Quiz On Information Technology With Question and Answer

1. When you place your twitch monitor leads on the lateral side of the patient’s face, which muscle are you wanting to stimulate?

Ulnar

Orbicularis Oculi

Flexor Hallucis

Adductor Pollicis

2.

You are inserting a PA lin. Where is your catheter located when you see the #3 waveform?

Right Atrium

Pulmonary Artery

Too far in, producing a wedge pressure

Right Ventricle

3. Which site is most frequently used for arterial lines?

Femoral

Ulnar

Brachial

Radial

4. Which invasive arterial monitoring site carries the greatest risk of hematoma and is accessible in low-flow states?

Brachial

Femoral

Radial

Ulnar

5. Which of the following methods is useful to use for anesthetic titration:

Hemodynamic response

ETCO2

BIS

Knowledge and expectation of drug response

All of the above

6.

You are inserting a PA lin. Where is your catheter located when you see the #4 waveform?

Too far in, producing a wedge pressure

Right Ventricle

Pulmonary Artery

Right Atrium

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?

Immediately start CPR, the patient must be in PEA.

Send someone to go get another BP cuff for you.

Check for radial pulse, since Systolic must be at least 80 if you can palpate radial pulse.

Insert a central line.

8. If video does not load click here or open in another window. https://www.youtube.com/watch?v=xpcUxwpOQ_A

What in the *HELL* was that?

Awe, I love Beaker.

Seriously, the quiz maker must be a freak.... but that was funny.

All the above.

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?

No, non-depolarizers do not require reversal

No, if the patient has 4/4 twitches and can breathe and therefore meets criteria to extubate.

Yes, patient may still be up to 75% blocked

10. Which of the following is a not a non-depolarizing muscle relaxant?

Rocuronium

Mivacurium

Succinylcholine

Vecuronium

11. What is an appropriate intubating dose of Succinylcholine?

1-1.5 mg/kg

.08-0.1 mg/kg

0.6-1.2 mg/kg

0.15-0.2 mg/kg

0.4-0.5 mg/kg

12.

You are inserting a PA lin. Where is your catheter located when you see the #2 waveform?

Right Ventricle

Too far in, producing a wedge pressure

Right Atrium

Pulmonary artery

13. Which of the following is the preferred method of measuring BP during surgery?

Auscultation

Arterial Tonometry

Arterial Line

Oscillometry

14. You have attempted a radial arterial line on Mrs. Holten and have not been successful. What site should be your 2^nd choice for an arterial line?

Brachial

Femoral

Subclavian

Jugular

15. The 2 types of intraoperative recall are:

Internal/External

Implicit/Explicit

Implied/Replied

Instinct/Distinct

16. What would be an appropriate intubating dose of vecuronium for a 65 yr old male weighing 85 kg?

120 mg

17 mg

170 mg

8.5 mg

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?

Orbicularis oculi and then flexor hallucis

Flexor hallucis and then ulnar

Orbicularis oculi and then adductor pollicis

Ulnar and then flexor hallucis

Ulnar and then orbicularis oculi

18. Which of the following would NOT cause elevated CVP readings?

Hypovolemia

Cardiac Tamponade

Pulmonary HTN

Chronic LV failure

19. Which nerve is best to monitor on train of four in order to assess for intubating conditions?

Adductor Pollicis

Orbicularis Oculi

Posterior Tibial Nerve

All are equally good options

20. What does the ‘a’ wave in a CVP waveform represent?

Atrial pressure during contraction

Bulging tricuspid, early ventricular contraction

Tricuspid valve opening during diastole

Venous return(atrium filling) against a closed tricuspid valve

21. What does the ‘y’ descent represent in a CVP waveform?

Downward movement of the ventrical during systole

Bulging tricuspid, early ventricular contraction

Tricuspid valve opening during diastole

Venous return(atrium filling) against a closed tricuspid valve

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?

Open up your bag of IV fluids to infuse quicker and add volume.

Start a dopamine drip

Start a nitro drip

Give some lasix

23. When properly placing a BIS monitor on a patient, where should electrode #1 be placed?

In the center of forehead, 2 inches from bridge of nose

At the patients temple, level with their eye

Directly above the patients eyebrow.

On the right side of the pts face, adjacent to electrode #2

24. Sole reliance of BIS for intraoperative management can:

Reduce awareness

Improve anesthetic plan/course

Improve recovery times

Not to be solely used, needs to be in conjunction with traditional monitoring

25. What would be an appropriate BIS value to maintain during maintenance of anesthesia?

100

30

70

50

26. The Maximal Oscillation during oscillometry correlates to…

Mean Arterial pressure

Systolic BP

Diastolic BP

Ventricular Contractility

27. How will an increase in your EMG tone affect your BIS reading?

It will cause a decrease in BIS readings.

It will not effect your readings.

It will make it impossible to get any readings at all.

It will cause an increase in your BIS readings.

28. What percentage of blockade is necessary to facilitate intubation?

75%

99%

90%

95%

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?

Nothing, these values are fine.

Pt has LV failure, give inotropes.

Pt is hypovolemic, give volume

Pt is in RV failure, give vasodilators.

30. What changes to your CVP would you expect to see on a patient with atrial fibrillation?

Loss of A waves

Giant Cannon A waves

Larger V waves

Loss of C waves

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:

EMG activity is present during awake states

EMG activity is present during emergence

Can be reduced by administration of analgesics, hypnotics and/or muscle relaxants

All of the above

32. What do you predict will be the effect of intubation on BIS, BP & heart rate?

Increase BP & HR, BIS may or may not increase

BIS will not change, BP and HR will increase

BIS will increase, BP and HR will stay same

BIS will increase, BP & HR will decrease

33.

You are inserting a PA lin. Where is your catheter located when you see the #1 waveform?

Right Ventricle

Pulmonary Artery

Right Atrium

Too far in, producing a wedge pressure

34. Which of the following BIS readings indicates a moderate hypnotic state?

68

23

45

92

35. What does the ‘v’ wave represent in a CVP waveform?

Atrial pressure during contraction

Bulging tricuspid, early ventricular contraction

Tricuspid valve opening during diastole

Venous return(atrium filling) against a closed tricuspid valve

36. When a patient experiences deliberate recollection of events it is known as….

Explicit recall

Implicit recall

External recall

Internal recall

37. If your paralyzed OR patient has 1 full twitch and that’s it, how many receptors are blocked?

75%

75-80%

85%

90%

99%

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?

Tell the surgeon he is a moron and should hurry up so you can go to lunch

Check the electrodes and make sure they are on and in the correct position and recheck your TOF

Reparalyze the patient

Do nothing and pretend you didn’t hear the surgeon over his loud rock music

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

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

39. What is an appropriate cuff size?

Equal to diameter of arm

70-80% of arm diameter

20-50% greater than the diameter of arm

Twice arm diameter

40. Electrocautery will NOT interfere with the arterial pressure waveform.

True

False

41. Which of the following is not an indication for a central line?

Acute burn patient with need for aggressive fluid management

A patient with severe atherosclerosis who recently had a carotid endarterectomy and is on an anticoagulant drip.

Septic patient who will need several caustic drugs as well as hyperalimentation infused.

A patient in 3rd degree heart block who requires emergent insertion of transvenous pacing wires.

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?

Left Internal Jugular

Right Femoral

Right Internal Jugular

Left Subclavian

43. What does the ‘c’ wave in a CVP waveform represent?

Atrial pressure during contraction

Bulging tricuspid, early ventricular contraction

Tricuspid valve opening during diastole

Venous return(atrium filling) against a closed tricuspid valve

44. Where should the CVP catheter be when inserted properly?

In the Right Atrium

At junction of superior vena cava

In the pulmonary artery

In the radial artery

45. What is the normal range for CVP readings?

0-3 mm HG

5-10 mm HG

12-18 mm HG

15-30 mm HG

46. Blood Flow is __ and governed by _ law.

Laminar, Poiseiulles

Turbulent, Renolds

Mixed, Poiseiulles

Determined by gradients, Ficks

47. When interpreting an arterial waveform you notice that the dicrotic notch is very low on the down slope. What does this mean?

The line is inserted improperly and needs to be adjusted

The patient may be hypertensive.

The patient may have a very low SVR.

Nothing, so long as the notch is there it is good.

48. During periods of rest, there is ______ Potassium outside the cell then in the cell.

Less

Equal

More

49. What is an appropriate intubating dose of Vecuronium?

1-1.5 mg/kg

.08-0.1 mg/kg

0.6-1.2 mg/kg

0.15-0.2 mg/kg

0.4-0.5 mg/kg

50. What would be an appropriate intubating dose of succinylcholine for a 41 yr old female weighing 75 kg?

110 mg

8 mg

150 mg

16 mg

51. Which of the following would NOT be an indication for invasive arterial monitoring?

End organ disease which necessitates precise beat-to-beat blood pressure measurement.

Need for multiple ABG’s and labs during case.

Severe hypertension

Anticipation of wide blood pressure swings

52. CVP pressure reflects pressure in the __________ in a normal heart.

Right Atrium

Left Atrium

Right Ventricle

Left Ventricle

53. BIS monitoring effectively prevents awareness

True

False

54. The most common cause of intraop recall is:

Unknown reason

Faulty equipment

Anesthetic technique

Empty Vaporizer

55. At which BIS value would you see an isoelectric EEG?

0

20

30

40

56. Which nerve is best to monitor on your train of four in order assess for extubation adequacy?

Orbicularis Oculi

Adductor Pollicis

Posterior Tibial Nerve

All are equally good options

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?

Give the needle to your preceptor and say "pretty please? Can you insert this for me?"

Find the point that sternal and clavicular heads join the sternocleidomastoid, insert needle 30 degrees at ipsilateral nipple

Posterior border of sternocleidomastoid and external jugular vein, ispsilateral corner of the sternal notch

At cricoid level, lateral to carotid, insert needle 30 degrees ipsilateral nipple. Start with 22g finder needle.

58. Which one of the following statements is most correct regarding timing of the CVP/ right atrial pressure waves with ECG tracing?

The v wave occurs at the RST junction

The a wave occurs just after the P wave

The v wave occurs at the end of the QRS complex

The c wave occurs after the T wave

59. Methods to reduce intraop recall include all of the following except:

Keep BIS 40-60

Refill vaporizers after every case

Perform leak check only in the morning

Vigilantly monitor your patient

60. What would be considered a normal SVO2?

60%

90%

75%

100%

61. The benefits of using BIS include all of the following except:

Reduced PONV

Fast wakeup/extubation

Early discharge from PACU

Prevents anesthetic awareness

62. Which of the following would only need to bind to 1 of the alpha subunits in order to exert its intended effect?

Vecuronium

Acetylcholine

Succinylcholine

All of the above

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?

He started shivering because temp low, give Demerol 25 mg IV stat

Check TOF and redose his muscle relaxant to 0/4

Maybe artifact from the bare hugger, turn it off and see what happens to your reading

Patient is in pain and getting light, need to give pain meds, hypnotics or go up on your VAA

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?

I have 4/4 twitches, Not enough was given and I am not blocked.

I am in Phase 1 block.

I am in Phase 2 block

Depolarizing muscle relaxants do not produce Phased blocks.

65. Depolarizing muscle relaxing agents may be reversed using an anticholinesterase drug given with an anticholinergic agent.

True

False

66. In a phase 1 block of Succinocholine what would you expect to see on the TOF?

4/4, but decreased amplitude

0/4, no twitches

2/4 with a fade

1/4 because it’s a short acting relaxant

67. If you place your twitch monitor leads over the ulnar nerve and you see finger flexion, what does that mean?

You are in the right spot

You are stimulating the median nerve instead of the ulnar

The patient needs more muscle relaxant

You shouldn’t use the ulnar nerve anymore, switch to the facial

68. Which one of the following statements about hemodynamic waveforms is most correct?

Hemodynamic pressures rise during inspiration in a patient breathing spontaneously

Hemodynamic pressures fall during inspiration in a patient receiving positive-pressure mechanical ventilation

Hemodynamic pressures should be read at end-expiration in a patient breathing spontaneously

Hemodynamic pressures should be read at peak-inspiration in a patient receiving positive-pressure ventilation

69. When waking the patient at the end of surgery, you should reverse your muscle relaxation prior to decreasing your anesthetic.

True

False

70. In a phase 2 block of Succinocholine what would you expect to see on the TOF?

4/4, but decreased amplitude

0/4, no twitches

4/4, with strong twitches

2/4, with fade

71. A negative Allen’s test indicates there is no collateral blood flow and is an absolute contraindication to a radial artery arterial line.

True

False

72. You are planning to insert an arterial line on a 68 yr old male. What technique would you choose to insert the line?

Strain Gauge Technique

High Anterior technique

Wheatstone technique

Seldinger Technique

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?

Increase CVP, CI, PCWP, & PAP

Increase CVP. Decrease CI, PCWP, & PAP

Increase CVP, PCWP, & PAP. Decrease CI.

Decrease CVP, CI, PCWP, & PAP

74. There is an increased risk in the intraoperative recall in all of the following cases except:

Craniotomy because surgeon’s like these patients light

OB because of a decrease in MAC requirements

Trauma because of hemodynamic instability

Bypass because of hemodilution

75. Which of the following patients would not be at an increased risk for intra-operative recall?

27 yr old female having a c-section

4 yr old male undergoing repair of heart defect, requiring cardiopulmonary bypass.

63 yr old male undergoing bronchoscopy

36 yr old female having resection of brain tumor.

76. Which of the following is NOT one of the 5 glycoprotein subunits on nicotinic receptors?

Alpha

Beta

Gamma

Kappa

Delta

77. Which of the following is not an adverse effect associated with non-invasive BP monitoring?

Compartment Syndrome

Sciatic Nerve Parasthesia

Thrombophlebitis

Limb edema & pain

78. Which of the following will not cause an increase in Pulmonary Artery Pressure?

Left Ventricular failure

Mitral Regurge

Pulmonary HTN

Ischemia

79. What would you use to reverse the muscle relaxant effects of depolarizing muscle relaxants?

Neostigmine alone.

Neostigmine & glycopyrolate

Mivacurium

Just wait it out, these agents can not be reversed

80. Which of the following is a complication associated only with PA lines, but not CVP lines?

Pneumothorax

Complete heart block in pts with Left BBB.

Cardiac Perforation

Air Embolism

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:

Artifact and need to trouble shoot machine

Effects of the medications are alternating the BIS readings

Abnormal response to sequence of induction

Normal response but numbers are too varied, need to trouble shoot

82. Pressure is peripherally than it is centrally. Velocity is _ peripherally than it is centrally.

Lower, lower

Higher, higher

Lower, higher

Higher, lower

83. During emergence, the patient will typically become responsive and open their eyes above what BIS level?

60

80

70

100

84. Which of the following is NOT true regarding non-depolarizing muscle relaxants?

Antagonized by anticholinesterase drugs

Will not produce Fade on TOF monitoring

Intubation facilitated at 95% blockade

Can decrease fasciculation cause by depolarizing agents

85. For surgical relaxation to be appreciated you must have how many of your twitches on train on four decreased?

Only R4 needs to be decreased

All twitches need to be absent or decreased.

R2-R4 need to be decreased, R1 can be maintained at baseline amplitude

R3 and R4 need to be decreases, while R1 and R2 can maintain baseline amplitude.

Need 90% blockade for surgical relaxation.

Explanation

Need 90% blockade for surgical relaxation.

86. The state in which you are in a moderate hypnotic state with low probability of consciousness is

60-70

40-60

70-100

0-40

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?

95%

99%

90%

75%

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?

RV failure, give vasodilators

LV failure, give inotropes.

Pulmonary edema, give diuretics

Hypervolemia, give diuretics

89. What BIS reading would indicate your patient is in a light hypnotic state?

68

92

45

23

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?

75%

90%

85%

95%

91. What is likely to occur as a result of checking your twitches too frequently?

You will get a falsely higher reading on your TOF

Patient will most likely develop parasthesia

You will get a falsely lower reading

Not a darn thing will happen, I’ll zap them as much as I wanna.

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?

Find the point that sternal and clavicular heads join the sternocleidomastoid, insert needle 30 degrees at ipsilateral nipple

Posterior border of sternocleidomastoid and external jugular vein, ispsilateral corner of the sternal notch

At cricoid level, lateral to carotid, insert needle 30 degrees ipsilateral nipple. Start with 22g finder needle.

93. What it is an appropriate range for PCWP readings?

15-25

5-15

0-5

25-40

94. In which of the following areas would the muscles have the most nerves?

Back

Hands

Knees

Neck

95. Which one of the following is the most characteristic difference between right ventricular (RV) waveform and the pulmonary artery (PA) waveform?

The RV systolic pressure is usually more than 10 mm Hg higher than the PA systolic pressure

The RV diastolic and PA systolic pressure are similar

The RV diastolic pressure is lower than the PA diastolic pressure

The mean RV pressure is higher than the mean PA pressure

96. If your arterial line is overdampened….

Your MAP will still be relatively accurate

You diastolic BP will be underestimated

Your systolic BP will be overestimated

You will have unusually high pressure readings.

97. What changes to your CVP would you expect to see on a patient with mitral regurgitation?

Loss of A waves

Giant Cannon A waves

Larger V waves

Loss of C waves

98. When properly placing a BIS monitor on a patient, where should electrode #4 be placed?

In the center of forehead, 2 inches from bridge of nose

At the patients temple, level with their eye

Directly above the patients eyebrow.

Adjacent to electrode #1

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?

0/4

1/4

2/4

3/4

4/4

100. What does the ‘x’ descent in a CVP waveform represent?

Downward movement of the ventrical during systole

Bulging tricuspid, early ventricular contraction

Tricuspid valve opening during diastole

Venous return(atrium filling) against a closed tricuspid valve

101. The most frequent source of EEG contamination is:

Signal quality index

BIS number

Electromyogram activity

Suppression ratio

102. Which of the following reading indicates a deep hypnotic state?

68

23

92

45

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?

He most likely has right ventricular failure.

He is hypervolemic.

He is hypovolemic.

He most likely has left ventricular failure.

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?

Up to 75%

Up to 50%

Up to 33%

None will be blocked.

105. Which of the following vessels would have the highest measured pressure?

Aorta

Femoral

Subclavian

Radial

Hemodynamic ppt slide 7

Explanation

Hemodynamic ppt slide 7

106. What changes to your CVP would you expect to observe on a patient with complete AV block?

Loss of A waves

Giant Cannon A waves

Larger V waves

Loss of C waves

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:

Patient is reacting as expected, anyone’s BIS will go up with a head clamp placement

Patient is extremely sensitive to stimuli and you haven’t given enough pain medication

Patient is not well controlled and you need to have a tighter control on anesthetics

Patient is responding normally and you failed to give sufficient hypnotics

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?

Only R4 needs to be decreased

All twitches need to be absent or decreased.

R2-R4 need to be decreased, R1 can be maintained at baseline amplitude

R3 and R4 need to be decreased, while R1 and R2 can maintain baseline amplitude.

Need 95% blockade for intubation

Explanation

Need 95% blockade for intubation

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?

0/4

1/4

2/4

3/4

4/4

110. When inserting a PA catheter, at approximately what distance would you inflate your balloon?

30 cm

50 cm

10 cm

20 cm

111. The BIS monitor measures:

Anesthetic depth

Consciousness/Memory function

Effects of anesthetics in the brain

Relationship between patient and drug, which is dependent on dose

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?

75%

95%

85%

90%

113. Which of the following is true regarding Zone III, where we would like to have our PA catheters placed? (More than one answer)

Pulm Venous Pressure > alveolar pressure > PAP

PAP > Pulm venous pressure > Alveolar pressure

Physiologically, not anatomically, defined so it can change.

Located in Pulmonary Vein

Alveolar pressure > PAP > pulm venous pressure

NZ 312

Explanation

NZ 312

Submit

114. When you are using the tetanus button, how long do you depress it?

For 2 seconds

It doesn’t matter because the machine gives a set pulse

5 seconds

Just a quick press of the button

115. Which of the following statements about measurement of the pulmonary artery occlusion pressure is most correct?

The balloon should remain inflated for at least 45 seconds to insure an optimal seal within the pulmonary artery

Air should be aspirated from the balloon with a syringe following the measurement procedure

“Overwedging” can only occur with excessive balloon inflation

The pulmonary artery occlusion pressure is lower than the mean pulmonary artery pressure

116. Which one of the following statements about the pulmonary artery occlusion pressure (PAOP) is most correct?

The pulmonary artery occlusion pressure is measured through the most proximal catheter port

The PAOP waveform often contains 3 positive waves (a, c, v)

During inflation of the balloon the pulmonary artery pressure changes to a right ventricular waveform

Quiz On Information Technology With Question and Answer

1. When you place your twitch monitor leads on the lateral side of the patient’s face, which muscle are you wanting to stimulate?

2.

What first name or nickname would you like us to use?

2. You are inserting a PA lin. Where is your catheter located when you see the #3 waveform?

3. Which site is most frequently used for arterial lines?

4. Which invasive arterial monitoring site carries the greatest risk of hematoma and is accessible in low-flow states?

5. Which of the following methods is useful to use for anesthetic titration:

6. You are inserting a PA lin. Where is your catheter located when you see the #4 waveform?

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?

8. If video does not load click here or open in another window. https://www.youtube.com/watch?v=xpcUxwpOQ_A

10. Which of the following is a not a non-depolarizing muscle relaxant?

11. What is an appropriate intubating dose of Succinylcholine?

12. You are inserting a PA lin. Where is your catheter located when you see the #2 waveform?

13. Which of the following is the preferred method of measuring BP during surgery?

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?

15. The 2 types of intraoperative recall are:

16. What would be an appropriate intubating dose of vecuronium for a 65 yr old male weighing 85 kg?

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?

18. Which of the following would NOT cause elevated CVP readings?

19. Which nerve is best to monitor on train of four in order to assess for intubating conditions?

20. What does the ‘a’ wave in a CVP waveform represent?

21. What does the ‘y’ descent represent in a CVP waveform?

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?

23. When properly placing a BIS monitor on a patient, where should electrode #1 be placed?

24. Sole reliance of BIS for intraoperative management can:

25. What would be an appropriate BIS value to maintain during maintenance of anesthesia?

26. The Maximal Oscillation during oscillometry correlates to…

27. How will an increase in your EMG tone affect your BIS reading?

28. What percentage of blockade is necessary to facilitate intubation?

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?

30. What changes to your CVP would you expect to see on a patient with atrial fibrillation?

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:

32. What do you predict will be the effect of intubation on BIS, BP & heart rate?

33. You are inserting a PA lin. Where is your catheter located when you see the #1 waveform?

34. Which of the following BIS readings indicates a moderate hypnotic state?

35. What does the ‘v’ wave represent in a CVP waveform?

36. When a patient experiences deliberate recollection of events it is known as….

37. If your paralyzed OR patient has 1 full twitch and that’s it, how many receptors are blocked?

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?

39. What is an appropriate cuff size?

40. Electrocautery will NOT interfere with the arterial pressure waveform.

41. Which of the following is not an indication for a central line?

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?

43. What does the ‘c’ wave in a CVP waveform represent?

44. Where should the CVP catheter be when inserted properly?

45. What is the normal range for CVP readings?

46. Blood Flow is ______ and governed by _____ law.

47. When interpreting an arterial waveform you notice that the dicrotic notch is very low on the down slope. What does this mean?

48. During periods of rest, there is ______ Potassium outside the cell then in the cell.

49. What is an appropriate intubating dose of Vecuronium?

50. What would be an appropriate intubating dose of succinylcholine for a 41 yr old female weighing 75 kg?

51. Which of the following would NOT be an indication for invasive arterial monitoring?

52. CVP pressure reflects pressure in the __________ in a normal heart.

53. BIS monitoring effectively prevents awareness

54. The most common cause of intraop recall is:

55. At which BIS value would you see an isoelectric EEG?

56. Which nerve is best to monitor on your train of four in order assess for extubation adequacy?

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?

58. Which one of the following statements is most correct regarding timing of the CVP/ right atrial pressure waves with ECG tracing?

59. Methods to reduce intraop recall include all of the following except:

60. What would be considered a normal SVO2?

61. The benefits of using BIS include all of the following except:

62. Which of the following would only need to bind to 1 of the alpha subunits in order to exert its intended effect?

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?

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?

65. Depolarizing muscle relaxing agents may be reversed using an anticholinesterase drug given with an anticholinergic agent.

66. In a phase 1 block of Succinocholine what would you expect to see on the TOF?

67. If you place your twitch monitor leads over the ulnar nerve and you see finger flexion, what does that mean?

68. Which one of the following statements about hemodynamic waveforms is most correct?

69. When waking the patient at the end of surgery, you should reverse your muscle relaxation prior to decreasing your anesthetic.

70. In a phase 2 block of Succinocholine what would you expect to see on the TOF?

71. A negative Allen’s test indicates there is no collateral blood flow and is an absolute contraindication to a radial artery arterial line.

72. You are planning to insert an arterial line on a 68 yr old male. What technique would you choose to insert the line?

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?

74. There is an increased risk in the intraoperative recall in all of the following cases except:

75. Which of the following patients would not be at an increased risk for intra-operative recall?

76. Which of the following is NOT one of the 5 glycoprotein subunits on nicotinic receptors?

77. Which of the following is not an adverse effect associated with non-invasive BP monitoring?

78. Which of the following will not cause an increase in Pulmonary Artery Pressure?

2.

You are inserting a PA lin. Where is your catheter located when you see the #3 waveform?

6.

You are inserting a PA lin. Where is your catheter located when you see the #4 waveform?

12.

You are inserting a PA lin. Where is your catheter located when you see the #2 waveform?

14. You have attempted a radial arterial line on Mrs. Holten and have not been successful. What site should be your 2^nd choice for an arterial line?

33.

You are inserting a PA lin. Where is your catheter located when you see the #1 waveform?

46. Blood Flow is __ and governed by _ law.

82. Pressure is peripherally than it is centrally. Velocity is _ peripherally than it is centrally.