Technology Exam 2

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1. Malfunctioning of either unidirectional valve in a circle system may allow rebreathing of carbon dioxide, resulting in hypercapnia.
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About This Quiz
Technology Exam 2 - Quiz

Review of material for exam 2. Including breathing circuits and ECG and ETCO2 monitoring.

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2. How often should a patients BP be measured during general anesthesia?
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3. Intra-op hypothermia causes decreased drug metabolism, so  your pt will take longer to wake up.
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4. Mapleson Circuits require high fresh gas flows to prevent re-breathing.
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5. In a semi-open breathing system, FGF must be 2-3x the minute ventilation to prevent any rebreathing.
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6. Which of the following is not one of the monitored gases?
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7. For anesthetic purposes, what is the only reliable method of measuring urinary output?
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8. Long breathing tubes with high compliance increase the difference between the volume of gas delivered to a circuit by a reservoir bag or ventilator and the volume actually delivered to a patient.
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9. When using a BP cuff, the first oscillations heard when deflating the cuff correlate with...
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10. When using a BP, the last oscillation heard correlates with...
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11. What are the two fundamental purposes of all anesthesia breathing systems? (click two answers)
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12. Which non-rebreathing circuit contains a Fresh gas hose inside the expiratory limb?
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13.


Identify the above rhythm.
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14.

The above capnogram represents what?
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15. The pulse oximeter operates on what principle?
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16. According to M&M which two leads should you choose to monitor for most pts in the OR?
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17.

Identify the above ECG rhythm.
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18. Which of the following techniques for non-invasive BP monitoring would be MOST effective to use for monitoring of BP during a case?
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19. When the patient is spontaneously ventilating, the APL valve needs to be closed so that circuit pressure remains negligible throughout inspiration and expiration.
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20. Does setting a non-zero vapor concentration at the vaporizer immediately result in an identical inspired vapor concentration?
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21. What is true regarding flow?
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22.

The above capnogram is indicative of what?
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23.

Identify the above rhythm.
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24. All of the following will reduce Resistance in Laminar flow except...
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25.

The above capnogram is indicative of what?
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26. What is a normal PR interval?
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27. Resistance through the breathing circuit can be decreased by all of the following except...
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28. Proper placement of a non-invasive cuff include all of the following except?
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29. Circle system at extremely low FGF with an APL valve closed is an example of what class of breathing circuit:
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30. How much FGF do you need in a semi-open system?
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31. What would happen if your pts pacemaker were to accidentally during the relative refractory period?
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32. Does changing the setting on the N2O flowmeter from 3.5 L/min to 0 L/min immediately result in an inspired N2O concentration of 0?
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33. The function of the breathing circuit is all of the following except:
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34. The greatest decrease in temperature occurs during what portion of the anesthetic process?
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35.

Identify the above rhythm. (That is NOT a U-wave)
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36.

The above capnogram is indicative of what?
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37. A sudden drop in you CO2 on the capnometer may also indicate what?
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38. Which of the following is not a characteristic of A-fib?
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39. What is the primary determinant of whether a system if closed, semi closed, or semi open within our breathing circuits?
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40. You are the SRNA for Mr. Pier and notice his O2 sat drops from 98 to 94 percent. His O2 sat is steady at 94 and does not appear to drop further, but should you be concerned?
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41. A 12-lead ECG measures mechanical activity of the heart.

Explanation

measures electrical, not mechanical, activity.

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42. Which of the following is NOT true regarding a closed circuit?
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43. Which type of circuit is most efficient during Controlled ventilation?
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44. Which ECG leads are your inferior leads?
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45. In a patient with Pulmonary Embolism, what would you expect would happen with your ETCO2 readings?
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46. Continual measurement of NIBP may cause development of petechiae on all of the following patients except?
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47. What are the components of a circle system?
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48. In Laminar flow resistance is ______________ to flow rate.
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49. Which of the following is NOT a characteristic of a semi-closed circuit?
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50.

The above capnogram represents what?
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51. Phase II of the capnograph correlates with..
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52. Consequences of hypothermia include all of the following except?
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53. What is the MAP for a pt whose BP 90/60?
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54. Rebreathing is influenced by...
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55. The most common method to measure NIBP is?
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56. During induction and emergence,

Explanation

NZ 286

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57. When using a semi-open circuit, what happens if your FGF drops below minute ventilation?
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58.

Identify the above rhythm.
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59.

Identify the above rhythm.

Explanation

Inverted P wave with short PR interval

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60. Two reasons that a circle system can cause increased inspired CO2 are:

Explanation

NZ 283 Low FGF has nothing to do with a circle system.

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61. Which type of non-rebreathing circuit is used almost exclusively in children?
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62. A pt is coming into the ER. He is a 73 yr old male who had severe chest pain at home and called EMS for help. Upon admission a diagnosis of ST elevation Acute Anterior MI is made. All of the following would be appropriate interventions except:
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63. Why is it that temperature falls faster during the first hour of surgery then during consecutive hours?
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64. You are caring for Mr. Rogers today. After many years of hosting a wonderful children's show, he discovered all those little puppets he saw were hallucinations caused by a massive cerebral aneurysm.  Mr. Rogers collapsed when the cerebral aneurysm ruptured and was then taken into the OR emergently upon arrival to the hospital. He is now in your ICU and you have been told to keep his MAP above 80. His BP is currently  115/70, is his MAP where it needs to be?
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65. Which of the following cases should not use an oscillometric BP cuff?
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66. What could you do to decrease amount of CO2 (rebreathing) in a NRB circuit?

Explanation

long expiratory pause allows for exhaled gas to be more thoroughly flushed out by high FGF since inspiration will draw on gases present in expiratory limb. PPT slide 18

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67.
Identify the above ECG rhythm.
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68. When would you use a calorimetric CO2 monitor?

Explanation

This is the little purple/yellow thing. It gives a yes/no answer only. It is not good during a cardiac arrest due to insufficient CO2 within the lungs. It is easily deactivated by humidity and water.

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69. Which one is NOT true of blood pressure readings?
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70. All of the following will cause the oxyhemoglobin dissociation curve to shift to the left except....
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71. Which of the following will cause a falsely high pulse ox reading?
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72. Phase III of the capnogram correlates with...
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73. How does a non-diverting gas monitor work?
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74.

Identify the above ECG rhythm.
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75. The equation for calculating MAP is which of the following?
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76.

Identify the above rhythm.
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77.

The above capnogram is indicative of what?
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78.

Identify the above rhythm.
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79.

Identify the above ECG.
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80. You are the SRNA for Mrs. Cloos who is having a wound debridement of her left foot. When watching her ETCO2 monitor, you notice your baseline CO2 slowly climbing higher. Your vent setting are AC 12 / Tv 600 / O2 35 % and FGF at 2L/min. What would you do to correct the rising baseline CO2?

Explanation

Pt is re-breathing CO2. Increase FGF will correct this.

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81. The dicrotic notch in an arterial waveform...
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82. How does a Diverting Gas monitor work?
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83. What are your anterior leads?
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84. You are caring for a pt with methemoglobinemia and place a pulse ox on their finger. You find their pulse ox is currently 85%. What should be your first intervention?
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85. Which type of circuit is most efficient during Spontaneous Ventilation?
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86.

The above capnogram represents what?
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87. All of the following may cause falsely elevated BP readings from a cuff except:
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88. You are using a semi-closed system, and want to determine how much FGF to use. Your pt is breathing 600 Tv at 10 breaths per minute. How much FGF would be appropriate to maintain your semi-closed circuit?

Explanation

FGF needs to be less than minute ventilation (not equal, not more). 150 ml/min is too little and would lead to total rebreathing.

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89. Which leads would you examine in order to determine if there is any axis deviation?
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90. Which is not a function of all breathing circuits?
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91. Phase I of the capnograph reading correlates with...
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92. What is a normal QT interval?
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93. You are caring for Mr. Bares who is having removal of a tumor from his liver. Your vent settings are AC 10/ Tv 650/ 35%  O2 and you FGF is at 4L/min. Everything is going well, when you notice your ETCO2 reading are slowly going up. Your baseline stays the same but your reading are getting higher. The patient is adequately paralyzed and it at 1.5 MAC. What would you do to correct the rising CO2?

Explanation

Pt is hypoventilating, increasing RR will fix this.

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94. Hypothermia is indicated as a temperature less than?
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95. Insufflation is the method used to inducing pediatric patients with sevoflurane.

Explanation

MM 31

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96. A non-rebreathing circuit or circle system at high gas flows is an example of what class of breathing circuit:
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97. Which of the following is NOT a disadvantage associated with diverting gas monitors?
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98. What will doubling the radius of a tube do to resistance and flow?
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99.

Identify the above rhythm.
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100. Do the bellows contain CO2 during mechanical ventilation?
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101. What are the components of a mapleson circuit?

Explanation

MM 35

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102.

Identify the above rhythm.

Explanation

Look for the P waves along V1, they are there.

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103.

Identify the above ECG rhythm.
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104.

Identify the above ECG.
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105. Arterial blood pressure is a measurement of organ perfusion.

Explanation

M&M 123, an indication but not a measurement

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106.

Identify the above ECG.
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107.

Identify the above ECG rhythm.

Explanation

Characteristic Slurred upstroke to QRS indicating pre-excitation (delta wave).

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108.

Is there any axis deviation in the above ECG?
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109. Where would you find the J point on an ECG?
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110. Circle system at fresh gas flows less than minute ventilation is an example of what class of breathing circuit:
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111.

Identify the above ECG.
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112. Which of the following offers the most resistance?
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113. What two things do all non-rebreathing circuits lack? (two answers)
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114. What would happen to your patient if their pacemaker should accidentally fire during the absolute refractory period?
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115. Is gas flow in the CO2 absorber bi-directional?
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116. If you half the radius of your breathing circuit what will this do resistance and flow?
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117.

The following capnogram represents what?
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118.

Identify the above rhythm.
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119. When using a BP cuff the peak in oscillation correlates with..
Submit
120.

What does the above ECG show?
Submit
121. Which of the following is not a complication of poorly placed BP cuff?
Submit
122. An upsloping ST depression is a sign of acute ischemic abnormality.
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123.


Identify the rhythm pictured above.
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124.

Is there any axis deviation in the above ECG?
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125. Shifting the oxyhemoglobin dissociation curve to the right means decreases the affinity of O2 for hemoglobin. This means the hemoglobin will more readily release O2..... but also needs a higher partial pressure of O2 to become saturated.  All of the following may cause a shift to the right except....

Explanation

This stuff wasn't really in our books, outside of a very small blurb in MM pg 141. But vince said to know the curves.... Just google "oxyhemoglobin dissociation curve" and come up with some lovely sites that explain it all very well.

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126. What is the difference between an open and a semi-open system?
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127. All of the following may be causes of prolonged QT interval except:
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128.

Identify the above rhythm.

Explanation

.Dig toxicity has a characteristic downsloping ST depression

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129. You are caring for a pt with Severe COPD. What would you expect their ETCO2 reading to look like?

Explanation

M&M 143

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130. What is true of the J-point?
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131. As a pulse moves peripherally, the arterial waveform ...
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132. Which of the following is NOT a disadvantage associated with non-diverting gas monitors?
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133.

Identify above rhythm.

Explanation

Q waves leads 2 & 3

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134. What is the most common arrythmia in anesthesia?

Explanation

per Vince's in class lecture

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135.

Identify the above ECG.

Explanation

large P waves in leads 2 & 3

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136.

Identify the above ECG rhythm. Examine V5 lead for clues.
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137.

Identify the above rhythm.
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Malfunctioning of either unidirectional valve in a circle system may...
How often should a patients BP be measured during general anesthesia?
Intra-op hypothermia causes decreased drug metabolism, so  your...
Mapleson Circuits require high fresh gas flows to prevent...
In a semi-open breathing system, FGF must be 2-3x the minute...
Which of the following is not one of the monitored gases?
For anesthetic purposes, what is the only reliable method of measuring...
Long breathing tubes with high compliance increase the difference...
When using a BP cuff, the first oscillations heard when deflating the...
When using a BP, the last oscillation heard correlates with...
What are the two fundamental purposes of all anesthesia breathing...
Which non-rebreathing circuit contains a Fresh gas hose inside the...
Identify the above rhythm.
The above capnogram represents what?
The pulse oximeter operates on what principle?
According to M&M which two leads should you choose to monitor for...
Identify the above ECG rhythm.
Which of the following techniques for non-invasive BP...
When the patient is spontaneously ventilating, the APL valve needs to...
Does setting a non-zero vapor concentration at the vaporizer...
What is true regarding flow?
The above capnogram is indicative of what?
Identify the above rhythm.
All of the following will reduce Resistance in Laminar flow except...
The above capnogram is indicative of what?
What is a normal PR interval?
Resistance through the breathing circuit can be decreased by all of...
Proper placement of a non-invasive cuff include all of the following...
Circle system at extremely low FGF with an APL valve closed is an...
How much FGF do you need in a semi-open system?
What would happen if your pts pacemaker were to accidentally during...
Does changing the setting on the N2O flowmeter from 3.5 L/min to 0...
The function of the breathing circuit is all of the following except:
The greatest decrease in temperature occurs during what portion of the...
Identify the above rhythm. (That is NOT a U-wave)
The above capnogram is indicative of what?
A sudden drop in you CO2 on the capnometer may also indicate what?
Which of the following is not a characteristic of A-fib?
What is the primary determinant of whether a system if closed, semi...
You are the SRNA for Mr. Pier and notice his O2 sat drops from 98 to...
A 12-lead ECG measures mechanical activity of the heart.
Which of the following is NOT true regarding a closed circuit?
Which type of circuit is most efficient during Controlled ventilation?
Which ECG leads are your inferior leads?
In a patient with Pulmonary Embolism, what would you expect would...
Continual measurement of NIBP may cause development of petechiae on...
What are the components of a circle system?
In Laminar flow resistance is ______________ to flow rate.
Which of the following is NOT a characteristic of a semi-closed...
The above capnogram represents what?
Phase II of the capnograph correlates with..
Consequences of hypothermia include all of the following except?
What is the MAP for a pt whose BP 90/60?
Rebreathing is influenced by...
The most common method to measure NIBP is?
During induction and emergence,
When using a semi-open circuit, what happens if your FGF drops below...
Identify the above rhythm.
Identify the above rhythm.
Two reasons that a circle system can cause increased inspired CO2 are:
Which type of non-rebreathing circuit is used almost exclusively in...
A pt is coming into the ER. He is a 73 yr old male who had severe...
Why is it that temperature falls faster during the first hour of...
You are caring for Mr. Rogers today. After many years of hosting a...
Which of the following cases should not use an oscillometric BP cuff?
What could you do to decrease amount of CO2 (rebreathing) in a NRB...
Identify the above ECG rhythm.
When would you use a calorimetric CO2 monitor?
Which one is NOT true of blood pressure readings?
All of the following will cause the oxyhemoglobin dissociation curve...
Which of the following will cause a falsely high pulse ox reading?
Phase III of the capnogram correlates with...
How does a non-diverting gas monitor work?
Identify the above ECG rhythm.
The equation for calculating MAP is which of the following?
Identify the above rhythm.
The above capnogram is indicative of what?
Identify the above rhythm.
Identify the above ECG.
You are the SRNA for Mrs. Cloos who is having a wound debridement of...
The dicrotic notch in an arterial waveform...
How does a Diverting Gas monitor work?
What are your anterior leads?
You are caring for a pt with methemoglobinemia and place a pulse ox on...
Which type of circuit is most efficient during Spontaneous...
The above capnogram represents what?
All of the following may cause falsely elevated BP readings from a...
You are using a semi-closed system, and want to determine how much FGF...
Which leads would you examine in order to determine if there is any...
Which is not a function of all breathing circuits?
Phase I of the capnograph reading correlates with...
What is a normal QT interval?
You are caring for Mr. Bares who is having removal of a tumor from his...
Hypothermia is indicated as a temperature less than?
Insufflation is the method used to inducing pediatric patients with...
A non-rebreathing circuit or circle system at high gas flows is an...
Which of the following is NOT a disadvantage associated with diverting...
What will doubling the radius of a tube do to resistance and...
Identify the above rhythm.
Do the bellows contain CO2 during mechanical ventilation?
What are the components of a mapleson circuit?
Identify the above rhythm.
Identify the above ECG rhythm.
Identify the above ECG.
Arterial blood pressure is a measurement of organ perfusion.
Identify the above ECG.
Identify the above ECG rhythm.
Is there any axis deviation in the above ECG?
Where would you find the J point on an ECG?
Circle system at fresh gas flows less than minute ventilation is an...
Identify the above ECG.
Which of the following offers the most resistance?
What two things do all non-rebreathing circuits lack? (two answers)
What would happen to your patient if their pacemaker should...
Is gas flow in the CO2 absorber bi-directional?
If you half the radius of your breathing circuit what will this do...
The following capnogram represents what?
Identify the above rhythm.
When using a BP cuff the peak in oscillation correlates with..
What does the above ECG show?
Which of the following is not a complication of poorly placed BP cuff?
An upsloping ST depression is a sign of acute ischemic abnormality.
Identify the rhythm pictured above.
Is there any axis deviation in the above ECG?
Shifting the oxyhemoglobin dissociation curve to the right means...
What is the difference between an open and a semi-open system?
All of the following may be causes of prolonged QT interval except:
Identify the above rhythm.
You are caring for a pt with Severe COPD. What would you expect their...
What is true of the J-point?
As a pulse moves peripherally, the arterial waveform ...
Which of the following is NOT a disadvantage associated with...
Identify above rhythm.
What is the most common arrythmia in anesthesia?
Identify the above ECG.
Identify the above ECG rhythm. Examine V5 lead for clues.
Identify the above rhythm.
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