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1.     When you place your twitch monitor leads on the lateral side of the patient’s face, which muscle are you wanting to stimulate?
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Quiz On Information Technology With Question And Answer - Quiz

If you have a problem connecting to the internet in your place of work, or you find yourself with any other issue regarding your computer, you’re probably content to let the IT department fix the issue for you. Today, however, we aim to boost some of your personal knowledge on... see moreInformation Technology to give you an insight into what makes your computer run smoothly as it should. see less

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2.

You are inserting a PA lin. Where is your catheter located when you see the #3 waveform?
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3. Which site is most frequently used for arterial lines?
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4. Which invasive arterial monitoring site carries the greatest risk of hematoma and is accessible in low-flow states?
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5. Which of the following methods is useful to use for anesthetic titration:
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6.

You are inserting a PA lin. Where is your catheter located when you see the #4 waveform?
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7. You are in the middle of a knee arthroscopy when your BP cuff stops working. Your SAO2 is not picking up a good tracing either, though your ECG is working well and shows NSR. What should you do?
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8. If video does not load click here or open in another window. https://www.youtube.com/watch?v=xpcUxwpOQ_A
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9. You are currently the SRNA for Mr. Blook.  You used vecuronium during the procedure to paralyze the patient and are now trying to assess adequacy for extubation. The patient currently has 4/4 twitches, with equal amplitude equal to your baseline. He is breathing on his own with a normal tidal volume. Does this patient still require reversal agent?
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10. Which of the following is a not a non-depolarizing muscle relaxant?
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11. What is an appropriate intubating dose of Succinylcholine?
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12.

You are inserting a PA lin. Where is your catheter located when you see the #2 waveform?
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13. Which of the following is the preferred method of measuring BP during surgery?
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14. You have attempted a radial arterial line on Mrs. Holten and have not been successful. What site should be your 2nd choice for an arterial line?
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15. The 2 types of intraoperative recall are:
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16. What would be an appropriate intubating dose of vecuronium for a 65 yr old male weighing 85 kg?
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17. You are being pimped at clinical by a nasty CRNA.  They want you to place your twitch monitors over the best nerve to check for intubating status and then move it to the best nerve to assess if the patient is ready to wake up.  Where do you put it first and then at the end?
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18. Which of the following would NOT cause elevated CVP readings?
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19. Which nerve is best to monitor on train of four in order to assess for intubating conditions?
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20. What does the ‘a’ wave in a CVP waveform represent?
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21. What does the ‘y’ descent represent in a CVP waveform?
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22. You are caring for Mr. Stink-eye, who has a PA line. You notice an increase in your CVP, CI, & PA pressure. As a super cool SRNA, What is your response to this?
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23. When properly placing a BIS monitor on a patient, where should electrode #1 be placed?
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24. Sole reliance of BIS for intraoperative management can:
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25.   What would be an appropriate BIS value to maintain during maintenance of anesthesia?
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26. The Maximal Oscillation during oscillometry correlates to…
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27. How will an increase in your EMG tone affect your BIS reading?
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28. What percentage of blockade is necessary to facilitate intubation?
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29. You are caring for a pt undergoing an extensive bowel resection. On you monitor you have a CVP of 3 and a PCWP of 4. What would be your next intervention?
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30. What changes to your CVP would you expect to see on a patient with atrial fibrillation?
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31. With the knowledge that altered EMG readings results from increased tone of the frontalis muscle of the forehead, which lies beneath the BIS sensor, it can be assumed that:
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32. What do you predict will be the effect of intubation  on BIS, BP & heart rate?
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33.

You are inserting a PA lin. Where is your catheter located when you see the #1 waveform?
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34. Which of the following BIS readings indicates a moderate hypnotic state?
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35. What does the ‘v’ wave represent in a CVP waveform?
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36. When a patient experiences deliberate recollection of events it is known as….
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37. If your paralyzed OR patient has 1 full twitch and that’s it, how many receptors are blocked?
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38. You are in the OR with a exploratory laparotomy patient who you gave Rocuronium to 20 minutes ago.  The surgeon is saying that the patient is moving and he can’t close.  You do a TOF and have 0 twitches, what should you do?

Explanation

the best choice is B, but in reality who cares what the twitches are, you aren't going to give more roc at the end of a case, if pt's moving push some Propofol

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39. What is an appropriate cuff size?
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40. Electrocautery will NOT interfere with the arterial pressure waveform.
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41. Which of the following is not an indication for a central line?
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42. What would be your preferred site of insertion for a CVP line on a patient in acute respiratory failure with no contraindications at any site?
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43. What does the ‘c’ wave in a CVP waveform represent?
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44. Where should the CVP catheter be when inserted properly?
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45. What is the normal range for CVP readings?
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46. Blood Flow is ______ and governed by _____ law.
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47. When interpreting an arterial waveform you notice that the dicrotic notch is very low on the down slope. What does this mean?
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48. During periods of rest, there is ______ Potassium outside the cell then in the cell.
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49. What is an appropriate intubating dose of Vecuronium?
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50. What would be an appropriate intubating dose of succinylcholine for a 41 yr old female weighing 75 kg?
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51. Which of the following would NOT be an indication for invasive arterial monitoring?
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52. CVP pressure reflects pressure in the __________ in a normal heart.
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53. BIS monitoring effectively prevents awareness
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54. The most common cause of intraop recall is:
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55. At which BIS value would you see an isoelectric EEG?
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56. Which nerve is best to monitor on your train of four in order assess for extubation adequacy?
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57. You are planning to insert a central line on Mr. Dee who is in the ICU for Acute Liver Failure. You want to use the Low Anterior Approach to insert the line. How would you perform this technique?
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58. Which one of the following statements is most correct regarding timing of the CVP/ right atrial pressure waves with ECG tracing?
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59. Methods to reduce intraop recall include all of the following except:
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60. What would be considered a normal SVO2?
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61. The benefits of using BIS include all of the following except:
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62. Which of the following would only need to bind to 1 of the alpha subunits in order to exert its intended effect?
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63. You are in the middle of your case and BIS has been running in the 40’s. You notice that your patient’s temp is trending below 36°C, so you decide to turn on the bare hugger. All of the sudden you notice that your BIS is up to 60, what is the most probable cause and what do you do?
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64. You have just given your patient succinycholine and find they have 4/4 weak twitches. All the twitches are of equal amplitude and weaker than your baseline twitches. What phase of block are you in?
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65. Depolarizing muscle relaxing agents may be reversed using an anticholinesterase drug given with an anticholinergic agent. 
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66. In a phase 1 block of Succinocholine what would you expect to see on the TOF?
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67. If you place your twitch monitor leads over the ulnar nerve and you see finger flexion, what does that mean?
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68.   Which one of the following statements about hemodynamic waveforms is most correct?
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69. When waking the patient at the end of surgery, you should reverse your muscle relaxation prior to decreasing your anesthetic.
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70. In a phase 2 block of Succinocholine what would you expect to see on the TOF?
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71. A negative Allen’s test indicates there is no collateral blood flow and is an absolute contraindication to a radial artery arterial line. 
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72. You are planning to insert an arterial line on a 68 yr old male. What technique would you choose to insert the line?
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73. You are caring for Mrs. Gil today who has acute pulmonary edema. What sort of reading would you expect to see on her Pulmonary Artery Catheter?
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74. There is an increased risk in the intraoperative recall in all of the following cases except:
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75. Which of the following patients would not be at an increased risk for intra-operative recall?
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76. Which of the following is NOT one of the 5 glycoprotein subunits on nicotinic receptors?
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77. Which of the following is not an adverse effect associated with non-invasive BP monitoring?
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78. Which of the following will not cause an increase in Pulmonary Artery Pressure? 
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79. What would you use to reverse the muscle relaxant effects of depolarizing muscle relaxants?
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80. Which of the following is a complication associated only with PA lines, but not CVP lines?
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81. 58 y/o male, ASA II, MP 3 scheduled for intramedullary rodding of a femur fracture. Standard induction and monitors placed. Medications given: Midaz 2 mg, Fentanyl 150 mcg, Propofol 200 mg, Vec 10 mg, BIS=30. Intubation has failed, continued mask ventilation for 3 minutes and now BIS = 80. Second intubation attempt, redosed with Propofol 100 mg, intubation successful and BIS reads 40. What accounts of the fluctuation in the BIS reading:
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82. Pressure is ______ peripherally than it is centrally.  Velocity is  _______ peripherally than it is centrally.
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83. During emergence, the patient will typically become responsive and open their eyes above what BIS level?
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84. Which of the following is NOT true regarding non-depolarizing muscle relaxants?
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85. For surgical relaxation to be appreciated you must have how many of your twitches on train on four decreased?

Explanation

Need 90% blockade for surgical relaxation.

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86. The state in which you are in a moderate hypnotic state with low probability of consciousness is
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87. You have givien your patient a non-depolarizing muscle relaxant and now find they have 0/4 twitches on the train of four. Roughly what percentage of the receptors are now blocked?
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88. You are caring for a patient with a PA line and notice an increase in your CVP, while at the same time you see a decrease in your CI, PCWP, & PA Pressure. What does this mean and how would you treat it?
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89. What BIS reading would indicate your patient is in a light hypnotic state?
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90. You have given your patient vecuronium and are assessing the number of twitches on your train of four. R1 and R2 are equal to your baseline. R3 is of decreased amplitude, while R4 is gone. At this point you know roughly what percentage of your receptors are blocked?
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91. What is likely to occur as a result of checking your twitches too frequently?
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92. You are planning to insert a central line on Mr. Jing who is in the ICU for cardiomyopathy. You want to use the High Anterior Approach to insert the line. How would you perform this technique?
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93. What it is an appropriate range for PCWP readings?
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94. In which of the following areas would the muscles have the most nerves?
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95.    Which one of the following is the most characteristic difference between right ventricular (RV) waveform and the pulmonary artery (PA) waveform?
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96. If your arterial line is overdampened….
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97. What changes to your CVP would you expect to see on a patient with mitral regurgitation?
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98. When properly placing a BIS monitor on a patient, where should electrode #4 be placed?
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99. The surgeon starts to close the patient’s incision, so as a smart SRNA you check the patients TOF to see if you can give a reversal yet.  You get a 1 strong twitch and 1 partial twitch.  What do you document?
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100. What does the ‘x’ descent in a CVP waveform represent?
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101.  The most frequent source of EEG contamination is:
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102. Which of the following reading indicates a deep hypnotic state?
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103. You are caring Mr. Garjian today. You observe the following values: CVP 15, CI 1.8, PCWP 26, and PAP 43/ 25. What do these failures mean for Mr. Garjian?
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104. You are getting ready to allow your previous paralyzed patient to be extubated.  He can hold a head lift for 5 seconds.  How many receptors can still be blocked?
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105. Which of the following vessels would have the highest measured pressure?

Explanation

Hemodynamic ppt slide 7

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106. What changes to your CVP would you expect to observe on a patient with complete AV block?
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107. 45 y/o male, 95 kg, ASA 1 scheduled for a craniotomy and resection of an AVM. Routine monitors including BIS, A-line and evoked potentials. Medications given: Midaz 2mg in holding, initial BIS 88 and with placement of other monitors BIS increased to 95. Induction sequence: Propofol 150 mg, Fentanyl 50 mcg, Vec 10 mg. BIS now 50. Surgeon in the room to perform a scalp block and place a head clamp, BIS back up to 80. What are you noticing and what have you failed to do:
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108. You are about to induce your patient.  You are giving a non-depolarizing muscle relaxant and are going to use train of four to determine when your patient is ready for intubation. How many twitches need to be decreased in amplitude before you can intubate?

Explanation

Need 95% blockade for intubation

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109. You have a paralyzed patient and are doing a TOF.  You get zero twitches.  So, you decide to do a post-tetanic face to assess when you might get 1 twitch back.  You do the tetanus and then recheck a TOF.  You see 2 strong twitches and a partial third.  No fourth.  What do you document?
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110. When inserting a PA catheter, at approximately what distance would you inflate your balloon?
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111. The BIS monitor measures:
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112. You are monitoring train of four on a patient who has received non-depolarizing muscle relaxants. The patient has 4/4 weak twitches with fade. R1 is equal to baseline but all of your other twitches are decreased. What percentage of your receptors may be blocked?
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113. Which of the following is true regarding Zone III, where we would like to have our PA catheters placed? (More than one answer)

Explanation

NZ 312

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114. When you are using the tetanus button, how long do you depress it?
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115.     Which of the following statements about measurement of the pulmonary artery occlusion pressure is most correct?
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116. Which one of the following statements about the pulmonary artery occlusion pressure (PAOP) is most correct?
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    When you place your twitch monitor leads on the...
You are inserting a PA lin. Where is your catheter located when you...
Which site is most frequently used for arterial lines?
Which invasive arterial monitoring site carries the greatest risk of...
Which of the following methods is useful to use for anesthetic...
You are inserting a PA lin. Where is your catheter located when you...
You are in the middle of a knee arthroscopy when your BP...
If video does not load click here or open in another window. ...
You are currently the SRNA for Mr. Blook.  You used vecuronium...
Which of the following is a not a non-depolarizing muscle relaxant?
What is an appropriate intubating dose of Succinylcholine?
You are inserting a PA lin. Where is your catheter located when you...
Which of the following is the preferred method of measuring BP during...
You have attempted a radial arterial line on Mrs. Holten and have not...
The 2 types of intraoperative recall are:
What would be an appropriate intubating dose of vecuronium for a 65 yr...
You are being pimped at clinical by a nasty CRNA.  They want you...
Which of the following would NOT cause elevated CVP readings?
Which nerve is best to monitor on train of four in order to assess for...
What does the ‘a’ wave in a CVP waveform represent?
What does the ‘y’ descent represent in a CVP waveform?
You are caring for Mr. Stink-eye, who has a PA line. You notice an...
When properly placing a BIS monitor on a patient, where should...
Sole reliance of BIS for intraoperative management can:
  What would be an appropriate BIS value to maintain during...
The Maximal Oscillation during oscillometry correlates to…
How will an increase in your EMG tone affect your BIS reading?
What percentage of blockade is necessary to facilitate intubation?
You are caring for a pt undergoing an extensive bowel resection. On...
What changes to your CVP would you expect to see on a patient with...
With the knowledge that altered EMG readings results from increased...
What do you predict will be the effect of intubation  on BIS, BP...
You are inserting a PA lin. Where is your catheter located when you...
Which of the following BIS readings indicates a moderate hypnotic...
What does the ‘v’ wave represent in a CVP waveform?
When a patient experiences deliberate recollection of events it is...
If your paralyzed OR patient has 1 full twitch and that’s it, how...
You are in the OR with a exploratory laparotomy patient who you gave...
What is an appropriate cuff size?
Electrocautery will NOT interfere with the arterial pressure waveform.
Which of the following is not an indication for a central line?
What would be your preferred site of insertion for a CVP line on a...
What does the ‘c’ wave in a CVP waveform represent?
Where should the CVP catheter be when inserted properly?
What is the normal range for CVP readings?
Blood Flow is ______ and governed by _____ law.
When interpreting an arterial waveform you notice that the dicrotic...
During periods of rest, there is ______ Potassium outside the cell...
What is an appropriate intubating dose of Vecuronium?
What would be an appropriate intubating dose of succinylcholine for a...
Which of the following would NOT be an indication for invasive...
CVP pressure reflects pressure in the __________ in a normal heart.
BIS monitoring effectively prevents awareness
The most common cause of intraop recall is:
At which BIS value would you see an isoelectric EEG?
Which nerve is best to monitor on your train of four in order assess...
You are planning to insert a central line on Mr. Dee who is in...
Which one of the following statements is most correct regarding timing...
Methods to reduce intraop recall include all of the following except:
What would be considered a normal SVO2?
The benefits of using BIS include all of the following except:
Which of the following would only need to bind to 1 of the alpha...
You are in the middle of your case and BIS has been running in the...
You have just given your patient succinycholine and find they have 4/4...
Depolarizing muscle relaxing agents may be reversed using an...
In a phase 1 block of Succinocholine what would you expect to see on...
If you place your twitch monitor leads over the ulnar nerve and you...
  ...
When waking the patient at the end of surgery, you should reverse your...
In a phase 2 block of Succinocholine what would you expect to see on...
A negative Allen’s test indicates there is no collateral blood flow...
You are planning to insert an arterial line on a 68 yr old male. What...
You are caring for Mrs. Gil today who has acute pulmonary edema. What...
There is an increased risk in the intraoperative recall in all of the...
Which of the following patients would not be at an increased risk for...
Which of the following is NOT one of the 5 glycoprotein subunits on...
Which of the following is not an adverse effect associated with...
Which of the following will not cause an increase in Pulmonary Artery...
What would you use to reverse the muscle relaxant effects of...
Which of the following is a complication associated only with PA...
58 y/o male, ASA II, MP 3 scheduled for intramedullary rodding of a...
Pressure is ______ peripherally than it is centrally.  Velocity...
During emergence, the patient will typically become responsive and...
Which of the following is NOT true regarding non-depolarizing muscle...
For surgical relaxation to be appreciated you must have how many of...
The state in which you are in a moderate hypnotic state with low...
You have givien your patient a non-depolarizing muscle relaxant and...
You are caring for a patient with a PA line and notice an increase in...
What BIS reading would indicate your patient is in a light hypnotic...
You have given your patient vecuronium and are assessing the number of...
What is likely to occur as a result of checking your twitches too...
You are planning to insert a central line on Mr. Jing who is in the...
What it is an appropriate range for PCWP readings?
In which of the following areas would the muscles have the most...
   Which one of the following is the most characteristic...
If your arterial line is overdampened….
What changes to your CVP would you expect to see on a patient with...
When properly placing a BIS monitor on a patient, where should...
The surgeon starts to close the patient’s incision, so as a smart...
What does the ‘x’ descent in a CVP waveform represent?
 The most frequent source of EEG contamination is:
Which of the following reading indicates a deep hypnotic state?
You are caring Mr. Garjian today. You observe the following values:...
You are getting ready to allow your previous paralyzed patient to be...
Which of the following vessels would have the highest measured...
What changes to your CVP would you expect to observe on a patient with...
45 y/o male, 95 kg, ASA 1 scheduled for a craniotomy and resection of...
You are about to induce your patient.  You are giving a...
You have a paralyzed patient and are doing a TOF.  You get zero...
When inserting a PA catheter, at approximately what distance would you...
The BIS monitor measures:
You are monitoring train of four on a patient who has received...
Which of the following is true regarding Zone III, where we would like...
When you are using the tetanus button, how long do you depress it?
    Which of the following statements about measurement...
Which one of the following statements about the pulmonary artery...
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