Quiz On Information Technology With Question And Answer

116 Questions

Settings
Please wait...
Quiz On Information Technology With Question And Answer

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 Information Technology to give you an insight into what makes your computer run smoothly as it should.


Questions and Answers
  • 1. 
    If video does not load click here or open in another window. http://www.youtube.com/watch?v=xpcUxwpOQ_A
    • A. 

      What in the *HELL* was that?

    • B. 

      Awe, I love Beaker.

    • C. 

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

    • D. 

      All the above.

  • 2. 
    Which of the following is the preferred method of measuring BP during surgery?
    • A. 

      Auscultation

    • B. 

      Arterial Tonometry

    • C. 

      Arterial Line

    • D. 

      Oscillometry

  • 3. 
    The Maximal Oscillation during oscillometry correlates to…
    • A. 

      Mean Arterial pressure

    • B. 

      Systolic BP

    • C. 

      Diastolic BP

    • D. 

      Ventricular Contractility

  • 4. 
    What is an appropriate cuff size?
    • A. 

      Equal to diameter of arm

    • B. 

      70-80% of arm diameter

    • C. 

      20-50% greater than the diameter of arm

    • D. 

      Twice arm diameter

  • 5. 
    Which of the following is not an adverse effect associated with non-invasive BP monitoring?
    • A. 

      Compartment Syndrome

    • B. 

      Sciatic Nerve Parasthesia

    • C. 

      Thrombophlebitis

    • D. 

      Limb edema & pain

  • 6. 
    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?
    • A. 

      Immediately start CPR, the patient must be in PEA.

    • B. 

      Send someone to go get another BP cuff for you.

    • C. 

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

    • D. 

      Insert a central line.

  • 7. 
    Pressure is ______ peripherally than it is centrally.  Velocity is  _______ peripherally than it is centrally.
    • A. 

      Lower, lower

    • B. 

      Higher, higher

    • C. 

      Lower, higher

    • D. 

      Higher, lower

  • 8. 
    Blood Flow is ______ and governed by _____ law.
    • A. 

      Laminar, Poiseiulles

    • B. 

      Turbulent, Renolds

    • C. 

      Mixed, Poiseiulles

    • D. 

      Determined by gradients, Ficks

  • 9. 
    Which of the following vessels would have the highest measured pressure?
    • A. 

      Aorta

    • B. 

      Femoral

    • C. 

      Subclavian

    • D. 

      Radial

  • 10. 
    Which of the following would NOT be an indication for invasive arterial monitoring?
    • A. 

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

    • B. 

      Need for multiple ABG’s and labs during case.

    • C. 

      Severe hypertension

    • D. 

      Anticipation of wide blood pressure swings

  • 11. 
    A negative Allen’s test indicates there is no collateral blood flow and is an absolute contraindication to a radial artery arterial line. 
    • A. 

      True

    • B. 

      False

  • 12. 
    Which site is most frequently used for arterial lines?
    • A. 

      Femoral

    • B. 

      Ulnar

    • C. 

      Brachial

    • D. 

      Radial

  • 13. 
    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?
    • A. 

      Brachial

    • B. 

      Femoral

    • C. 

      Subclavian

    • D. 

      Jugular

  • 14. 
    Which invasive arterial monitoring site carries the greatest risk of hematoma and is accessible in low-flow states?
    • A. 

      Brachial

    • B. 

      Femoral

    • C. 

      Radial

    • D. 

      Ulnar

  • 15. 
    Electrocautery will NOT interfere with the arterial pressure waveform.
    • A. 

      True

    • B. 

      False

  • 16. 
    When interpreting an arterial waveform you notice that the dicrotic notch is very low on the down slope. What does this mean?
    • A. 

      The line is inserted improperly and needs to be adjusted

    • B. 

      The patient may be hypertensive.

    • C. 

      The patient may have a very low SVR.

    • D. 

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

  • 17. 
    You are planning to insert an arterial line on a 68 yr old male. What technique would you choose to insert the line?
    • A. 

      Strain Gauge Technique

    • B. 

      High Anterior technique

    • C. 

      Wheatstone technique

    • D. 

      Seldinger Technique

  • 18. 
    If your arterial line is overdampened….
    • A. 

      Your MAP will still be relatively accurate

    • B. 

      You diastolic BP will be underestimated

    • C. 

      Your systolic BP will be overestimated

    • D. 

      You will have unusually high pressure readings.

  • 19. 
    Which of the following is not an indication for a central line?
    • A. 

      Acute burn patient with need for aggressive fluid management

    • B. 

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

    • C. 

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

    • D. 

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

  • 20. 
    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?
    • A. 

      Left Internal Jugular

    • B. 

      Right Femoral

    • C. 

      Right Internal Jugular

    • D. 

      Left Subclavian

  • 21. 
    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?
    • A. 

      First, obtain a blow gun. Then standing far enough away where the patient can’t see or attempt to hit you, insert a dart into the gun…. Aim at his neck…. And BLOW.

    • B. 

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

    • C. 

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

    • D. 

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

  • 22. 
    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?
    • A. 

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

    • B. 

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

    • C. 

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

    • D. 

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

  • 23. 
    What does the ‘a’ wave in a CVP waveform represent?
    • A. 

      Atrial pressure during contraction

    • B. 

      Bulging tricuspid, early ventricular contraction

    • C. 

      Tricuspid valve opening during diastole

    • D. 

      Venous return(atrium filling) against a closed tricuspid valve

  • 24. 
    What does the ‘c’ wave in a CVP waveform represent?
    • A. 

      Atrial pressure during contraction

    • B. 

      Bulging tricuspid, early ventricular contraction

    • C. 

      Tricuspid valve opening during diastole

    • D. 

      Venous return(atrium filling) against a closed tricuspid valve

  • 25. 
    What does the ‘x’ descent in a CVP waveform represent?
    • A. 

      Downward movement of the ventrical during systole

    • B. 

      Bulging tricuspid, early ventricular contraction

    • C. 

      Tricuspid valve opening during diastole

    • D. 

      Venous return(atrium filling) against a closed tricuspid valve

  • 26. 
    What does the ‘v’ wave represent in a CVP waveform?
    • A. 

      Atrial pressure during contraction

    • B. 

      Bulging tricuspid, early ventricular contraction

    • C. 

      Tricuspid valve opening during diastole

    • D. 

      Venous return(atrium filling) against a closed tricuspid valve

  • 27. 
    What does the ‘y’ descent represent in a CVP waveform?
    • A. 

      Downward movement of the ventrical during systole

    • B. 

      Bulging tricuspid, early ventricular contraction

    • C. 

      Tricuspid valve opening during diastole

    • D. 

      Venous return(atrium filling) against a closed tricuspid valve

  • 28. 
    Where should the CVP catheter be when inserted properly?
    • A. 

      In the Right Atrium

    • B. 

      At junction of superior vena cava

    • C. 

      In the pulmonary artery

    • D. 

      In the radial artery

  • 29. 
    CVP pressure reflects pressure in the __________ in a normal heart.
    • A. 

      Right Atrium

    • B. 

      Left Atrium

    • C. 

      Right Ventricle

    • D. 

      Left Ventricle

  • 30. 
    Which of the following is a complication associated only with PA lines, but not CVP lines?
    • A. 

      Pneumothorax

    • B. 

      Complete heart block in pts with Left BBB.

    • C. 

      Cardiac Perforation

    • D. 

      Air Embolism

  • 31. 
    What would be considered a normal SVO2?
    • A. 

      60%

    • B. 

      90%

    • C. 

      75%

    • D. 

      100%

  • 32. 
    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?
    • A. 

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

    • B. 

      Start a dopamine drip

    • C. 

      Start a nitro drip

    • D. 

      Give some lasix

  • 33. 
    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?
    • A. 

      RV failure, give vasodilators

    • B. 

      LV failure, give inotropes.

    • C. 

      Pulmonary edema, give diuretics

    • D. 

      Hypervolemia, give diuretics

  • 34. 
    What is the normal range for CVP readings?
    • A. 

      0-3 mm HG

    • B. 

      5-10 mm HG

    • C. 

      12-18 mm HG

    • D. 

      15-30 mm HG

  • 35. 
    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?
    • A. 

      Nothing, these values are fine.

    • B. 

      Pt has LV failure, give inotropes.

    • C. 

      Pt is hypovolemic, give volume

    • D. 

      Pt is in RV failure, give vasodilators.

  • 36. 
    When inserting a PA catheter, at approximately what distance would you inflate your balloon?
    • A. 

      30 cm

    • B. 

      50 cm

    • C. 

      10 cm

    • D. 

      20 cm

  • 37. 
    Which of the following would NOT cause elevated CVP readings?
    • A. 

      Hypovolemia

    • B. 

      Cardiac Tamponade

    • C. 

      Pulmonary HTN

    • D. 

      Chronic LV failure

  • 38. 
    What changes to your CVP would you expect to observe on a patient with complete AV block?
    • A. 

      Loss of A waves

    • B. 

      Giant Cannon A waves

    • C. 

      Larger V waves

    • D. 

      Loss of C waves

  • 39. 
    What changes to your CVP would you expect to see on a patient with mitral regurgitation?
    • A. 

      Loss of A waves

    • B. 

      Giant Cannon A waves

    • C. 

      Larger V waves

    • D. 

      Loss of C waves

  • 40. 
    What changes to your CVP would you expect to see on a patient with atrial fibrillation?
    • A. 

      Loss of A waves

    • B. 

      Giant Cannon A waves

    • C. 

      Larger V waves

    • D. 

      Loss of C waves

  • 41. 
    Which of the following is true regarding Zone III, where we would like to have our PA catheters placed? (More than one answer)
    • A. 

      Pulm Venous Pressure > alveolar pressure > PAP

    • B. 

      PAP > Pulm venous pressure > Alveolar pressure

    • C. 

      Physiologically, not anatomically, defined so it can change.

    • D. 

      Located in Pulmonary Vein

    • E. 

      Alveolar pressure > PAP > pulm venous pressure

  • 42. 
    Which of the following will not cause an increase in Pulmonary Artery Pressure? 
    • A. 

      Left Ventricular failure

    • B. 

      Mitral Regurge

    • C. 

      Pulmonary HTN

    • D. 

      Ischemia

  • 43. 
    Which one of the following statements is most correct regarding timing of the CVP/ right atrial pressure waves with ECG tracing?
    • A. 

      The v wave occurs at the RST junction

    • B. 

      The a wave occurs just after the P wave

    • C. 

      The v wave occurs at the end of the QRS complex

    • D. 

      The c wave occurs after the T wave

  • 44. 
       Which one of the following is the most characteristic difference between right ventricular (RV) waveform and the pulmonary artery (PA) waveform?
    • A. 

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

    • B. 

      The RV diastolic and PA systolic pressure are similar

    • C. 

      The RV diastolic pressure is lower than the PA diastolic pressure

    • D. 

      The mean RV pressure is higher than the mean PA pressure

  • 45. 
    Which one of the following statements about the pulmonary artery occlusion pressure (PAOP) is most correct?
    • A. 

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

    • B. 

      Inflation of the balloon momentarily stops the flow of blood and creates a static column of blood between the tip of the catheter and the right atrium

    • C. 

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

    • D. 

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

  • 46. 
        Which of the following statements about measurement of the pulmonary artery occlusion pressure is most correct?
    • A. 

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

    • B. 

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

    • C. 

      “Overwedging” can only occur with excessive balloon inflation

    • D. 

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

  • 47. 
      Which one of the following statements about hemodynamic waveforms is most correct?
    • A. 

      Hemodynamic pressures rise during inspiration in a patient breathing spontaneously

    • B. 

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

    • C. 

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

    • D. 

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

  • 48. 
    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?
    • A. 

      Increase CVP, CI, PCWP, & PAP

    • B. 

      Increase CVP. Decrease CI, PCWP, & PAP

    • C. 

      Increase CVP, PCWP, & PAP. Decrease CI.

    • D. 

      Decrease CVP, CI, PCWP, & PAP

  • 49. 
    What it is an appropriate range for PCWP readings?
    • A. 

      15-25

    • B. 

      5-15

    • C. 

      0-5

    • D. 

      25-40

  • 50. 
    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?
    • A. 

      He most likely has right ventricular failure.

    • B. 

      He is hypervolemic.

    • C. 

      He is hypovolemic.

    • D. 

      He most likely has left ventricular failure.

  • 51. 
    BIS monitoring effectively prevents awareness
    • A. 

      True

    • B. 

      False

  • 52. 
    When properly placing a BIS monitor on a patient, where should electrode #1 be placed?
    • A. 

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

    • B. 

      At the patients temple, level with their eye

    • C. 

      Directly above the patients eyebrow.

    • D. 

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

  • 53. 
    When properly placing a BIS monitor on a patient, where should electrode #4 be placed?
    • A. 

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

    • B. 

      At the patients temple, level with their eye

    • C. 

      Directly above the patients eyebrow.

    • D. 

      Adjacent to electrode #1

  • 54. 
    The BIS monitor measures:
    • A. 

      Anesthetic depth

    • B. 

      Consciousness/Memory function

    • C. 

      Effects of anesthetics in the brain

    • D. 

      Relationship between patient and drug, which is dependent on dose

  • 55. 
    Which of the following methods is useful to use for anesthetic titration:
    • A. 

      Hemodynamic response

    • B. 

      ETCO2

    • C. 

      BIS

    • D. 

      Knowledge and expectation of drug response

    • E. 

      All of the above

  • 56. 
    The benefits of using BIS include all of the following except:
    • A. 

      Reduced PONV

    • B. 

      Fast wakeup/extubation

    • C. 

      Early discharge from PACU

    • D. 

      Prevents anesthetic awareness

  • 57. 
    The state in which you are in a moderate hypnotic state with low probability of consciousness is
    • A. 

      60-70

    • B. 

      40-60

    • C. 

      70-100

    • D. 

      0-40

  • 58. 
    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:
    • A. 

      Artifact and need to trouble shoot machine

    • B. 

      Effects of the medications are alternating the BIS readings

    • C. 

      Abnormal response to sequence of induction

    • D. 

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

  • 59. 
     The most frequent source of EEG contamination is:
    • A. 

      Signal quality index

    • B. 

      BIS number

    • C. 

      Electromyogram activity

    • D. 

      Suppression ratio

  • 60. 
    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:
    • A. 

      EMG activity is present during awake states

    • B. 

      EMG activity is present during emergence

    • C. 

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

    • D. 

      All of the above

  • 61. 
    Sole reliance of BIS for intraoperative management can:
    • A. 

      Reduce awareness

    • B. 

      Improve anesthetic plan/course

    • C. 

      Improve recovery times

    • D. 

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

  • 62. 
    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:
    • A. 

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

    • B. 

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

    • C. 

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

    • D. 

      Patient is responding normally and you failed to give sufficient hypnotics

  • 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?
    • A. 

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

    • B. 

      Check TOF and redose his muscle relaxant to 0/4

    • C. 

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

    • D. 

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

  • 64. 
    The 2 types of intraoperative recall are:
    • A. 

      Internal/External

    • B. 

      Implicit/Explicit

    • C. 

      Implied/Replied

    • D. 

      Instinct/Distinct

  • 65. 
    Methods to reduce intraop recall include all of the following except:
    • A. 

      Keep BIS 40-60

    • B. 

      Refill vaporizers after every case

    • C. 

      Perform leak check only in the morning

    • D. 

      Vigilantly monitor your patient

  • 66. 
    The most common cause of intraop recall is:
    • A. 

      Unknown reason

    • B. 

      Faulty equipment

    • C. 

      Anesthetic technique

    • D. 

      Empty Vaporizer

  • 67. 
    There is an increased risk in the intraoperative recall in all of the following cases except:
    • A. 

      Craniotomy because surgeon’s like these patients light

    • B. 

      OB because of a decrease in MAC requirements

    • C. 

      Trauma because of hemodynamic instability

    • D. 

      Bypass because of hemodilution

  • 68. 
      What would be an appropriate BIS value to maintain during maintenance of anesthesia?
    • A. 

      100

    • B. 

      30

    • C. 

      70

    • D. 

      50

  • 69. 
    At which BIS value would you see an isoelectric EEG?
    • A. 

      0

    • B. 

      20

    • C. 

      30

    • D. 

      40

  • 70. 
    What do you predict will be the effect of intubation  on BIS, BP & heart rate?
    • A. 

      Increase BP & HR, BIS may or may not increase

    • B. 

      BIS will not change, BP and HR will increase

    • C. 

      BIS will increase, BP and HR will stay same

    • D. 

      BIS will increase, BP & HR will decrease

  • 71. 
    During emergence, the patient will typically become responsive and open their eyes above what BIS level?
    • A. 

      60

    • B. 

      80

    • C. 

      70

    • D. 

      100

  • 72. 
    Which of the following patients would not be at an increased risk for intra-operative recall?
    • A. 

      27 yr old female having a c-section

    • B. 

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

    • C. 

      63 yr old male undergoing bronchoscopy

    • D. 

      36 yr old female having resection of brain tumor.

  • 73. 
    When waking the patient at the end of surgery, you should reverse your muscle relaxation prior to decreasing your anesthetic.
    • A. 

      True

    • B. 

      False

  • 74. 
    What BIS reading would indicate your patient is in a light hypnotic state?
    • A. 

      68

    • B. 

      92

    • C. 

      45

    • D. 

      23

  • 75. 
    Which of the following reading indicates a deep hypnotic state?
    • A. 

      68

    • B. 

      23

    • C. 

      92

    • D. 

      45

  • 76. 
    Which of the following BIS readings indicates a moderate hypnotic state?
    • A. 

      68

    • B. 

      23

    • C. 

      45

    • D. 

      92

  • 77. 
    How will an increase in your EMG tone affect your BIS reading?
    • A. 

      It will cause a decrease in BIS readings.

    • B. 

      It will not effect your readings.

    • C. 

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

    • D. 

      It will cause an increase in your BIS readings.

  • 78. 
    When a patient experiences deliberate recollection of events it is known as….
    • A. 

      Explicit recall

    • B. 

      Implicit recall

    • C. 

      External recall

    • D. 

      Internal recall

  • 79. 
    In which of the following areas would the muscles have the most nerves?
    • A. 

      Back

    • B. 

      Hands

    • C. 

      Knees

    • D. 

      Neck

  • 80. 
    During periods of rest, there is ______ Potassium outside the cell then in the cell.
    • A. 

      Less

    • B. 

      Equal

    • C. 

      More

  • 81. 
    Which of the following is NOT one of the 5 glycoprotein subunits on nicotinic receptors?
    • A. 

      Alpha

    • B. 

      Beta

    • C. 

      Gamma

    • D. 

      Kappa

    • E. 

      Delta

  • 82. 
    Which of the following would only need to bind to 1 of the alpha subunits in order to exert its intended effect?
    • A. 

      Vecuronium

    • B. 

      Acetylcholine

    • C. 

      Succinylcholine

    • D. 

      All of the above

  • 83. 
    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?
    • A. 

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

    • B. 

      I am in Phase 1 block.

    • C. 

      I am in Phase 2 block

    • D. 

      Depolarizing muscle relaxants do not produce Phased blocks.

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

      Antagonized by anticholinesterase drugs

    • B. 

      Will not produce Fade on TOF monitoring

    • C. 

      Intubation facilitated at 95% blockade

    • D. 

      Can decrease fasciculation cause by depolarizing agents

  • 85. 
    Depolarizing muscle relaxing agents may be reversed using an anticholinesterase drug given with an anticholinergic agent. 
    • A. 

      True

    • B. 

      False

  • 86. 
    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?
    • A. 

      75%

    • B. 

      90%

    • C. 

      85%

    • D. 

      95%

  • 87. 
    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?
    • A. 

      75%

    • B. 

      95%

    • C. 

      85%

    • D. 

      90%

  • 88. 
    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?
    • A. 

      95%

    • B. 

      99%

    • C. 

      90%

    • D. 

      75%

  • 89. 
    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?
    • A. 

      Only R4 needs to be decreased

    • B. 

      All twitches need to be absent or decreased.

    • C. 

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

    • D. 

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

  • 90. 
    For surgical relaxation to be appreciated you must have how many of your twitches on train on four decreased?
    • A. 

      Only R4 needs to be decreased

    • B. 

      All twitches need to be absent or decreased.

    • C. 

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

    • D. 

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

  • 91. 
    What percentage of blockade is necessary to facilitate intubation?
    • A. 

      75%

    • B. 

      99%

    • C. 

      90%

    • D. 

      95%

  • 92. 
    What is likely to occur as a result of checking your twitches too frequently?
    • A. 

      You will get a falsely higher reading on your TOF

    • B. 

      Patient will most likely develop parasthesia

    • C. 

      You will get a falsely lower reading

    • D. 

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

  • 93. 
    Which nerve is best to monitor on train of four in order to assess for intubating conditions?
    • A. 

      Adductor Pollicis

    • B. 

      Orbicularis Oculi

    • C. 

      Posterior Tibial Nerve

    • D. 

      All are equally good options

  • 94. 
    Which nerve is best to monitor on your train of four in order assess for extubation adequacy?
    • A. 

      Orbicularis Oculi

    • B. 

      Adductor Pollicis

    • C. 

      Posterior Tibial Nerve

    • D. 

      All are equally good options

  • 95. 
    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?
    • A. 

      No, non-depolarizers do not require reversal

    • B. 

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

    • C. 

      Yes, patient may still be up to 75% blocked

  • 96. 
    Which of the following is a not a non-depolarizing muscle relaxant?
    • A. 

      Rocuronium

    • B. 

      Mivacurium

    • C. 

      Succinylcholine

    • D. 

      Vecuronium

  • 97. 
    What is an appropriate intubating dose of Succinylcholine?
    • A. 

      1-1.5 mg/kg

    • B. 

      .08-0.1 mg/kg

    • C. 

      0.6-1.2 mg/kg

    • D. 

      0.15-0.2 mg/kg

    • E. 

      0.4-0.5 mg/kg

  • 98. 
    What is an appropriate intubating dose of Vecuronium?
    • A. 

      1-1.5 mg/kg

    • B. 

      .08-0.1 mg/kg

    • C. 

      0.6-1.2 mg/kg

    • D. 

      0.15-0.2 mg/kg

    • E. 

      0.4-0.5 mg/kg

  • 99. 
    What would be an appropriate intubating dose of vecuronium for a 65 yr old male weighing 85 kg?
    • A. 

      120 mg

    • B. 

      17 mg

    • C. 

      170 mg

    • D. 

      8.5 mg

  • 100. 
    What would be an appropriate intubating dose of succinylcholine for a 41 yr old female weighing 75 kg?
    • A. 

      110 mg

    • B. 

      8 mg

    • C. 

      150 mg

    • D. 

      16 mg

  • 101. 
    What would you use to reverse the muscle relaxant effects of depolarizing muscle relaxants?
    • A. 

      Neostigmine alone.

    • B. 

      Neostigmine & glycopyrolate

    • C. 

      Mivacurium

    • D. 

      Just wait it out, these agents can not be reversed

  • 102. 
    If your paralyzed OR patient has 1 full twitch and that’s it, how many receptors are blocked?
    • A. 

      75%

    • B. 

      75-80%

    • C. 

      85%

    • D. 

      90%

    • E. 

      99%

  • 103. 
    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?
    • A. 

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

    • B. 

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

    • C. 

      Reparalyze the patient

    • D. 

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

  • 104. 
    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?
    • A. 

      0/4

    • B. 

      1/4

    • C. 

      2/4

    • D. 

      3/4

    • E. 

      4/4

  • 105. 
    When you are using the tetanus button, how long do you depress it?
    • A. 

      For 2 seconds

    • B. 

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

    • C. 

      5 seconds

    • D. 

      Just a quick press of the button

  • 106. 
    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?
    • A. 

      0/4

    • B. 

      1/4

    • C. 

      2/4

    • D. 

      3/4

    • E. 

      4/4

  • 107. 
    In a phase 1 block of Succinocholine what would you expect to see on the TOF?
    • A. 

      4/4, but decreased amplitude

    • B. 

      0/4, no twitches

    • C. 

      2/4 with a fade

    • D. 

      1/4 because it’s a short acting relaxant

  • 108. 
    In a phase 2 block of Succinocholine what would you expect to see on the TOF?
    • A. 

      4/4, but decreased amplitude

    • B. 

      0/4, no twitches

    • C. 

      4/4, with strong twitches

    • D. 

      2/4, with fade

  • 109. 
    If you place your twitch monitor leads over the ulnar nerve and you see finger flexion, what does that mean?
    • A. 

      You are in the right spot

    • B. 

      You are stimulating the median nerve instead of the ulnar

    • C. 

      The patient needs more muscle relaxant

    • D. 

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

  • 110. 
        When you place your twitch monitor leads on the lateral side of the patient’s face, which muscle are you wanting to stimulate?
    • A. 

      Ulnar

    • B. 

      Orbicularis Oculi

    • C. 

      Flexor Hallucis

    • D. 

      Adductor Pollicis

  • 111. 
    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?
    • A. 

      Orbicularis oculi and then flexor hallucis

    • B. 

      Flexor hallucis and then ulnar

    • C. 

      Orbicularis oculi and then adductor pollicis

    • D. 

      Ulnar and then flexor hallucis

    • E. 

      Ulnar and then orbicularis oculi

  • 112. 
    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?
    • A. 

      Up to 75%

    • B. 

      Up to 50%

    • C. 

      Up to 33%

    • D. 

      None will be blocked.

  • 113. 
    You are inserting a PA lin. Where is your catheter located when you see the #1 waveform?
    • A. 

      Right Ventricle

    • B. 

      Pulmonary Artery

    • C. 

      Right Atrium

    • D. 

      Too far in, producing a wedge pressure

  • 114. 
    You are inserting a PA lin. Where is your catheter located when you see the #2 waveform?
    • A. 

      Right Ventricle

    • B. 

      Too far in, producing a wedge pressure

    • C. 

      Right Atrium

    • D. 

      Pulmonary artery

  • 115. 
    You are inserting a PA lin. Where is your catheter located when you see the #3 waveform?
    • A. 

      Right Atrium

    • B. 

      Pulmonary Artery

    • C. 

      Too far in, producing a wedge pressure

    • D. 

      Right Ventricle

  • 116. 
    You are inserting a PA lin. Where is your catheter located when you see the #4 waveform?
    • A. 

      Too far in, producing a wedge pressure

    • B. 

      Right Ventricle

    • C. 

      Pulmonary Artery

    • D. 

      Right Atrium