Semester 5: Comprehensive Exam

What is the systemic vascular resistance (SVR) of a patient whose mean arterial pressure is 80, central venous pressure is 10, and cardiac output is 4.5? (Round to nearest whole number)

1244 M&M Chapter 20, page 355 SVR = 80 x [(MAP-CVP)/CO] Jennifer

3) What is the etiology of TRALI (Transfusion Related Acute Lung Injury)? a) Bacterial contamination of blood products b) Hereditary c) Is not fully explained N&P Chapter 20 pg. 398

C Jared

5) Pharyngoesophageal perforation is associated with what 3 factors? a) Cancer, Age, Gender b) Weight, Age, Gender c) Difficult intubation, age over 60 years, and female gender M&M Ch. 54 pg. 1212

C Jared

5. Which of the following is not part of the triad of fat embolism? a. Dyspnea b. Confusion c. Petechiae d. Leg pain

5 d. leg pain

The resting membrane potential for a normal ventricular cell is ________: A) -80 to -90 mV B) -20 to -30 mV C) -50 to -60 mV D) -10 to -20 mV

A) -80 to -90 mV Devin [M&M p.345]

Anesthesia accidents and mishaps account for approximately ______% of maternal deaths. A) 2-3 B) 5-10 C) 0.5-2 D) 10-20

A) 2-3 Devin [M&M p.845]

2. Elderly patients have a _______ % reduction in blood volume. A) 20-30 B) 5-10 C) 10-20 D) 40-50

A) 20-30 [N&P p.1215] Devin

1. Relative contraindications to regional block includes: Select 3 a. Septicemia b. Chronic headache/backache c. Stenotic vavular disease d. Patient refusal

A, B, C N&P 1103 Rebecca

4.) What is the effective dose (ED95) of succinylcholine in a neonate? (N and P, page 1173) A. 620 mcg/kg B. 525 mcg/kg C. 175 mcg/kg D. 150 mcg/kg

A. 620 mcg/kg Shackelford

Which of the following individuals would have the highest total body fluid as a percent of body weight? A. Newborn B. Adult male C. Adult female D. Geriatric male

A. Newborn N&P page 382, 1st column 2nd paragraph Abe

Age is ________ a contraindication to anesthesia and surgery! A. Not B. Definitely C. Absolutely D. Sometimes

A. Not M&M Ch. 43 pg. 908 K. Jensen

The heart muscle consists of specialized tissue. Select 2 types of tissue specific to cardiac muscle. A. Striated muscle B. Endothelium C. Intercalated disks D. Epithelium

A. Striated muscle C. Intercalated disks M&M Ch. 20 pg. 344 K. Jensen

1.) Which of the following are signs of a tension pneumothorax? SELECT 3 (N and P, page 1003) A. Sudden hypoxemia B. Tachycardia C. Bradycardia D. Jugular vein distention

A. Sudden hypoxemia B. Tachycardia D. Jugular vein distention Maggie

What is personal protection is required when providing neuraxial anesthesia? a. All of the above b. Sterile gloves c. Cap d. Mask

All of the above Charlie N&P pg. 1138

Which of the following is NOT a risk factor for the development of atherosclerosis? A. Hypertension B. Diabetes C. Hypoglycemia D. Sedentary lifestyle

C. Hypoglycemia N&P page 562, Box 25-1 Abe

5. When performing a median nerve block at the elbow, the median nerve lies medial to which artery? A. radial artery B. brachial artery C. ulnar artery D. cephalic artery

Answer: B. brachial artery N & P, pg. 1115 Stefania

What is considered to be normal myocardial oxygen consumption? a. 4-6 mL/O2/100g/min b. 6-8 mL/O2/100g/min c. 8-10 mL/O2/100g/min d. 10-12 mL/O2/100g/min

Answer: C NP 23: 481 Byron

4. Bone cement implantation syndrome is most commonly seen in which of the following procedures? a. Knee arthroplasty b. Shoulder arthroplasty c. Hip arthroplasty d. Knee arthroscopy

Answer: C - Hip arthroplasty N&P pg. 1004 stetler

2. What is the antiseptic of choice when preparing for neuraxial anesthesia a. Chlorhexidine gluconate in alcohol base b. Rubbing alcohol c. Iodine d. Peroxide

Chlorhexidine gluconate in alcohol base Charlie N&P pg. 1138

Research suggests that for every 1 MET a patient can attain, there is a corresponding reduction in annual mortality of? a. 6% b. 8% c. 11% d. 15%

c. 11% NP: 1216 Byron

4. Which of the following are risk factors for developing aortic stenosis? Pick 4 a. Advanced age b. Male c. Rheumatic fever d. Smoking e. HTN f. Family history of heart disease.

i. Answer: A,B,D,E ii. N&P page 537 Sommers

3. After ______ years of age, sacral anatomy changes and identification of the epidural space for caudal anesthesia is difficult due to bone growth. a. 8 b. 6 c. 12 d. 18

a. 12 Reference N&P pg 1097 Mandy

5. In the operating room, an increase in core body temperature of 1 degree Celsius may increase caloric expenditure by what percent? (Select one) a. 12-14% b. 1-2% c. 8-10% d. 18-20%

a. 12-14% N&P p. 1206 Jason Franklund

5. Pulmonary complications account for nearly _____% of perioperative deaths in persons over the age of 65 years old. A) 60 B) 20 C) 5 D) 40

D) 40 Devin [N&P p.1215]

When the patient is supine, abduction of the arms greater than _____ degrees stretches the brachial plexus around the humeral head and can cause injury. A) 15 B) 45 C) 25 D) 90

D) 90 [N&P p.408] Devin

5. _____________ is a normally non-harmful stimulus that is perceived as painful. A) Dysesthesia B) Neuralgia C) Paresthesia D) Allodynia

D) Allodynia Devin [N&P p.1244]

Clinical features of Hyponatremia include all of the following EXCEPT what? A) Seizure B) Coma C) Confusion D) Heart attack

D) Heart attack Devin [N&P p.385]

_____________ and ______________ lower systemic vascular resistance and increase blood flow. a. Decreased blood viscosity b. Decreased blood volume c. Vasodilation d. Vasoconstriction

a. Decreased blood viscosity c. Vasodilation M&M p. 802 Lexi

3) Ankle procedures requiring a tourniquet are commonly performed under what type of anesthesia? a) General or MAC b) MAC only c) Spinal or Epidural

3) C N&P Chapter 40 pg. 1005

3. How many hours a spinal can LMWH be restarted? a. 4 hours b. immediately c. 24 hours d. 12 hours

3. a. 4 hours

1. Which of the following is not a sign or symptom of bone cement implantation syndrome? a. Hypoxia b. Hypotension d. Pulmonary hypertenstion e. Hypertension

1. e Hypertension Mbom, sorry....

One unit of PRBCs increases hemoglobin an average of how much? a. 1g/dl b. 5g/dl c. 4 g/dl d. 3 g/dl

1g/dl Charlie N&P pg. 396

At what vertebral level does the spinal cord end in the average adult? a. L2 b. L1 c. T12 d. S1

A. L2 N&P page 1071 Justin

What is the single factor identified for emergence delirium? A. There is no single factor, it is a combination of multiple factors. B. Ketamine administration C. Desflurane D. Propofol

A. There is no single factor, it is a combination of multiple factors. Justin N&P 1193

5. Local anesthetics exert their actions by blocking which channels? A. K+ B. Ca+ C. Na+ D. Cl-

Answer: C. Na+ N & P, pg. 1251 Stefania

Select ALL of the Class III antidysrhthmic agents: a. Quinidine b. Sotalol c. Amiodarone d. Cisapride

B C NP 1296 DB

Which of the following is true regarding NPO status in obstetric patients according to the American College of Obstetricians and Gynecologists? (N&P 1136) a. Must be NPO 4 hours before stage 2 labor begins b. Clear liquid intake may be allowed in patients in labor without complications c. Must stop clear liquids after the epidural is inserted d. Can continue to eat and drink until she enters the second stage of labor

B. Clear liquid may be allowed in patients in labor without complications

5) Where does the intercostal nerve emerge from and what structure does it follow? a) Paravertebral foramen and follows the intercostal muscle fascia b) Coracobrachialis muscle and follows the rib in the costal groove c) Intervertebral foramen and follows the rib in the costal groove N&P Chapter 45 pg. 1117

C Jared

1. Which portion of an antibody binds to the microbe's antigen? a. Fab region b. Fc region c. Fc receptor d. Phagocyte NP ch 41 pg 1020

a. Fab region Mbom

2. Which of the following are the two most common postoperative cognitive disorders in the elderly? Select two A. delirium B. Post-op cognitive Dysfunction (POCD) C. Post traumatic Stress Disorder (PTSD) D. Alzheimer's Disease

A & B Justin N&P 1292

3. What two methods are done for myocardial preservation during cardiac surgery? (select 2) a. Mild to moderate systemic hypothermia b. Systemic Hyperthermia c. Cold Cardioplegia d. Induced Tachycardia

A & C N&P: 519 Justin

3. Older adults are vulnerable to hypotension due to a a. Decrease in total body water b. Increase in total boy water c. Decrease in fat composition d. Increase in metabolic rate

A decrease in total body water n&p 1215 rebecca

2. Airway mortality occurs due to a. A failure to ventilate b. Failure to intubate c. Failure to turn on oxygen d. Failure to lube the lips

A failure to ventilate Charlie N&P pg 1295

All of the following preexisting conditions can increase a patients risk of developing postoperative position-related injuries EXCEPT: A) Migraine headaches B) Hypertension C) Diabetes mellitus D) Peripheral vascular disease

A) Migraine headaches [N&P p.407] Devin

The detection of what should be the primary objective in patients with vascular disease? A) Myocardial ischemia B) hypotension C) increased JVD D) muffled heart sounds

A) Myocardial ischemia Devin [N&P p.561]

2. _________ pain is caused by damage to peripheral or central neural structures resulting in abnormal processing of painful stimuli. A) Neuropathic B) Idiopathic C) Somatic D) Visceral

A) Neuropathic [N&P p.1244] Devin

Optimal results with CPB require close cooperation and communication between all of the following EXCEPT: A) OR RN B) Surgeon C) anesthesiologist D) perfusionist

A) OR RN Devin [M&M p.345]

The triad for fat embolism syndrome includes all of the following EXCEPT? A) Pulsus paradoxus B) Dyspnea C) Confusion D) Petechiae

A) Pulsus paradoxus Devin [M&M p.789]

Post-op carotid artery hemorrhage following a carotidendarterectomy can manifest in which of the following ways (choose all that apply): (Nagelhout ch25, pg 583) a. Upper airway obstruction b. Recurrent laryngeal nerve damage demonstrated as respiratory stridor c. Tracheal deviation d. Tension pneumothorax

A. C. Hale

Mean arterial pressure increases or decreases by approximately how many mmHg per inch for each change in height between the heart and a body region? A. 2 mmHg B. 4 mmHg C. 6 mmHg D. 8 mmHg

A. 2 mmHg N&P page 403, 2nd column 2nd paragraph Abe

Neuraxial Anesthesia is safe for: (select 3) A. All operations below the neck B. Decreasing morbidity and mortality C. Cesarean and vaginal births D. Craniotomies

A. All operations below the neck B. Decreasing morbidity and mortality C. Cesarean and vaginal births M&M Ch. 46 pg. 938 K. Jensen

What plasma protein is primarily responsible for the binding of basic drugs? A. Alpha-1-Acid Glycoprotein B. Albumin C. Monoamine oxidase D. Catechol-O-Methyltransferase

A. Alpha-1-Acid Glycoprotein N&P page 1191, 2nd column 3rd paragraph Abe

Because the contractile components of the neonatal heart are immature, the maintenance of a stable cardiac output in the neonate is largely dependent on what factor? A. HR B. Preload C. Afterload D. Contractility

A. HR N&P page 1164, 2nd column 3rd paragraph Abe

Important factors to assess the volume status of a patient include: oral intake, persistent vomiting or diarrhea, gastric suction and recent_________. A. Hemodialysis B. Heparin-induced thrombocytopenia C. Heart murmur D. Hepatic enzymes

A. Hemodialysis M&M Ch. 51 pg. 1162 K. Jensen

In patients with chronic lung disease, neuraxial blocks can reduce the incidences of: (select 3) A. Pulmonary Embolism B. Venous Embolism C. Respiratory Depression D. Rhabdomyolysis

A. Pulmonary Embolism B. Venous Embolism C. Respiratory Depression M&M Ch. 45 pg. 939 K. Jensen

5. Which of the following leads to hyperkalemia? a. Redistribution of potassium from ICF to ECF b. Decreased potassium intake c. Vomiting d. Redistribution of potassium from ECF to ICF.

A. Redistribution of potassium from ICF to ECF N&P 387 Justin

What program was introduced in 2006 by the Centers for Medicaid and Medicare Services with the goal to find common opportunities for improving surgical care and to provide definitions and guidelines to decrease risks to patients? A. SCIP program B. EMTALA program C. HIPPA program D. Affordable Care Act

A. SCIP program N&P page 999, 2nd column 1st paragraph Abe

1. Coronary blood supply from the left main artery includes all of the following arteries except? A. Anterior descending B. Circumflex C. Obtuse marginal D. Posterior descending

Answer D. Posterior descending. Morgan & Mikhail page 452. Blair Ryan.

4. Residual air in the cardiac chambers can best be evaluated by ______. A. Percussion B. 2 view chest x-ray C. Direct vision with endoscope threaded through the aorta D. Transesophageal Echocardiogram TEE

Answer D. Transesophageal Echocardiogram TEE. Morgan & Mikhail page 452. Blair Ryan.

4. As an anesthesia provider preparing for Congenital Hernia Repair you should do all of the following except: Choose the incorrect statement. A. Administer an anticholinergic prior to induction to prevent bradycardia. B. Provide an analgesic for awake intubation to decrease the stress response from instrumenting airway. C. Gently ventilate to avoid filling the stomach, as this will increase the intrathoracic pressure. D. Decrease concentrations of volatile anesthetic by adding 50% Nitrous Oxide with mech. Ventilation.

Answer D: Nitrous oxide should be avoided because it will increase the volume of gastrointestinal tissue and further impair ventilation. Nagelhout pg. 1184 Blair Ryan

What is an appropriate maintenance infusion in mcg/kg/h for fentanyl that is compatible with early extubation after cardiac surgery? (Whole numbers only)

1, 2, or 3 M&M Ch. 22, page 455, table 22-1 Jennifer

1. An Interscalene block is appropriate for which surgeries? a. Shoulder and upper arm, not appropriate for surgeries at or distal to the elbow b. Procedures at or distal to the elbow, not ideal for catheter placement c. Surgery at or distal to elbow, less risk of pneumothorax and vascular puncture d. Surgery distal to the elbow, poor site for catheter placement

1- A Mbom

You are about to do anesthesia on a fussy 1 year old patient. You are expecting you will need to perform an inhalation induction. Which of the following volatile anesthetics would be best to use. A. Sevoflurane B. Isoflurane C. Desflurane D. Never perform and inhalation induction on a 1 year old.

A. Sevoflurane Justin N&P 1193

5) Where is the sciatic nerve usually blocked to ensure anesthesia to the tibial and peroneal nerves? a) S1-S5 b) Low in the popliteal fossa c) High in the popliteal fossa

5) C N&P Chapter 40 pg. 1005

2. Guidelines suggest blood transfusions for what hemoglobin level? a. 6 g/dL or less b. 7 g/dL c. 8 g/dL d. 6 g/dL or less but can be justified in patients at risk of decreased cerebral oxygen delivery

6 g/dL or less but can be justified in patients at risk of decreased cerebral oxygen delivery Nagelhout page 520 Budenbender

A premature infant's blood volume on average is how much? a. 90-100 ml/kg b. 130-140 ml/kg c. 60-70 ml/kg d. 50-60 ml/kg

90-100 ml/kg Charlie N&P pg. 395

Elderly patients treated with Beta blockers ______ ________their medication therapy in the perioperative period. A. Should continue B. Shouldn't continue C. Should increase D. Should decrease

A. Should continue M&M Ch. 43 pg. 908 K. Jensen

Hemodynamic changes are usually greatest in which of the following positions? (select 3) A. Sitting B. Prone C. Flexed lateral D. Supine E. Lateral

A. Sitting B. Prone C. Flexed lateral N&P page 403, 1st column 4th paragraph Abe

What 2 ions/electrolytes are found in the highest concentration in the extracellular fluid compartment? A. Sodium B. Chloride C. Potassium D. Phosphate

A. Sodium B. Chloride N&P page 382, 1st column 5th paragraph Abe

Botulinum Toxin (Botox) has been approved for the treatment of _________ .(Select 3) A. Spasticity B. Focal Dystonia C. Migraine Headaches D. Root canals

A. Spasticity B. Focal Dystonia C. Migraine Headaches M&M Ch. 47 pg. 1060 K. Jensen

Name three "field blocks" used to minimize surgical pain: A. Superficial Cervical Plexus Block B. Intercostobrachial Block C. Saphenous Block D. Sciatic Block

A. Superficial Cervical Plexus Block B. Intercostobrachial Block C. Saphenous Block M&M Ch. 46 pg. 978 K. Jensen

When phagocytes bind to a pathogen they destroy it by endocytosis with lysosomal enzymes in a process called "respiratory burst." Select 3 products produced by this burst. A. Superoxide ion B. Nitric oxide C. Hydrogen peroxide D. Sodium oxide

A. Superoxide ion B. Nitric oxide C. Hydrogen peroxide N&P Ch. 41 pg. 1015 K. Jensen

Hemodynamic changes are usually minimal in which of the following positions? (select 2) A. Supine B. Lateral C. Sitting D. Prone E. Flexed Lateral

A. Supine B. Lateral N&P page 403, 1st column 4th paragraph Abe

4. Labor pain impulses from the uterus and cervix are supplied at what spinal level? a. T10 to L1-L2 b. T19 c. S1-S3 d. T8

A. T10 to L1-2 N&P 1131 Justin

What is the most sensitive test for detecting intraoperative myocardial ischemia? A. TEE B. EKG C. Troponin D. CKMB

A. TEE N&P page 512, 1st column 1st paragraph Abe

Cases ending in a settlement are reported to____________ and are a part of a practitioner's permanent record. A. The National Practitioners Data Bank B. The Data Bank of National Judgments C. The Hospitals Data Bank Blacklist D. National Risk Management List

A. The National Practitioners Data Bank. M&M Ch. 54 pg. 1201 K. Jensen

2. Why does the response to aortic cross-clamping in patients with aortoiliac occlusive disease produce less hemodynamic variability as compared to patients with aneurysmal disease? A. The development of collateral circulation provides alternative blood flow in patients with occlusive disease. B. Aortoiliac occlusive disease is much less painful C. Aortoiliac occlusive disease is much easier to fix D. Restoring circulation is occlusive disease is much less invasive

A. The development of collateral circulation provides alternative blood flow in patients with occlusive disease. N&P page 561, 1st column 2nd paragraph Abe

The sacrum is wedged between what pelvic structures? A. The iliac crests bilaterally B. The ischial tuberosities C. The anterior superior iliac spines D. The pubic bones

A. The iliac crests bilaterally N&P page 1070, 2nd column last paragraph Abe

Which statement most accurately describes the risk of inducing a sympathectomy via regional anesthesia in a patient who is severely intravascularly volume depleted? A. The patient is at risk for hypoperfusion to vital organs and subsequent hypoxic tissue injury B. The patient is at risk for hypertensive crisis C. The patient will be resistant to the regional anesthetic D. The patient is at risk for a hypersensitivity reaction

A. The patient is at risk for hypoperfusion to vital organs and subsequent hypoxic tissue injury N&P page 1103, 1st column 1st paragraph Abe

Which of the following most correctly defines ischemic preconditioning? A. The phenomenon whereby a short period of ischemia improves the hearts ability to tolerate subsequently longer periods of ischemic insult. B. The process by which the myocardium slowly infarcts C. The process of balancing myocardial supply & demand D. Irreversible myocardial necrosis

A. The phenomenon whereby a short period of ischemia improves the hearts ability to tolerate subsequently longer periods of ischemic insult. N&P page 512, 1st column 3rd paragraph Abe

1. In regards to blood volume distribution, 84% of the blood is located in the systemic circulation. The remaining 16% is located where? A. Brain (16%) B. Kidneys (7%) & Liver (9%) C. All of the vital organs, evenly D. Heart (7%) & Pulmonary circulation (9%)

Answer D: See table 20-5 in M&M on page 359. Blair Ryan

Obstetric anesthesia care accounts for approximately _____% of the American Society of Anesthesiologists Closed Claims database claims. A) 2 B) 4 C) 8 D) 12

D) 12 Devin [M&M p.845]

4. From the ages of 20 to 90, a decrease of ________% is seen in the GFR, renal drug clearance, renal blood flow, and renal mass. A) 50-70 B) 10-20 C) 5-15 D) 25-50

D) 25-50 Devin [N&P p.1215]

Abdominal aortic aneurysms grow approximately ____ mm/year. A) 1 B) 2 C) 3 D) 4

D) 4 Devin [N&P p.563]

Recommendations for positioning to prevent ulnar nerve injury in anesthetized patients include all of the following EXCEPT: A) abducting the arms <90 deg B) Arms supinated C) Padding D) Arms pronated

D) Arms pronated Devin [N&P p.407]

Which component of the CPB machine helps to reduce systemic embolism. A) Reservoir B) Cardiotomy suction C) Heat exchanger D) Arterial filter

D) Arterial filter Devin [M&M p.347]

Blood from the oxygenator enters the heat exchanger and can either be cooled or warmed, depending on the temperature of the water flowing through the exchanger. During this process, heat transfer occurs by ____________? A) Convection B) Radiation C) Evaporation D) Conduction

D) Conduction Devin [M&M p.438]

Potent inhaled anesthetics _________ SA node automaticity. A) Stop B) Have no effect C) Stimulate D) Depress

D) Depress Devin [M&M p.347]

____________ is the most common electrolyte abnormality in hospitalized patients. A) Hypercalcemia B) Hypokalemia C) Hypernatremia D) Hyponatremia

D) Hyponatremia Devin [N&P p.385]

What are the most common morbidities within Obstetrics?. A) Anesthesia complications B) Amniotic fluid embolism C) Uterine fibroids D) Severe preeclampsia and severe hemorrhage

D) Severe preeclampsia and severe hemorrhage Devin [M&M p.844]

4. ___________ is the transformation of a noxious stimulus into an action potential. A) Nociception B) Perception C) Transmission D) Transduction

D) Transduction Devin [N&P p.1244]

Risk factors for DVT & PE include all of the following EXCEPT: A) Lower extremity fracture B) >60 yrs old C) Obesity D) Upper extremity fracture

D) Upper extremity fracture Devin [M&M p.792]

Which of the following is NOT a component of the Law of Laplace. A) Vessel radius B) Transmural pressure C) Wall tension D) Viscosity

D) Viscosity Devin [N&P p.563]

During the plateau phase (phase 2), Ca+ inflow occurs through ____________? A) fast T-type voltage gated calcium channels B) fast L-type voltage gated sodium channels C) slow T-type voltage gated sodium channels D) slow L-type voltage gated calcium channels

D) slow L-type voltage gated calcium channels Devin [M&M p.344]

The number of people in the world that are 65 years and older has increased by _____% over the last 50 years. A. 25 B. 50 C. 100 D. 300

D. 300 Abe N&P page 1214, 1st column 1st paragraph

4. According to the Society of Thoracic Surgeons (STS), what percent of cardiac surgery patients receive a blood transfusion? a. 5% b. 10% c. 20% d. 50%

D. 50% N&P: 519 Justin

What is the average blood loss for a vaginal delivery? A. 50 ml B. 100 ml C. 1000 ml D. 500 ml

D. 500 ml N&P page 1127, 2nd column 2nd paragraph Abe

Which of the following are advantages for laparoscopy for anterior spine surgery? a. Enhanced Visualization b. Shorter Hospitalization. c. Decreased blood loss d. All of the above.

D. All of the above N&P Page 1008, Box 40-5 Justin

Which of the following are more likely to be seen in a patient with rheumatoid arthritis? a. Pleural Effusion b. Obliterative bronchiolitis. c. Intrapulmonary Nodules d. All of the above.

D. All of the above N&P Page 1012 Box 40-8. Justin

Which of the following are associated with an increased ocular venous pressure. A. Jugular vein obstruction B. Head down position C. Increased abdominal pressure. D. All of the above.

D. All of the above Justin N&P 410

What is a potential benefit of using spinal anesthesia for a TURP procedure, when compared to general anesthesia? a. Less nausea and vomiting b. Less total opioid requirements c. Less risk of bladder rupture d. All of the above

D. All of the above N&P 1074-1075 Justin

2. Which of the following contribute to higher blood pressure commonly seen in the geriatric population? A. Loss of elastin in the arteries B. Loss of elastin in veins C. Loss of increased peripheral resistance. D. All of the above.

D. All of the above N&P 1216 Justin

3. Which of the following should be included in the preoperative assessment of the geriatric patient? A. Exercise intolerance B. Angina History C. Valvular disease D. All of the above.

D. All of the above N&P 1216 Justin

4. Which of the following are signs that your patient may be having acute pain? A. Increased HR B. Increased BP C. Increased respiratory rate D. All of the above

D. All of the above N&P 1248 Justin

2. Perception of pain occurs in which of the following areas? A. Amygdala B. Somatosensory areas of the cortex C. Hypothalamus D. All of the above are associated with the perception of pain.

D. All of the above are associated with the perception of pain. N&P 1246 Justin

Which of the following is associated with visual loss after NON-othalmic surgery? A. Ischemic Optic Neuropathy B. Central Retinal Artery Occlusion C. Central retinal vein occlusion D. All of the above are associated with visual loss in the non-othalmic surgical patient.

D. All of the above are associated with visual loss in the non-othalmic surgical patient. Justin N&P 409

1. Which of the following options gives the most accurate definition of pain? A. An unpleasant sensory experience B. An unpleasant emotional experience C. An unpleasant experience causing tissue damage D. An unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.

D. An unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage. Abe N&P page 1244, 1st column 3rd paragraph

3. How often should blood pressure be checked once epidural has begun. a. Every 2 minutes for 15 minutes then every 5 minutes for additional 15 minutes b. Every 10 minutes c. Once immediately after d. Blood pressure does not need to be monitored

Every 2 minutes for 15 minutes then every 5 minutes for additional 15 minutes Charlie N&P pg. 1138

5. What spinal approach aims for the largest area between spinous processes avoids the interspinous ligaments. a. Paramedian approach b. Midline approach c. Taylor approach d. They all must puncture the interspinous ligaments

Paramedian approach Charlie N&P pg. 1081

2. What is the ideal patient position for an intercostal nerve block a. Prone with arms hanging off table b. Supine with arms tucked at the side c. Standing d. Steep Trendelenburg

Prone with arms hanging off table Charlie N&P pg. 1117

1. What type of aortic dissection involves the ascending aorta and may extend inot the aortic arch. a. Type A b. Type b c. Type c d. Type F

Type A Charlie N&P pg. 572

When will an acute transfusion complication be noticed? a. Up to 24 hours post infusion b. Within first ten minutes of infusion c. Up to 2 weeks after infusion d. Acute complications are not seen with blood transfusions

Up to 24 hours post infusion Charlie N&P pg. 396

The initial therapeutic dose of fresh frozen plasma (FFP) is usually how many mL/kg? a. 10-15 b. 15-20 c. 25-30 d. 35-40

a. 10-15 M&M Chapter 51 page 1171 Jennifer

2. What is the appropriate bolus (mg) and lockout interval (min) for Fentanyl 0.01mg/ml? N&P pg 1252 table 51-4 a. 10-20 mcg, 4-10min b. 25-50 mcg, 30 min c. 10-20 mcg, 30 min d. 25-50 mcg, 4-10 min

a. 10-20 mcg, 4-10min

If tension pneumothorax occurs ideally placement of a chest tube is desirable; however, an immediate and very effective treatment is needle decompression. Which of the following options correctly identify the placement of and equipment for this intervention? (Select 3) a. 14-18 gauge angiocatheter b. Anterior 2nd or 3rd intercostal space c. Lateral 5th or 6th intercostal space d. Lateral 4th or 5th intercostal space

a. 14-18 gauge b. anterior 2nd or 3rd intercostal space d. lateral 4th or 5th intercostal space NP: 1003 Byron

3. Approximately what percentage of patients older than 70 years are affected by diabetes? (M&M pg 911) a. 15% b. 20% c. 25% d. 30%

a. 15%

4. What is an effective dose of 1.5-2% Lidocaine (with or without epinephrine) for a caudal epidural anesthetic? a. 15-20 ml b. 1-2 ml c. 5 mcg/ml d. None of the above

a. 15-20 ml M&M Ch. 45 Pg. 966 Thetford

4. What glucose level should be maintained according to the Society of Thoracic Surgeons, in the patient with diabetes mellitus during cardiac surgical care? a. 180 mg/dL or less b. 100 mg/dL c. < 200 mg/dL d. Continue basal insulin dose

a. 180 mg/dL or less Nagelhout page 522 Budenbender

In the situation of negative antibody screen without crossmatch, the incidence of serious hemolytic reactions with ABO- and Rh-compatible transfusions is less than ___. a. 1:10,000 b. 1:100,00 c. 1:20,000 d. 1:200,000

a. 1:10,000 M&M Chapter 51 page 1170 Jennifer

5. The possibility of placing an unintended intravascular or intrathecal epidural catheter is significant. If a test dose is administered, how long would it take to show signs of sensory blockade if the injection was intrathecal? a. 2-3 min b. 3-5 mins c. 4-6 mins d. >6 mins

a. 2-3 min M&M page 853

2. You are the CRNA administering anesthesia to a patient ungergoing an ORIF of the right ankle. There are no complications expected during this procedure. According to N&P, what are the additional fluid requirements for this surgery? a. 0-2mL/kg b. 2-4mL/kg c. 4-8mL/kg d. 8-12mL/kg

a. 2-4mL/kg Reference: N&P pg 394 Table 20-9 Mandy

4. Noxious pain is conducted by what two types of nerve fibers? (Select 2) a. A delta b. A alpha c. B fibers d. C fibers

a. A delta c. B fibers M&M p. 1025 Jason Franklund

2. A retrospective analysis of a critical incident is commonly called? N&P pg 1300 a. A root cause analysis b. Team huddle c. Falls risk analysis d. Incident report

a. A root cause analysis Fieber

2. Which blood group can receive blood from any ABO group and are known as universal recipients? (Select one) a. AB b. A c. B d. O

a. AB NP p. 395 Franklund

1. Which of the following methods is the simplest for reducing/eliminate abdominal compression in the prone position? (Select one) a. Bilateral chest rolls b. Wedge pillow c. Ankle bolster d. Axillary roll

a. Bilateral chest rolls Jason Franklund N&P p. 1008

A sudden increase in what 2 factors may indicate light anesthesia and the need for more anesthetic during induction for cardiac surgery? (Select all that apply) a. Blood pressure b. Heart rate c. Oxygen saturation d. ETCO2

a. Blood pressure b. Heart rate M&M Ch. 22, page 454 Jennifer

Select the three potentially life-threatening complications associated with a total hip replacement (THR): a. Bone cement implantation syndrome b. Intra-operative hemorrhage c. Venous thromboembolism d. Pneumothorax

a. Bone cement implantation syndrome b. Intra-operative hemorrhage c. Venous thromboembolism M&M Chapter 38, page 795 Jennifer

2. Pain from the diaphragm can be referred to what dermatome? (Select one) a. C4 b. T6 c. T10 d. T4

a. C4 M&M p. 1027 Jason Franklund

2. What two factors are most often used to quantify left ventricular systolic function? (M&M pg. 354) a. Cardiac output b. Heart rate c. Ejection fraction d. Blood pressure

a. Cardiac output c. Ejection fraction

1. What disease is the most common concomitant illness in the older adult and the primary cause for perioperative and postoperative risk in the older adult? a. Cardiovascular disease b. Lung disease c. Renal failure d. Liver failure

a. Cardiovascular disease Charlie N&P PG 1218

5. The second most common vascular operation performed in the United States per year? a. Carotid Endarterectomy b. Coronary Revascularization (this is the 1st most common) c. Aortic Aneurysm d. Varicose vein stripping.

a. Carotid Endarterectomy Fieber N&P Pg 578

3. Risk factors associated with an increase in mortality in patients with a ruptured AAA include all of the following EXCEPT? (select one) a. Caucasian b. Female c. Insurance status d. Renal failure

a. Caucasian N&P p. 570 Jason

2. Where are the target receptors for Clonidine located? a. Centrally and peripherally b. Centrally c. Peripherally d. Not able to predict

a. Centrally and peripherally Charlie N&P pg 1251

What is the initial immediate management of a needle stick in the workplace? a. Cleaning the wound b. Notifying the appropriate authority within the facility c. Personal laboratory testing following the exposure d. Patient laboratory testing following the exposure

a. Cleaning the wound M&M p. 1224 Lexi

3. Because of an infant's compliant chest wall during forceful diaphragmatic contraction, the chest wall will do what? N&P Pg 1203 a. Collapse b. Distention c. Symmetrical movement of abdomen and diaphragm d. Tenting of the diaphragm

a. Collapse Fieber

1. Crystalloids are safe and equally effective as compared to ______; therefore the use of synthetic colloids should be __________. a. Colloids; Avoided b. Crystalloids; Avoided c. Colloids; Used

a. Colloids; Avoided Budenbender Nagelhout Chapter 20; page 395 "Crystalloids are safe and equally effective as compared to colloids; therefore the use of synthetic colloids should be avoided.

2. Which of the following are associated with early decelerations? a. Compression of the fetal head b. Fetal distress c. Uteroplacental insufficiency d. Descent of fetal head

a. Compression of the fetal head d. Descent of fetal head M&M Ch. 41 Pg. 868-869 Thetford

What is the first action of the anesthesia provider once they receive a summons? (M&M pg 1201) a. Contact his or her malpractice in surer/risk management department. b. Call Morgan and Morgan c. Contact the department of health d. None of the above

a. Contact his or her malpractice in surer/risk management department.(M&M pg 1201) Josh

Select the following ways blood platelets can be activated during the process of inflammation: (Select 3) a. Contact with damaged endothelial cells b. IgG immune complexes c. Platelet-activating factor released from activated macrophages d. IL-6 stimulated production of acute-phase proteins

a. Contact with damaged endothelial cells b. IgG immune complexes c. Platelet-activating factor released from activated macrophages N&P page 1023 Jennifer

1. Using the Crockroft Gault formula you are attempting to calculate the? N&P Pg 1219 a. Creatinine clearance b. Bioavailability c. GFR d. Albumin

a. Creatinine clearance Fieber

5. Which of the following are characteristics of meperidine use in the parturient patient? (Select 2) a. Crosses placenta easy and recovered from fetus within 2 minutes of IV administration b. Capable of causing neonatal respiratory depression c. NOT capable of causing neonatal respiratory depression d. Greater capability to cause respiratory depression than morphine or methadone Nagelhout Page 1134

a. Crosses placenta easy and recovered from fetus within 2 minutes of IV administration b. Capable of causing neonatal respiratory depression Nagelhout Page 1134

5. What forms the roof of the cubital tunnel and is a potential area for nerve compression because fibrous tissues and the elbow capsule for a semirigid canal that changes shape with flexion and extension of the forearm? a. Cubital tunnel retinaculum b. Medial epicondyle of Humerus c. Olecranon fossa d. Flexor carpi ulnaris NP 407 "The cubital tunnel retinaculum forms the roof of the cubital tunnel, a potential area..."

a. Cubital tunnel retinaculum NP 407 "The cubital tunnel retinaculum forms the roof of the cubital tunnel, a potential area..." DB

What is the usual definition of perioperative mortality? a. Death within 48 hrs of surgery b. Death between 48 hrs and 72 hrs following surgery c. Death within a month following surgery d. Death within a year following surgery

a. Death within 48 hrs of surgery(M&M pg 1203) Josh

5. How is impaired efficiency of gas exchange reflected in the elderly a. Decline in resting arterial oxygen tension (PaO2), which is attributed to premature closing of small airways in reduction of alveolar surface area b. Increase in PaO2 c. Decrease in residual volume d. Decrease in closing capacity

a. Decline in resting arterial oxygen tension (PaO2), which is attributed to premature closing of small airways in reduction of alveolar surface area NP 1217 DB

2. General Anesthesia is indicated for what group of parturients? N&P Pg 1145 a. High risk for hypovolemic shock b. Patients with T4 level spinal c. Patients with a working epidural d. Providers doesn't have time for neuraxial options

a. High risk for hypovolemic shock Fieber

3. What action is believed to be responsible for the increased inotropic effect of Digoxin? a. Higher concentration of calcium within the cardiac cell b. Lower concentration of calcium within the cardiac cell c. Higher efflux of sodium into ECF d. Digoxin is a negative inotrope

a. Higher concentration of calcium within the cardiac cell Nagelhout Chapter 23, page 478 Budenbender

3. Which of the following is a primary concern associated with laparoscopy for anterior spinal surgery? (select one) a. Hypercarbia b. Hypocarbia c. Hypoventilation d. Hyperventilation

a. Hypercarbia Jason Franklund N&P p. 1009

1. Volatile anesthetics can potentially cause all of the following except a. Hypertension b. Vasodilation c. Hypotension d. Myocardial depression

a. Hypertension Charlie N&P pg. 526

1. Which two of the following are the most common comorbidities in the elderly? a. Hypertension b. Diabetes c. Coronary artery disease d. Osteoarthritis

a. Hypertension Reference: N&P pg 1221 b. Coronary artery disease Mandy

1. Metabolic factors that contribute to incidences of apnea in a premature infant include all of the following except? N&P1178 a. Hyperthermia b. Hypothermia c. Hypoglycemia d. Hypocalcemia

a. Hyperthermia

1. Which of the following is NOT used to decrease the incidence of paraplegia? (Select one) a. Hyperthermia b. Hypothermia c. Somatosensory evoked potentials d. Motor evoked potentials

a. Hyperthermia N&P p. 570 Jason

Which of the following are manifestations of bone cement implantation syndrome? Select all that apply (select 5) a. Hypoxia b. Arrhythmia c. Hyponatremia d. Hypotension e. Pulmonary hypertension f. Increased cardiac output g. Decreased cardiac output

a. Hypoxia b. Arrhythmia d. Hypotension e. Pulmonary hypertension g. Decreased cardiac output (M&M pg 790) Josh

3. Hallmark signs associated with a diaphragmatic herniation? a. Hypoxia b. Barrel chest c. Scaphoid abdomen d. Auscultation of bowel sounds in the thorax

a. Hypoxia c. Scaphoid abdomen d. Auscultation of bowel sounds in the thorax M&M Ch. 42 Pg. 899 Thetford

Regional anesthesia selected for the anesthetic management of a carotid endarterectomy (CEA) requires anesthesia to what range of cervical nerves? a. II-IV b. II-V c. I-V d. I-IV

a. II-IV N&P Chapter 25, page 581 Jennifer

2. Which of the following is not a stage of peripheral B cell development? a. Mature B cell b. Memory B cell c. Plasma cell d. Immature B cell NP ch 41 pg 1020

a. Immature B cell Mbom

A shift in a LV pressure-volume loop upward on the vertical axis represents a. Increase in pressure b. Decrease in pressure c. Increase in volume d. Decrease in volume

a. Increase in pressure Crouse N&P pg. 482

2. Which of the following results in a decreased total body water in older women? a. Increased body fat b. Decreased body fat c. Increased muscle mass d. Decreased muscle mass3

a. Increased body fat d. Decreased muscle mass M&M Ch. 43 Pg. 914 Thetford

A shift in a LV pressure-volume loop from left to right on the horizontal axis will represent a. Increased volume b. Decreased volume c. Increased pressure d. Decreased pressure

a. Increased volume Crouse N&P pg. 482

1. What effect during which phase does the lidocaine have on the conductivity of the myocardial cell? a. Inhibitory effect, phase 0 b. Inhibitory effect, phase 1 c. Shortens duration of phase 4 by decreases the cardiac cell membrane's permeability d. Excitatory effect, phase 0

a. Inhibitory effect, phase 0 Nagelhout Chapter 23, poe 478 Budenbender

What term is defined as the intrinsic ability of the myocardium to pump in the absence of change in preload or afterload? a. Inotropy b. Chronotropy c. Lusitropy d. Dromotropy

a. Inotropy M&M Chapter 20, page 355 Jennifer

3. Which of the following approaches most often meets the anesthesia of the UPPER ARM and SHOULDER? a. Interscalene b. Supraclavicular c. Infraclavicular d. Axillary

a. Interscalene NP 1107 Budenbender

What are some implications associated with prolonged fasting in the pediatric patient? a. Irritability as a result of thirst and hunger b. Pre-induction hypovolemia and hypoglycemia c. Pre-induction hypervolemia and hyperglycemia d. Increased risk of aspiration pneumonitis

a. Irritability as a result of thirst and hunger b. Pre-induction hypovolemia and hypoglycemia DB NP 1196

5. What is the cause of ischemic optic neuropathy a. Ischemia in a portion of the optic nerve b. Ischemia in a portion of the facial nerve c. Ischemia in a portion of the vagus nerve d. Long exposure to surgical lights

a. Ischemia in a portion of the optic nerve Charlie N&P pg 409

3. Common preop meds to reduce separation anxiety include? (Select 2) a. Ketamine b. Versed c. Propofol d. Anectine

a. Ketamine b. Versed M&M page 888 Willie

2. 90% of disc herniations occur at what level(s)? (M&M pg 1023) a. L4-L5 b. L1-L3 c. L2-L3 d. T6-T8

a. L4-L5

4. What are two common airway complications with a pediatric patient? N&P Pg 1203 a. Laryngospasm b. Bronchospasm c. Excessive secretions d. Pulmonary edema

a. Laryngospasm b. Bronchospasm Fieber

2. A patient is identified with a smoking history. Which of the following posses an increase risk factor for nerve injury as well as delayed healing when asking a follow-up questions about their history of smoking? a. Last cigarette was 3 weeks ago b. Has not smoked for 3 months c. Has not smoked for 20 years but had a 1 PPD history for 25 years d. Smoked once in high school, but nothing since

a. Last cigarette was 3 weeks ago NP 407 "A history of smoking within 1 month of the surgical procedure has been identified as a risk factor for nerve injury, as well as for delayed healing." DB

What are the symptoms of proximal tracking of local anesthetic and blockade of the cervicothoracic ganglion? a. Myosis b. Diplopia c. Ptosis d. Mydriasis e. Diaphoresis f. Anhidrosis

a. Myosis c. Ptosis f. Anhidrosis (M&M pg 983) Josh

3. The composition of Lactated Ringers is? Select all that apply. N&P Pg 392 a. NA 130 mEq/L b. K+ 4 mEq/L c. Glucose 5 mEq/L d. Lactate 28 mEq/L e. pH 6.5 f. Osm 440

a. NA 130 mEq/L b. K+ 4 mEq/L d. Lactate 28 mEq/L e. pH 6.5

4. In neonates, which of the following fluids is appropriate to replace third-space losses? a. Hetastartch b. NS c. LR d. D5NS

a. NS b. LR Reference N&P pg 1175 Mandy

5. Which ion is the SA node more permeable to? a. Na+ b. K+ c. Cl- d. Ca+

a. Na+ Nagelhout Chapter 23, page 478 Budenbender

What disease is characterized by immune-mediated joint destruction with chronic and progressive inflammation of synovial membranes? a. Rheumatoid arthritis b. Osteoarthritis c. Avascular necrosis d. Diabetic neuropathy

a. Rheumatoid arthritis M&M Chapter 38, page 795 Jennifer

Which of the following are symptoms of an allergic reaction? (Select 3) a. Rhinitis b. Conjunctivitis c. Headache d. Pruritus

a. Rhinitis b. Conjunctivitis d. Pruritus N&P page 1023 Jennifer

3. During Thoracic aortic aneurysm surgery, where is the preferred site for Arterial line placement? a. Right radial b. Left radial c. Femoral d. None of the above

a. Right radial Reference: N&P pg 573 Mandy

At what spinal level does the dural sac, subarachnoid and subdural space extent to in the adult? a. S2 b. L1 c. L5 d. L4

a. S2 (M&M pg 944) Lake

Cesarean section requires that dermatomes up to and including what thoracic level to be anesthetized? a. T4 b. T5 c. T6 d. T7

a. T4 M&M Chapter 41, page 856 Jennifer

Hyperbaric solutions tend to move to the most dependent area of the spine, what area is this? a. T4-T8 b. T1-T4 c. L1-L4 d. T4-T10

a. T4-T8 M&M Chapter 45, page 956 Jennifer

4. Symptoms of an acute hemolytic reaction include which of the following? a. Tachycardia b. Hypotension c. Hypothermia d. Hemoglobinuria e. Bradycardia

a. Tachycardia b. Hypotension d. Hemoglobinuria M&M Ch. 51 Pg. 1172 Thetford

3. Where does the transmission of primary afferents synapse in the dorsal horn? a. Fast-sharp pain fibers i. Rexed laminae I only ii. Rexed laminae I and III iii. Rexed laminae V b. Slow-chronic pain fibers i. Rexed laminae I only ii. Rexed laminae I and III iii. Rexed laminae V

a. ii b. iii NP 1246 DB

4. What can postural changes alter in a patient's respiratory system? a. Ventilation b. Lung compliance c. Lung volume d. Diaphragm movement

a. Ventilation b. Lung compliance c. Lung volume n&p 404 rebecca

2. Which of the following statements is true? a. When using the CSE technique there is no risk of infection in the subdural space. b. Neurologic injury associated with spinal and epidural anesthesia is very high when the combined spinal/epidural technique is used. c. When the combined spinal epidural technique is used, there is a possibility of catheter migration through the dural puncture into the subarachnoid space. d. The deposition of metallic particles when using the combined spinal epidural technique was proven to be just a myth and should not even cause concern.

a. When the combined spinal epidural technique is used, there is a possibility of catheter migration through the dural puncture into the subarachnoid space. Reference: N&P pg 1096-1097 Mandy

3. In pediatric anesthesia, which of the following may be extubated deep? (Select one) a. an empty stomach b. difficult to ventilate/intubate c. full stomach d. neonates

a. an empty stomach N&P p. 1206 Jason Franklund

1. Which of the following is NOT an indication for blood transfusion? (Select one) a. cardiac surgery b. symptomatic anemia c. acute blood loss of more than 30% d. hemodynamically unstable with continuous blood loss

a. cardiac surgery N&P p. 396 Franklund

2. Where is the central idea for a root cause analysis placed on a concept map? (Select one) a. center b. top c. bottom d. right

a. center N&P p. 1302 Jason Franklund

3. A decrease in erythropoiesis and life span of the newborn's RBC produces a ____ in Hgb, reaching nadir by __ months. a. Decrease;3 b. Increase;3 c. Decrease;4 d. Increase;4

a. decrease; 3 rebecca

2. Which of the following adverse events is NOT associated with delirium in the older adult? (Select one) a. decreased healthcare cost b. depression c. death d. functional decline

a. decreased healthcare cost N&P p. 1220 Jason Franklund

4. Which of the following is NOT included in open disclosure of a critical incident? (Select one) a. delayed communication b. accurate information c. remedial action d. expression of regret

a. delayed communication N&P p. 1303 Jason Franklund

5. Complications of femoral cardiopulmonary bypass cannulation include all of the following EXCEPT? (Select one) a. diversion of blood away from the heart b. retrograde aortic dissection c. limb ischemia d. chest wall hemorrhage

a. diversion of blood away from the heart N&P p. 545 Jason

4. A patient experiencing an MI related to supply ischemia or chronic overload of the left ventricle exhibit ___ a. Eccentric hypertrophy b. Concentric hypertrophy c. Eccentric hypotrophy d. Concentric hypotrophy

a. eccentric hypertrophy n&p pg 514 rebecca

2. Continual increased left ventricular volume results in? (Select one) a. eccentric hypertrophy b. eccentric hypotrophy c. concentric hypertrophy d. concentric hypotrophy

a. eccentric hypertrophy (eccentric = irregular shape) (concentric = regular shape) N&P p. 499 Franklund

3. What vessels are included in the arterial systems? a. Epicardial b. Subendocardial c. Endocardial d. Subepicardial

a. epicardial b. subendocardial n&p pg 473 rebecca

3. Which of the following is the anesthetist NOT in control of during positioning of the patient? (Select one) a. feet b. airway c. head/neck d. coordinating

a. feet N&P p. 417 Jason Franklund

3. Which of the following is NOT a risk factor associated with the development of delirium? (Select one) a. female b. inadequate pain control c. anticholinergic drugs d. duration of anesthesia

a. female N&P p. 1220 Jason Franklund

5. Which of the following is NOT appropriate for the treatment of a 23-year-old pregnant woman that is hypotensive, bradycardic with a prolonged QRS complex and has a magnesium level of 38.7 mg/dL? (Select one) a. fluid bolus b. calcium chloride c. diuresis d. endotracheal intubation

a. fluid bolus N&P p. 1151 Jason

Absorption of irrigation fluid can potentially lead to which of the following complications? (Select 4) a. Fluid volume overload b. CHF c. Pulmonary edema d. Hyperkalemia e. Hyponatremia

a. fluid volume overload b. CHF c. pulmonary edema e. hyponatremia NP: 1003 Byron

3. Which of the following should be removed from discussion during reevaluation of a root cause analysis? (Select one) a. focus on the individual b. reinforcement of good practice c. support for individuals d. explanations to patients and families

a. focus on the individual N&P p. 1303 Jason Franklund

5. What is the definition of radiculopathy? a. functional abnormality of one or more nerve roots b. pain in the distribution of a nerve or a group of nerves c. reduced cutaneous sensation d. pain in an area lacking sensation

a. functional abnormality of one or more nerve roots M&M p. 1026 Jason Franklund

1. Which of the following is NOT an appropriate action for a potentially difficult airway in a pediatric patient? (Select one) a. give neuromuscular blocking agents b. use external manipulation of the trachea during intubation c. use 100% oxygen after deep anesthesia is reached d. prepare a variety of blades, tubes and airways

a. give neuromuscular blocking agents N&P p. 1206 Jason Franklund

2. What position should the ultrasound probe be placed in relative to the spine to identify the ligamentum flavum? (Select one) a. horizontal b. vertical c. caudad d. cephalad

a. horizontal N&P 1091 Jason Franklund

Identify each of the following: a. Brugada syndrome? i. Hereditary channelopathy with RIGHT ventricular conduction delay and ST ELEVATION in right precordial leads (dome or cover-like) associated with incomplete or complete RBBB or ultimately VF ii. Channelopathy with QT interval (> 480 ms) iii. Channelopathy with QT interval (< 340 ms) iv. Genetically mediate cardiac channelopathy induced by exercise or emotional stress with structurally normal hearts b. Long QT syndrome i. Hereditary channelopathy with RIGHT ventricular conduction delay and ST ELEVATION in right precordial leads (dome or cover-like) associated with incomplete or complete RBBB or ultimately VF ii. Channelopathy with QT interval (> 480 ms) iii. Channelopathy with QT interval (< 340 ms) iv. Genetically mediate cardiac channelopathy induced by exercise or emotional stress with structurally normal hearts c. Short QT syndrome i. Hereditary channelopathy with RIGHT ventricular conduction delay and ST ELEVATION in right precordial leads (dome or cover-like) associated with incomplete or complete RBBB or ultimately VF ii. Channelopathy with QT interval (> 480 ms) iii. Channelopathy with QT interval (< 340 ms) iv. Genetically mediate cardiac channelopathy induced by exercise or emotional stress with structurally normal hearts d. Catecholaminergic polymorphic VT i. Hereditary channelopathy with RIGHT ventricular conduction delay and ST ELEVATION in right precordial leads (dome or cover-like) associated with incomplete or complete RBBB or ultimately VF ii. Channelopathy with QT interval (> 480 ms) iii. Channelopathy with QT interval (< 340 ms) iv. Genetically mediate cardiac channelopathy induced by exercise or emotional stress with structurally normal hearts

a. i. b. ii. c. iii. d. iv. NP 1295 DB

Match the following chemical mediators/neurotransmitters: a. Peptide found and released from the peripheral AFFERENT nociceptor C fibers and involved with SLOW, chronic pain. Acts via the G-protein linked neurokinin-1 receptor resulting in vasodilation, extravasation of plasma proteins, degranulation of mast cells, and sensitization of the stimulated sensory nerve i. Substance P ii. Glutamate iii. Cytokines iv. Prostaglandins b. Major excitatory neurotransmitter released in the CNS and from the Aδ and C primary afferent nerve fibers. It effects are instantaneous, prodcing initial, fast-sharp pain i. Substance P ii. Glutamate iii. Cytokines iv. Prostaglandins c. Released in response to tissue injury by a variety of immune and Nonimmune cells via the inflammatory response. Include interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) i. Substance P ii. Glutamate iii. Cytokines iv. Prostaglandins d. Along with thromboxanes and leukotrienes are a metabolite of arachidonic acid, synthesized from COX-1 and COX-2 and are associated withcronic pain, sensitize peripheral nociceptors causing hyeralgesia i. Substance P ii. Glutamate iii. Cytokines iv. Prostaglandins

a. i. b. ii c. iii d. iv NP 1245-1246 DB

4. Which of the following drugs is the neonate capable of metabolizing efficiently? (Select one) a. ibuprofen b. acetaminophen c. chloramphenicol d. sulfonamides

a. ibuprofen N&P p. 1172 Franklund

2. Which of the following approaches listed is the ONLY technique that provides adequate analgesia and anesthesia to the shoulder along with the rest of the upper extremity? a. Axillary b. Supraclavicular c. Interscalene d. Infraclavicular

Answer: C- interscalene N&P pg. 1108 stetler

2. Which of the following is NOT a characteristic of Beck's triad? A. low blood pressure B. jugular vein distension C. distant heart sounds D. tachycardia

Answer: D. tachycardia N & P, pg. 533 Stefania

2. Which of the following is NOT a characteristic of turbulent flow? A. increasing resistance to flow B. Reynold's number greater than 2000 C. chaotic movement of molecules D. parallel flow

Answer: D., parallel flow N & P, pg. 489 Stefania

3. All of the following are criteria for surgical intervention of an AAA EXCEPT? a. Ruptured AAA b. Patients who are symptomatic for an AAA c. 4-5cm AAA with greater then 0.5 cm enlargement in the past six months d. 5.0 cm AAA or greater for an elective repair for patients with a reasonable life expectancy e. All of the following are criteria for surgical intervention of an AAA

Answer: E All of the following N&P pg. 563 Stetler

5. Select the false statement regarding hemodynamics during cardio-pulmonary bypass. A. Mean arterial pressure equals)Pump flow XSVR B. SVR can be increased with phenylephrine, vasopressin, or norepinephrine. C. SVR can be decreased with clevidipine, nicardipine, or nitroprusside. D. Most centers strive for blood flows of 2-2.5 L/min/m 2 (50-60 mL/kg/min) and mean arterial pressures between 50 and 80 mm Hg. E. All of the above are correct.

Answer: E Morgan & Mikhail pg. 458.

3. Which of the following are considered predisposing factors to premature rupture of membranes? a. Short cervix b. Infection c. Multiple gestations d. Smoking e. All of the above

Answer: E- All of the above Morgan & Mikhail's Clinical Anesthesiology pg. 863 Stetler

5. Which of the following medications can be given induce the production of pulmonary surfactant in a preterm infant? a. Glucocorticoid b. Terbutaline c. Magnesium d. Ritodrine

Answer: Glucocorticoid (betamethasone) Morgan & Mikhail's Clinical Anesthesiology pg. 864 Stetler

3. Regarding NPO guidelines, match the following times with the type of liquid a. Breast milk b. Infant formula c. Light meal d. Fried or fatty foods i. 4 hours ii. 6 hours iii. 8 hours or more

Answers: a—I; b—ii; c—ii; d—iii Reference N&P pg 1175 Mandy

1. Match the following advantages to the type of solution. a. Promotes urinary flow b. Causes more rapid resuscitation c. Useful in condition of altered vascular permeability d. Used for extracellular fluid replacement i. Colloid ii. Crystalloid

Answers: a—ii; b—I; c—I; d—ii Reference: N&P pg 394 Mandy

1. What is the recommend amount of time that Betadine should remain in contact with the patient's skin in order to properly work? a. At least 1 minute b. At least 10 minutes c. At least 30 minutes d. Betadine works on contact and doesn't require drying time

At least 1 minute Charlie N&P pg. 1080

5. Which of the following muscle relaxants pharmacological profile is unaltered in aging patients? a. Atracurium b. succinylcholine c. rocuronium d. pancuronium M&M ch 43 pg 915

Atracurium Mbom

Which is NOT the cause of airway mortality? a. Failure to ventilate b. Failure to intubate c. Failure to paralyze d. Failure to hydrate

B NP 1295 DB

Which of the following complications are often equal to or outnumber cardiac events a. Cardiac events are #1 b. Pulmonary complications c. Dehydration d. Starvation from being NPO

B NP 1295 DB

1. What is the preferential channel for conduction of the action potential from the atria to the ventricles? a. AV node b. Atrioventricular Bundle c. SA node d. Perkinje System

B Atrioventricular bundle N&P: 475 Justin

The incidence of ulnar neuropathy after surgery and anesthesia ranges from _______%. A) 0.01-0.02 B) 0.04-0.5 C) 0.5-1.5 D) 1.5-2.0

B) 0.04-0.5 [N&P p.407] Devin

What is the intracellular concentration of potassium? A) 4.2 B) 140 C) 120 D) 3.5

B) 140 Devin [N&P p.383]

The typical cardio pulmonary bypass machine has _____ basic components? A) 2 B) 6 C) 4 D) 5

B) 6 Devin [M&M p.437]

Fat embolism syndrome typically presents within ________ following long-bone or pelvic fracture. A) 24 hours B) 72 hours C) 48 hours D) 84 hours

B) 72 hours Devin [M&M p.789]

_______&_________ are major risk factors in the pathogenesis of atherosclerosis in the peripheral vascular system. A) hypotension & tachycardia B) Cigarette smoking & diabetes mellitus C) running & jogging D) alchohol & illicit drugs

B) Cigarette smoking & diabetes mellitus Devin [N&P p.561]

1. In the older adult, the heart and vascular system is _______ compliant, leading to a _________ propagation of the pulse pressure waveform, increase in afterload, and an increase in systolic BP. A) Less, Slower B) Less, Faster C) More, Faster D) More, Slower

B) Less, Faster Devin [N&P p.1215]

At rest, the myocardial cell membrane is nominally permeable to K+, but is relatively impermeable to ____? A) K B) Na C) Mg D) Ca

B) Na Devin [M&M p.344]

All of the following are causes of maternal hemorrhage EXCEPT? A) Placenta previa B) Uterine fibroids C) Abruptio placentae D) Uterine rupture

B) Uterine fibroids Devin [M&M p.844]

1. ________ pain is often associated with the distention of an organ capsule or the obstruction of a hollow viscus. A) Somatic B) Visceral C) Acute D) Idiopathic

B) Visceral Devin [N&P p.12144]

Normal resting cell membrane potential is __________? A. -20 to -40 mV B. -80 to -90 mV C. 80 to 90 mV D. -60 to -80 mV

B. -80 to -90 mV M&M Ch, 20 pg. 345 K. Jensen

The anesthesia provider must assess, monitor, and document blood loss. A fully soaked 4X4 sponge is estimated to hold _________ mL of blood A. 15 mL B. 10 mL C. 30 mL D. 100 mL

B. 10 mL M&M Ch. 51 pg. 1167 K. Jensen

The umbilical cord has how many arteries? A. 1 B. 2 C. 3 D. 4

B. 2 N&P page 1163, 1st column 3rd paragraph Abe

Cardiovascular diseases increase with age. Cardiac complications account for______to ______ of deaths following noncardiac surgery in patients with preexisting cardiovascular disease? A. 10% to 15% B. 25% to 50% C. 50% to 75% D. <10%

B. 25% to 50% M&M Ch. 21 pg.375 K. Jensen

Functional capacity that is less than ________ METS is directly associated with adverse outcomes. A. 10 B. 4 C. 6 D. 8

B. 4 M&M Ch. 43 pg. 908 K. Jensen

What is the duration of action of IV dilaudid? (N and P, page 1250) A. 5-6 hours B. 4-5 hours C. 2-3 hours D. 3-4 hours

B. 4-5 hours Maggie

1.) For the reversal of warfarin, FFP is usually administered in what doses? (N and P, page 397) A. 9 mL/kg B. 5-8 mL/kg C. 1-2 mL/kg D. 2-4 mL/kg

B. 5-8 mL/kg Shackelford

5.) What is the effective dose (ED95) of rocuronium in a neonate? (N and P, page 1173) A. 100 mcg/kg B. 600 mcg/kg C. 500 mcg/kg D.200 mcg/kg

B. 600 mcg/kg Shackelford

What is the average blood volume for a full-term neonate? A. 90-100 ml/kg B. 80-90 ml/kg C. 60 ml/kg D. 70 ml/kg

B. 80-90 ml/kg N&P page 395, Table 20-11 Abe

5. What is preemptive analgesia? A. Assuming your patient is in pain when they cannot speak. B. Administering analgesics prior to painful stimuli C. When a patient thinks they feel pain before stimuli has occured. D. When a patient tells you they need pain medication.

B. Administering analgesics prior to painful stimuli N&P 1248 Justin

What plasma protein is primarily responsible for the binding of acidic drugs? A. Alpha-1-Acid glycoprotein B. Albumin C. Monoamine oxidase D. Catechol-O-Methyltransferase

B. Albumin N&P page 1191, 2nd column 3rd paragraph Abe

Patients who have type-B blood have what type of serum antibodies? A. Anti-B B. Anti-A C. Anti-A & Anti-B D. No serum antibodies

B. Anti-A N&P page 395, Table 20-12 Abe

4. Uterine blood flow is dependent on _____ and has ____ autoregulatory capabilities a. Venous pressure; many b. Arterial pressure; few c. Arterial pressure; many d. Venous pressure; few

B. Arterial pressure; few N&P 1103 Rebecca

Most patients who develop a descending thoracic aortic aneurysm (DTAA) are: A. Symptomatic B. Asymptomatic C. Confused D. Short of breath

B. Asymptomatic N&P Ch. 25 pg. 572 K. Jensen

Which of the following are considered to be "auxiliary cells" (select 3) A. Lymphocytes B. Basophils C. Mast Cells D. Platelets

B. Basophils C. Mast Cells D. Platelets N&P Ch. 41 pg. 1015 K. Jensen

4.) Which nerve fibers are smallest in diameter? (N and P, page 1074) A. A-beta B. C Fibers C. B fibers D. A-Alpha

B. C-fibers Maggie

Occipital Nerve Blocks are therapeutically and diagnostically useful blocks in patients with neuralgia and headaches. The greater occipital nerve branches off of the _____ ______ spinal nerves. A. C5-C6 B. C2- C3 C. C4- C5 D. C-7-T-1

B. C2- C3 M&M Ch. 47 pg. 1065 K. Jensen

Which of the following respiratory changes in the geriatric population is correct? A. Increased lung compliance B. Decreased lung compliance C. Increased intercostal muscle mass D. Increased elastic recoil of the lung

B. Decreased Lung Compliance N&P 1217 Justin

The right ventricle receives __________, _________ blood. (Select 2) A. Pulmonary B. Deoxygenated C. Systemic venous D. Oxygenated

B. Deoxygenated C. Systemic venous M&M Ch. 20 pg. 344 K. Jensen

5. In the preverbal patient, which of the following would NOT be considered a sign of pain? a. Tachycardia b. Elevated BP c. Crying d. Restlessness E. Grimacing D. All of the above are associated with pain in the preverbal patient

D. All of the above are associated with pain in the preverbal patient N&P page 1168

4. When should you aspirate after placement of epidural cath. a. Before every injection b. only after initial placement c. after each injection d. aspiration is not necessary unless you thing something is wrong

Before every injection Charlie N&P pg. 1138

5. Which of the following is considered a clear liquid? a. Black coffee b. Fruit juice with minimal pulp c. Sprite d. Coca Cola

Black coffee a. Sprite Reference: N&P pg 1175 Mandy

1) What are some risk factors for delirium? a) Age, Surgery, Genetic b) DM, Age, Surgery, Seizure c) Older age, Male gender, Dementia, Alcohol abuse, Depression, Duration of anesthesia, Poor functional status, Abnormal electrolytes and glucose, Parkinson's disease, Cardiovascular disease, Dehydration, DM/Hyperthyroidism, Anticholinergic drugs used intraoperatively, inadequate pain control, and type of surgery N&P Ch. 49 pg. 1220

C Jared

1) What is the best suited block for upper extremity (hand and wrist) soft-tissue surgical procedures of 1 hour or less? a) Brachial Plexus block b) Auxiliary block c) Bier block N&P Chapter 45 pg. 1116

C Jared

1) What is the incidence of bacterial contamination in a unit of platelets? a) 1: 1,000,000 b) 1: 50,000 c) 1: 12,000 N&P Chapter 20 pg. 399

C Jared

1) What is the most common location for nerve injury associated with peripheral nerve block claims? a) Adductor canal b) Intercostal c) Brachial Plexus M&M Ch. 54 pg. 1208

C Jared

1) When a pregnancy has been diagnosed as placenta previa, what type of anesthesia should a CRNA prepare? a) MAC or General b) MAC or Regional c) General or Regional N&P Ch. 46 pg. 1153

C Jared

2) What are the two types of acute nociceptive pain? a) Neuropathic, Somatic b) Neuropathic, Visceral c) Visceral, Somatic M&M Ch. 47 pg. 1026

C Jared

2) What constitutes the third most common source of anesthesia litigation? a) Airway manipulation b) Brain Injury c) Nerve Injury M&M Ch. 54 pg. 1208

C Jared

2) What is CEA? A) Cerebral Endoscopic Arteriogram B) Circulatory Ejection Aspiration C) Carotid Endarterectomy N&P Chapter 25 pg 587

C Jared

2) Why is the nondependent leg straight and supported by a pillow between the lower extremities in the lateral decubitus position? a) Prevents patient from moving during surgery b) Prevents Common Peroneal Nerve damage c) Prevents compression of the inferior leg by the superior extremity N&P Ch. 21 pg. 417

C Jared

3) In the pediatric population, what is the most common cause of respiratory arrest? a) Failed intubation b) Medication error c) Laryngospasm M&M Ch. 54 pg. 1209

C Jared

3) What 2 types of procedures does delirium most commonly occur? a) OB GYN & Vascular b) Neuro & Intraabdominal c) Orthopedic & Cardiac N&P Ch. 49 pg. 1220

C Jared

3) What are the two classifications of somatic pain? a) Neuropathic, Visceral b) Neurological, Superficial c) Superficial, Deep M&M Ch. 47 pg. 1026

C Jared

3) What is the most common complication of a CEA? A) Pulmonary Emboli B) MI C) Stroked N&P Chapter 25 pg 585

C Jared

3) What is the most common presentation of placenta previa? a) placenta accreta (on the myometrium) - 5% b) placenta increta (into the myometrium) - 17% c) placenta percreta (completely through the myometrium) - 78% N&P Ch. 46 pg. 1153

C Jared

3) What muscle tissue problems have been reported when positioned in the lateral decubitus position? a) Polymyositis b) Myasthenia Gravis c) Rhabdomyolysis N&P Ch. 21 pg. 417

C Jared

3) What type of nerve block can lead to the highest local anesthetic plasma levels of any regional techniques? a) Adductor canal block b) Bier block c) Multiple-level intercostal nerve block N&P Chapter 45 pg. 1117

C Jared

4) In the lateral decubitus position, where is the axillary roll placed? a) Directly under the axilla b) Cephalad to the axilla c) Slightly caudad to the axilla N&P Ch. 21 pg. 417

C Jared

4) Neurologic deficits and Neurologic diseases are most often associated with what type of complications? a) PONV b) Neuropathy c) Delirium N&P Ch. 49 pg. 1220

C Jared

4) Non-hemolytic transfusion reactions are relatively common, occurring in 1% to 5% of all transfusions, and are associated with what symptoms? a) Head ache, chills, and oliguria b) Fever, back ache, hypothermia c) Fever, chills, and urticaria N&P Chapter 20 pg. 398

C Jared

4) What classification of pain is rheumatoid arthritis and osteoarthritis? a) Neurologic b) Somatic c) Nociceptive M&M Ch. 47 pg. 1027

C Jared

4) What is one advantage of using multiple-level intercostal nerve blocks? a) Reduction in the concentration of anesthetic required to facilitate normal respirations b) Reduction in the volume of anesthetic required to facilitate normal respiration c) Reduction in the amount of pain medication required to facilitate normal respiration in the postoperative period N&P Chapter 45 pg. 1117

C Jared

4) What is the most common site for dental injury? a) Molars b) Premolars c) Upper Incisors M&M Ch. 54 pg. 1211

C Jared

4) What percentage of all parturients experience post-partum hemorrhage? a) 10% b) 20% c) 4% N&P Ch. 46 pg. 1153

C Jared

4) What type of anesthesia reduces the risk of stroke for CEA procedure's? A) MAC B) General C) Regional N&P Chapter 25 pg 581

C Jared

5) Approximately how much should we decrease our induction dose in the elderly? a) 5% to 20% b) 20% to 40% c) 30% to 40% N&P Ch. 49 pg. 1220

C Jared

5) Once supportive treatment is initiated for TRALI, what else must the anesthesia provider do? a) Keep transfusing the blood b) Perform a therapeutic phlebotomy c) Notify the blood bank that a transfusion reaction suspected to be TRALI has occurred N&P Chapter 20 pg. 398

C Jared

5) What is the major limiting factor for regional technique in CEA cases? A) Increased risk for stroke B) Decreased risk of aspiration C) Patient acceptance N&P Chapter 25 pg 581

C Jared

5) What is the most common cause of PPH (post-partum hemorrhaging) that accounts for 80% of all postpartum bleeding? a) placental retention b) lacerations of the cervix or vaginal wall c) uterine atony N&P Ch. 46 pg. 1153

C Jared

5) Why is the sitting position preferred for a shoulder arthroplasty/arthroscopy? a) Reduces airway complications and aids surgical exposure b) Reduces thoracic malposition and aids surgical exposure c) Reduces brachial plexus stretch and aids surgical exposure and manipulation N&P Ch. 21 pg. 417

C Jared

Jared Dumas Student Questions: Pain Management 1) What is the main cause of acute pain? a) Neuropathic b) Fibromyalgia c) Nociceptive M&M Ch. 47 pg. 1026

C Jared

Prior to use, the CPB circuit must be primed with about how much fluid for adults? A) 2000-3000 mL B) 200-300 mL C) 1200-1800 mL D) 500-1000 mL

C) 1200-1800 mL Devin [M&M p.438]

3. Elderly patients able to perform greater than ____ METs are at a decreased risk for perioperative cardiac complications. A) 2 B) 1 C) 4 D) 3

C) 4 [N&P p.1215] Devin

The clinical importance of sodium disorders is due largely to the influence of sodium on the water content in ________ cells. A) Muscle B) Cardiac C) Brain D) Kidney

C) Brain Devin [N&P p.384]

2) Mechanical ventilation can increase evaporative loss of water and decrease the release of atrial natriuretic peptide, leading to what kind of electrolyte imbalance? a) Conservation of potassium b) Conservation of calcium C) Conservation of Sodium

C) Conservation of Sodium N&P Ch. 20 pg. 383 JDumas

Regardless of the time of last oral intake, all OB patients are considered to have what? A) Empty stomachs B) Half-full stomachs C) Full stomachs D) Quarter-full stomachs

C) Full stomachs Devin [M&M p.845]

3. ________ pain is associated with chronic pain states and is used to describe pain that has no apparent cause. A) Visceral B) Neuropathic C) Idiopathic D) Acute

C) Idiopathic [N&P p.1244] Devin

All of the following are criteria for high risk in abdominal aortic aneurysm repair except what? A) Female B) Older than 70 years C) Male D) Diabetes

C) Male Devin [N&P p.563]

All of the following can occur if a pneumatic tourniquet is inflated for longer than 2 hours EXCEPT: A) permanent nerve damage B) Rhabdomyolysis C) Peripheral optic neuropathy D) Transient muscle dysfunction

C) Peripheral optic neuropathy Devin [M&M p.791]

3. What is the incidence rating of delirium and Post-op cognitive dysfunction in the elderly undergoing cardiac procedures? A. 5% B. 10%-20% C. 30%-80% D. 90%

C. Justin N&P 1293

Ketamine can produce analgesia without loss of consciousness within 2-5 minutes. What dose is given to achieve analgesia for the labor intensive parturient? a. 2-5 mg IV b. 5-10 mg IV c. 10-15 mg IV d. 15-20 mg IV

C. 10-15 mg IV (M&M pg 847) Josh

In the lithotomy position, elevation of the legs above the trunk may provide the patient an autotransfusion of how many mL per leg? A. 25-50 B. 50-75 C. 100-250 D. 350-400

C. 100-250 N&P page 403, 2nd column 1st paragraph Abe

Increased cardiac conduction velocity, increased force of contraction, and increased heart rate are primarily mediated by what adrenergic receptor? a. Alpha-1 b. Alpha -2 c. Beta-1 d. Beta-2

C. beta - 1 N&P: 475 Justin

What is the normal range for pulmonary capillary wedge pressure? a. 1-10 mmHg b. 4-12 mmHg c. 5-15 mmHg d. 10-20 mmHg

C: 5-15 mmHg NP: 525 Byron

How long prior to surgery does the Society of Thoracic Surgeons recommend discontinuing Plavix prior to elective surgery? a. 1-3 days b. 3-5 days c. 5-7 days d. 7-14 days

C: 5-7 days NP: 523 Byron

Cardiac effects of hypocalcemia include a. Cardiac arrest b. Tachycardia c. Hypertension d. Increased inotropy

Cardiac arrest Charlie N & P pg. 390

Fill in the blank: According to Nagelhout, the __________ is the narrowest location of the pediatric airway.

Cricoid NP: 1166 Byron

1. What is the definition of allodynia? (Select one) a. perception of an ordinarily nonnoxious stimulus as pain b. absence of all sensation c. diminished response to noxious stimulation d. absence of pain perception

a. perception of an ordinarily nonnoxious stimulus as pain M&M p. 1026 Jason Franklund

1. What is the primary risk associated with an intercostal nerve block? (Select one) a. pneumothorax b. hematoma c. spinal anesthesia d. local anesthetic toxicity

a. pneumothorax N&P 1119 Jason Franklund

5. Who is the "second victim" in an unanticipated adverse patient event? (Select one) a. practitioner b. family c. patient d. practitioner's spouse

a. practitioner N&P p. 1303 Jason Franklund

1. Total body water is highest during which stage of maturation? (Select one) a. premature b. infant c. child d. adult

a. premature N&P p. 1172 Franklund

The ........... valve connects the RV to the pulmonary artery?

a. pulmonic Mbom

4. Chronic elevation of left atrial pressure will ultimately result in failure of the? (Select one) a. right ventricle b. right atria c. left ventricle d. left atria

a. right ventricle N&P p. 498 Franklund

3. Which of the following nerves is NOT part of the lumbar plexus? (Select one) a. saphenous b. lateral femoral cutaneous c. obturator d. femoral

a. saphenous N&P 1119 Jason Franklund

3. Which of the following is NOT an example of nonnoxious pain? (Select one) a. sharp pain b. light touch c. proprioception d. temperature sensation

a. sharp pain M&M p. 1025 Jason Franklund

Cardiovascular changes that accompany a normal pregnancy include an increased: (select three) (M&M pg 826) a. Stroke volume b. systolic blood pressure c. systemic vascular resistance d. heart rate e. plasma volume f. diastolic blood pressure

a. stroke volume d. heart rate e. plasma volume

An intersternocleidomastoid approach is a newer supraclavicular approach to block the brachial plexus. There are several benefits to this approach, among them is that there is no risk for which of the following possible complications associated with other approaches? (Select 3) a. Subarachnoid injection b. Epidural injection c. Pleural puncture d. Intravertebral artery injection

a. subarachnoid injection b. epidural injection d. intravertebral artery injection NP: 1111 Byron

Which of the following are complications that can occur with arthroscopic procedures? (Select 3) a. Subcutaneous emphysema b. Pneumomediastinum c. Pericardial effusion d. Tension pneumothorax

a. subcutaneous emphysema b. pneumomediastinum d. tension pneumothorax NP: 1003 Byron

4. What is the proper care for the dependent ear in the lateral position? (Select one) a. suspended by a gel donut b. on a pillow c. on a bolster d. protected with ear muffs

a. suspended by a gel donut N&P p. 417 Jason Franklund

5. Complete the following sentence." The left circumflex artery arises from _____at an_____ angle, and it is directed posteriorly as it travels around the _____ of the heart within the AV sulcus."

a. the left main coronary artery, obtuse, left side n&p pg 473 rebecca

4. Which of the following postoperative adverse reactions is NOT associated with delirium? (Select one) a. unidentifiable etiology b. myocardial infarction c. pneumonia d. death

a. unidentifiable etiology N&P p. 1220 Jason Franklund

4. What vitamin should newborns receive prophylactically because their levels are 20-50% of adult levels? a. Vitamin k b. Vitamin b c. Vitamin c d. Vitamin d

a. vitamin k rebecca

1.) What is the recommended dosage of epinephrine for a neonate in asystole or that has a spontaneous heart rate of less than 60 beats/min? a.) 0.01-0.03 mg/kg b.) 0.1mg-0.3 mg/kg c.) 1mg-3 mg/kg d.) 1mg

a.) 0.01-0.03 mg/kg M&M page 874

2.) What is the recommended dosage of naloxone for the reversal of respiratory depression in a neonate due to opioids given to the mother in labor? a.) 0.1mg/kg b.) 1mg/kg c.) 5mg d.) 10mg M&M page 874

a.) 0.1mg/kg M&M page 874

1.) For blood salvage and reinfusion to be used effectively, what is the minimum amount of blood loss must occur? a.) 1-1.5L b.) 2-3L c.) 5L d.) < 0.5L M&M page 1176

a.) 1-1.5L Zino

3.) What is the mL/kg for volume expansion of a neonate presenting with low blood pressure? a.) 10 mL/kg b.) 20 mL/kg c.) 2 mL/kg d.) 30 mL/kg M&M page 874

a.) 10 mL/kg M&M page 874

5.) Cardiac compressions should be provided at what rate for neonates requiring CPR? a.) 120/min b.) 50/min c.) 20/min d.) 200/min M&M page 873

a.) 120/min M&M page 873

3.) At least how many fingerbreadths of space between the mandible and neck must there be with a patient is the modified sitting position? a.) 2 b.) 4 c.) 1 d.) 0 Nagelhout page 418

a.) 2 Zino

4.) A blood glucose less than what is considered to be hypoglycemic in a neonate after delivery? a.) 35 mg/dL b.) 50 mg/ dL c.) 60 mg/dL d.) 100 mg/dL M&M page 874

a.) 35 mg/dL M&M page 874

1.) MAC for inhalation agents is reduced by what percent over decade of age over 40 years? a.) 4% b.) 10% c.) 50% d.) 15% M&M page 914

a.) 4% Zino

4.) Systolic blood pressure from the calf during beach chair position can read how much higher than if the upper arm was used? a.) 40 mm Hg b.) 60 mm Hg c.) 20 mm Hg d.) 100 mm Hg M&M page 801

a.) 40 mm Hg Zino

2.) A modified or beach chair position is when the torso is elevated to what degree? a.) 45 degrees b.) 90 degrees c.) 30 degrees d.) 110 degrees Nagelhout page 417

a.) 45 degrees Zino

2.) Preoperative placement of an indwelling perineural catheter with subsequent infusion of a dilute local anesthetic infusion allows for postoperative analgesia for up to how long? a.) 48-72 hrs b.) 1 week c.) 14 days d.) 12 hrs M&M page 801

a.) 48-72 hrs Zino

4.) If a patient requests blood donated from a family member, how long in advance must they family member donate? a.) 7 days b.) 24 hours c.) 2 days d.) 12 hours M&M page 1176

a.) 7 days Zino

5.) Extracellular concentration of potassium increases how much after 1 unit of PRBCs transfused? a.) <4 mEq per unit b.) 6 mEq per unit c.) 10 mEq per unit d.) 2 mEq per unit M&M page 1175

a.) <4 mEq per unit Zino

1.) Which of the following can the anesthesia provider do to treat relatively high magnesium levels? (select 3) a.) Administer calcium b) Administer a loop diuretic c.) Dialysis d.) Administer lactated ringers

a.) Administer calcium b) Administer a loop diuretic c.) Dialysis M&M page 1136, Zino

3.) What two phosphate- binding antacids can be given in patients with hyperphosphatemia? a.) Aluminum hydroxide b.) Aluminum carbonate c.) bicitrate d.) Nexium

a.) Aluminum hydroxide b.) Aluminum carbonate M&M page 1134, Zino

2.) What antimuscarinic drug must be given before an awake induction of a neonate presenting with spina bifida? a.) Atropine b.) Glycopyrrolate c.) Robinul d.) Scopolamine M&M page 1188

a.) Atropine Zino

4.) What reflex is responsible for the profound hypotension and bradycardia during shoulder surgery in the sitting position? a.) Bezold-Jarisch b.) Vagal c.) Hering Breuer d.) J-receptor Nagelhout page 418

a.) Bezold-Jarisch Zino

2.) Recovery from anesthesia in the geriatric population may be prolonged due to increased_____ and decreased_______. a.) Body fat, pulmonary gas exchange b.) Pulmonary gas exchange, body fat c.) Muscle mass, body fat d.) FRC, height M&M page 914

a.) Body fat, pulmonary gas exchange Zino

3.) What vertebral nerves are involved when performing a superficial cervical plexus block? a.) C1-C4 b.) C1-C6 c.) C4-T1 d.) C3-C5 M&M page 1017

a.) C1-C4 Zino

4.) Superficial cervical plexus block effectively blocks which cervical nerves? a.) C2-C4 b.) C1-C3 c.) C2-C5 d.) C1-C7

a.) C2-C4 M&M page 483 Zino

2.) When performing an intercostal nerve block, in what direction is the needle pointed after walking off the rib? a.) Cephalad b.) Caudal c.) Laterally d.) Medially M&M page 1018

a.) Cephalad Zino

1.) In the prone position, care must be taken to protect the eyes to avoid what two complications? a.) Corneal abrasions b.) Post op vision loss c.) Increased venous return d.) Decreased periorbital swelling Nagelhout page 419

a.) Corneal abrasions b.) Post op vision loss Zino

1.) Where is the preferable location to place the arterial transducer while a patient is in the beach chair position? a.) External meatus of the ear b.) Below the heart c.) The level of the heart d.) It doesn't matter where it is placed M&M page 801

a.) External meatus of the ear Zino

4.) Arnold-Chiari malformation is a result of the hindbrain being displaced downward into what anatomic feature? a.) Foramen magnum b.) Foramen ovale c.) Spinous process d.) Vertebral body M&M page 1188

a.) Foramen magnum Zino

5.) Brachial plexus blocks do not anesthetize what nerve distribution? a.) Intercostobrachial b.) Interscalene c.) Axillary d.) Paravertebral M&M page 801

a.) Intercostobrachial Zino

3.) What type of block is ideal for shoulder procedures? a.) Interscalene block b.) Supraclavicular block c.) Infraclavicular block d.) Axillary block M&M page 801

a.) Interscalene block Zino

4.) The cervical plexus of C1-C4 provide sensation to which of the following? Select 3 a.) Jaw b.) Neck c.) Anterior shoulder d.) Ear e.) Nose M&M page 1017

a.) Jaw b.) Neck c.) Anterior shoulder Zino

2.) Spinal and epidural spinal cord injury can be avoided if the injection is below what level in adults? a.) L1 b.) L5 c.) S1 d.) T12 M&M page 970

a.) L1 Zino

3.) Spinal and epidural spinal cord injury can be avoided if the injection is below what level in children? a.) L3 b.) L1 c.) L5 d.) T6 M&M page 970

a.) L3 Zino

3.) With geriatrics, protein bound drugs such as barbiturates have a______ distribution due to decreased albumin production. a.) Larger b.) Smaller c.) No change d.) Barbiturates are not protein bound drugs M&M page 914

a.) Larger Zino

5.) What are two airway complications that are associated with hypocalcemia? a.) Laryngeal stridor (Laryngospasm) b.) Bronchospasm c.) Bronchodilation d.) Decreased airway secretions

a.) Laryngeal stridor (Laryngospasm) b.) Bronchospasm M&M page 1133, Zino

3.) If spina bifida malformation is too large for the neonate to be placed supine for induction, what is the next recommended position? a.) Lateral b.) Prone c.) Remains supine d.) Reverse Trendelenburg M&M page 1188

a.) Lateral Zino

5.) Herniation of the spinal cord that includes meninges and neural elements is called? a.) Myelomeningocele b.) Meningocele c.) Chiari malformation d.) Scoliosis M&M page 1187

a.) Myelomeningocele Zino

1.) What is the induction method of choice for neonates presenting with hydrocephalus and increased ICP? a.) RSI with OETT b.) Standard induction with OETT c.) Standard induction with NETT d.) Standard induction with LMA M&M page 1187

a.) RSI with OETT Zino

5.) What kind of response do elderly patient have to beta adrenergic agents? a.) Reduced b.) Increased c.) Greatly increased d.) No change M&M page 911

a.) Reduced Zino

1.) During descending thoracic aorta surgery, when is the greatest risk for hemodynamic instability? a.) Release of the aortic cross clamp b.) During aortic cross clamp c.) During rewarming d.) None of the above

a.) Release of the aortic cross clamp M&M page 479 Zino

1.) If an epidural catheter is to be removed while the needle remains insitu, what are the recommendations for removal? a.) Remove both the catheter and needle together b.) Remove only the catheter c.) Leave the catheter and remove the needle d.) Remove the needle, then the catheter M&M page 972

a.) Remove both the catheter and needle together Zino

2.) What are 2 contraindications to using blood salvaging? a.) Septic contamination of the wound b.) Malignancy c.) Large wounds d.) Wounds on the back M&M page 1176

a.) Septic contamination of the wound Zino

5.) Signs and symptoms of a spinal or epidural hematoma include: select 3 a.) Sharpe back/leg pain b.) Dull back/leg pain c.) Sphincter dysfunction d.) Motor weakness M&M page 970

a.) Sharpe back/leg pain c.) Sphincter dysfunction d.) Motor weakness Zino

4.) Signs and symptoms of formation of a spinal or epidural hematoma are usually how fast? a.) Sudden b.) Delayed c.) No symptoms d.) 2-4 days M&M page 970

a.) Sudden Zino

3.) What type of regional block maybe utilized for carotid surgery? a.) Superficial cervical plexus block b.) Interscalene block c.) Bier block d.) Spinal anesthesia

a.) Superficial cervical plexus block M&M page 483 Zino

1.) When performing a paravertebral block, what levels must be anesthetized for a patient undergoing a mastectomy? a.) T3-T6 b.) T1-T4 c.) C7-T2 d.) T4-T10 M&M page 1019

a.) T3-T6 Zino

5.) What is the major advantage of using regional anesthesia with carotid surgery compared to general anesthesia? a.) The patient can be examined intraoperatively for neurological deficits b.) Costs less c.) Does not require cooperation with the surgeon d.) Has more hemodynamic instability

a.) The patient can be examined intraoperatively for neurological deficits M&M page 483 Zino

3.) Why must blood be cooled after it has been removed from a patient before surgery? a.) To preserve platelet function b.) Gets rid of bacteria c.) Hospital protocol d.) Destroys antigens M&M page 1176

a.) To preserve platelet function Zino

5.) With the prone position, if the arms are tucked, the palms should be facing where? a.) Toward the thighs b.) Away from the body c.) Supine d.) Prone Nagelhout page 419

a.) Toward the thighs Zino

5.) List the following structures in order superiorly to inferiorly when referring to an intercostal block. a.) Vein, Artery, Nerve b.) Artery, Nerve, Vein c.) Vein, Nerve, Artery d.) Nerve, Vein, Artery M&M page 1019

a.) Vein, Artery, Nerve Zino

2.) What can be done to minimize hemodynamic instability during the release of the aortic cross clamp? (Select 3) a.) Volume loading b.) Decreasing anesthetic depth c.) Partial/slow release of cross clamp d.) Administer magnesium

a.) Volume loading b.) Decreasing anesthetic depth c.) Partial/slow release of cross clamp M&M page 479 Zino

1. "Atria natriuretic peptide is released from the _____ in response to _______ and B-type natriuretic peptide is released from the _____ in response to _____." a. Atria, fluid overload; ventricle, increased wall stress b. Ventricle, increased wall stress; atria, fluid overload c. Ventricle, fluid overload; atria, wall stress

a.atria, fluid overload; ventricle, increased wall stress n&p pg 513 rebecca

How many vertebrae are in the human spine? a. 7 cervical, 12 thoracic, 5 lumbar, 5 sacral b. 8 cervical, 12 thoracic, 5 lumbar, 5 sacral c. 7 cervical, 12 thoracic, 7 lumbar, 7 sacral d. 5 cervical, 12 thoracic, 7 lumbar, 7 sacral

answer - a. M&M page 940 Krum

Place the following anatomical landmarks in order from posterior to anterior as the needle would pass in an epidural catheter placement. a. skin, supraspinous ligament, interspinous ligament, ligamentum flavum, epidural space b. supraspinous ligament, skin, ligamentum flavum, epidural space, interspinous ligament c. skin, ligamentum flavum, epidural space, interspinous ligament, supraspinous ligament d. skin, epidural space, interspinous ligament, supraspinous ligament, ligamentum flavum

answer - a. M&M page 940 Krum

What ligaments give rise to the main support for the vertebral bodies and the intervertebral disks? a. anterior and posterior longitudinal ligaments b. inferior and superior longitudinal ligaments c. ligamentum flavum d. ligamentum equine

answer - a. M&M page 941 Krum

What is the name of the second cervical vertebrae? a. atlas b. axis c. cornical d. cervix

answer - b. M&M page 941 Krum

One unit of platelets generally contains how many mL of plasma? (whole numbers only)

any numbers between 50 - 70 M&M Chapter 51 page 1170 Jennifer

Hypotensive bradycardic episodes are a relatively common adverse effect of shoulder arthroscopy, which of the following is the most common proposed mechanism for this event? a. Cushing's Reflex b. Bezold-Jarisch Reflex c. Hering-Breuer Reflex d. Bainbridge Reflex

b. Bezold-Jarisch Reflex NP: 1006 Byron

In contrast to an adult airway, the laryngeal location of the pediatric airway falls between what cervical vertebrae? a. C1-C3 b. C2-C4 c. C3-C6 d. C4-C7

b. C2-C4 NP: 1166 Byron

2. Which of the following is an example of secondary frailty? a. Aging b. CHF c. COPD d. End-stage Cancer

b. CHF c. COPD d. End-stage Cancer Reference: N&P pg 1222

2. Feedings in pediatric patients with a tracheoesophageal fistula leads to which of the following? a. Gastric distention b. Choking c. Coughing d. Cyanosis e. Cardiac arrest

b. Choking c. Coughing d. Cyanosis M&M Ch. 42 Pg. 900 Thetford

A patient who was just in an MVC has experienced approximately 1,000cc of blood loss, with a reduction in their blood volume by 20% and has a hemoglobin of 9 g/dL would be considered to be what class of hemorrhage? a. Class I b. Class II c. Class III d. Class IV

b. Class II NP: 398 Byron

4. Plasma catecholamines are directly proportional to which of the following? a. Stimulation of the parasympathetic system b. Left ventricular failure c. Degree of sympathetic blockade d. None of the above

b. Left ventricular failure M&M page 367 Willie

Which local anesthetic when given intrathecally has been attributed to cauda equine syndrome and transient neurologic symptoms? a. Bupivacaine b. Lidocaine c. Ropivacaine d. Chloroprocaine

b. Lidocaine NP: 1137 Byron

The compliment proteins are synthesized by the ______. a. Thymus b. Liver c. Bone marrow d. Spleen

b. Liver (N&P pg 1017) Josh

3. If a test dose has no signs of intravascular or intrathecal injection, what should be done next? a. The test dose has local anesthetic and no additional medication is required b. Local anesthetic with opioid mixture should be administered c. Local anesthetic only should be administered d. Opioids only should be administered

b. Local anesthetic with opioid mixture should be administered. M&M page 852

What is the second most abundant INTRAcellular cation? a. Potassium b. Magnesium c. Calcium d. Sodium

b. Magnesium NP: 389 Byron

What is the most consistent acid-base abnormality following massive transfusion? (M&M pg 1161) a. Respiratory alkalosis b. Metabolic alkalosis c. Respiratory acidosis d. Metabolic acidosis

b. Metabolic alkalosis (M&M pg 1161) Josh

3. Which of the following is not a contraindication to neuraxial anesthesia? (M&M pg 937) a. Patient refusal b. Moderate hypertension c. Elevated intracranial pressure d. Infection at the site of injection

b. Moderate hypertension Ian

4. What block is essential to complete the anesthesia for the forearm and wrist? (M&M pg 998) a. Radial nerve block b. Musculocutaneous nerve block c. Ulnar nerve block d. Median nerve block

b. Musculocutaneous nerve block

Which sensory level is associated with adequate anesthesia of a spinal or epidural initiated for hip surgery? a. T10 b. T8 c. T6 d. T4

b. T8 M&M p.916 Lexi

4. According to the American Society of Regional Anesthesia and Pain Medicine, what is the incidence of epidural hematomas? a. 1 in 1,000 epidurals b. 1 in 100,000 epidurals c. 1 in 150,000 epidurals d. 1 in 225,000 epidurals

c. 1 in 150,000 epidurals M&M page 948

Although the initiating causes of ductus veinosus closure are unknown, when does closure of the ductus veinosus begin? (N&P pg 1163) a. 1-8 days postnatal b. 8 hours postnatal c. 1-3 hours postnatal d. 20 minutes postnatal

c. 1-3 hours postnatal (N&P pg 1163) Josh

What is the specific gravity of CSF at 37*C? a. 1.000-1.003 b. 1.005-1.008 c. 1.003-1.008 d. 1.003-1.010

c. 1.003-1.008 M&M Chapter 45, page 956 Jennifer

4. What is the onset of epidural anesthesia? (M&M pg 938) a. 20-30 minutes b. 5-10 minutes c. 10-20 minutes d. 30-60 minutes

c. 10-20 minutes Ian

When using a pneumatic tourniquet, what is the common inflation pressure? a. 250 mm Hg b. 300 mm Hg c. 100 mm Hg above systolic blood pressure d. 50 mm Hg above systolic blood pressure

c. 100 mm Hg above systolic blood pressure (M&M pg 791) Josh

4. How much blood does a soaked "lap" pad hold? (M&M pg 1167) a. 50-75 ml b. 10-20 ml c. 100-150 ml d. 200 ml

c. 100-150 ml

3. Neurogensis, followed by synaptogenesis and increased myelination proceeds during which time of in utero development? a. 3 to 4 weeks' b. 4 to 12 weeks c. 12 to 20 weeks d. Up to birth

c. 12 to 20 weeks Nagelhout Page 1168 "Neurogenesis proceeds during weeks 12 to 20, followed by synaptogenesis and increased myelination." Budenbender

What is the expected baseline heart rate of a neonate? a. 100 b. 120 c. 140 d. 160

c. 140 (M&M pg 880) Josh

Understanding that sodium and chloride are found in equal parts in 0.9% saline solution, how much, in mEQ/L, of each is found in normal saline (NS)? a. 90 mEQ/L b. 9 mEQ/L c. 154 mEQ/L d. 308 mEQ/L

c. 154 mEQ/L (M&M pg. 1179) Josh

3. By what percentage will the MAC of Sevoflurane be reduced in a 80 yr old male? a. 4% b. 10% c. 16% d. 20% M&M ch 43 pg 914

c. 16% Mbom

3. A balanced (damage control resuscitation) approach to blood product transfusions include replacement of FFP, PLT, and PRBC in what ratio? a. 2:1:1 b. 2:1:2 c. 1:1:1 d. 1:1:2

c. 1:1:1 M&M Ch. 51 Pg. 1172 Thetford

In 96% of children, the anterior fontanelle closes by what age? a. 6 months b. 1 year c. 2 years d. 3. Years

c. 2 years N&P Chapter 47, page 1168 Jennifer

3. At what week of gestation does sensory nerve distribution form in the fetus? a. 10 weeks b. 15 weeks c. 20 weeks d. 25 weeks

c. 20 weeks N&P page 1168

When centrifuged, one unit of whole blood yields approximately how many mL of packed red blood cells (PRBCs)? a. 300 b. 350 c. 250 d. 200

c. 250 M&M Chapter 51 page 1170 Jennifer

5. For how many months must the symptoms of fibromyalgia be present before diagnosis can be made? (M&M pg 1042) a. 2 months b. 6 months c. 3 months d. 12 months

c. 3 months

4. How many venous systems are included in the heart? What are they? a. 2. Posterior cardiac vein, thebesian valve b. 1. Coronary sinus c. 3.coronary sinus, anterior cardiac veins, thebesian valve d. 4. Coronary sinus, posterior cardiac vein, anterior cardiac vein, thebesian valve

c. 3- coronary sinus, anterior cardiac veins,, thesbesian valve n&p pg 473 rebecca

What is the expected baseline respiratory rate for a 12-month old pediatric patient? a. 20 b. 25 c. 30 d. 40

c. 30 (M&M pg 880) Josh

What is the mg/kg dose of IM succinylcholine for a pediatric patient if laryngospasm were to occur before an intravenous line could be established? a. 5-7 b. 1-3 c. 4-6 d. 2-5

c. 4-6 M&M Chapter 42, page 891 Jennifer

Pediatric patients scheduled for elective procedures who have a severe upper respiratory tract infection should be rescheduled. What is the recommended amount of time to postpone the surgery following resolution of symptoms? a. 1-2 weeks b. 2-4 weeks c. 4-6 weeks d. 6-8 weeks

c. 4-6 weeks NP: 1197 Byron

When performing an inhalation/mask induction on a pediatric patient, how much does the use of 66% N2O decrease the necessary inspired concentration of sevoflurane to achieve intubating conditions? a. 20% b. 30% c. 40% d. 50%

c. 40% NP: 1200 Byron

5. Shivering increases oxygen consumption by up to what percentage? (N&P pg 1215) a. 100% b. 1000% c. 400% d. 50%

c. 400%

When using intrathecal morphine (0.1-0.5 mg) what is the expected onset of analgesia? a. 5-10 min b. 20-20 min c. 45-60 min d. Onset is instantaneous

c. 45-60 min (M&M pg 848) Josh

What percent of fetal blood flows through the pulmonary circuit? a. 15-55% b. 10-15% c. 5-10% d. There is virtually no blood flow through fetal lungs

c. 5-10% (N&P pg 1163) Josh

Anticoagulation for carotid artery stenting is initiated with a heparin bolus at what range? a. 100-200 units/kg b. 25-50 units/kg c. 50-100 units/kg d. 300 units/kg

c. 50-100 units/kg N&P p. 585 Lexi

What is the estimated blood volume of an infant 3 months to 3 years of age? a. 90 - 100 b. 80 - 90 c. 75 - 80 d. 65 - 70

c. 75 - 80 N&P Chapter 47, page 1165, table 47-2 Jennifer

What is the average blood volume of a full term infant? a. 60-70 mL/kg b. 70-80 mL/kg c. 80-90 mL/kg d. 90-100 mL/kg

c. 80-90 mL/kg NP: 395 Byron

5. Myocardial contractility is depressed by all of the following except...(M&M pg 355) a. Hypoxia b. Acidosis c. Alkalosis d. Depletion of catecholamine stores within the heart

c. Alkalosis

3. What drug class is most useful for patients with neuropathic pain? (M&M pg 1024) a. Narcotic b. NSAIDs c. Antidepressants d. Tylenol

c. Antidepressants

2) Which of the following is not an indication for spinals and epidurals? a) Lumbar spine surgery b) Joint surgeries c) Upper abdominal procedures, d) Open heart surgery M&M ch 45 pg 947

d) Open heart surgery Mbom

3. During a shoulder surgery performed in sitting position under an interscalene block, which reflex can cause profound hypotension and bradycardia? (N&P ch 21, pg 418) a. Kratschmer b. Trigemino-Cardiac c. Landau d. Bezold-Jarisch

d. Hale

4. Lactated Ringers is composed of all of the following electrolytes, EXCEPT: (N&P ch 48, pg 1208) a. potassium b. chloride c. calcium d. magnesium

d. Hale

5. Tension pneumocephalus, associated with the sitting position, manifests as: (N&P ch 21, pg 418) a. Restlessness b. Deterioration of consciousness c. Convulsions d. All of the above

d. Hale

Which of the following incidences of sudden arrhythmic death syndrome has the greatest incidence of occurring due to a preexcitation syndrome with an accessory pathway "Bundle of Kent" causing AV reentrant tachycardia and/or VF with normal hearts? a. Brugada Syndrome b. Long QT syndrome c. Short QT syndrome d. Wolff-Parkinson-White syndrome

d. NP 1295 DB

What is the mg/kg dose of IM atropine for a pediatric patient if bradycardia occurs before an intravenous line could be established? a. 0.01 b. 0.1 c. 0.2 d. 0.02

d. 0.02 M&M Chapter 42, page 891 Jennifer

4. What is an appropriate loading dose for fentanyl in mcg/kg that is compatible with early extubation after cardiac surgery? a. 3-6 b. 5-10 c. 1-3 d. 1-5

d. 1-5 M&M Ch. 22, page 455, table 22-1 Jennifer

According to OSHA standards, what is the maximum trace concentration a provider can be exposed to nitrous oxide? a. 2 ppm b. 5 ppm c. 10 ppm d. 25 ppm

d. 25 ppm M&M p. 1223 Lexi

5. Shivering increase oxygen consumption by a. 100% b. 200% c. 300% d. 400%

d. 400% n&p 12215 rebecca

Dose requirements for the EEG endpoint using fentanyl and alfentanil are ___% lower in elderly patients. a. 10% b. 30% c. 40% d. 50%

d. 50% M&M Chapter 43, page 915 Jennifer

At what age does kidney function approach normal values (corrected for size)? a. 3 months b. 12 months c. 24 months d. 6 months

d. 6 months (M&M pg 880) Josh

Subtrochanteric fracture is associated with what volume of occult blood loss? a. >250 ml b. >500 ml c. <750 ml d. <1 L

d. <1 L M&M p.916 Lexi

What would a patient's expected serum potassium level be if they were exhibiting ECG changes of their QRS complex degrading to a sine wave pattern and the transition to V-fib? a. 5.0-6.0 mEq/L b. 6.0-7.5 mEq/L c. 7.5-8.0 mEq/L d. >8.5 mEq/L

d. >8.5 mEq/L NP: 389 Byron

Which of the following is NOT considered to be a cause of pseudohyperkalemia? a. Hemolysis of blood sample b. Leukocytosis c. Thrombosis d. Acidemia e. Prolonged fist clenching during blood draw

d. Acidemia NP: 388 Byron

3. Short term regulation of Mean Arterial Pressure is achieved by? N&P pg 490 a. Baroreceptors b. Chemoreceptors c. Atrial stretch reflex d. All of the above

d. All of the above Fieber

4. Long term regulation of Mean Arterial Pressure is achieved by the renal body fluid system the components of include? N&P pg 491 a. Renin-angiotensin system b. Aldosterone secretion c. Nervous system d. All of the above

d. All of the above Fieber

What promotes the closure of the ductus arteriosus? a. Increased systemic vascular resistance b. Decreased pulmonary vascular resistance c. Absence of maternal prostaglandins d. All of the above

d. All of the above (N&P pg 1163) Josh

3. What should be done if during performing an interscalene block aspiration of arterial blood is noted? a. Withdraw the needle b. Hold pressure for 3-5 mins c. Reassess landmarks d. All of the above

d. All of the above M&M page 985

5. Hypertension is classified on the basis of its causes. Essential hypertension, is also referred to as primary and idiopathic. Because it has? N&P pg 491 a. No identifiable causes b. Accounts for 95% of all cases c. Its diagnosis is based on exclusion d. All of the above

d. All of the above Fieber

5. What are the common reasons for using a precordial stethoscope with pediatric patients? a. Assess HR b. Quality of heart sounds c. Airway patency d. All of the above are correct

d. All of the above are correct M&M page 888 Willie

4. Which of the following is commonly used to decreases the stress response to laryngoscopy in the pediatric patient? a. Anectine b. Fentanyl c. Ketamine d. Atropine

d. Atropine M&M page 888 Willie

3. Which of the following is not a component of plasmalyte a. Sodium b. Chloride c. Magnesium d. Bicarb

d. Bicarb Mbom

Which of the following local anesthetics is used primarily to rapidly produce a surgical block in the presence of preexisting epidural in the case of an emergency cesarean section? a. Bupivacaine b. Lidocaine c. Ropivacaine d. Chloroprocaine

d. Chloroprocaine NP: 1137 Byron

All of the following are postoperative complications after carotid endarterectomy (CEA) EXCEPT? a. Hemodynamic instabity b. Stroke c. Respiratory insufficiency d. Chronic carotid occlusion

d. Chronic carotid occlusion N&P Chapter 25, page 583, box 25-15 Jennifer

4. All of the following are Age related changes to the CNS except? N&P 1220 a. Progressive loss of Neurons b. Decrease of Neurotransmitter activity c. Decreased Brain mass d. Excessive secretion of ALL hormones

d. Excessive secretion of ALL hormones Fieber

How long after carotid artery stenting will the patient have to continue anticoagulants? a. 6 weeks b. 6 months c. 1 year d. For his/her lifetime

d. For his/her lifetime N&P p. 585 Lexi

All of the following are symptoms of cardiovascular toxicity associated with unintentional IV Bupivicaine injection, EXCEPT which symptom? a. Left ventricular depression b. AV heart block c. V-tach/V-fib d. Hypertensive crisis

d. Hypertensive crisis M&M p. 274 Lexi

2. All of the following are true regarding hepatic function except? N&P Pg 1219 a. Decreased clearance b. Prolonged half-life c. Both increased and decreased half life d. Increased clearance

d. Increased clearance Fieber

2. What of the following is NOT a cardiovascular challenge associated with neuromuscular blocking agents? a. Decrease in venous return b. Reduced stroke volume c. Reduced cardiac output d. Increased vascular resistance

d. Increased vascular resistance N&P page 403 Willie

Which of the following is not a part of the CV system a. Heart b. Aorta c. Arteries d. Lymphatic vessels e. Veins

d. Lymphatic vessels Mbom

Appropriate chest compressions on a neonate include which of the following? a. Holding the neonate in the prone position b. Performing compressions with one single palm c. Holding the neonate over your knee, head facing down d. Performing compressions with both thumbs just beneath the nipple line

d. Performing compressions with both thumbs just beneath the nipple line M&M p. 873 Lexi

3. Which of the follow should deserve a closer look in a patient presenting with osteoarthris? a. Patient airway and neck mobility b. Lab values for calcium c. X-ray and ct scans of all major joints d. Family history for MH i. Answer: A- airway ii. M+M page795

i. Answer: A- airway ii. M+M page795

3. Which of the following blocks would be best used for a ORIF of the olecranon (elbow)? a. Supraclavicular b. Interscaline c. Infraclavicular d. Axillary

i. Answer: A-supraclavicular ii. M+M page 982, 986, 989 sommers

1. You have an 89-year-old patient with great lung function, but poor heart function. How will the onset of action of the inhaled anesthetics be different for this patient? a. Slower onset of action b. Faster onset of action c. No change in the onset of action d. Not enough information given

i. Answer: B- faster ii. M+M page 914

2. What IV access is recommended for open heart surgery a. 2 peripheral ivs and one art line, and a central line. b. one peripheral iv and one central line c. A PA cath with an art line d. 2 large 16-18 iv in the antecubital

i. Answer: B- one peripheral iv and one central line ii. M&M page 444 Sommers

1. You are providing the anesthesia for a 68-year-old patient undergoing a total knee arthroplasty. The total tourniquet time is 90 minutes. Upon releasing the tourniquet which of the following would you be LEAST likely to see? a. Decrease in arterial pressure b. A decrease in central venous pressure c. Increase in heart rate d. Increase in temperature. e. Increased ETCO2

i. Answer: D- increased temp ii. M&M page 791

4. Knowing that both renal and hepatic function is decreased in elderly patients, how would you alter the dose of atracurium? a. Decreased be 50% b. Decreased by 10% c. No change in the dose d. Slightly increased

i. Answer: c- no change ii. M+M page 915

4. You elected for a GETA with a popliteal regional block for a total knee replacement on a 68-year-old patient. Isoflurane 0.4% N20 50% and intermittent doses of fentanyl are keeping the patient comfortable. Tranexamic acid is given, tourniquet is inflated. About 70 minutes into the case tachycardia and hypertension in noted. 50 mcg of fentanyl is given with little effect. What is the most likely cause for the SNS response in this patient? a. Failed block b. Tranexamic acid reaction with bone cement c. Tourniquet pain d. Less than 1.3 MAC of gas

i. Answer: tqt pain ii. M&M page 791

5. What is the normal production rate of CSF A. 0.35ml/min or 500mls/day B. 0.5mls/min or 720mls/day C. 0.75mls/min or 1080mls/day D. 1ml/min or 1440mls/day

• Answer A • N&P 1148 Fletcher

3. What are the 2 most common reasons for spinal surgeries? (select 2) A. Intervertebral disk herniation B. Spinal stenosis C. Scoliosis D. Kyphosis

• Answer A,B • N&P 1007

3. Typical signs of increasing venous pressure and cardiac congestion include (select all that apply) A. Engorgement of neck veins, B. Hepatomegaly, C. Hypotension D. Diminished spinal reflexes E. Peripheral edema

• Answer A,B,E • N&P 23 pg 495 Fletcher

2. A MAC level greater than ____ acts as a tocolytic, and can result in decreased uterine contractility, and increased blood loss . A. 0.5 B. 0.8 C. 1.0 D. 1.3

• Answer B • N&P 1147 Fletcher

2. The brachial plexus is formed from rami from the ____ to _____ nerves. A. C3-C5 B. C5-C7 C. C5-T1 D. C2-T2

• Answer C • N&P 1108

3. In order to ensure adequate anesthesia and minimize awareness the predelivery MAC goal of the laboring parturient under general anesthesia is what? A. 0.4 B. 0.6 C. 0.8 D. 1

• Answer C • N&P 1147

4. What is the total volume of CSF that is normally present within the subarachnoid space? A. 75mls B. 100mls C. 150mls D. 200mls

• Answer C • N&P 1148 Fletcher

2. Venous air embolism (VAE) is a well-known consequence of surgery performed in the _____ position. A. Prone B. Supine C. Sitting D. Inverted

• Answer C • N&P 414

4. In the prone position which zone of west increases? A. Zone 1 B. Zone 2 C. Zone 3 D. Zone 4

• Answer: 3 • N&P 1007

5. What is the volume of an interscalene test dose? A. 1ml B. 2ml C. 5ml D. 10ml

• Answer: A • N&P 1109

1. What is the primary excitatory neurotransmitter released by primary afferents in the dorsal horn? A. Glutamate B. GABA C. Substance P D. Epinephrine

• Answer: A • N&P 1253

4. Class I Hemorrhagic shock typically exhibits a blood loss of ______? A. <750 B. 750-1500 C. 1500-2000 D. >2000

• Answer: A • N&P 384 Fletcher

2. What is the second most common vascular operation performed in the United Stated? A. Carotid Endarterectomy B. Coronary Revascularization C. AV fistula placement D. Saphenous vein harvest

• Answer: A • N&P 578 Fletcher

3. Most Strokes are caused by ______ A. Cerebral ischemia B. Intracranial hemorrhage C. Obesity D. Blunt trauma

• Answer: A • N&P 578 Fletcher

1. What is the most common electrolyte abnormality in hospitalized patients? A. Hyponatremia B. Hypernatremia C. Hypercalcemia D. Hypocalcemia

• Answer: A • N&P pg. 385 Fletcher

1. What is the most common cause of acute pericarditis? A. Viral Infection B. Blunt force trauma C. Aging process D. Hyperventilation

• Answer: A • N&p ch 23 pg. 494 Fletcher

5. What medications are most often used in a PCA delivery system?(select 3) A. Fentanyl B. Morphine C. Ketamine D. Demerol E. Hydromorphone

• Answer: A, B, E • N&P 1252

5. What are the primary components of CO? (select all that apply) A. Preload B. Catecholamine release C. Afterload D. Contractility E. Hematocrit

• Answer: A,C,D • N&P ch. 23 pg 497 Fletcher

3. During an interscalene block of the brachial plexus the catheter is placed at the level of the _______. A. Roots B. Trunks C. Divisions D. Cords

• Answer: B • Answer 1108

1. Repetitive twisting, bending, and heavy lifting in the work environment are occupational hazards that commonly lead to what occupational injury that is a leading cause of work absence? A. Hypertension B. Back injury C. Cholecystitis D. Irritable bowel syndrome

• Answer: B • N&P 1007

1. What dose range of Succinycholine is utilized for the induction of general anesthesia in the Parturient patient? A. 0.5-1mg/kg B. 1-1.5mg/kg C. 1.5-3/mg/kg D. 5-7mg/kg

• Answer: B • N&P 1147 Fletcher

1. What is the most common vascular operation performed in the United Stated? A. Carotid Endarterectomy B. Coronary Revascularization C. AV fistula placement D. Saphenous vein harvest

• Answer: B • N&P 578 Fletcher

5. The neurological symptoms associated with CVA are most often related to ______ A. Lactic acidosis B. Decreased CBF C. Inceased CBF D. Hypovolemia

• Answer: B • N&P 579 Fletcher

4. Mitral Valve stenosis is considered severe when the valve area is less than? A. 0.5cm2 B. 1.0cm2 C. 2.0cm2 D. 3.0cm2

• Answer: B • N&P ch 24 pg 541 Fletcher

3. Why is chronic aortic insufficiency tolerated for long periods of time, when acute Aortic insufficiency causes rapid deterioration? A. The heart does not need to compensate in chronic aortic insufficiency B. The heart has time to compensate in chronic aortic insufficiency C. Acute insufficiency creates no immediate sign or symptom and is not clinically relevant D. Acute insufficiency is typically transient and resolves very quickly.

• Answer: B • N&P ch. 24 pg 540 Fletcher

3. Studies in vivo and in cadavers indicate that the incidence of PFO can be as high as ____ in the general population. A. 25% B. 35% C. 45% D. 90%

• Answer: B • N&P 414

5. How can venous air embolism be detected intraoperatively? (select 2) A. ETCO2 increases B. ETCO2 decreases C. Mill-wheel murmur D. Hyperoxia

• Answer: B, C • N&P 414

2. Treatment of hyponatremia usually includes what two things? (select 2) A. vasopressor B. Fluid restriction C. Diuresis. D. Oral fluid administration

• Answer: B,C • N&P pg. 385 Fletcher

2. The regurgitation volume in aortic regurgitation is directly proportional to what? (select all that apply) A. Systolic time B. SVR C. Diastolic time D. Regurgitatnt orifice size

• Answer: B,C,D • N&P ch 24 pg. 540 Fletcher

4. Ischemic stroke accounts for approx.. ___% of first time strokes. A. 60% B. 70% C. 80% D. 90%

• Answer: C • N&P 578 Fletcher

2. The majority of spinal surgeries are placed in what position? A. Beach chair B. Supine C. Lateral D. Prone

• Answer: D • N&P 1007

5. What should be the #1 priority of the anesthesia provider, once a patient is successfully turned into the prone position? A. Replace the O2 sat monitor B. Replace the EKG monitor C. Cycle the BP cuff D. Reconnect the ET tube and listen for breath sounds

• Answer: D • N&P 1008

4. The cricoid cartilage ring correlates to which vertebral body? A. C3 B. C4 C. C5 D. C6

• Answer: D • N&P 1108

4. Why isn't Demerol recommended to be administered via a PCA delivery system? A. It is too expensive B. Precipitates form on contact with plastic. C. It is too potent D. Its metabolite can accumulate and cause seizures

• Answer: D • N&P 1252

2. What is the principal symptom associated with acute pericarditis? A. Shortness of breath B. Hypotension C. Anxiety D. Sudden onset chest pain

• Answer: D • N&P 23 pg 494 Fletcher

5. Class IV hemorrhagic shock typically exhibits a blood loss of ______? A. <750 B. 750-1500 C. 1500-2000 D. >2000

• Answer: D • N&P 384 Fletcher

5. What is the least common left sided valvular defect? A. Mitral regurigation B. Aortic stenosis C. Aortic regurgitation D. Mitral stenosis

• Answer: D • N&P ch 24 pg 541 Fletcher

4. What anesthetic carries the most satisfaction with women giving birth via Cesarean delivery? A. TIVA B. MAC C. General D. Neuraxial

Answer D. In the United States most elective cesarean sections are performed under spinal anesthesia. Regional anesthesia has become the preferred technique because general anesthesia has been associated with a greater risk of maternal morbidity and mortality. M&M pg. 855 Blair Ryan

4. Which of the following blood products is used for hypofibrinogenemia? (Select one) a. Cryoprecipitate b. PRBCs c. FFP d. Platelets

a. Cryoprecipitate N&P p. 396 Franklund

2. Endovascular Grafts are made from? Select 2 a. Dacron b. Polytetrafluoroethylene c. Microfiber d. Autologous fibers

a. Dacron b. Polytetrafluoroethylene Fieber N&P Pg 576

4. When should caution be exercised in the use of neuraxial analgesia? a. FHR tracing that suggests hypoxia recorded in pre-anesthesia assessment (Late decelerations or variable decelerations) b. Possible urgent and unplanned operative vaginal delivery c. Possible urgent and unplanned cesarean section d. When less than 2 cycles per minute are irregular in amplitude

a. FHR tracing that suggests hypoxia recorded in pre-anesthesia assessment (Late decelerations or variable decelerations) Nagelhout Page 1134 Budenbender

Postoperative visual loss is generally attributable to five causes. In the ASA POVL registry, which two accounted for 81% of all cases? a. Ischemic optic neuropathy b. Central retinal artery occlusion c. Central retinal vein occlusion d. Cortical blindness e. Glycine toxicity

a. Ischemic optic neuropathy b. Central retinal artery occlusion NP: 409 Byron

3. You are the CRNA caring for a patient that has sustained trauma in an MVA. A CT scan revealed the patient did not receive any cerebral trauma. Which of the following fluids would be the most appropriate for initial treatment of hypovolemia? a. D50.45%NS b. Lactated Ringers c. 0.9% Sodium chloride d. 0.45% Sodium Chloride

a. Lactated Ringers Reference: N&P pg 394 Mandy

3. A patient that is at high risk for heart failure but without structural heart disease or symptoms has a ____________ NYHA functional class. a. None b. I-Asymptomatic c. II d. IV

a. None Nagelhout Page 522 Budenbender

Which TWO of the following are neurological manifestations of sickle cell anemia? a. Stroke b. Coma c. Epidural hemorrhage d. Confusion

a. Stroke b. Coma M&M p. 1178 Lexi

It is believed that between 30-50% of babies presenting with tracheoesophageal fistula or esophageal atresia also present with the collection of conditions termed, VACTERL. VACTERL is an acronym for what? (N&P ch 47, pg 1185) a. Vertebral anomalies, anal atresia, colic, tracheoesophageal fistula, respiratory and limb malformations b. Viral pneumonia, anal atresia, cardiac, tracheoesophageal fistula, respiratory and limb malformations c. Vertebral anomalies, anal atresia, cardiac, tracheoesophageal fistula, renal and limb malformations d. Vertebral anomalies, acid reflux, colic, tracheoesophageal fistula, renal and limb malformations

c. Hale

All of the following are predisposing preoperative factors for delirium after surgery for the geriatric patient EXCEPT? a. Increasing age b. Male gender c. Female gender d. Diabetes

c. Female gender M&M Chapter 43, page 913, table 43-3 Jennifer

1. For some patients during an orthoscopic surgery, which of the following can have absolutely no substitute? a. Regional anesthesia b. Local anesthesia c. General anesthesia d. Sedation

c. General anesthesia Nagelhout Chapter 40, Page 1002 "As previously mentioned, for some patients there is absolutely no substitute for receiving general anesthesia." Budenbender

3. How many types of hemorrhagic shock are there? A. 1 B. 2 C. 3 D. 4

• Answer: D • N&P pg. 384 Fletcher

2. Which of the following symptoms is consistent with a serum osmolality > 430 mOsm/kg? a. Coma b. Confusion c. Ataxia d. Agitation

A. Coma N&P 387 Justin

Which two things are required from a patient before the anesthesia provider can safely place a regional block: A. Cooperation B. Counseling C. Participation D. Payment

A. Cooperation C. Participation M&M Ch. 46 pg. 977 K. Jensen

The narrowest part of an airway in children < age 5 is: _________. A. Cricoid cartilage B. Glottis C. Pharynx D. Larynx

A. Cricoid cartilage M&M Ch. 42 pg. 879 K. Jensen

2. What is the purpose of adding a colloid to the CPB prime fluid? a. Decreased post-operative edema b. Ensure adequate anticoagulation c. Treat anemia d. Colloids are never added to the CPB prime

A. Decrease Post-op edema N&P: 517 Justin

What are the most common causes of ischemic optic neuropathy? (Select two) A. Decreased perfusion to the optic nerve B. Increased Intraocular Pressure. C. Ketamine induction. D. Prone Positioning.

A. Decreased perfusion to the optic nerve B. Increased Intraocular Pressure. Justin N&P 410

The point of maximal impulse is the location where the pulsation from the cardiac apex may be palpated through the chest wall. Which of the following most accurately describes the point at which you would place your hand to palpate this pulsation? A. Left 5th intercostal space, midclavicular line B. Right 5th intercostal space, midclavicular line C. Left 1st intercostal space, midclavicular line D. Right 1st intercostal space, midclavicular line

A. Left 5th intercostal space, midclavicular line N&P page 470 1st column 4th paragraph Abe

What are the main vessels that diverge from the left main coronary artery? (select 2) A. Left anterior descending B. Circumflex C. Right coronary D. Posterior descending

A. Left anterior descending B. Circumflex N&P page 471 figure 23-2 Abe

4. What is the primary ion movement during phase 0 of cardiac action potential? a. Na+ moving from ECF to ICF b. K+ Moving from ECF to ICF c. Na+ moving from ICF to ECF d. There is no ion movement during phase 0

A. Na+ moving from ECF to ICF N&P: 478 Justin

There are two components of immunity; innate and acquired. Select 2 cells that belong to the innate immune system. A. Natural Killer Cells B. Phagocytes C. T-cells D. B-cells

A. Natural Killer Cells B. Phagocytes N&P Ch. 41 pg. 1015-16 K. Jensen

Calculate the mean arterial pressure of a patient with a diastolic pressure of 55 and pulse pressure of 38? Provide your answer in whole numbers.

Answer - 68 (M&M pg 361) Lake

Calculate the ejection fraction of an individual with a end diastolic volume of 109 mL, end systolic volume of 29 mL. Provide your answer in whole numbers.

Answer - 73 (M&M pg 356) Lake

In patients with adequate cardiac function, what value of PAOP would indicate hypovolemia? a. 8 mmHg b. 10 mmHg c. 12 mmHg d. 14 mmHg

Answer - a M&M page 1163 Krum

At what point should the PAOP be measured? a. end expiration b. beginning expiration c. end inspiration d. beginning inspiration

Answer - a. M&M page 1163 Krum

4. Select from the following all the common indications for a sympathetic nerve block. Select 5 a. reflex sympathetic dystrophy b. visceral pain c. acute herpetic neuralgia d. postherpetic pain e. uncontrolled HTN f. peripheral vascular disease g. treatment of hiccoughs

Answer a, b, c, d, f. M&M page 1072 Krum

2. T-cells mature in which organ? a. Thymus b. Spleen c. Thyroid d. Fetal Liver & Postnatal Bone Marrow

Answer a. Nagelhout & Plaus Page 1017 Krum

4. Select the best definition of diapedesis. a. the migration of a phagocyte across a cell wall. b. the initial stages of diabetes. c. the filtration of inflammatory mediators through the glomerulus. d. an infection of the pancrease gland leading to diabetes.

Answer a. Nagelhout & Plaus Page 1017 Krum

2. Select the appropriate action that happens during the Phase 1 of the cardiac action potential. a. Activation of voltage-gated Na channels allows Na entry and decreases the permeability to K - Upstroke. b. Inactivation of Na channel and transient increase in K permeability allows K out - Early Rapid Repolarization. c. Activation of slow calcium channels allows Ca entry - Plateau. d. Inactivation of Ca Channels and increased permeability to K allows K out - Final Repolarization. e. Normal permeability restored (atrial & ventricular cells) Na-K pump allows K in, Na out - Resting potential.

Answer b M&M page 347

3. The tubercle of the C6 transverse process is also known as what? a. Kernigs process b. Chassaignac's tubercle c. Chynne Stoke tubercle d. point of no return

Answer b. M&M page 1066 Krum

In adults the glottis is at C6, but in infants and neonates the glottis is at... a. C7 b. C4 c. C2 d. T1

Answer b. M&M page 879 Krum

3. The highest morbidity associated with obstetrics is A. Severe hypotension B. Aortocaval compression C. Severe Hemorrhage D. Prolapsed umbilical cord.

Answer. C Hemorrhage. 6.7 per 1000 incidence. M&M pg. 845. Blair Ryan

5. Which of the following needles is associated with a greater incidence of dural puncture? a. Tuohy b. Crawford c. Weiss winged d. Blunt tip

Answer: B - Crawford needle Morgan & Mikhail's Clinical Anesthesiology pg. 959 Stetler

2. An ACT level of ¬¬¬______ must be established before initiating cardio-pulmonary bypass? A. > 300 B. 400-480 C. > 600 D. Initiating bypass is acceptable before checking ACT levels.

Answer: B An ACT longer than 400-480 s is considered adequate at most centers. Morgan & Mikhail pg. 456.

4. Select the correct statement regarding cannulation of the cardio pulmonary bypass catheters. A. Venous cannulation precedes arterial cannulation. B. Systolic blood pressure should be 90-100 mm Hg ideally for arterial cannulation. C. Air bubbles are of concern, particularly when cannulating the venous/atrial catheter. D. Arrhythmias are more common cannulating the aorta than the right atrium.

Answer: B The small opening of most arterial cannulas produces a jet stream that, when not positioned properly, can cause aortic dissection or preferential flow of blood to the innominate artery. The systemic arterial pressure is customarily reduced to 90-100 mm Hg systolic during placement of the aortic cannula to reduce the likelihood of dissection. Morgan & Mikhail pg. 457.

1. Pick the 2 absolute contraindications to neuraxial blockade. A. Stenotic valvular heart lesions B. Severe aortic stenosis C. Severe mitral stenosis D. Severe spinal deformity E. Major Blood loss

Answer: B and C. Severe Aortic or Mitral Valve stenosis are listed as absolute contraindications in Table 45-1 in M&M pg. 948. Blair Ryan

2. At what range should the preterm neonate's Hct be at for surgery? A. 25-30% B. 30-40% C. 20-25% D. 40-50%

Answer: B, 30-40% N & P, pg. 1176 Stefania

1. After cardiac surgery, all of the following may be characteristics of cardiac tamponade EXCEPT: A. sudden decrease in chest tube drainage B. hypertension, bradycardia C. increased and equalizing filling pressures D. pulsus paradoxus, electrical alternans

Answer: B. hypertension, bradycardia N & P, pg. 533 Stefania

2. All of the following are potential consequences that can occur due to increased small airway closure in the elderly EXCEPT: A. increased anatomic dead space B. increased PaO2 C. decreased alveolar surface area D. decreased blood flow in the pulmonary capillaries

Answer: B. increased PaO2 N & P, pg. 1218 Stefania

3. When using a tourniquet during a procedure, which two nerves should be blocked in the axilla to help decrease tourniquet pain? A. radial nerve, ulnar nerve B. intercostobrachial nerve, brachial cutaneous nerve C. intercostobrachial nerve, radial nerve D. brachial cutaneous nerve, median nerve

Answer: B. intercostobrachial nerve, brachial cutaneous nerve N & P, pg. 1114 Stefania

1. Which of the following formulas correctly expresses Ohm's law in regards to the flow of fluid (blood) through a tube (blood vessels)? A. Q = (P1 + P2) / R B. Q = (P1 x P2) / R C. Q = (P1 - P2) / R D. Q = (P2 - P1) / R

Answer: B., Q = (P1 x P2) / R N & P, pg. 489 Stefania

4. Which of the following is the correct equation that expresses Poiseuille's Law? A. Q = ([P1 + P2] r4) / (8 x n x l) B. Q = ([P1- P2] r4) / (8 x n x l) C. Q = 8 x n x l / ([P1- P2] r4) D. Q = ([P1- P2] d4) / (8 x n x 1)

Answer: B., Q = ([P1- P2] r4) / (8 x n x 1) N & P, pg. 489 Stefania

1. Which of the following is NOT a similarity between the elderly and infants? a. Decreased arterial oxygen tension b. Decreased renal tubular function c. Increased lung compliance d. Increased susceptibility to hypothermia

Answer: C increased lung compliance M&M pg. 908 stetler

3. Choose the incorrect statement. A. Blood is transfused to increase oxygen-carrying capacity, increase intravascular volume, and restore hemostasis. B. Estimating blood volume (EBV) takes into account patient age and weight. C. EBV is based on sex and ideal body weight D. The ultimate test of blood compatibility is a type and crossmatch, during which donor blood and recipient blood are mixed together in what is essentially a trial transfusion.

Answer: C is a false statement. Nurse Anesthesia, pg. 395. Blair Ryan

2. Which of the following risk factors is most highly correlated with an abdominal aortic aneurysm a. Age b. Diabetes c. Smoking d. Hypertension

Answer: C smoking N&P pg. 563 Stetler

5. What is an appropriate test dose after placing an epidural? A. 2% lidocaine with 1:200,000 epi, 6 cc B. 4% lidocaine with 1:200, 000 epi, 3 cc C. 2% lidocaine with 1:200,000 epi, 3 cc D. 1% lidocaine with 1:100,000 epi, 3 cc

Answer: C, 2% lidocaine with 1:200,000 epi, 3 cc N & P, pg: 1144 Stefania

5. Hetastarch should not exceed what rate when administering due to its effect of directly inhibiting clot formation? A. 40 mL/kg B. 50 mL/kg C. 20 mL/kg D. 100 mL/kg

Answer: C, 20 mL/kg N & P, pg: 393 Stefania

4. Which reflex is assumed to be the cause of hypotensive bradycardic episodes (HBEs)? A. Hering's reflex B. Cushing's reflex C. Benzold-Jarisch reflex D. Horner's reflex

Answer: C, Benzold-Jarisch reflex N & P, pg. 1006 Stefania

3. Which of the following is the correct cause of postdural puncture headache (PDPH)? A. Too rapid injection of local anesthetic following a spinal. B. needle puncture of the spinal cord during spinal needle placement. C. a decrease in the CSF available in the subarachnoid space through a leak created by an introducer needle puncturing the dura D. sitting up too quickly after administration of spinal anesthetic

Answer: C, a dec. in the CSF available in the subarachnoid space through a leak created by an introducer needle puncturing the dura N & P, pg. 1084 Stefania

2. All of the following are risks when administered hypertonic saline EXCEPT: A. hyperchloremia B. hypernatremia C. cellular overhydration D. limited intravascular duration

Answer: C, cellular overhydration N & P, pg: 392 Stefania

5. Which nerve is most prone to injury in the lithotomy position from excessive flexion of the thigh at the hip? A. common peroneal B. tibial C. obturator D. saphenous

Answer: C, obturator N & P, pg. 413 Stefania

1. All of the following are appropriate anesthetic techniques for a shoulder arthroscopy except? A. general anesthesia B. interscalene block C. spinal anesthetic D. supraclavicular block

Answer: C, spinal anesthetic N & P, pg. 1006 Stefania

4. What type of block can be given for obstetric patients who are not candidates for spinal morphine, when spinals or epidurals are contraindicated, or in those who receive general anesthesia? A. cervical plexus block B. lumbar plexus block C. transversus abdominal plane block D. intercostal block

Answer: C, transversus abdominal plane block N & P, pg. 1144 Stefania

2. Blood for intraoperative transfusion should be warmed to ______degrees Celsius during infusion to avoid profound ______ a. 39, hypothermia b. 37, hyperthermia c. 37, hypothermia d. 39, hyperthermia

Answer: C- 37 degrees Celsius, hypothermia Morgan & Mikhail's Clinical Anesthesiology pg. 1171 stetler

3. Which rami form the inferior or lower trunk? a. C5-C-6 b. C7 c. C8-T1 d. C5-C8

Answer: C- C8-T1 N&P pg. 1108 stetler

2. When using an intraaortic balloon pump, when on the intraaortic pressure tracing should the balloon be inflated in order to augment diastolic blood pressure and coronary floor after closure of the aortic valve? a. When the left ventricle begins to eject b. During ventricular filling c. Immediately after the dicrotic notch is seen d. Just before the dicrtoic notch is seen

Answer: C- Immediately after the dicrotic notch is seen Morgan & Mikhail's Clinical Anesthesiology pg. 464 stetler

1. At what level does the spinal chord end in the newborn? a. L1 b. L2 c. L3 d. L4

Answer: C- L3 N&P pg. 1182 stetler

4. What is the suggested inflation volume for a size 4 LMA? A. 10 mL B. 60 mL C. 45 mL D. 20 mL

Answer: C. 45 mL N & P, pg. 1202 Stefania

3. Particular attention to IV fluid administration is very important with pediatrics. What is a good rule to follow when replacing fluid deficit? A. 10 ml replaced for every 1 hour NPO. B. 4 ml/ kg/ per hour of NPO. C. The same as the adult 4:2:1 rule. D. Double the 4:2:1 rule.

Answer: C. Maintenance requirements for pediatric patients can be determined by the "4:2:1 rule": 4 mL/kg/h for the first 10 kg of weight, 2 mL/kg/h for the second 10 kg, and 1 mL/kg/h for each remaining kilogram. M&M pg. 893.

3. Autoregulation can be described as? A. The anesthesia providing control of your circulation while the patient is under GETA. B. Caffeine and ephedrine supported circulation. C. Tissue beds regulating their own blood flow. D. The ventilator in the volume control setting

Answer: C. Most tissue beds regulate their own blood flow (autoregulation). See M&M on page 359. Blair Ryan

2. Osmolarity is to ________, as Osmolality is to __________. A. Grams: Pounds B. Osmoles: molecules C. Liters: Kilograms D. Chemistry: Physics

Answer: C. Osmolarity is an expression of the number of osmoles of solute in a liter of solution, whereas osmolality expresses the number of osmoles of solute in a kilogram of solvent. Nurse Anesthesia, pg. 383. Blair Ryan

4. Tourniquet pain is real and can be dull achy to burning excruciating pain. It is signaled by which type of nerves A. Alpha B. Beta C. Unmyelinated C-fibers D. Alpha Delta

Answer: C. The burning and aching pain corresponds to the activation of unmyelinated C fibers. Nagelhout. Pg. 1001. Blair Ryan

5. Which of the following is an accurate indication for surgical intervention based on ACC/AHA guidelines? A. patients who have successfully undergone PCI B. patients with stenosis greater than 50% in the right coronary artery C. patients with triple vessel disease D. patients with stenosis greater than 30% in the left main trunk

Answer: C. patients with triple vessel disease N & P, pg. 534 Stefania

5. At what age in the upright position, and at what age in the supine position does the closing volume begin to exceed functional residual capacity? A. upright: 45, supine: 65 B. upright: 75, supine: 45 C. upright: 65, supine: 45 D. upright: 45, supine: 30

Answer: C. upright: 65, supine: 45 N & P, pg. 1217 Stefania

5. Which of the following characteristics are not true regarding baroreceptors? A. located in the internal carotid arteries and aortic arch B. increase impulse production when they are stretched C. are efficient in long-term blood pressure regulation D. at MAP of less than 60 mmHg the baroreceptors do not transmit impulses, increases in MAP between 60-160 mmHg impulses sent to inhibitory vasomotor centers are increased.

Answer: C., are efficient in long-term blood pressure regulation N & P, pg. 490 Stefania

5. Which of the following procedures results in a particularly frequent incidence of delirium? a. Shoulder surgery b. Knee surgery c. Extremity surgery d. Hip surgery

Answer: D Hip surgery M&M pg. 912 stetler

4. What nerve is not part of the lumbar plexus? A. the femoral (L2-4) B. lateral femoral cutaneous(L1-3) C. obturator (L2-4) D. Sciatic Nerve

Answer: D Sciatic Nerve makes up part of the sacral plexus. Blair Ryan M&M pg 1001.

5. What may be a reason a patient is having arthroplasty? A. Pain Relief B. Stability of Joint Motion C. Deformity Correction D. All of the Above Answers.

Answer: D The goals of arthroplasty are pain relief, stability of joint motion, and deformity correction. Nagelhout. Pg. 1001. Blair Ryan

2. Which of the following are hallmark signs of transfusion incompatibility? a. Hypotension b. Fever c. Hemoglobinuremia d. Bleeding diathesis e. All of the above

Answer: E- All of the above N&P pg. 1025 Stetler

1. Match the degree of dehydration with the clinical signs & symptoms. a. Sunken anterior fontanelle b. Normal mucous membranes c. Intense thirst d. Lethargic behavior i. Mild ii. Moderate iii. Severe

Answers: a—iii; b—I; c—iii; d—iii Reference: N&P pg 1175 table 47-10 Mandy

4. All of the following are acceptable approaches to spinal anesthesia except a. Anterior approach b. Midline approach c. Paramedian approach d. Taylor approach

Anterior approach Charlie N&P pg. 1080-81

The brachial plexus passes between the ________ and _______ ________ at the level of the _________ _______ or ___. Fill in the blanks.

Anterior, middle scalene, cricoid cartilage, C6 (M&M pg 983) Josh

The ............ valve separates the LV and aorta?

Aortic valve Mbom

2. What is the expected total increase in blood volume in a pregnant patient at full term? a. 5-10% b. 25-40% c. 100% d. No change

B. 25-40% N&P 1133 Justin

What is the normal range for left ventricular end diastolic pressure? a. 1-10 mmHg b. 4-12 mmHg c. 5-15 mmHg d. 10-20 mmHg

B: 4-12 mmHg NP: 525 Byron

Pulmonary artery catheter should be placed cautiously in patients with a left bundle branch block due to the risk of developing which of the following? (Select 2) a. Atrial Fibrillation b. Right Bundle Branch Block c. Supraventricular Tachycardia d. Complete Heart Block

B: RBBB D: CHB NP: 525 Byron

Which of the following nerve fibers is unmyelinated? a. A-Alpha b. A-gamma c. A-Beta d. C Fibers

D. C-fibers N&P page 1074 Justin

Which of the following factors would influence the anesthetic plan for a patient undergoing an orthopedic procedure? A. The specific type of surgery the patient is having B. The length of time the procedure is expected to take C. The preferences of the patient D. Airway concerns E. The patient's comorbidities F. All of the above are factors that would influence the anesthetic plan

F. All of the above are factors that would influence the anesthetic plan N&P page 999, 1st column 3rd paragraph Abe

2. What type of aortic dissection starts at the proximal descending aorta and extends distally a. Type B b. Type a c. Type c d. Type f

Type B Charlie N&P pg. 572

5. Which type of aortic lesion can be intitially treated with B-adrenergic blocking agents a. Type B b. Type a c. Type c d. Type f

Type B Charlie N&P pg. 572

A person with type O blood can receive what type of blood? a. Type O only b. Type A and O c. Type B and O d. Type A, B and O

Type O only Charlie N&P pg. 395

The most common dysrhythmia associated with mitral valve prolapse is: (N&P ch23, pg 503) a. PVC's b. SVT c. AV block d. Vtach

a. Hale

4. During pregnancy, creatinine level rises to a. 140-160 ml/min b. 130-140 ml/min c. 120-130 ml/min d. 110-120 ml/min

a. 140-160 ml/min n&p 1130 becca

1. Which of the following patients should be tested for rheumatoid arthritis according to the American college of rheumatology? a. A 56 y/o female that has definite synovitis in the right knee b. A 61 y/o male that walks daily; no medical history and has persistant swelling in the left foot with elevated uric acid levels c. A 85 y/o male with a lengthy medical history d. All of the above

a. A 56 y/o female that has definite synovitis in the right knee Reference: N&P pg 1012 box 40-7 mandy

1. When should central neuraxial anesthesia be avoided? a. Any patient with a known coagulopathy b. Platelet counts > 100,000 c. Bleeding times of normal values

a. Any patient with a known coagulopathy Nagelhout page 1076 Budenbender

2. Which of the following is NOT included in the triad of common symptoms of ruptured AAAs? (Select one) a. Hypertension b. Hypotension c. Pulsatile mass d. Back pain

a. Hypertension N&P p. 570 Jason

2. On the Goldman Cardiac risk index what is the highest risk class? a. IV b. III c. II d. I

a. IV Charlie N&P PG 1218

Select all of the specific responsibilities of peer review committees. (Select 3) a. Identifying potential problems b. Formulating and periodically revising departmental policies c. Performing machine checks every morning d. Enforcing standards required for clinical privileges

a. Identifying potential problems b. Formulating and periodically revising departmental policies d. Enforcing standards required for clinical privileges M&M Chapter 54 page 1211 Jennifer

Of the following, which is more prone to developing respiratory complications. a. Preterm infant b. Neonate c. Infant

a. Preterm infant (N&P pg 1163) Josh

1. What can occur when a patient is in the sitting or prone position what can head flexion cause a. Spinal cord shifted anteriorly and compressed against posterior vertebral body b. Pressure on spinal cord is relieved c. Spinal cord shifts laterally and prevents compression d. Blood flow and oxygenation increases

a. Spinal cord shifted anteriorly and compressed against posterior vertebral body Charlie N&P pg 409

Where do T-cells mature? a. Thymus b. Liver c. Bone marrow d. Spleen

a. Thymus (N&P pg 1017) Josh

1. What position are "candy cane" supports utilized? (Select one) a. lithotomy b. lateral decubitus c. sitting d. jackknife

a. lithotomy N&P p. 416 Jason Franklund

At what transfusion rate will cardiac depression occur as a result of hypocalcemia in the average patient? (M&M pg 1161) a. >0.5 unit every 5 minutes b. >1 unit every 5 minutes c. >2 units every 5 minutes d. >3units every 5 minutes

b. >1 unit every 5 minutes (M&M pg 1161) Josh

ACT, or activated clotting time is maintained around what value for carotid artery stenting? a. >200 seconds b. >250 seconds c. >300 seconds d. >350 seconds

b. >250 seconds N&P p. 585 Lexi

5) When does third spacing, post-operatively, return back into the intravascular space? a) 1-day post-op b) 2 days' post-op c) 3 days' post-op

c) 3 days' post-op N&P Ch, 20 pg. 383 JDumas

What dermatomes are most commonly affected by an acute herpes zoster rash? a. T1-T2 b. T2-T3 c. T3-L4 d. T3-L3

d. T3-L3 M&M Chapter 47 page 1049 Jennifer

5. If a patient that is on chronic opioid therapy receives an agonist-antagonist during the operative period, what is the likely result?? a. Cardiac Depression b. Severe Respiratory depression c. Bronchospasm d. Withdrawl syndrome

d. Withdrawl syndrome Reference: N&P 1257 Mandy

4. What is the gold standard for detection of PFO in patients scheduled for surgery in the sitting position? A. EKG B. TEE C. CVP D. ART

• Answer B • N&P 414

1. Which is not one of the four primary approaches for blocking the brachial plexus? A. Axillary B. Interscalene C. Supraclavicular D. Paramedian E. Infraclavicular

• Answer D • N&P 1107

4. What is the normal mitral valve area? A. 1 to 2 cm2 B. 2 to 3cm2 C. 3 to 4 cm2 D. 4 to 6 cm2

• Answer D • N&P 23 pg. 497 Fletcher

3. Chronic pain is defined as pain that has no apparent biological value and lasts longer than _____ months A. 1 B. 3 C. 5 D. 7

• Answer: B • N&P 1252

2. How do anticonvulsants treat neuropathic pain? A. They activate mu, kappa, and delta receptors B. They inhibit neuronal firing, and stabilize nerve membrane to decrease repetitive neural ectopic firing. C. They are NMDA receptor agonists D. The activate the GABA receptor

• Answer: B • N&P 1253

1. Because blood pressure decreases by ____mmHg per centimeter change in height. A. 0.5 B. 0.75 C. 1 D. 1.25

• Answer: B • N&P 414

Aortic insufficiency is classified as acute or chronic, and primary or secondary. Match the following descriptions with their classifications: (N&P ch23, pg 502) a. Rheumatic valvular disease 1. Primary chronic b. Infective endocarditis 2. Primary acute c. Aortic root dissection 3. Acute secondary

(MATCHED AS-IS: A1, B2, C3) Hale

5. Select all of the follow complications involved with a Cervicothoracic (Stellate) Block. Select 7 a. intravascular injection b. diarrhea c. subarachnoid injection d. irritable bowel f. hematoma g.pneumothorax h. epidural anesthesia i. brachial plexus block j. hoarseness due recurrent laryngeal nerve blockade

Answer a, c, f, g, h, i, j. M&M page 1072-1073 Krum

2. The suprascapular nerve arises from what nerve roots? a. C4-C6 b. C7-C9 c. C7-T1 d. C3-C8

Answer a. M&M 1066 Krum

1. An occipital nerve block is used to... a. diagnose and treat headaches in the occipital region b. improve vision deficits originating in the occipital lobe c. relieve tension in the muscles of the occipital area of the head and neck d. decrease the pain of the neonate during passage through the birth canal

Answer a. M&M page 1065 Krum

Pediatrics have a ____ surface area than adults per kilogram, in other words they have a ____ body-mass index. a. larger, smaller b. smaller, larger c. decreased, increased d. depressed, elevated

Answer a. M&M page 879 Krum

5. Patients chronically taking beta blockers should do which of the following? a. take their beta-blocker the day of the procedure to limit the chance of beta blocker withdrawal b. take a vitamin C the day of the procedure to prevent a beta blocker over dose c. postpone all elective procedures until beta blockade is no longer needed d. substitute beta blocker dose with anticoagulant the day of the procedure

Answer a. M&M page 908 Krum

Aortic Aneurysm repair can utilizes the use of an endovascular stent graft. This graft is... a. placed within the aortic lumin. b. placed outside the aortic lumin. c. circumferentially around the aorta. d. inserted through the Internal jugular vein.

Answer a. N&P page 575. Krum

Post operative renal failure is possible after placement of an endovascular aortic stent placement due to which of the following. a. migration of the graft causing renal artery occlusion. b. sepsis related to infections and hypotension c. anaphylaxis d. UTI

Answer a. N&P page 576 Krum

The procedure to place and endovascular stent graft is done in which of the following areas? a. MRI room b. Interventional Radiology c. Emergency Room D. Intensive Care Unit

Answer b. N&P page 575 Krum

In children 5 years or younger, the narrowest part of the airway is the... a. vocal cords. b. trachea. c. cricoid cartilage. d. lips

Answer c. M&M page 879 Krum

1. What METS level is associated with potential adverse outcomes? a. < 8 METS b. < 6 METS c. < 4 METS d. < 10 METS

Answer c. M&M page 908 Krum

4. Select the appropriate action that happens during the Phase 3 of the cardiac action potential. a. Activation of voltage-gated Na channels allows Na entry and decreases the permeability to K - Upstroke. b. Inactivation of Na channel and transient increase in K permeability allows K out - Early Rapid Repolarization. c. Activation of slow calcium channels allows Ca entry - Plateau. d. Inactivation of Ca Channels and increased permeability to K allows K out - Final Repolarization. e. Normal permeability restored (atrial & ventricular cells) Na-K pump allows K in, Na out - Resting potential.

Answer d M&M page 347

In neonates, which of the following would indicate a lack of intravascular fluid volume? a. excellent skin turgor b. protruding fontanels c. tachycardia in the presence of hypertension d. hypotension without tachycardia.

Answer d. M&M page 879 Krum

4. Cardiac Surgery has the propensity to have alterations in patient's response to treatments and medications. Select from below the statement that show good understanding of the needs of cardiac anesthesia. a. anesthetic plan should be firm and rigid, sticking to the same course from start to finish and thus it is important to have large volumes of medication drawn up to be ready to give at a moment's notice. b. The anesthetic plan should not be firm and the anesthetist should be flexible and utilize multiple techniques when others fail. c. Each case should be treated the same. Cardiac function is only determined by fluid volume and thus only the amount of fluid given is important. d. All of the above are true.

Answer is b. M&M page 444 Krum

What two factors can be used in estimating coronary perfusion pressure? a. DBP b. SBP c. LVEDP d. LVESP

Answer: A & C NP 23: 481 Byron

3. Oxytocin contains a preservative that can lead to what if given in high doses? Select 3 A. hypotension B. flushing C. difficulty breathing D. tachycardia

Answer: A, B, D, hypotension, flushing, tachycardia N & P, pg. 1143 Stefania

3. Which of the following food allergies may increase the risk of a latex allergy? a. Avocado b. Mango c. Peanut d. Kiwi

Answer: A, B, D- Avocado, Mango, Kiwi N&P pg. 1026 Stetler

5. Cryoprecipitate contains which clotting factors? A. Fibrinogen B. Platelets C. Factor VIII D. Prothrombin E. Von Willebrand Factor

Answer: A, C, E. A less frequently used blood component, cryoprecipitate, contains factor VIII, von Willebrand factor, and fibrinogen. Nurse Anesthesia, pg. 398. Blair Ryan

3. Unlike dopamine, which of the following is true regarding dobutamine? (Select 2) a. Does not increase filling pressures b. Cardiac output is decreased c. May cause less tachycardia d. Causes significant changes in blood pressures

Answer: A, C- unlike dopamine, dobutamine does not increase filling pressures and may be associated with less tachycardia Morgan & Mikhail's Clinical Anesthesiology pg. 465 stetler

4. The posterior chord divides and gives way to which of the following nerves? a. Axillary b. Median c. Musculocutaneous d. Radial

Answer: A, D - Axillary, Radial N&P pg. 1108 stetler

2. An Suprclavicular block is appropriate for which surgeries? a. Shoulder and upper arm, not appropriate for surgeries at or distal to the elbow b. Procedures at or distal to the elbow, not ideal for catheter placement c. Surgery at or distal to elbow, less risk of pneumothorax and vascular puncture d. Surgery distal to the elbow, poor site for catheter placement

B Mbom

3. Your patient is becoming hypotensive during a laminectomy and a few doses of intermittent vasopressors has become less effective. There are no obvious signs of bleeding and the patient is young and healthy otherwise. What do you do next? A. Administer a fluid challenge of 1-liter bolus of LR. B. Give 25% Albumin to fix it and continue with the case. C. The patient has 2 units of blood available, go ahead and give the first unit. D. Administer Marcodex (Dextran 70).

Answer: A. Administer a fluid challenge of 1-liter bolus of LR. Crystalloids, when given in sufficient amounts, are just as effective as colloids in restoring intravascular volume. They also carry much less side effects/ reactions. M&M pg. 1164. Blair Ryan

2. The musculocutaneous nerve is usually located between which two muscles? A. coracobrachialis, pectoralis major B. coracobrachialis, biceps C. pectoralis major, biceps D. pectoralis minor, coracobrachialis

Answer: A. coracobrachialis, pectoralis major N & P, pg. 1113 Stefania

5. Which of the following are correct criteria for defining HBEs? Select 3 A. dec. in HR by 30 bpm within a 5 minute interval B. HR < 60 bpm C. dec. in SBP of more than 30 mmHg within a 5 minute interval D. any SBP less than 90 mmHg

Answer: A. dec in HR by 30 bpm within a 5 minute interval, C. dec. in SBP of more than 30 mmHg within a 5 minute interval, D. any SBP less than 90 mmHg N & P, pg. 1006 Stefania

4. All of the following are effects of clonidine and dexmedetomidine EXCEPT: A. extreme respiratory depression B. sedation C. anxiolytic, analgesic D. sympatholytic, vagomimetic

Answer: A. extreme respiratory depression N & P, pg. 1251 Stefania

4. Fluid therapy is divided into 3 categories. From the following options which is not included? A. Preload B. Maintenance C. Deficit D. Replacement

Answer: A: Fluid therapy can be divided into maintenance, deficit, and replacement requirements. M&M pg. 893.

Between what range of mean arterial pressures is normal autoregulation of the coronary circulation said to occur? a. 50-130 mmHg b. 60-140 mmHg c. 70-150 mmHg d. 80-160 mmHg

Answer: B NP 23: 481 Byron

5. An adult is having and allergic reaction. As the anesthesia provider, you determine that the symptoms indicate a grade 3 reaction. Based on the severity of the reaction, how much epinephrine should be given to this patient? a. 5-10 mcg b. 10-20 mcg c. 100-200mcg d. 1 mg

Answer: C- 100-200 mcg N&P pg. 1025 Stetler

4. The prolonged circulation time seen in the geriatric patient __________ the onset of IV drugs and ________ the induction with inhalation agents. a. Speeds, speeds b. Speeds, delays c. Delays, speeds d. Delays, delays

Answer: C- delays, speeds M&M pg. 910 stetler

1. Due to recent studies, the narrowest portion of the pediatric airway is now thought to be where? A. cricoid cartilage B. trachea C. glottis D. thyroid cartilage

Answer: C. glottis N & P, pg. 1201 Stefania

5. What is the appropriate size LMA for a 5 year old child who weighs 18 kilograms? A. 3 B. 1.5 C. 4 D. 2

Answer: D. 2 N & P, pg. 1202 Stefania

3. With clonidine, what is the ratio of alpha-2:alpha-1 activation? A. 1:220 B. 2:1 C. 10:1 D. 220:1

Answer: D. 220:1 N & P, pg. 1251 Stefania

2. Most tourniquet machines alarm at one hour. What is the maximum time a tourniquet should be inflated? A. 45 min B. 1 hour C. 90 min D. 2 hours

Answer: D. A maximum of 2 hours is generally considered safe. Nagelhout. Pg. 1000. Blair Ryan

4. At what cervical level is a interscalene block performed? A. C4 B. C3 C. C8 D. C6

Answer: D. C6 N & P, pg. 1113 Stefania

1. What is the correct loading dose of Heparin to be given before checking an ACT and starting cardio-pulmonary bypass? A. 100 units/ kg B. 200,000 units regardless of weight as you can't overdose Heparin C. 440-480 units/ kg D. 300-400 units/ kg

Answer: D. Heparin, 300-400 units/kg, is usually given while the aortic purse string sutures are placed before cannulation. Morgan & Mikhail pg. 456.

5. Which nerve is not included in the sacral plexus? A. Sciatic B. Tibial C. Common peroneal nerve D. Saphenous Nerve

Answer: D. Saphenous Nerve Blair Ryan M&M pg 1001.

5. What size breathing bag is optimal for delivering tidal volumes to toddlers, infants and neonates. A. Use the adult bag. B. Use small non latex glove and a rubber band to seal. C. 3 L bag D. 1 L bag.

Answer: D. Small tidal volumes can also be manually delivered with greater ease with a 1-L breathing bag than with a 3-L adult bag. M&M pg. 892.

5. Which ABO blood type is considered the universal DONOR? A. Type A B. Type B C. Type AB D. Type O

Answer: D. Type O. Type A blood has A RBC antigen, type B blood has B RBC antigen, type AB blood has both A and B RBC antigens, and type O blood has neither A nor B RBC antigen present. M&M pg. 1169. Blair Ryan

What is the peripheral vascular resistance (PVR) of a patient whose mean pulmonary artery pressure is 12, left atrial pressure is 6 and cardiac output is 4.5? (Round to nearest whole number)

107 M&M Chapter 20, page 355 PVR = 80 x [(PAP-LAP)/CO] Jennifer

Match the Maternal History with the Anticipated Neonatal Sequelae: 1. Rh-ABO incompatibility 2. Diabetes 3. Polyhydramnios 4. Alcoholism A. Hemolytic Anemia, Hyperbilirubinemia, Kernicterus B. Hypoglycemia, Large or Small for gestational age C. TE Fistula, Anencephaly D. Hypoglycemia, Fetal alcohol syndrome, Small for gestational age

1:A 2:B 3:C 4:D N&P Ch. 47 pg. 1178 K. Jensen

4) What type of anesthesia is sufficient for all surgical procedures below the knee that do not require a thigh tourniquet? a) General or Spinal b) General only c) Regional anesthesia that combines sciatic and femoral nerve blocks

4) C N&P Chapter 40 pg. 1005

3. What is the average distance that can be expected to reach the epidural space a. 4-5 cm b. 10 cm c. <2 cm d. 15 cm

4-5 cm Charlie N&P pg. 1080

4. Flexion and extension radiographs of the cervical spine should be done in patients with severe rheumatoid arthritis that use all of the following except? a. Steroids b. Methotrexate c. Immune therapy d. Ibuprofen

4. d. ibuprofen

Fetal hemoglobin is the predominant hemoglobin species in the newborn, contributing to what % of total hemoglobin? (Whole numbers only)

70, 80 or 90 N&P Chapter 47, page 1165 Jennifer

3. Match the osmolarity to the associated sodium concentrations of crystalloid intravenous solutions: (N&P ch 48, pg 1208) a. Hypertonic- Na+ >155mEq/L b. Isotonic- Na+ 130-155mEq/L c. Hypotonic- Na+ <130mEq/L 1. Osmolarity < 280mOsm/L 2. Osmolarity > 310mOsm/L 3. Osmolarity 280-310mOsm/L

A (2) B (3) C (1) Hale

Class IV hemorrhagic shock means a blood loss of______mL? A) > 2000 B) > 1000 C) >3000 D) >4000

A) > 2000 Devin [N&P p.384]

Epidural and Intrathecal catheters provide relief from pain at significantly _________ total doses. (select 2) A. Lower B. Higher C. Increased D. Decreased

A. Lower D. Decreased M&M Ch. 47 pg. 1059 K. Jensen

Neonates and infants differ from older children and adults regarding respiratory anatomy. Select 2 differences: A. Weaker intercostal muscles B. Stronger intercostal muscles C. Weaker diaphragms D. Stronger faster diaphragms

A. Weaker intercostal muscles C. Weaker diaphragms M&M Ch. 42 pg. 878 K. Jensen

Causes of hypomagnesemia include a. All of the above b. Renal failure c. Chronic diarrhea d. Diabetes mellitus

All of the above Charlie N & P pg. 391

In the neonate, the failure rate of spinals is... a. 20% b. 30% c. 40% d. 50%

Answer - a. N&P page 1178 Krum

2. Guidelines change regarding anticoagulants/ antiplatelet agents and their safety with neuraxial anesthesia. Where is the most up-to-date source to check the recent literature? A. Morgan and Mikhail's Clinical Anesthesiology 5th edition B. Nurse Anesthesia by John Nagelhout C. The American Society of Regional Anesthesia and Pain Medicine (ASRA) website. D. Class PowerPoints

Answer C: ASRA guidelines on this subject and continually update when applicable. M&M pg. 948. Blair Ryan

4. Autonomic control of the vasculature is primarily sympathetic nervous controlled. Sympathetic nerve fibers stem from ¬¬¬¬__________ and innervate all parts of the vascular except¬¬¬¬¬__________. Choose the correct answer for each blank. From the following first blank cranial sacral ganglions, thoraco-lumbar ganglions, cardiac myocardium. Second blank arteries, venules, veins, capilaties or arterioles.

Answer Cranial-Sacral nerve ganglions, capillaries. Sympathetic outflow to the circulation passes out of the spinal cord at all thoracic segments and the first two lumbar segments. These fibers reach blood vessels via specific autonomic nerves or by traveling along spinal nerves. Sympathetic fibers innervate all parts of the vasculature except for capillaries. See M&M on page 360. Blair Ryan

3. Volumes as small as ___________mLs may lead to hemolytic reactions that may result in death. (N&P ch20, pg 398) a. 10mls b. 50mls c. 100mls d. 250mls

a. Hale

5. Mild dehydration is associated with a ______% decrease in body weight. (N&P ch 48, pg 1209) a. 5 b. 6-8 c. 10 d. generally no significant decrease in body weight is seen with only mild dehydration

a. Hale

The IABP should be timed with the _____________ of the arterial waveform so that the balloon inflates once the aortic valve closes and diastole begins. (N&P ch24, pg 549) a. Dicrotic notch b. Peak systolic pressure c. Systolic uptake d. Systolic decline

a. Hale

Which of the following are excitatory neurotransmitters? a. Substance P b. Glutamate c. Glycine d. GABA

a. b. NP 1247

Three of most common complications of IABP use include which of the following: (N&P ch24, pg 549) a. Vascular Injury b. Infection at the IABP insertion site c. Thrombocytopenia d. Hematoma

a. b. c. Hale

Select the inhibitory endogenous opioids: a. Enkephalin b. Dynorphin c. Substance P d. Dorsolateral funiculus (DLF)

a. b. NP 1247 DB

5. What is the correct amount of dextrose in D5W? a. 50g/L b. 5g/L c. 5g/dL d. 50g/dL

a. 50g/L

4. The brain doubles in weight within _____ months of life and ______ in weight within 1 year. a. 6 months; triples b. 6 months; doubles c. 3 months; quadruples d. 6 months; quintuples

a. 6 months; triples Nagelhout Page 1168 "The brain doubles in weight within the first 6 months of life and triples in weight within 1 year." Budenbender

What is the expected baseline blood pressure of the neonate? a. 65/40 b. 95/65 c. 100/70 d. 110/60

a. 65/40 (M&M pg 880) Josh

3. What is considered the most common cardiovascular complication after noncardiac surgery? a. Myocardial infarct b. Hypertension c. Hypotension d. Rapid ventricular response

Myocardial infarct Charlie N&P pg 1294

4. The extracellular space is larger in the neonate, therefore the initial dose of local anesthetic will result in which of the following a. Equal peak plasma concentration b. Higher peak plasma concentration c. Lower initial peak plasma concentration

N&P pg. 1182 Answer: D- lower peak and plasma concentrations stetler

Neuromuscular effects of hypocalcemia include a. All of the above b. Increased strength c. Muscle spasm d. Tetany

a. All of the above Charlie N & P pg. 390

4. The first step in a root cause analysis is? N&P pg 1300 a. Identifying the problems b. Assembling multidisciplinary group c. Understand the process involved d. Collecting factual information. e. Find research for associated problem

a. Identifying the problems Fieber

1. Lack of development of inhibitory tracts may actually ________ the intensity and duration of painful stimuli. a. Increase b. Decrease c. Have no change

a. Increase N&P page 1168

1. As a benefit of a combined spinal-epidural for C-section a ____ spinal dose can be used? N&P Pg 1145 a. Lower b. Higher c. Same

a. Lower Fieber

2. What is the only absolute contraindication for TEE a. Pathologic conditions of the esophagus b. Latex allergy c. Hypotension d. Myocardial depression

a. Pathologic conditions of the esophagus Charlie N&P pg. 526

1. ______ Needles pierce the dura with a clearly perceptible "click" or "pop" not easily noticed with ________ needles. N&P pg 1079 a. Pencil point, Cutting b. Cutting, Pencil point c. 35 gauge, 18 gauge d. 20 gauge, 16 gauge

a. Pencil point, Cutting

1. Which of the following needle types is associated with an extremely low incidence of postdural puncture headache? a. Pencil-point b. Touhy c. Whitacre d. Quincke

a. Pencil-point b. Whitacre Reference: N&P pg 1097 Mandy

2. Mean Arterial Pressure is an important indicator of? N&P pg 490 a. Perfusion of tissue beds b. Kidney function c. Coronary artery blood oxygenation d. Central venous pressure

a. Perfusion of tissue beds Fieber

3. Select two major determinants of coronary blood flow. (M&M pg. 357) a. Perfusion pressure b. Intraventricular pressure c. Vascular resistance d. Pule pressure

a. Perfusion pressure c. Vascular resistance

5. Patients that develop atrial arrhythmias and atrial enlargement are highly sensitive to which of the following? a. Perioperative fluid administration b. Beta blockers c. ACE inhibitors d. Calcium channel blockers

a. Perioperative fluid administration M&M, page 910 Willie

1. Substance P is a peptide found and released from_____ nociceptor ____ fibers. a. Peripheral afferent/ C b. Peripheral efferent/ C c. Central afferent/ C d. Central efferent/ C

a. Peripheral afferent/ C n&p 1245 rebecca

4. Which of the following should not be done after the epidural has been dosed? a. Place the patient in a low fowler's position b. Position supine with left uterine displacement c. Apply O2 by face mask d. Monitor BP Q 1-2 mins for the first 15 mins

a. Place the patient in a low fowler's position M&M page 852

The ............ valve separates the RA and RV?

Tricuspid valve Mbom

A visual estimation of blood loos includes the surgical suction and "lap" sponges. A full soaked lap sponge can hold _____ to _______ mL of blood A. 25 to 50 mL B. 100 to 150 mL C. 10 to 20 mL D. 500 to 1000 mL

B. 100 to 150 mL M&M Ch. 51 pg. 1167 K. Jensen

A patient who presents with parched mucous membranes, is obtunded, has markedly decreased urinary output, an increased heart rate > 120 and a decreased blood pressure may have up to what percentage of fluid loss? A. 10% B. 15% C. 5% D. 8%

B. 15% M&M Ch. 51 table 51-1 pg. 1162 K. Jensen

The most common diagnoses associated with patients who have preexisting cardiovascular diseases are: Pulmonary Edema, Systolic/Diastolic heart failure, MI, Arrhythmias, and Thromboembolism. Postoperative pulmonary edema increases by ______ in patients with poorly compensated heart failure? A. 1% B. 16% C. 50% D. 6%

B. 16% M&M Ch. 21 pg. 377 K. Jensen

According to the SCIP project, when Vancomycin is chosen as the preoperative antibiotic, it must be given within _____ hour(s) of incision time. A. 1 B. 2 C. 3 D. 4

B. 2 N&P page 999, 2nd column 1st paragraph Abe

3.) What is the daily requirement of sodium in a newborn? (N and P, page 1170) A. 1-2 mEq/kg B. 2-3 mEq/kg C. 5 mEq/kg D. 4 mEq/kg

B. 2-3 mEq/kg Shackelford

Anesthesia related mishaps and accidents accounts for ______% of maternal deaths. A. 5-10% B. 2-3% C. 15-20% D. 1-2%

B. 2-3% M&M Ch. 41 pg. 845 K. Jensen

By the year 2040 the percentage of persons over the age of 65 will be ____________% of the population in the United States. A. 50% B. 24% C. 15% D. 60%

B. 24% M&M Ch. 43 pg. 907 K. Jensen

What is the most significant absolute contraindication to regional anesthesia? A. Septicemia B. Patient refusal C. Severe spinal deformity D. Preexisting neurologic disease

B. Patient refusal N&P page 1102, 2nd column 2nd paragraph Abe

5.) What is the primary concern when caring for a patient with rheumatoid arthritis? (N and P, page 1012) A. Blood glucose B. Patient's airway C. Blood pressure D. ASA status

B. Patient's airway Maggie

3. What is the principal electrolyte of the ICF? a. Sodium b. Potassium c. Calcium d. Magnesium

B. Potassium N&P 387 Justin

During the plateau phase of the cardiac cycle, Ca+ enters the cell through which type of ion channel? (Select 2) A. T-type B. Slow L-type C. Voltage gated D. G-protein

B. Slow L-type C. Voltage gated M&M Ch. 20 pg. 345 K. Jensen

5. If the anesthesia providers suspects their patient may have had awareness during surgery, what resource should the anesthesia provider use to assess awareness? A. The detail test B. The Brice Questionnaire C. The Frank-Starling Test D. McMurphy's Test

B. The Brice Questionnaire N&P 1297 Justin

4. When are tourniquets are applied? a. During the procedure b. After the initiation of anesthesia c. After incision d. It doesn't matter

B. after the initiation of anesthesia N&P pg 1000 rebecca

1) During lateral decubitus positioning, what 2 head structures on the dependent side should be free of pressure after turning (2)? a) Ear & Teeth b) Eye & Hair c) Eye & Ear N&P Ch. 21 pg. 417

C Jared

1) What drug is required for life after receiving CEA? A) Ibuprofen B) Fentanyl C) Aspirin N&P Chapter 25 pg 585

C Jared

2) How often does delirium occur in patients > 65? a) 0% to 5% b) 5% to 10% c) 10% to 26% N&P Ch. 49 pg. 1220

C Jared

2) What is the ASA transfusion practice guidelines recommendation for judicious preoperative administration of reversal agents? a) Vitamin K, FFP b) Prothrombin-complex concentrate, Vitamin K, FFP c) Vitamin K, prothrombin-complex concentrate, recombinant factor VII, and FFP N&P Chapter 20 pg. 399

C Jared

2) What is the most common factor limiting the duration of a bier block to 1 hour? a) Fear/anxiety b) No preop medication given c) Discomfort produced by the tourniquet N&P Chapter 45 pg. 1116

C Jared

2) When a pregnancy has been diagnosed as placenta previa, what is the major complication a CRNA should prepare for? a) ↓ perfusion to the brain b) tachycardia c) increased blood loss N&P Ch. 46 pg. 1153

C Jared

5) When does neural compression occur? a) Whenever a nerve branches away from the body b) Wherever a nerve exits a plexus c) Wherever a nerve courses through an anatomically narrowed passage M&M Ch. 47 pg. 1041

C Jared

3. An Infraclavicular block is appropriate for which surgeries? a. Shoulder and upper arm, not appropriate for surgeries at or distal to the elbow b. Procedures at or distal to the elbow, not ideal for catheter placement c. Surgery at or distal to elbow, less risk of pneumothorax and vascular puncture d. Surgery distal to the elbow, poor site for catheter placement

C Mbom

A well-known complication of cardiac surgery is ulnar neuropathy, with a prevalence as high as ________: A) 5% B) 20% C) 38% D) 50%

C) 38% [N&P p.407] Devin

Following depolarization, the cells are typically refractory to subsequent normal depolarizing stimuli until phase _____? A) 3 B) 2 C) 4 D) 1

C) 4 Devin [M&M p.344]

5.) Total serum calcium is dependent on what other laboratory level? (N and P, page 388) A. Sodium B. Magnesium C. Albumin D. Potassium

C. Albumin Shackelford

What cardiac valves are NOT anchored to the endocardium by chordae tendinae? A. Mitral B. Tricuspid C. Aortic D. Pulmonic

C. Aortic D. Pulmonic N&P page 472 figure 23-4 Abe

4. Which of the following is true about the composition of D5 1/4NS? a. Hypertonic b. Hypotonic c. isotonic

C. Isotonic Mbom

What nerve holds the highest incidence of injury? (N and P, page 420) A. Common peroneal B. Radial C. Ulnar D. Brachial plexus

C. Ulnar Maggie

3. When planning on positioning a patient in prone, when should the head, neck, shoulder, and arm mobility be assessed? N&P pg 418 a. Pre-op b. Post-op c. At home d. The next day

a. Pre-op

Select the following conditions that would decrease CSF volume, therefore are associated with greater dermatomal spread for a given volume of injectate. (Select 3) a. Pregnancy b. Large abdominal tumors c. Ascites d. Diabetes

a. Pregnancy b. Large abdominal tumors c. Ascites M&M Chapter 45, page 957 Jennifer

4. Which of the following are appropriate sites for monitoring oxygen saturation in patients undergoing thoracic aortic aneurysm repair? (select all that apply) a. Right hand b. Left hand c. Ear d. Nasal passages

a. Right hand b. Ear c. Nasal passages Reference: N&P pg 573 Mandy

The distance between the two vertical lines of the LV pressure-volume loop represents a. SV b. EF c. EDV d. ESV

a. SV Crouse N&P pg. 482

4. An Axillary block is appropriate for which surgeries? A. Shoulder and upper arm, not appropriate for surgeries at or distal to the elbow B. Procedures at or distal to the elbow, not ideal for catheter placement C. Surgery at or distal to elbow, less risk of pneumothorax and vascular puncture D. Surgery distal to the elbow, poor site for catheter placement

D Mbom

Fat embolism syndrome has a mortality rate of _______. A) 70-80% B) 30-40% C) 5-10% D) 10-20%

D) 10-20% Devin [M&M p.792]

5. Shivering increases oxygen consumption by up to _____%? A. 100 B. 200 C. 300 D. 400 N&P page 1215, 1st column 1st paragraph

D. 400 Abe N&P page 1215, 1st column 1st paragraph

Which of the following affects the F(A)/F(I) curve in the pediatric patient? A. Inspired anesthetic content B. Agent B:G coefficient C. Alveolar ventilation D. All of the above.

D. All of above Justin N&P 1192

Which of the following are characteristics of postoperative delirium? A. Increased psychomotor activity B. Decreased Mobility C. Confusion with depression D. All of the above

D. All of the Above Justin N&P Page 1292: Table 53-3

4. Which of the following commonly used anesthetic drugs is known to cause QT prolongation? A. Isoflurane B. Sevoflurane C. Atropine D. All of the above

D. All of the above Justin N&P 1296

2. How are atria natriuretic peptide (ANP) and B- type natriuretic peptide (BNP) able to help protect the myocardium? a. By inducing diuresis, natriuresis , and vasodilation b. By inhibiting diuresis, natriuresis, and vasodilation c. By inhibiting diuresis, natriuresis, and vasoconstriction

a by inducing diuresis, natiuresis,and vasodilation n&p pg 513 rebecca

Which of the following is a relative contraindication to perform a regional block? A. Patient refusal B. Infection at the injection site C. Uncorrected coagulapathy D. Severe spinal deformity

D. Severe spinal deformity N&P page 1103, box 45-1 Abe

5. What is the most accurate method of estimating blood in surgical sponges and "lap" pads? (M&M pg 1167) a. Weigh them before and after use b. Squeeze them out into a graduated cylinder c. Compare them to manufacturer provided pictures showing varying degrees of absorbed blood with estimated blood loss d. Ask the surgeon

a. Weigh them before and after use

2. What is required to classify an acceleration in a fetal heart rate a. When there are two or more accelerations in a 20-minute period b. One acceleration in a 20 minute period c. Sudden decrease in fetal heart rate d. A decrease after the peak of the contraction

a. When there are two or more accelerations in a 20-minute period Nagelhout Page 1133

1. Chemoreceptors are located? N&P pg 490 a. Within Carotid and Aortic bodies b. Saphenous vein c. Vena cava d. Jugular Veins

a. Within Carotid and Aortic bodies Fieber

5. Which of the following is NOT part of proper alignment when positioning a patient into the lateral position? (Select one) a. arms b. shoulder c. hips d. head

a. arms N&P p. 417 Jason Franklund

1. Which of the following should NOT be included when constructing a root cause analysis report? (Select one) a. blame b. logic c. cogent d. facts

a. blame N&P p. 1302 Jason Franklund

4.) What vitamin is essential for absorption of phosphorus in the intestinal tract? a.) Vitamin D b.) Vitamin B c.) Vitamin C d.) Vitamin A

a.) Vitamin D M&M page 1134, Zino

What is the name of the first cervical vertebrae? a. atlas b. apex c. cornical d. cervix

answer - a. M&M page 941 Krum

Match the additional fluid requirement for the different degrees of tissue trauma a. Minimal (eg, herniorrhaphy) b. Moderate (eg, cholecystectomy) c. Severe (eg, bowel resection) ___ 2-4 mL/kg ___ 4-8 mL/kg ___ 0-2 mL/kg

b - 2-4 mL/kg c - 4-8 mL/kg a - 0-2 mL/kg M&M Chapter 51, page 1169, table 51-6 Jennifer

Match the following terms with the correct definition a. Hypokinesis b. Akinesis c. Dyskinesis ___ Failure to contract ___ Decreased contraction ___ Paradoxic bulging

b - Failure to contract a - Decreased contraction c - Paradoxic bulging M&M Chapter 20, page 355 Jennifer

2. Hyperglycemia in pediatric neurological procedures as been well established to be associated with: (N&P ch 48, pg 1208) a. Improved neurological outcome b. Worsened neurological outcome c. Very little change in the neurological outcome d. Increased nausea and vomiting

b. Hale

4. The following description specifies proper positioning for which surgical position? "The preferred arm placement is flexed, slightly abducted, and with the forearms and hands lower than the shoulders and adequately supported. The arms should rest at a comfortable height on the armboards and should not support the weight of the shoulders. Padding should be placed under the shoulders to prevent sagging of the shoulders and stretching of the brachial plexus." (N&P ch 21, pg 418) a. Supine b. Prone c. Lateral Decubitus d. Sitting

b. Hale

A surgical patient returns to the ER the next day and reports painless visual loss, a non-reactive pupil, no light perception, and difficult time detecting color. These are likely signs and symptoms of: a. Post-operative hemorrhagic stroke b. Post-operative vision loss c. Drug allergy d. Conjunctivitis Nagelhout and Plaus ch 40, pg 1010

b. Hale

The most common method of intubating a neonate with an esophageal fistula is: (N&P ch 47, pg 1186) a. Awake fiberoptic and RAE tube b. Intubate R mainstem and pull ETT back until lung sounds heard on L side c. Traditional laryngoscopy and ETT placement d. Nasal intubation in case surgeon must operate on oropharynx

b. Hale

Which of the following is/are appropriate doses of fentanyl for the pediatric patient? a. 0.25-0.5 mcg/kg IV b. 0.5-1 mcg/kg IV c. 5 mcg/kg PO/transmucosal d. 10 mcg/kg PO/transmucosal

b. 0.5-1 mcg/kg IV d. 10 mcg/kg PO/transmucosal NP: 1199 Byron

3. Which of the following is an appropriate dose of 0.125-0.25% Bupivacaine or Ropivacaine (with or without epinephrine for a caudal epidural. a. 0.01-0.05 ml/kg b. 0.5-1.0 ml/kg c. 2 ml d. 2-4 ml/kg

b. 0.5-1.0 ml/kg M&M Ch. Pg. 965 Thetford

4. What is the appropriate bolus (mg) and lockout interval (min) for Hydromorphone/methadone 1 mg/ml? N&P pg 1252 table 51-4 a. 0.05-0.25 mg, 8-20 min b. 0.5-2.5 mg, 8-20 c. 0.05-0.25 mg, 20-30 min d. 0.5-2.5 mg, 20-30 min

b. 0.5-2.5 mg, 8-20

Steady application of how many cm of positive end-expiratory pressure will usually overcome a laryngospasm in a pediatric patient? a. 5 b. 10 c. 15 d. 20

b. 10 M&M Chapter 42, page 891 Jennifer

What percentage of meconium-stained neonates results in small airway obstruction or severe respiratory distress? a. 10% b. 15% c. 20% d. 25%

b. 15% M&M p. 872 Lexi

3. Normal fetuses have how many accelerations per hour? a. 2-4 b. 15-40 c. 30-60 d. 60-120

b. 15-40 M&M Ch. 41 Pg. 868 Thetford

1. Accelerations of Fetal Heart Rate (FHR) are defined as increases of at least ___ bpm, lasting more than ___ seconds. a. 30:30 b. 15:15 c. 60:45 d. 45:25

b. 15:15 M&M Ch. 41 Pg. 868

In the postoperative period for patients who underwent a carotid endarterectomy (CEA), a systolic blood pressure greater than ___ mmHg is associated with an increased incidence of TIA, stroke, or myocardial infarction. a. 200 b. 180 c. 175 d. 160

b. 180 N&P Chapter 25, page 582 Jennifer

2. After requiring the use of a tourniquet during a procedure, how long should the tourniquet be used for? a. 4 hours b. 2 hours c. 3 hours d. 6 hours

b. 2 hours N&P pg 1000 rebecca

Pediatric patients scheduled for elective procedures who have a mild upper respiratory tract infection should be rescheduled. What is the recommended amount of time to postpone the surgery following resolution of symptoms? a. 1-2 weeks b. 2-4 weeks c. 4-6 weeks d. 6-8 weeks

b. 2-4 weeks NP: 1197 Byron

During induction of anesthesia for cardiac surgery, a reduction in blood pressure greater than ___% generally calls for administration of a vasopressor. a. 10 b. 20 c. 30 d. 40

b. 20 M&M Ch. 22, page 454 Jennifer

2. By what percentage does intravascular volume decrease in the postnatal period? a. 50% b. 25% c. 30% d. 40%

b. 25% rebecca

The neonatal period is generally regarded as the first ___ days of extrauterine life. a. 26 b. 28 c. 30 d. 32

b. 28 N&P Chapter 47, page 1163 Jennifer

5. The definition of chronic pain is, pain that has no biological value and last longer than_____ Or beyond the normal course of healing. N&P pg. 1252 a. 1 month b. 3 months c. 12 months d. 12 days

b. 3 months

Jehovah's Witnesses make up a fellowship of more than one million Americans that object to the administration of what medical treatment? a. Administration of resuscitative efforts b. Administration of blood products c. Administration of nonconventional/experimental treatments d. Administration of chemotherapeutic agents

b. Administration of blood products M&M p. 802 Lexi

The ______ ______ nerve runs along the anterior leg and enters the ankle between two tendons lateral to the dorsalis pedis artery. a. Superficial peroneal b. Deep peroneal c. Common peroneal d. Anterior peroneal

b. Deep peroneal M&M p. 1016 Lexi

3. Intrathecal opioids are effective towards extending postoperative analgesia. What is the most important side effect to monitor? a. Worsening hypotension b. Delayed respiratory depression c. Pruritis d. Urinary retention

b. Delayed respiratory depression M&M page 794

1. Which of the following analgesia techniques for unilateral knee replacement produces fewer side effects compared to others? a. Opioid administration b. Femoral perineural catheter c. Lumbar epidural d. All the above demonstrate similar side effects M&M Ch. 38 Pg. 800

b. Femoral perineural catheter M&M Ch. 38 Pg. 800 mf Thetford

2. Which are the following is NOT a clinical feature of hyponatremia: a. Seizure b. Flaccidness c. Cramps d. Cerebral edema

b. Flaccidness Budenbender Nagelhout Page 385 Box 20-1

Which of the following spinal needle types is considered to be a rounded bevel tip? a. Sprotte b. Greene c. Whitacre d. Pencan

b. Greene NP: 1079 Byron

The bacterial infection known as Acute Epiglottitis is commonly caused by which strain of bacteria? a. Haemophilus influenza A b. Haemophilus influenza B c. Any strain of H. influenza d. Both H. influenza A and B

b. Haemophilus influenza B M&M p. 902 Lexi

Which of the following is a factor associated with human errors and equipment misuse if the CRNA is unfamiliar with anesthetic technique or equipment? a. Inadequate preparation b. Inadequate experience and training c. Environmental limitations d. Physical and emotional factors

b. Inadequate experience and training M&M Chapter 54 page 1210, table 54-3 Jennifer

2. How does aging effect duration of action for spinal anesthetics? (M&M pg 907) a. Shorter duration of action b. Longer duration of action c. Has no effect on duration of action for spinal anesthetics d. Spinal anesthetics should be avoided in elderly patients

b. Longer duration of action

The spinal subarachnoid space extends from the foramen magnum and ends where in adults? a. S1 b. S2 c. S3 d. S4

b. S2 M&M Chapter 45 page 955 Jennifer

3. Which of the surgical position exert the minimal hemodynamic changes? a. Prone b. Supine c. Lateral d. Sitting

b. Supine N&P page 403 Willie

4. Why is the lithotomy position considered to cause hemodynamic deception? a. The abdominal contents increases cardiac pressures b. The elevated legs provides an autotransfusion c. The reduction in venous return causes a relative hypotension

b. The elevated legs provides an autotransfusion N&P page 403 Willie

What are two indications for a trigeminal nerve block? a. Severe throat pain b. Trigeminal neuralgia c. Perineal pain d. Intractable facial pain

b. Trigeminal neuralgia d. Intractable facial pain (M&M pg 1061) Josh

How is an acute hemolytic reaction manifested In the anesthetized patient? Select all that apply. a. Bradycardia b. Unexplained hypotension c. Hypothermia d. Rise in temperature e. Diffuse oozing in the surgical field f. Tachycardia g. Hemoglobinuria

b. Unexplained hypotension d. Rise in temperature e. Diffuse oozing in the surgical field f. Tachycardia g. Hemoglobinuria (M&M pg 1161) Josh

Which TWO of the following are ocular manifestations of sickle cell anemia? a. Glaucoma b. Vitreous hemorrhage c. Retinal detachment d. Ocular edema

b. Vitreous hemorrhage c. Retinal detachment M&M p. 1178 Lexi

5. The severity of symptoms related to an acute hemolytic reaction is dependent upon? a. Compatibility of blood product with infusing medications b. Volume of incompatible blood products c. Temperature of blood product transfused d. Rate of transfusion

b. Volume of incompatible blood products M&M Ch. 51 Pg. 1172 Thetford

Under what circumstances could cell salvage be used in an instance unrelated to surgical indication or requirement? a. When the patient requests so b. When the patient is a Jehovah's witness c. When the patient's blood type is unknown d. When blood product resources are low

b. When the patient is a Jehovah's witness N&P p.400 Lexi

What two modifications of body position pose a particular risk to the brachial plexus? a. Adduction of the arms b. Abduction of the arms c. Flexion of the head d. Rotation of the head

b. abduction of the arms d. rotation of the head NP: 408 Byron

It is well known that abduction of the arms greater than 90 degrees can damage, this is due to ________ of the brachial plexus at the ___________? (Fill in the blanks) a. Compression b. Stretching c. Humerus d. clavicle

b. stretching c. humerus NP: 408 Byron

The laboring parturient is complaining of dull and diffuse pain in her abdomen. Which of the following is true concerning her pain: (N&P pg 1131) a. the cervix is fully dilated b. the pain is transmitted to the T10-L1 segments of the spinal cord c. a pudendal nerve block will treat the pain d. the patient is experiencing pain related to third stage of labor

b. the pain is transmitted to the T10-L1 segments of the spinal cord

1. The atrioventricular valves consist of: a. Thebesian valve b. Tricuspid valve c. Eustachian valve d. Mitral valve

b. tricuspid d. mitral valve n&p pg 472 rebecca

2.) How should dosing of NMBs be adjusted with patients who have high magnesium levels? a.) No change b.) Reduced c.) increased d.) Has no effect

b.) Reduced M&M page 1136, Zino

3) What is the muscle relaxant of choice for pediatric intubation? a) Atracurium b) Cisatracurium c) Rocuronium M&M Ch. 42 pg. 885

c Dumas

4) If you have high fluid loss from the GI tract, Kidney, and Diaphoresis, what kind of fluid loss is this considered to be? a) Iatrogenic cause b) Relative cause c) Absolute cause

c) Absolute cause N&P Ch. 20 pg. 383 JDumas

4) Which of the following is not a relative contraindication to neuraxial anesthesia? a) Aortic or mitral stenosis b) Sepsis c) An intracranial mass d) Left ventricular outflow obstruction M&M ch 45 pg 948

c) An intracranial mass Mbom

4) How should anesthesia prepare for the 3 most stimulating events during CPB? a) Lighten the anesthetic and administer ketamine b) Deepen the anesthetic and administer fibrinolytic c) Deepening the anesthetic and administering additional muscle relaxant if needed

c) Deepening the anesthetic and administering additional muscle relaxant if needed N&P Chapter 24 pg 528 Jared

5) When should the lungs be deflated during CPB? a) During initial incision to decrease the risk of cardiac or pulmonary laceration b) During initiation of bypass pump c) During sternotomy to decrease the risk of cardiac or pulmonary laceration

c) During sternotomy to decrease the risk of cardiac or pulmonary laceration N&P Chapter 24 pg 528 Jared

1) A neonate has been diagnosed with Malrotation and Midgut Volvulus, what type of anesthesia should the CRNA prepare for? a) Regional with general b) Only general c) General with RSI

c) General with RSI N&P Ch. 47 pg. 1186 JDumas

1) General Anesthesia increases the release of Antidiuretic hormone release and can cause what kind of electrolyte imbalance? a) Hypokalemia b) Hyperkalemia c) Hyponatremia

c) Hyponatremia N&P Ch. 20 pg. 383 JDumas

3) What compartment of the body contains two thirds total body fluid volume? a) Extracellular b) Cerebral vascular c) Intracellular

c) Intracellular N&P Ch. 20 pg. 382 JDumas

2) Blood circulation through the capillary beds is by what kind of arteriolar sphincter? a) Post capillary sphincters b) Intra capillary sphincters c) Pre capillary sphincters

c) Pre capillary sphincters N&P Chapter 23 pg 488 JDumas

2) What type of neuraxial anesthesia is considered a denser anesthetic? a) Paravertebral injections b) Epidural anesthesia c) Spinal anesthesia

c) Spinal anesthesia N&P Chapter 44 pg. 1074 JDumas

3. The most common type of Endoleaks are Type___ and 70% spontaneously close within the first month after implantation. N&P Pg 577 a. IA b. I c. II d. III

c. II Fieber N&P Pg 577

Delayed enteral feeding caused by which postoperative side effect is one of the most common causes of prolonged hospital stay after surgery? a. Pain b. Altered mentation c. Ileus d. NPO status

c. Ileus M&M p. 1102 Lexi

5. Nerve cells within the spinal cord mature until completion at 6 to 7 years of age. At what level does the CONUS MEDULLARIS terminate in the infant and adult? a. Infant S3; Adult S1 b. Infant S1; Adult S3 c. Infant L3; Adult L1 d. Adult L1; Infant L3

c. Infant L3; Adult L1 Nagelhout Page 1169 Figure 47-5 "Comparison of levels of the conus medullaris and the dural sac in the infant and the older child or adult" Budenbender

5. What is an absolute contraindication to regional block? N&P pg 1103) a. Septicemia/bacteremia b. Chronic headache c. Infection at injection site d. Stenotic valvular disease

c. Infection at injection site

The compliment system plays a major role in what part of the immune system? a. Innate b. Acquired c. Innate and acquired d. Neither innate or acquired

c. Innate and acquired (N&P pg 1018) Josh

This type of block results in the highest blood level of local anesthetic of all blocks done on the body. a. Paravertebral block b. Interscalene block c. Intercostal block d. Cervical plexus block

c. Intercostal block M&M p. 1018 Lexi

What is the most common cause of neonatal depression? a. Meconium aspiration b. Low birth weight c. Intrauterine asphyxia d. Prematurity

c. Intrauterine asphyxia M&M p. 872 Lexi

What is the most common cause, accounting for 89% of instances, of postoperative visual loss following prone spinal procedures? a. Central retinal artery occlusion b. Central retinal vein occlusion c. Ischemic optic neuropathy d. Cortical blindness

c. Ischemic optic neuropathy NP: 409 Byron

3. You are the CRNA performing a pre-op examination on a patient that is undergoing chronic pain management. Upon examination, you notice that the patient has a fentanyl patch in place from the floor. What is your next action? Select 2 Possible choices. a. Immediately remove the patch since it may cause the patient to have respiratory depression during surgery. b. Cancel the case since it is unclear how much of the fentanyl is actually in the patient's system. c. Leave the patch in place and continue with the case. d. Remove the patch and administer a continuous fentanyl infusion during the case.

c. Leave the patch in place and continue with the case. d. Remove the patch and administer a continuous fentanyl infusion during the case. Reference: N&P pg 1257

1. Whether an epidural catheter is already in place or one is being initiated, what is the test dose composed of ? a. Lidocaine 1.0%/ Epi 1:20,000 b. Lidocaine 1%/ Epi 1:200,000 c. Lidocaine 1.5%/ Epi 1:200,000 d. Lidocaine 1.5%

c. Lidocaine 1.5%/ Epi 1:200,000 M&M page 852

What ligament composes the posterior border of the spinal canal? a. Interspinous ligament b. Supraspinous ligament c. Ligamentum flavum d. Posterior longitudinal ligament

c. Ligamentum flavum (M&M pg 943) Lake

4. Which of the follow actions should the anesthetist NOT perform for a pediatric patient with a congenital diaphragmatic hernia? a. Placement of NGT to decrease distention b. Avoid high levels of positive-pressure ventilation c. Maintain peak inspiratory pressures greater than 30 cmH20 d. Avoid the use of N2O e. Avoid use of muscle relaxants during intubation

c. Maintain peak inspiratory pressures greater than 30 cmH20 M&M Ch. 42 Pg. 899 Thetford

3. With respect to hetastarch, how are the larger molecules eliminated? a. Broken down by CYP450 b. Conjugated and eliminated in bile c. Must be broken down by amylase d. None of the above

c. Must be broken down by amylase M&M page 1166

4. Which of the following is not associated with beach chair position as a result of decreased cerebral perfusion? a. Blindness b. Stroke c. Myocardial Infarction d. Brain death M&M Ch. 38 Pg. 800

c. Myocardial Infarction M&M Ch. 38 Pg. 800 mf Thetford

Rh-negative patients usually develop antibodies against the D antigen only after an Rh-positive transfusion or with pregnancy, in the situation of an Rh-_____ mother delivering an Rh-____ baby a. Positive, positive b. Positive, negative c. Negative, positive d. Negative, negative

c. Negative, positive M&M Chapter 51, page 1169 Jennifer

1. What type(s) of blood can a patient with O+ blood type receive? (M&M pg 1169) a. ABO- b. O+ only c. O- or O+ d. Any, O+ is universal receiver

c. O- or O+

5. For patients taking Warfarin, what is the recommended coagulation lab result that should be documented prior to a neuraxial block? a. Bleeding time b. PTT and INR c. PT & INR d. None required

c. PT & INR M&M page 948

2. When optimal positioning in the seated position is not possible, which approach to regional anesthesia may be ideal? a. Midline approach b. Right lateral approach c. Paramedian approach d. Left lateral approach

c. Paramedian approach M&M p.916 Lexi

4. Right ventricular afterload is mainly dependent on what? (M&M pg 355) a. Systemic vascular resistance b. Heart rate c. Pulmonary vascular resistance d. Right atrial preload

c. Pulmonary vascular resistance

What nerve is the terminal branch of the posterior cord of the brachial plexus? a. Ulnar nerve b. Axillary nerve c. Radial nerve d. Median nerve

c. Radial nerve M&M Chapter 46, page 997 Jennifer

2. Studies have shown that lower gastric residual volumes and higher gastric pH is associated with which of the following? a. Maintaining NPO greater than 10 hours before induction b. Consuming a meal 2 hours before induction c. Receiving clear liquids a few hours before induction d. Receiving breast milk a few hours before induction

c. Receiving clear liquids a few hours before induction M&M page 888 Willie

3. Which of the following is not a result of left ventricular failure if untreated? a. Pulmonary vascular congestion b. Progressive transudate of fluid in the pulmonary interstitium c. Reduced PAOP d. Pulmonary edema

c. Reduced PAOP M&M page 367 Willie

2. Which of the following are NOT capable of blocking an infant's metabolic stress response? a. Opioids b. Increased crying c. Repeated heel lancing d. None of the above

c. Repeated heel lancing N&P page 1168

Which local anesthetic is known for having a greater therapeutic index than Bupivicaine? a. Levobupivicaine b. Lidocaine c. Ropivacaine d. Cocaine

c. Ropivacaine M&M p. 274 Lexi

3. Open and arthroscopic shoulder operations are most commonly performed in what position? a. Lateral decubitus b. Supine c. Sitting/Beach chair d. Lithotomy M&M Ch. 38 Pg. 800

c. Sitting/Beach chair M&M Ch. 38 Pg. 800 mf Thetford

What personal protective equipment is necessary during chondylomata laser procedures when compared with other laser uses due to DNA proliferation? (Pick 2) a. Gloves b. Gowns c. Smoke evacuators d. OSHA approved masks

c. Smoke evacuators d. OSHA approved masks M&M p. 1224 Lexi

When using a transdermal system for the delivery of fentanyl the anesthesia provider is aware that the major obstacle of fentany absorption is? a. Subcutaneous tissue b. Blood vessels c. Stratum corneum d. Hepatic first pass

c. Stratum corneum (M&M pg 1060) Josh

Match the blood type with the type of RBC antigen it contains: a. Type A blood b. Type B blood c. Type AB blood d. Type O blood ___ neither A nor B RBC antigens ___ A RBC antigen ___ B RBC antigen ___ both A and B RBC antigens

d - neither A or B RBC antigens a - A RBC antigen b - B RBC antigen c - both A and B RBC antigens M&M Chapter 51, page 1169 Jennifer

1) Which of the following does not occur due to the blockade sympathetic fibers arising from T5-L1 which control vasomotor tone? a) Vasodilation of venous capacitance vessels b) Pooling of blood in viscera and extremities c) Arterial vasodilation d) Arterial and venous vasoconstriction M&M ch 45 pg 946

d) Arterial and venous vasoconstriction Mbom

2. A horseshoe headrest is often used to support the head for shoulder procedures performed in the sitting position. The head is secured using straps or adhesive tape. All of the following are true regarding the use of a horseshoe headrest, except: (N&P ch 21, pg 418) a. excessive traction or stretch can be placed on the neck and brachial plexus with excessive movements during surgery b. if the restraining straps are loose, the head can become partially or completely dislodged from the headrest with the potential for cervical spine injury c. accidental extubation can occur if the endotracheal tube is secured by a supporting device and the head is displaced d. less risk of eye compression versus the three-pin head holder

d. Hale

2. Which of the following is not true of plasma concentrations of drugs in geriatrics? a. Increased Vd of lipid soluble drugs b. Decreased Vd of water soluble drugs c. Reduced drug clearance d. Decreased Vd of lipid drugs M&M ch 43 pg 914

d. Decreased Vd of lipid drugs Mbom

1. Which of the following is not a geriatric pharmacological change? a. Decrease in muscle mass b. Reduced Vd of water soluble drugs c. Increased body fat d. Decreased body fat M&M ch 43 pg 913

d. Decreased body fat Mbom

Which of the following irrigation solutions is a contraindication to cell salvage? a. Sterile water b. Normal saline c. Lactated ringers d. Distilled water

d. Distilled water N&P p.401 Lexi

5. Which of the following approaches is a safe and simple technique for providing surgical anesthesia of the lower arm, with an efficacy comparable to other approaches? a. Axillary b. Interscalene c. Supraclavicular d. Infraclavicular

d. Infraclavicular NP 1107 Budenbender

2. Which of the following is not a component of LR? a. Sodium b. Chloride c. Potassium d. Magnesium

d. Magnesium Mbom

1. Fetal heart rate (FHR) variability of greater than 25 bpm is classified as: a. Absent b. Minimal c. Moderate d. Marked

d. Marked Nagelhout Page 1133 Budenbender

5. Pressure on the abdomen in the prone position will cause all of the following *except*? N&P 419 a. Impede venous return b. Increase venous pressure c. Inhibit movement of diaphragm interfering with ventilation d. Minimal blood loss in the surgical site

d. Minimal blood loss in the surgical site

What type of nerve block is essential to complete anesthesia for the forearm and wrist and is commonly included when performing an axillary block? a. Supraclavicular block b. Brachial plexus block c. Intercostobrachial block d. Musculocutaneous block

d. Musculocutaneous block M&M Chapter 46, page 998 Jennifer

What contraindication present in patients undergoing cardiovascular surgery limits the use of thoracic regional anesthesia? a. Desire for greater depth of anesthesia b. Desire for longer acting anesthesia c. Need for preoperative DVT prophylaxis d. Need for full heparinization during cardiopulmonary bypass

d. Need for full heparinization during cardiopulmonary bypass M&M p. 1102 Lexi

A patient who has an AB+ blood type has what antibodies present in their serum? a. Anti-A b. Anti-B c. Anti-A & Anti-B d. None

d. None NP: 395 Byron

5. All of the following conditions usually accompany a patient with ankylosing spondylitis EXCEPT? a. Heart valve dysfunction b. Bundle branch blocks c. Restrictive lung disease d. Obstructive lung disease

d. Obstructive lung disease Reference: N&P pg 1011 Mandy

2. Which of the following is NOT true regarding popliteal nerve blocks? a. Popliteal blocks provide coverage to the foot and ankle during surgery. b. Popliteal blocks spare most of the hamstrings. c. The popliteal nerve block can be achieved by lateral or posterior approach. d. Popliteal blocks prevent lifting of the foot.

d. Popliteal blocks prevent lifting of the foot. M&M Ch. 46 Pg. 1013 Thetford

5. When managing perioperative fluid therapy which of the following are NOT included? a. Normal losses b. Pre-existing deficits c. Surgical wound losses d. Predicted losses

d. Predicted losses M&M page 1166

Malpractice occurs when all of the following four requirements have been met except? (Select all that apply) a. Duty b. Breach of duty c. Injury d. Probable cause e. Proximate cause f. Emergency Consent

d. Probable cause f. Emergency Consent (M&M pg 1199) Josh

4. All of the following nonvolatile anesthetics have reduced doses in geriatrics except? a. Propofol b. Etomidate c. Benzos d. REmifentanil M&M ch 43 pg 915

d. REmifentanil Mbom

5. Which of the following does not occur with chronic sympathetic activation? a. Receptor uncoupling b. Receptor down-regulation c. Decrease in catecholamine stores d. Receptor up-regulation

d. Receptor up-regulation M&M page 367 Willie

What are the components of lactate ringers solution? a. Sodium, Chloride, Glucose and Lactate b. Sodium, Chloride, Glucose, Magnesium and Lactate c. Sodium, Chloride, Glucose, Potassium, and Lactate d. Sodium, Chloride, Potassium, Calcium, and Lactate

d. Sodium, Chloride, Potassium, Calcium, and Lactate (M&M pg. 1179)

4. Which of the following sites is the primary target of ankylosing spondylitis? a. Upper extremities b. Lower extremities c. Lungs and other vital organs d. Spinal column and surrounding tissues

d. Spinal column and surrounding tissues Reference N&P pg 1011 Mandy

Augmentation of what hemodynamic parameter increases cardiac output allowing heart rate and blood pressure to remain unchanged? a. SVR b. MAP c. CPP d. Stroke Volume

d. Stroke Volume M&M p. 802 Lexi

What type of nerve block provides analgesia for procedures done on the neck, clavicle, and the anterior shoulder? a. Deep cervical plexus block b. Interscalene block c. Paravertebral block d. Superficial cervical plexus block

d. Superficial cervical plexus block M&M p. 1017 Lexi

In addition to its strong stimulating effect on the HPA axis, surgical stress also stimulates which specific nervous system? a. Somatic nervous system b. Autonomic nervous system c. Parasympathetic nervous system d. Sympathetic nervous system

d. Sympathetic nervous system N&P p. 1031 Lexi

5. The greater radicular artery provides the majority of blood flow to the anterior spinal artery. Where level of the spine does this artery originate? a. T6-L1 b. T4-T6 c. L1-L5 d. T8-L2

d. T8-L2 Reference: N&P pg 573 Mandy

1. Methadone may be administered via all of the following routes EXCEPT: a. Oral b. IV c. Rectal d. Topical

d. Topical Reference : N&P pg 1256 Mandy

2.) What function do the A-beta nerve fibers hold? (N and P, page 1074) A. Pain B. Sensory C. Motor D. Touch and Pressure

d. Touch and Pressure Maggie

4. What types of decelerations are most common and related to umbilical cord compression and decreases in umbilical blood flow? a. Variable accelerations b. Early decelerations c. Late decelerations d. Variable decelerations

d. Variable decelerations M&M Ch. 41 Pg. 869 Thetford

Disease of what body system is the most common concomitant illness in the older adult and the primary cause for perioperative and postoperative risk in the older adult? a. Neurological b. Respiratory c. Endocrine d. Cardiovascular

d. cardiovascular NP: 1217 Byron

In the anesthetic implications of the review of systems and history, which of the following should be considered for possible anesthetic implications for the endocrine and metabolic system? a. Elevated ICP b. Septal defect, avoid air bubbles in IV line c. B-agonist or theophylline drugs; pulmonary HTN or cor pulmonale; steroid use; adrenal insufficiency; postoperative hypoxia d. Hypoglycemia

d. hypoglycemia DB NP 1195

4. In a patient with severe mitral stenosis how much of the ventricular filling is caused by the atrial kick? a. 5-10% b. 10-20% c. 20-30% d. up to 40%

d. up to 40% Nagelhout Chapter 23, page 479 Budenbender

3) Which of the following is not an absolute contraindication to neuraxial anesthesia? a) Severe hypovolemia, b) Increased ICP c) Infection at injection site d) Bleeding disorder or anticoagulation e) Aortic or mitral stenosis M&M ch 45 pg 947

e) Aortic or mitral stenosis Mbom

4. Transfusion-associated graft-versus-host disease results when donor lymphocytes incorporate themselves into the tissues of the recipient, leading to immune system reactions, including: (N&P ch20, pg 398) a. Rash b. Leukopenia c. Thrombocytopenia d. Sepsis e. All of the following

e. Hale

Alterations in waveform tracings and dangerous physiologic effects can be caused by errors in the timing of the IABP such as: (N&P ch24, pg 550) a. Early deflation of balloon b. Late deflation of balloon c. Early inflation of balloon d. Late inflation of balloon e. All of the above

e. Hale

VAD's (LVAD, RVAD) are categorized using all of the following factors: (N&P ch24, pg 550) a. Type of blood flow (continuous or pulsatile) b. Length of time the device can be used for support (long, intermediate, short) c. Location of the device (intra-, extra-, or paracorporeal) d. Source of driving power (pneumatic or electric) e. All of the above

e. Hale

Opioids may be given intrathecally as a single injection or intermittently as an epidural. Pure opioid techniques are most useful for which of the following high risk category patients? a. Moderate to severe aortic stenosis b. Tetralogy of Fallot c. Eisenmenger's syndrome d. Pulmonary hypertension e. All of the above

e. All of the above (M&M pg 848) Josh

2. Which are considered noxious substances that cause nociceptor responses? a. Bradykinin b. 5-HT c. Serotonin d. Potassium e. All of the above

e. All of the above M&M page 1033 Willie

4. Which of the following are characteristics that make Hetastartch more attractive to use compared to Dextrans? a. Less expensive b. Nonantigenic c. Coagulation studies are not usually affected d. May by given in large volumes e. All of the above

e. All of the above M&M page 1166

4. Which of the following conditions increase morbidity and mortality? a. Heart failure b. Stroke c. Arrhythmias d. Hypertension e. All of the above

e. All of the above M&M, page 910 Willie

Of the following what are potential complications associated with Endovascular (EVAR) Aortic Aneurysm Repair? a. Aortic dissection b. Microembolization c. Endoleak d. Infection e. All of the above are potential complications of EVAR

e. All of the above are potential complications of EVAR (N&P pg 576) Lake

5. Which step is not a step in the process in the root cause analysis? N&P pg 1300 a. Identifying the problems b. Assembling multidisciplinary group c. Understand the process involved d. Collecting factual information. e. Blame the student

e. Blame the student Fieber

1. Hypoglycemia is actually an uncommon pediatric perioperative concern. Some of those that are susceptible, however, include: (N&P ch 48, pg 1208): a. Premature infants b. Very critically ill infants c. Infants of diabetic mothers d. Children on glucose-based parenteral nutrition e. Infants weighing less than 10kg f. All of the above

f. Hale

1. Which of the following are associated with administering dextrans at > 20 ml/kg per day? a. Causes antiplatelet effects b. May interfere with blood typing c. May cause increased bleeding times d. Has been associated with kidney failure e. Can be antigenic f. All of the above

f. All of the above M&M page 1166

5. It is important to follow all of the items to limit or prevent laryngospasm in an infant except? N&P pg 1204 Box 48-6 a. Avoid noxious airway stimulation during light anesthesia b. Assure sufficient anesthesia prior to instrumentation c. Apply topical lidocaine to suppress laryngeal sensory nerve d. Iv lidocaine prior to Extubation e. Suction oral pharynx prior to extubation. f. Tracheal extubation when fully awake g. Administer 100% O2 for 10-15 min prior to extubation

g. Administer 100% O2 for 10-15 min prior to extubation Fieber

2. A patient has lost about 20% of their blood volume, what is the fluid replacement of choice for this patient? a. Crystalloids b. Albumin c. PRBC Blood d. Whole blood

i. Answer: A- Crystalloids ii. N&P page 384 Sommers

2. What are the divisions of the brachial plexus moving from proximal to distal? a. Roots, trunks, divisions, cords, branches b. Roots, trunks, cords, divisions, branches c. Roots, cords, divisions, trunks, branches d. Roots, divisions, cords, trunks, branches

i. Answer: A- RTDCB ii. M+M page 984 sommers

5. What size of aortic valve is considered severe, and what size is considered critical? a. Severe: 1cm critical: 0.7 cm b. Severe: 3cm +/- 1 cm critical: 4cm c. Severe: 1.4 mm critical: 0.7 mm d. Severe: 2cm critical: 1.4 cm

i. Answer: A- Severe: 1cm critical: 0.7 cm ii. N&P page 537 Sommers

1. What is cardiotomy suction? a. Suctions blood off the field and returns it to the CPB b. Suctions blood from the vena cava and propels it through the aorta c. Suctions fluid and separates RBCs and irrigation fluid. d. Suctions heart tissue

i. Answer: A- Suctions blood off the field and returns it to the CPB ii. M&M page 439 Sommers

5. What is the K+ concentration in a one-liter bag of lactated ringers? a. 2 mEq b. 4 mEq c. 8 mEq d. <0.8 mEq

i. Answer: B- 4 mEq ii. N&P page 392 Sommers

5. You are preforming an axillary block with a nerve stimulator, the stimulator causes the patient to flex his wrist, what nerve is your needle tip closest to? a. Median b. Radial c. Ulnar d. Musculocutaneous

i. Answer: B- radial ii. M+M page 992 Sommers

5. A/An ____________ in muscle mass, and ____________ in fat, leads to a/an ___________ in total body water in the older adult. a. Increase, increase, decrease b. Decrease, decrease, increase c. Decrease, increase, decrease d. Increase, decrease, increase

i. Answer: C- decrease, increase, decrease ii. M+M page 914

4. You are preforming a supraclavicular block and you know that _______ is a serious adverse effect to watch for. a. Failed block- requiring additional anesthesia b. Necrotic muscle c. Pneumothorax d. Paresthesia

i. Answer: C- pneumo ii. M+M page 986 sommers

3. Dose requirements for fentanyl to reach the same EEG endpoint, in an elderly patient is ______ less than in younger patients. a. 25% b. 33% c. 50% d. 75% e. 90%

i. Answer: C-50% ii. M+M page 915

1. When preforming a field block what is the target? a. Nerve bundles b. Nerve trunks c. Terminal cutaneous nerves d. Neves distal to the extremities

i. Answer: C-terminal nerves ii. M+M page 978 sommers

4. A 75 Kg patient presents to the OR for a scheduled hernia repair, what is the maintenance fluid requirement for this patient? a. 125 ml/hr b. 145ml/hr c. 95ml/hr d. 115ml/hr

i. Answer: D- 115ml/hr ii. N&P page 393 Sommers

1. Which of these is NOT a component of a fluid challenge a. Type of fluid b. Rate of administration c. End point (goal) d. Low point (change treatment)

i. Answer: D- Low point (change treatment) ii. N&P page 384 Sommers

2. Which of the following is NOT a cardiovascular manifestation of rheumatoid arthritis? a. Cardiac valve fibrosis b. Pericardial effusion c. Vasculitis d. Patient foremen ovale

i. Answer: D- PFO ii. M+M page 795

3. Which parameters are not necessary to monitor during open heart surgery? a. Urinary output b. Arterial blood pressure c. Temperature d. TEE e. PA pressure

i. Answer: PA pressure ii. M&M page 445 Sommers

3. Which of the following will cause hypokalemia? a. Rhabdomyolysis b. Burns c. Acidosis d. Hypoaldosteronism e. Addison's disease

i. Answer: b- Burns ii. N&P page 388-389

5. A patient receives a spinal for a total knee arthroplasty, which of the following is true regarding DVT risk for this patient? a. This patient is a higher risk due to venous stasis b. This patient is at a higher risk due to inability to amubulate within 12 hours of surgery c. This patient is at a lower risk due to a decrease in SNS activation d. This patient is at a lower risk due to decreases in narcotic requirements

i. Answer: c- decreased SNS release ii. M+M page 793

1. What is the Definition of Pulsus Bisferiens? A. Doubling of the heart rate from calcium toxicity B. A double systolic peak on an arterial line from Aortic regurgitation C. When a peripheral pulse can be palpated on only the right side. D. When the atria and the ventricles contract simultaneously.

• Answer: B • N&P ch 24. Pg 540 Fletcher

Damage to the carotid body can occur with a CEA. How would the anesthesia provider treat this? (Nagelhout ch25, pg583) a. Supplemental oxygen b. PEEP c. Increasing I:E ratio d. Tracheostomy

A. Hale

The current incidence of stroke after a CEA is approximately: (Nagelhout ch25, pg 583) a. 2% b. 5% c. 15% d. 50%

A. Hale

What are the unique side effects of methadone? SELECT ALL THAT APPLY (N and P, page 1256) A. QT prolongation B. Torsades des pointes C. Ventricular arrhythmia's D. Atrial Fibrillation

A. QT prolongation B. Torsades des pointes C. Ventricular arrhythmia's Maggie

The umbilical cord has how many veins? A. 1 B. 2 C. 3 D. 4

A. 1 N&P page 1163, 2nd column 1st paragraph Abe

According to the SCIP project, when Ancef is chosen as the preoperative antibiotic, it must be given within _____ hour(s) of incision time. A. 1 B. 2 C. 3 D. 4

A. 1 N&P page 999, 2nd column 1st paragraph Abe

Transfusion guidelines for a patient with a normal Hct. include transfusion only after an estimated blood loss greater than _______ to _______ % of their total blood volume. A. 10 to 20% B. 5 to 10% C. 20 to 30% D. 15 to 20%

A. 10 to 20% M&M Ch. 51 pg. 1161 #2 K. Jensen

What is the onset of action of ketamine (N and P, page 1250) A. 30-40 seconds B. 2-3 minutes C. 4-5 minutes D. 10 minutes

A. 30-40 seconds Maggie

What is the average blood volume for a premature neonate? A. 90-100 ml/kg B. 80-90 ml/kg C. 60 ml/kg D. 70 ml/kg

A. 90-100 ml/kg N&P page 395, Table 20-11 Abe

Knowing that infants have a larger extracellular fluid compartment and greater total body water content compared to adults, choose the correct statement regarding the dosing of water-soluble medications in infant patients. A. A larger drug loading dose is required to achieve the desired plasma concentration B. A smaller drug loading dose is required to achieve the desired plasma concentration C. An equivalent drug loading dose will achieve the desired plasma concentration D. All of the above are false

A. A larger drug loading dose is required to achieve the desired plasma concentration N&P page 1191, 2nd column 2nd paragraph Abe

3. What is the substance used as the cellular energy in the process of excitation-contraction coupling? a. ATP b. ADP c. 5-HT d. Dopamine

A. ATP N&P Page 475 Justin

What is the mechanism by which neuromuscular blocking agents may contribute to decreased venous return? A. Abolition of muscle tone B. Increased SVR C. Increased PVR D. Increased PAOP

A. Abolition of muscle tone N&P page 403, 1st column 3rd paragraph Abe

3. Sympathetic blockade can be accomplished using which of the following techniques? a. Intrathecal b. Epidural c. Paravertebral d. All of the above

Answer: D- All of the above M&M pg. 1072 Stetler

Patients who have type-A blood have what type of serum antibodies? A. Anti-B B. Anti-A C. Anti-A & Anti-B D. No serum antibodies

A. Anti-B N&P page 395, Table 20-12 Abe

Which of the following correctly reflects the calculation of coronary perfusion pressure? A. Aortic diastolic pressure - Left ventricular end diastolic pressure B. MAP - ICP C. MAP - CVP D. [SBP + 2(DBP)] / 3

A. Aortic diastolic pressure - Left ventricular end diastolic pressure N&P page 510, 2nd column 2nd paragraph Abe

Indications of hypovolemia include: (select 3) A. Dehydration of mucous membranes B. Thready peripheral pulses C. Pitting edema D. Decreased blood pressure

A. Dehydration of mucous membranes B. Thready peripheral pulses D. Decreased blood pressure M&M Ch. 51 pg. 1162 K. Jensen

Increased surgical risk is associated with which 3 conditions? A. Diabetes mellitus B. Congestive heart failure C. Preoperative creatinine >2 mg/dl D. Cataracts

A. Diabetes mellitus B. Congestive heart failure C. Preoperative creatinine >2 mg/dl M&M Ch. 21 pg. 378 K. Jensen

What has been reported after doing a procedure where the patient is in the lateral decubitus position? (N and P, page 417) A. Rhabdomyolysis B. Pneumothorax C. Hypercalcemia D. Hypokalemia

A. Rhabdomyolysis Maggie

Select 3 factors that contribute to the premature infant's incidence of apnea. A. Incomplete myelination of central nervous center- Physiological B. Hypothermia- Metabolic C. Inadequate development of respiratory centers- Physiological D. Hyperthermia- Metabolic

A. Incomplete myelination of central nervous center- Physiological B. Hypothermia- Metabolic C. Inadequate development of respiratory centers- Physiological N&P Ch. 47 pg. 1178 K. Jensen

Following a CEA, there may be loss of cerebral vascular autoregulation and increased cerebral blood flow. The term for this is called: (Nagelhout ch25, pg 583) a. Cerebral Hyperreflexia Syndrome b. Cerebral Hyperperfusion Syndrome c. Cerebral Hypoperfusion Syndrome d. Cranial Hyperfusion State

B. Hale

Which 2 anesthetic techniques have played a significant role in decreasing perioperative pain following orthopedic surgery? A. General Anesthesia B. Neuraxial Anesthesia C. Regional Anesthesia D. TIVA

B. Neuraxial Anesthesia C. Regional Anesthesia M&M Ch. 38 pg. 790 K. Jensen

Alveoli are not fully mature in children until age________. A. 6 B. 8 C. 12 D. 4

B. 8 M&M Ch. 42 pg. 878 K. Jensen

3.) How many days does it take for someone to test positive for HIV antibodies? (N and P, page 398) A. 5-6 days B. 8 to 10 days C. 1-2 days D. 3-4 days

B. 8-10 days Shackelford

What is the standard induction dose for propofol for the infant patient. A. 1-1.5 mg/kg B. 3-4 mg/kg C. 2-2.5 mg/kg D. 0.5-1 mg/kg

C. 2-2.5 mg/kg Justin N&P 1193

33 vertebrae make up the spinal column. Moveable joint surfaces and cartilaginous vertebral bodies exist between _____ of the 33 vertebrae. A. 12 B. 19 C. 24 D. 32

C. 24 N&P page 1070, 1st column 4th paragraph Abe

What is the intravascular half life of colloid solutions? a. 8-10 hrs b. 1-2 hrs c. 3-6 hrs d. 12-14 hrs

C. 3-6 hrs (M&M pg 1161) Josh

5. Application of a tourniquet for _____ mins causes tourniquet pain and _____ a. 30; hypotension b. 45; hypertension c. 60; hypertension d. 90; hypotension

C. 60; hypertension N&P pg 1000 rebecca

At rest, the myocardial cell membrane is relatively impermeable to _______? (Select 2) A. K+ B. Mag+ C. Ca++ D. Na+

C. Ca++ D. Na+ M&M Ch, 20 pg. 344 K. Jensen

Immune responses to bacteria and viruses trigger soluble mediators that are secreted by the cells. Which of the following is considered to be an immune mediator? A. Phagocytes B. Lymphocytes C. Cytokines D. Mast cells

C. Cytokines N&P Ch. 41 pg. 1015 K. Jensen

3. Which of the following statements is false? a. CHF, COPD and malignancy are the strongest predictors of mortality in older adults with hip fracture. b. Frail older adults are more likely to have complications post-operatively. c. The goal of anesthesia for the elderly patient is more complex than any other patient population. d. Primary frailty occurs as part of aging.

C. The goal of anesthesia for the elderly patient is more complex than any other patient population Reference: N&P pg 1222 Mandy

3.) What are the most common reasons for spinal surgery? SELECT 2 (N and P, page 1007) A. Intervertebral disc herniation B. Aortic Stenosis C. Spinal stenosis D. Athletic injury

C. Spinal stenosis A. Intervertebral disc herniation Maggie

What portion of the heart muscle is at greatest risk for an ischemic event during anesthesia? A. Epicardium B. Pericardium C. Subendocardium D. Outer 1/3 of the heart

C. Subendocardium N&P page 511, 1st column 1st paragraph Abe

5. What should be ordered on every patient that has received an intercostal nerve block? a. Chest X-ray b. Stat EKG c. Urine analysis d. Coagulation study

Chest X-ray Charlie N&P pg. 1119

Which of the following Cranial Nerve - Response pairing is incorrect? (Nagelhout ch25 pg 583) a. VII - Facial: symmetrical smile b. IX - Glossopharyngeal: swallowing c. XI - Spinal Accessory: shoulder shrug d. XII - Hypoglossal: vocal cord paralysis

D. Hale

According to Nagelhout and Plaus, the number of individuals 60 years of age and older will exceed the number of younger adults by the year _____. A. 2020 B. 2030 C. 2040 D. 2050

D. 2050 Abe N&P page 1214, 1st column 1st paragraph

How is Clonidine metabolized? a. Liver b. Nonspecific esterase c. Plasma cholinesterase d. Lungs

a. Liver Charlie N&P pg 1251

4. What anesthetic technique is associated with the lowest risk of apnea? N&P1178 a. Spinal b. TIVA c. General d. MAC

a. Spinal

What is the single best EKG lead for detecting myocardial ischemia? A. V1 B. AVR C. V5 D. AVF

C. V5 N&P page 512, 1st column 1st paragraph Abe

2. After _______ hours, patients receiving LMWH can receive neuraxial anesthesia a. 10-12 hours b. 24 hours c. 4-6 hours d. 8-10 hours

2. a. 10-12 hrs

What is the standard test dose for an epidural a. 3 ml of lidocaine 1.5% + epi 1:200,000 b. 5 cc lidocaine 2% c. Epinephrine 1:1000 d. Whatever the patient needs for adequate anesthesia

3 ml of lidocaine 1.5% + epi 1:200,000 Charlie N&P pg. 1138

2. Although it is more likely to cause apnea, than in a younger patient, what drug is the idea induction medication for the elderly? a. Etomidate b. Propofol c. Ketamine d. Fentanyl

. Answer: B- propofol ii. M+M page 914

1) What is a major cause of pain and disability in ankles requiring ankle arthroplasty? a) Sciatic nerve impingement b) Diabetes c) End Stage Osteoarthritis

1) C N&P Chapter 40 pg. 1005 JDumas

When uploaded, place a STAR next to your name.

1. Anderson, Abraham* 2. Anozier, Rebecca 3. Broadhead, Justin* 4. Budenbender, David* 5. Byron, Matthew* 6. Crouse, Charles* 7. Dumas, Jared* 8. Faylor, Stefania* 9. Fieber, Adam* 10. Fletcher, Kyle* 11. Franklund, Jason* 12. Hale, Kaitlin* 13. Holt, Devin* 14. Jackson, Amanda* 15. Jensen, Kathleen* 16. Krum, Paul* 17. Lake, Josh* 18. Mbom, Caroline 19. McCorvey, Willie 20. Nguyen, Jennifer* 21. Ryan, Blair 22. Shackelford, Margaret 23. Sommers, Douglas* 24. Stetler, Christine* 25. Stoddard, Ian* 26. Thetford, Mark* 27. Varias, Alexandra* 28. Zino, Kenneth*

Match the Maternal History with the Anticipated Neonatal Sequelae: 1. Toxemia 2. Hypertension 3. Drug Addiction 4: Oligohydramnios A. Small for gestational age, Muscle relaxant interaction with magnesium B. Small for gestational age. C. Withdrawal, Small for gestational age D. Renal hypoplasia, Pulmonary hypoplasia

1:A 2:B 3:C 4:D N&P Ch. 47 pg. 1178 K. Jensen

2) What three major complications could arise during a total hip arthroplasty? a) Cement emboli, DVT, Fat embolism b) PE, Fat embolism, Liver cirrhosis c) Deep vein thrombosis (DVT), pulmonary embolism (PE), and fat embolism

2) C N&P Chapter 40 pg. 1005

1. In the sinus node action potential phase 4 is initiated and propelled primarily by? (M&M pg. 345) a. An inward flow of both sodium ions and calcium ions b. An outward flow of sodium ions and an inward flow of potassium ions c. An outward flow of both calcium ions and sodium ions d. An outward flow of sodium ins and an inward flow of calcium ions

A. An inward flow of both sodium ions and calcium ions

Spinal cord ischemia during TAAA surgery can be a devastating complication. The spinal cord is perfused through the artery of Adamkiewicz (greater radicular artery) to the anterior spinal artery from T-8-L2. Hypoperfusion can cause a loss of motor control. Monitoring of spinal cord perfusion is accomplished by the insertion of a lumbar intrathecal catheter. Spinal cord perfusion pressure is estimated by: A. Arterial blood pressure - CSF pressure B. CSF pressure - Arterial blood pressure C. MAP - ICP D. SVR- CSF pressure

A. Arterial blood pressure - CSF pressure N&P Ch. 25 pg. 573 K. Jensen

What is the most common cause of occlusive peripheral vascular disease? A. Atherosclerosis B. Trauma C. Hypotension D. SIRS

A. Atherosclerosis N&P page 561, 1st column 1st paragraph Abe

5. What is thought to be the activating factor for systemic inflammatory response syndrome (SIRS) in patients undergoing CPB? a. Blood is exposed to foreign surfaces of CPB machine and ischemic perfusion injury or embolization caused by the release of endotoxin primarily from splanchnic hypoperfusion. b. High Dose Heparin Usage c. Hypoventilation during the time the patient is on bypass and the lungs are "dropped" d. SIRS is a common occurrence with the use of isoflurane in times of cardiac stress.

A. Blood is exposed to foreign surfaces of CPB machine and ischemic perfusion injury or embolization caused by the release of endotoxin primarily from splanchnic hypoperfusion. N&P: 521 Justin

Even when placed correctly, Spinal Anesthesia can produce both: (select 2) A. Bradycardia B. Tachycardia C. Hypertension D. Hypotension

A. Bradycardia D. Hypotension M&M Ch. 45 pg. 939 K. Jensen

2.) What is the larygeal location in the pediatric patient? (N and P, page 1166) A. C2-C4 B. C1 C. T1 D. C4-C6

A. C2-C4 Shackelford

Neonates and infants have proportionately larger heads and tongues. The glottis is at vertebral level _______________. A. C4 B. C6 C. C7 D. C3

A. C4 M&M Ch. 42 pg. 878 K. Jensen

What are the cardiovascular effects of steroids? SELECT ALL THAT APPLY (N and P, page 1255) A. CHF B. DVT C. Cardiomyopathy D. Anemia

A. CHF B. DVT C. Cardiomyopathy Maggie

Select 2 treatments for "Apnea of Prematurity" in a premature neonate: A. Caffeine B. 100% O2 C. CPAP D. Dopamine

A. Caffeine C. CPAP N&P Ch. 47 pg. 1178 K. Jensen

The most common complications that occur in the postoperative setting among the elderly involve what 3 body systems? A. Cardiac B. Pulmonary C. Neurologic D. Genitourinary E. Musculoskeletal F. Gastrointestinal

A. Cardiac B. Pulmonary C. Neurologic Abe N&P page 1214, 2nd column 1st paragraph

5. What is the most critical immediate complication of regional anesthesia? a. Cardiovascular b. Sepsis c. Neuropathy d. Paralysis

A. Cardiovascular N&P 1103 Rebecca

4. Which of the following is the most common concomitant illness in the older adult, and the primary cause for preoperative and post operative risk? A. Cardiovascular Disease B. Hyperthyroidism C. Muscle Wasting D. Respiratory disease

A. Cardiovascular Disease N&P 1217 Justin

What is the functional unit of the placenta? A. Chorionic villus B. Syncytial trophocytes C. Arachnoid villi D. Placental sinusoids

A. Chorionic villus N&P page 1163, 1st column 3rd paragraph Abe

Kidney protection during TAAA surgery includes: (select 3) A. Cold crystalloid perfusion B. Normothermic blood perfusion C. Distal aortic perfusion D. Controlled hypotensive technique

A. Cold crystalloid perfusion B. Normothermic blood perfusion C. Distal aortic perfusion N&P Ch. 25. Pg. 573 K. Jensen

1.) What is the narrowest part of the pediatric airway? (N and P, page 1166) A. Cricoid B. 5th generation C. 13th generation D. Glottis

A. Cricoid Shackelford

Which of the following is NOT a renal benefit of an epidural technique in vascular surgery? A. Decreased renal blood flow B. Increased blood flow in the renal cortex C. Decreased renovascular constriction

A. Decreased renal blood flow N&P page 562, Box 25-2 Abe

Preparation for your defense begins before any injury has occurred. With each new case the anesthesia provider must: (Select 3) A. Discuss risks and benefits. B. Obtain informed consent. C. Appropriately document the physical assessment. D. Just hand the patient a consent form to sign.

A. Discuss risks and benefits. B. Obtain informed consent. C. Appropriately document the physical assessment. M&M Ch. 54 pg. 1201 K. Jensen

Identify 3 activities that a patient with a functional capacity of 4 METs is able to perform. A. Doubles Tennis B. Golfing C. Walking 4 mph D. Skiing

A. Doubles Tennis B. Golfing C. Walking 4 mph M&M Ch. 21 pg. 378 K. Jensen

There are 4 requirements for malpractice to occur. Select the correct order: A. Duty, breach of duty, injury, and proximate cause of injury is a deviation from the standard of care. B. Duty, injury, breach of duty, and proximate cause of injury is a deviation from the standard of care. C. Injury, breach of duty, duty, and proximate cause of injury is a deviation from the standard of care. D. Proximate cause of injury is a deviation from the standard of care, injury, breach of duty, duty.

A. Duty, breach of duty, injury, and proximate cause of injury is a deviation from the standard of care. M&M Ch. 54 pg. 1200 K. Jensen

What structures of the vertebral column form the intervertebral foramina when they are stacked on top of each other? A. Facet joints B. Transverse processes C. Spinous processes D. Intervertebral discs

A. Facet joints N&P page 1070, 2nd column 2nd paragraph Abe

4.) What components are present in cryoprecipitate? Select 3 (N and P, page 398) A. Factor VIII B. von Willebrand factor C. Fibrinogen D. Factor VII

A. Factor VIII B. von Willebrand factor C. Fibrinogen Shackelford

3. Which of the following is an excitatory pain-modulating neurotransmitter? A. Glutamate B. GABA C. Serotonin D. Glycine

A. Glutamate N&P 1247 Justin

Knowing that infants have a decreased fat and muscle concentration compared to adults, choose the correct statement regarding the plasma concentration of lipid soluble drugs when administered to infants according to weight. A. Higher plasma concentrations occur for lipid soluble drugs B. Lower plasma concentrations occur for lipid soluble drugs C. Equivalent plasma concentrations occur for lipid soluble drugs D. All of the above are false

A. Higher plasma concentrations occur for lipid soluble drugs N&P page 1191, 2nd column 2nd paragraph Abe

Select 3 clinical manifestations of bone cement implantation syndrome. A. Hypoxia, from increased pulmonary shunt B. Increased cardiac output C. Hypotension D. Arrhythmias, heart block, sinus arrest

A. Hypoxia, from increased pulmonary shunt C. Hypotension D. Arrhythmias, heart block, sinus arrest M&M Ch. 38 pg. 790 K. Jensen

Laparoscopic, intrathoracic, and upper abdominal surgeries may require a combination of general anesthesia and neuraxial anesthesia, because those operations can significantly _________ _________. A. Impair ventilation B. Require bypass C. Increase morbidity and mortality D. Increase permanent neurological injury

A. Impair ventilation M&M Ch. 45 pg. 938 K. Jensen

Ventilatory responses to hypoxia and hypercarbia are _______, and inhibitory reflexes are______ in a premature neonate. A. Impaired B. Non-existent C. Exaggerated D. Normal

A. Impaired C. Exaggerated N&P Ch. 47 pg. 1178 K. Jensen

1. What is the expected change in minute ventilation in the pregnant patient at term? a. Increase 50% b. Decrease 50% c. No change d. Decrease 20%

A. Increase 50% N&P 1131 Justin

During pregnancy cardiac output increases by about 40%. Which of the following factors contribute to the increase in cardiac output? (select 2) A. Increased HR B. Increased SV C. Decreased FRC D. Decreased RV

A. Increased HR B. Increased SV N&P page 1127, 1st column 3rd paragraph Abe

The inflammatory response that precedes the development of many systemic diseases can be attributed to: (select 2) A. Lifestyle choices B. Genetic polymorphisms C. Bad Luck D. Aging

A. Lifestyle choices B. Genetic polymorphisms M&M Ch. 43 pg. 908 K. Jensen

Local anesthetic toxicity requires supportive measures, including calling a Code Blue, and CPR. Name two other measures that the anesthesia provider might need if cardiac collapse or seizures occur: A. Lipid emulsion B. Cardiopulmonary bypass C. Code red D. Dialysis

A. Lipid emulsion B. Cardiopulmonary bypass M&M Ch. 46 pg. 977 K. Jensen

A relative contraindication to placement of a peripheral nerve block includes: A. Local infection at site B. Peripheral Neuropathy C. Previous nerve injury D. Tattoo at site

A. Local infection at site M&M Ch. 46 pg. 977 K. Jensen

1.) What two anatomical landmarks must be identified prior to a median block at the wrist? (N and P, page 1116) (SELECT 2) A. Long palmar muscle B. All of the above C. Brachioradialis muscle D. Radial flexor muscle

A. Long palmar muscle D. Radial flexor muscle Maggie

2.) Which of the following are significant risk factors for developing bone cement implantation syndrome? SEELCT 3 (N and P, page 1004) A. Long-term arthroplasty B. New York Heart Association class 3 or 4 C. ASA class 3 or higher D. Diabetes

A. Long-term arthroplasty B. New York Heart Association class 3 or 4 C. ASA class 3 or higher Maggie

All anesthesia providers should acquire: A. Medical malpractice insurance with appropriate coverage for their practice. B. Medical malpractice insurance with minimal coverage and a good lawyer. C. Avoidance techniques for all high risk cases. D. Expert witnesses of their own.

A. Medical malpractice insurance with appropriate coverage for their practice. M&M Ch. 54 pg. 1200 K. Jensen

Anatomical differences between infants and adults include: (select 2) A. More horizontal and pliable ribs B. Barrel chest C. Protuberant abdomens D. Six pack abdominal muscles

A. More horizontal and pliable ribs C. Protuberant abdomens M&M Ch. 42 pg. 878 K. Jensen

Although true local anesthetic allergies are rare, the problem may be caused by a preservative in the local anesthetic solution or by a product of local anesthetic hydrolysis called _____. A. Para-aminobenzoic acid B. Hydrochloric acid C. Lactic acid D. Carbonic acid

A. Para-aminobenzoic acid N&P page 1103, 2nd column 3rd paragraph Abe

Coronary Artery Disease (CAD) patients, who receive neuraxial anesthesia, experience a decreased stress response that translates into less: (select 2) A. Perioperative ischemia B. Reduced morbidity and mortality C. Hypocoagulation D. Increase splinting

A. Perioperative ischemia B. Reduced morbidity and mortality M&M Ch. 45 pg. 939 K. Jensen

5. Match the following enzymatic reactions with their corresponding phase of metabolism (phase-I or Phase-II)? A. Oxidation: B. Reduction: C. Hydrolysis: D. Glucuronidation: E. Methylation: F. Acetylation: G. Sulfation:

A. Phase-I B. Phase-I C. Phase-1 D. Phase-II E. Phase-II F. Phase-II G. Phase-II N&P page 1192, 1st column 2nd paragraph Abe

4.) Which of the following are pulmonary diseases commonly found in patients with rheumatoid arthritis? SELECT 3 (N and P, page 1012) A. Pleural Effusion B. Vasculitis C. Upper lobe fibrosis D. Asthma

A. Pleural Effusion B. Vasculitis C. Upper lobe fibrosis Maggie

3.) What is the most important complication of the supraclavicular approach to a brachial plexus block? (N and P, page 1110) A. Pneumothorax B. Hypotension C. Bradycardia D. Hemorrhage

A. Pneumothorax Maggie

Which two blocks warrant the highest concern for local hematoma and hemorrhage due to their proximity to the neuraxis and retroperitoneal space. A. Posterior Lumbar Plexus Block B. Paravertebral Block C. Interscalene D. Femoral Block

A. Posterior Lumbar Plexus Block B. Paravertebral Block M&M Ch. 46 pg. 977 K. Jensen

What are 3 ions/electrolytes that are found in high concentrations intracellularly? A. Potassium B. Phosphate C. Magnesium D. Sodium N&P page 382, 1st column 4th paragraph

A. Potassium B. Phosphate C. Magnesium N&P page 382, 1st column 4th paragraph Abe

Which of the following is considered to place the patient at a higher risk for developing bone cement implantation syndrome? a. Preexisting pulmonary hypertension b. ASA Class 1 c. ASA Class 2 d. Hypotension

A. Pre-Existing Pulmonary HTN N&P Page 1004, Box 40-4 Justin

Which of the following most correctly describes the source of the relative dilutional anemia that is seen during pregnancy? A. The plasma volume increases to a greater extent than the actual RBC volume B. The plasma volume increases while the RBC volume stays the same C. The plasma volume stays the same while the RBC volume increases D. All of the above are false

A. The plasma volume increases to a greater extent than the actual RBC volume N&P page 1127, 2nd column 2nd paragraph Abe

5. Which of the following is NOT one of the processes that are used to define somatic pain? A. Translation B. Transduction C. Transmission D. Perception E. Modulation

A. Translation Abe N&P page 1244, 2nd column 2nd paragraph

The ACC/AHA revised its guidelines for perioperative evaluation in 2007. Under the new guidelines, patients with which of the following conditions should seek a cardiology intervention prior to non-emergent surgery? (Select 2) A. Unstable coronary syndromes B. Decompensated heart failure C. Hypertension D. A-fib

A. Unstable coronary syndromes B. Decompensated heart failure M&M Ch. 21 pg. 377 K. Jensen

5. When the nurse anesthetist views the fetal heart rate monitor (FHR) they are able to see decelerations that begin late in the contraction (late decelerations). They know that this may indicate what condition? a. Uteroplacental insufficiency b. Fetal death c. Maternal tachycardia d. A healthy fetus.

A. Uteroplacental Insufficiency N&P 1133 Justin

Regarding the patient in the prone position for spinal surgery, which of the following is false? a. Ventilation is not impaired in the prone position b. Zone 3 increases. c. Zone 2 decreases d. Barotrauma is more likely to occur.

A. Ventilation is not impaired in the prone position. N&P Page 1007, First Column, last paragraph Justin

A more accurate measurement of blood loss can be obtained if laps and sponges are ___________. This is especially important in pediatric cases. A. Weighed B. Sent to the lab for H & H C. Squeezed into a measuring container D. Visually estimated

A. Weighed M&M Ch. 51 pg. 1167 K. Jensen

2. Which of the following options most accurately describes somatic pain? A. Well localized, sharp in nature, and generally hurts at the point or area of stimulus. B. Dull, cramping, or squeezing pain that is vague in nature C. Burning, tingling, or shocklike pain D. Intense enough to bring you to tears

A. Well localized, sharp in nature, and generally hurts at the point or area of stimulus. Abe N&P page 1244, 1st column 4th paragraph

4.) Hypobaric solutions are defined as: (SELECT 2) (N and P, page 1081) A. a baricity less than 0.999 B. when baricity is equal to 1 C. Rise or float to the highest anatomical position D. a baricity of 1.0015

A. a baricity less than 0.999 C. Rise or float to the highest anatomical position Maggie

1. In an attempt to help replace volume in a hypovolemic patient, what measure can be taken? a. Intravascular volume replacement b. Position the patient in trendelenberg c. Treat them with vasopressors d. Pray that they become hemodynamically stable

A. a. Intravascular volume replacement n&p 403 rebecca

What are the most common causes of intra-operative opic nerve injury? SELECT ALL THAT APPLY (N and P, page 410) A. increased intraocular pressure B. decreased perfusion C. increased perfusion D. decreased intraocular pressure

A. increased intraocular pressure B. decreased perfusion Maggie

2. An allergy to a local anesthetic may be caused by what? a. The preservative in the anesthetic solution b. The way the anesthetic is administered c. Family history of allergic reaction to local anesthetic d. The dose in which the anesthetic is given.

A. the preservation in the anesthetic solution N&P 1103 Rebecca

Which of the following surgical positions is often used as a treatment for hypotension in the surgical patient? A. Trendelenburg B. Supine C. Sitting D. Prone

A. trendelenburg Justin N&P 403

What happens to platelets in banked blood? a. Absent after 2 days of storage b. Double in number every day c. Platelets are not effected by storage d. Decrease 1% per week of storage

Absent after 2 days of storage Charlie N&P pg. 396

1. How is the newborns oxygen consumption when compared to an adult on in ml/kg/min. a. Almost doubled b. Almost a third c. The same d. Much less

Almost doubled Charlie N&P pg. 1167

Select from below all of the following possible signs of fluid loss. a. dry or parched mucous membranes b. lethargy or obtunded sensorium c. orthostatic hypotension d. decreased urinary flow e. decreased pulse rate f. elevated blood pressure

Answer - a, b, c, d M&M page 1162 Krum

Select the following late signs of hypervolemia such as in cases when CHF is present. a. tachycardia b. JVD c. pulmonary crackles, rales, wheezing d. cyanosis e. constipation

Answer - a, b, c, d M&M page 1162 Krum

Select from below all of the following laboratory tests that would indicated dehydration. a. increased H&H b. decreased H&H c. metabolic acidosis d. metabolic alkalosis e. hypernatremia f. hyponatremia

Answer - a, c, e M&M page 1162 Krum

Crystalloids contain _________, Colloids contain __________. a. aqueous solutions of ions with/without glucose, high MW solutions of proteins & large glucose polymers. b. high MW solutions of proteins & large glucose polymers, aqueous solutions of ions with/without glucose. c. None of the above

Answer - a. M&M page 1163 Krum

Stroke Volume Variation (SVV) is measured over a set amount of time. Spontaneous inspiration causes blood pressure to decrease and the opposite is true with positive pressure ventilation. Normal SVV is ________ on controlled ventilation. Patients with a greater than normal SVV may be _________. a. 10-15%, responsive to fluid therapy. b. 10-15%, unresponsive to fluid therapy. c. 20-30%, responsive to diuretic therapy. d. 10-15%, responsive to diuretic therapy.

Answer - a. M&M page 1163 Krum

When accurate hemodynamic and fluid status is important, the stroke volume variation (SVV) can be measured. Select the equation for calculating the stroke volume variation. a. SVV = (SVmax - SVmin)/SVmean b. SVV = (SVmax + SVmin)/SVmean c. SVV = (SVmax x SVmin)/SVmean

Answer - a. M&M page 1163 Krum

Deflation of a tourniquet cuff is followed by a ... a. decrease in CVP, BP, and temperature while HR increases. b. increase in CVP, BP, and temperature while HR increases. c. decrease in CVP, BP, and temperature while HR decrease. d. decrease in CVP, BP, and temperature while HR remains unchanged.

Answer - a. M&M page 791 Krum

Following the release of a thigh tourniquet, it is expected that the EtCO2 will... a. increase. b. decrease. c. no longer be needed and can be removed. d. be the only measure that is important concerning the extubation criteria of the patient.

Answer - a. M&M page 791 Krum

Due to increased risk of aspiration in the parturient, supine position should be avoided unless... a. a displacement device such as a wedge greater than 15 degrees is utilized. b. the patient is less than BMI of 30. c. the spouse is in the room and the two may see each other better. d. unless prone position is used which is better for delivery anyway.

Answer - a. M&M page 845 Krum

Pain during the first stage of labor is considered visceral due to the pain pathways associated mainly arise from visceral dermatomes. Furthermore, the first stage of labor can be divided into two phases. Select the correct dermatome coverage for the two different phases. a. Initial phase T11-T12, Latent phase T10-L1 b. Initial phase T9-L2, Latent phase T10-T12 c. Initial phase T10-L1, Latent phase T11-T12 d. Initial phase is worst, Latent phase is least

Answer - a. M&M page 846 Krum

To prevent apnea in the neonate, which of the following should be avoided? a. Opiates and IV sedatives b. Desflurane and Sevoflurane c. Spinal anesthesia

Answer - a. N&P page 1178 Krum

Pitting edema and increased urine flows are signs of which of the following... a. lack of fluid volume b. excess extracellular fluid and possible hypervolemia c. diabetes d. excellent health

Answer - b M&M page 1162 Krum

Blood that is contained within the extremity distal to a tourniquet is high in metabolic waste products. These products when released into the core systemic circulation will... a. help to normalize the core pH. b. increase the minute ventilation of the spontaneous breathing patient. c. decrease the minute ventilation of the spontaneous breathing patient. d. almost always lead to electrolyte imbalances that cause arrhythmias.

Answer - b. M&M page 791 Krum

Even with GA or even adequate RA... a. tourniquet pain is rarely ever manifest. b. tourniquet pain may cause increase in MAP 1 hr after inflation. c. tourniquet pain is evidenced by hypotension and increased sedation.

Answer - b. M&M page 791 Krum

With the use of a tourniquet, which of the following is the appropriate pressure to inflate to? a. 50 mmHg > SBP b. 100 mmHg > SBP c. 50 mmHg < SBP d. 100 mmHg < SBP

Answer - b. M&M page 791 Krum

Meperidine is a suitable opioid for laboring mothers and given 10-25 mg IV or 25-50 mg IM to a total of 100 mg. When would be the expected time to assess and witness maximal maternal and fetal respiratory depression? a. 5 min IV, 45 min IM b. 15 min IV, 2 hrs IM c. 45 min IV, 5 hrs IM d. 0.5 min IV, 4.5 min IM

Answer - b. M&M page 846-847 Krum

In the neonate, ventilatory response to hypoxia and hypercarbia are impaired and reflexes to inhibit are exaggerated. Which of the following is the strategy to stabilize respiratory rhythm? a. Narcotics b. Caffeine and CPAP c. Versed or low dose propofol d. Extreme love and support

Answer - b. N&P page 1178 Krum

Which anesthetic technique would have the lowest risk for postoperative apnea in a case involving lower extremity procedures in the neonatal. a. GA b. 100% FiO2 c. Spinal Anesthesia without sedation d. Spinal Anesthesia with sedation

Answer - c. N&P page 1178 Krum

All of the following statements are true except... a. CVP readings are not always an accurate indication of volume status. b. PAOP readings are not always an accurate indication of volume status. c. Echocardiography is the least invasive and most reliable way to establish cardiac filling and function. d. CVP - PAOP should = 5 mmHg anything less than this indicated hypovolemia

Answer - d. M&M page 1163 Krum

All of the following are appropriate measure to take to reduce the risk of aspiration except. a. PO clear antacid 15-30 mL q 30 min prior to c-section. b. H2 blocker PO 100-150 mg or IV 50 mg c. Reglan 10 mg PO or IV d. Zofran 4 mg IV 30 min prior to induction

Answer - d. M&M page 845 Krum

Select the correct NPO time to be achieved in the laboring parturient needing cesarean section. a. 3 hrs b. 6 hrs c. 8 hrs d. NPO time is somewhat irrelevant due to the fact that all parturient's are considered full stomach and thus at risk for pulmonary aspiration.

Answer - d. M&M page 845 Krum

If diabetes is part of the maternal history, anticipated neonatal sequelae associated would be all of the following except which? a. hypoglycemia b. birth trauma c. large or small gestational age associated problems d. anemia

Answer - d. N&P page 1178 Krum

5. Sympathetic derived vasoconstriction is made possible by acting on which receptor? A. Alpha 1 B. Alpha 2 C. Dopamine D. Beta 1 E. Beta 2

Answer A Alpha 1. Sympathetic-induced vasoconstriction (via A1 -adrenergic receptors) can be potent in skeletal muscle, kidneys, gut, and skin; it is least active in the brain and heart. See M&M on page 360. Blair Ryan

2. Select the 2 incorrect statements. A. Crystalloids will stay in the intravascular space and away from extracellular areas when administered intravenously. B. Crystalloids half-life is about 6 hours making it the immediate remedy for hypovolemia. C. Colloids carry the risk of causing an allergic reaction. D. Administration of crystalloid to replace intraoperative blood loss should be given at a 3 ml: 1 ml of blood loss.

Answer A&B are incorrect. The intravascular half-life of a crystalloid solution is 20-30 min. Colloid solutions help maintain plasma colloid oncotic pressure and for the most part remain intravascular, whereas crystalloid solutions rapidly equilibrate with and distribute throughout the entire extracellular fluid space. M&M pg. 1165. Blair Ryan

3. TEE is a good tool to assess or diagnose ¬¬¬¬___________? Select all of the correct responses. A. Pericardial diseases (pericardial effusions and constrictive pericarditis) B. Cardiac tumors. C. Coronary blood flow D. Measure the amount of oxygen extracted from the sub-endocardium E. Atrial or Ventricular septal defect

Answer A, B, E. Morgan & Mikhail page 452. Blair Ryan.

1. Respiratory changes associated with aging include all except A. Increased elasticity. B. Increased FRC and residual volume C. Increased dead space D. Increased closing capacity

Answer A. Aging Decreases elasticity of lung tissue, allowing over distention of alveoli and collapse of small airways. Morgan & Mikhail pg. 907 Blair Ryan

3. Congenital Diaphragamatic Hernias are no longer considered emergent. They can be repaired via all of the following approaches except. A. Transvenous B. Laparotomy C. Thoracoscopic D. Laparoscopic

Answer A: Laparotomy, thoracoscopic repair, and a laparoscopic approach may be used. Nagelhout pg. 1184 Blair Ryan

2. Factors that influence blood flow in the vascular tree are which? Select all correct answers (4) A. circulating hormones. B. Mechanisms of local and metabolic control C. The conscious self D. Endothelium-derived factors E. The autonomic nervous system

Answer ABDE. A multiplicity of factors influences blood flow in the vascular tree. These include mechanisms of local and metabolic control, endothelium-derived factors, the autonomic nervous system, and circulating hormones. See M&M on page 359. Blair Ryan

4. Physiological changes in body habitus include______ (select 2)? A. Loss of fat B. Loss of muscle C. Increased adipose D. No changes in muscle mass

Answer B and C. A progressive decrease in muscle mass and increase in body fat (particularly in older women) results in decreased total body water. Morgan & Mikhail pg. 914 Blair Ryan

5. Propofol should be decreased by approximately how much in elderly patients? A. No adjustment necessary. B. 20% C. 50% D. 75%

Answer C. Elderly patients require nearly 50% lower blood levels of Propofol for anesthesia than do younger patients. Morgan & Mikhail pg. 914 Blair Ryan

5. Electroencephalography (EEG) is incorporated with progressive hypothermia during coronary artery bypass surgeries. Which of the following are expected findings with induced hypothermia? Choose the best answer A. Increased amplitude and decreased latency. B. Decreased amplitude and decreased latency. C. EEG slowing, burst suppression, and, finally, an isoelectric recording. D. Complaints of feeling cold, shivering and bradycardia.

Answer C. Morgan & Mikhail page 453. Blair Ryan.

4. According to the reading from Nagelhout's Anesthesia, what HGB is indicated for a need to likely transfuse? A. 10 g/ dL B. 8 g/ dL C. 6 g/ dL

Answer C. The ASA Task Force concluded that transfusion is "usually unnecessary" in patients with hemoglobin greater than or equal to 10 g/dL and should "usually be administered" when hemoglobin is less than 6 g/dL. Nurse Anesthesia, pg. 396. Blair Ryan

1. With regard to ET intubation with pediatric patients, please select the false statement. A. Be prepared with ETT 0.5mm greater and less than predicted size. B. A gas leak that occurs at 15-20 cm H2O with the cuff down indicates proper sizing. C. Bury the ETT into right main stem, then pull back until bilateral breath sounds auscultated. D. 4 + age / 4 is a good calculation to measure depth of ETT placement.

Answer D. 12 + Age/2 = Length of tube (in cm) is a method some practitioners use as a guide for depth of ETT. M&M pg. 892.

2. Spinal Anesthetics. Choose the CORRECT statement. A. Neuraxial Anesthesia is less in favor than general anesthesia for elderly patients. B. The physiological changes of aging make it easier to administer neuraxial anesthetics. C. Elderly patients have a decreased sensitivity to LA's. Give higher doses. D. There is more spread in epidurals and longer duration of spinal anesthetics with the elderly.

Answer D. Administration of a given volume of epidural local anesthetic tends to result in more extensive spread in elderly patients. A longer duration of action should be expected from a spinal anesthetic. Morgan & Mikhail pg. 912 Blair Ryan

1. An emergency indicating an STAT cesarean delivery under general anesthesia can be d/t A. The mother's well-being. B. The fetus's well-being. C. Both of mother and baby D. All of the above

Answer D. All of the above. M&M pg. 860 Blair Ryan

3. A patient is seen pre-op and on Coumadin, but he is unsure the reason. The surgeon has requested a neuraxial blockade to assist with pain management. As the potential CRNA, what should you do? A. Note the patient takes Warfarin on the chart. B. The above plus order INR level day of surgery C. The above and instruct patient to d/c warfarin 5 days prior to surgery D. Consult the prescribing physician to further discuss anticoagulant concern.

Answer D. Anesthesia staff should ALWAYS consult with the patient's primary physicians whenever considering the discontinuation of antiplatelet or antithrombotic therapy. M&M pg. 948. Blair Ryan

3. Neuro and elderly. Everything decreases except¬¬¬¬______? A. Dopamine neurotransmitter B. Serotonin receptors C. GABA Receptors D. Astrocytes and microglial cells

Answer D. Astrocytes and microglial cells increase in number. Morgan & Mikhail pg. 912 Blair Ryan

2. Some late decelerations are observed with fetal heart monitoring. The OB nurse tells you the baby must be delivered immediately. What do you do? A. Intubate pt. and prepare for GA. B. Spinal analgesic C. Epidural Analgesic D. Inquire for further signs of fetal distress with the health care team and evaluate the patient.

Answer D. Late decelerations are not the best indicator and can be a false positive that the fetus is truly in danger. Other signs to consider include. Nonreassuring fetal heart rate pattern, Repetitive late decelerations, Loss of fetal beat-to-beat variability associated with late or deep decelerations, sustained fetal heart rate <80 beats/min, Fetal scalp pH <7.20, Meconium-stained amniotic fluid, Intrauterine growth restriction. M&M pg. 860. Blair Ryan

5. The fetus is partially out of the birth canal but the head remains stuck. Which agent can help relax the uterus so baby can pass? A. Oxytocin 1-6mU/min gtt B. Succinylcholine 20% of an intubating dose. This will break the uterine contraction temporarily. C. Remifentanil for its quick onset and short time frame allowing the surgeon to tug baby out. D. nitroglycerin, 50-100 mcg intravenously, can be administered.

Answer D. Nitro. Also, rapid induction of general endotracheal anesthesia and administration of a volatile agent may be attempted in such instances to relax the uterus. M&M pg. 861 Blair Ryan

2. Coronary blood supply from the right coronary artery includes all of the following arteries except? A. SA and AV arteries B. Posterior descending artery C. Conus and acute marginal artery D. Obtuse and circumflex arteries.

Answer D. Obtuse and circumflex arteries. Morgan & Mikhail page 452. Blair Ryan.

3. What pressure would you like your tourniquet inflated to? A. I will be receiving anesthesia, so it doesn't matter B. 250 mm HG C. 300mm HG D. 50-75 mm HG more than SBP.

Answer D: The research of Klenerman recommends between 50 and 75 mmHg more than the patient's systolic pressure. Nagelhout. Pg. 1001. Blair Ryan

1. Select the appropriate action that happens during the Phase 0 of the cardiac action potential. a. Activation of voltage-gated Na channels allows Na entry and decreases the permeability to K - Upstroke. b. Inactivation of Na channel and transient increase in K permeability allows K out - Early Rapid Repolarization. c. Activation of slow calcium channels allows Ca entry - Plateau. d. Inactivation of Ca Channels and increased permeability to K allows K out - Final Repolarization. e. Normal permeability restored (atrial & ventricular cells) Na-K pump allows K in, Na out - Resting potential.

Answer a M&M page 347

3. Hematopoietic stem cells precursor the following types. Select 6 a. mast cells b. platelets c. antigen-presenting cells d. natural killer cells e. red blood cells f. gamma cells g. B cells h. T cells

Answer a, b, c, d, g, h. Nagelhout & Plaus Page 1017 Krum

5. TNF-α has proinflammatory properties. Select from below the following actions TNF-α promotes. a. clotting b. leukocyte adhesion & diapedesis c. macrophage activation d. cytokine production by other cells e. increased INR & PT

Answer a, b, c, d. Nagelhout & Plaus Page 1017 Krum

3. Select all of the following expected age related cardiovascular changes. a. decreased vascular and myocardial compliance b. decreased autonomic responsiveness c. myocardial fibrosis d. increased myocardial endurance with excessive exertion e. valvular calcification

Answer a, b, c, e. M&M page 908 Krum

In the pediatric population, resting HR is normally faster than that of adults and the stroke volume is fixed due to ______. Thus, the activation of a parasympathetic response, anesthetic overdose, or hypoxia may result in ______. a. a non-compliant immature left ventricle, severe bradycardia and reductions in cardiac output. b. compliant right ventricles, severe tachycardia and increased cardiac output. c. non-compliant right ventricles, adequate perfusion to the coronary vessels. d. patent foramen ovale, increased venous return and elevated pulmonary vascular resistance.

Answer a. M&M page 879 Krum

4. Natural age progression leads to a decrease in heart rate due to which of the following? a. increased vagal tone and decreased sensitivity of adrenergic receptors b. increased sympathetic impulses and increased adrenergic sensitivity c. sedentary lifestyles that slow the action of the AV node d. elevated troponin levels that innervate parasympathetic responses

Answer a. M&M page 908 Krum

2. Select the best explanation of a diastolic dysfunction. a. ventricle depression that prevents relaxing and consequently inhibits filling at relatively low pressures b. ventricle relaxation that promotes filling at relatively low pressures leading to excessive CO c. decreased afterload and increases the filling volumes while decreasing filling pressure of ventricles

Answer a. M&M page 909 Krum

Prior to endovascular aortic stent graft placement systemic anticoagulation is done by... a. plavix 100 mg/kg b. heparin 50-100 units/kg c. aspirin 80 mg d. lidocaine 1-2 mg/kg

Answer b. N&P 576 Krum

3. Select the appropriate action that happens during the Phase 2 of the cardiac action potential. a. Activation of voltage-gated Na channels allows Na entry and decreases the permeability to K - Upstroke. b. Inactivation of Na channel and transient increase in K permeability allows K out - Early Rapid Repolarization. c. Activation of slow calcium channels allows Ca entry - Plateau. d. Inactivation of Ca Channels and increased permeability to K allows K out - Final Repolarization. e. Normal permeability restored (atrial & ventricular cells) Na-K pump allows K in, Na out - Resting potential.

Answer c M&M page 347

Aortic endovascular stent placement has shown to shorten length of stay when what type of anesthesia is utilized. a. General Anesthesia b. Neuraxial Anesthesia c. Local Anesthesia

Answer c. N&P page 576 Krum

1. B-cells mature in which organ? a. Thymus b. Spleen c. Thyroid d. Fetal Liver & Postnatal Bone Marrow

Answer d. Nagelhout & Plaus Page 1017 Krum

5. Select the appropriate action that happens during the Phase 4 of the cardiac action potential. a. Activation of voltage-gated Na channels allows Na entry and decreases the permeability to K - Upstroke. b. Inactivation of Na channel and transient increase in K permeability allows K out - Early Rapid Repolarization. c. Activation of slow calcium channels allows Ca entry - Plateau. d. Inactivation of Ca Channels and increased permeability to K allows K out - Final Repolarization. e. Normal permeability restored (atrial & ventricular cells) Na-K pump allows K in, Na out - Resting potential.

Answer e M&M page 347

1. Cardiopulmonary bypass can lead to increases in stress hormones and systemic inflammatory response. Select from below all of the following which me be elevated as a result of CPB. a. catecholamines b. cortisol c. arginine vasopressin d. angiotensin

Answer is a, b, c and d. M&M page 442 Krum

3. Select from below all the factors that should be included in the preoperative assessment to establish adequacy of cardiac function. a. Exercise Tolerance b. EF c. Coronary Stenosis Severity d. Ventricular Wall Motion Abnormalities e. End-Diastolic Pressures f. Cardiac Output g. Valvular Areas & Gradients h. FEV1 i. PT/INR

Answer is a, b, c, d, e, f, g. M&M page 443 Krum

2. Select the statements that are true regarding the effects of CPB on Pharmacokinetics. a. Serum concentrations of water soluble drugs are decreased when CPB is started, while lipid soluble drugs are minimally effected by CPB. b. CPB has no effect on pharmacokinetics of any drugs. c. CPB suddenly increases the Volume of Distribution from hemodilution and decreases the proteirn binding of drugs. d. Opioids can bind to CPB components but this is inconsequential.

Answer is a, c and d. M&M page 443 Krum

5. Intravenous catheterization needed for CPB should include 2 large bore IV's. One of which is recommended to be placed into a large central vein such as IJ, EJ, or Subclavian. Studies have shown that the best time to place the central line is a. in the pre-operative area prior to the procedure. b. in the cardiac ICU 24 hrs prior to the procedure c. in the OR after induction. d. any time in the preop or in the OR after induction. Studies have shown no benefit for timing, it's simply important to just get the access.

Answer is d. M&M page 444 Krum

Coronary blood flow is regulated by intrinsic and extrinsic factors that affect coronary artery tone. From the following select the components that comprise the intrinsic factors (Select 2). a. Anatomic arrangement of the coronary vessels b. Perfusion pressure of the coronary vessels c. Compressive factors within the myocardium d. Metabolic factors e. Humoral factors f. Neural Factors

Answer: A & B NP 23: 480 Byron

2. With regard to general anesthesia with mechanical ventilation of pediatric patients, please select the false statement. A. MAC is less in peds than adults. B. Sevoflurane can predispose pediatrics to emergence delirium and agitation. C. All of the volatile anesthetics can be used to anesthetize children. D. Unidirectional valves, breathing tubes, and carbon dioxide absorbers can cause considerable resistance to small pediatric patients spontaneously breathing.

Answer: A Although the MAC is greater in children than in adults, neonates may be particularly susceptible to the cardio depressant effects of general anesthetics. M&M pg. 892.

2. A surgeon has requested a tourniquet to be used for an upper extremity surgery. Which block or blocks will allow the patient to be anesthetized for the operation? (Select 2 choices) A. Brachial plexus block above cords B. Sciatic nerve block C. PSOAs block D. Intercostobrachial Nerve Block

Answer: A and D. Brachial plexus block at the level of the cords provides excellent anesthesia for procedures at or distal to the elbow. The upper arm and shoulder are not anesthetized with this approach. As with other brachial plexus blocks, the intercostobrachial nerve (T2 dermatome) is spared. Blair Ryan M&M pg 1000.

4. What is the appropriate size ETT for a preterm neonate? A. 2.0-3.0 B. 1.5-2.5 C. 2.5-3.5 D. 3.0-4.0

Answer: A, 2.0-3.0 N & P, pg. 1177 Stefania

5. Which of the following physiologic changes can be seen with the release of a pneumatic tourniquet? (Select 3) a. Transient decrease in core temperature b. Transient fall in systemic arterial pressures c. Transient fall in pulmonary arterial pressures d. Transient increase in pulmonary arterial pressures

Answer: A, B, C - Transient decrease in core temp, transient fall in systemic and pulmonary arterial pressures N&P pg. 1000 stetler

5. Select all of the following anesthesia techniques that are acceptable for EVAR. A. general anesthesia B. neuraxial anesthesia C. local anesthesia with sedation D. awake with no anesthesia or sedation

Answer: A, B, C, general anesthesia, neuraxial anesthesia, or local anesthesia with sedation N & P pg: 576 Stefania

4. ______________ and _____________ may be considered the most important techniques used to enhance cardiac function during abdominal aortic aneurysmectomies (select 2) a. Fluid loading b. Preoperative cardiac testing c. Restoration of intravascular volume d. Prophylactic coronary revascularization

Answer: A, C Fluid loading and restoration of intravascular volume N&P pg. 564 Stetler

5. Which of the following respiratory characteristics are true of the neonate? a. Decrease Lung compliance b. Increase lung compliance c. Decrease elastic recoil d. Decrease rigidity of chest wall

Answer: A, C, D decrease lung compliance, decrease elastic recoil, decrease rigidity of chest wall N&P pg. 1179 stetler

4. Which of the following are more likely to have a latex allergy? a. A healthcare worker b. A patient with asthma c. A baby with a congenital neural defect d. A patient with a allergy to bananas

Answer: A, C, D- Healthcare worker, baby with congenital neural defect, and patient with an allergy to bananas N&P pg. 1025 Stetler

1. The intercellular compartment contains 2/3 of the total body volume (TBV) and consists of high concentration of which elements? (Select 3) A. Potassium B. Chloride C. Magnesium D. Sodium E. Phosphate

Answer: A, C, E The Intercellular (ICF) compartment contains approximately two thirds of the body's total fluid volume and is characterized by high concentrations of potassium, phosphate, and magnesium. Nurse Anesthesia, pg. 382. Blair Ryan

2. Treatment of uterine rupture involves which of the following? (Select 2) a. Volume resuscitation b. Volume restriction c. Blood transfusion d. Laparotomy

Answer: A, D- Volume resuscitation and immediate laparotomy Morgan & Mikhail's Clinical Anesthesiology pg. 863 Stetler

2. Sympathetic innervation of the GI tract stems from which spinal cord segments via prevertebral ganglia? A. T5-L2 B. T1-L3 C. T2-S1 D. T5-L4

Answer: A, T5-L2 N & P, pg. 1084 Stefania

2. All of the following are potential causes of compartment syndrome EXCEPT: A. an extremity wrapping that is too loosely fit B. vascular obstruction C. external compression of an elevated extremity D. systemic hypotension

Answer: A, an extremity wrapping that is too loosely fit N & P, pg. 412-413 Stefania

1. When administering lactated ringers solution, lactate is metabolized into what? Where does this take place? A. bicarbonate, liver B. bicarbonate, lungs C. lactic acid, kidneys D. lactic acid, biliary

Answer: A, bicarbonate, liver N & P, pg: 392 Stefania

4. All of the following increase the risk of PDPH EXCEPT? A. elderly B. pregnant patients C. use of cutting needles D. multiple punctures

Answer: A, elderly N & P, pg. 1085 Stefania

1. Which of the following is true regarding fetal hemoglobin? A. has a higher affinity for O2 than adult hemoglobin B. is abbreviated as HgbA C. 20-30% of the neonates total hemoglobin at birth D. the preterm neonate has a lower amount of fetal hemoglobin at birth than a term neonate

Answer: A, has a higher affinity for O2 than adult hemoglobin N & P, pg. 1176 Stefania

2. Which potential risk is increased in the sitting position rather than the lateral position for a shoulder arthroscopy? A. venous air embolism B. nerve injuries C. increased awareness D. increased bleeding

Answer: A, venous air embolism N & P, pg. 1006 Stefania

1. An axillary brachial plexus block will provide anesthesia to which nerves when properly done? Select all that apply. A. Radial B. Median C. Musculocutaneous D. Ulnar

Answer: A,B,D. The Radial, Median and Ulnar will benefit from a single injection. The Musculocutaneous separates cephalad to injection site and is not effected. Blair Ryan M&M pg 999.

1. Select all of the analgesic agents that work via alpha-2 agonism. ( Select 2) A. aspirin B. clonidine C. fentanyl D. dexmedetomidine

Answer: B. clonidine, D. dexmedetomidine N & P, pg. 1251 Stefania

4. Correct placement of the needle for a stellate block will result in which of the following? a. Horner's syndrome b. Increased skin temperature of ipsilateral arm c. Hypotension d. Numbness and tingling of ipsilateral arm

Answer: A,B- Horner's syndrome, increased skin temperature of ipsilateral arm M&M pg. 1072 Stetler

1. The classic triad of symptoms of a ruptured abdominal aortic aneurysm include which of the following a. Abdominal discomfort or back pain b. Hypertension c. Hypotension d. Pulsatile mass

Answer: A,C,D Abdominal discomfort or back pain, hypotension, and a pulsatile mass N&P pg. 570 Stetler

5. Platelet transfusions are given to patients with which of the following conditions? (Select 2) a. Thrombocytopenia b. Anemia c. Dysfunctional platelets d. Neutropenia

Answer: A,C- Thrombocytopenia and Dysfunctional platelets Morgan & Mikhail's Clinical Anesthesiology pg. 1171 stetler

2. The maximal heart rate in the geriatric patient declines by approximately how many beats per minute per year of age over 50? a. 1 b. 2 c. 3 d. 4

Answer: A- 1 bpm M&M pg. 908 stetler

1. Total injection volumes for medial branch blocks should be limited to less then ______mL to prevent rupture of the joint capsule. a. 1 b. 2 c. 3 d. 4

Answer: A- 1mL M&M pg. 1069 Stetler

4. Platelet counts less then ______ are associated with increased blood loss during surgery. a. 50,000 x 10^9/L b. 60,000 x 10^9/L c. 70,000 x 10^9/L d. 80,000 x 10^9/L

Answer: A- 50,000 x 10^9/L Morgan & Mikhail's Clinical Anesthesiology pg. 1171 stetler

5. ______ is a highly positively charged protein that binds and effectively inactivates heparin a. Protamine b. Vitamin K c. Clevidipine d. Prostaglandin E

Answer: A- Protamine Morgan & Mikhail's Clinical Anesthesiology pg. 466 stetler

2. __________ increases red blood cell production by stimulating the division and differentiation of erythroid progenitors in the bone marrow. a. Erythropoietin b. FFP c. Factor X d. Fibrinogen

Answer: A- erythropoietin Morgan & Mikhail's Clinical Anesthesiology pg. 797 stetler

3. How does the CSF volume of a neonate compare to that of an adult? a. Twice that of an adult b. Half that of an adult c. Same as the adult d. Triple that of an adult

Answer: A- twice that of an adult N&P pg. 1182 stetler

5. Which of the following nerves supplies sensory innervation to the extensor region of the forearm, arm, and hand? a. Radial b. Axillary c. Median d. Musculocutaneous

Answer: A-radial nerve N&P pg. 1108 stetler

5. Fill in the correct weight with its respective category. A. ____low birth weight (LBW) B. ____ very low birth weight (VLBW) C. ____ extremely low birth weight (ELBW) <1000g, <500g, <1500g, <2000g, <3000, <2500

Answer: A. (LBW) <2500g, B. (VLBW) <1500 g, C. (ELBW) <1000g N & P, pg. 1177 Stefania

3. Following the 1, 2, 3, 4/7, 8, 9, 10 rule, what is the appropriate depth for an infant weighing 2 kg? A. 8 cm B. 7 cm C. 9 cm D. 10 cm

Answer: A. 8 cm N & P, pg. 1201 Stefania

1. What is a congenital diaphragmatic hernia? A. a defect of the diaphragm that allows extrusion of the abdominal contents into the thoracic cavity. B. an obstructive lesion characterized by an "oliveshaped" enlargement of the pylorus muscle. C. It is normally diagnosed immediately after birth when an orogastric tube cannot pass into the stomach, when there is coughing and choking after the first feeding, or after recurrent pneumonia associated with feedings. D. intestinal inflammation that is a life-threatening emergency situation.

Answer: A. A congenital diaphragmatic hernia (CDH) is a defect of the diaphragm that allows extrusion of the abdominal contents into the thoracic cavity. Nagelhout pg. 1184 Blair Ryan

2. What was the initial reason endovascular aortic aneurysm repair (EVAR) was developed? A. for patients who were not surgical candidates due to significant coexisting disease B. to minimize the risk of infection C. to decrease costs D. to decrease the risk of spinal cord ischemia

Answer: A. for patients who were not surgical candidates due to significant coexisting disease N & P pg: 574 Stefania

3. All of the following are desirable hemodynamics to consider in the management of a CABG EXCEPT? A. increased HR B. normal sinus rhythm C. maintain PVR, SVR D. decrease preload, and depress contractility if LV function is normal

Answer: A. increased HR N & P, pg. 535 Stefania

1. Select the correct structural respiratory changes that typically occur with aging. (Select 2) A. increased lung compliance B. flattened diaphragm C. decreased lung compliance D. heightened diaphragm

Answer: A. increased lung compliance, B. flattened diaphragm N & P, pg. 1218 Stefania

2. All of the following results due to activation of alpha-2 receptors: (select 2) A. inhibition of adenyl cyclase B. decreased cAMP levels C. activation of adenyl cyclase D. increased cAMP levels

Answer: A. inhibition of adenyl cyclase, B. decreased cAMP levels N & P, pg. 1251 Stefania

4. Select all of the following positioning recommendations that are appropriate to prevent ulnar nerve injuries. (Select 2) A. supinate forearms to padded arm boards B. do not flex elbows more than 90 degrees C. pronate forearms to padded arm boards D. be sure the elbows are flexed more than 90 degrees

Answer: A. supinate forearms to padded arm boards, B. do not flex elbows more than 90 degrees N & P, pg. 413 Stefania

2. Which of the following formulas can be used to determine the appropriate size ETT for pediatric patients? Select 2 A. 16 + age / 4 B. 16 - age / 4 C. age / 4 + 2 D. age / 4 + 4

Answer: A., D. 16 + age / 4 , age / 4 + 4 N & P, pg. 1201 Stefania

3. Which of the following is a correct formula to calculate Reynold's number? A. Re = (v x d x p) / n B. Re = (v x d x n) / p C. Re = (v x n x p) /d D. Re = (v x r x p) / n

Answer: A., Re = (v x d x p) / n N & P, pg. 489 Stefania

Of the following factors, which of the following is the major determinant of coronary perfusion pressure under normal physiologic conditions? a. SBP b. DBP c. CVP d. LVEDP e. LVESP

Answer: B NP 23: 481 Byron

2. At which level does the dural sac end in the newborn? a. S1 b. S2 c. S3 d. S4

Answer: C- S3 N&P pg. 1182 stetler

2. Which of the physiologic signs are associated with Congenital Diaphragmatic Hernia (CDH)? Select 2. A. The lung contralateral to the CDH is effected greatest. B. The effected lung has reduced-sized bronchi, less bronchial branching, decreased alveolar surface area, and abnormal pulmonary vasculature. C. Physiologic changes result in DECREASED pulmonary artery pressure and causes LEFT -> RIGHT shunting. D. Physiologic changes result in increased pulmonary artery pressure and causes right-to-left shunting

Answer: B and D The effected lung has reduced-sized bronchi, less bronchial branching, decreased alveolar surface area, and abnormal pulmonary vasculature. Physiologic changes result in increased pulmonary artery pressure and causes right-to-left shunting Nagelhout pg. 1184 Blair Ryan

3. At what serum magnesium level will you see respiratory depression? A. 5 B. 10 C. 4 D. 7

Answer: B, 10 N & P, pg:392 Stefania

3. In the sitting position it is important to be aware of where the blood pressure cuff is in relation to the brain. The magnitude of the gradient is approximately how many mmHg per inch of height differential? A. 5 mmHg B. 2 mmHg C. 10 mmHg D. 8 mm Hg

Answer: B, 2 mmHg N & P, pg. 1006 Stefania

3. Which of the following is associated with decreased blood loss during hip surgery? (Select all that apply) a. General Anesthesia b. Epidural Anesthesia c. Spinal Anesthesia d. All of the above

Answer: B, C- Epidural anesthesia, Spinal anesthesia Morgan & Mikhail's Clinical Anesthesiology pg. 797 stetler

4. Which of the following is the correct composition of lactated ringers solution? A. Na: 150, K: 4, glucose: 0 B. Na: 130, K: 4, glucose: 0 C. Na: 120, K: 6, glucose: 20 D. Na: 120, K: 6, glucose: 5

Answer: B, Na: 130, K: 4, glucose: 0 N & P, pg: 392 Stefania

1. What level of blockade is needed for adequate spinal anesthesia for a cesarean delivery? A. T6 B. T4 C. T8 D. T10

Answer: B, T4 N & P, 1143 Stefania

3. Select all appropriate anesthesia considerations that may help minimize small airway closure. (Select 2) A. providing high inspired O2 concentration B. alveolar recruitment maneuvers C. providing PEEP D. hyperventilation to decrease PaCO2

Answer: B, alveolar recruitment maneuver, C. providing PEEP N & P, pg. 1218 Stefania

3. All of the following are potential causes of brachial plexus injuries EXCEPT: A. arms not secured to arm board B. arms abducted less than 90 degrees C. arm abduction and lateral flexion of the head to the opposite side D. shoulder braces placed too medially or laterally

Answer: B, arms abducted less than 90 degrees N & P, pg. 413 Stefania

1. Parasympathetic innervation of the GI primarily consists of what nerve? A. glossopharyngeal B. vagus C. hypoglossal D. spinal accessory

Answer: B, vagus N & P, pg. 1084 Stefania

1. Even when an epidural is employed in labor, uterine rupture is often accompanied by the abrupt onset of which of the following symptoms? (select 2) a. Hypertension b. Hypotension c. Abdominal pain d. Tachycardia

Answer: B,C- Hypotension and continuous abdominal pain Morgan & Mikhail's Clinical Anesthesiology pg. 863 Stetler

3. Atrial enlargement predisposes patients to which of the following? (Select 2) a. Torsades de pointes b. Atrial fibrillation c. Premature atrial complexes d. Atrial flutter

Answer: B,D- Atrial fibrillation and Atrial flutter M&M pg. 909 stetler

4. Labor is considered "preterm" when it occurs between how many weeks gestation? a. 15-20 b. 20-37 c. 37-40

Answer: B- 20-37 weeks gestation Morgan & Mikhail's Clinical Anesthesiology pg. 863 Stetler

1. Although permanent neurological complications are rare following peripheral blocks, transient neuropathies occur in what percent of patients? a. 2% b. 3% c. 4% d. 5%

Answer: B- 3% N&P pg. 1104 stetler

1. What is the most common cause for a major hemolytic transfusion reaction? a. Allergic reaction b. Human error c. Rapid transfusion d. Infection

Answer: B- Human error N&P pg. 1025 Stetler

1. Blood transfusions should be given as ________, which will allow optimal utilization of blood bank resources. a. RBC's b. PRBC's c. Platelets d. Whole blood

Answer: B- PRBC's Morgan & Mikhail's Clinical Anesthesiology pg. 1171 stetler

2. When a spinal anesthetic is used, which of the following determines the level of anesthesia? a. The baracity of the solution b. Patient positioning c. The dose of local anesthetic d. The volume of local anesthetic

Answer: B- Patient positioning Morgan & Mikhail's Clinical Anesthesiology pg. 958 Stetler

2. The pudental nerve arises from which of the following nerve roots? a. S1-S3 b. S2-S4 c. S1-S5 d. L10-S1

Answer: B- S2-S4 M&M pg. 1071 Stetler

1. Bilateral hip arthroplasty may be safely performed in patients as a combined procedure assuming the absence of significant _____________ after insertion of the first femoral component. a. DVT b. Pulmonary embolization c. EKG changes d. Mental status changes

Answer: B- pulmonary embolization Morgan & Mikhail's Clinical Anesthesiology pg. 797 stetler

3. What is the duration of action of lidocaine when administered with epinephrine a. 60 min b. 60-90 min c. 100-150 min d. 120-240 min

Answer: B-60-90 min Morgan & Mikhail's Clinical Anesthesiology pg. 958 Stetler

1. For a patient with poor preoperative ventricular function, ___________ should be administered as the first line agent prior to separation of CPB a. Phenylephrine b. Milrinone c. Inamrinone d. Epinephrine

Answer: B-Milrinone Morgan & Mikhail's Clinical Anesthesiology pg. 464 stetler

5. Which of the following is NOT a common indication for sympathetic nerve blockade? a. Visceral pain b. Somatic pain c. Peripheral vascular disease d. Reflex sympathetic dystrophy

Answer: B-Somatic pain M&M pg. 1072 Stetler

4. Low molecular weight heparin is ordered for a patient to prevent DVT's. How long must you wait until after removal of the epidural catheter before initiating the first dose? A. 1 hour B. 2 hours C. 4 hours D. 8 hours

Answer: B. 2 hour. M&M pg. 949. Blair Ryan

4. What is the dose of heparin administered before catheter manipulation for systemic anticoagulation during an EVAR? A. 100-200 units/kg B. 50-100 units/kg C. 25-50 units/kg D. 75-100 units/kg

Answer: B. 50-100 units/kg N & P pg: 576 Stefania

3. Select the false statement regarding bier blocks. A. Releasing the tourniquet too early may result in local anesthetic toxicity. B. Bier blocks are limited to extremities. C. Bier blocks duration of action is up to 6 hours D. Another name for Bier blocks is IV regional anesthesia.

Answer: C. Bier blocks provide surgical anesthesia for short surgical procedures (45-60 min) on an extremity. Blair Ryan M&M pg 1000.

1. Which method to determine hemodynamic & intravascular status in real time is best evidenced? A. Central Venous Pressure (CVP) B. Pulmonary Artery Occlusive Pressure (PAOP) C. Doppler Echocardiogram D. Creatinine Clearance

Answer: C. Doppler Echocardiogram. esophageal Doppler, or transesophageal echocardiography should be considered when accurate determination of hemodynamic and fluid status is important. M&M pg. 1163. Blair Ryan

1. Tourniquet time including inflation and deflation should be documented by A. CRNA B. OR nurse C. Both D. Is not usually documented.

Answer: C. The time of inflation should be documented in the anesthesia record and should be in parallel with the time documented in the operating room (OR) record. Nagelhout. Pg. 1000. Blair Ryan

4. Which ABO blood type is considered the universal recipient? A. Type A B. Type B C. Type AB D. Type O

Answer: C. Type AB Type AB has both Antigen A and Antigen B, no antibodies present. M&M pg. 1169. Blair Ryan

1. All of the following are risk factors for aortic aneurysms EXCEPT: A. diabetes mellitus B. smoking C. female gender D. chronic obstructive pulmonary disease

Answer: C. female gender N & P pg: 575 Stefania

4. Which of the following induction agents is best for a patient with cardiac tamponade? A. propofol B. etomidate C. ketamine D. thiopental

Answer: C. ketamine N & P, pg. 534 Stefania

3. What drugs may be used in cardiac surgery in patients that are having repeat operation; who refuse blood products; who are at high risk for postoperative bleeding; who have preexisting coagulopathy; and who are undergoing long and complicated procedures involving the heart or aorta? A. glycoprotein IIb/IIIa inhibitors B. (abciximab [RheoPro], eptifibatide [Integrilin], or tirofiban [Aggrastat]) C. Warfarin [Coumadin] D. -aminocaproic acid and tranexamic acid

Answer: D The antifibrinolytic agents currently available, -aminocaproic acid and tranexamic acid, do not affect the ACT and only rarely induce allergic reactions. Morgan & Mikhail pg. 457.

5. Which of the following is considered the single most significant risk factor influencing long-term survivability in a patient who requires abdominal aortic reconstruction? a. Diabetes Mellitus b. Age c. Renal dysfunction d. Coronary artery disease

Answer: D coronary artery disease N&P pg. 568 Stetler

2. Despite left uterine displacement, hypotension occurs with spinal anesthesia in what % of obstetric patients undergoing cesarean delivery? A. 50% B. 60% C. 25% D. 80%

Answer: D, 80% N & P, pg. 1143 Stefania

3. What 2 electrolyte abnormalities can result from massive blood transfusion? A. hyperkalemia, hypercalcemia B. hypokalemia, hypocalcemia C. hypokalemia, hypercalcemia D. hyperkalemia, hypocalcemia

Answer: D, hyperkalemia, hypocalcemia N & P, pg. 1176 Stefania

1. Which of the following characteristics correctly correlates with compartment syndrome? A. increased pressure, increased tissue perfusion B. decreased pressure, increased tissue perfusion C. decreased pressure, decreased tissue perfusion D. increased pressure, decreased tissue perfusion

Answer: D, increased pressure, decreased tissue perfusion N & P, pg. 412 Stefania

5. All of the following are appropriate treatments for conservative management of PDPH EXCEPT? A. caffeine B. adequate hydration C. oral analgesics D. upright sitting position

Answer: D, upright sitting position N & P, pg. 1085 Stefania

4. Arginine vasopressin should be used in patients with which of the following characteristics? a. Refractory hypotension b. Low SVR c. Resistance to norepinephrine d. All the above

Answer: D- All the above Morgan & Mikhail's Clinical Anesthesiology pg. 465 stetler

3. Transfusions of FFP are indicated in the treatment of which of the following? a. Isolated factor deficiencies b. Reversal of warfarin therapy c. Correction of coagulopathy associated with liver disease d. All of the above

Answer: D- all of the above Morgan & Mikhail's Clinical Anesthesiology pg. 1171 stetler

1. Epinephrine can prolong the duration of action of tetracaine by more then ________ % a. 20 b. 30 c. 40 d. 50

Answer: D-50% Morgan & Mikhail's Clinical Anesthesiology pg. 958 Stetler

4. At which of the following levels can an epidural block be performed? a. Lumbar b. Thoracic c. Cervical d. All of the above

Answer: D-All of the above Morgan & Mikhail's Clinical Anesthesiology pg. 958 Stetler

5. Low molecular weight heparin is ordered for a patient to prevent DVT's. How long must you wait until after a dose of heparin to remove the epidural catheter? A. 1 hour B. 2 hours C. 4 hours D. 10 hours

Answer: D. 10 hours. M&M pg. 949. Blair Ryan

5. As an anesthesia provider preparing for Congenital Hernia Repair you should do all of the following except: Choose the incorrect statement. A. Monitoring must include blood pressure, ECG, pulse oximetry, capnography, temperature, and heart rate. B. All conditions that can increase pulmonary vascular resistance—hypoxia, hypothermia, or acidosis—must be avoided. C. Carbon dioxide should be kept at normal or slightly elevated levels and oxygen saturation maintained above 80 mmHg. D. All of the above correct

Answer: D. All of the above correct Nagelhout pg. 1184 Blair Ryan

3. All of the following are advantages of EVAR EXCEPT: A. no aortic cross clamping B. improved hemodynamic stability C. decreased blood loss D. decreased time

Answer: D. decreased time N & P pg: 575 Stefania

4. Due to decreased protective airway reflexes found in the elderly, all of the following are appropriate anesthesia considerations EXCEPT: A. RSI with GA B. ensure full reversal of NMB C. vigilant monitoring D. deep extubation

Answer: D. deep extubation N & P, pg. 1218 Stefania

1. While performing an axillary block, which of the following nerves are typically missed and need to be blocked separately? A. radial nerve B. ulnar nerve C. median nerve D. musculocutaneous nerve

Answer: D. musculocutaneous nerve N & P, pg. 1113 Stefania

3. Which of the following options most accurately describes visceral pain? A. Well localized, sharp in nature, and generally hurts at the point or area of stimulus. B. Dull, cramping, or squeezing pain that is vague in nature C. Burning, tingling, or shocklike pain D. Intense enough to bring you to tears

B. Dull, cramping, or squeezing pain that is vague in nature Abe N&P page 1244, 2nd column 1st paragraph

The exothermic reaction and expansion of hardening bone cement can lead to: (select 3) A. 2nd degree burns in surrounding tissue B. Embolism of cement, bone marrow, and fat into venous channels C. Systemic absorption of methylmethacrylate, with resulting vasodilation D. Intramedullary hypertension (>500 mm Hg.)

B. Embolism of cement, bone marrow, and fat into venous channels C. Systemic absorption of methylmethacrylate, with resulting vasodilation D. Intramedullary hypertension (>500 mm Hg.) M&M Ch. 38 pg. 790 K. Jensen

5. The practice of anesthesia for elderly patients is built on ________? a. Experience b. Evidence-based concepts c. Policies and procedures of each hospital d. Common sense

B. Evidence-based concepts Reference: N&P pg 1222

Patients with long bone fractures are predisposed to ____________. A. Venous thromboembolism B. Fat embolism syndrome C. Rhabdomyolysis D. Peripheral nerve damage

B. Fat embolism syndrome M&M Ch. 38 pg. 790 K. Jensen

1. Which of the following is not a clinical manifestation of hypernatremia? a. Hypovolemia b. Hypervolemia c. Muscle Twitching d. Seizure

B. Hypervolemia N&P 387

Some of the most devastating neurological consequences of thoracic aortic aneurysm (TAAA) surgery are: (select 2) A. Loss of taste B. Immediate Paraplegia C. Delayed Paraplegia D. Facial droop

B. Immediate Paraplegia C. Delayed Paraplegia N&P Ch. 25 pg. 573 K. Jensen

Laboratory evaluation of intravascular volume status and tissue perfusion include: serial hematocrit, arterial pH, urine specific gravity or osmolality, BUN to serum creatinine ratio. These measurements are *direct/indirect* and often cannot be relied upon intraoperatively because laboratory results are often *delayed/immediate* and may be affected by other perioperative factors. (select 2) A. Direct B. Indirect C. Immediate D. Delayed

B. Indirect D. Delayed M&M Ch. 51 pg. 1162 K. Jensen

3.) What is the largest interlaminar space? (N and P, page 1081) A. C2 B. L5 C. C1 D. S1

B. L5 Maggie

Codeine is transformed by the liver into ________________. A. Norepinephrine B. Morphine C. Dilaudid D. Methadone

B. Morphine M&M Ch. 47 pg. 1058 K. Jensen

1.) What function do the A-alpha nerve fibers hold? (N and P, page 1074) A. Sensory B. Motor C. Proprioception D. Pain

B. Motor Maggie

Choose the correct statement in regard to placement of a thoracic epidural. A. Needle angulation is more caudad compared to lumbar epidural B. Needle angulation is more cephalad compared to lumbar epidural C. The needle is not angulated cephalad or caudad D. The thoracic interspaces are much wider than the lumbar interspaces

B. Needle angulation is more cephalad compared to lumbar epidural N&P page 1070, 2nd column 4th paragraph Abe

Patients who experience _______ _______ require escalating doses to maintain the same effect. A. Decreasing Tachyphylaxis B. Opioid Tolerance C. Withdrawal symptoms D. Sedation & Nausea

B. Opioid Tolerance M&M Ch. 47 pg. 1058 K. Jensen

Within the United States increased mortality risks are associated with which 3 groups of women? A. Under age 18 B. Over age 35 C. African American D. No prenatal care

B. Over age 35 C. African American D. No prenatal care M&M Ch. 41 pg. 844 K. Jensen

Serial concentrations of hemoglobin and hematocrit reflect the ratio of blood cells to __________. A. Albumin B. Plasma C. Intravascular fluid volume D. Blood loss

B. Plasma M&M Ch. 51 pg. 1167 K. Jensen

1. Which of the following is not a component of Normal saline a. Sodium b. Potassium c. Bicarb d. Chloride

B. Potassium C. Bicarb Mbom

Late indications for hypervolemia in patients with CHF include: (select 3) A. Pitting edema B. Pulmonary crackles and rales C. Wheezing D. Elevated jugular pulse pressure

B. Pulmonary crackles and rales C. Wheezing D. Elevated jugular pulse pressure M&M Ch. 51 pg. 1162 K. Jensen

The preoperative assessment for a patient with a DTAA should include cardiac, renal and neurological evaluations. Hoarseness in a patient may reveal compression of the ________nerve. A. Trigeminal Nerve B. Recurrent Laryngeal Nerve C. Facial Nerve D. Superior Laryngeal Nerve

B. Recurrent Laryngeal Nerve N&P Ch. 25 pg. 573 K. Jensen

4. Which of the following is a cause of hypokalemia? a. Vomiting b. Redistribution of potassium from ECF to ICF c. Redistribution of potassium from ICF to ECF d. Decreased potassium intake.

B. Redistribution of potassium from ECF to ICF. N&P 387 Justin

Which of the following is NOT one of the great vessels that branch off from the aortic arch? A. Brachiocephalic artery B. Right common carotid artery C. Left common carotid artery D. Left subclavian artery

B. Right common carotid artery N&P page 471 figure 23-2 Abe

5.) In a sciatic nerve block, what nerves lie medial to the tibial nerve? (SELECT 2) (N and P, page 1122) A. Biceps femoris B. Semimembranosus C. Semitendinosus D. All of the above

B. Semimembranosus C. Semitendinosus Maggie

2.) What are the signs of Horner's Syndrome? (SELECT 3) (N and P, page 1110) A. Hypotension B. Triad of miosis C. Partial ptosis D. Loss of hemifacial sweating

B. Triad of miosis C. Partial ptosis D. Loss of hemifacial sweating Maggie

3. When fitting for a tourniquet, the size should be _____ of the limb diameter. a. ¾ b. Half c. Doubled d. Tripled

B. half N&P pg 1000 rebecca

1. What is the one of the greatest concerns when a tourniquet is used? a. The actual pain the tourniquet may cause b. The perception of tourniquet pain c. The damage it may cause to the surrounding tissues i. N&P pg 1000

B. the perception of tourniquet pain N&P pg 1000 rebecca

How long prior to surgery does the Society of Thoracic Surgeons recommend discontinuing aspirin prior to elective surgery? a. 1-3 days b. 3-5 days c. 5-7 days d. 7-14 days

B: 3-5 days NP: 523 Byron

4. Which of the following correctly describes the movement of ions by the Na-K-ATPase pump? A. 1 Na+ pumped out of cell for every 1 K+ pumped into cell B. 2 Na+ pumped out of cell for every 1 K+ pumped into cell C. 3 Na+ pumped out of cell for every 2 K+ pumped into cell D. 3 Na+ pumped out of cell for every 3 K+ pumped into cell

C. 3 Na+ pumped out of cell for every 2 K+ pumped into cell N&P page 382, 1st column 4th paragraph Abe

Which of the following pediatric patients would you expect to have a higher MAC, based on age alone? A. 1 Week old neonate B. 12 year old C. 4 month old D. 6 year old

C. 4 Month old Justin N&P 1192

The maternal mortality index includes the number of women who die while pregnant and within _____ days of the termination of pregnancy. A. 30 B. 60 C. 42 D. 15

C. 42 M&M Ch. 41 pg. 844 K. Jensen

How much glucose is contained in 5% Dextrose in water? a. 500 mg/L b. 50 mg/L c. 50 g/L d. 5 g/L

C. 50 g/L (M&M pg. 1179) Josh

2.) What platelet level warrants transfusion? (N and P, page 397) A. 125 x 103 B. 150 x 103 C. 50 x 103 D. 175 x 103

C. 50 x 103 the 3 at the end is an exponent Shackelford

4. What percentage of individuals over the age of 70 years will have at least one chronic illness? a. 30% b. 40% c. 50% d. 60%

C. 50% Reference: N&P pg 1221 Mandy

The intracellular fluid compartment contains approximately what percent of the body's total fluid volume? A. 10% B. 30% C. 66% D. 90%

C. 66% N&P page 382, 1st column 4th paragraph Abe

How much more potent is dilaudid than morphine? (N and P, page 1250) A. One is not more potent than the other B. 5-10 times more potent C. 7-8 times more potent D. 1000 times more potent

C. 7-8 times more potent Maggie

What is the average blood volume for an infant? A. 90-100 ml/kg B. 85-90 ml/kg C. 80 ml/kg D. 60 ml/kg

C. 80 ml/kg N&P page 395, Table 20-11 Abe

Glycine toxicity is seen in patients with a deficiency of L-arginine, which is a by-product of which of the following? (N and P, 411) A. Luadonisine B. Lactic Acid C. Ammonia D. Bicarbonate

C. Ammonia Maggie

Which of the following is NOT a sign of tension pneumothorax? a. Tachycardia b. Hypotension c. Bradycardia d. Tracheal shift

C. Bradycardia N&P Page 1003, Box 40-3 Justin

4. Which of the following options most accurately describes neuropathic pain? A. Well localized, sharp in nature, and generally hurts at the point or area of stimulus B. Dull, cramping, or squeezing pain that is vague in nature C. Burning, tingling, or shocklike pain D. Intense enough to bring you to tears

C. Burning, tingling, or shocklike pain Abe N&P page 1244, 2nd column 1st paragraph

5. What ion is responsible for the plateau phase (phase 2) during the cardiac action potential? a. Na+ b. K+ c. Ca++ d. Cl-

C. Ca++ N&P: 478 Justin

3. Patients with fixed- volume cardiac states are at risk for what compromise? a. Respiratory b. Renal c. Cardiovascular d. Hepatic

C. Cardiovascular N&P 1103 Rebecca

The 2 leading causes of maternal mortality associated with a live birth in 2010 were: A. Amniotic fluid embolism B. Hypertensive disorders of pregnancy C. Cardiovascular diseases D. Cardiomyopathy

C. Cardiovascular diseases D. Cardiomyopathy M&M Ch. 41 pg. 844 K. Jensen

Polymophic neutrophils (PMNs) and macrophages are released from the bone marrow and circulate in the blood for <24 hours. How do they make their way into the site of inflamed tissue? A. Osmosis B. Diffusion C. Diapedisis D. Infiltration

C. Diapedisis N&P Ch. 41 pg. 1015 K. Jensen

Which of the following is true regarding pain modulation? A. It always suppresses the pain impulse B. It always enhances the pain impulse C. It can both enhance or suppress the pain impulse D. It happens only in the peripheral site of injury

C. It can both enhance or suppress the pain impulse N&P 1246 Justin

Which of the following is ALWAYS an absolute contraindication to neuraxial anesthesia? a. hypovolemia b. Mallampati score of 2 c. Patient refusal d. ASA class 4

C. Patient Refusal N&P 1075 Justin

A patient requires a forceps delivery. She already has an epidural infusion of 0.125% bupivacaine for labor pain, what other analgesic option is appropriate for this procedure? (N&P pg 1131) a. Paracervical nerve block b. Current epidural infusino is adequate, nothing extra needed c. Pudendal nerve block d. Vonversion to spinal analgesia

C. Pudendal nerve block

5. Which of the following lung volumes is increased in the geriatric lung? A. Forced Vital Capacity B. Forced Expiratory Volume in 1 second. C. Residual Volume D. Small airway diameter

C. Residual Volume N&P 1217 Justin

The highest incidence of severe obstetric morbidity is: A. HELLP syndrome B. Severe preeclampsia C. Severe hemorrhage D. Uterine rupture

C. Severe hemorrhage M&M Ch. 41 pg. 845 Table 41-1 K. Jensen

How does diaphragmatic elevation during pregnancy change the position of the heart in the thoracic cage? A. The heart is shifted down and to the left B. The heart is shifted down and to the right C. The heart is shifted up and to the left D. The heart is shifted up and to the right

C. The heart is shifted up and to the left N&P page 1127, 1st column 5th paragraph Abe

4.) What is the greatest risk associated with intravenous regional anesthesia (IVRA)? (N and P, page 1116) A. Hypotension B. Sepsis C. The potential transfer of a large amount of local anesthetic from the extremity to the central circulation D. Nerve injury

C. The potential transfer of a large amount of local anesthetic from the extremity to the central circulation Maggie

What is the most frequently encountered problem with long term intrahtecal opioid administration? a. Nausea b. Pruritis c. Tolerance d. Respiratory depression

C. Tolerance (M&M 1059) Josh

Excessive pressure on the medial epicondyle of the humerus is a common cause for injury of what nerve? A. Radial B. Median C. Ulnar D. Sciatic

C. Ulnar Justin N&P 409

Which of the following statements regarding obtaining informed consent to perform regional anesthesia is FALSE? A. The patient should be informed of the acceptable techniques that will provide analgesia or anesthesia B. Significant risks and benefits should be discussed C. The patient's questions should be answered completely D. Avoid discussing the major risks in order to decrease the patient's anxiety

D. Avoid discussing the major risks in order to decrease the patient's anxiety N&P page 1102, 2nd column 2nd paragraph Abe

Which of the following is NOT a risk factor for the development of atherosclerosis? A. Hypercholesterolemia B. Elevated triglycerides C. Cigarette smoking D. Hypotension

D. Hypotension N&P page 562, Box 25-1 Abe

Which of the following is NOT a factor that affects an elderly patient's ability to thermoregulate? A. Loss of lean body mass B. Increased total body fat C. Decreased metabolic rate D. Increased total body water

D. Increased total body water Abe N&P page 1215, 1st column 3rd paragraph

Which patient poplation are ulnar neuropathies more common in? (N and P, page 407) A. Woman; older than age 50 B. Men; older than age 60 C. Women; older than age 65 D. Men; older than age 50

D. Men; older than age 50 Maggie

1. Which of the following solutions is NOT used as "prime" in the CPB circuit? a. Normosol-R b. Lactated Ringers c. Plasmalyte-A d. Normal Saline

D. Normal Saline N&P: 517 Justin

Which of the following is NOT a source from which the right atrium receives blood flow? A. Superior Vena Cava B. Inferior Vena Cava C. Coronary Sinus D. Pulmonary Veins

D. Pulmonary Veins N&P page 471, 1st column 4th paragraph Abe

You are caring for a pregnant patient who is undergoing non-obstetric surgery, and no previous cardiac history. While listening to her heart you hear a grade 1 systolic murmur. What is the most appropriate action after obtaining this information? A. Immediately cancel the case B. Obtain cardiac clearance before proceeding with surgery C. Obtain a stat echocardiogram D. Recognize this is likely a benign murmur caused by increased fluid volume during pregnancy

D. Recognize this is likely a benign murmur caused by increased fluid volume during pregnancy N&P page 1127, 1st column 5th paragraph Abe

Which of the following structures is not an important landmark for the anesthesia provider to identify with the needle when performing neuraxial anesthesia? A. Supraspinous ligament B. Interspinous ligament C. Ligamentum flavum D. Round ligament

D. Round ligament N&P page 1071, 2nd column 2nd paragraph Abe

To what level should a spinal be for a TURP procedure? a. T5 b. L1 c. L4 d. T10

D. T10 N&P Page 1075 Justin

Which of the following test results would require intervention before a patient could be cleared to have a total joint replacement? A. Hgb of 13 B. WBC of 8 C. Platelet count of 200 D. UA results showing WBC of 30, 4+ bacteria, positive nitrite, & positive leukocyte esterase

D. UA results showing WBC of 30, 4+ bacteria, positive nitrite, & positive leukocyte esterase N&P page 999, 1st column 4th paragraph Abe

Patients who have pelvic, hip, or knee surgery are at increased risk for ____________. A. Peripheral nerve damage B. Fat embolism syndrome C. Rhabdomyolysis D. Venous thromboembolism

D. Venous thromboembolism M&M Ch. 38 pg. 790 K. Jensen

Which of the following is NOT a normal shunt that exists in fetal circulation? A. Ductus venosus B. Foramen ovale C. Ductus arteriosus D. Ventricular septal defect

D. Ventricular septal defect N&P page 1163, 2nd column 1st paragraph Abe

4. What 2 changes in newborn lung volumes result in rapid desaturation with interruption of ventilation? a. Decreased FRC and increased O2 consumption b. Increased TV and increased total lung capacity c. Decreased respiratory rate and decreased residual volume d. Decrease in size and decrease in resistance

Decreased FRC and increased O2 consumption Charlie N&P pg. 1167

3. How is vital capacity in the newborn when compared to an adult. a. Decreased by half b. Three times more c. They are the same d. Four times more

Decreased by half Charlie N&P pg. 1167

3. Which of the following does NOT affect the transfer of free (non-protein-bound) drug across the placenta? a. Molecular weight b. Concentration gradient c. Lipid Solubility d. Ionization e. All of the above affect transfer of a drug.

E. All of the above affect the transfer of a drug. N&P 1131 Justin

2. Which of the following electrolyte imbalance is most likely following massive blood transfusion due to citrate toxicity? (M&M pg 1175) a. Hypernatremia b. Hypokalemia c. Hypocalcemia d. Hypermagnesemia

Hypocalcemia

Chvostek's and trousseau sign are associated with a. Hypocalcemia b. Hypermagnesium c. Hyperkalemia d. Hypernatremia

Hypocalcemia Charlie N & P pg. 390

4. According to a study from the Pediatric Perioperative Cardiac Arrest Resgistery what was identified as the greatest cause of pediatric perioperative cardiac arrest? a. Hypovolemia b. Hypoxemia c. Hypokalemia d. Hypertension

Hypovolemia Charlie N&P pg 1294

2. How are the small airways in the neonate and how does this effect breathing? a. Increase airway resistance which increases work of breathing b. Airway resistance is decreased which decreases work of breathing c. Airway resistance in increased which decreases work of breathing d. Airway resistance is the same as in adults

Inrease airway resistance which increases work of breathing Charlie N&P pg. 1167

5. Which of the following blocks used to be described as the spinal of the arm? a. Interscalene b. Suprascapular c. Infrascapular d. Axillary

Interscalene Mbom

Determine if the following airway descriptions are adult descriptions of the airway or pediatric descriptions of the airway. Laryngeal location C2-C4 - Pediatric/Adult Narrowest location of airway is the glottis - Pediatric/Adult Shape of the glottis is V-shaped - Pediatric/Adult Right mainstem bronchus is less vertical - Pediatric/Adult

Laryngeal location C2-C4 - Pediatric Narrowest location of airway is the glottis - Adult Shape of the glottis is V-shaped - Adult Right mainstem bronchus is less vertical - Pediatric N&P Chapter 47, page 1166 Jennifer

5. It is recommended to reduce risk of sudden intraoperative cardiac arrest to keep the adult heart rate? a. Less then 130 bpm b. Under 200 c. 30-40 d. HR doesn't matter if there is a good blood pressure

Less then 130 bpm Charlie N&P pg 1294

The ......... valve separates the LA and LV?

Mitral valve Mbom

2. Brachial plexus block at the level of the cords provides excellent anesthesia for what procedures? (M&M pg 975) a. Shoulder arthroplasty b. Humerus fracture c. ORIF of radius d. Clavicle repair

ORIF of radius

4. When performing an intercostal nerve block, the use of a 22-gauge short-beveled needle will result in a. Reduces risk of pneumothorax or pleural injection b. Decreases success of block c. Increase risk of direct nerve damage d. This needle should not be used ever

Reduces risk of pneumothorax or pleural injection Charlie N&P pg. 1119

All of the following are causes of Hypocalcemia accept a. Renal failure b. Sepsis c. Pancreatitis d. Burns

Renal failure Charlie N & P pg. 390

To decrease malpractice liability when unexpected events occur, the anesthesia provider must: (Select 3) A. Seek necessary consultations. B. Execute a treatment plan to mitigate injury. C. Generate an appropriate differential diagnosis. D. Deviate from acceptable practices.

Seek necessary consultations. B. Execute a treatment plan to mitigate injury. C. Generate an appropriate differential diagnosis. M&M Ch. 54 pg. 1200 K.Jensen

2. What spinal needles will often require the use of an introducer? a. Spinal needles smaller than 25 gauge b. Spinal needles larger than 25 gauge c. All spinal needles use an introducer d. Introducers are never used with spinal needles

Spinal needles smaller than 25 gauge Charlie N&P pg. 1080

Which of the following is not found in the costal groove of the rib? a. Subclavian artery b. Intercostal artery c. Intercostal vein d. Intercostal nerve

Subclavian artery Charlie N&P pg. 1117

4. What treatment for a thoracic aortic lesion will increase chance of long term survival a. Surgical intervention b. High dose medication regiment c. Ignore it d. Chronic hypertension

Surgical intervention Charlie N&P pg. 572

5. How does the diaphragm of the newborn respond to NDMRs when compared to their peripheral musculature? a. The diaphragm is more responsive to NDMR b. The diaphragm reacts the same as peripheral musculature c. NDMR are never used in newborns d. The diaphragm is not affect by NDMR

The diaphragm is more responsive to NDMR Charlie N&P pg. 1167

3. What is the correct needle placement when performing an intercostal block a. The needle should first make contact with the rib and then walked caudal off the rib b. The needle should pass easily between the ribs making sure not to make contact with the ribs c. The needle should be placed just cephalad of the target rib d. The needle should first make contact with the rib and then walked cephalad

The needle should first make contact with the rib and then walked caudal off the rib Charlie N&P pg. 1118

5. Which of the following volumes of local anesthetic would be appropriate to inject for an epidural per segment? (Select one) a. 1.5 mL b. 1 mL c. 10 mL d. 0.7 mL

a. 1.5 mL N&P 1091 Jason Franklund

1. Match the hemoglobin level with the associated reduction of volume by blood loss in a hemorrhage situation. (N&P ch20, pg 398) a. Hgb >= 10g/dL b. Hgb 8-10g/dL c. Hgb 6-8g/dL d. Hgb =<6g/dL i. 1. 30-40% reduction in volume or 1500-2000ml blood loss ii. <15% reduction in volume or <750ml blood loss iii. >40% reduction in volume or >2000ml blood loss iv. 15-30% reduction in volume or 750-1500mls blood loss

a-ii b-iv c-i d-iii Hale

A newborn presenting to the operating room for repair of gastroschisis or an oomphalocele exhibits multiple complicating factors for the anesthesia provider. Some of these include: (select all that apply) (N&P ch47, pg 1185) a. Severe dehydration b. Massive fluid loss from exposed viscera c. Internal third-spacing of fluid due to bowel obstruction d. Hyperthermia e. Potential for sepsis f. Postoperative ventilation requirements

a. b. c. e. f. Hale

Maintenance of anesthesia in a patient with aortic stenosis can be managed with what actions by the anesthesia provider? (N&P ch23, pg 502) a. Avoid muscle relaxants that can cause histamine release b. Using higher-dose opioid based techniques c. Administering higher concentrations of inhaled agents d. Use of volatile agents in combination with nitrous oxide

a. b. d. Hale

The degree of regurgitation in aortic insufficiency depends on which three factors? (N&P ch23, pg 502) a. Diastolic time b. Diastolic pressure gradient c. Right ventricular filling pressures d. Degree of incompetence of aortic valve

a. b. d. Hale

Children with repaired EA/TEF can experience problems later in life relating to the surgery. These include: (N&P ch 47, pg 1186) a. Diverticulum at the site of the old fistula b. Delayed failure of the anastomosis c. Esophageal strictures d. All of the above

a. c. Hale

5. Clinical benefits of leukoreduction (filtering out WBC's) for the treatment of transfusion reactions include which two of the following: (N&P ch20, 399) a. Reduced risk of CMV transmission b. Abolished risk of organ dysfunction c. Reduced risk of Hepatitis A d. Reduced frequency and severity of Non-Hemolytic Febrile Transfusion Reactions

a. d. Hale

The two greatest risk factors for perioperative vision loss in prone patients during spinal surgery receiving general anesthesia are (choose 2): a. Prolonged procedure length b. Patients of African descent c. Middle aged patients. d. Substantial blood loss Nagelhout and Plaus ch 40, pg 1010

a. d. Hale

How is EF calculated a. (SV-EDV) x 100 b. SV + ESV / 100 c. EDV + ESV/ SV d. HR x SV x 100

a. (SV-EDV) x 100 Crouse N&P pg. 482

4. At what vertebral interspace should an epidural needle be placed for each of the following procedures? (Matching) a. labor i. L2-L3 b. upper abdominal surgery ii. T8-T10 c. thoracic surgery iii. T4-T5 d. shoulder surgery iv. C7-T1

a. - i. b. - ii. c. - iii. d. -iv. N&P 1091 Jason Franklund

3. What is the appropriate bolus (mg) and lockout interval (min) for adult Hydromorphone 0.2mg/ml? N&P pg 1252 table 51-4 a. 0.05-0.25 mg, 5-10 min b. 0.5-2.5 mg, 5-10 c. 0.05-0.25 mg, 20-30 min d. 0.5-2.5 mg, 20-30 min

a. 0.05-0.25 mg, 5-10 min

SGQ Pain management 1. What is the appropriate bolus (mg) and lockout interval (min) for Morphine 1mg/ml? N&P pg 1252 table 51-4 a. 0.5-2.5 mg 5-10 min b. 0.05-0.25 mg, 1-3 min c. 0.5-2.5 mg, 1-3 min d. 0.05-0.25 mg, 5-10 min

a. 0.5-2.5 mg 5-10 min

2. Pencil-point needles are associated with less than a ____ % risk of PDPH and a failure rate of 5% N&P pg1079 a. 1 b. 10 c. 20 d. 50

a. 1

5. PRBC infusions are generally administered in what ratio? (Select one) a. 1 mL for each 2 mL of blood loss b. 1 mL for each 1 mL of blood loss c. 2 mL for each 1 mL of blood loss d. 2 mL for each 3 mL of blood loss

a. 1 mL for each 2 mL of blood loss NP p. 396 Franklund

2. Normal pediatric doses should not be given until the neonate is how old? a. 1 month b. 2 months c. 3 months d. 6 months

a. 1 month N&P p. 1172 Franklund

4. The risk of hypertension for perioperative complications doubles for every ________ increase in blood pressure a. 20 mmHg systolic/10 mmHg diastolic b. 30 mmHg systolic/ 15 mmHg diastolic c. 15 mmHg systolic/ 20 mmHg diastolic d. 25 mmHg systolic/ 30 mmHg diastolic

a. 20 mmHg systolic/ 10 mmHg dialostic n&p 1215 Rebeccca

2. By how much is blood volume reduced in the geriatric population? a. 20%-30% b. 10%-20% c. 30%-40% d. 25%30%

a. 20%-30% n&p 1215 rebecca

3. Failure to intubate has been reported in to occur as frequently as 1 in ____ ? N&P Pg 1145 a. 250 b. 1000 c. 10000 d. 2500

a. 250 Fieber

4. Which landmark lies 1-2 cm below a line drawn between the posterior iliac spines in children? a. 5th lumbar interspace b. 2nd sacral interspace c. 3rd sacral interspace d. none of the above

a. 2nd sacral interspace Reference: N&P pg 1098 Mandy

When local anesthetic is used intramuscularly for release of direct myofascial pain there is some evidence on myotoxic effects, approximately how long does it take for muscular regeneration? a. 3 - 4 weeks b. 4 - 6 weeks c. 6 - 8 weeks d. 8 - 10 weeks

a. 3 - 4 weeks M&M p. 274 Lexi

4. What is a normal serum magnesium level during pregnancy? (select one) a. 3 mg/dL b. 1.3 mg/dL c. 4.5 mg/dL d. 12 mg/dL

a. 3 mg/dL N&P p. 1151 Jason

5. The percentage of body weight contributed by fat in the neonate is? (Select one) a. 3% b. 12% c. 20% d. 24%

a. 3% N&P p. 1171 Franklund

2. The Osm Of NS 0.9% is? N&P Pg 392 a. 308 b. 140 c. 440 d. 900

a. 308

1. The Osm of 5% albumin is? N&P Pg 392 a. 330 b. 140 c. 440 d. 500

a. 330

5. How Much fluid per hour would you administer in the first hour of resuscitation to a patient who has been NPO for 8 hours and Weighs 45 kg to overcome their fluid deficit not accounting for third spacing? N&P Pg 393 a. 340 ml b. 170 ml c. 85 ml d. 680 ml

a. 340 ml

5. Of patients with heart failure, what is the percentage that will experience mitral regurgitation a. 35% to 50% b. 45% to 50% c. 10% to 20%

a. 35% to 50% n&p pg 514 rebecca

2. Premature labor is defined as regular uterine contractions occurring prior to how many weeks of gestation? (Select one) a. 37 b. 36 c. 38 d. 39

a. 37 N&P p. 1150 Jason

Neonatal compressions should be done with what perfusion to ventilation ratio? a. 3:1 compressions to ventilations per minute b. 1:3 compressions to ventilations per minute c. 2:1 compressions to ventilations per minute d. 1:2 compressions to ventilations per minute

a. 3:1 compressions to ventilations per minute M&M p. 873 Lexi

3. Healthy full-term neonates have normal renal drug clearance by how many weeks? (select one) a. 4 b. 6 c. 8 d. 2

a. 4 N&P p. 1172 Franklund

Which of the following is the correct formula for the appropriate diameter size for an endotracheal tube for the pediatric patient? a. 4 + (age/4) b. 4 - (age/4) c. 3 - (age/3) d. 4 + (age/3)

a. 4 + (age/4) M&M Chapter 42, page 891 Jennifer

The MAC for inhalational agents in the geriatric population is reduced by ___% per decade of age over 40 years. a. 4% b. 5% c. 6% d. 7%

a. 4% M&M Chapter 43, page 914 Jennifer

What ejection fraction is indicative of significant left ventricular impairment a. 40% b. 50 c. 60 d. 70

a. 40% Crouse N&P pg. 482

3. The maximum benefit of corticosterioids administered during tocolysis of premature delivery is achieved at how many hours? (select one) a. 48 b. 36 c. 24 d. 18

a. 48 N&P p. 1150 Jason

1. The majority of MIs will occur how soon after surgery? a. 48 hrs b. 1-2 hrs c. 1-2 weeks d. 1-2 months

a. 48 hrs Charlie N&P pg 1295

While the process can be made to minimize the number of needle insertions, a complete ankle block requires a series of how many blocks? a. 5 b. 4 c. 3 d. 2

a. 5 M&M p. 1017 Lexi

3. When does closing volume exceed FRC? (select 2) a. 65 years of age in the erect position b. 45 year of age in supine position c. 65 years of age in supine position d. 45 years of age in the erect position

a. 65 years of age in the erect position b. 45 year of age in supine position NP 1217 DB

What percentage of Sevoflurane is suggested with 60% nitrous oxide to speed an inhalation induction in a pediatric patient? a. 7-8% b. 8-9% c. 9-10% d. 11-12%

a. 7-8% M&M Chapter 42, page 890 Jennifer

1. Blood volume is approximately ______ ml/kg but may be as high as _____ ml/kg in premature neonate a. 80 - 90; 100 b. 70 -80; 120 c. 60-70; 100 d. 90-95; 100

a. 80-90;100 rebecca n&p

4. How Much fluid per hour would you administer as maintenance to a patient who has been NPO for 8 hours and Weighs 45 kg? N&P Pg 393 a. 85 ml/hr b. 45 ml/hr c. 680 ml/hr d. 340 ml/hr

a. 85 ml/hr

1. Nasal RAE Tubes have all of the following features except? N&P pg 1203 a. 90 degree bend b. 180 degree bend c. Two Murphy eyes d. Additional length and sit closer to the carina to prevent accidental dislodgment.

a. 90 degree bend Fieber

What is the estimated incidence of post-dural puncture headache (PDPH) with the use of non-cutting needles? a. <1% b. 2% c. 3% d. 5%

a. <1% NP: 1079 Byron

3. How can an anesthetist help prevent the development of facial edema in a patient? a. A 10 degree head up tilt b. A 30 degree head up tilt c. Left tilt d. A 25 degree head tilt

a. A 10 degree head up tilt n&p 404 rebecca

4. What is the origin of the ulnar nerve in the brachial plexus? a. A branch of the medial cord b. A branch of the musculocutaneous c. A branch of the lateral thoracic d. A brank of the posterior cord NP 407 "The ulnar nerve traverses the length of the upper extremity from its origins as a branch of the medial cord of the brachial plexus to its terminal branches in the hand."

a. A branch of the medial cord NP 407 "The ulnar nerve traverses the length of the upper extremity from its origins as a branch of the medial cord of the brachial plexus to its terminal branches in the hand." DB

4. What are the most important tests of blood compatibility are those used in determining blood groupings? a. ABO b. Rh c. Antibodies d. Give trial transfusions to figure it out

a. ABO b. Rh Budenbender Nagelhout page 395 "The most important tests of blood compatibility are those used to determine ABO and Rh (also known as type D) blood groupings."

4. Which of the following monoclonal antibodies is used in patients undergoing coronary angioplasty to prevent clotting? a. Abciximab b. Infliximab c. Etanercept d. Rituximab NP ch 41 pg 1021

a. Abciximab Mbom

4. You are performing a pre-op exam on a 37 y/o female that has come to you from the floor. She takes scheduled opioids on a daily basis but the nurse held them today since she was NPO. Which of the following is the most appropriate next action? a. Explain to the patient that this is normal to prevent her from the possibility of aspiration. b. Call the nurse on the floor to ensure the patient receives the scheduled dose as soon as she returns from the OR. c. Administer an equivalent dose of the patient's opioid in the pre-op setting. d. None of the above are correct.

a. Administer an equivalent dose of the patient's opioid in the pre-op setting. Reference: N&P 1257 Mandy

5. Bacterial meningitis is a rare complication after spinal or epidural anesthesia and difficult to directly attribute to the anesthetic, vigilance must be maintained to identify which of the following predisposing factors? (select 3) a. Advanced age b. Diabetes c. Alcoholism d. Scoliosis

a. Advanced age b. Diabetes c. Alcoholism Nagelhout page 1077 Budenbender

1. Select the three risk factors linked to bleeding and blood transfusions: a. Advanced age - 70 years or older b. Low red cell volume either from preoperative anemia and/or small body size c. Urgent or complex surgery involving prolonged CPB times d. Blood transfusion disease

a. Advanced age - 70 years or older b. Low red cell volume either from preoperative anemia and/or small body size c. Urgent or complex surgery involving Nagelhout page 520 Budenbender

Pharyngoesophageal perforation is associated with what 3 characteristics? a. Age >60 b. Age <50 c. Male gender d. Female gender e. Difficult intubation

a. Age >60 d. Female gender e. Difficult intubation M&M Chapter 54 page 1212 Jennifer

4. What two treatments are used to prophylactically prevent HBE (Hypotensive Bradycardia Events)? N&P 1007 a. Aggressive treatment of fluid deficits and blood loss b. Minimize venous pooling c. Zofran preop d. Decadron postop

a. Aggressive treatment of fluid deficits and blood loss b. Minimize venous pooling Fieber N&P 1007

2. Which of the following is the most important when caring for a patient with rheumatoid arthritis? a. Positioning—especially the neck b. Padding pressure points c. Airway maintenance d. Pre-treatment with IV Tylenol for pain

a. Airway maintenance Reference N&P pf 1012 Mandy

What are two potential complications associated with the use of radiocontrast dye when providing anesthesia for the EVAR patient? a. Allergy to contrast dyes b. Hypertension c. Renal compromise d. Diarrhea

a. Allergy to contrast dyes c. Renal compromise (N&P pg 576) Lake

4. What is the recommendation for preventing spinal cord injury from positioning a. Allowing minimum of two fingerbreadths between the sternum and the mandible b. Place 2 pillows under patients head c. Hyperflexion of the head as much as possible d. Firmly secure head to table with tape to prevent movement

a. Allowing minimum of two fingerbreadths between the sternum and the mandible Charlie N&P pg 409

Which of the following contraindications to cell salvage is related to field contamination? a. Amniotic fluid b. Synthetic resins c. Carbon monoxide d. Electrocautery smoke

a. Amniotic fluid N&P p.401 Lexi

2. Which of the following operating tables places the patient in a modified knee-chest position? (Select one) a. Andrews frame b. Wilson frame c. Relton adjustable frame d. Foster frame

a. Andrews frame Jason Franklund N&P p. 1009

2. You are caring for a parturient who is experiencing a hemorrhage what Neonatal sequelae should you anticipate? (Select 2) N&P1178 a. Anemia b. Shock c. Hypoglycemia d. Apnea

a. Anemia b. Shock

2. Which of the following medications are NOT a contraindication to spinal and epidural anesthesia (select 2): a. Aspirin b. NSAIDs c. Clopidogrel

a. Aspirin b. NSAIDs Nagelhout page 1076 Budenbender

1. The "Maze" surgical procedure is performed for the treatment of? (Select one) a. Atrial Fibrillation b. Atrial Flutter c. Supraventricular Tachycardia d. Sinoatrial Arrest

a. Atrial Fibrillation N&P p. 542 Jason

1. From the following select all the primary approaches for blocking the brachial plexus (3): a. Axillary b. Interscalene c. Infraclavicular d. Bier

a. Axillary b. Interscalene c. Infraclavicular NP page 1107 Budenbender

2. Of the 4 primary approaches, which is the most frequently used technique used to produce anesthesia for the forearm and hand? a. Axillary b. Interscalene c. Supraclavicular d. Infraclavicular

a. Axillary NP 1107 Budenbender

Select the MOST important factors effecting the dermatomal spread of spinal anesthesia (select 3) a. Baricity of anesthetic solution b. Position of the patient before injection c. Drug dosage d. Site of injection e. Age f. Drug volume

a. Baricity of anesthetic solution c. Drug dosage d. Site of injection M&M Chapter 45, page 956, table 45-2 Jennifer

2. What occurs when the spinal cord is lengthened a. Becomes thinner, reduced blood flow and ischemia b. Becomes thicker has increased blood flow and oxygenation c. Becomes stronger and has greater venous capacitance d. The spinal cord is not effected from lengthening

a. Becomes thinner, reduced blood flow and ischemia Charlie N&P pg 409

Elderly patients may display lower dose requirements for medications, which of the following is an example of a drug class that the elderly may need a dose reduction in? a. Benzodiazepines b. Beta blockers c. ACE-inhibitors d. Vasopressors

a. Benzodiazepines M&M Chapter 43, page 914 Jennifer

1. Profound hypotension and bradycardia may occur with shoulder surgery in the sitting position with an Interscalene block, related to what reflex? N&P 418 a. Bezold-Jarisch b. Herring-brewer c. Juxtaglomerular d. Conrad

a. Bezold-Jarisch Fieber

Which of the following are physiologic changes that can be anticipated with a neuraxial block with local anesthetics? (Select 4) a. Decrease in SVR b. Increased SVR c. Decreased venous return d. Increased venous return e. Decreased LV filling f. Increased LV filling g. Bradycardia h. Tachycardia

a. Decrease SVR c. Decrease venous return e. Decrease LV filling g. Bradycardia NP: 1078 Byron

4. Which of the following occurs with the aging patient a. Decrease in albumin b. Increase in alpha 1-acid glycoprotein c. Decrease in alpha 1-acid glycoprotein d. Increase in albumin

a. Decrease in albumin b. Increase in alpha 1-acid glycoprotein M&M Ch. 43 Pg. 914 Thetford

1. Which are age-related alterations of the respiratory system? (select 3) a. Decrease in chest wall compliance b. Develop calcifications of chest wall, intervertebral joints, and intercostal joints c. Decreased intercostal muscle mass d. Increased in chest wall compliance

a. Decrease in chest wall compliance b. Develop calcifications of chest wall, intervertebral joints, and intercostal joints c. Decreased intercostal muscle mass NP 1217 DB

3. duration of action of drugs in response to aging? a. Decrease in renal function b. Increase in renal function c. Decrease in hepatic function d. Increase in hepatic function

a. Decrease in renal function c. Decrease in hepatic function M&M Ch. 43 Pg. 914 Thetford

2. The use of NSAIDs in adjunct with systemic opioids has proven to accomplish which of the following? a. Decrease the amount of postop pain b. Decrease opioid related PONV c. Decrease postop bleeding d. Decrease opioid related sedation M&M Ch. 48 Pg. 1099

a. Decrease the amount of postop pain b. Decrease opioid related PONV d. Decrease opioid related sedation M&M Ch. 48 Pg. 1099 Thetford

3. How is chest wall compliance affected in the older adult? a. Decreased b. Increased c. Not effected d. Varies per patient

a. Decreased Charlie N&P PG 1218

5. Why are older patients at an increased risk of pulmonary aspirations a. Decreased airway reflexes b. Decreased tongue size c. Increased inspiratory pressure d. Decreased closing capacity

a. Decreased airway reflexes Charlie N&P PG 1218

4. What are the advantages of using Ketamine on induction of General anesthesia for a C-Section? (Select 2) N&P Pg 1145 a. Decreased analgesic demands up to 24 hours post op b. Indirect sympathomimetic effect helps support BP c. Fetal stability d. Direct inhibition of Mu2 receptors on the anterior horn of the spinal cord.

a. Decreased analgesic demands up to 24 hours post op b. Indirect sympathomimetic effect helps support BP Fieber

Acidosis can alter the extracellular distribution of calcium, which of the following correctly describe this physiologic process? (Select 2) a. Decreases the protein-bound fraction b. Increases the protein-bound fraction c. Decreases the ionized fraction d. Increases the ionized fraction

a. Decreases the protein-bound fraction d. Increases the ionized fraction NP: 389 Byron

3. Prone positioning changes west zone by ______ zone 2, whereas zone 3 _____. N&P 1007 a. Decreasing, Increases b. Increases, Decreases c. Hyperinflation, hypoxemia d. Hypoxemia, Hyperinflation

a. Decreasing, Increases Fieber N&P 1007

5. What is the most frequently occurring neurological complication in older adults postoperatively? N&P Pg 1220 a. Delirium b. PONV c. Loss of bowel function d. Hematoma

a. Delirium Fieber

What marks the beginning of the litigation process? a. Delivery of a summons b. When a grievance is filed c. When the jury is selected d. None of the above

a. Delivery of a summons (M&M pg 1201) Josh

What is the most common persisting airway injury in anesthesia? a. Dental injury b. Lip injury c. Esophageal injury d. Laryngeal injury

a. Dental injury M&M Chapter 54 page 1211 Jennifer

4. Type II endoleaks are caused by collateral retrograde perfusion. Whereas Type I and III are caused by? N&P Pg 577 a. Device-related problems b. Improper positioning c. High blood pressure d. Poor diet

a. Device-related problems Fieber N&P Pg 577

4. Which is NOT a cause of hypovolemic hypernatremia? a. Diabetes Insipidus b. Diuretics c. Respiratory loss d. Adrenal insufficiency

a. Diabetes Insipidus Budenbender Nagelhout Page 386 Figure 20-3

Exsanguination of a single lower extremity with the use of a tourniquet causes rapid shifts of blood into central circulation. This is not typically a concern but exsanguination of both legs may not be well tolerated in the patient with which of the following condition? a. Diastolic dysfunction b. Increased lipids c. Rheumatoid arthritis d. Type 2 diabetes

a. Diastolic dysfunction (M&M pg 791) Josh

1. Every healthcare organization should have a framework for handling critical events and complications embedded in ________? N&P pg 1300 a. Effective communication b. Litigation c. Deposition d. Recorded communication

a. Effective communication Fieber

Match the following cerebral monitoring method with its specific result. a. Electroencephalogram I. Measures cortical electrical function b. Somatosensory evoked potentials. II. Assesses sensory evoked potentials c. Carotid stump pressures III. Assesses perfusion pressure in the operative carotid artery d. Trainscranial Doppler IV. Assesses blood flow velocity in the middle cerebral artery e. Cerebral oximetry V. Assesses cerebral regional oxygen saturation

a. Electroencephalogram I. Measures cortical electrical function b. Somatosensory evoked potentials. II. Assesses sensory evoked potentials c. Carotid stump pressures III. Assesses perfusion pressure in the operative carotid artery d. Trainscranial Doppler IV. Assesses blood flow velocity in the middle cerebral artery e. Cerebral oximetry V. Assesses cerebral regional oxygen saturation (N&P pg 580) Lake

In the anesthetic implications of the review of systems and history, which of the following should be considered for possible anesthetic implications for the central nervous and neuromuscular system? a. Elevated ICP b. Septal defect, avoid air bubbles in IV line c. B-agonist or theophylline drugs d. Risk of aspiration; reactive airways; hypoxia

a. Elevated ICP DB NP 1195

5. How is Dexmeetomidine metabolized? a. Hepatic glucuronide conjugation b. Nonspecific esterase c. Plasma cholinestase d. Unchanged in urine

a. Hepatic glucuronide conjugation Charlie N&P pg 1251

5. Why is it recommended that all agents used in the combined spinal epidural technique be preservative free? a. Preservatives cause anaphylactic reactions in all patients b. Prevents cardiac arrhythmias c. Eliminates any neurotoxic effects d. Using agents with preservatives is acceptable

a. Eliminates any neurotoxic effects Reference: N&P pg 1096 Mandy

5. Select all that apply. Which monoclonal antibodies are used for the treatment of rheumatoid arthritis? a. Etanercept b. Infliximab c. Abciximab d. Basiliximab NP ch 41 pg 1021

a. Etanercept b. Infliximab Mbom

Which of the following tumors are malignant spine tumors? (Select 3) a. Ewing's sarcoma b. Giant cell tumors c. Osteosarcomas d. Eosinophilic granulomas e. Osteomas f. Hemaniomas

a. Ewing's sarcoma b. Giant cell tumors c. Osteosarcomas M&M Chapter 47 page 1047 Jennifer

1. Which of the following is associated with diminished cardiac reserve in the elderly? a. Exaggerated drop in BP during induction of GA b. Excessive increase in BP during induction of GA c. Sustained cardiac function during induction of GA

a. Exaggerated drop in BP during induction of GA M&M page 909 Willie

4. What are the surgical treatments for an extrascapular hip fracture? (Select 2) a. Extramedullary implant b. Intramedullary implant c. Modified arthroscopy d. Paramedullary implant

a. Extramedullary implant b. Intramedullary implant M&M page 794

2. Which of the following blood products is used for the reversal of anticoagulant effects? (Select one) a. FFP b. PRBCs c. Platelets d. Cryoprecipitate

a. FFP N&P p. 396 Franklund

4. Match the blood product with its intended use? (Matching) a. FFP b. Platelets c. Cryoprecipitate d. PRBCs i. reversal of anticoagulant effects ii. hemorrhage prevention iii. hypofibrinogenemia iv. Improve oxygen delivery to tissues

a. FFP i. reversal of anticoagulant effects b. Platelets ii. hemorrhage prevention c. Cryoprecipitate iii. hypofibrinogenemia d. PRBCs iv. Improve oxygen delivery to tissues NP p. 396 Franklund

What clotting factors are found to be absent in banked blood? (Select 2) a. Factor II b. Factor V c. Factor VII d. Factor VIII

a. Factor V d. Factor VIII NP: 396 Byron

What components are contained within cryoprecipitate? (Select 3) a. Factor VIII b. Factor V c. Von Willebrand Factor d. Factor II e. Fibrinogen f. Fibrin

a. Factor VIII c. vWF e. Fibrinogen NP: 398 Byron

5. Which of the following nerves innervates the foot and is not part of the sciatic system? a. Femoral nerve b. Sural nerve c. Common peroneal nerve d. Tibial nerve

a. Femoral nerve M&M Ch. 46 Pg. 1015 Thetford

3. Addition of which drugs to an epidural with local anesthetics will reduce postoperative pain without delaying recovery of bowel function? a. Fentanyl b. Sufentanil c. Toradol d. Paracetamol M&M Ch. 48 Pg. 1099

a. Fentanyl b. Sufentanil M&M Ch. 48 Pg. 1099 Thetford

2. Which of the following are contributing factors to the diminishing chest wall compliance in geriatric population? a. Flattening of diaphragm b. Loss of vertebral disc height c. Change in spinal lordosis d. Rounding of diaphragm

a. Flattening of diaphragm b. Loss of vertebral disc height c. Change in spinal lordosis NP 1217 DB

1. What are the target receptors for Clonidine and dexmedetomidine? a. G-coupled A2 receptors b. G-coupled B1 receptors c. G-coupled A1 receptors d. G-coupled B2 recpetors N&P pg. 1251

a. G-coupled A2 receptors Charlie N&P pg 1251

5. Which of the following is associated with NSAID administration perioperatively? a. GI bleeding b. Decreased kidney function c. Enhanced wound healing d. Reduced opioid requirements by 30% M&M Ch. 48 Pg. 1099

a. GI bleeding b. Decreased kidney function d. Reduced opioid requirements by 30% M&M Ch. 48 Pg. 1099 Thetford

3. Which of the following herbal medicationshas the effect of increased fibrinolysis? a. Garlic b. Gikgo c. Ginseng

a. Garlic Nagelhout page 1076 Tabel 44-2 Budenbender

Prevention of hypothermia and dehydration in addition to preventing infection, are the main goals of managing which congenital disorder? a. Gastrochisis b. Omphalocele c. Hypertrophic pyloric stenosis d. Diaphragmatic hernia

a. Gastrochisis M&M p. 901 Lexi

This congenital disorder occurs lateral to the umbilicus, lacks a hernia sac, and is most commonly an isolated congenital finding. a. Gastrochisis b. Omphalocele c. Hypertrophic pyloric stenosis d. Diaphragmatic hernia

a. Gastrochisis M&M p. 901 Lexi

5. Which of the following anesthesia techniques for cardiac surgery known to be unpopular due to potential legal consequences? (Pick 3) a. General anesthesia with a thoracic epidural b. General anesthetic with an ETT c. Light general anesthesia with a thoracic epidural d. Thoracic epidural only

a. General anesthesia with a thoracic epidural c. Light general anesthesia with a thoracic epidural d. Thoracic epidural only M&M page 453 Willie

When compared to Lidocaine, Bupivicaine is associated with what degree of conduction changes and risk of lethal arrhythmias? a. Greater degree b. Lesser degree c. There is no difference between the two drugs d. Neither drug carries a degree of conduction disturbance or dysrhythmia

a. Greater degree M&M p. 274 Lexi

Cardiovascular disease is the most common concomitant illness in the older adult. What are the most frequently associated cardiovascular coexisting diseases seen? (Select 4). a. HTN b. CHF c. Dysrhythmias d. CAD e. Valvular Disorders f. Myocardial Ischemia g. PVD

a. HTN b. CHF d. CAD f. Myocardial ischemia NP: 1217 Byron

4. Patients with which of the following conditions may safely receive Normal saline? a. Head injury b. Metabolic acidosis c. Alkalosis d. Hyponatremia

a. Head injury b. Alkalosis c. Hyponatremia Reference: N&P Pg 394 Mandy

You have just given report to the PACU nurse following a shoulder arthroscopy with a peripheral block when you are paged to return to the PACU because your patient is experiencing dyspnea, hypercapnia, and hypoxemia. What is the most likely cause? a. Hemidiaphragmatic paresis as a result of an interscalene block b. Aspiration pneumonitis c. Narcotic overdose d. Residual neuromuscular blockade

a. Hemidiaphragmatic paresis as a result of an interscalene block (M&M pg 983) Josh

3. Which of the following are the 2 positions utilized for shoulder arthroscopy procedures? a. Lateral decubitus b. Modified Fowlers c. Trendelenburg d. Jackknife position

a. Lateral decubitus b. Modified Fowlers Nagelhout Chapter 40, Page 1002 "For example, shoulder arthroscopy uses one of two positions to accomplish the surgery, either lateral decubitus or modified Folwler's." Budenbender

2. Where do second-order neurons synapse with third order neurons, which then send projections to the cerebral cortex? (select 2) a. Lateral thalamus b. Intralaminar nuclei c. Tract of Lissauer

a. Lateral thalamus b. Intralaminar nuclei NP 1246 DB

2. Which of the following nerves is most susceptible to injury during thoracic aortic surgery due to its close proximity to the aortic arch? a. Right recurrent laryngeal b. Left recurrent laryngeal c. Neither of the above d. Both of the above

a. Left recurrent laryngeal Reference: N&P pg 573 Mandy

2. What cardiovascular similarities are seen in adults and infants? a. Less ability to respond to hypovolemia with an increased HR b. Less ability to respond to hypertension c. Responds quickly to hypoxia d. None of the above

a. Less ability to respond to hypovolemia with an increased HR M&M, page 910 Willie

What is the most common anesthetic technique used for carotid artery stenting? a. Local anesthetic at the site combined with minimal sedation b. Complete regional anesthesia c. General anesthesia with LMA or ETT d. There is no standard anesthetic technique for this procedure

a. Local anesthetic at the site combined with minimal sedation N&P p. 585 Lexi

Of the following, which are contraindications to an interscalene block? Select all that apply. (M&M pg 982) a. Local infection b. INR of 1.5 c. Severe coagulopathy d. Refusal

a. Local infection c. Severe coagulopathy d. Refusal (M&M pg 982) Josh

Of the following, what are some complications associated with spinal opioid therapy? Select all that apply (select 3) a. Local skin infection b. Renal toxicity c. Epidural abscess d. Liver failure e. Meningitis

a. Local skin infection c. Epidural abscess e. Meningitis (M&M pg 1059) Josh

Which of the following characteristics most accurately describes the shape of the pediatric epiglottis? (Select 2) a. Longer b. Shorter c. More narrow d. Wider e. V-Shaped

a. Longer c. More narrow NP: 1166 Byron

1. Age- related changes to the body composition and its ability to thermoregulate are characterized by: SELECT 3 a. Loss of lean body mass b. Increased total body fat c. Decreased metabolic rate d. Increased total body water

a. Loss of lean body mass b. Increased total body fat c. Decreased metabolic rate n&p 1215 rebecca

Paravertebral block provides anesthesia for which TWO procedure categories? a. Lower abdominal wall surgery b. Thoracic wall surgery c. Upper extremity surgery d. Upper abdominal surgery

a. Lower abdominal wall surgery b. Thoracic wall surgery M&M p. 1019 Lexi

What is the major advantage to using regional anesthesia over general anesthesia in hip surgery in the elderly? a. Lower incidence of DVT b. Lower incidence of pain c. Quicker postoperative recovery d. Increased ease of epidural/spinal placement

a. Lower incidence of DVT M&M p.916 Lexi

1. What is the formula for maximum allowable blood loss? (Select one) a. MABL = EBV x (starting hematocrit - target hematocrit) / starting hematocrit b. MABL = EBV x (target hematocrit + starting hematocrit) / target hematocrit c. MABL = EBV x (starting hematocrit - target hematocrit) / starting hematocrit d. MABL = EBV x (target hematocrit + starting hematocrit) / target hematocrit

a. MABL = EBV x (starting hematocrit - target hematocrit) / starting hematocrit NP p. 395 Franklund

2. How can hypovolemia be unrecognized in the lithotomy and trendelenberg position? a. MAP can appear normal despite volume deficit b. CVP and PAP can be increased c. You will be able to identify it d. There is no such thing

a. MAP can appear normal despite volume deficit n&p 404 rebecca

3. What is true in regards to the use of opioids a. Maintain stable hemodynamics b. Increase respiratory rate c. Cause myocardial depression d. Will require higher doses of inhaled anesthetics

a. Maintain stable hemodynamics Charlie N&P pg. 526

Anaphylactoid reactions are caused by mediator release from what two types of cells in response to a non-IgE mediated triggering event? (Select 2) a. Mast cells b. Basophils c. Leukocytes d. Cytokines

a. Mast cells b. Basophils N&P page 1023 Jennifer

3. Which of the following is not a stage of Bone marrow B cell development? a. Mature B cell b. Lymphoid progenitor c. Stem cell d. Pro-B cell NP ch 41 pg 1020

a. Mature B cell MBom

4. Which of the following nerves are required for an ankle block? a. Medial calcaneal branches of tibial nerve b. Common peroneal nerve c. Saphenous nerve d. Tibial nerve e. Superficial peroneal nerve f. Sural nerve g. Sciatic nerve h. Radial nerve

a. Medial calcaneal branches of tibial nerve b. Common peroneal nerve c. Saphenous nerve e. Superficial peroneal nerve f. Sural nerve M&M Ch. 46 Pg. 1015 Thetford

The ulnar nerve is the continuation of the medial cord of the brachial plexus and maintains a position located where in the upper arm? a. Medial to the axillary and brachial arteries b. Proximal to the axillary and brachial arteries c. Distal to the axillary and brachial arteries d. Transverse to the axillary and brachia arteries

a. Medial to the axillary and brachial arteries M&M Chapter 46, page 996 Jennifer

3. Where do second order neurons cross in the spinal cord? a. Midline of the spinal cord through the anterior commissure b. The lateral aspect of the spinal cord c. The inferior aspect of the spinal cord d. The superior aspect of the spinal cord

a. Midline of the spinal cord through the anterior commissure n&p 1246 rebecca

5. Which of the following opioid doses are appropriate for a caudal epidural? (Select all that apply) a. Morphine 50-70 mcg/kg b. Dilaudid 1-2 mg/kg c. Fentanyl 50-100 mcg d. Metoprolol 25-50 mg

a. Morphine 50-70 mcg/kg c. Fentanyl 50-100 mcg M&M Ch. 45 Pg. 966 Thetford

1. What effects does anesthesia have on the cardiovascular system? (Choose 2) a. Myocardial depression b. Vasodilation c. Vasoconstriction d. Hypercontraction

a. Myocardial depression b. Vasodilation N&P page 403 Willie

5. Once CSF is confirmed with a spinal needle it is recommended to turn the needle 360 degrees in 90 degree increments to ensure what? N&P pg 1080 a. Needle tip is seated well within the subarachnoid space. b. Not touching spinal cord c. In the epidural space d. Not in a blood vessel

a. Needle tip is seated well within the subarachnoid space.

When administering depolarizing or nondepolarizing muscular blocker which of the following vasoactive medications may have significant interactions resulting in potentiation muscle relaxation? a. Nifedipine b. Nipride c. Nitroglycerin d. Labetalol e. Lisinopril

a. Nifedipine (M&M pg 392) Lake

1. Although a delayed hemolytic reaction is typically caused by which of the following? a. Non-D antigens b. Granulocyte colony-stimulating factor (G-CSF) c. Foreign alleles d. IgA antibodies

a. Non-D antigens c. Foreign alleles M&M Ch. 51 Pg. 1171-1172 Thetford

During an emergency transfusion when the recipient's blood type and Rh status is not known with certainty and transfusion must be started before determination, what red blood cells may be used? a. O Rh-negative b. O Rh-positive c. AB Rh-negative d. AB Rh-positive

a. O Rh-negative M&M Chapter 51, page 1170 Jennifer

3. Contraindications to a minimally invasive approach to mitral valve repair include all of the following except? (select one) a. Obesity b. severe aortic regurgitation c. aortic and/or thoracic surgery d. atherosclerosis of the descending aorta or femoral vessels

a. Obesity N&P p. 544 Jason

3. Which of the following are characteristics of early decelerations (select 2) a. Occur with each uterine contraction b. Start and end with the contraction c. Vary in appearance, duration, depth, and shape d. Maintain beat-to-beat variability with deceleration

a. Occur with each uterine contraction b. Start and end with the contraction Nagelhout Page 1133 Budenbender

2. The addition of cross matching a blood specimen prior to transfusion, how much more compatible is the transfusion? a. One hundredth of 1% b. On tenth of 1% c. 1%

a. One hundredth of 1% Budenbender Nagelhout Chapter 20: page 395 "The addition of crossmatching increases the possibility of a compatible transfusion only one hundredth of 1%."

What is the result of compliment activation? Select all that apply a. Opsonization b. Apoptosis c. Chemotaxis d. Activation of mast cells and basophils

a. Opsonization c. Chemotaxis d. Activation of mast cells and basophils (N&P pg 1018) Josh

3. Root cause analysis is based on the premise that adverse events are caused by? N&P pg 1300 a. Organizational processes b. Human errors c. Computer programs d. Patient errors

a. Organizational processes Fieber

Which of the following an example of postoperative intervention the nurse anesthetist can perform to prevent delirium after surgery in the geriatric patient? (Select 3) a. Orient the elderly by providing a clock, calendar or orientation board b. Providing fluid management c. Setting up a bowel protocol d. Keeping urinary catheters in as long as possible for the patient's convenience

a. Orient the elderly by providing a clock, calendar or orientation board b. Providing fluid management c. Setting up a bowel protocol M&M Chapter 43, page 914, Table 43-4 Jennifer

5. What is a DeBakey Type II dissection? (Select one) a. Originates in the ascending aorta and confined to this area b. Originates in the ascending aorta; extends to aortic arch and beyond c. Originates in the descending aorta; extends distally d. Originates in the descending aorta; extends proximally

a. Originates in the ascending aorta and confined to this area N&P p. 571 Jason

5. Which of the following blood products is used to improve oxygen delivery to tissues? (Select one) a. PRBCs b. Platelets c. FFP d. Cryoprecipitate

a. PRBCs N&P p. 396 Franklund

1. From the following preexisting conditions, which exacerbate the physiologic effects of various positions: a. PVD b. METs > 10 c. NPO > 12 hours d. Previous chiropractic work performed

a. PVD NP 406 "Hypertension, diabetes mellitus, peripheral vascular disease, peripheral neuropathies, and alcoholism can exacerbate the physiologic effects of various positions." DB

1. Which of the following are independent risk factors for Descending Thoracic and Thoracoabdominal Aneurysms? (select all that apply) a. Pain b. Elderly c. COPD d. Male e. Female

a. Pain b. Elderly c. COPD N&P 572-573 mandy

5. Which muscle relaxant is the only one to have significant cardiac effects? a. Pancuronium b. Atracurium c. Cisatracurium d. Mivacurium

a. Pancuronium Charlie N&P pg. 527

2. An acute IV hemolysis is generally a result of an ABO blood incompatibility. Most common causes include misidentification which of the following? a. Patient b. Blood specimen c. Patient bed number d. Unit transfused

a. Patient b. Blood specimen d. Unit transfused M&M Ch. 51 Pg. 1172 Thetford

2. Critical factors in the selection and presentation of the available anesthesia techniques appropriate for arthroscopic procedures are which of the following? a. Patient positioning b. Overall state of health c. Patient's preference

a. Patient positioning b. Overall state of health Nagelhout Chapter 40, Page 1002 "...are the patient positioning necessary to facilitate the proposed arthroscopic procedure and the overall state of health of the patient." Budenbender

4. The Taylor approach is best used for what surgical procedures? (Select 2) N&P pg 1081 a. Pelvic b. Perineal c. Thoracic d. Ankle

a. Pelvic b. Perineal

5. Emphasis on which of the following two things, assist in choosing the best care for each patient? a. Personally interviewing the patient b. For the CRNA to have an understanding of the physiologic changes associated with various positions c. Previous anesthetic record d. Patients allergies

a. Personally interviewing the patient b. For the CRNA to have an understanding of the physiologic changes associated with various positions Nagelhout Chapter 40, Page 1002 "Reviewing the patient's chart and more importantly, personally interviewing the patient along with understanding the physiologic changes associated with various positions, assist in choosing the best care for each patient. " Budenbender

4. All of the following are expected effects of Dexmedetomidine except which? a. Respiratory depression b. Sedative c. Analgesic d. Anxiolytic

a. Respiratory depression Charlie N&P pg 1251

2. An Increase in Anesthetic depth during inhalational induction of an infant will depress compensatory mechanisms leading to? N&P Pg 1203 a. Pharyngeal narrowing and collapse b. Tenting of the oropharyngeal space c. Stimulating compensatory mechanisms d. Closure of the vocal cords.

a. Pharyngeal narrowing and collapse Fieber

3. Which of the following blood products is used for hemorrhage prevention? (select one) a. Platelets b. PRBCs c. FFP d. Cryoprecipitate

a. Platelets N&P p. 396 Franklund

5. Select 2 pulmonary manifestations of a patient with rheumatoid arthritis. a. Pleural effusion b. Pulmonary nodules c. Pneumothorax d. Pneumonia

a. Pleural effusion b. Pulmonary nodules M&M Chapter 38, page 795, table 38-1 Jennifer

Which of the following epidural catheter characteristics have been found to result in fewer paresthesias, intravascular placements, less prone to obstruction and provide better spread of local anesthetics in the epidural space? (Select 2) a. Polyurethane b. Nylon c. Multiple orifice d. Single orifice

a. Polyurethane c. Multiple Orifice NP: 1138 Byron

5. With spinal procedure what is often the most complex part of the anesthetic plan? N&P 1007 a. Positioning b. Hemodynamics c. Sedation d. Pain control

a. Positioning Fieber N&P 1007

2. Complex spinal surgery patients present what significant challenges. (Select Three) a. Positioning b. Airway control c. Fluid/Blood transfusions management d. SIRS

a. Positioning b. Airway control c. Fluid/Blood transfusions management Fieber N&P 1007

4. Hypocalcemia causes all of the following except? (Select one) a. Positive inotropy b. Decreased myocardial contractility c. Increased LVEDP d. Increased CVP

a. Positive inotropy N&P p. 570 Jason

1. All of the following are complications of EVAR Graft deployment except? N&P pg576 a. Post-op Vison loss b. Microembolization c. Occlusion of major branch arteries d. Aortic Perforation/ Rupture

a. Post-op Vison loss Fieber N&P pg576

2. During phase 1, rapid repolarization at +2 to +30 mV, what happens with movement of potassium? a. Potassium gates open and potassium moves out to ECF b. Potassium gates close and potassium moves into the ICF c. Potassium gates open and potassium moves into the ICF d. Potassium gates don't open until Phase 1

a. Potassium gates open and potassium moves out to ECF Nagelhout Chapter 23, page 478 Budenbender

4. What is the primary goal to avoid in positioning the patient in prone? N&P 419 a. Pressure on the abdomen b. Pressure on the ears c. Pressure on the breasts and groin d. >40 ml/kg for the entire procedure of fluid replacement.

a. Pressure on the abdomen

4. Which of the following is a major disadvantage of using laparoscopy for anterior spinal surgery? (Select one) a. Proficiency in technique b. Diminished blood loss c. Shorter length of stay d. Decreased medical costs

a. Proficiency in technique Jason Franklund N&P p. 1008

Unlike many anesthetic agents' ability to alter T-cell proliferation, this anesthetic agent showed no change from T-cell baseline. a. Propofol b. Ketamine c. Thiopental d. Halothane

a. Propofol N&P p. 1031 Lexi

2. Which of the following terms describes a patient that exhibits drug-seeking behavior until the pain actually goes away. a. Tolerance b. Opioid addiction c. Pseudoaddiction d. None of the above

a. Pseudoaddiction Reference: N&P pg 1256 Mandy

What are the major causes of maternal morbidity and mortality associated with general anesthesia? (select 2) a. Pulmonary aspiration of gastric contents b. Failed endotracheal intubation c. Hypotension d. Tachycardia resulting in MI

a. Pulmonary aspiration of gastric contents b. Failed endotracheal intubation M&M Chapter 41, page 857

Which of the following spinal needles are referred to as "cutting needles"? (Select 2) a. Quincke b. Sprotte c. Whitacre d. Pitkin

a. Quincke d. Pitkin NP: 1079 Byron

5. The surgeon is performing a scoliosis correction in the prone position and nicks the aorta. What is the surgical priority in this emergent situation? (Select one) a. Rapid closure of the surgical wound b. Administer 100% FIO2 c. Establish secondary large bore IV access d. Verify availability of blood

a. Rapid closure of the surgical wound Jason Franklund N&P p. 1009

Which TWO of the following are pulmonary manifestations of sickle cell anemia? a. Recurrent pulmonary infections b. Pneumothorax c. Pleuritis d. Hemothorax

a. Recurrent pulmonary infections c. Pleuritis M&M p. 1178 Lexi

5. Positional changes may result in? a. Redistribution of ventilation and perfusion b. Fluid distribution c. Hemodynamic instability d. Increase in respiratory rate

a. Redistribution of ventilation and perfusion n&p 404 rebecca

4. The combination of Versed and Fentanyl can result in a. Reduced SVR and hypotension b. Increased SVR and Hypertension c. Increased respiratory rate and tidal volume d. When combined require higher doses of each

a. Reduced SVR and hypotension Charlie N&P pg. 527

1. What are two advantages to utilizing regional anesthesia? (Select 2) a. Reduction in post-op DVT b. Decrease in 1 month mortality c. Reduction in surgical errors d. Improved cardiovascular health

a. Reduction in post-op DVT b. Decrease in 1 month mortality M&M page 794

3. The mechanism of increased glucose intolerance related to surgery in an elderly patient is related to? N&P 1219 a. Release of Growth hormone b. Release of ADH c. Release of Pitocin d. Release of Oxytocin

a. Release of Growth hormone Fieber

2. Which of the following activations during heart failure leads to cardiac dysfunction if not counteracted with medications? a. Renin-angiotensin-aldosterone system b. Negative inotropic response c. Cholinergic activation

a. Renin-angiotensin-aldosterone system M&M page 367 Willie

1. Which of the following are common consequences of having an open heart procedure? a. Residual air retained in the left ventricular apex b. High levels of sodium crystal formation c. Reduction in blood glucose d. None of the above

a. Residual air retained in the left ventricular apex M&M page 452 Willie

3. Since the sciatic nerve block cannot provide coverage of the cutaneous medial leg and ankle joint, what nerve must be additionally blocked to provide complete anesthesia below the knee? a. Saphenous (Femoral) b. Common peroneal c. Lateral plantar nerve d. Phrenic nerve

a. Saphenous (Femoral) M&M Ch. 46 Pg. 1014 Thetford

1. What nerve divides into the tibial and common peroneal branches proximal to the popliteal fossa, providing sensory to the lower leg? a. Sciatic nerve b. Femoral nerve c. Common peroneal nerve d. Sural nerve

a. Sciatic nerve M&M Ch. 46 Pg. 1013 Thetford

Which of the following are characteristics attributable to bupivacaine? (Select 3) a. Sensory fibers blocked more readily than motor fibers b. Motor fibers blocked more readily than sensory fibers c. Marked placental transfer d. Limited placental transfer e. More tachyphylaxis with long term administration vs lidocaine f. Less tachyphylaxis with long term administration vs lidocaine

a. Sensory fibers blocked more readily than motor fibers d. Limited placental transfer f. Less tachyphylaxis with long term administration vs lidocaine NP: 1137 Byron

1. Which of the following is NOT considered an absolute contraindication to neuraxial blockade? a. Sepsis b. Infection at injection site c. Patient refusal d. Severe mitral stenosis

a. Sepsis M&M page 948

2. Which of the following would NOT be considered a relative contraindication for neuraxial blockade? a. Severe aortic stenosis b. Demyelinating lesion c. Severe spinal deformity d. Hypertrophic obstructive cardiomyopathy

a. Severe aortic stenosis M&M page 948

An interscalene brachial plexus block is indicated for which of the following? a. Shoulder and proximal humerus surgeries b. Distal to mid-humerus surgeries c. Elbow and forearm surgeries d. Wrist and hand surgeries

a. Shoulder and proximal humerus surgeries (M&M pg 982) Josh

Two types of muscle fibers are present in muscle tissue, specifically the diaphragm and intercostals, which of the following characteristics describe Type 1 muscle fibers? (Select 3) a. Slow twitch b. Fast twitch c. Resistant to fatigue d. Fatigue easily e. Comprise 25% of a newborn's diaphragm f. Comprise 55% of a newborn's diaphragm

a. Slow twitch c. Resistant to fatigue e. Comprise 25% of a newborn's diaphragm

3. Maternal Hypertension is associate with what neonatal sequelae? N&P1178 a. Small for gestational age and its associated problems b. Shock c. Anemia d. TE fistula

a. Small for gestational age and its associated problems

4. What can increase a patients change of postoperative respiratory complications 3-6fold? a. Smoking b. Female c. Diabetic d. Male

a. Smoking Charlie N&P PG 1218

3. Nociceptors can be found in which of the following tissues? (Choose 2) a. Somatic tissues b. Visceral tissues c. Cartilage tissue d. Blood cells

a. Somatic tissues b. Visceral tissues M&M page 1033 Willie

3. What monitoring method has been identified as useful in monitoring for position related spinal cord injury a. Somatosensory evoked potentials b. Peripheral nerve stimulation c. BISS d. There is no way to monitor for spinal cord injury

a. Somatosensory evoked potentials Charlie N&P pg 409

What type of disease of the spine is associated with pain that usually radiates into the buttocks, thighs, and legs and is characteristically worse exercise and relieved by rest, particularly sitting with the spine flexed? a. Spinal stenosis b. Degenerative disc disease c. Herniated disc d. Scolosis

a. Spinal stenosis M&M Chapter 47 page 1046 Jennifer

1. The two most common reasons for spinal surgery are? a. Spinal stenosis b. Disc herniation c. Sympathectomy d. Kyphoplasty

a. Spinal stenosis b. Disc herniation Fieber N&P 1007

3. All of the following are techniques for spinal administration except? N&P pg 1080-1081 a. Stabb b. Taylor c. Midline d. Paramedian

a. Stabb

1. What should be readily available when administering regional anesthetics? (M&M pg 975) (select 3) a. Standard hemodynamic monitors b. Supplemental oxygen c. PRBC's d. Resuscitative medications

a. Standard hemodynamic monitors b. Supplemental oxygen d. Resuscitative medications

2. Which of the following would be the desired motor response for performing an interscalene block with a nerve stimulator? a. Stimulation of the deltoid or biceps b. Stimulation of the diaphragm c. Stimulation of the trapezius muscle d. Stimulation of the serratus muscle

a. Stimulation of the deltoid or biceps M&M page 985

5. What is the muscle relaxant of choice for induction of General anesthesia in the parturient? N&P Pg 1147 a. Succinylcholine b. Atracurium c. Rocuronium d. Cisatracurium

a. Succinylcholine Fieber

Which of the following is the appropriate method of suctioning meconium from a neonate? Select 2 a. Suction repeatedly until no meconium is obtained b. Suction a maximum of 3 times c. Suction only once, there is no additional benefit after the first attempt d. Suction a maximum of 5 times

a. Suction repeatedly until no meconium is obtained b. Suction a maximum of 3 times M&M p. 872 Lexi

4. Which of the following can be used during shoulder arthroscopy procedure? a. Supplemental traction with weights b. Abduction may be necessary c. Supine position with the foot

a. Supplemental traction with weights b. Abduction may be necessary Nagelhout Chapter 40, Page 1002 "For some shoulder arthroscopy procedures, supplemental traction with weights and abduction may be necessary to provide optimum operative visualization." Budenbender

Nonsteroidal anti inflammatory agents such as Ketorolac are avoided during labor due to the following complications, select all that apply (select 2) a. Suppression of uterine contractions b. Fetal acidemia c. Fetal respiratory suppression d. Closure of fetal ductus arteriosis

a. Suppression of uterine contractions d. Closure of fetal ductus arteriosis (M&M pg 847) Josh

5. The pain of first stage labor is defined as non-localized aching/cramping because non- specific nociceptor visceral stimulation is carried to the CNS by unmyelinated C fibers that enter the cord at a. T10, T11, T12, L1 b. T12, L1 c. L1, L2, L3 d. T8, T9, T10

a. T10, T11, 12, L1 n&p 1131 becca

The intercostobrachial nerve originates from which thoracic vertebrae? a. T2 b. T3 c. T4 d. T5

a. T2 M&M Chapter 46, page 1000 Jennifer

5. What are some of the objective signs of anemia in the anesthetized patient? (select 2) a. Tachycardia b. Decreased mixed venous oxygen saturation c. Increased mixed venous oxygen saturation d. Normocardia

a. Tachycardia b. Decreased mixed venous oxygen saturation Budenbender Nagelhout page 395 "Tachycardia and decreased mixed venous oxygen saturation are suggestive of anemia, especially in the setting of intraoperative hemorrhage."

4. What are two symptoms that a pediatric patient may exhibit perioperatively if light anesthesia is coupled with surgical stimulation? a. Tachycardia & hypertension b. Bronchospasms & sternal retractions c. Dilated pupils and nystagmus d. Bradycardia & hypotension

a. Tachycardia & hypertension N&P page 1168

What type of headache is usually described as a tight bandline pain or discomfort that is often associated with tightness in the neck muscles? a. Tension headache b. Migraine c. Cluster headache d. Light headache

a. Tension headache M&M chapter 47 page 1050 Jennifer

5. Who is responsible for coordinating preoperative evaluation and acting as a gatekeeper to ensure that undue risks are minimized? N&P1178 a. The Anesthesia provider b. Circulator c. Pre-op Nurse d. Surgeon

a. The Anesthesia provider

1. Which of the following statements is true regarding the brachial plexus? a. The brachial plexus passes between the anterior and middle scalene muscles at the level of the cricoid cartilage (C6). b. . The brachial plexus passes between the anterior and posterior scalene muscles at the level of the cricoid cartilage (C6). c. . The brachial plexus passes superior to the anterior and posterior scalene muscles at the level of the atlas vertebrae (C1). d. None of the above are correct.

a. The brachial plexus passes between the anterior and middle scalene muscles at the level of the cricoid cartilage (C6). M&M page 985

5. How much does the MAP increase or decrease as BP is measured at locations above or below the heart? a. The increase or decrease is approximately 2 mmHg per inch in change in height b. The increase or decrease is approximately 3 mmHg per inch in change in height c. The increase or decrease is approximately 4 mmHg per inch in change in height d. The increase or decrease is approximately 6 mmHg per inch in change in height

a. The increase or decrease is approximately 2 mmHg per inch in change in height N&P page 403 Willie

2. Which of the following are true in relation to coronary anatomy? (Choose 1) a. The left main coronary artery quickly divides into the LAD & Left Circumflex b. The left coronary artery divides into the LAD & RCA c. The LAD divides into the Left main and Left circumflex d. The RCA divides into the Right Circumflex

a. The left main coronary artery quickly divides into the LAD & Left Circumflex. M&M page 452 Willie

What is the discovery phase of a malpractice lawsuit? a. The process by which the plaintiffs' attorney accesses the medical record and depose the witness under oath. b. The discovery phase is when the defendant discovers they are being accused of malpractice. c. The discovery phase is not part of the process d. Both A and B are correct

a. The process by which the plaintiffs' attorney accesses the medical record and depose the witness under oath.(M&M pg 1201) josh

4. What is another name for the supraclavicular block? a. The spinal of the arm b. The lateral plexus c. The upper bundle of neuraxial d. The broken wing block

a. The spinal of the arm M&M page 986

2. Which of the following is the most important when considering NPO status of liquids? a. The volume of liquid ingested b. The type of liquid ingested c. Both are equally important d. Neither of these matter

a. The type of liquid ingested Reference: N&P pg 1175 Mandy

1. Which of the following has demonstrated an increased incidence of postoperative nausea and vomiting? a. Tramadol b. Rofecoxib c. Valdecoxib d. Paracetammo M&M Ch. 48 Pg. 1099

a. Tramadol M&M Ch. 48 Pg. 1099 Thetford

2. _________ is the process by which and action potential is conducted from the _______ to the CNS. a. Transmission/ periphery b. Transmission/ central c. Transduction/ periphery d. Transduction/ central

a. Transmission/ periphery n&p 1246 rebecca

4. Positioning for minimally invasive mitral valve robotic surgery includes all of the following EXCEPT? (Select one) a. Trendelenburg b. placing a roll under the right scapula to elevate the hemithorax c. padding the right arm along the right side of the patients body d. supine

a. Trendelenburg N&P p. 544 Jason

1. If _____ or more units of O-_______ whole blood have been given, the patient may NOT be able to receive tranfusions of his or her own type (A, B, or AB). a. Two; negative b. One; negative c. Two; positive

a. Two; negative Budenbender Nagelhout Chapter 20; Page 395 "However, if two or more units of O-negative whole blood have been given, the patient may not be able to receive tranfusions of his or her own type (A, B, or AB)"

3. Which aortic lesion requires immediate surgical intervention a. Type A b. Type b c. Type c d. Type f

a. Type A Charlie N&P pg. 572

What type of hypersensitivity is a rapidly developing reaction that results from antigen-antibody interaction in an individual who has been previously exposed and sensitized to the antigen? a. Type I b. Type II c. Type III d. Type IV

a. Type I N&P page 1023 Jennifer

3. What blood type should be reserved for females of childbearing years in an emergency situation? (select one) a. Type O Rh-negative b. Type AB Rh-negative c. Type A Rh-negative d. Type B Rh-negative

a. Type O Rh-negative NP p. 395 Franklund

3. Which type of neuropathy is one of the most frequently reported injury after surgery and anesthesia with an incidence ranging from 0.04% to 0.5%? a. Ulnar b. Tibial c. Femoral d. Sciatic NP 407 "Ulnar neuropathy is one of the most frequently..."

a. Ulnar NP 407 "Ulnar neuropathy is one of the most frequently..." DB

4. It is _______ to base the decision to use an upper extremity block ( or any regional technique) solely on the premise that ______ anesthesia should be avoided, because ultimately, it may be unavoidable. a. Unwise, general b. Unwise, regional c. Wise, general d. Wise, regional

a. Unwise, general NP 1107 Budenbender

2. The sitting position is associated with many serious complications what is the most feared? N&P 418 a. Venous air embolism b. Pneumocephalus c. Quadriplegia d. Peripheral nerve injury

a. Venous air embolism

4. Changes in lung volumes with aging: a. Residual Volume (RV) i. Increase ii. Decrease iii. No change b. Functional residual capacity (FRC) i. Increase ii. Decrease iii. No change c. Expiratory Reserve volume (ERV) i. Increase ii. Decrease iii. No change d. Inspiratory Reserve Volume (IRV ) i. Increase ii. Decrease iii. No change e. Vital Capacity (VC) i. Increase ii. Decrease iii. No change f. Height adapted Total Lung Capacity (TLC) i. Increase ii. Decrease iii. No Change g. Forced expiratory volume in 1 second (FEV1/FVC) i. Increase ii. Decrease iii. No change h. Closing volume (CV) i. Increase ii. Decrease iii. No change i. Closing capacity (CC) i. Increase ii. Decrease iii. No change

a. increase b. increase c. decrease d. decrease e. decrease f. no change g. decrease h. increase i. increase NP 1217 DB

1. Match the mitral valve lesion with the appropriate hemodynamic goal? (Matching) a. increase HR b. decrease HR c. decrease afterload d. maintain normal afterload i. mitral regurgitation ii. mitral stenosis iii. mitral regurgitation iv. mitral stenosis

a. increase HR i. mitral regurgitation b. decrease HR ii. mitral stenosis c. decrease afterload iii. mitral regurgitation d. maintain normal afterload iv. mitral stenosis N&P p. 500 Franklund

3. "Supply ischemia causes a(n) ____ in ventricular compliance (dilation) and ___ in contractility, whereas demand ischemia ______ compliance (stiffening) without initially impacting contractility." a. Increase, decrease; reduces b. Decrease, decrease; reduces c. Increase, increase, reduces

a. increase, decrease; reduces n&p pg 514 rebecca

1. Cardiac output _______ mostly because of a(n) ______ is stroke volume and to a lesser extent heart rate. a. Increase/ increase b. Decrease/decrease c. Decrease/increase d. Increase/ decrease

a. increase/decrease n&p pg 1130 becca

3. Pregnant women have an _______ sensitivity to local anesthetics and a __________ MAC for all general anesthesia a. increase; decrease b. Increase; increase c. Decrease; decrease d. Decrease; increase

a. increase; decrease n&p 1130 becca

2. Which of the following is NOT an advantage of lower-extremity nerve blocks? (Select one) a. increased recovery room admissions b. decreased nausea and vomiting c. decreased urinary retention d. reduced postoperative analgesia

a. increased recovery room admissions N&P 1119 Jason Franklund

3. Which of the following is NOT one of the five hemodynamic goals in the anesthetic management of the patient with mitral stenosis? (select one) a. keep heart rate high b. maintain sinus rhythm c. maintain contractility d. maintain afterload e. maintain contractility

a. keep heart rate high "maintain low normal HR" N&P p. 498 Franklund

5. Which of the following is NOT a hemodynamic goal in the anesthetic management of the patient with mitral regurgitation? (Select one) a. keep the HR low b. decrease afterload c. maintain contractility d. maintain or increase preload

a. keep the HR low "Increase HR" N&P p. 500 Franklund

2. Which of the following is NOT necessary for transport of the pediatric patient to the PACU? (Select one) a. keeping standard monitors on b. placing the patient in the lateral position c. applying supplemental oxygen d. performing a chin lift while feeling for exhalation

a. keeping standard monitors on N&P p. 1206 Jason Franklund

3. What type of spread would you expect when injecting local anesthetic into the cervical region compared to the lumbar region? (Select one) a. larger b. less c. equal d. irrelevant

a. larger N&P 1091 Jason Franklund

4. What nerve provides sensory innervation to the lateral aspect of the thigh? (Select one) a. lateral femoral cutaneous b. saphenous c. obturator d. ilioinguinal

a. lateral femoral cutaneous N&P 1119 Jason Franklund

2. In what position are the fingers at risk for compression when the lower section of the bed is raised? (Select one) a. lithotomy b. prone c. lateral decubitus d. sitting

a. lithotomy N&P p. 416 Jason Franklund

2. Which of the following is NOT an advantage of the minimally invasive approach to mitral valve surgery? (Select one) a. longer operation b. decreased length of hospital stay c. decreased blood loss d. improved cosmetics

a. longer operation N&P p. 544 Jason

4. What is the effect of hyperglycemia intraoperatively? (Select one) a. loss of free water b. release of ADH c. decreased GFR d. suppression of renin

a. loss of free water N&P p. 1206 Jason Franklund

1. What is the gold standard method for identifying entry into the epidural space? (Select one) a. loss of resistance b. ultrasound c. hanging drop method d. Macintosh balloon

a. loss of resistance N&P 1090 Jason Franklund

5. Which of the following is NOT associated with postoperative delirium? (Select one) a. low ASA status b. impaired cognitive function c. TIA d. abnormal albumin

a. low ASA status N&P p. 1220-1221 Jason Franklund

Complications that are associated with subacromial decompression, such as subcutaneous emphysema, pneumomediastinum, and tension pneumothorax, have been associated with the use of which of the following instruments? (Select 2) a. Mechanical irrigation pumps b. Arthroscope c. Power-saver suction d. Anchoring tools

a. mechanical irrigation pumps c. power-saver suction NP: 1003 Byron

The supraclavicular approach for a brachial plexus block can result in a common side effect known as Horner's syndrome, which of the following symptoms are seen with this syndrome? (Select 3) a. Miosis b. Hemidiaphragmatic paralysis c. Partial ptosis d. Loss of hemifacial sweating e. pneumothorax

a. miosis c. partial ptosis d. loss of hemifacial sweating NP: 1110 Byron

1. Which of the following is NOT associated with a high rate of maternal morbidity and mortality? (Select one) a. neuraxial anesthesia b. pulmonary hypertension c. malignancy d. systemic lupus erythematosus

a. neuraxial anesthesia

1. What is the most common type of complication in older adults? (Select one) a. neurological b. cardiovascular c. respiratory d. renal

a. neurological N&P p. 1220 Jason Franklund

5. What nerve is frequently injured when patients undergo extensive pelvic surgery? (Select one) a. obturator b. ilioinguinal c. femoral d. lateral femoral cutaneous

a. obturator N&P 1119 Jason Franklund

Goals for anesthetic management of a patient with aortic insufficiency/ regurgitation include: maintain heart rate slightly _____________ than normal, ____________ afterload, and maintain or _____________ preload. (N&P ch23, pg 503) a. Lower, decrease, decrease b. Higher, decrease, increase c. Higher, increase, increase d. Lower, increase, decrease

b. Hale

What hemoglobin concentration has arbitrarily been defined as being "adequate" for pediatric patients presenting for surgery? a. 8 g/dL b. 10 g/dL c. 12 g/dL d. 14 g/dL

b. 10 g/dL NP: 1197 Byron

Heparin is administered prior to initiating carotid artery angioplasty stenting (CAS). What is the target ACT? (N&P pg 585) a. 300 seconds b. 250 seconds c. 150 seconds d. 100 seconds

b. 250 seconds (N&P pg 585) Lake

1. The most significant neurologic growth and development occurs in utero. The neural tube is nearly completely formed by how many weeks' gestational age? a. 1 week b. 3 to 4 weeks c. 5th week d. 18 weeks

b. 3 to 4 weeks Nagelhout Page 1168 "The most significant neurologic growth and development occurs in utero. The neural tube is nearly completely formed by 3 to 4 weeks' gestational age." Budenbender

2. How many ml of a test dose should be administered into an epidural? a. 1-2ml b. 3ml c. 5ml d. 10-15ml

b. 3ml M&M page 852

One-day postoperative recovery plans after uncomplicated surgery should include ambulation for a minimum of how many hours each day? a. 2-4 hours b. 4-6 hours c. 1-2 hours d. 6-8 hours

b. 4-6 hours M&M p. 1102 Lexi

Healthcare workers alone make up ________ percent of all Hepatitis C infections, at least half of which lead to chronic hepatitis. a. 40-80 % b. 4-8 % c. 14-18 % d. >40 %

b. 4-8 % M&M p. 1224 Lexi

2. Systolic blood pressure reading on the calf compared to the patients upper arm can read how much higher? a. 10 mmHg b. 40 mmHg c. 80 mmHg d. 20 mmHg M&M Ch. 38 Pg. 801

b. 40 mmHg M&M Ch. 38 Pg. 801 mf Thetford

Bupivacaine should be chosen as the local anesthetic for spinal anesthesia instead of lidocaine if the obstetrician will not likely complete the surgery in how many minutes? a. 30 minutes b. 45 minutes c. 60 minutes d. 25 minutes

b. 45 minutes M&M Chapter 41, page 856 Jennifer

2. During pregnancy, by how much is tidal volume increased and what is the cause of this increase? a. 20%; increase in TV b. 45%; increase in TV. c. 30%; decrease in TV d. 80%; decrease in TV

b. 45% increase in TV n&p pg 1130 becca

Administration of a single unit of platelets may be expected to increase the platelet count by how much? a. 10,000 - 20,000 x 10^9/L b. 5,000 - 10,000 x 10^9/L c. 20,000 - 30,000 x 10^9/L d. 5,000 - 15,000 x 10^9/L

b. 5,000 - 10,000 x 10^9/L M&M Chapter 51 page 1171 Jennifer

What would a patient's expected serum potassium level be if they were exhibiting ECG changes of a prolonged PR interval, tall peaked T waves and a shortened QT interval? a. 5.0-6.0 mEq/L b. 6.0-7.5 mEq/L c. 7.5-8.0 mEq/L d. >8.5 mEq/L

b. 6.0-7.5 mEq/L NP: 389 Byron

While administering anesthesia to a patient with a tourniquet, when should the provider expect to begin seeing signs of tourniquet pain following implementation of a tourniquet? a. 30 min b. 60 min c. 90 min d. 120 min

b. 60 min (M&M pg 791) Josh

1. Polymodal mechanoheat nociceptors are the most prevalent among nociceptors and respond to extreme temperatures in which range? a. >50°C and <52°C b. >42°C and <40°C c. >40°C and <42°C d. >45°C and <47°C

b. >42°C and <40°C M&M page 1033 Willie

2. What is the purpose for administering a hypobaric or isobaric spinal solution? a. A hypobaric solution increases the depth that the anesthetic will sink b. A hypobaric or isobaric solution facilitates positioning for the block and surgery c. Both do not affect the anesthetic spread or location of action d. None of the above

b. A hypobaric or isobaric solution facilitates positioning for the block and surgery M&M page 794

4. The cornea and tooth pulp are almost exclusively innervated by which nociceptive fibers? a. A-alpha & A-beta b. A-delta and C-fibers c. B-fibers and C-fibers d. A-gamma and A- delta

b. A-delta and C-fibers M&M page 1033 Willie

What are the tHree defining characteristics of unstable angina? a. Angina that is relieved with rest b. Abrupt increase in severity or duration of angina attacks c. Angina relieved by medication d. Angina induced by exercise e. Angina at rest f. New onset angina with severe and frequent episodes

b. Abrupt increase in severity or duration of angina attacks e. Angina at rest f. New onset angina with severe and frequent episodes (M&M pg 388) Lake

1. The dural sac terminates at which sacral vertebra in adults and in infants? (Select all that apply) a. Adults: L1-L2 b. Adults: S1 c. Infants: S3 d. Infants: L3 e. S1 for Adults and Infants

b. Adults: S1 c. Infants: S3 M&M Ch. 45 Pg. 964 Thetford

4. Modulation of the pain transmission involves altering neural__________ activity along the pathway. a. Efferent b. Afferent c. Impulsive

b. Afferent n&p1246 rebecca

When is the baseline ACT for cardiac surgery best measured? a. During surgery b. After skin incision c. In preop d. At the end of surgery

b. After skin incision M&M Ch. 22, page 454 Jennifer

1. The evaluation of a patient with pain should include all of the following key components except: (M&M pg. 1023) a. Location b. Age c. Onset d. Alleviating factors

b. Age

Administration of what solution is viewed as a gray area and must be treated on a person-to-person basis for a Jehovah's Witness? a. Hetastarch b. Albumin c. Dextran d. Crystalloid

b. Albumin M&M p. 802 Lexi

A healthy patient is entering the latent phase of labor and requests an epidural. What is the most appropriate action at this time? (N&P pg 1136) a. Inform the patient they must wait until the cervix has dilated to 5 cm b. Approve the request with the consent of the obstetrician c. Obtain a platelet count, then proceed if >75,000/uL d. wait until the patient has been NPO > 2 hours

b. Approve the request with the consent of the obstetrician

Symptoms such as hoarseness or inspiratory stridor in a patient with rheumatoid arthritis may signal that the glottic opening is narrowed. Arthritis of what joint is involved with these symptoms? a. Thryoarytenoid b. Cricoarytenoid c. Cricothyroid d. Corniculate

b. Cricoarytenoid M&M Chapter 38, page 795 Jennifer

5. Which of the following fluid types can cause osmotic diuresis and dilute plasma proteins? Select all that apply!! a. Colloid b. Crystalloid c. NS d. LR

b. Crystalloid c. NS d. LR Reference: N&P pg 394 Mandy

1. Which of the following is not true regarding age-related physiological changes of the elderly? (M&M pg 909) a. Decreased pulmonary elasticity b. Decreased chest wall rigidity c. Decreased renal blood flow d. Elevated systolic blood pressure

b. Decreased chest wall rigidity

1. Neuraxial blocks typically produce what effects on hemodynamics? (M&M pg 937) a. Increases in blood pressure that may be accompanied by a decrease in heart rate b. Decreases in blood pressure that may be accompanied by a decrease in heart rate c. Increases in blood pressure that may be accompanied by an increase in heart rate d. Decreases in blood pressure that may be accompanied by an increase in heart rate

b. Decreases in blood pressure that may be accompanied by a decrease in heart rate Ian

5. Which of the following statements are true? a. Deep somatic nociceptors are more sensitive to noxious stimuli than cutaneous nociceptors b. Deep somatic nociceptors are less sensitive to noxious stimuli than cutaneous nociceptors but are easily sensitized by inflammation c. Deep somatic nociceptors are near identical in sensitivity to cutaneous nociceptors d. None of the above are true

b. Deep somatic nociceptors are less sensitive to noxious stimuli than cutaneous nociceptors but are easily sensitized by inflammation. M&M page 1033 Willie

What type of symptoms does esophageal perforation usually present with? (Select 3) a. Immediate-onset subcutaneous emphysema or pneumothorax b. Delayed-onset subcutaneous emphysema or pneumothorax c. Unexpected febrile state d. Sepsis

b. Delayed-onset subcutaneous emphysema or pneumothorax c. Unexpected febrile state d. Sepsis M&M Chapter 54 page 1212 Jennifer

What type of neuropathy is the most common type of neuropathic pain encountered in practice and is a major cause of morbidity? a. Postherpetic neuralgia b. Diabetic neuropathy c. Stoke d. Phantom limbs

b. Diabetic neuropathy M&M Chapter 47 page 1048 Jennifer

3. Diastolic dysfunction occurs more frequently among the elderly compared to the young. What is a major component of diastolic dysfunction? a. High systolic pressures decrease filling b. Diastolic dysfunction decreases ventricular relaxation resulting in decrease filling at low pressures c. Diastolic dysfunction results in a decrease in filling pressures d. Diastolic dysfunction dramatically increases ventricular compliance M&M, page 909

b. Diastolic dysfunction decreases ventricular relaxation resulting in decrease filling at low pressures M&M, page 909 Willie

2. Hetastarch is produced from starch molecules derivative from a plant. How are smaller starch molecules eliminated? a. The molecules are metabolized by nonspecific esterases b. Eliminated by the kidneys c. Broken down by the CYP450 system d. Conjugated and eliminated in bile

b. Eliminated by the kidneys M&M page 1166

When measuring PAOP, when should the measurement be obtained in relation to the respiratory cycle? a. End inspiration b. End expiration c. During inspiration d. During exhalation

b. End expiration (M&M pg. 1178) Josh

Mixed agonist-antagonist agents (butorphanol or nalbuphine) can be a good choice for analgesia during labor and are associated with little to no cumulative respiratory depression. What is the concern with repeated use of these agents during labor? a. There is no concern with repeated doses b. Excessive sedation c. Repeat doses cause massive histamine release d. Repeat doses are associated with prolongation of labor

b. Excessive sedation (M&M pg 847) Josh

5. For cases of controlled hypotension it is recommended for the atrial catheter to be calibrated/zeroed at? a. Xiphoid process b. External meatus of the ear c. Phlebostatic axis d. Calibration is not needed M&M Ch. 38 Pg. 800

b. External meatus of the ear M&M Ch. 38 Pg. 800 mf Thetford

What is the typical manifestation of tourniquet pain in the patient receiving general anesthesia? (select all that apply) a. Hypotension b. Hypertension c. Tachycardia d. Diaphoresis

b. Hypertension c. Tachycardia d. Diaphoresis (M&M pg 791) Josh

Which electrolyte disorder, related to persistant vomiting, is most common in neonates with hypertrophic pyloric stenosis? a. Hyperchloremic metabolic alkalosis b. Hypochloremic metabolic alkalosis c. Hyperkalemic metabolic alkalosis d. Hypokalemic metabolic alkalosis

b. Hypochloremic metabolic alkalosis M&M p. 901 Lexi

Premature neonates have relatively reduced glycogen stores and subsequent risk for hypoglycemia. What characteristic of the neonate may offset this potential complication? a. Brown fat metabolism b. Impaired glucose excretion c. Large surface area d. Small BMI

b. Impaired glucose excretion (M&M pg 881) Josh

5. What risk factor do the herbal medications; garlic, ginkgo, and ginseng all potentiate? (N&P pg 1076) a. Hypotension b. Increased risk of bleeding c. Hypertension d. Hypoglycemia

b. Increased risk of bleeding Ian

5. All of the following are appropriate methods to decrease emergence delirium in the aging individual except? a. Early mobilization and rehabilitation b. Informing the patient they have to sit down and shut up c. Use of glasses or hearing devices as needed d. Reorientation to place and time

b. Informing the patient they have to sit down and shut up M&M Ch. 43 Pg. 914 Thetford

3. What block results in the highest blood levels of local anesthetic per volume injected? (M&M pg 1018) a. Brachial plexus block b. Intercostal block c. Bier block d. Superficial cervical plexus block

b. Intercostal block

An early rise in lymphocytes, specifically related to induction of anesthesia and initial surgical incision was seen with which volatile anesthetic? a. Sevoflurane b. Isoflurane c. Desflurane d. Halothane

b. Isoflurane N&P p. 1031 Lexi

On a mL/kg basis, how does the newborn's functional residual capacity compare in contrast to that of an adult's? a. It is increased b. It is decreased c. There is no difference on a mL/kg basis

b. It is decreased NP: 1167 Byron

When apoptic cells are not replaced and reflected pressure waves during late systole create strain on the myocardium the result is what age related cardiovascular change? a. Myocardial stiffening b. Myocardial hypertrophy c. Reduced Beta receptor responsiveness d. Conduction system abnormalities

b. Myocardial hypertrophy NP: 1216 Byron

Which of the following statements is true regarding nasogastric tubes after abdominal surgery? a. NGTs speed up recovery of bowel function b. NGTs increase incidence of aspiration c. NGTs are not routinely used after abdominal surgery d. NGTs should remain in place a long period of time following abdominal surgery

b. NGTs increase incidence of aspiration M&M p. 1103 Lexi

This congenital disorder occurs at the base of the umbilicus, has a hernia sac, and is associated with many other congenital abnormalities. a. Gastrochisis b. Omphalocele c. Hypertrophic pyloric stenosis d. Diaphragmatic hernia

b. Omphalocele M&M p. 901 Lexi

Which TWO of the following are skeletal manifestations of sickle cell anemia? a. Osteoporosis b. Osteomyelitis c. Kyphosis d. Dactylitis

b. Osteomyelitis d. Dactylics M&M p. 1178 Lexi

Where does the spinal cord receive its blood supply from? a. Single posterior and paired anterior arteries b. Paired posterior and single anterior arteries c. Anterior spinal artery d. Posterior spinal artery

b. Paired posterior and single anterior arteries (M&M pg 944) Lake

Endoleaks are a known potential serious complication associated with EVAR surgery. Wich of the following provides the most accurate description of an endoleak? a. A leak from within the graft into the thoracic or abdominal cavities b. Persistent blood flow and pressure between the Endovascular graft and the aortic aneurysm c. Perforation of the aorta when deploying the graft d. All of the above are examples of Endoleaks

b. Persistent blood flow and pressure between the Endovascular graft and the aortic aneurysm (N&P pg 577) Lake

The level of what important plasma may possibly predict POSToperative morbidity and mortality? a. Plasma IL-1 b. Plasma IL-6 c. Plasma IL-12 d. Plasma IL-4

b. Plasma IL-6 N&P p. 1031 Lexi

3. Which of the following diseases are also commonly found in patients with rheumatoid arthritis patients? a. Pneumothorax b. Pleural effusions c. Upper lobe fibrosis d. Interstitial lung disease

b. Pleural effusions c. Upper lobe fibrosis d. Interstitial lung disease Reference: N&P pg 1012 Mandy

5. A patient with a congenital diaphragmatic herniation displays a sudden drop in lung compliance, blood pressure, and oxygenation. This would warrant concern for which complication? a. Bowel perforation b. Pneumothorax c. Infectious croup d. Pneumonia

b. Pneumothorax M&M Ch. 42 Pg. 899 Thetford

Which concern regarding regional anesthesia is less common among the elderly when compared to younger patients? a. Hypotension b. Postdural puncture headache c. Respiratory depression d. Bradycardia

b. Postdural puncture headache M&M p.916 Lexi

Which of the following characteristics predisposes a patient to the cardiotoxic effects of Bupivicaine? a. Obesity b. Pregnancy c. Hypertension d. Hypercapnia

b. Pregnancy M&M p. 274 Lexi

5. Late decelerations with decreased variability are associated with which of the following? a. Spinal cord compression b. Prolonged asphyxia c. Head compression d. Normal fetuses

b. Prolonged asphyxia M&M Ch. 41 Pg. 868 Thetford

3. Anaphylactic reactions to blood transfusions are: (M&M pg 1173) a. Common (1:2500) b. Rare (1:150,000) c. Very rare (1:500,000) d. There is no risk of anaphylactic reactions to blood transfusions

b. Rare (1:150,000)

After confirmation of proper placement of the endotracheal tube, excessive hyperventilation should be avoided because it can ____ uterine blood flow and has been associated with fetal ____. a. Increase/acidosis b. Reduce/acidosis c. Increase/alkalosis d. Reduce/alkalosis

b. Reduce/acidosis M&M Chapter 41, page 858 Jennifer

4. How is the MAC for inhalational agents altered after 40 years of age? (M&M pg 914) a. Increased 1% every year after age 40 b. Reduced 4% per decade of age after 40 c. Reduced 8% per decade of age after 40 d. Increased 5% for all patients over age 40

b. Reduced 4% per decade of age after 40

4. Which of the following is not true regarding Acetaminophen (Paracetamol)? a. Analgesic effect is 20-30% less than NSAIDs b. Reduces opioid related side effects c. Administration routes include; oral, rectal, parenteral d. Is not consider an NSAID M&M Ch. 48 Pg. 1099

b. Reduces opioid related side effects M&M Ch. 48 Pg. 1099 Thetford

1. Which of the following is not a compensatory mechanism associated with heart failure? a. Increased preload b. Reduction in afterload c. Activation of the sympathetic nervous system d. Increased release of AVP

b. Reduction in afterload M&M page 367 Willie

3. What is the most significant concern when considering a neuraxial block in a patient with preexisting neurological deficits? a. Addiction to nerve blocks b. Report of worsening of symptoms following the block c. Risk of anesthetic allergy d. None of the above

b. Report of worsening of symptoms following the block M&M page 948

In the anesthetic implications of the review of systems and history, which of the following should be considered for possible anesthetic implications for the cardiovascular system? a. Elevated ICP b. Septal defect, avoid air bubbles in IV line c. B-agonist or theophylline drugs d. Risk of aspiration; reactive airways; hypoxia

b. Septal defect, avoid air bubbles in IV line DB NP 1195

All obstetric patients should receive prophylaxis against aspiration pneumonia by receiving what medication prior to general anesthesia? a. Pepcid b. Sodium citrate c. Reglan d. Tums

b. Sodium citrate M&M chapter 41, page 857 Jennifer

2. The neurologic growth and development in utero of the fetus created during 4 to 12 weeks gestational age are which of the following: (select 2) a. Limbs b. Spinal cord c. Forebrain d. Myelination

b. Spinal cord c. Forebrain Nagelhout Page 1168 "It further differentiates over the next 4 to 12 weeks to create other anatomic structures that include the forebrain, facial bones, and spinal cord." Budenbender

5. What is the reason for IV potassium be replaced as a chloride once respiratory muscle weakness and dysrhythmias have ceased? a. The hyperchloride state makes it difficult for the kidney to conserve potassium b. The hypochloride state makes it difficult for the kidney to conserve potassium c. The hypochloride state makes it easy for the kidney to conserve potassium d. The hypochloride state makes it difficult for the kidney to excrete potassium

b. The hypochloride state makes it difficult for the kidney to conserve potassium Budenbender Nagelhout Page 387

1. Which of the following is the most common type of tracheoesophageal fistulas that is characterized by the upper esophagus terminating in a blind pouch, while the lower esophagus connects to the trachea? a. Type I b. Type IIIB c. Type II d. Type IIIA e. Type IV

b. Type IIIB M&M Ch. 42 Pg. 900 Thetford

Which of the following indications for cell salvage is NOT related to a specific surgery? a. Valve replacement b. Unexpected massive blood loss c. Abdominal aortic aneurysm repair d. Redo bypass grafting

b. Unexpected massive blood loss N&P p.400 Lexi

What anatomic landmark correlates to the vertebral body of C6 and is used to find the corresponding transverse process called Chassaignac's tubercle? a. Thyroid cartilage b. Cricoid cartilage c. Thyroid notch d. Cricothyroid membrane

b. cricoid cartilage NP: 1108 Byron

2. The heart is an aerobic organ. What vital component is needed to meet its high metabolic demand? a. It does not need anything to meet its high metabolic demand b. It depends on a constant supply of oxygen c. It depends on deoxygenated blood to meet metabolic demands d. Intermittent supply of oxygen

b. depends on a constant supply of oxygen n&p pg 473 rebecca

When using a nerve stimulator, stimulation resulting in contraction of the triceps brachii and elbow extension is indicative of what portion of the brachial plexus being stimulated? a. Superior trunk b. Middle trunk c. Inferior trunk

b. middle trunk NP: 1111 Byron

5. For what age group would you expect an estimated blood volume of 80-90 ml/kg? a. Premature b. Newborn c. Adults d. Children

b. newborn rebecca

1) What is the minimum dose of atropine required before succinylcholine administration? a) 1.0 mg minimum b) 2.0 mg minimum c) 0.1 mg minimum M&M Ch. 42 pg. 885

c Dumas

2) A child is more susceptible to: cardiac arrhythmias, hyperkalemia, rhabdomyolysis, myoglobinemia, masseter spasm, malignant hyperthermia than adults after receiving what type of muscle relaxant? a) Cisatracurium b) Atracurium c) Succinylcholine M&M Ch. 42 pg. 885

c Dumas

4) What is the largest mechanism of cardiac arrest in the pediatric population according to the Pediatric Perioperative Cardiac Arrest (POCA) Registry? a) Cardiovascular problems b) Respiratory problems c) Medication related problems M&M Ch. 42 pg. 886

c Dumas

5) What is the most common equipment-related mechanisms that led to a cardiac arrest in the pediatric population? a) Failed circuit b) Laryngoscope c) Central Venous Catheterization M&M Ch. 42 pg. 886

c Dumas

Match the following cranial nerves with their respective functions: a. CN VII (facial) b. CN IX (glossopharyngeal) c. CN X (vagus) d. CN XI (spinal accessory) e. CN XII (hypoglossal) ___ laryngeal muscles movement ___ muscles of tongue ___ shoulder muscles ___ muscles of facial expression, saliva secretion ___ swallowing, pharyngeal muscle

c - laryngeal muscles movement e - muscles of tongue d - shoulder muscles a - muscles of facial expression, saliva secretion b - swallowing, pharyngeal muscle N&P Chapter 25, page 583, table 25-8 Jennifer

5) When should neuraxial anesthesia be avoided? a) Any patient with a known MI b) Any patient with a known Cancer c) Any patient with a known coagulopathy

c) Any patient with a known coagulopathy N&P Chapter 44 pg. 1076 JDumas

3) Any baby with an intestinal obstruction is at highest risk for what kind of problem? a) Sepsis b) Perforated bowel c) Aspiration

c) Aspiration N&P Ch. 47 pg. 1186 JDumas

3) In general, why is the assessment of venous distention important? a) Assess osmolality b) Assess pulmonary function c) Assess fluid overload and cardiovascular dynamics

c) Assess fluid overload and cardiovascular dynamics N&P Chapter 23 pg 488 JDumas

2) Why is it absolutely necessary to have adequate IV access, central line/art line if possible in a neonate diagnosed with Malrotation and Midgut Volvulus? a) Because you will be administering high volume of blood b) Because you will be administering high volume of drugs c) Because you will be administering fluids due to volume depletion from peritonitis, ileus, bowel manipulation, and sepsis

c) Because you will be administering fluids due to volume depletion from peritonitis, ileus, bowel manipulation, and sepsis N&P Ch. 47 pg. 1186 JDumas

4) What is the correct placement of an endotracheal tube in a neonate with TEF (transesophageal fistula). a) Above the fistula b) At the level of the fistula c) Between the fistula and the carina

c) Between the fistula and the carina N&P Ch. 47 pg. 1186 JDumas

3) Studies have shown neuraxial anesthesia to decrease what intraoperative complications? a) Nerve damage, IOP, Cardiac complications b) Intraoperative fluid requirement, analgesics, volatile agents c) Blood loss, incidence of postoperative thromboembolic events, postoperative ileus

c) Blood loss, incidence of postoperative thromboembolic events, postoperative ileus N&P Chapter 44 pg. 1074 JDumas

1) What is the function of microcirculation? a) Control membrane permeability and transport of lymphocytes b) Control heat, metabolism, and hormones c) Control the delivery of nutrients to the capillary tissue beds, remove waste products, maintain ionic concentrations, and transport hormones to the tissues

c) Control the delivery of nutrients to the capillary tissue beds, remove waste products, maintain ionic concentrations, and transport hormones to the tissues. N&P Chapter 23 pg 488 JDumas

5) What is one of the six major advantages of using neuromuscular blocking agents in neonatal anesthesia? a) Neuromuscular blocking agents are not advantageous b) They supplement nitrous oxide c) Controlling efficient ventilation throughout surgery

c) Controlling efficient ventilation throughout surgery N&P Ch. 47 pg. 1186 JDumas

2) What are the 2 ultimate goals of induction for cardiac surgery? a) Prevention of kidney failure and respiratory rehabilitation b) Controlled hypotension technique and control diabetes c) Hemodynamic stability and block the stimulating effects of laryngoscopy

c) Hemodynamic stability and block the stimulating effects of laryngoscopy N&P Chapter 24 pg 528 Jared

3) During CPB, what are the 3 most stimulating events? a) Induction, incision, and sternal spread b) Induction, incision, and extubation c) Incision, sternotomy, and sternal spread

c) Incision, sternotomy, and sternal spread N&P Chapter 24 pg 528 Jared

5) The abdominal aorta terminates at the common iliac arteries in the pelvis. These arteries divide into _______ and _______ iliac arteries. The internal iliac arteries supply blood to structures within the pelvis, whereas the external iliac arteries supply blood to the _______? a) Internal and External, kidneys b) Deep and Superficial, intestines c) Internal and External, legs

c) Internal and External, legs N&P Chapter 23 pg 488 JDumas

4) What 2 veins drain blood from the head and neck back to the heart? a) Azygos vein and Cephalic vein b) Renal vein and Spermatic vein c) Internal jugular vein and External jugular vein

c) Internal jugular vein and External jugular vein N&P Chapter 23 pg 488 JDumas

1) Which combination of induction medications works BEST for cardiac surgery? a) Combination of Lidocaine, Fentanyl, Propofol, and Succinylcholine works best b) Combination of Lidocaine, Propofol, and Succinylcholine works best c) No combination of induction medications has proven superior in cardiac anesthesia

c) No combination of induction medications has proven superior in cardiac anesthesia N&P Chapter 24 pg 528 Jared

4) What pre/post-operative documentation is vital when administering CNB on a patient with a pre-existing neurological disease? a) Head to toe assessment, Pre/post vitals, Cardiac function b) Glasgow coma score, Location of IV, Volume of CNB agent used c) Precise documentation of the patient's preexisting disease state and existing neurologic compromise and attentive follow-up care

c) Precise documentation of the patient's preexisting disease state and existing neurologic compromise and attentive follow-up care N&P Chapter 44 pg. 1076 JDumas

1) What are some main advantages to neuraxial anesthesia? a) less pain, less anesthesia requirement, early mobility, less urinary retention b) less side effects, less defecation, less side effects, less mental alertness c) less nausea, less vomiting, less urinary retention, less total opioid requirement, and greater mental alertness

c) less nausea, less vomiting, less urinary retention, less total opioid requirement, and greater mental alertness N&P Chapter 44 pg. 1074 JDumas

1. For neurosurgical procedures, a three-pin head holder is generally used to secure the head. All of the following are true regarding the three-pin head holder, except: (N&P ch 21, pg 418) a. avoids eye compression b. jugular venous obstruction can occur if the head is excessively flexed on the neck c. at least four fingerbreadths of space should be allowed between the neck and mandible d. incorrect placement of the head holder and contact of its metal bars with the nose/skin can cause pressure ulcers

c. Hale

2. All of the following are true regarding cryoprecipitate except: (N&P ch20, pg 398) a. Contains factor VIII, von Willebrand factor, and fibrinogen b. Should be administered through a filter c. Must be administered as slowly as possible d. Must be administrated within 6hrs of thawing

c. Hale

5. At what prolonged intraocular pressure has there been found to be an increased incidence of post-operative vision loss: a. 20mmHg b. 20cmH2O c. 40mmHg d. 40cmH20 Nagelhout and Plaus ch 40, pg 1010

c. Hale

A baby presents with bilious emesis due to bowel strangulation, bloody stools, peritonitis, and hypovolemia. These symptoms could be representative of what neonatal condition: a. Ladd Disease b. Transesophageal fistula c. Malrotation and Midgut Volvulus d. Pyloric stenosis

c. Hale

Most cases of post-operative vision loss demonstrate vision loss within: a. The first 12 hours b. 12-24 hours c. 24-48 hours d. 3-7 days Nagelhout and Plaus ch 40, pg 1010

c. Hale

____________ ECMO is the preferred method of treatment for respiratory failure. _____________ ECMO is used if left ventricular support is also required. (N&P ch24, pg 549) a. Venoarterial, venovenous b. Venovenous, venovenous c. Venovenous, venoarterial d. Venoarterial, venoarterial

c. Hale

The two main causes of visual loss during/after non-ocular surgery are (choose 2): a. Undiagnosed optic nerve lesion b. Adverse pharmacologic response c. Retinal vascular occlusion d. Ischemic optic neuropathy Nagelhout and Plaus ch 40, pg 1010

c. d. Hale

Which of the following is the ejection fraction of a patient whose end-diastolic volume is 110, end-systolic volume is 30, heart rate is 65, and cardiac output is 7 L/min? a. 0.61 b. 0.50 c. 0.72 d. 0.45

c. 0.72 M&M Chapter 20, page 356 EF = [(EDV-ESV)/EDV] Jennifer

1. What is the incidence of aspiration among the pediatric surgical population? a. 1 in 250 b. 1 in 500 c. 1 in 1,000 d. 1 in 1,500

c. 1 in 1,000 M&M page 888 Willie

In the anesthetic implications of the review of systems and history, which of the following should be considered for possible anesthetic implications for the respiratory system? a. Elevated ICP b. Septal defect, avoid air bubbles in IV line c. B-agonist or theophylline drugs; pulmonary HTN or cor pulmonale; steroid use; adrenal insufficiency; postoperative hypoxia d. Risk of aspiration; reactive airways; hypoxia

c. B-agonist or theophylline drugs; pulmonary HTN or cor pulmonale; steroid use; adrenal insufficiency; postoperative hypoxia DB NP 1195

3. What information can be retrieved from using a Transcranial Doppler (TCD)? a. Blood flow volume from the circle of Willis b. Blood flow velocity from the cerebral sinus c. Blood flow velocity in the middle cerebral artery d. Temporal artery blood pressure

c. Blood flow velocity in the middle cerebral artery M&M page 452 Willie

What is the site of B-cell maturation in the adult? a. Thymus b. Liver c. Bone marrow d. Spleen

c. Bone marrow (N&P pg 1017) Josh

What causes the closure of the foramen ovale? a. Decreased right atrial pressure b. Increased left atrial pressure c. Both a and b are correct d. None are correct

c. Both a and b are correct (N&P pg 1163) Josh

1. Aging causes which of the following changes among drugs and their relationship to the patient? a. Pharmacodynamic change b. Pharmacokinetic change c. Both of these

c. Both of these M&M Ch. 43 Pg. 913 Thetford

The level of what important plasma may possibly predict PERIoperative morbidity? a. Plasma IL-1 b. Plasma IL-6 c. CRP d. TNF

c. CRP N&P p. 1031 Lexi

Which of the following medications can be used to treat magnesium sulfate overdose? a. Sodium Bicarbonate b. Potassium Chloride c. Calcium Chloride d. Amiodarone

c. Calcium Chloride NP: 1137 Byron

All of the following are main actions of histamine-1 receptors EXCEPT? a. Vasodilation b. Increased vascular permeability c. Cardiac stimulation d. Contraction of most smooth muscle other than that of blood vessels

c. Cardiac stimulation N&P page 1023, box 41-3 Jennifer

All of the following are cardiovascular manifestations of rheumatoid arthritis except? a. Pericardial thickening b. Myocarditis c. Cardiac tamponade d. Aortic regurgitation

c. Cardiac tamponade M&M Chapter 38, page 795, table 38-1 Jennifer

Which TWO of the following are cardiovascular manifestations of sickle cell anemia? a. Pleural effusion b. Endocarditis c. Cor pulmonale d. Congestive heart failure

c. Cor pulmonale d. Congestive heart failure M&M p. 1178 Lexi

Of the following what is the most common cause of myocardial ischemia? a. Severe hypertension b. Coronary arterial vasospasm c. Coronary artery atherosclerosis d. Tachycardia

c. Coronary artery atherosclerosis (M&M pg 387) Lake

2. Caudal epidural anesthesia is commonly used for all of the following procedures except? (Select all that apply) a. Urogenital b. Inguinal c. Cranial d. Rectal e. Lower extremity f. Surgeries above the diaphragm

c. Cranial f. Surgeries above the diaphragm M&M Ch. 45 Pg. 964 Thetford

5. What substance is released in response to injury by immune and non immune cells via the inflammatory process? a. Prostaglandins b. serotonin c. Cytokines d. Histamines

c. Cytokines n&p 1246 rebecca

Reduced LV relaxation due to impaired calcium homeostasis and reduced beta receptor responsiveness results in what age related consequence to the cardiovascular system? a. Myocardial stiffening b. Myocardial hypertrophy c. Diastolic dysfunction d. Systolic dysfunction

c. Diastolic dysfunction NP: 1216 Byron

What is the most common cause of nonsurgical bleeding following massive blood transfusion? a. Disseminated intravascular coagulation (DIC) b. Hypocalcemia c. Dilutional thrombocytopenia d. Hyperkalemia

c. Dilutional thrombocytopenia (M&M pg 1161) Josh

3. Shoulder braces Shoulder braces used during cases requiring steep trendelenburg can compress neurovascular structures and cause brachial plexus neuropathy. In an effort to avoid this, where should the shoulder braces be placed? a. Near the base of the neck b. Mid clavicle c. Distal end of the clavicle d. They should not be used due to high risk of injury

c. Distal end of the clavicle NP: 408 Byron

Which of the following methods provides the most accurate measurements of cardiac filling and function? a. Pulmonary artery catheter b. Central venous catheter c. Echocardiography d. None of the above

c. Echocardiography (M&M pg. 1178) Josh

The addition of what vasoconstrictor for digital blocks has been claimed to seriously compromise blood flow to the digit? a. Dobutamine b. Ephedrine c. Epinephrine d. Neosynephrine

c. Epinephrine M&M Chapter 46, page 1000 Jennifer

4. Substance P has ______ effect on nociception, Glutamate has _______ effect on nociception, and Norepinephrine has ________ effect nociception. (M&M pg 1034) a. Inhibitory, Inhibitory, Excitatory b. Excitatory, Inhibitory, Excitatory c. Excitatory, Excitatory, Inhibitory d. Excitatory, Excitatory, Excitatory

c. Excitatory, Excitatory, Inhibitory

What block is indicated for spastic contractions of facial muscles? a. Pudendal block b. Trigeminal nerve block c. Facial nerve block d. Glossopharyngeal block

c. Facial nerve block (M&M pg 1064) Josh

All of the following diseases are tested in donated blood EXCEPT? a. Human immunodeficiency virus b. Hepatitis B c. Hepatitis A d. Syphilis

c. Hepatitis A M&M Chapter 51, page 1170 Jennifer

5. What is the most significant reason that supraclavicular blocks are rarely used? a. High incidence of nerve damage b. High risk of vertebral artery puncture c. High risk of pneumothorax d. Poor patient satisfaction

c. High risk of pneumothorax M&M page 986

What is the most common problem in the postoperative period for a patient who has undergone a carotid endarterectomy (CEA)? a. Hypotension b. Bradycardia c. Hypertension d. Tachycardia

c. Hypertension N&P Chapter 25, page 582 Jennifer

1. Upon reviewing a preoperative laboratory data, you find your patient has a serum osmolality > 285 mOsm. As the nurse anesthetist what is your recommendation with the associated finding? a. Proceed with the surgery making a note of the abnormality b. Cancel the surgery c. Hypertonic hyponatremia, treat underlying hypertonic state d. Lab artifact, no need to treat

c. Hypertonic hyponatremia, treat underlying hypertonic state Nagelhout Page 386 Figure 20-2 Budenbender

3. What is the first thing to restore in a patient with chronic hypernatremia accompanied by volume depletion? a. Hypertonic crystalloids b. Hypotonic crystalloids c. Isotonic crystalloids d. D5 0.9% NaCl

c. Isotonic crystalloids Budenbender Nagelhout Page 387

Where is the subdural space located? a. It is a potential space between the pia mater and spinal cord b. It is a potential space between the pia mater and arachnoid mater c. It is a potential space between dura mater and arachnoid membrane d. The subdural space is where spinal fluid is located

c. It is a potential space between dura mater and arachnoid membrane (M&M pg 943) Lake

2. When performing a lumbar spinal puncture what level usually avoids potential needle trauma to the cord in adults? (M&M pg 937) a. C12 b. T12 c. L1 d. L3

c. L1 Ian

In an adult the spinal cord normally extends to what spinal level? a. L3 b. T12 c. L1 d. S1

c. L1 (M&M pg 943) Lake

5. What is the most common position for performing a total hip arthroplasty? a. Prone b. Supine c. Lateral d. Lithotomy

c. Lateral M&M page 794

4. What is the most common complication associated with carotid artery stenting? a. Carotid artery dissection b. Horner Syndrome c. Stroke from thromboembolism d. Hemorrhage from anticoagulation

c. Stroke from thromboembolism N&P p. 585 Lexi

Which TWO mortality risks were higher among anesthesiologists when compared to internists? a. Heart disease b. Cancer c. Suicide d. Drug-related death

c. Suicide d. Drug-related death M&M p. 1223 Lexi

The Intercristal Line or Tuffer's Line is the imaginary line that can be drawn between which to anatomic landmarks? a. Origin of the scapular spines b. Tip of the 12th ribs c. Superior aspect of the iliac crests d. Posterior superior iliac spines

c. Superior aspect of the iliac crests NP: 1079 Byron

5. What is the target blood glucose during the postoperative care of the patient with diabetes mellitus is essential if the patient will be in the ICU for more than 3 days? a. 180 mg/dL or less b. Consult endocrinology for diabetic patients c. Target should be 150 mg/dl or less d. Transition patient to subcutaneous insulin

c. Target should be 150 mg/dl or less Nagelhout page 522 Budenbender

4. Which of the following drugs are an absolute contraindication for regional anesthesia in the patient receiving thromboprophylaxis? a. Bivalirudin (angiomax) b. Desirudin (Iprivask) c. Thrombolytics d. Thrombin inhibitors

c. Thrombolytics Nagelhout page 1077 Tabel 44-3

How would a Jehovah's Witness undergoing a surgery with the potential for massive blood loss change your anesthesia plan of care? a. Avoid placement of any invasive lines as this would increase risk for blood loss b. Controlled hypotension techniques should be avoided c. Use of aprotinin should be considered d. Additional consents should be obtained

c. Use of aprotinin should be considered M&M p. 802 Lexi

A nephrectomy does not always require blood replacement with cell salvage, which of the following reasons would indicate the use of cell salvage? a. When the patient chooses so b. When the surgeon requests it c. When the tumor involves major vessels d. When the patient blood type is unknown

c. When the tumor involves major vessels N&P p.400 Lexi

What is the only approach to the brachial plexus block that can provide adequate anesthesia to the shoulder as well as the rest of the extremity? a. Supraclavicular approach b. Infraclavicular approach c. Interscalene approach d. Axillary approach

c. interscalene approach NP: 1108 Byron

4. What phenomenon is associated with increased emboli detection using a TCD? a. Bilateral hemisphere stroke b. Intracranial bleeding c. postoperative neurobehavioral dysfunction d. Increases the MAC requirements

c. postoperative neurobehavioral dysfunction M&M page 453 Willie

4.) Serum creatinine level in the elderly population is usually______. a.) Reduced b.) Increased c.) Stays the same d.) Increased greatly M&M page 911

c.) Stays the same Zino