to procedure?
- A.
6 hours
- B.
8 hours
- C.
3 hours
- D.
4 hours
- 6.Which of the following would not be an appropriate way to reduce intra-op heat loss in the pediatric patient?
- A.
Use of an overhead radiant heating unit
- B.
Use of a water mattress, with circulating warm water
- C.
Use cloths dipped in 40o C water and place onto child’s head during procedure
- D.
Use a Bair hugger placed on the child’s body
- 7.What type of breathing circuit would you choose for a child weighing less than 10 kg?
- A.
Small semi-closed Circuit
- B.
Mapleson A
- C.
Standard adult semi closed system
- D.
Jackson-Rees Circuit
- 8.What type of circuit would you choose for a pediatric patient weighing more than 10 kg?
- A.
Small semi-closed Circuit
- B.
Mapleson A
- C.
Standard adult semi closed system
- D.
Jackson-Rees Circuit
- 9.When setting an adult vent for pediatric use in pressure-controlled mode, which of the following would be inappropriate?
- A.
Set I:E ratio 1:2
- B.
Pop off limit to vent to 30 cm H2O
- C.
VT to minimum of 200 ml/kg/min
- D.
All the above are correct
- 10.What would be an appropriate size LMA for an infant weighing 9 kg?
- A.
0.5
- B.
1
- C.
1.5
- D.
2.5
- 11.What would be an appropriate size LMA for a child weighing 27 kg?
- A.
3
- B.
1.5
- C.
4
- D.
2.5
- 12.What would be an appropriate sized ETT for a 3 yr old child weighing 18 kg?
- A.
4.5
- B.
4
- C.
3.5
- D.
3
- 13.What would be an appropriate size ETT for a 9 yr old child weighing 33 kg?
- A.
5
- B.
6
- C.
4.5
- D.
7
- 14.What size laryngoscope blade would you choose to intubate a 3 yr old child?
- A.
1 mil
- B.
2 mac
- C.
1.5 mil
- D.
0 mac
- 15.What size laryngoscope blade would you choose to intubate an 8 yr old child?
- A.
1.5 mil
- B.
3 mac
- C.
2.5 mil
- D.
2 mac
- 16.In order to work well EMLA cream must be applied at least how many minutes prior to IV start?
- A.
45 minutes
- B.
2 hours
- C.
30 minutes
- D.
15 minutes
- 17.What is an appropriate hourly maintenance fluid rate for a child weighing 15 kg?
- A.
60 ml
- B.
50 ml
- C.
25 ml
- D.
15 ml
- 18.When doing a pedi drug set up, it is recommended to draw up your drugs in ‘unit dose’ syringes.
- A.
True
- B.
False
- 19.What would be an appropriate dose of pre-op versed for a 6 yr old child weighing 24 kg?
- A.
24 mg IV
- B.
6 mg PO
- C.
12 mg PO
- D.
48 mg PO
- 20.The majority of pediatric cardiac arrests occur when?
- A.
Induction
- B.
Maintenance
- C.
Emergence
- D.
Rates are equal during all 3 phases
- 21.Most pediatric arrests are due to ________ causes in children.
- A.
Cardiac
- B.
Respiratory
- C.
Congenital defects
- D.
Circulatory collapse
- 22.What is the most common cause of respiratory arrest in pediatric patients?
- A.
Airway Obstruction
- B.
Difficult intubation
- C.
Laryngospasm
- D.
Bronchospasm
- 23.Which of the following is not a risk factor associated with cardiac arrests in the pediatric patient?
- A.
Emergency Surgery
- B.
ASA 3-5
- C.
Congenital Airway Deformities
- D.
Children 1-4 yrs old
- 24.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?
- A.
Approach the parent and attempt to calm him first
- B.
Come back later when both are feeling a bit better
- C.
Approach the child, and attempt to calm him first.
- D.
Give the child some versed.
- 25.A child with a recent URI would be at an increased risk for all of the following except:
- A.
Laryngospasm
- B.
Pneumonia
- C.
Atelectasis
- D.
Wheezing
- 26.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.
- A.
True
- B.
False
- 27.You are auscultating heart sounds on a 7 yr old child and hear a short, soft, systolic murmur. How would you classify this murmur?
- A.
Pathologic
- B.
Detrimental
- C.
Innocent
- D.
None of above
- 28.What pre-op medication would you choose for a 3 week old child, who weighs 4 kg, undergoing surgery to correct a pyloric stenosis?
- A.
Ketamine 8 mg IM
- B.
Versed 0.4mg IM
- C.
Fentanyl lollipop 40 mcg PO
- D.
Atropine 0.08 mg IM
- 29.When monitoring the pediatric patient, where should the precordial stethoscope be placed?
- A.
Left sternal border 2nd or 3rd intercostals space
- B.
Right sterna border 2nd or 3rd intercostals space
- C.
Left midclavicular line 5th intercostals space
- D.
Depends upon what you are trying to monitor
- 30.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.
A precordial stethoscope should be used to evaluate heart tone, rate, and murmurs.
- B.
O2 sat probe should be placed on the left hand for the procedure
- C.
Twitch monitor should be placed along ulnar nerve at the wrist
- D.
The only change to ECG monitoring is the use of pediatric ECG leads and changing alarm limits.
- 31.The best way to administer an IV fluid bolus to an infant is through use of a pressure bag to administer fluid quickly.
- A.
True
- B.
False
- 32.Which of the following children would likely experience the greatest amount of separation anxiety?
- A.
A 4 month old child
- B.
An 11 month old child
- C.
A 5 yr old child
- D.
A 13 yr old child
- 33.What would be the ideal position for induction of a 4 yr old child who is frightened and refuses to lie flat on the OR table?
- A.
Use a couple nurses to make the child lie down and then induce
- B.
Stand next to the child, as they sit on the side of the OR table and then apply the mask to induce.
- C.
Have the child sit in center of OR table while you sit nearby and wrap your arm around child to induce via mask inhalation.
- D.
Use reason, tell the child if they do not lie down you will have to give them a shot instead.
- 34.Which of the following is not true regarding use of Brutane?
- A.
You should apply face mask using two hands in order to have a tight grip
- B.
Children induced this way are more prone to larnygospasm
- C.
You should have sux and atropine drawn up and within easy reach
- D.
This technique is not appropriate for hysterical children
- 35.For a normal inhalational induction your N2O should be at ______ and your O2 should be at ________ to start out with.
- A.
70%, 30%
- B.
50%, 50%
- C.
40%, 60%
- D.
0 %, 100 %
- 36.What size IV catheter would be best to use on a 3 yr old child?
- A.
24
- B.
22
- C.
20
- D.
18
- 37.During an inhalational induction, once your pediatric patient is tubed your first priority should be…
- A.
Inserting the precordial stethoscope
- B.
Applying nerve monitor to assess paralysis
- C.
Starting an IV
- D.
Turning up the sevo higher
- 38.Which of the following is incorrect regarding maintenance of survival position?
- A.
The jaw and chin should be rotated downward to further open the airway
- B.
Using tips of your fingers, jaw thrust should be applied bilaterally
- C.
Fingers should be placed on bony prominence of face
- D.
Downward pressure should not be applies to mask, instead lift jaw up to form tight seal
- 39.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?
- A.
Inhalational induction as patient Is not likely to cooperate with IV placement
- B.
IV must be placed prior to procedure for safe induction.
- C.
IM induction with ketamine
- D.
None of above are appropriate
- 40.The first step in the pediatric RSI sequence is….
- A.
Preoxygenation with spontaneous ventilation
- B.
Application of cricoids pressure
- C.
Pretreatment with atropine
- D.
Delivery of induction agent
- 41.What would be an appropriate IM stun dose ketamine for a 14 yr old boy weighing 40 kg?
- A.
320 mg
- B.
200 mg
- C.
160 mg
- D.
80 mg
- 42.The MAC for all anesthetic agents are highest at what age?
- A.
6-12 months
- B.
4-6 yrs
- C.
1-4 yrs
- D.
0-6 months
- 43.Which of the following inhalational anesthetic agents may cause bradycardia, vasodilation and myocardial depression in infants?
- A.
Desflurane
- B.
Isoflurane
- C.
Sevoflurane
- D.
Opioids
- 44.Which of the inhalational agents had the highest incidence of emergence delirum?
- A.
Sevoflurane
- B.
Isoflurane
- C.
Desflurane
- D.
Halothane
- 45.You are the nurse for a premature child who was born at full term. The child is now 10 weeks old and doing very well. The child is having a minor procedure and was maintained with fentanyl 2mcg/kg and 0.5 MAC Isoflurane. The childs mother wants to know when the child can come home. What do you tell her?
- A.
As soon as I wheel her out of the OR you can take her!
- B.
We will watch her in the PACU for 2-3 hours after the procedure and then she may go home.
- C.
We will keep her for 48-72 hours just to monitor her for safety.
- D.
We will most likely keep her overnight on a pulse oximeter just to watch her.
- 46.High dose opioid therapy during maintenance of anesthesia may be appropriate for which of the following?
- A.
Child with cardiac instability who requires surgical intervention
- B.
Pt who will be extubated after surgery and requires pain control
- C.
A healthy 2 yr old who is no longer at risk for post-op apnea
- D.
A child with respiratory insufficiency who may not have sufficient gas exchange for inhalational agents.
- 47.Which of the following children is the best candidate for a deep extubation?
- A.
An 18 month old child who just had a minor procedure, no past HX and spontaneous ventilation for whole case.
- B.
A 9 yr old healthy child with asthma (no attacks in one year and no wheezes) having a minor elective procedure, spontaneous ventilation maintained throughout procedure
- C.
An 5 yr old healthy child with no medical history, needed paralysis during procedure but has now been fully reversed.
- D.
A 7 yr old child who came for emergent appendectomy
- 48.Which of the following properly describes the Sundown Sign?
- A.
When toddlers become confused at night and start climbing out of bed.
- B.
A sign commonly seen in pts with a PPFO where the pt will turn blue (sundown) while coughing or bucking and creating a temporary shunt.
- C.
Contraction of the inferior rectus muscle of the eye causing the eyeball to look downward toward the toes.
- D.
Just before waking up when the child begins to move and both feet point down as their back arches upward due to stimulation from ETT.
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