Technology General Knowledge Quiz With Questions And Answers

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1. Which site is most frequently used for arterial lines?
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2. Which of the following is a not a non-depolarizing muscle relaxant?
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3. What is an appropriate intubating dose of Succinylcholine?
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4. What does the ‘a’ wave in a CVP waveform represent?
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5. Which of the following methods is useful to use for anesthetic titration:
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6. 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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7. What would be an appropriate intubating dose of succinylcholine for a 41 yr old female weighing 75 kg?
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8.

You are inserting a PA lin. Where is your catheter located when you see the #2 waveform?
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9.

You are inserting a PA lin. Where is your catheter located when you see the #3 waveform?
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10. 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?
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11. 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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12. What is the normal range for CVP readings?
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13. Sole reliance of BIS for intraoperative management can:
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14.     When you place your twitch monitor leads on the lateral side of the patient’s face, which nerve are you wanting to stimulate?
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15. What do you predict will be the effect of intubation  on BIS, BP & heart rate?
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16. During periods of rest, there is ______ Potassium outside the cell then in the cell.
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17. Which nerve is best to monitor on your train of four in order assess for extubation adequacy?
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18. What would be an appropriate intubating dose of vecuronium for a 65 yr old male weighing 85 kg?
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19. 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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20. Which invasive arterial monitoring site carries the greatest risk of hematoma and is accessible in low-flow states?
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21.   What would be an appropriate BIS value to maintain during maintenance of anesthesia?
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22.

You are inserting a PA lin. Where is your catheter located when you see the #1 waveform?
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23. 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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24. The 2 types of intraoperative recall are:
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25. Which nerve is best to monitor on train of four in order to assess for intubating conditions?
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26.

You are inserting a PA lin. Where is your catheter located when you see the #4 waveform?
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27. 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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28. CVP pressure reflects pressure in the __________ in a normal heart.
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29. Which of the following would NOT cause elevated CVP readings?
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30. When properly placing a BIS monitor on a patient, where should electrode #1 be placed?
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31. How will an increase in your EMG tone affect your BIS reading?
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32. Depolarizing muscle relaxing agents may be reversed using an anticholinesterase drug given with an anticholinergic agent. 
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33. 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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34. When waking the patient at the end of surgery, you should reverse your muscle relaxation prior to decreasing your anesthetic.
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35. Which of the following BIS readings indicates a moderate hypnotic state?
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36. When a patient experiences deliberate recollection of events it is known as….
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37. 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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38. Which of the following is not an adverse effect associated with non-invasive BP monitoring?
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39. 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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40. 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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41. At which BIS value would you see an isoelectric EEG?
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42. What would you use to reverse the muscle relaxant effects of depolarizing muscle relaxants?
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43. The Maximal Oscillation during oscillometry correlates to…
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44. What changes to your CVP would you expect to see on a patient with atrial fibrillation?
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45. What BIS reading would indicate your patient is in a light hypnotic state?
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46. 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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47. In a phase 1 block of Succinocholine what would you expect to see on the TOF?
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48. 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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49. 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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50. What does the ‘v’ wave represent in a CVP waveform?
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51. Which of the following is NOT one of the 5 glycoprotein subunits on nicotinic receptors?
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52. Which of the following will not cause an increase in Pulmonary Artery Pressure? 
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53. If you place your twitch monitor leads over the ulnar nerve and you see finger flexion, what does that mean?
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54. The most common cause of intraop recall is:
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55. Which of the following is NOT true regarding non-depolarizing muscle relaxants?
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56. What percentage of blockade is necessary to facilitate intubation?
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57. What does the ‘c’ wave in a CVP waveform represent?
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58. What does the ‘y’ descent represent in a CVP waveform?
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59. Pressure is ______ peripherally than it is centrally.  Velocity is  _______ peripherally than it is centrally.
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60. Electrocautery will NOT interfere with the arterial pressure waveform.
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61.  The most frequent source of EEG contamination is:
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62. In a phase 2 block of Succinocholine what would you expect to see on the TOF?
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63.
Which of the following is the preferred method of measuring BP during surgery?
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64. Which of the following is not an indication for a central line?
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65. Where should the CVP catheter be when inserted properly?
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66. 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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67. Methods to reduce intraop recall include all of the following except:
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68. What would be considered a normal SVO2?
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69. There is an increased risk in the intraoperative recall in all of the following cases except:
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70. Which of the following would NOT be an indication for invasive arterial monitoring?
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71. Which of the following is a complication associated only with PA lines, but not CVP lines?
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72. During emergence, the patient will typically become responsive and open their eyes above what BIS level?
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73. 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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74. If your arterial line is overdampened….
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75. 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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76. In which of the following areas would the muscles have the most nerves?
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77. Which of the following patients would not be at an increased risk for intra-operative recall?
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78. What is an appropriate cuff size?
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79. Blood Flow is ______ and governed by _____ law.
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80. The state in which you are in a moderate hypnotic state with low probability of consciousness is
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81.    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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82. 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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83. 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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84. 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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85. What is likely to occur as a result of checking your twitches too frequently?
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86.   Which one of the following statements about hemodynamic waveforms is most correct?
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87. 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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88. 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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89. The benefits of using BIS include all of the following except:
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90. 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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91. 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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92. 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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93. What it is an appropriate range for PCWP readings?
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94. 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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95. Which of the following reading indicates a deep hypnotic state?
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96. 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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97. 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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98. When inserting a PA catheter, at approximately what distance would you inflate your balloon?
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99. When properly placing a BIS monitor on a patient, where should electrode #4 be placed?
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100. 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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101. If your paralyzed OR patient has 1 full twitch and that’s it, how many receptors are blocked?
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102. 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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103. What does the ‘x’ descent in a CVP waveform represent?
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104. What changes to your CVP would you expect to see on a patient with mitral regurgitation?
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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. The BIS monitor measures:
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107. 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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108. What changes to your CVP would you expect to observe on a patient with complete AV block?
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109. Which one of the following statements about the pulmonary artery occlusion pressure (PAOP) is most correct?
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110. 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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111. 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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112.     Which of the following statements about measurement of the pulmonary artery occlusion pressure is most correct?
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113. When you are using the tetanus button, how long do you depress it?
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Which site is most frequently used for arterial lines?
Which of the following is a not a non-depolarizing muscle relaxant?
What is an appropriate intubating dose of Succinylcholine?
What does the ‘a’ wave in a CVP waveform represent?
Which of the following methods is useful to use for anesthetic...
You are currently the SRNA for Mr. Blook.  You used vecuronium...
What would be an appropriate intubating dose of succinylcholine for a...
You are inserting a PA lin. Where is your catheter located when you...
You are inserting a PA lin. Where is your catheter located when you...
You are in the OR with a exploratory laparotomy patient who you gave...
You are being pimped at clinical by a nasty CRNA.  They want you...
What is the normal range for CVP readings?
Sole reliance of BIS for intraoperative management can:
    When you place your twitch monitor leads on the...
What do you predict will be the effect of intubation  on BIS, BP...
During periods of rest, there is ______ Potassium outside the cell...
Which nerve is best to monitor on your train of four in order assess...
What would be an appropriate intubating dose of vecuronium for a 65 yr...
You are in the middle of a knee arthroscopy when your BP...
Which invasive arterial monitoring site carries the greatest risk of...
  What would be an appropriate BIS value to maintain during...
You are inserting a PA lin. Where is your catheter located when you...
You are caring for Mr. Stink-eye, who has a PA line. You notice an...
The 2 types of intraoperative recall are:
Which nerve is best to monitor on train of four in order to assess for...
You are inserting a PA lin. Where is your catheter located when you...
What would be your preferred site of insertion for a CVP line on a...
CVP pressure reflects pressure in the __________ in a normal heart.
Which of the following would NOT cause elevated CVP readings?
When properly placing a BIS monitor on a patient, where should...
How will an increase in your EMG tone affect your BIS reading?
Depolarizing muscle relaxing agents may be reversed using an...
You are caring for a pt undergoing an extensive bowel resection. On...
When waking the patient at the end of surgery, you should reverse your...
Which of the following BIS readings indicates a moderate hypnotic...
When a patient experiences deliberate recollection of events it is...
Which of the following would only need to bind to 1 of the alpha...
Which of the following is not an adverse effect associated with...
A negative Allen’s test indicates there is no collateral blood flow...
You are in the middle of your case and BIS has been running in the...
At which BIS value would you see an isoelectric EEG?
What would you use to reverse the muscle relaxant effects of...
The Maximal Oscillation during oscillometry correlates to…
What changes to your CVP would you expect to see on a patient with...
What BIS reading would indicate your patient is in a light hypnotic...
You have just given your patient succinycholine and find they have 4/4...
In a phase 1 block of Succinocholine what would you expect to see on...
You have attempted a radial arterial line on Mrs. Holten and have not...
When interpreting an arterial waveform you notice that the dicrotic...
What does the ‘v’ wave represent in a CVP waveform?
Which of the following is NOT one of the 5 glycoprotein subunits on...
Which of the following will not cause an increase in Pulmonary Artery...
If you place your twitch monitor leads over the ulnar nerve and you...
The most common cause of intraop recall is:
Which of the following is NOT true regarding non-depolarizing muscle...
What percentage of blockade is necessary to facilitate intubation?
What does the ‘c’ wave in a CVP waveform represent?
What does the ‘y’ descent represent in a CVP waveform?
Pressure is ______ peripherally than it is centrally.  Velocity...
Electrocautery will NOT interfere with the arterial pressure waveform.
 The most frequent source of EEG contamination is:
In a phase 2 block of Succinocholine what would you expect to see on...
Which of the following is the preferred method of measuring BP during...
Which of the following is not an indication for a central line?
Where should the CVP catheter be when inserted properly?
58 y/o male, ASA II, MP 3 scheduled for intramedullary rodding of a...
Methods to reduce intraop recall include all of the following except:
What would be considered a normal SVO2?
There is an increased risk in the intraoperative recall in all of the...
Which of the following would NOT be an indication for invasive...
Which of the following is a complication associated only with PA...
During emergence, the patient will typically become responsive and...
You are planning to insert an arterial line on a 68 yr old male. What...
If your arterial line is overdampened….
You are planning to insert a central line on Mr. Dee who is in...
In which of the following areas would the muscles have the most...
Which of the following patients would not be at an increased risk for...
What is an appropriate cuff size?
Blood Flow is ______ and governed by _____ law.
The state in which you are in a moderate hypnotic state with low...
   Which one of the following is the most characteristic...
For surgical relaxation to be appreciated you must have how many of...
Which one of the following statements is most correct regarding timing...
With the knowledge that altered EMG readings results from increased...
What is likely to occur as a result of checking your twitches too...
  ...
You are caring for a patient with a PA line and notice an increase in...
You have given your patient vecuronium and are assessing the number of...
The benefits of using BIS include all of the following except:
The surgeon starts to close the patient’s incision, so as a smart...
You are caring for Mrs. Gil today who has acute pulmonary edema. What...
You are about to induce your patient.  You are giving a...
What it is an appropriate range for PCWP readings?
You have givien your patient a non-depolarizing muscle relaxant and...
Which of the following reading indicates a deep hypnotic state?
You are caring Mr. Garjian today. You observe the following values:...
You are planning to insert a central line on Mr. Jing who is in the...
When inserting a PA catheter, at approximately what distance would you...
When properly placing a BIS monitor on a patient, where should...
You are monitoring train of four on a patient who has received...
If your paralyzed OR patient has 1 full twitch and that’s it, how...
You are getting ready to allow your previous paralyzed patient to be...
What does the ‘x’ descent in a CVP waveform represent?
What changes to your CVP would you expect to see on a patient with...
Which of the following vessels would have the highest measured...
The BIS monitor measures:
You have a paralyzed patient and are doing a TOF.  You get zero...
What changes to your CVP would you expect to observe on a patient with...
Which one of the following statements about the pulmonary artery...
Which of the following is true regarding Zone III, where we would like...
45 y/o male, 95 kg, ASA 1 scheduled for a craniotomy and resection of...
    Which of the following statements about measurement...
When you are using the tetanus button, how long do you depress it?
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