Technology Exam 2

1. Malfunctioning of either unidirectional valve in a circle system may allow rebreathing of carbon dioxide, resulting in hypercapnia.

True

False

2. How often should a patients BP be measured during general anesthesia?

Every 1-2 minutes

Every 3-5 minutes

Every 15 minutes

Whenever I damn well feel like it.

3. Intra-op hypothermia causes decreased drug metabolism, so your pt will take longer to wake up.

True

False

4. Mapleson Circuits require high fresh gas flows to prevent re-breathing.

True

False

5. In a semi-open breathing system, FGF must be 2-3x the minute ventilation to prevent any rebreathing.

True

False

6. Which of the following is not one of the monitored gases?

CO2

Anesthetic Agent

Driving Gas

Expired Concentration of Gases

7. For anesthetic purposes, what is the only reliable method of measuring urinary output?

Monitoring closely I&O, including blood

No reliable method

Inserting a foley

Fluid Volume Status

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.

True

False

9. When using a BP cuff, the first oscillations heard when deflating the cuff correlate with...

Diastolic BP

Systolic BP

MAP

Perfusion Pressure

10. When using a BP, the last oscillation heard correlates with...

Systolic BP

MAP

Diastolic BP

Perfusion Pressure

11. What are the two fundamental purposes of all anesthesia breathing systems? (click two answers)

Delivery of O2 & anesthetic gases.

To accurately measure amount of FGF going into vaporizer

To provide the perfect medium for application of Poiseuille's law

Elimination of CO2

Submit

12. Which non-rebreathing circuit contains a Fresh gas hose inside the expiratory limb?

Mapleson F (Jackson-Rees)

Mapleson A

Mapleson D (Bain)

Mapleson C

13.

Identify the above rhythm.

Right Atrial Hypertrophy

Inferior wall MI

Dig Toxicity

Premature Atrial Contractions

14.

The above capnogram represents what?

Hypoventilation

COPD or Bronchospasm

Normal Capnogram

Rebreathing of CO2

15. The pulse oximeter operates on what principle?

Pousielles Law

Korotkoffs Principle

Gay-Lusaacs Law

Lamber Beer Law

16. According to M&M which two leads should you choose to monitor for most pts in the OR?

I & avL

III & V3

II & V5

V1 & avF

17.

Identify the above ECG rhythm.

2nd degree heart block

Hyperkalemia

Sinus Tach

NSR

18. Which of the following techniques for non-invasive BP monitoring would be MOST effective to use for monitoring of BP during a case?

Palpation

Doppler

Oscillometry

Arterial Tonometry

19. When the patient is spontaneously ventilating, the APL valve needs to be closed so that circuit pressure remains negligible throughout inspiration and expiration.

True

False

20. Does setting a non-zero vapor concentration at the vaporizer immediately result in an identical inspired vapor concentration?

Yes

No

Depends on FGF

Depends on setting of vaporizer knob

21. What is true regarding flow?

Is measured by pressure/resistance

Is measured by resistance/pressure

Is adequate as long as resistance is more than pressure.

According to rapper 'Flo Rida", this is what shawty hit before she got "low low low low low"

22.

The above capnogram is indicative of what?

Hypoventilation

Pregnant pt

Normal capnogram

Rebreathing of CO2

23.

Identify the above rhythm.

NSR

Inferior Wall MI

Left Bundle Branch Block

High Lateral MI

24. All of the following will reduce Resistance in Laminar flow except...

Increasing Flow Rate

Increasing Viscosity

Increasing diameter of tubing.

Decreasing length of tubing.

Eliminating unnecessary valves

25.

The above capnogram is indicative of what?

Pregnant patient

COPD or Bronchospasm

Malignant Hyperthermia

Spontaneous ventilation

26. What is a normal PR interval?

0.2-1 second

0.12-0.20 seconds

It is dependent upon the R-to-R interval

27. Resistance through the breathing circuit can be decreased by all of the following except...

Decreasing length of tube

Increasing diameter of tube

Avoiding kinks or bends

Maintaining turbulent flow

28. Proper placement of a non-invasive cuff include all of the following except?

The cuff should be placed loosely for comfort of the patient

Wrapping of the limb may be provided for comfort where the cuff is placed

The cuff should be placed tight enough so it won’t slide down the limb

An appropriate size cuff should be place according to the patient’s size of the limb

29. Circle system at extremely low FGF with an APL valve closed is an example of what class of breathing circuit:

Open

Semi-open

Semi-closed

Closed

30. How much FGF do you need in a semi-open system?

Less than minute ventilation to encourage rebreathing.

Equal to minute ventilation

4L/min

2-3 times minute ventilation

31. What would happen if your pts pacemaker were to accidentally during the relative refractory period?

Not a damn thing. No electrical impulse will make the heart conduct here.

An R-on-T PVC which may throw the pt into VT.

A normal QRS comples will be conducted as this is when the pacer *should* fire.

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?

Yes

No

Depends on FGF

Depends on O2 flowmeter settings

33. The function of the breathing circuit is all of the following except:

Convey O2 and anethestic gas to the patient

Deliver negative pressure ventilation

Remove waste from patient

Transfer excess gas to scavenging system

34. The greatest decrease in temperature occurs during what portion of the anesthetic process?

Phase I (1st hour)

Phase II (3-4 hours)

Emergence

In PACU

35.

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

Hyperkalemia

Old MI

2:1 AV Block

NSR

36.

The above capnogram is indicative of what?

Curare Cleft

Malfunctioning valve

Normal capnogram

Lung Transplant

37. A sudden drop in you CO2 on the capnometer may also indicate what?

Pulmonary HTN

Hypercarbia

Re-breathing of CO2

Decrease in cardiac Output

38. Which of the following is not a characteristic of A-fib?

Recognizable QRS complexes

Atrial kick is lost

Risk of thrombus formation is significant after 48 hours

Abnormally tall, peaked P waves before every QRS

39. What is the primary determinant of whether a system if closed, semi closed, or semi open within our breathing circuits?

Presence of CO2 absorber

Size of the circuit

Amount of Fresh Gas Flow

Ability to add PEEP into circuit

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?

Nope, as long as the pulse ox is >90 then the oxyhemoglobin dissociation curve is not that steep.

That depends entirely upon how concerned my preceptor appears to be.

41. A 12-lead ECG measures mechanical activity of the heart.

True

False

measures electrical, not mechanical, activity.

Explanation

measures electrical, not mechanical, activity.

42. Which of the following is NOT true regarding a closed circuit?

Allows for total rebreathing of gases

Only to be used during controlled ventilations with open pop-off valve

Always provides for neutralization of CO2

Always contains unidirectional valves.

43. Which type of circuit is most efficient during Controlled ventilation?

Mapleson D

Maplseon C

Mapleson A

Mapleson F

44. Which ECG leads are your inferior leads?

V3-4

V5-6

II, III, & avF

I, avL

45. In a patient with Pulmonary Embolism, what would you expect would happen with your ETCO2 readings?

Increase ETCO2

Decrease ETCO2

Stay the same due to compensatory mechanisms.

46. Continual measurement of NIBP may cause development of petechiae on all of the following patients except?

Those on anticoagulants

Those taking NSAIDS

Those taking Tylenol

Those with thin, redundant skin

47. What are the components of a circle system?

Breathing tube, Fresh gas inlet, APL valve, Reservoir bag, Mask

Breathing tube, Fresh gas inlet, APL valve, Reservoir bag, Mask, Unidirectional Valves

Breathing tube, Fresh gas inlet, APL valve, Mask

Breathing tube, Fresh gas inlet, Uni-directional valves, APL valve, Reservoir Bag, CO2 Absorbent, CO2 Absorber, Mask

48. In Laminar flow resistance is ______________ to flow rate.

Directly proportional

Equal

Indirectly Proportional

49. Which of the following is NOT a characteristic of a semi-closed circuit?

Always provides for neutralization of CO2

Contains unidirectional valves

Always has a reservoir bag

Allows for Total rebreathing of gases

50.

The above capnogram represents what?

Hypoventilation

Air leak caused by incompetent valve

Lung Transplant

Normal Capnogram

51. Phase II of the capnograph correlates with..

Mix of dead space and alveolar gas

Alveolar Gas

Dead Space

52. Consequences of hypothermia include all of the following except?

Cardiac arrhythmias

Decreased Drug Metabolism

Increased risk of post-op sepsis

Decrease risk of myocardial ischemia

53. What is the MAP for a pt whose BP 90/60?

60

70

75

90

54. Rebreathing is influenced by...

Amount of FGF

Size of breathing tube

Size of reservoir bag

Laminar Flow

55. The most common method to measure NIBP is?

Arterial Tonometry

Doppler Probe

Auscultation

Oscillometry

56. During induction and emergence,

A circle system with higher flows is suitable because each breath reflects the dialed concentration of agent more precisely.

A semi-closed system with low FGF is preferred because there is only partial rebreathing.

A closed system is most suitable because there is complete rebreathing, which allows for "recycling" of the anesthetic agents.

NZ 286

Explanation

NZ 286

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

Nothing, gas flow SHOULD be below minute ventilation

The system then turns into a semi-closed circuit.

You run the risk of inflicting barotrauma on your pt.

An alarm will sound to alert you.

58.

Identify the above rhythm.

V Fib

2nd Degree heart block

Dig Toxicity

Atrial Flutter

59.

Identify the above rhythm.

NSR

Junctional Rhythm

Hypokalemia

1st degree heart block

Inverted P wave with short PR interval

Explanation

Inverted P wave with short PR interval

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

Absorbent Granules exhausted and Faulty Unidirectional Valve

Absorbent Granules exhausted and Low Fresh Gas Flows

Low Fresh Gas Flows and Faulty Unidirectional Valve

Low Fresh Gas Flows and Use of N2O

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

Explanation

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

61. Which type of non-rebreathing circuit is used almost exclusively in children?

Mapleson A

Mapleson D (Bain)

Nasal Cannula

Mapleson F (Jackson-Rees)

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:

Give O2 & Nitro to help relieve chest pain.

Consider fibrinolytics & antiplatelet agents.

Administer a beta blocker.

Call Cath lab for possible stent placement.

63. Why is it that temperature falls faster during the first hour of surgery then during consecutive hours?

Because the pt is uncovered

The anesthetic gases reset the hypothermic set point of the body.

Because of peripheral vasodilation which steals heat from the core and loss of compensatory shivering.

Because of cooled gases being pumped into patients and cooling the pt centrally.

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?

Yep! Sure is.

No... it is too low.

65. Which of the following cases should not use an oscillometric BP cuff?

Mrs. K who is having a fem pop

Mr. L who is having colorectal surgery

Mrs. C who is having repair of a shoulder injury

Mr. G who is having cardiopulmonary bypass

66. What could you do to decrease amount of CO2 (rebreathing) in a NRB circuit?

Decrease FGF

High tidal volume

Long Expiratory Pause

Close the APL valve

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

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

67.
Identify the above ECG rhythm.

Acute Inferior MI

Left Bundle Branch Block

Acute Anterior/ Lateral MI

Wolfe-parkinson-white syndrome

68. When would you use a calorimetric CO2 monitor?

During all cases to monitor ETCO2.

When doing an intubation up in the units as a quick yes/no indication or tracheal intubation.

For a pt who is recieving humidified air and has excessive airway secretions.

When performing an emergent intubation during Cardiac arrest.

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.

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.

69. Which one is NOT true of blood pressure readings?

Standard of care says BP must be measured at least every 3-5 minute during anesthesia.

A bladder cuff too small for the patient will yield a false high reading.

A bladder cuff too large for the patient will yield a false high reading.

A bladder cuff that is too small for the extremity will require more pressure to occlude the artery beneath.

70. All of the following will cause the oxyhemoglobin dissociation curve to shift to the left except....

Carbon Monoxide Poisoning

Alkalosis

Fetal Hemoglobin

Hyperthermia

71. Which of the following will cause a falsely high pulse ox reading?

Carbon Monoxide Poisoning

Methylene Blue Dye

Low Limb Perfusion

Leakage of light from electrode

72. Phase III of the capnogram correlates with...

Mix of Alveolar gas and dead space

Alveolar Gas

Dead Space

73. How does a non-diverting gas monitor work?

Measures the gas by using a sensor located directly within the gas stream.

Through a sensor inside each vaporizer which directly measures the amount of vapor absorbed by the FGF.

74.

Identify the above ECG rhythm.

NSR

Hyperkalemia

Junctional Rhythm

Digitalis Effect

75. The equation for calculating MAP is which of the following?

3SBP + DBP / 2

2SBP + DBP / 3

SBP + 3DBP/ 2

SBP + 2DBP/ 3

76.

Identify the above rhythm.

3rd degree heart block

A Flutter

2:1 AV block

Long QT syndrome

77.

The above capnogram is indicative of what?

Hyperventilation

Mucus Plug

Malignant Hyperthermia

CPR

78.

Identify the above rhythm.

Posterior Wall MI

Hyperkalemia

Acute Inferior Wall MI

WPW Syndrome

79.

Identify the above ECG.

Acute Lateral MI

Left Ventricular Hypertrophy

Old MI

Hypokalemia

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?

Increase RR to 14

Increase your Tidal Volume

Start mixing the dantrolene, this is going to be BAD.

Increase your FGF

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

Explanation

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

81. The dicrotic notch in an arterial waveform...

Reflects closure of the aortic valve in diastole.

Reflects closure of the mitral and tricuspid valves

Will be elevated in a patient with aortic regurgitation.

Occurs earlier in a arterial waveform taken from the radial than in the aortic.

82. How does a Diverting Gas monitor work?

Measures the gas by using a sensor located directly within the gas stream.

Through a sensor inside each vaporizer which directly measures the amount of vapor absorbed by the FGF.

83. What are your anterior leads?

II, III, avF

I, avL

V1-2

V3-4

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?

Administer oxygen 4L/min via nasal cannula

Request a stat ABG and CXR

Place the pulse ox onto another limb with better circulation.

85. Which type of circuit is most efficient during Spontaneous Ventilation?

T-Piece

Mapleson D

Mapleson F

Mapleson A

86.

The above capnogram represents what?

Curare Clefts in pt attempting to breath

Esophageal intubation

Cardiogenic oscillations in low frequency ventilation

Hiccups

87. All of the following may cause falsely elevated BP readings from a cuff except:

Poor Tissue Perfusion

Small BP cuff

Arterial Stiffness

Hyperthermia

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?

4 L / min

12 L /min

~ 150 ml / min

6 L / min

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

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.

89. Which leads would you examine in order to determine if there is any axis deviation?

III & avL

V1 & V6

II & V3

I & avF

90. Which is not a function of all breathing circuits?

Deliver oxygen and anesthetic gases.

Have minimal dead space and low resistance to breathing

Eliminate CO2 by either washout or by soda lime absorption

91. Phase I of the capnograph reading correlates with...

Mix of dead space and alveolar gas

Alveolar Gas

Dead Space

92. What is a normal QT interval?

> 0.5 seconds

> 1/2 R-to-R interval

< 1 box (0.2 seconds)

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?

Decrease Tidal Volume to 500

Increase the Fresh gas flow

Increase the rate to 12

Increase the Sevo, he must be trying to breathe on his own.

Pt is hypoventilating, increasing RR will fix this.

Explanation

Pt is hypoventilating, increasing RR will fix this.

94. Hypothermia is indicated as a temperature less than?

32 ° C

34 ° C

35 ° C

36 ° C

95. Insufflation is the method used to inducing pediatric patients with sevoflurane.

True

False

MM 31

Explanation

MM 31

96. A non-rebreathing circuit or circle system at high gas flows is an example of what class of breathing circuit:

Open

Semi-open

Semi-closed

Closed

97. Which of the following is NOT a disadvantage associated with diverting gas monitors?

Slower response time

Prone to water precipitation in aspiration tubing which can cause erroneous readings.

If Vt is small FGF from the circuit may dilute ETCO2 measurement.

98. What will doubling the radius of a tube do to resistance and flow?

Decrease resistance by half, increase flow 16 times

Increase resistance 16 times, decrease flow 16 times.

Double resistance and flow.

Decrease resistance 16 times, increase flow 16 times

99.

Identify the above rhythm.

A fib with Left Bundle branch

SVT

V-Fib

Anterior wall MI

100. Do the bellows contain CO2 during mechanical ventilation?

Yes

No

Depends on FGF

Depends whether CO2 absorber is exhausted or not

101. What are the components of a mapleson circuit?

Breathing tube, Fresh gas inlet, APL valve, Reservoir bag, Mask

Breathing tube, Fresh gas inlet, Uni-directional valves, Reservoir bag, Mask

Breathing tube, Fresh gas inlet, APL valve, Mask

Breathing tube, Fresh gas inlet, Uni-directional valves, APL valve, Reservoir Bag, CO2 Absorbent, CO2 Absorber, Mask

MM 35

Explanation

MM 35

102.

Identify the above rhythm.

Atrial Flutter

Wide Complex Tachycardia

Cardiac Ischemia

V Tach

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

Explanation

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

103.

Identify the above ECG rhythm.

Old MI

Acute Anterior Wall MI

Acute Inferior Wall MI

Right Bundle Branch Block

104.

Identify the above ECG.

Left Bundle Branch Block

Right Bundle Branch Block

Acute Inferior MI

Digitalis Effect

105. Arterial blood pressure is a measurement of organ perfusion.

True

False

M&M 123, an indication but not a measurement

Explanation

M&M 123, an indication but not a measurement

106.

Identify the above ECG.

Junctional Rhythm

Atrial Fibrillation

2nd degree heart block

V-tach

107.

Identify the above ECG rhythm.

Digitalis Toxicity

NSR

Inferior wall MI

Wolff-Parkinson-White Syndrome

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

Explanation

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

108.

Is there any axis deviation in the above ECG?

Yes, Left axis deviation.

Yes, Right axis deviation.

Yes, deviation of undetermined cause.

Nope, Looks normal to me.

109. Where would you find the J point on an ECG?

Between the S wave and ST segment

After the T wave

Between ST segment and T wave

Right before QRS complex, it indicates old MI

110. Circle system at fresh gas flows less than minute ventilation is an example of what class of breathing circuit:

Open

Semi-open

Semi-closed

Closed

111.

Identify the above ECG.

NSR

Old MI

Right Ventricular Hypertrophy

A-fib

112. Which of the following offers the most resistance?

Nonrebreathing valve

CO2 Cannister

Tracheal Tube

Y Piece

Breathing Circuit

113. What two things do all non-rebreathing circuits lack? (two answers)

Unidirectional valves

Soda Lime CO2 absorption

Reservoir Bags

APL valves

Submit

114. What would happen to your patient if their pacemaker should accidentally fire during the absolute refractory period?

Not a damn thing. No electrical impulse will make the heart conduct here.

An R-on-T PVC which may throw the pt into VT.

A normal QRS comples will be conducted as this is when the pacer *should* fire.

115. Is gas flow in the CO2 absorber bi-directional?

Yes

No

Depends whether ventilation is spontaneous or mechanical

Depends how anesthetized the patient is

116. If you half the radius of your breathing circuit what will this do resistance and flow?

Decrease flow by 16, increase resistance by 2.

Increase resistance by 16, decrease flow by 16.

Double resistance, half flow

Decrease resistance by 16, increase flow by 16.

117.

The following capnogram represents what?

Rebreathing of CO2

Esophageal intubation

Hyperventilation

COPD

118.

Identify the above rhythm.

Paced Rhythm

Wolff Parkinson White

NSR

Junctional Rhythm

119. When using a BP cuff the peak in oscillation correlates with..

Perfusion Pressure

Systolic BP

Diastolic BP

MAP

120.

What does the above ECG show?

NSR

Junctional Rhythm

Right Ventricular Hypertrophy

Left Atrial Hypertrophy

121. Which of the following is not a complication of poorly placed BP cuff?

Compartment syndrome

Ecchymosis

Nerve Damage

Thrombostasis

122. An upsloping ST depression is a sign of acute ischemic abnormality.

True

False

123.

Identify the rhythm pictured above.

2:1 AV block

NSR

Premature Atrial Contraction

Hypokalemia

124.

Is there any axis deviation in the above ECG?

Yes, Left axis deviation.

Yes, Right axis deviation.

Yes, deviation of undetermined cause.

Nope, looks normal to me.

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....

Acidosis

Hypercarbia

Methemeglobinemia

Acute Anemia

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.

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.

126. What is the difference between an open and a semi-open system?

Partial Rebreathing of gases.

Neutralization of CO2.

Presence of gas reservoir bag.

Presence of unidirectional valves

127. All of the following may be causes of prolonged QT interval except:

Drugs

Electrolyte Imbalances

Respiratory Disturbances

CNS disease

Post MI patient

128.

Identify the above rhythm.

Digitalis Toxicity

HyperKalemia

A fib

Anterior Wall MI

.Dig toxicity has a characteristic downsloping ST depression

Explanation

.Dig toxicity has a characteristic downsloping ST depression

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

Higher than average CO2 readings.

Lower than average CO2 readings.

Frequent oscillations in the reading due to stiffness of lung.

No plateau reached on capnograph before the next inspiration.

M&M 143

Explanation

M&M 143

130. What is true of the J-point?

It is used in analyzing ST segment elevations that could potentially be myocardial ischemia

It is used in analyzing depressed ST segments that are upsloped or downsloped.

It is defined as the junction between S wave and T wave.

Its measurement is more accurate with heart rates less than 100.

131. As a pulse moves peripherally, the arterial waveform ...

Becomes more distorted, with exaggerated systolic and pulse pressure

Becomes more flattened because it gets farther from the pulsation of the heart.

Has a dicrotic notch that gets more exaggerated.

Becomes "undampened".

132. Which of the following is NOT a disadvantage associated with non-diverting gas monitors?

Can only measure CO2 and O2

Slow response time to changes in gas concentrations.

Potential for infection and cross contamination

Increases dead space.

133.

Identify above rhythm.

Paced rhythm

A-fib

Old Inferior MI

LGL syndrome

Q waves leads 2 & 3

Explanation

Q waves leads 2 & 3

134. What is the most common arrythmia in anesthesia?

Junctional Rhythm

Sinus Bradycardia

2nd Degree heart block

A-fib

per Vince's in class lecture

Explanation

per Vince's in class lecture

135.

Identify the above ECG.

Digitalis effect

WPW syndrome

Right Atrial Hypertrophy

Left ventricular hypertrophy

large P waves in leads 2 & 3

Explanation

large P waves in leads 2 & 3

136.

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

Digitalis Effect

Anterior wall MI

Hypokalemia

Premature Atrial Contraction

137.

Identify the above rhythm.

PVC's

2:1 AV Block

Atrial Fibrillation

Atrial Bigeminy

Technology Exam 2

1. Malfunctioning of either unidirectional valve in a circle system may allow rebreathing of carbon dioxide, resulting in hypercapnia.

2.

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

2. How often should a patients BP be measured during general anesthesia?

3. Intra-op hypothermia causes decreased drug metabolism, so your pt will take longer to wake up.

4. Mapleson Circuits require high fresh gas flows to prevent re-breathing.

5. In a semi-open breathing system, FGF must be 2-3x the minute ventilation to prevent any rebreathing.

6. Which of the following is not one of the monitored gases?

7. For anesthetic purposes, what is the only reliable method of measuring urinary output?

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.

9. When using a BP cuff, the first oscillations heard when deflating the cuff correlate with...

10. When using a BP, the last oscillation heard correlates with...

11. What are the two fundamental purposes of all anesthesia breathing systems? (click two answers)

12. Which non-rebreathing circuit contains a Fresh gas hose inside the expiratory limb?

13. Identify the above rhythm.

14. The above capnogram represents what?

15. The pulse oximeter operates on what principle?

16. According to M&M which two leads should you choose to monitor for most pts in the OR?

17. Identify the above ECG rhythm.

18. Which of the following techniques for non-invasive BP monitoring would be MOST effective to use for monitoring of BP during a case?

19. When the patient is spontaneously ventilating, the APL valve needs to be closed so that circuit pressure remains negligible throughout inspiration and expiration.

20. Does setting a non-zero vapor concentration at the vaporizer immediately result in an identical inspired vapor concentration?

21. What is true regarding flow?

22. The above capnogram is indicative of what?

23. Identify the above rhythm.

24. All of the following will reduce Resistance in Laminar flow except...

25. The above capnogram is indicative of what?

26. What is a normal PR interval?

27. Resistance through the breathing circuit can be decreased by all of the following except...

28. Proper placement of a non-invasive cuff include all of the following except?

29. Circle system at extremely low FGF with an APL valve closed is an example of what class of breathing circuit:

30. How much FGF do you need in a semi-open system?

31. What would happen if your pts pacemaker were to accidentally during the relative refractory period?

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?

33. The function of the breathing circuit is all of the following except:

34. The greatest decrease in temperature occurs during what portion of the anesthetic process?

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

36. The above capnogram is indicative of what?

37. A sudden drop in you CO2 on the capnometer may also indicate what?

38. Which of the following is not a characteristic of A-fib?

39. What is the primary determinant of whether a system if closed, semi closed, or semi open within our breathing circuits?

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?

41. A 12-lead ECG measures mechanical activity of the heart.

42. Which of the following is NOT true regarding a closed circuit?

43. Which type of circuit is most efficient during Controlled ventilation?

44. Which ECG leads are your inferior leads?

45. In a patient with Pulmonary Embolism, what would you expect would happen with your ETCO2 readings?

46. Continual measurement of NIBP may cause development of petechiae on all of the following patients except?

47. What are the components of a circle system?

48. In Laminar flow resistance is ______________ to flow rate.

49. Which of the following is NOT a characteristic of a semi-closed circuit?

50. The above capnogram represents what?

51. Phase II of the capnograph correlates with..

52. Consequences of hypothermia include all of the following except?

53. What is the MAP for a pt whose BP 90/60?

54. Rebreathing is influenced by...

55. The most common method to measure NIBP is?

56. During induction and emergence,

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

58. Identify the above rhythm.

59. Identify the above rhythm.

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

61. Which type of non-rebreathing circuit is used almost exclusively in children?

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:

63. Why is it that temperature falls faster during the first hour of surgery then during consecutive hours?

65. Which of the following cases should not use an oscillometric BP cuff?

66. What could you do to decrease amount of CO2 (rebreathing) in a NRB circuit?

67. Identify the above ECG rhythm.

68. When would you use a calorimetric CO2 monitor?

69. Which one is NOT true of blood pressure readings?

70. All of the following will cause the oxyhemoglobin dissociation curve to shift to the left except....

71. Which of the following will cause a falsely high pulse ox reading?

72. Phase III of the capnogram correlates with...

73. How does a non-diverting gas monitor work?

74. Identify the above ECG rhythm.

75. The equation for calculating MAP is which of the following?

76. Identify the above rhythm.

77. The above capnogram is indicative of what?

78. Identify the above rhythm.

13.

Identify the above rhythm.

14.

The above capnogram represents what?

17.

Identify the above ECG rhythm.

22.

The above capnogram is indicative of what?

23.

Identify the above rhythm.

25.

The above capnogram is indicative of what?

35.

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

36.

The above capnogram is indicative of what?

50.

The above capnogram represents what?

58.

Identify the above rhythm.

59.

Identify the above rhythm.

67.
Identify the above ECG rhythm.

74.

Identify the above ECG rhythm.

76.

Identify the above rhythm.

77.

The above capnogram is indicative of what?

78.

Identify the above rhythm.

79.

Identify the above ECG.

86.

The above capnogram represents what?

99.

Identify the above rhythm.

102.

Identify the above rhythm.

103.

Identify the above ECG rhythm.

104.

Identify the above ECG.

106.

Identify the above ECG.

107.

Identify the above ECG rhythm.

108.

Is there any axis deviation in the above ECG?

111.

Identify the above ECG.

117.

The following capnogram represents what?

118.

Identify the above rhythm.

120.

What does the above ECG show?

123.

Identify the rhythm pictured above.

124.

Is there any axis deviation in the above ECG?

128.

Identify the above rhythm.

133.

Identify above rhythm.

135.

Identify the above ECG.

136.

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

137.

Identify the above rhythm.