SGQ Comprehensive Exam

3) What does Standard Deviation (SD) and Standard Error of the Mean (SEM) reflect? A) Average dose requirements for 50% of the population B) Response of geriatric patients to a given drug C) Pharmacologic principles of population variance

C) Pharmacologic principles of population variance N&P Ch 5 pg 56 Jared Dumas

2) What happens when a nerve is stimulated? a. Potential remains the same b. Action potential is inhibited c. Reversal of the potential occurs until the threshold potential is reached d. Membrane potential occurs but threshold does not occur

C. reversal of the membrane potential occurs until threshold potential is reached Rebecca n&p pg 127

Which of the following drugs cause a decrease in pseudo cholinesterase activity? (Select all that apply, Select 3) a. Neostigmine b. Lidocaine c. Esmolol d. Fentanyl e. Pancuronium

a. Neostigmine c. Esmolol e. Pancuronium (M&M pg 207) Lake

Which of the following produces bronchodilation? a. Volatile agents b. Propranolol c. Esmolol d. Timolol

a. Volatile agents N&P p. 95 Jason

Brainstem Auditory Evoked Potentials (BAEPs) send signals via what sensory form? a. taste b. hearing c. smell d. touch e. sight

b. hearing NP-pg. 330 Krum

1. Which of the following drug uses is associated with an increased metabolic rate? a. Amphetamines b. Ectasy c. Cocaine d. All of the above

d. All of the above N&P page 321 Willie

5. Which can sound waves not penetrate through? a. Solid b. Liquid c. Gas d. Vacuum

i. Answer: D- vacuum ii. N+P page 228 Sommers

ST segment trending monitors have an average sensitivity of _____% in detecting myocardial ischemia. A: 99% B: 74% C: 25% D: 50%

B: 74% Reference: N&P page 292, second column, second paragraph Abe

3. What drugs are used as first line therapy for shock? Select 2 a. Dopamine b. Epinephrine c. Norepinephrine d. Clonidine

A &C i. N&P pg 188 anozier

What is the correct pin position for an N2O e-cylinder according to the Pin Index Safety System? A: 1:5 B: 2:5 C: 3:5 D: 4:5

C: 3:5 Reference: N&P page 247, Table 15-1 Abe

2.) This type of stimulation denotes four successive 200-us stiumuli in 2 sec (Hz). a) Sustained tetany b) Double burst c) Train of four d) All of the above

c.) Train of four M&M page 139 Zino

3.) How are COX inhibitors excreted from the body after biotransformation? a.) Liver b.) Feces c.) Urine d.) Lungs

c.) Urine M&M page 197 Zino

5.) What local anesthetic is known to reduce pain and epistaxis related to nasal intubations? a.) Lidocaine b.) Tetracaine c.) Cocaine d.) Bupivicaine

c.) cocaine M&M page 274 Zino

4.) What is the preservative called that is prepared with amide anesthetics? a.) Methlyparaben b.) PABA c.) Methylene blue d.) Sodium hydroxide

A M & M page 274 Zino

4. Which type of receptors are opioid receptors? a. G-protein coupled receptors b. Ligand gated receptors c. Nuclear receptors d. Intracellular cAMP receptors Reference: N&P pg 147

A Reference: N&P pg 147 Mandy

4. Which of the following portions of the EEG waveform do inhalation agents affect? a. Frequency b. Amplitude c. Burst suppression d. Shape

A & B Frequency and Amplitude N&P 328 mandy

2. Which portion of the ETCO2 waveform represents the longest duration of the measurement? a. Third Phase b. First Phase c. Second phase d. Plateau phase

A & D N&P pg 316

1. What type of receptor is the GABA(a) Receptor? a. Ligand-gated ion channel b. Mechanoreceptor c. Ionophore d. G-protein Receptor

A - Ligand gated Ion Channel N&P -106 Justin

1.) What is the vapor pressure of isoflurane? (NP, page 223) A. 238 mmHg B. 160 mmHg C. 660 mmHg D. 655 mmHg

A 238 mmHg Maggie

1. Therapeutic doses reflect average doses for what patient population? a. "Normal" healthy patients b. Patients with renal failure. c. Elderly Patients d. Pediatric Patients.

A. Normal Health Patient N&P 55 Justin

3. Match the following local anesthetics with the type of chemical structure. a. Ropivacaine b. Tetracaine c. Procaine d. Lidocaine e. Chloroprocaine

Answers: A)Amide B)Ester C) Ester D) Amide E) Ester M&M Ch. 16 Pg. 270-271 Mark Thetford

Which of the following is not considered one of the three common properties of receptors? A: Sensitivity B: Selectivity C: Specificity D: Conductivity

D: Conductivity Reference: N&P page 53, 2nd column 3rd paragraph

What is median effective dose a. Dose at which 50% of population responds as desired b. Desired effect is obtained with only half of the required dose c. The effective dose is double the mean of the standard dose d. None of these

Dose at which 50% of population responds as desired Charlie N &P pg. 57

Why is the Circle system more effective than Mapleson circuits? A. reduced waste of anesthetic gases B. better control of anesthetic depth C. CO2 extraction via CO2 absorber D. Unidirectional valves E. All of the above

E. All of the above Morgan & Mikhail, Ch 3, pg 36 Caroline

Generally accepted criteria for brain death include: A. Coma B. Absence of motor activity, including decerebrate, decorticate and spinal reflexes C. Absence of brainstem reflexes D. Absence of ventilatory effort E. All of the above

E. All of the above M&M pg. 1280 K. Jensen

Pulmonary artery catheter with the balloon inflated in what West Zone of the lung? a. West Zone 3 b. West zone 2 c. West zone 1 d. West zone 4

a. West Zone 3 N&P pg 303 BIEBER

Amnestic effects of benzodiazepines are reversed less rapidly than hypnotic effects, which are reversed in approximately how many minutes? a. < 1 minute b. < 2 minutes c. 3-5 minutes d. > 5 minutes

a. < 1 minute M&M p. 290 Lexi

Which of the following Mapleson circuits is most useful during spontaneous ventilation? a. Mapleson A b. Mapleson B c. Mapleson C d. Mapleson D

a. Mapleson A M&M pg. 35 Jennifer

What three determinants of the actual FIO2 delivered to the adult patient with a nasal cannula? a. Dead space b. Oxygen flow c. FRC d. Nasopharyngeal volume e. Vital capacity f. Inspiratory flow

b. Oxygen flow d. Nasopharyngeal volume f. Inspiratory flow (M&M pg 1283) Lake

What is emitted when a fluorescent molecule is excited to a higher energy state? a. Proton b. Photon c. Electron d. Neutron

b. Photon N&P p. 236 Lexi

5. Hydralazine under goes? (Select 2) a. Glucuronidation b. Reduction c. Acetylation d. Hydroxylation

c. Acetylation d. Hydroxylation M&M, page 260 Willie

3. Which of the follow clinical procedures is NOT likely to involve an EEG? a. Carotid endarterectomy b. Epilepsy surgery c. Therapeutic hypothermia d. Thyroidectomy

i. Answer: D- thyroidectomy ii. M&M page 130 Sommers

Placement of an AICD can be done in what hospital setting a. Operating room b. Cardiac procedure room c. Cardiac cath lab d. All of the above

d. All of the above N&P pg. 1269 Charlie

Which nerve roots innervate the anal sphincter? a. C2-C4 b. C8-T1 c. T12 d. S2-S4 N&P Ch 18 pg 332

d. S2-S4 Mbom

Physiological reflexes that occur as a result of endotracheal intubation, can cause which of the following? a. Hypertension b. Tachycardia c. Increased ICP d. Increased IOP e. All of the above

e. All of the above M&M, pg. 334 Lexi

2. Which of the following is used for Oxygen Analysis? a. Paramagnetic oxygen sensor b. pH optode c. Polarographic electrode (clark electrode) d. Fluorescence Quenching e. All of the above

e. All of the above N&P Ch. 14 Pg. 233-234 Mark Thetford

2. Which of the following is not a ventilator mode? a. CMV b. AC c. IMV d. MMV e. All of these are correct M&M, ch 57 pg 1289-1290

e. All of these are correct Mbom

Locations for direct arterial blood pressure monitoring include: a. Radial b. Ulnar c. Brachial d. Axillary e. Femoral f. Dorsalis pedis g. all of the above

g. all of the above (N&P ch16, pg 307) Kaitlin

Which is not an effect of propranolol administration? A. Decreased BP B. decreased myocardial contractility, C. lowered heart rate D. diminished renin release. E. All are effects of propranolol administration

• Answer: E • M&M page 251 Fletcher

3. Which of the following are adverse effects of ACE inhibitors. (select 2) A. cough, B. angioedema, C. hypokalemia D. Raynaud's disease

• Answers: A&B • N&P pg. 201 Fletcher

What contributes to the water solubility of Midazolam at a low pH? A. The Imidazole ring B. Molecular Weight C. route of administration D. PKA

• Answer A • M&M pg. 179 Fletcher

5. Which of the following anticholingeric drugs is least likely to cause sedation? a. Atropine b. Glycopyrrolate c. Scopolamine

Answer: B- Glycopyrrolate Morgan & Mikhail's Clinical Anesthesiology pg. 234 Stetler

4. The "v" wave on the CVP tracing will appear shortly after which wave on the ECG? A. P wave B. PR interval C. QRS interval D. T wave

Answer: D. T wave N & P, pg. 301 Stefania Can appear after QRS as well. Same page #.

2. Match the following descriptions with the correct antagonist (competitive, noncompetitive) 1. _____weak affinity for receptor 2. _____strong affinity for the receptor 3. _____phenoxybenzamine, aspirin 4. _____atropine, esmolol

Answers: 1. Competitive 2. Noncompetitive 3. Noncompetitive 4. Competitive N & P pg. 58 Stefania

What do capnographs reliably indicate? (M and M, page 127) A. Reliably indicate PE B. Reliably detect esophageal intubation but do NOT reliably indicate bronchiole intubation C. Reliably detect bronchiole intubation D. Reliably detect ARDS

B. Reliably detect esophageal intubation but do NOT reliably indicate bronchiole intubation Maggie

True or False- Insufflation can be used to maintain arterial oxygenation during brief periods of apnea.

True Morgan and Mikhail's page 31 Krum

(True or False) Because of the unidirectional valves, apparatus dead space in a circle system is limited to the area distal to the point of inspiratory and expiratory gas mixing at the Y-piece.

True (Page 40 of M & M) Willie

True or False. If liquid nitrous oxide is kept at a constant temperature (20°C), it will vaporize at the same rate at which it is consumed and will maintain a constant pressure (745 psig) until the liquid is exhausted?

True M&M pg 13 Adam

4. The Normal Physiologic response of the cerebral vasculature to CO2 is to Vasoconstriction in the presence of? a. Hypocapnia b. Hypercapnia c. Hypercarbia d. Pizza We all like pizza

a. Hypocapnia N&P pg 89 Fieber

3. Which of the following is associated with the greatest increase in atracurium's duration of action? a. Hyperthermia b. Hypothermia c. Alkaline pH d. Acidic pH

b. Hypothermia Willie M&M 216

In regards to the pharmacokinetics of ketamine, what type of compartment model does ketamine most closely follow? a. One-Compartment Model b. Two-Compartment Model c. Three-Compartment Model d. Four-Compartment Model

b. Two-Compartment Model NP: 113 Byron

The model theory proposing that receptors exist in a state of equilibrium in either an activated state or an inactivated state. Subsequently, receptors can shift towards an activated state despite no agonist or ligand being present is referred to as the: a. Two-Compartment model b. Two-State Model c. Three-Compartment Model d. Three-State Model

b. Two-state model NP: 58 Byron

3. Hypothermia is associated with all of the following except? a. Increased blood glucose b. Vasodilation c. Decreased drug metabolism d. Increased risk of surgical infection

b. Vasodilation M&M Ch. 6 Pg. 136 Mark Thetford

What is cardioversion synchronized with a. R wave b. P wave c. T wave d. Does not require synchronization

a. R wave N&P pg. 1269 Charlie

4. The most common side effects of Clonidine administration include all of the following except? a. Tachycardia b. Sedation c. Dizziness d. Bradycardia e. Dry Mouth

a. Tachycardia M&M Ch. 17 Pg. 287 Mark Thetford

3. You are running a sodium nitroprusside drip and maintaining a MAP of 60. The MAP starts to increase despite your attempts to titrate the drip. What is happing? (Select one) a. Tachyphylaxis b. Upregulation c. Tolerance d. Downregulation

a. Tachyphylaxis Jason [M&M p. 255]

1. The chronic use of Levabuterol/xopenex, β2-agonist, by a patient can result in: a. Tachyphylaxis secondary to down-regulation of β-receptors b. Decreased responsiveness of airway c. Lower risk of asthma-related death d. To speed up labor

a. Tachyphylaxis secondary to down-regulation of β-receptors Nagelhout page 191 David Budenbender

3. The most reliable means of assessing Fade of twitches is to use? N&P pg 161 a. Tetanus b. TOF c. Single twitch d. Double burst

a. Tetanus N&P pg 161 Fieber

What is the intubating dose of Atracurium? A. 0.2 mg/kg B. 0.5 mg/kg C. 0.7 mg/kg D. 1 mg/kg

• Answer: B • Nagelhout and Plaus page 165 Fletcher

Which reversal agent is classified as a selective antagonist and reverses aminosteroid-induced neuromuscular blockade? a. Sugammadex b. Neostigmine c. Edrophonium d. Pyridostigmine

*a. Sugammadex* M&M Ch. 12, pg. 231 Jennifer

5. What is the normal range for SvO2? a. 65-77% b. 45-65% c. 90-100% d. 12-18%

65-77% NP p. 306 Jason

Which type of cylinders can be used around an MRI machine? A. nonferrous (aluminum) cylinders B. Stainless steel cylinders C. Plastic coated cylinders D. Any standard cylinder is safe around MRI machines

A N&P 250

4. What are some DERMAL effects of histamine? (select 2) A. Skin dryness B. Flushed/ reddened skin C. Raised skin/ skin wheal D. Pale, cool skin

Answer: B, C The classic wheal-and-flare response of the skin to histamine results from increased capillary permeability and vasodilation, primarily via H 1 -receptor activation. M&M pg 279. Blair Ryan

Mu receptors are not homogenous! Match the mu receptor to its specific sub-group. A: Mu1 B: Mu2 C: Mu3 1. Cardiac 2. Glandular 3. Neuronal

Answer: A3, B1, C2. receptor subgroups have been identified including: neuronal (M 1), cardiac (M 2), and glandular (M 3) receptors Morgan and Mikhail pg. 233 Mr. Ryan

4. PA catheters were once thought to be the gold standard for managing hemodynamics of complex cases. From the list select all that can be interpreted with its use. a. Stroke volume indirectly b. Cardiac output c. Pulmonary occlusion pressure d. The arterial oxygen content of the blood.

Answer: ABC. D is incorrect but the pulmonary (most distal) port can be used to draw the most accurate SvO2 levels. M&M Chapter 5 pg 116, 120. Blair Ryan

What is the normal range for a LVEDP? a. 20-25 b. 15-5 c. 1-3 d. 4-12

Answer: D N & P 300 Justin

Select 3 ways in which abnormal wall motion may be described during a TEE? A. Hyperkinesia B. Hypokinesia C. Akinesia D. Dyskinesia

B, C, D N&P 309

How would you describe a patient with a Class IV (severe) New York Heart Association Functional Classification for Heart Failure? (N&P ch13, pg205) a. Comfortable at rest but less than ordinary activity causes fatigue palpitation, or dyspnea b. Unable to carry out any physical activity without discomfort c. Symptoms of cardiac insufficiency at rest d. If any physical activity is undertaken, discomfort is increased

B, C, and D Hale

3. What is the physiological effects of using Inverse I:E ratio ventilation? a. Increased FRC b. Decreased tidal volume c. Reduction in work of breathing d. All of the above

a. Increased FRC M & M, page 1294 Willie

3. What percentage of ICU admissions does AKI approximately account for? (M&M pg 1312) a. 35% b. 15% c. 1% d. 100%

b. 15%

2. Administration of which of the following drugs may reduce the propofol dose by more than 10%? a. Fospropofol b. Midazolam c. Demerol d. Benedryl

b. Midazolam Reference: M&M pg 187 Mandy

When using a semilogarithmic scale, to achieve a detailed representation of the dose response curve it is best to represent the dose in a. Log units b. Milligrams c. Grams d. Milliliters

a. Log units Charlie N &P pg. 56

1. What is the mechanism of action of isoproterenol? a. Pure Beta-agonist b. Alpha 2 agonist c. Pure Alpha agonist d. Mixed Alpha and Beta Agonist

a. Pure Beta-agonist M&M - Page 248, First column, third paragraph Justin

3. Which antihypertensive has the fastest onset time? N&P pg 199 a. Sodium nitroprusside b. Nicardipine c. Nitroglycerin d. Hydralazine

a. Sodium nitroprusside Fieber

2. Which of the following would NOT lower blood pressure? (Select one) a. Vazculep b. Volatile gases c. Calcium channel blockers d. ACE inhibitors

a. Vazculep Jason [M&M p. 255]

In contrast to the pharmacologic properties of propofol, fospropofol possesses which of the following characteristics: (Select 3) a. Water Soluble b. Lipid Soluble c. Prodrug d. Active Drug Form e. Rapid Onset f. Delayed Onset

a. Water Solubility c. Prodrug f. Delayed Onset NP: 1268 Byron

What are the current recommendations for a patient receiving dual platelet therapy prior to surgical intervention? a) Stop all platelet therapy 7 days before surgery. b) No recommendations exist. c) Consultation with a cardiologist regarding safe management of a patient on platelet therapy. d) Continue ALL platelet therapy during the perioperative period to protect coronary stents.

c) Consultation with a cardiologist regarding safe management of a patient on platelet therapy M&M pg. 299 Lake

What is the absolute maximum dose for injection of plain lidocaine per recommended guidelines for an infiltrative procedure? a. 100 mg total dose b. 200 mg total dose c. 300 mg total dose d. 400 mg total dose

c. 300 mg total dose Byron NP 137

What is the minimum recommended oxygen flow rate to limit rebreathing of CO2 when using a "simple" mask? a. 2 L/min b. 4 L/min c. 5 L/min d. 10 L/min

c. 5 L/min (M&M pg 1283) Lake

At a PO2 of 40 mmHg, hemoglobin is approximately saturated at what %? a. 50% b. 30% c. 75% d. 60%

c. 75% (N&P pg 319) Lake

4. At what dosages does the histamine associated with atracurium become significant? a. 0.1 mg/kg b. 0.05mg/kg c. >0.5 mg/kg d. 0.25mg/kg

c. >0.5 mg/kg Willie M&M 216

More rapid absorption of eye drops systemically occurs via which route? a. Vessels in the conjunctival sac b. By swallowing c. Nasolacrimal duct mucosa d. Accidental injection

c. Nasolacrimal duct mucosa M&M p. 236 Lexi

6. All of these Factors influence Pharmacokinetics of drugs except? N&P Pg 74 a. Age b. Gender c. Temperature d. Disease states e. All Are True

e. All Are True Fieber N&P Pg 74

3. Which if the following type of nerves are LEAST sensitive to LA a. A- alpha b. A-delta c. B- fibers d. A -gamma

i. Answer: A- A-Alpha ii. M&M page 266 sommers

5. This type of neuron is responsible for proprioception. a. A- alpha b. A-delta c. A -gamma d. B fibers e. C fibers

i. Answer: A- A-alpha ii. M&M page 266 sommers

5. What is the major risk following smoke inhalation? a. Airway obstruction b. Carbon monoxide poisoning c. Oral mucosa burns d. Cyanide toxicity

i. Answer: A- airway obstruction. ii. M&M page 1307 Sommers

What measures are taken to prevent bacterial contamination of subsequent patients ventilated with an anesthesia machine? a. Bacterial filter at the Y-piece b. Bacterial filter at the inspiratory tube. c. Bacterial filter at the expiratory tube. d. All of the above are correct.

d. All of the above are correct. (Page 40 of M & M) Willie

1. All of the following are properties of propofol EXCEPT? a. Antipruritic properties b. Antiemetic properties c. Anticonvulsant d. Increases intraocular pressure e. Increases cerebral blood flow

d. Increases intraocular pressure e. Increases cerebral blood flow Reference: M&M pg 187 mandy

4. This type of neuron is responsible for pain and temperature. a. A- alpha b. A-delta c. B fibers d. C fibers

i. Answer: E- C fibers. ii. M&M page266 sommers

What is the definition of a Ligand? A. Two substances that are repelled by each other B. "ligand" is another name for tendon C. A molecule that is able to bind to and form a complex with a receptor to produce a biologic response D. A molecule that inactivates all the receptors in its immediate vicinity.

• Answer: C • N&P Page 60 Kyle Fletcher

Most drugs are _____and must be metabolized to _____ products for excretion. A. Lipophobic, polar B. Hydrophilic, nonpolar C. Lipophilic, polar D. Hydrophobic, nonpolar

• Answer: C • Nagelhout and Plaus page 76 Kyle Fletcher

Barbiturates can precipitate what disorder? A. Acute intermittent Porphyria B. Seizures C. Alcohol withdrawl D. Seizures

• Answer A • M&M 179 Fletcher

What two gasses are associated with emergence delirium? (select two) A. Sevoflurane B. Desflurane C. Isoflurane D. Nitrous Oxide

• Answer A&B • Nagelhout and Plaus page 91 Fletcher

Which Volatile Anesthetics cause an increase in HR? (select 2) A. Isoflurane B. Desflurane C. Sevoflurane D. Nitrous Oxide

• Answer A&B • Nagelhout and Plaus page 92 Fletcher

Motor Evoked Potentials (MEPs) are used to monitor the ________ of motor tracts. a. Position b. Function c. Color d. All of the above

b. Function (N&P pg 331) Lake

1. Which neurotransmitter does propofol exhibit an effect on? a. NMDA b. GABA c. Glutamate d. Serotonin

b. GABA N&P pg 106 Rebecca

3. Where are Beta 3 receptors found? a. Heart b. Gallbladder c. Brain

b. Gallbladder c. Brain i. M& M pg 242 Rebecca

2. Which of the following are more sensitive to spinal cord ischemia? a. SEPs b. MEPs c. All EPs are equally sensitive d. All types of EPs

b. MEPs M&M Ch. 6 Pg. 135 Mark Thetford

Which opiate is known for its unique ability to stop shivering postoperatively? a. Morphine b. Meperidine c. Fentanyl d. Alfentanil

b. Meperidine M&M, p. 195 Lexi

What is the most accurate description of an isomer? a. Molecules that have the same structural formula but different chemical formula b. Molecules that have the same chemical formula but different structural formula c. Molecules that have The same chemical formula and structural formula d. All of the above are true

b. Molecules that have the same chemical formula but different structural formula (N&P pg 215) Lake

1. What is SvO2? a. Mixed venous oxygen saturation b. Systemic Vascular oxygenation c. Mean arterial oxygen saturation d. Stroke volume saturation

a. Mixed venous oxygen saturation NP p. 306 Jason

After removal of the guidewire during internal jugular venous insertion, what finger should be placed over the catheter hub to prevent aspiration of air until the IV tubing is connected to it? a. Index finger b. Thumb c. Ring finger d. Pinky finger

*b. Thumb* M&M pg. 103 Jennifer

4. In a two-compartment model, the elimination phase consists of: (M&M pg 148) a. Metabolism only b. Excretion only c. Both metabolism and excretion d. None of the above

*c. Both metabolism and excretion* Ian

Which law states that when pressure is constant, volume and temperature are directly proportional to one another? a. LaChatelier's b. Boyle c. Charles d. Gay-Lussac

*c. Charles* N&P Ch. 14, pg. 224, table 14-5 Jennifer

When using the Mapleson A circuit, or Magill attachment, what is the required fresh gas flow during spontaneous breathing? a. 2 x minute ventilation b. 3 x minute ventilation c. Equal to minute ventilation d. None of the above

*c. Equal to minute ventilation* M&M Pg 33 Lake

Match the following SI prefix names and factors. A. Kilo 1. 10^-3 B. Centi 2. 10^-2 C. Milli 3. 10^3 D. Giga 4. 10^9 Answers A:3, B:2, C:1, D:4

Answers A:3, B:2, C:1, D:4 N&P Ch. 14 pg. 212. K. Jensen

Match the following System International (SI) unit with the measurement. A. Kilogram 1. Electrical current B. Kelvin 2. Temperature C. Meter 3. Length D. Ampere 4. Mass

Answers- A:4, B:2, C:3, D:1 N&P Ch. 14 pg. 212. K. Jensen

How do you calculate a drug's therapeutic index? a. C50 for toxicity ÷ C50 for therapeutic effect b. C50 for therapeutic effect ÷ C50 for toxicity c. Emax for toxicity ÷ Emax for therapeutic effect d. Emax for therapeutic effect ÷ Emax for toxicity

a. C50 for toxicity ÷ C50 for therapeutic effect M&M - pg. 150 Lexi

The only reliable way to determine residual volume of nitrous oxide is to? a. Weigh the cylinder (TW) b. Pressure of 745 psig c. Sample the line gas d. Just replace the tank

Weigh the cylinder (TW) M&M pg 13 Adam

What two names is Succinylcholine also known as? (Select all that apply) a. Diacetylcholine b. Succinylmonocholine c. Suxamethonium d. Triacetuylcholine

a. Diacetylcholine c. Suxamethonium (M&M pg 205) Lake

Oxygenated and deoxygenated hemoglobin are ______________ and they act ___________ in response to electromagnetic radiation (EMR). a. Different, differently b. Similar, differently c. Similar, similarly d. Different, similarly

a. Different, differently N&P p. 237 Lexi

In regards to drug pharmacokinetics, what are the mechanisms by which drugs leave the central compartment? (Select 3) a. Distribution b. Metabolism c. Absorption d. Excretion

a. Distribution b. Metabolism d. Excretion NP: 67 Byron

3. Which columns/tracts can SSEP assess directly? (Select 2) a. Dorsal column (fasciculus cuneatus and gracilis) b. Lateral sensory tract of the spinal cord c. Superior Corticospinal tract on changes in the anterior d. Lateral motor tract

a. Dorsal column (fasciculus cuneatus and gracilis) b. Lateral sensory tract of the spinal cord p. 331 N& P Willie

4. The exposure of a drug versus physiological response is referred to as which of the following? a. Dose-response relationship b. Concentration-response relationship c. Exposure-concentration relationship d. Potency-efficacy relationship

a. Dose-response relationship b. Concentration-response relationship M&M Ch. 7 Pg. 149 Thetford

4. Barbiturates are principally bio-transformed via _____ oxidation to inactive water soluble metabolites. M&M pg 177 a. Hepatic b. Renal c. Hoffman degradation d. Plasmacholinesterases

a. Hepatic Fieber

4. Capacity Dependent elimination occurs with agents that possess a low extraction ratio of 0.3 or less. Hepatic perfusion does not have a significant effect on Clearance of these drugs (Diazepam and Theophylline). Instead they rely heavily on ______ for elimination? N&P Pg 73 a. Hepatic Enzymes b. temperature c. pH d. vasoconstriction

a. Hepatic Enzymes Fieber N&P Pg 73

5. Which of the following modes delivers small conventional tidal volumes at a rate of 60-120 breaths per minute? a. High frequency ventilation b. CMV c. PCV d. SIMV with PSV

a. High frequency ventilation M & M, page 1294 Willie

3. During emergence, which of the following should NOT be avoided? a. Higher PaCO2 values b. Low MV c. Hypercarbia d. Acidemia

a. Higher PaCO2 values N&P p. 94 Jason

Select all of the likely hemodynamic responses associated with the use of phenylephrine. (Select 3) a. Increased SVR b. Decreased SVR c. Increased CO d. Decreased CO e. Tachycardia f. Bradycardia

a. Increased SVR d. Decreased CO f. Bradycardia MM: 245 Byron

2. Which of the following refers to Parenteral administration? a. Injections b. Nebulizer c. Sustained release agent on skin d. Intraocular

a. Injections Nagelhout page 66 David Budenbender

2. Prilocaine's metabolite o-toluidine produces what potentially problematic condition in a dose-dependent fashion? (M&M pg. 271) a. Kidney failure b. Numbness and tingling c. Methemoglobinemia d. Pulmonary embolism

c. *Methemoglobinemia*

What is the minimal alveolar concentration (MAC) of an anesthetic that is able to blunt the autonomic response to noxious stimuli? a. 0.3-0.5 MAC b. 0.6-1.0 MAC c. 1.6-2.0 MAC d. 2.5-3.0 MAC

c. 1.6-2.0 MAC NP 82 Byron

When using a nonrebreather mask what is the typical desired oxygen flow? a. 1-5 L/min b. 5-10 L/min c. 10-15 L/min d. Any flow rate will do

c. 10-15 L/min (M&M pg 1284) Lake

What is the maximum dosage guideline for total cumulative infiltrative injection dose per procedure of lidocaine with epinephrine? a. 2.5 mg/kg b. 4.5 mg/kg c. 7 mg/kg d. 8 mg/kg

c. 7 mg/kg

What is the maximum dosage guideline for total cumulative infiltrative injection dose per procedure of plain lidocaine? a. 2.5 mg/kg b. 4.5 mg/kg c. 7 mg/kg d. 8 mg/kg

c. 7 mg/kg Byron NP 137

What percentage of cardiac output does the vessel rich group receive? a. 25% b. 50% c. 75% d. 80%

c. 75% NP: 68 Byron

Small increases in the dose of a potent drug will cause which type of effect in dose response? a. Small increases b. Proportional increased based on increase in dose c. Large increases d. No increase

c. Large increases M&M - pg. 150 Lexi

2. Which of the following is a metabolite produced once codeine is metabolized by CYP? a. Oxycodone b. Remifentanil c. Morphine d. Meperidine

c. Morphine M&M Ch. 10 Pg. 193 Mark Thetford

Which sensor device is available as a reusable cli-on or as a disposable stick-on probe? a. EKG leads b. BP cuffs c. O2 saturation sensor d. CO2 scrubber

c. O2 saturation sensor N&P Ch 17 pg 320 Mbom

Which of the following drugs does NOT possess a quarternary ammonium compound which prevents transfer to the blood brain barrier? a. Neostigmine b. Pyridostigmine c. Physostigmine d. Edrophonium

c. Physostigmine M&M p. 237 Lexi

What is used to stimulate the motor cortex when using MEPs? a. Vagal stimulation b. Cattle prod c. Magnetic stimulation d. Electrical stimulation e. Both c & d

e. Both c & d (N&P pg 331) Lake

4. All of the following NMB intubating doses is false? a. Succinylcholine 1.0mg/kg b. Rocuronium 0.8mg/kg c. Pancuronium 0.07mg/kg d. Vecuronium 0.05mg/kg e. Cisatracurium 1.2mg/kg M&M, Ch. 11, pg 214

e. Cisatracurium 1.2mg/kg Mbom

Which of the following is NOT linked to pulmonary compromise in the perioperative setting? a. Patients > 60 years old b. COPD c. Markedly reduced exercise tolerance d. Heart Failure e. Depression

e. Depression Morgan and Makhail's page 298 Krum

1. Renin, a proteolytic protein, is released from the juxtaglomerular apparatus in the kidney in response to A. Increased blood pressure B. diminished blood pressure C. increased Ca++ D. Decreased K+

• Answer: B • N&P pg. 201 Fletcher

All of the following are several factors that contribute to intraoperative EEG changes making the monitoring device more challenging to interpret, EXCEPT? a. Hypothermia b. Hyperthermia c. Volatile anesthetics d. Local anesthetics

*d. Local anesthetics* N&P Chapter 18, pg. 333 Jennifer

All of the following types of flow occur through tubes and orifices EXCEPT? a. Laminar b. Turbulent c. Transitional d. Retrograde

*d. Retrograde* N&P Ch. 14, pg. 225 Jennifer

Sodium nitroprusside and other nitrovasodilators relax: A) Both arteriolar and venous smooth muscle B) Arteriolar smooth muscle C) Venous smooth muscle D) Neither arteriolar or venous smooth muscle

A) Both arteriolar and venous smooth muscle Devin [M&M p.257]

If a stylet is used, it should be inserted into the tracheal tube, which is then bent to resemble: (Morgan & Mikhail, pg 326) a. A hockey stick b. A tennis racket c. A baseball bat d. A lightsaber

A. A hockey stick

5. The energy of electromagnetic radiation is directly related to a. Time b. Frequency c. Length d. All of the above

Answer: B, Frequency N&P pg. 232 Stetler

1. Azotemia caused by urinary tract obstruction is defined as which of the following? a. Prerenal azotemia b. Postrenal azotemia c. Intrarenal azotemia d. Reversible azotemia

Answer: B- Postrenal azotemia Morgan & Mikhail's Clinical Anesthesiology pg. 1310 stetler

4. Barbiturates are derived from what? A. hydrochloric acid B. barbituric acid C. thiopituric acid D. carbonic acid

Answer: B., barbituric acid M & M, pg. 176 Stefania

1. Which of the following is the correct classification of fenoldopam? A. beta-1 antagonist B. selective d-1 receptor agonist C. selective d-4 receptor agonist D. beta-1 agonist

Answer: B., selective d-1 receptor agonist M & M, pg. 248 Stefania

5. Which of the following is the principle use of opioids? a. Sedation b. General anesthesia c. Analgesia d. Antiemetic

Answer: C Analgesia Morgan & Mikhail's Clinical Anesthesiology pg. 19 Stetler

2. All of the following are factors that increase MAC EXCEPT: A. hyperthermia B. younger age C. hypothyroidism D. red-headed females

Answer: C, hypothyroidism N & P, pg: 88 Stefania

2. What is the MAC % for desflurane? a. 1.15 b. 2 c. 5.8 d. 104

C. 5.8 N&P - 79, 7-1 Justin

5. What characteristics of fentanyl make it effective via the transdermal route? )M&M pg 192) a. High molecular weight and water solubility b. It is activated by human sweat which helps it enter through pores in the skin c. Low molecular weight and high lipid solubility d. It is metabolized highly in the liver, transdermal administration delays breakdown and allows one fentanyl patch to be used for several weeks.

*Low molecular weight and high lipid solubility*

3) A patient is seen during a preoperative assessment and tells you they are allergic to a certain drug. As an astute SRNA, what actions should you take? Select all that apply. a. Avoid medications in the same class b. Know the difference between an allergic reaction and adverse effects c. Tell them they have nothing to worry about and still administer it to them d. Be aware that an allergy to a drug is an absolute contraindication

A. Avoid medications in the same class B.Know the difference between and allergic reaction and adverse reaction D. Be aware that an allergy to a drug is an absolute contraindication N&P pg 343 Rebecca

Reducing or preventing _______ and _________is the recommendation for using BIS monitoring during general anesthesia? A. Awareness / Recall B. Awakeness / Reflexes C. Assertiveness / Regurg

A. Awareness / Recall N&P Ch. 18 pg. 329 K. Jensen

Alpha-1 acid glycoprotein (AAG) binds which types of drugs? SELECT TWO A. Basic Drugs B. Barbituates C. Acidic Drugs D. Local Anesthetics

A. Basic Drugs D. Local Anesthetics (M and M, page 145) Maggie

The patient is linked to the anesthesia machine via: A. Breathing circuits B. Breathing systems C. Mapleson A D. Bag Mask Valve

A. Breathing circuits M&M pg. 29 Jensen

Scope and standards for the practice of CRNA's explain specific, required monitoring parameters. One of these parameters is to monitor oxygenation continuously, and the modifiers for this requirement include all of the following except: (N&P ch17, pg 314) a. By SvO2 measurements every hour b. By clinical observation c. By pulse oximetry d. Arterial blood gas analysis if needed

A. By SvO2 measurements every hour. (N&P ch17, pg 314) Kaitlin

You look into your patients mouth and are able to see the soft palate, tonsillar faces, tonsillar pillars, and the entire uvula, which Mallampati class would this be? A. Class 1 B. Class 2 C. Class 3 D. Class 4.

A. Class 1 N&P page 348 Justin

Disadvantages of Nitrous Oxide: (N&P ch8, pg 97) a. Expansion of closed air spaces b. Requires high concentrations c. Pungent odor d. Amount of oxygen delivered is reduced e. Diffusion hypoxia f. Airway irritation

A. Expansion of closed air spaces B. Requires high concentrations D. Amount of oxygen delivered is reduced E. Diffusion hypoxia Kaitlin

5) What other receptor does local anesthetic s have an effect on? a. G-protein - coupled receptor b. C- protein - coupled receptor c. CG- protein - coupled receptor

A. G- protein- coupled receptor Rebecca N&P pg 127

Miosis, (pinpoint pupils) is a common reaction of opioids. This is due to the depression of _________ in the interneuron, which stimulates a parasympathetic response in the oculomotor nerve, which constricts the pupil. A. GABA B. PABA C. Mu D. Kappa

A. GABA N&P Ch. 11 pg. 149-150 K. Jensen

5. The greater the standard deviation, the _____ the mean reflects central tendency of responses. a. Less b. More c. The two are unrelated. d. Not enough information is provided.

A. Less N&P 55 Justin

Renal failure is evident when the patient's creatinine clearance levels are? A. Less than 10 mL/min B. 50-80 mL/min C. Greater than 100 mL/min D. These levels are not useful in determining renal function

A. Less than 10 mL/min N&P Pg. 367 Crouse

5. Which of the following drugs belongs to the amide class of local anesthetics? a. Lidocaine b. Chloroprocaine c. Procaine d. Tetracaine

A. Lidocaine Nagelhout and Plaus - Page 129, Box 10-1 Justin

The formula to compute a time-weighted average of arterial pressures during a pulse cycle is the mean arterial pressure formula of: A. MAP = (SBP) + 2(DBP)/3 B. MAP = 2(SBP) + (DBP)/4 C. MAP = (SBP) + (DBP)/3 D. MAP = 4 + (SBP)/(DBP)

A. MAP = (SBP) + 2(DBP)/3 M&M page 87 K. Jensen

What condition would cause an increase in end-tidal CO2? (M and M, page 127) A. Malignant Hyperthermia B. Hyperventilation C. Hypotension D Increased tidal volumes

A. Malignant Hyperthermia Maggie

Which of these circuits is more efficient for controlled/mechanical ventilation? A. Mapleson D B. Mapleson F C. Mapleson A D. Water's to-and-fro

A. Mapleson D Morgan and Mikhail, Ch 3, pg 35 Caroline

Spirometers are used to: a. Measure exhaled tidal volume in the breathing circuit on all anesthesia machines b. Reduce pressure from gas canisters to 45-55 psi c. Provide supplemental oxygen d. Clean exhaled air to avoid OR environmental exposure to volatile agents

A. Measure exhaled tidal volume in the breathing circuit on all anesthesia machines (M&M, pg. 67)

Scope and standards for the practice of CRNA's explain specific, required monitoring parameters. One of these parameters is to monitor neuromuscular function and status, this can be done by: (N&P ch17, pg 314) a. Monitoring TOF when NMB agents are used b. Sustained tetany via peripheral nerve stimulator throughout shorter procedures c. Checking pupils every 3mins during case d. Monitoring neuromuscular function is only required for procedures lasting longer than 2hrs

A. Monitoring TOF when NMB agents are used. (N&P ch17, pg 314) Kaitlin

Post-procedure residual paralysis is linked to an increased rate of_______? A. Morbidity B. Asthma C. Myoclonus D. Metabolism

A. Morbidity M&M p. 224 K. Jensen

A dose dependent depression of respiration's by all opiate agonists is produced by effects on the _______ and _________ receptors in the respiratory center in the brainstem. (Select 2) A. Mu B. Delta C. Kappa D. G-protein

A. Mu B. Delta N&P Ch. 11 pg, 149 K. Jensen

Select two types of receptors for Acetylcholine. A. Muscarinic B. Nicotinic C. Mu D. Kappa

A. Muscarinic B. Nicotinic M&M p. 224 K. Jensen

Which cations must flow through the open ACh receptor channel to generate "end-plate potential" (Select 2) A. Na+ and Ca++ in B. K+ out C. K+ in and Na+ out D. Ca++ in and Na+ out

A. Na+ and Ca++ in B. K+ out M&M Ch. 11 pg. 201 K Jensen

Which of the following medication administration routes is the most convenient and economical, may have significant first-pass effect, and requires patient cooperation? a. Oral b. Intravenous c. Intrathecal d. Intramuscular

A. Oral N&P 65 Justin

2. Which of the following patients would benefit the MOST from global ischemic monitoring via a derived 12-lead? a. Patient's at substantial risk for CAD b. Every patient would c. Not any patient demographic in particular d. Patients > 65 years old

A. Patients at substantial risk for CAD. ~Nagelhout Page 295 It is possible that patients at substantial risk for CAD would benefit from global ischemic monitoring via a derived 23-lead. Budenbender

3. What is the mechanism of action of milrinone? a. Phosphodiesterase 3 inhibition b. Beta-2 blockade c. Alpha-2 agonist d. Alpha-1 antagonist

A. Phosphodiesterase 2 inhibition N&P, Page 189 Justin

What are the tasks of oxygen in the anesthesia gas machine? (select all that apply) A. Power oxygen flush valve B. Activate oxygen low-pressure alarms C. Activate oxygen high pressure alarms D. Compresses the bellow of mechanical ventilators

A. Power oxygen flush valve B. Activate oxygen low-pressure alarms D. Compresses the bellow mechanical ventilator N&P pg 254 Rebecca

Expiratory valve malfunction is detected by the presence of what? (M and M, page 127) A. Presence of CO2 in inspired gas B. Low pressure alarms C. Presence of CO2 in exhaled gas D. High pressure alarms

A. Presence of CO2 in inspired gas Maggie

Which brain monitoring method can be used to monitor the integrity of *sensory* pathways? a. SSEP b. MEP or TES-MEP c. TCD d. EEG Nagelhout and Plaus ch18, pg 326

A. SSEP Kaitlin

5. What effect does dobutamine have on systemic vascular resistance? a. Slight decrease in SVR b. Slight increase in SVR c. Massive increase in SVR. d. No effect at any dosing range

A. Slight decrease in SVR. N&P page 189 Justin

Carbonation of local anesthetics has what effect A. Speeds onset and increase intensity B. Slows onset, decreases intensity C. Makes local anesthetic worthless D. Has no effect

A. Speeds onset and increase intensity Charlie N&P pg. 132

4. What causes the dicrotic notch in pulmonary artery pressure waveforms? (N&P, pg 300) a. Sudden closure of the pulmonic valve leaflets b. A strong precordial thump c. Shockwave from surgeons mallet during ORIF procedures d. Caused by positive pressure ventilation

A. Sudden closure of the pulmonic valve leaflets

2) Regarding various forms of ST-segment depression, which type of ST depression has greater specificity (fewer false positives)? Select 2 a. An upsloping depressed ST b. A horizontal depressed ST c. A down sloping depressed ST d. A vertical depressed ST i. N&P pg 293

B. A horizontal depressed ST C.a down sloping depressed ST N&P pg 293 Rebecca

4. GABA-a channels are associated with movement of which ion? a. Potassium b. Chloride c. Sodium d. Magnesium

B. Chloride N&P - 107 Justin

In the nerve terminal, acetylcholine undergoes synthesis by which enzyme? A. Acetylcholinesterase B. Cholineacetyltransferase C. Muscarinicase D. Cholinesterase

B. Cholineacetyltransferase M&M p. 224 K. Jensen

1. What is the effects of phenylephrine on heart rate? a. Increased HR b. Decreased HR c. No change in HR d. Varies depending on the receptors targeted.

B. Decreased HR N&P, Page 189. Justin

4.) Prolonged binding and activation of a receptor by an agonist may lead to what? a.) Sensitization b.) Desensitization c.) Nothing d.) Degeneration

B. Desensitization M&M page 151 Zino

Oxygen and nitrous are delivered from their pipeline central supply source to the OR through a piping network. For safety purpose, what system is utilized to prevent incorrect hose attachment? A. Pin Index Safety System (PISS) B. Diameter Index Safety System (DISS) C. Cylinder Inlet Safety System D. All of the above

B. Diameter Index Safety System (DISS) (M & M, page 51) Maggie

True or False: Insufflation of anesthetic gases increases the risk of fire in the OR? A. True B. False

B. False M&M pg 30 Jensen

A *quantitative* method of brain monitoring includes: a. TCD b. Jugular oximetry c. Thermal diffusion flowmetry d. SSEP Nagelhout and Plaus ch18, pg 326

B. Jugular oximetry Kaitlin

Dysphoria appears to occur more commonly in drugs that have strong ______ receptor effects, or when taken in the absence of pain. A. Mu B. Kappa C. Delta D. Beta

B. Kappa N&P Ch. 11 pg. 149 K. Jensen

The only induction agent that can be administered via intramuscular route is: (M&M ch 9, pg 183) a. Etomidate b. Ketamine c. Propofol d. None of the above

B. Ketamine Hale

Rhythmic contraction of the ________ ejects blood into the vascular system, resulting in pulsatile arterial pressures. A. Left atrium. B. Left ventricle. C. Pulmonary valve. D. Right Ventricle.

B. Left ventricle. M&M page 87 K. Jensen

The nondepolarizing agent, Rocuronium, shares its aminosteroid structure with which other nondepolarizing drug (N&P ch12, pg 172): a. Vecuronium b. Pancuronium c. Mivacurium d. Succinylcholine

B. Pancuronium Kaitlin Hale

Cylinders of oxygen and nitrous oxide attach to the anesthesia machine by a hanger-yoke. What safety system is utilized to prevent connection of the wrong gas cylinder? A. Oxygen Supply Failure System B. Pin Index Safety System (PISS) C. Diameter Index Safety System (DISS) D. Cylinder Inlet Safety System

B. Pin Index Safety System (PISS) (M & M, page 51) Maggie

High-quality critical care is can be very expensive. What is more expensive? A. Ferrari B. Poor-quality critical care C. CRNA School D. Health Insurance

B. Poor-quality critical care M&M pg. 1278 K. Jensen

Perioperative monitoring is the primary duty of: A. The charge nurse. B. The anesthesia provider. C. The circulating nurse. D. The surgeon.

B. The anesthesia provider. M&M page 87 K. Jensen

2. What does ED50 stand mean? a. The effective dose for exactly 50 people. b. The effective dose for 50% of the population. c. The effective dose for patients at least 50 years of age. d. 50 times the normal dose is more effective

B. The effective dose for 50% of the population. N&P 55 Justin

4) What must first penetrate the cell membrane of the axoplasm before they produce the effect a. The charged portion of the local anesthetic b. The uncharged portion of the local anesthetic c. The ionized portion of the local anesthetic d. The unionized portion of the local anesthetic

B. The uncharged portion of the local anesthetic Rebecca N&P pg 127

Which organization issues regulations for the manufacturing, handling, transport, storage, and disposal of cylinders? A. United States Pharmacopeia B. U.S. Department of Transportation C. National Fire Protection Association D. Food and Drug Administration

B. U.S. Department of Transportation N&P pg. 248 Rebecca

The primary concern with the administration of Etomidate is (M&M ch 9, pg 185): a. Histamine release resulting in hypotension b. Decreased myocardial contractility c. Adrenocortical suppression d. Increased intracranial pressure

C. Adrenocortical suppression. Hale

The monitor used most frequently to monitor anesthesia depth is? A. SNAP II (Stryker) B. AEP Monitor (Danmeter) C. Bispectral index (BIS) Monitor. D. SEDLine Monitor (Hospira)

C. Bispectral index (BIS) Monitor. N&P Ch. 18 pg. 328 K Jensen

1. Signal transduction for GABAA receptor involves which inward ion movement through the opened central channel? a. Sodium b. Potassium c. Chloride d. Magnesium

C. Chloride involves inward CHLORIDE ion movement through the opened central channel. Budenbender

Components of flowmeters include all EXCEPT? A. Knob B. Needle valve C. Fail- safe valve D. Flowtube

C. Fail- safe valve N&P pg. 254 Rebecca

What is the inhalation agent that contains a bromine in its chemical structure? (M and M, page 163) A. Isoflurane B. Desflurane C. Halothane D. Sevoflurane

C. Halothane

Near-infrared spectrometry (NIRS) is a method of monitoring the hemodynamics of the brain by monitoring the ____________ and blood volumes? A. Lactic acid B. Albumin C. Hemoglobin oxygenation D. EEG waves

C. Hemoglobin oxygenation N&P Ch. 18 pg. 329 K. Jensen

Scope and standards for the practice of CRNA's explain specific, required monitoring parameters. One of these parameters is to monitor ventilation continuously, and the modifiers for this requirement include all of the following except: (N&P ch17, pg 314) a. Verify intubation of the trachea by auscultation, chest excursion, and confirmation of CO2 in the expired gas. b. Continuously monitor end-tidal CO2 during controlled or assisted ventilation including any anesthesia or sedation technique requiring artificial airway support. c. Hold your hand over their mouth to feel if the patient is breathing or not. d. Use spirometry and ventilator pressure monitors as indicated.

C. Hold your hand over their mouth to feel if the patient is breathing or not. (N&P ch17, 314) Kaitlin Hale

What effects does nitrous oxide have on CRB, CBV and intracranial pressure? (M and M, page 165) A. No change B. Decreased CBF, CBC, and intracranial pressure C. Increased CBF, CBV and mild elevation in intracranial pressure D. Increased CBF, decreased CBV, and increased intracranial pressure

C. Increased CBF, CBV and mild elevation in intracranial pressure

5.) If the binding of an endogenous ligand is chronically blocked, then receptors may proliferate resulting in what? a.) Desensitization b.) Nothing c.) Increased sensitization d.) Degeneration

C. Increased sensitization M&M page 151 Zino

3. According to the relative rating of central venous access table which site for central venous catheter placement has the highest success rate (pulmonary artery catheter placement)? (M&M, pg 101) a. Basilic b. External jugular c. Internal Jugular d. Subclavian e. Femoral

C. Internal Jugular

4) The PR segment is extended out via a horizontal line. What does this serve as? a. Depolarization of the ventricle b. Repolarization of the atria c. Isoelectric reference to determine the degree of ST segment shift d. Depolarization of the atria

C. Isoelectric reference to determine the degree of ST segment shift N&P pg 293 Rebecca

The administration of Ketamine in conjunction with other drugs can cause varying effects. One of the following drugs/effect combinations are mismatched, which one? (M&M ch 9, pg 184) a. Volatile anesthetics → synergistic effect with ketamine. b. Diazepam, midazolam → attenuate cardiostimulatory effects of ketamine. c. NDNMBs → bradycardia with ketamine. d. Alpha/Beta blockers → unmask direct myocardial depressant effects of ketamine.

C. NDNMB's -- bradycardia with ketamine. Hale

What is the STOP-BANG questionnaire used to assess? A. Dietary changes B. Bowel function C. Obstructive Sleep Apnea D. Diabetes management

C. Obstructive Sleep Apnea N&P page 350 Justin

A Mallampati class IV airway includes which of the following: A. The upper part of the faucial pillars is visible B. Only the soft and hard palates are visible C. Only the hard palate is visible D. The entire palatal arch is visible

C. Only the hard palate is visible (M & M, page 313) Maggie

What condition is associated with reduced AAG levels? A. CAD B. Hypothyroidism C. Pregnancy D. Stress

C. Pregnancy (M and M, page 145) Maggie

3. Compared to the other inhalation agents, desflurane and nitrous oxide is ________ than moderately soluble agents a. Equal to b. Lower c. Greater d. No comparison i. N&P pg 79

C. greater Rebecca N&P pg 79

Which of the following are non-invasive methods of brain monitoring (choose 2): a. Microdialysis b. Brain tissue PO2 c. SSEP d. Laser Doppler flowmetry e. EEG Nagelhout and Plaus ch18, pg 326

C. SSEP E. EEG Kaitlin

The following volatile anesthetic is unique in that it is unlikely to produce fulminant hepatic failure: (N&P ch8, pg 96) a. Desflurane b. Isuflurane c. Sevoflurane d. Nitrous Oxide

C. Sevoflurane Kaitlin

What is the rate of rise in drug concentration in an organ determined by? SELECT TWO A. Molecules in the blood that are free or unbound B. Protein Binding C. The organ's perfusion D. The relative solubility in the organ compared to the blood

C. The organ's perfusion D. The relative solubility in the organ compared to the blood (M and M, page 145) Maggie

4. What does the term standard deviation mean? a. The standard at which all people will deviate from their appropriate task. b. The average number of people involved in a particular study type. c. The population response variability d. When the study results are not the standard expected results.

C. The population response variability N&P 55 Justin

3.) The range for a drug to be between the concentration associated with a desired therapeutic effect and the concentration associated with a toxic response is considered what? a.) Ideal concentration b.) Safe concentration c.) Therapeutic window d.) Critical concentration

C. Therapeutic Window M&M page 150 Zino

4. Volume of distribution occurs at different rates depending on many factors. Match the compartment with their respective part of the body.

Central Compartment - Blood Peripheral Compartment- Muscle, fat, skin Ultra-rapidly equilibrating compartment -Lungs, brain, heart Answer above is matched correctly. Morgan and Mikhail pg. 146 Blair Ryan

The following are components involved or causes of anesthetic mishaps that have led to sub optimal patient outcomes. a. Vaporizers b. Ventilators c. Disconnected Circuits d. Oxygen Supply e. Valves Which is the leading problem?

Choose C Page 47. Morgan and Mikhail's Mr. Ryan

The DISS system (Diameter Index Safety System) is used to assure the correct size of a. ET Tubes b. Nasal Trumpets c. Gases hoses from the house supply. d. Attaching cylinders to the anesthesia machine.

Choose C Page 51. Morgan and Mikhail's Mr. Ryan

Some more modern machines have special features that increase their functionality which have you seen on your rotations at NCH? (select all applicable) a. Condensed machines that are mobile. b. Machines that can be used with diagnostic MRI machines. c. Ansethesia machines that use software that automatically put information such as vent modes, vital signs, minute ventilation and other pertinent readings into the patient's electronic chart automatically. d. Have not seen any of these, but I read they exist.

Choose D Page 49. Morgan and Mikhail's Mr. Ryan

Although the mechanism of action of general anesthetics remains unknown, the primary site of action is now considered to be which of the following: A: The lipid bilayer surrounding the nerve cells B: The cell nucleus C: The mitochondria D: Membrane receptors

D: Membrane receptors Reference: N&P page 53, 1st column 2nd paragraph Abe

All of the following are likely to cause tracheal laceration/perforation EXCEPT: A. Inflating the cuff with 15cc air after intubation B. Manipulation of ETT without deflating cuff C. Multiple intubation attempts D. Cricoid pressure

D. Circoid pressure N & P 466

What is the purpose of taping the patients eyes closed? (Morgan & Mikhail, pg 327) a. It's part of the free eyelash removal service offered at NCH b. It prevents the patient from looking at you during the case c. Helps make sure the patient stays asleep, or at least looks asleep for any auditors d. Helps prevent injury to patients eyes by unintentional abrading of the cornea

D. Helps prevent injury to patients eyes by unintentional abrading of the cornea

Which of the following indicates the need for a positive inotropic drug? (M & M, page 104) A. High SV B. Low PAOP C. High SV D. High PAOP/LVEDP, low SV

D. High PAOP/LVEDP, low SV (M and M, page 104) Maggie

Which of the following drug administration routes circumvents the blood-brain barrier? a. Inhalation b. Intravenous c. Sublingual d. Intrathecal

D. Intrathecal N&P 65 Justin

Treatment of acute cyanide toxicity from an infusion of Sodium Nitroprusside includes all of the following EXCEPT: A. Mechanical ventilation with 100% oxygen B. Administration of Sodium Thiosulfate 150 mg/kg over 15 minutes C. Administration of 3% Sodium Nitrate 5 mg/kg over 5 minutes D. NC on 4L

D. NC on 4L M&M Ch. 15 pg. 258 K. Jensen

3. What is the function of type B nerve fibers? a. Muscle tone b. Pain c. Heat d. Postganglionic autonomic vasomotor.

D. Postganglionic Autonomic Vasomotor N&P 128, Table 10-1

Scope and standards for the practice of CRNA's explain specific, required monitoring parameters. One of these parameters is to monitor cardiovascular status continuously, and the modifiers for this requirement include all of the following except: (N&P ch17, pg 314) a. Via electrocardiogram b. Via heart sounds c. Record blood pressure and heart rate at least every 5 minutes d. Record blood pressure and heart rate at least every 3 minutes

D. Record blood pressure and heart rate at least every 3 mins. (N&P ch17, pg 314) Kaitlin

Characteristics of a depolarizing (Phase I) Block include all of the following except (N&P ch12, pg 172): a. Muscle fasciculation precedes onset of neuromuscular blockade. b. Sustained response to tetanic stimulation. c. Block potentiated by anticholinesterase drugs. d. Reversal with anticholinesterase drugs.

D. Reversal with anticholinesterase drugs. Kaitlin Hale

What is a disadvantage of the Bain circuit? A. It has less bulk B. It retains heat C. It retains humidity D. The incorporated fresh gas inlet can kink/disconnect and cause massive rebreathing

D. The incorporated fresh gas inlet can kink/disconnect and cause massive rebreathing Morgan & Mikhail, Ch 3, pg 36 Caroline

1. Which of the following is NOT a reason for maintaining normothermia for therapeutic and diagnostic procedures? a. To decrease the incidence of wound infection. b. To maintain normal blood coagulation. c. To decreases sympathetic activity related vasoconstriction. d. To increase anesthesia recovery time.

D. To increase anesthesia recovery time. N&P, Page 1264 - Box 52-2 Justin

Which of the following adrenergic receptors is epinephrine capable of agonizing? A: Alpha-1 B: Alpha-2 C: Beta-1 D: Beta-2 E: All of the above

E: All of the above Reference: N&P page 186, 1st column 5th paragraph Abe

Match the Gas with the correct PISS? N&P pg 247 a. O2 1-5 b. N20 2-5 c. Air 3-5

N&P pg 247 Adam O2=2-5 N20=3-5 Air= 1-5

5. BIS monitoring is less predictable with which types of anesthesia?? a. General b. MAC c. Regional d. TIVA

Regional and TIVA N&P pg 328 Mandy

4. What kind of crystals make ultrasound possible? a. Magnetic b. Sound c. Piezoelectric d. Ultrasound e. Kyber

i. Answer: C- piezoelectric ii. N+P page 228 sommers

2. How long does it take to reach peak plasma levels following intramuscular injection of hydromorphone, morphine, or meperidine? (M&M pg 192) a. 20-60 min b. 5-10 min c. 60-80 min d. 2-4 hours

*20-60 min*

What is the onset of action for IV administered Morphine? a. 5-10 min b. 30-45min c. 20 min d. 1-2 min

20 min (N&P pg 153) Lake

All of the following are safe metals within the proximity of the MRI bore EXCEPT: A) Medication vials B) Stainless steel C) Nonferrous alloys D) Nickel & Titanium

A) Medication vials Devin [N&P p.1282]

Pick the correct statements in regard to what happens when GABA is agonized (pick 2). A: Potentiation of its inhibitory effect B: Influx of Cl- ions C: Influx of K+ ions D: Influx of Na+ ions

A: Potentiation of its inhibitory effect B: Influx of Cl- ions Reference: N&P page 53, 1st column 2nd paragraph Abe

1.) Which of the following drugs decrease hepatic blood flow, thus decreasing the clearance of lidocaine? (select two) a.) Histamine (H2) receptor blockers b.) Beta blockers c.) Epinephrine d.) Ephedrine

A and B M & M page 275 Zino

Which of the following is NOT a classification of opioids? A) Full agonist B) Agonists C) Partial agonists D) Agonists-antagonists E) Antagonists

A) Full agonist [N&P p.145] Devin

2. All of the following are safe metals within the proximity of the MRI bore EXCEPT: A) Medication vials B) Stainless steel C) Nonferrous alloys D) Nickel & Titanium [N&P p.1282]

A) Medication vials

Standard extubation criteria may be divided into global criteria and respiratory criteria. Which of the following are examples of global criteria for extubation? A. Return of laryngeal and cough reflexes B. Vital capacity > 15mL/kg C. Train of four equal to at least 2/4 D. Appropriate level of consciousness

A return of laryngeal reflexes D. Appropriate level of consciousness N & P 462 box 22-9

Clopidogrel therapy is mandatory for _________ after placement of drug-eluting stents? A) 12 months B) 2 months C) 6 months D) 3-6 months

A) 12 months Devin [N&P p.207]

What is the onset time of Atracurium? A) 2-4 minutes B) 4-8 minutes C) 8-12 minutes D) 1-2 minutes

A) 2-4 minutes Devin [N&P p.175]

The disinhibitory effect of Etomidate on the parts of the nervous system that control extrapyramidal motor activity offers a potential explanation for the _________ incidence of myoclonus with Etomidate induction of anesthesia? A) 30-60% B) 10-20% C) 70-80% D) 60-100%

A) 30-60% Devin [M&M p.184]

Which of the following is the purpose for measuring the Jugular Oximetry (SjvO2)? A) To measure adequacy of hemispheric oxygenation B) To measure intracranial compliance C) To monitor electrical brain activity and detect seizures D) To monitor the integrity of sensory pathways

A) To measure adequacy of hemispheric oxygenation Devin [N&P p.326]

Which ventilator setting is volume limited, time cycled and provides a constant flow? A) Volume controlled ventilation B) Pressure controlled ventilation C) Pressure controlled ventilation with volume guarantee D) Synchronized intermittent mandatory ventilation

A) Volume controlled ventilation N&P pg. 274 Charlie

3. When using the Near-infrared spectroscopy, what should the anesthetist be mindful of to ensure adequacy of the reading? a. Peripheral oxygenation of the scalp b. The pulse oximeter reading c. The BIS monitor reading d. The positioning of the patient

A) peripheral oxygenation of the scalp N&P 329 mandy

What are 3 primary U/S imaging techniques used clinically? A. 2-D imaging B. M-Mode C. 3-D imaging D. Doppler exam

A, B, D N&P 309

When preparing to intubate a patient you should have the following additional supplies ready: (select 4) (Morgan & Mikhail, pg 326) a. An extra handle and blade b. Tracheal tube one size smaller than anticipated optimal size c. A treat for the anesthesiologist so he likes you better d. Suction e. Stylet f. Electrocautery device in case you need to do a tracheotomy

A, B, D, E

2. Indications for central venous catheters include: (select 4) (M&M, pg 100) a. Central venous pressure monitoring b. Infusion of caustic drugs and TPN c. The student needs practice putting them in d. Insertion of transcutaneous pacing leads e. Aspiration of air emboli f. To gain venous access in patients with great peripheral veins

A,B,D,E

Opiates are NOT __________. So, under anesthesia, awareness may be of concern. A. Anesthetics B. Analgesia C. Agonists D. Sedatives

A. Anesthetics N&P Ch. 11 pg, 149 K. Jensen

The anesthesia provider has PRIMARY control over which of the three combustion triad components? A. Oxidizers B. Fuel C. Ignition source D. None of the above

A. M&M ch.2 Kaitlin

What type of gauge is used to measure the pressure within the cylinders? A. Bordon Gauge B. Needle Gauge C. Radius Gauge D. Fill Gauge

A. N&P 248

While performing an oral airway examination you can see the Soft Palate, Faucial pillars, and entire uvula. What Mallampati classification would you give this patient? a. 1 b. 2 c. 3 d. 4

A. 1 N&P pg 431 Adam

5) What is the threshold value for ST segment deviation in males < 30 years of age? a. 1 mm (0.1 mV) b. 2 mm (0.2 mV) c. 2.5 mm (0.25 mV) d. 1.5 mm (0.15 mV)

A. 1 mm (0.1 mV) N&P pg 293 Rebecca

Rocuronium can be used in place of succinylcholine as muscle relaxer in a RSI situation, and its onset can be accelerated by giving __________% of the calculated intubating dose prior to induction. After anesthetized (1-3mins), the remaining dose is given. This practice is called priming (N&P ch12, pg 173). a. 10% b. 25% c. 50% d. 55%

A. 10% Kaitlin Hale

Typically what concentration of epinephrine is combined with local anesthetics? A. 1:200,000 B. 1:10,000 C. 1:1,000 D. Concentration has not effect on dose

A. 1:200,000 Charlie N&P pg. 132

For each rise of mm Hg of PaCO2 above baseline, normal awake patients increase their minute ventilation by how much? A. 2-3 L/min B. 5 L/min C. 10 L/min D. 15 L/min

A. 2-3 L/min Morgan & Mikhail, Ch 3, pg 42 Roel

An oscillometric blood pressure measurement is recorded during an average anesthetic procedure every: A. 3-5 minutes B. 6-8 minutes C. 1-2 minutes D. 10 minutes.

A. 3-5 minutes M&M page 88 K. Jensen

Which of the following is true regarding N2O: (N&P ch8, pg 96) a. Chronic exposure can lead to inactivation of the vitamin B12 component of methionine synthetase, which can disrupt deoxyribonucleic acid (DNA) synthesis. b. Significantly metabolized by intestinal microflora. c. Associated with hepatotoxicity. d. Leads to a harmful immunologic reaction.

A. Chronic exposure can lead to inactivation of the vitamin B12 component of methionine synthetase, which can disrupt deoxyribonucleic acid (DNA) synthesis. Kaitlin

What is the most accurate reflection of renal reserve or GFR? A. Creatinine clearance B. Urine protein C. BUN D. Serum Na

A. Creatinine clearance N&P pg. 366 Crouse

During mechanical ventilation signs of spontaneous respiratory effort can be seen as a ________ if the anesthesia is too light, or muscle relaxation is insufficient. A. Curare cleft B. A decrease in ETCO2 C. Hypoventilation D. CO2 absorbent exhaustion

A. Curare cleft NP Ch. 17 pg. 317 K. Jensen

5. What is the primary mechanism of action of fenoldopam? a. D1 agonist b. Alpha and Beta agonist c. Beta agonist d. SSRI

A. D1 agonist M&M - Page 248, Second column, fourth paragraph Justin

3. What are the effects of Beta-2 stimulation on peripheral vascular resistance? a. Decreased b. Increased c. It has no effect d. Not enough information to tell

A. Decreased M&M - Page 248, first column, third paragraph Justin

Match the inhalation agent with the effect on the EEG waves, on a low-dose anesthetic. (< Alpha > Beta, or > Beta) A. Desflurane- B. Isoflurane C. Sevoflurane D. N2O

A. Desflurane- 1. <Alpha, > Beta B. Isoflurane 2. < Alpha, > Beta C. Sevoflurane 3. < Alpha, > Beta D. N2O > Beta N&P Ch 18 pg. 329 Table 18-2 K. Jensen

Opioids effects on analgesia are due to its ability to: (select 2) A. Directly inhibit the ascending transmission of nociceptive information from the dorsal horn of the spinal cord. B. Activation of pain control pathways that descend from the midbrain, through the rostral ventromedial medulla to the dorsal horn of the spinal cord C. Cause circumstantial numbness in the forebrain D. Repeatedly depress decision making skills when taken in the absence of pain.

A. Directly inhibit the ascending transmission of nociceptive information from the dorsal horn of the spinal cord. B. Activation of pain control pathways that descend from the midbrain, through the rostral ventromedial medulla to the dorsal horn of the spinal cord N&P Ch. 11 pg 149 K. Jensen

2. Which of the following is an indication for the necessity of anesthesia in a remote location? a. Drug-induced mental disorder. b. ASA 1 patient. c. Patient requires IV fluid during the procedure. d. An adult patient undergoing a Transthoracic echocardiogram.

A. Drug induced mental disorder N&P Box 52-6 Justin

What could cause the combination of tachycardia and hypertension during general anesthesia? A. Hypoxia B. Hyperkalemia C. Septic Shock D. Hyponatremia

A. Hypoxia Morgan & Mikhail, Ch 3, pg 42 Roel

Which of the following drug administration routes has the most rapid onset, allows for titration of doses, and is suitable for large volumes? a. Intravenous b. Buccal c. Oral D. Rectal

A. IV N&P 65 Justin

2. What are Ketamine's effect on cerebral metabolic rate and blood flow? a. Increase cerebral metabolic rate, increases cerebral blood flow b. Decreases cerebral metabolic rate, increases cerebral blood flow c. Increases cerebral metabolic rate, decreases cerebral blood flow d. Decreases cerebral metabolic rate, decreases cerebral blood flow

A. Increase cerebral metabolic rate, increases cerebral blood flow N & P pg. 116 Charlie

Sodium Nitroprussides effect on cerebral perfusion is an: (select 2) A. Increase in intracranial pressure B. Abolishes cerebral autoregulation C. Decrease in intracranial pressure D. Enhances cerebral autoregulation

A. Increase in intracranial pressure B. Abolishes cerebral autoregulation M&M Ch. 15 pg. 258 K. Jensen

2. What symptoms trigger the endogenous release of arginine vasopressin? (select two) a. Increased serum osmolality b. Decreased serum osmolality c. Hypovolemia d. Hypervolemia

A. Increased serum osmolality. C. Hypovolemia H&P page 189 Justin

4. How should dobutamine be administered? a. Infusion at 2-20 mcg/kg/min b. 20 mg IV push Q 5 minutes c. 5 mg IM injection d. Infusion at 20 mg/hour

A. Infusion at 2-20 mcg/kg/min M&M - page 248, first column, third paragraph Justin

Sodium Nitroprusside effect on organ systems by dilation of venous and arteriole beds results in a phenomenon in the heart called______? A. Intracoronary steal B. Inverse steal C. V/Q mismatch D. CHF

A. Intracoronary steal M&M Ch. 15 pg. 258 K. Jensen

Some of the disadvantages of using an ICP to monitor the brain are: a. Invasive b. Risk of infection c. Inaccurate d. Risk of hemorrhage Nagelhout and Plaus ch18, pg 326

A. Invasive B. Risk of infection D. Risk of hemorrhage Kaitlin

A resuscitator is unlike a Mapleson circuit or a circle system because: A. It contains a nonrebreathing valve B. It is valveless C. It contains unidirectional valves D. It contains an APL valve

A. It contains a nonrebreathing valve Morgan & Mikhail, Ch 3, pg 41 Roel

5.) According to Boyle's Law, which two properties are indirectly proportional to one another? (NP, page 224) A. Pressure, volume B. Temperature, volume C. Pressure, temperature D. None of the above

A. Pressure, volume

4. What of the following drugs belongs to the ester class of local anesthetics? a. Procaine b. Articaine c. Lidocaine d. Bupivacaine

A. Procaine Nagelhout and Plaus - Page 129, Box 10-1 Justin

What is evident in a patient with Grave's disease? A. Patient has hyperthyroidism B. Patient has hypothyroidism C. Patient has renal failure D. Patient has liver failure

A. Pt has hyperthyroidism N&P pg. 369 Crouse

Regular saw-tooth oscillations on a flow waveform are all a result of_____, EXCEPT? A. Pulmonary Edema B. Cardiac oscillations C. Contraction of the heart and great vessels D. Gas being forced in and out of the lungs during contraction of the heart and great vessels.

A. Pulmonary Edema NP Ch. 17 pg. 317 K. Jensen

2. The drug response equation is fundamental to pharmacologic principles: Drug + R <-> (Drug receptor complex) <->Tissue response, what does the "R" represent? a. Receptor b. Receiver c. Constant d. Revolution

A. Receptor Nagelhout Chapter 5 page 55 Budenbender

The addition of epinephrine to a local anesthetic will do what to absorption? A. Reduce rate of vascular absorption B. Speed rate of vascular absorption C. Has no effect on rate of absorption D. Shortens length and effect of block

A. Reduce rate of vascular absorption Charlie N&P pg. 132

A Mallampati class I airway includes all of the following (Select all that apply): A. The entire palatal arch B. Bilateral faucial pillars visible down to their bases C. Only the soft palate D. Only the hard palate

A. The entire palatal arch B. Bilateral faucial pillars visible down to their bases (M & M, page 313) Maggie

The greatest pressure generated during a systolic contraction approximates the _________. The difference between the two measurements is called pulse pressure. A. Systolic arterial blood pressure. B. Diastolic blood pressure. C. PAWP pressures. D. CVP pressures.

A. Systolic arterial blood pressure. M&M page 87 K. Jensen

3. What is context sensitive half time? a. The time required for a 50% reduction in plasma concentration after stopping a continuous infusion. b. The time it takes for plasma concentration to decrease 50% after an oral drug. c. The patient factors that affect the half time of a drug. d. The time it takes for half of a drug dose to take effect.

A. The time required for a 50% reduction in plasma concentration after stopping a continuous infusion. N&P - 106 Justin

What is a disadvantage to the resuscitator breathing systems? A. They require high fresh gas flows to achieve a high FIO2 B. They are difficult to carry C. They are complex to understand D. They are prone to break down

A. They require high fresh gas flows to achieve a high FIO2 Morgan & Mikhail, Ch 3, pg 41 Roel

The insufflation technique avoid any direct contact with the patient, therefore there is no rebreathing of gasses at high flow: A. True B. False

A. True M&M pg. 30 Jensen

What physiologic condition would the anesthesia provider not use nitrous oxide? (Select all that apply) (M and M, page 167) A. Venous or arterial air embolism B. pneumothorax C. acute intestinal obstruction D pulmonary air cysts

A. Venous or arterial air embolism B. pneumothorax C. acute intestinal obstruction D pulmonary air cysts

What does the "V" wave indicate on a CVP waveform? (M&M, page 104) A. Venous return against a closed tricuspid valve B. Pulmonary Hypertension C. Ischemia D. Atrial enlargement

A. Venous return against a closed tricuspid valve (M and M, page 104) Maggie

Drug molecules obey the law of mass action. The law of mass action states: A. When the plasma concentration exceeds the concentration in the tissue, the drug moves from the plasma into the tissue. When the plasma concentration is less than the concentration in the tissue, the drug moves from the tissue back into the plasma. B. When the plasma concentration exceeds the concentration in the tissue, the drug moves into the third space C. Drug concentration is patient dependent D. All of the Above

A. When the plasma concentration exceeds the concentration in the tissue, the drug moves from the plasma into the tissue. When the plasma concentration is less than the concentration in the tissue, the drug moves from the tissue back into the plasma. (M and M, page 145) Maggie

All volatile agents produce: (N&P ch8, pg 96) a. a dose-dependent relaxation of skeletal muscle b. renal insufficiency c. potentiation of the effects of depolarizing and nondepolarizing muscle relaxants d. dose-dependent progressive urticarial

A. a dose-dependent relaxation of skeletal muscle C. potentiation of the effects of depolarizing and nondepolarizing muscle relaxants Kaitlin

What are two characteristics of a phase II (non-depolarizing) neuromuscular block? (N&P ch12, pg 172): a. Abscense of muscle fasciculation. b. Appearance of tetanic fade. c. Antagonism of block requiring ~20% more succ. d. Sustained response to tetanic stimulation.

A. absence of muscle fasciculation. B. Appearance of tetanic fade. Kaitlin Hale

3) How does local anesthetic block the propagation of action potential? a. By binding reversibly to specific receptors within or adjacent to the internal opening of the Na channel b. By binding on the outside of the receptor c. By binding to the external opening of the Na channel d. By binding to bothe the internal and external of the Na channe

A. by binding reversibly to specific receptors within or adjacent to the internal opening of the NA channel Rebecca N&P pg 127

2. All medications drawn up prior to the case must be labeled with drug name, strength, amount and _____ a. Expiration date b. Amount you intend on giving c. The OR room number

A. expiration date n&p pg 1261

1) In a single cardiac cycle, where is the PR segment measured? a. From the end of P wave to the beginning of QRS complex b. From the beginning of P wave to the end of R wave c. From the end of P wave to the end of QRS complex i. N&P pg 293

A. from the end of P wave to the beginning of QRS complex N&P pg293 Rebecca

2.) Drug receptors are typically what kind of macromolecule? a.) Protein b.) Sugar c.) Amino acid d.) DNA

A. protein M&M page 151 Zino

2. How does drug solubility effect anesthesia achieved by a patient? a. The more soluble the drug the slower the anesthesia achieved by the patient b. There is no effect c. It depends on the drug d. Drug solubility is not an indicator used i. N&P pg 79

A. the more soluble the drug the slower the anesthesia achieved by the patient Rebecca N&P pg 79

2) Direct B1 stimulation in the myocardium by epinephrine will result in a. All of the above b. Increase in blood pressure c. Increase in cardiac output d. Increase in myocardial oxygen demand

All of the above C. Crouse M & M pg. 246

Which is an accurate description of a supraglottic tube (Combitube, King Laryngeal Tube) a. placed blindly into the esophagus with a distal balloon to occlude the esophagus & a larger proximal balloon to occlude the posterior oropharynx. Between the two balloons is the ventilation port b. placed blindly into the trachea with a large balloon to occlude the esophagus to avoid ventilation of the stomach c. placed with direct visualization of the glottic opening and a second tube inserted with a balloon to occlude the esophagus d. placed with direct visualization of the glottic opening with two balloons and a ventilation port

ANSWER: A. (N&P ch22, pg 453) Kaitlin

Fill in the blank: Fiberoptic Scopes/Stylets can be used to _________________, facilitate ETT placement, or to change out ETTs a. Take samples of lung tissue for diagnostic testing b. Evaluate airway c. Clear the stomach of gastric contents d. Insert directly into cricoid cartilage for difficult intubation

ANSWER: B. (N&P ch22, pg 455) Kaitlin

5. With the following factors , match which airway management tool will most likely be associated with difficulty. 1. ____ Pt with a beard, NG tube, or no teeth. 2. ____ Mallampati score of III or IV, limited neck ROM. 3. ____ restricted mouth opening, upper airway obstruction, distorted airway preventing seal, stiff lungs 4. ____ distortion of neck anatomy, trauma around cricothyroid area, impediments causing impaired access to neck. A. supraglottic device placement and ventilation B. bag mask ventilation (BMV) C. invasive airway placement D. direct laryngoscopy with tracheal intubation

Answers: 1: B BMV, 2: D. direct laryngoscopy with tracheal intubation, 3: A supraglottic device placement and ventilation, 4: C invasive airway placement N&P, pg. 428 Stefania

1. The "a" wave on a CVP waveform represents: A. ventricular contraction B. atrial contraction C. ventricular filling D. tricuspid valve closing

Answers: B. atrial contraction N & P, pg. 301 Stefania

At approximately _________ from the teeth, the aortic valve leaflets and coronary arteries are visualized. A. 25-30cm B. 35-40cm C. 45-50cm D. None of the above

B N&P 309

2. Which catecholamine is the most potent vasopressor? a. Epinephrine b. Norepinephrine c. Dopamine d. Isoproterenol

B i. N&P pg 188 anozier

2.) How long does it take for regeneration to occur after a local anesthetic is injected? a.) 4 months b.) 2-4 weeks c.) 1 year d.) 3 days

B M & M page 274 Zino

Administration of oxygen in concentrations of greater than _____% should be guided by clinical presentation of the patient and not solely by protocols or habits. A) 10% B) 30% C) 50% D) 90%

B) 30% [M&M p. 23] Devin

What is the onset time of Succinylcholine? A) 30-90 seconds B) 30-60 seconds C) 60-90 seconds D) 10-60 seconds

B) 30-60 seconds Devin [N&P p.175]

The abrupt withdrawal of aspirin prior to surgery can cause what? A) Does not cause any adverse reaction B) A platelet rebound phenomenon and pro-thrombotic state leading to a major adverse cardiovascular event C) Causes severe anti-thombotic state D) Causes no problems if substituted with clopidogrel

B) A platelet rebound phenomenon and pro-thrombotic state leading to a major adverse cardiovascular event Devin [N&P p.206]

1. What is the most frequently used monitor for assessing anesthetic depth based on processed electroencephalogram? a. SSEP b. BIS c. EEG d. Infrared Spectroscopy

B) BIS N&P 328 mandy

Which ventilator setting is limited by peak inspiratory pressures, cycle is time controlled and has a decelerating flow pattern? A) Volume controlled ventilation B) Pressure controlled ventilation C) Pressure controlled ventilation with volume guarantee D) Synchronized intermittent mandatory ventilation

B) Pressure controlled ventilation N&P pg. 274 Charlie

Etomidate depressed the reticular activating system and mimics the inhibitory effects of what receptor? A) Alpha 2 B) GABA C) Adrenergic D) Mu

B) GABA Devin [M&M p.184]

Beta-blocker therapy should be ____________ peri-operatively in patients who are being treated with B-blockers as a part of their routine medical regimen. A) Stopped B) Maintained C) Cut in half D) Doubled

B) Maintained Devin [M&M p.257]

Diabetic patients taking ___________ undergoing CT scan with IV contrast must withhold the medication due to the risk of lactic acidosis. A) Metoprolol B) Metformin C) Aspirin D) Clopidogrel

B) Metformin Devin [N&P p.1282]

What is the recommended management for insulin the morning of surgery and perioperatively? A) Continue normal insulin pump settings B) NO insulin but if taken/given decrease the dose C) Do not check their glucose level D) Short surgery = continue insulin pump, long surgery = IV insulin drip recommended w/crystalloid 5% dextrose)

B) NO insulin but if taken/given decrease the dose D) Short surgery = continue insulin pump, long surgery = IV insulin drip recommended w/crystalloid 5% dextrose) N&P ch19, pg 369 Dumas

___________ is a term used to refer to a group of drugs, both naturally occurring and synthetically produced, that possess opium or morphine-like properties? A) Phenylpiperdine B) Opioid C) Neurotransmitter D) Orphanin

B) Opioid [N&P p.145] Devin

What doe3s the American National Standards Institute (ANSI) standards specify laser devices and eye protection must be labeled for?? A) Color of the laser and the thickness of eye protection required B) Protection offered or wavelength emitted C) Wavelength emitted and color of the laser D) There are no specific requirements

B) Protection offered or wavelength emitted M&M pg 24 Mandy

Which of the following is the most common anatomic location used for direct BP measurement? A) Ulnar artery B) Radial artery C) Brachial artery D) Femoral artery

B) Radial artery Devin [N&P p.307]

Which of the following should NOT take place before beginning a laser surgery? A) The laser device should be in the operating room B) The laser device should be kept in sterile processing until the surgery starts C) Warning signs should be posted on the doors D) Protective eyewear should be issued to all OR personnel

B) The laser device should be kept in sterile processing until the surgery starts [M&M p. 24] Devin

Clinical uses for Sodium Nitroprusside are related to its potency and reliability. The onset of action by Sodium Nitroprusside is ______ A. 5-7 minutes B. 1-2 minutes C. 30-60 minutes D. 10-15 minutes

B. 1-2 minutes M&M Ch. 15 pg. 257 K. Jensen

To test the tracheal tube's inflation system you should use a: (Morgan & Mikhail, pg 325) a. 20 cc syringe b. 10 cc syringe c. 60 cc syringe d. 5 cc syringe

B. 10 cc syringe

In the United States, the number of doctors required for observation of the brain death criteria varies from state to state. In Florida the number required is: A. 3 B. 2 C. 1 D. 4

B. 2 M&M pg. 1280 K. Jensen

1. What is the MAC % for sevoflurane? a. 1.15 b. 2 c. 6 d. 104

B. 2 Nagelhout and Plaus - Page 79, table 7-1 Justin

2. What is the elimination half-life of Midazolam in hours? a. 12-50 b. 2-4 c. 24-48 d. 12

B. 2-4 N&P- 106 Justin

5. What percent of cardiac output does the fat group receive? a. 75% b. 6% c. 80% d. 30%

B. 6 N&P - 81, 7-4 Justin

What does the "a" wave on a CVP waveform represent? (M & M, page 104) A. Pulmonic Valve closure B. Atrial contraction C. Ventricular contraction D. Mitral valve closure

B. Atrial contraction (M & M, page 104) Maggie

What components make up the equation to calculate blood pressure? (M & M, page 104) A. BP= CI x HR B. BP= CO x SVR C. BP= MAP x HR D. BP= SVR x MAP

B. BP= CO x SVR (M & M, page 104) Maggie

The term "insufflation" as related to anesthetic gases means: (select 2) A. Addition of CO2 in the circuit system B. Blowing of volatile anesthetic gases across a patients face C. Abdominal distention for laparoscopic surgery D. Application of a mask to the patients face for breathing volatile gases E. Is a valuable technique with pediatric patients

B. Blowing of volatile anesthetic gases across a patients face E. Is a valuable technique with pediatric patients M&M pg. 30 Jensen

2. Which of the following are the effects of dobutamine? (select 2) a. Increase LV filling pressure b. Decrease LV filling pressure c. Increase coronary blood flow d. Decrease coronary blood flow

B. Decrease LV filling pressure c. Increase coronary blood flow M&M - Page 248, first column, third paragraph Justin

On the Periodic Table the vertical columns are known as _________ and the horizontal rows are known as ________. A. Molecular Bonds B. Groups C. Periods D. Centuries

B. Groups C. Periods N&P Ch. 14 pg. 212. K. Jensen

Sodium Nitroprusside dilates the pulmonary vasculature and reduces the pulmonary artery pressure. This results in a _____. (Select 2) A. Decrease in physiological dead space B. Increase in physiological dead space C. No change in dead space D. Decrease in perfusion to normally ventilated alveoli M&M Ch 15 pg. 259 K. Jensen

B. Increase in physiological dead space D. Decrease in perfusion to normally ventilated alveoli M&M Ch 15 pg. 259 K. Jensen

5. What are the effects of decreased plasma proteins with albumin? a. Diminished effects b. Increased effects c. No change d. Decreased concentration of unbound molecules of propofol.

B. Increased Effects N&P - 106 Justin

What effect does nitrous oxide have of respiratory rate and tidal volume? (M and M, page 165) A. Increased RR and TV B. Increased RR, decreased TV C. Decreased RR and TV D. Decreased TV, no change in RR

B. Increased RR, decreased TV

1.) The study of how drugs affect the body is described as what? a.) Pharmacokinetics b.) Pharmacodynamics c.) Metabolism d.) Catabolism

B. Pharmacodynamics M&M pg. 149 Zino

The foundation of anesthesia dynamics lies within two specific areas or frameworks of study. Select 2. A. Biology B. Physics C. Chemistry D. Zoology

B. Physics C. Chemistry N&P Ch. 14 pg. 212. K. Jensen

Elevation of ETCO2 baseline indicates? A. Increase in oxygen saturation. B. Rebreathing. C. Increase in MAC. D. Not unusual in a long case.

B. Rebreathing. NP Ch. 17 pg. 317 K. Jensen

All of the following are true regarding pancuronium, except (N&P ch12, pg 174): a. Longest acting nondepolarizer. b. Releases histamine. c. Excretion via both the kidney and the in bile. d. Duration of action 60-90mins.

B. Releases histamine Kaitlin Hale

1. In regards to inhalation gases, which partition coefficient is an indicator of the speed of uptake and elimination? a. Oil/ gas partition coefficient b. Blood/gas partition coefficient c. Skin/gas partition coefficient d. Lung/gas partition coefficient i. N&P pg 79

B. blood/ gas partition coefficient Rebecca N&P pg 79

How does the ceiling effect of phase III of the reservoir bag filling protect the patient's lungs against high airway pressures? A. by providing a rapid peak in pressure B. by causing a slight decrease in pressure or plateau with further increases in volume C. by shrinking the reservoir bag D. by opening the APL valve

B. by causing a slight decrease in pressure or plateau with further increases in volume Morgan & Mikhail, ch 3 pg 35 Caroline

1. Beta 2 receptors are primarily ______ adrenergic receptors located on smooth muscles and glands. a. Presynaptic b. Postsynaptic c. Midsynaptic

B. postsynaptic i. M&M pg 242 Rebecca

1) Local anesthetics work by_________ binding to the voltage- gated sodium channels (Na). a. Irreversibly b. Reversibly c. Irreversibly reversible d. Irreversibly irreversible i. N&P page 127

B. reversibly Rebecca n&p pg 127

What is the correct pin position for an O2 e-cylinder according to the Pin Index Safety System? A: 1:5 B: 2:5 C: 3:5 D: 4:5

B: 2:5 Reference: N&P page 247, Table 15-1 Abe

Under which category of the preanesthesia questionnaire would it be most appropriate to document a patient's history of arthritis? A: Cardiovascular B: Musculoskeletal C: Renal D: Respiratory

B: Musculoskeletal Reference: N&P page 338, Figure 19-1 Abe

Choose the correct statements regarding nonionized drugs (pick 2)? A: Nonionized drugs are hydrophilic B: Nonionized drugs are lipophilic C: Nonionized drugs can diffuse across cell membranes D: Nonionized drugs are lipophobic

B: Nonionized drugs are lipophilic C: Nonionized drugs can diffuse across cell membranes Reference: N&P page 62, 2nd column 2nd paragraph Abe

What type of safety system is used to decrease the risk of attaching the wrong e-cylinder into a hanger yoke assembly (i.e attaching N2O cylinder into O2 hanger yoke assembly)? A: Diameter Index Safety System (DISS) B: Pin Index Safety System (PISS) C: Circular Index Safety System (CISS) D: Square Index Safety System (SISS)

B: Pin Index Safety System (PISS) Reference: N&P page 247, 3rd paragraph Abe

Colorimetric devices are disposable end-tidal CO2 detector devices used in emergency settings to verify proper placement of an ETT, which react to changes in pH and display it as a color change. Although these devices are sensitive enough to detect CO2 quickly, a minimum of _____ breaths have been suggested to avoid misinterpretation. A) 2 B) 4 C) 6 D) 10

C) 6 Devin [N&P p.315]

4) If a patient takes cimetidine the morning of surgery and the MDA requests Amiodarone given preoperatively due to patient having episodic Vtach, what would you do? A) Give Amiodarone B) Only give half the recommended dose C) Don't give the drug and request an alternative drug due to CYP450 enzyme inhibition that can lead to prolonged effects of Amiodarone

C) Don't give the drug and request an alternative drug due to CYP450 enzyme inhibition that can lead to prolonged effects of Amiodarone N&P Ch 6 pg 72 Table 6-3 Jared Dumas

Which of the following is NOT an item needed to properly manage a fire that can be assembled or identified beforehand? A) Ensuring the proper endotracheal tube for patients undergoing laser surgery B) Having water or saline ready on the surgical field C) Ensuring that the APL valve is opened immediately in the event of a surgical fire D) Identifying the location of fire extinguishers, gas cutoff valves, and escape routes

C) Ensuring that the APL valve is opened immediately in the event of a surgical fire [M&M p. 23] Devin

Propofol binds to the _________ receptor, which is coupled to a _________ channel, and activation of the receptor leads to hyperpolarization of the nerve membrane. A) GABA-B / Chloride B) GABA-A / Sodium C) GABA-A / Chloride D) GABA-B / Sodium [M&M p.185]

C) GABA-A / Chloride Devin [M&M p.185]

Nearly all of the hemodynamic changes associated with the administration of Atracurium have been linked to the release of ___________? A) Prostaglandins B) Bradykinin C) Histamine D) Substance P

C) Histamine Devin [N&P p.176]

Jared Dumas 1) What does prerenal azotemia result from? A) Hyperperfusion of the kidneys B) Isoperfusion of the kidneys C) Hypoperfusion of the kidneys

C) Hypoperfusion of the kidneys M&M Chapter 57 pg 1309

4) Treatment of prerenal azotemia is directed at correcting what 3 things? A) WBC, Foreign objects, IOP B) Urine output, CO, Positioning C) Improving cardiac function, Restore a normal blood pressure, Decrease renal vascular resistance

C) Improving cardiac function, Restore a normal blood pressure, Decrease renal vascular resistance M&M Chapter 57 pg 1310

A displaced transducer can cause (a/an) _____________ in arterial BP if positioned substantially BELOW the level of the heart. A) Decrease B) No change C) Increase D) Increase or decrease

C) Increase Devin [N&P p.307]

2) When microsomal enzymes are inhibited, what can happen to drugs in the body? A) Decrease the amount of drug available in the body B) Increase the amount of enzymes in the body C) Increase the plasma levels of drugs and potentially lead to increased activity and toxicity

C) Increase the plasma levels of drugs and potentially lead to increased activity and toxicity N&P Ch 6 pg 71 Jared Dumas

5) Post ischemic acute tubular necrosis follows what kind of surgical procedures more frequently than others (3)? A) VATS, Hernia repairs, Femoral ORIF B) C-section, Bunionectomy, Urethral Prosthesis Implant C) Open abdominal aortic aneurysm resection, Cardiac surgery with cardiopulmonary bypass, Operations to relieve obstructive jaundice.

C) Open abdominal aortic aneurysm resection, Cardiac surgery with cardiopulmonary bypass, Operations to relieve obstructive jaundice. M&M Chapter 57 pg 1311

Which of the following is FALSE regarding pacemakers and MRI scans? A) Reprogramming may occur B) The pacemaker may be inhibited C) Pacemakers are always safe in the MRI D) It may revert to an asynchronous mode E) The pacemaker may become dislodged or heated

C) Pacemakers are always safe in the MRI Devin [N&P p.1283]

Which ventilator setting provides a decelerating flow pattern at a constant rate, a time controlled cycle and adjusts inspiratory pressures to guarantee set tidal volume is delivered? A) Volume controlled ventilation B) Pressure controlled ventilation C) Pressure controlled ventilation with volume guarantee D) Synchronized intermittent mandatory ventilation

C) Pressure controlled ventilation with volume guarantee N&P pg. 274 Charlie

4) What are the 2 induction agents used for asthmatic patients? A) Propofol or Etomidate B) Ketamine or Etomidate C) Propofol or Ketamine

C) Propofol, Ketamine N&P Ch 9 pg 108 Jared

1) Chronic alcohol use causes enzyme induction, what does this do to the body ? A) Enzyme injection used as an induction agent B) Enzyme therapy for cirrhotic patients C) Quickly break down agents that use the same enzymatic system for biotransformation

C) Quickly breaks down agents that use the same enzymatic system for biotransformation N&P Ch 6 pg 71 Jared Dumas

2) What 3 factors decrease plasma protein levels and affect protein binding? A) Smoking, Drinking, Sunlight B) Increased interstitial pressure, Increased oncotic pressure, Decreased intravascular pressure C) Severe renal disease, Severe hepatic disease, Third trimester of pregnancy

C) Severe renal disease, Severe hepatic disease, Third trimester of pregnancy N&P Ch9 pg 106 Jared

3) Which of the 3 volatile agents does not cause respiratory irritation? A) Desflurane B) Isoflurane C) Sevoflurane

C) Sevoflurane N&P Ch8 Pg 97 Table 8-4 Jared Dumas

4) Which of the 3 volatile agents causes seizure activity on an EEG? A) Isoflurane B) Desflurane C) Sevoflurane

C) Sevoflurane N&P Ch8 Pg 97 Table 8-4 Jared Dumas

Which of the following is FALSE regarding the Electroencephalogram? A) To simplify EEG interpretation, the anesthetic delivery should ideally be "stable" and not changing during the critical surgical portions of the case B) Any changes in anesthetic delivery should be communicated to the EEG technician C) The EEG can only provide information on the subcortical brain, spinal cord, and the cranial and peripheral nerves D) The EEG can only provide information on the cerebral cortex function

C) The EEG can only provide information on the subcortical brain, spinal cord, and the cranial and peripheral nerves Devin [N&P p.327]

The most common risk factor for surgical fire relates to what? A) The open delivery of Sevoflurane B) The open delivery of Nitrous Oxide C) The open delivery of Oxygen D) There are no risk factors for surgical fires

C) The open delivery of Oxygen [M&M p.22] Devin

Which of the following statements is FALSE? A) Propofol sequestered in a forearm during BP-cuff inflation can cause intense pain B) When surgery involves an upper extemitiy, the BP cuff and IV can be placed on the opposite arm C) There are no discrepancies in BP measurements between upper and lower extremities and between arms D) A lower extremity (thigh or calf) can be used for BP measurements E) An alternative site for the BP cuff in a morbidly obese patient is the forearm

C) There are no discrepancies in BP measurements between upper and lower extremities and between arms Devin [N&P p.307]

Which of the following is the purpose of an EEG? A) To measure adequacy of hemispheric oxygenation B) To measure intracranial compliance C) To monitor electrical brain activity and detect seizures D) To monitor the integrity of sensory pathways

C) To monitor electrical brain activity and detect seizures Devin [N&P p.326]

2) What does the Standard Error of the Mean (SEM) describe? A) P-value B) Standard deviation C) Variance of the mean

C) Variance of the mean N&P Ch 5 pg 55 Jared Dumas

5) What 4 types of drugs are contraindicated in the treatment of Local Anesthetic Systemic Toxicity (LAST)? A) Benzodiazepines, Narcotics, ARBS, ACE Inhibitors B) Aminoglycosides, NSAIDS, Anti-emetics, 5HT-3 blockers C) Vasopressin, calcium channel blockers, β-blockers, local anesthetic

C) Vasopressin, calcium channel blockers, β-blockers, local anesthetic N&P Pg 138 BOX 10-3 Jared Dumas

1) On a linear arithmetic-graded response curve, approximately what dosage of Norepinephrine causes 100% blood vessel constriction? A) 25-45 ng/ml B) 35-55 ng-ml C) 50-60 ng/ml

C) approximately 50-60 ng/ml N&P Ch 5 pg 56 Figure 5-5 Jared Dumas

1) Single transduction for the GABA- a receptor involves a. Outward chloride ion movement through opened central channel b. Inward chloride ion movement through closed central channel c. Inward chloride ion movement through opened central channel d. Outward chloride movement through closed central channel

C. N&P pg55 Rebecca

5) The theoretical normal distribution of quantal (desired) responses to increasing drug dose take the shape of a. Bell curve b. Inverted curve c. Gaussian curve d. John curve i. N&P pg 55

C. N&P pg55 Rebecca

Which of the following is NOT one of the three functions of the hangar yoke? A. Orient the cylinder B. Provide a gas tight seal C. Provide bi-directional flow between the tank and anesthesia machine. D. Ensure unidirectional flow from the tank to the anesthesia machine.

C. N&P 248

There are 5 million receptors at each neuromuscular junction. How many must be activated for a normal muscle contraction? A. 50,000 B. 5,000 C. 500,000 D. 5

C. 500,000 M&M Ch. 11 pg. 201 K Jensen

What is the % increase or decrease in MAC per decade of age? (M and M, page 163) A. 6% increase B. 3% increase C. 6% decrease D. 3% decrease

C. 6% decrease

In assessing the surgical patient-undergoing anesthesia, a neck circumference greater than ________ inches is suggestive of difficulty in visualization of the glottic opening. A. > 21 inches B. > 26 inches C. > 27 inches D. > 24 inches

C. > 27 inches (M & M, page 313) Maggie

What circumstance would show a sudden cessation in CO2 during the expiratory phase? (M and M, page 127) A. Decreased lung compliance B. Increased lung compliance C. Circuit Disconnection D. Proper ETT placement

C. Circuit Disconnection Maggie

What characterizes the redistribution phase? A. Drug leaves the plasma B. Drug is metabolized in the liver C. Drug returns from peripheral tissues back into the plasma D. Drug is eliminated by the kidneys

C. Drug returns from peripheral tissues back into the plasma (M and M, page 145) Maggie

Plateau-phase sloping can occur due to _____? A. Too large of ETT B. Normal tidal volume slope C. Kinking of ETT or circuit tubing D. West, Zone III of lungs

C. Kinking of ETT or circuit tubing NP Ch. 17 pg. 317 K. Jensen

1) Objectives of the Preoperative interview includes all EXCEPT? : a. Ensuring that the goals of preoperative assessment are met b. Obtain written documentation of informed and witnessed consent c. To learn of patient's surgical history from their chart d. Acquaint the patient and family with the surgical process

C. To learn of patient's surgical history from their chart. N&P pg 340 Rebecca

How full should the cuff be inflated on an ETT? (Morgan & Mikhail, pg 327) a. To precisely 35 mm Hg b. At least 10-12 cc of air c. With the least amount of air necessary to create a seal during positive-pressure ventilation d. Until the pilot balloon feels just right

C. With the least amount of air necessary to create a seal during positive-pressure ventilation

4. The abbreviation MAC means a. Maximum alveolar concentration b. Memory and concentration c. Minimum alveolar concentration d. Mean alveolar concentration i. N&P pg 79

C. minimum alveolar concentration Rebecca N&P pg 79

How to place an art line: Palpate arterial pulse. ____________________. 20g non-tapered catheter is used to penetrate skin. Needle, bevel upward is directed at 45 degree angle toward the palpated pulse. If bone is encountered, complete catheter system is slowly withdrawn while observing for free flow of arterial blood. Once arterial blood is seen in hub, reduce angle of needle to 30 degrees and advance slightly. Thread catheter off of needle. Suture, sterile dressing. Arm board, roll gauze. What is the missing step? a. Tape patients' arms down tightly so they won't move during the procedure. b. Place tourniquet around upper arm. c. Prep skin with antiseptic solution and infiltrate with local anesthetic. d. Tell patient to hold their breath while you are inserting the needle.

C. prep skin with antiseptic solution and infiltrate with local anesthetic (N&P ch16, pg 308) Kaitlin

Estimates today indicate that up to _____% of the procedures that require anesthesia services are taking place outside the conventional operating room. A: 5% B: 10% C: 55% D: 80%

C: 55% Reference: N&P page 1260, 1st column 1st paragraph Abe

Under which category of the preanesthesia questionnaire would it be most appropriate to document a patient's history of diabetes? A: Neurologic B: Cardiovascular C: Endocrine D: Hematologic

C: Endocrine Reference: N&P page 338, Figure 19-1 Abe

What two chest leads are the most accurate in detecting myocardial ischemia? A: AVR & AVL B: V1 & V6 C: V2 & V3 D: AVL & AVF

C: V2 & V3 Reference: N&P page 292, second column, third paragraph Abe

What is the suggested preoperative treatment regimen for adrenocortical dysfunction? A) Food B) Calcium supplement C) Heparin D) Correction of fluid and electrolyte disturbances and the treatment of coexisting disorders, such as hypertension and diabetes mellitus

D) Correction of fluid and electrolyte disturbances and the treatment of coexisting disorders, such as hypertension and diabetes mellitus N&P ch19, pg 370 Dumas

Which of the following is considered to be the gold standard for recording BP? A) Oscillometric technique B) Audible discernment of Korotkoff sounds C) NIBP cuffs D) Direct measurement of arterial BP

D) Direct measurement of arterial BP Devin [N&P p.307]

All of the following are true regarding Etomidate EXCEPT: A) Etomidate has minimal effects on the cardiovascular system B) Etomidate by itself produces relatively light anesthesia for laryngoscopy, and marked increases in HR & BP may be recorded C) Etomidate causes adrenocortical suppression D) Etomidate has analgesic properties

D) Etomidate has analgesic properties Devin [M&M p.185]

What is the drug of choice for drug-induced torsades de pointes? A) IV calcium gluconate B) IV potassium chloride C) IV calcium carbonate D) IV magnesium sulfate

D) IV magnesium sulfate Devin [N&P p.207]

All of the following are considerations for preventing IV contrast medium extravasation EXCEPT: A) Use IV catheters (as opposed to metal needles or butterfly needles) B) Avoid use of the same vein if the first attempt at IV placement was missed C) Ensure the IV catheter is patent and is free flowing D) If extravasation does occur, do not aspirate any contrast

D) If extravasation does occur, do not aspirate any contrast Devin [N&P p.1282]

Which 2 Opiates are both opioid agonists & antagonists? A) Morphine & Meperidine B) Butorphanol & Sufentanil C) Nalbuphine & Naloxone D) Nalbuphine & Butorphanol

D) Nalbuphine & Butorphanol [N&P p.146] Devin

Potentially harmful items when in proximity to MRI include all of the following EXCEPT? A) Cardiac pacemakers B) Permanent eyeliner or tattoos C) Cochlear implants D) Nickel & Titanium

D) Nickel & Titanium Devin [N&P p.1283]

What is the treatment for PVCs in an asymptomatic patient, without structural heart disease? A) Procainamide B) Amiodarone C) Digoxin D) No drug therapy is indicated

D) No drug therapy is indicated Devin [N&P p.207]

What is the recommended management for insulin the night before surgery? A) Stop the insulin the night before surgery B) Take 2x the normal dose C) Replace with high calorie/simple carb diet D) Reduction in the dose of insulin the evening before surgery

D) Reduction in the dose of insulin the evening before surgery N&P ch19, pg 369 Dumas

4. Which of the following is a vasodilator? (Select one) a. Hydralazine b. Cocaine c. Phenylephrine d. Isoproterenol

a. Hydralazine Jason [M&M p. 255]

Which of the following is NOT an example of injury or harm that can occur with automatic NIBP measurements? A) Damage to peripheral nerves B) Development of a compartment syndrome C) Interference with delivery of drugs through an IV line D) Tendonitis

D) Tendonitis Devin [N&P p.307]

Which of the following is the purpose for measuring the SSEP? A) To measure adequacy of hemispheric oxygenation B) To measure intracranial compliance C) To monitor electrical brain activity and detect seizures D) To monitor the integrity of sensory pathways

D) To monitor the integrity of sensory pathways Devin [N&P p.326]

What is a frequency shift? A) Crescendo/Decrescendo wavelength B) Phenomenon that occurs at the end of a night shift C) Frequent shifting of the bowels D) With the flow of RBCs toward the TEE probe, the distance between the sound source and its reception is changing

D) With the flow of RBCs toward the TEE probe, the distance between the sound source and its reception is changing N&P Ch 16 pg 309 Jared Dumas

3. What is some equipment required when administering anesthesia in a remote location? a. Patient monitors b. Oxygen supplies c. Pulse oximeter d. All of the above

D. all of the above n&p pg 1262 rebecca

5. All of the following are causes of elevated central venous pressure, except: (N&P, pg 302) a. RV failure b. Tricuspid stenosis or regurgitation c. Volume overload d. Constrictive pericarditis e. Dehydration/hypovolemia

E. Dehydration/hypovolemia

5. Lockable anesthesia carts to permit organization of supplies, including ________, _________, and ____________ help to prepare the anesthesia care provider when practicing in a remote area. a. Endotracheal tube b. Laryngeal mask airway c. Intravenous fluids and tubing d. All of the above

D. all of the above n&p pg 1262 rebecca

4. What are some additional requirements for general anesthesia? a. Anesthetic medication b. Vaporizers c. Oxygen analyzer d. All of the above

D. all of the above n&p 1262 rebecca

Which of the following terms correlates with paradoxical movement? A. Hyerkinesia B. Akinesia C. Hypokinesia D. Dyskinesia

D. N&P 309

Some advantages of Desflurane include all of the following, EXCEPT: (N&P ch8, pg 97) a. Rapid uptake and elimination b. Stable molecules c. Minimal biotransformation d. No significant systemic toxicity e. Increases cerebral metabolic rate

E. Increases cerebral metabolic rate Kaitlin

Which of the following is TRUE regarding the safe practices of cylinder usage? A. Empty cylinders should always be left on the machine. B. Two washers may be used between the cylinder port and the yoke to ensure a snug fit. C. Oil should be placed on valves to ensure proper functioning. D. You should always protect the cylinder valve when carrying a cylinder, as it is the most fragile part.

D. N&P 249

What is the Glasgow Coma score for a patient that spontaneously opens their eyes, obeys commands, and is oriented? A. 3 B. 5 C. 11 D. 15

D. 15 N&P page 352 Justin

At 20 degrees Celsius, how many liters of nitrous oxide are there at a pressure of 745 psi? A. 500 L B. 660 L C. 945 L D. 1590 L

D. 1590 L (M & M, page 52) Maggie

2.) What is the vapor pressure of sevflurane? (NP, page 223) A. 150 mmHg B. 660 mmHg C. 238 mmHg D. 160 mmHg

D. 160 mmHg Maggie

During an Oral airway examination you see tongue, teeth and hard palate. Which Mallampati classification would you give this patient? N&P pg 431 a. 1 b. 2 c. 3 d. 4

D. 4 N&P pg 431 Adam

4. What is the duration of action of phenylephrine? a. 2 minutes b. 1 minute c. 1-2 hours d. 5-20 minutes.

D. 5-20 Minutes N&P page 189 Justin

You are in the preoperative clinic doing assessments for patients undergoing surgery the following day. What is the desirable thyromental distance in any given patient you're assessing? A. > 2 fingerbreadths B. < 3 fingerbreadths C. < 4 fingerbreadths D. > 3 fingerbreadths

D. > 3 fingerbreadths (M & M, page 313) Maggie

Transcutaneous carbon dioxide monitoring is a useful tool for monitoring all EXCEPT? A. One lung ventilation B. Obese patients with decreased FRC C. Hypoventilation D. V/Q mismatching E. PIP

E. PIP NP Ch. 17 pg. 317-318 K. Jensen

Which of the brain death criteria should be tested last, because of its detrimental effects on ICP? A. Coma B. Absence of motor activity, including decerebrate, decorticate and spinal reflexes C. Absence of brainstem reflexes D. Absence of ventilatory effort

D. Absence of ventilatory effort M&M pg. 1280 K. Jensen

3. Which of the following should always be included in the documentation when administering anesthesia for therapeutic and diagnostic procedures? a. EtCO2 b. Blood Pressure c. Heart Rate d. All of the above.

D. All of the Above N&P, Page 1264 - Second Column, first paragraph Justin

Acetylcholinesterase inhibitors, given in large doses, can prolong the neuromuscular blockade of ______? A. Succinylcholine B. Nondepolarizing drugs C. Depolarizing neuromuscular blocker D. All of the above

D. All of the above M&M p. 223 K. Jensen

Ethical and legal issues have led to changes in practice in critical care. Competent patients now have the right to: A. Refuse treatment B. Discontinue life-support machines C. Have advanced directives D. All of the above

D. All of the above M&M pg. 1279 K. Jensen

Why are resuscitation bags commonly used for emergency ventilation? A. They are simple to use B. They are portable C. They have the ability to deliver almost 100% oxygen D. All of the above

D. All of the above Morgan & Mikhail, Ch 3, pg 40 Roel

5. Which of the following are considerations and requirements of ancillary personnel for areas of anesthesia delivery for therapeutic or diagnostic procedure in remote locations? a. Personnel should have training in basic life support. b. Personnel must be made familiar with anesthesia responsibilities to serve as an assistant. c. Personnel must be able to assist with positioning and comfort. d. All of the above

D. All of the above N&P Box 52-7 Justin

2) What are some potential drug interactions affecting perianesthesia care? a. ACE inhibitors b. Beta Blockers c. None of the above d. All of the above

D. All of the above N&P pg 341 Rebecca

Increased CV stimulation during awake intubation can be minimized using which of the following drugs A. BEta blockers B. Ca Channel blockers C. Vasodilators D. All of the above

D. All of the above N & P 461 mandy

Which of the following can be gathered from the population dose-response characteristics from a quantal dose-response curve A. Effective dose B. Toxic dose C. Lethal dose D. All of the above

D. All of the above Charlie N &P pg. 57

What is the function of the reservoir bag in the anesthesia machine circuit? A. to supply fresh gas B. to function as a gas outlet C. to humidify the gases D. to act as a reservoir for anesthetic gas

D. to act as a reservoir for anesthetic gas Morgan & Mikhail, ch 3, pg 35 Caroline

Of the patients that are treated in remote areas outside of the OR, 69% have an ASA classification of_____ to _____. A: 1 to 6 B: 2 to 6 C: 1 to 5 D: 3 to 5

D: 3 to 5 Reference: N&P page 1260, 1st column 2nd paragraph Abe

What is the reversal agent that is given in the setting of propofol overdose? A: Narcan B: Romazicon C: Mucomyst D: All of the above are false. There is no reversal agent for propofol overdose

D: All of the above are false. There is no reversal agent for propofol overdose Reference: N&P page 104, 2nd column 3rd paragraph Abe

Which of the following does NOT result from epinephrine induced beta-1 stimulation of the heart? A: Positive inotropy B: Positive chronotropy C: Positive dromotropy D: Decreased myocardial oxygen demand

D: Decreased myocardial oxygen demand Reference: N&P page 186, 2nd column 3rd paragraph Abe

Which of the following substances is NOT considered to be a naturally occurring catecholamine? A: Epinephrine B: Norepinephrine C: Dopamine D: Phenylephrine

D: Phenylephrine Reference: N&P page 186, 1st column 2nd paragraph Abe

Which of the following is *not* considered a fundamental monitoring/assessment technique that is frequently utilized by anesthesia care providers? A: Inspection B: Auscultation C: Palpation D: Therapeutic touch

D: Therapeutic touch Reference: N&P page 292 first column, second paragraph Abe

The crisis management algorithm for anesthesia providers is more complex than the "Airway-Breathing-Circulation" algorithm used by first responders. This algorithm is C-O-V-E-R-A-B-C-D. Correctly identify the mismatched descriptor in the acronym. (N&P ch17, pg 314) a. C-Circulation, Color b. O-Oxygen, oxygen analyzer c. V-Ventilation, Vaporizer d. E-Esophageal temperature probe e. R-Review monitors, review equipment f. A-Airway g. B-Breathing h. C-Circulation i. D-Drugs

D. E-Esophageal temperature probe. (N&P ch17, pg 314) Kaitlin

Increased peak airway pressures, hypoxemia, unilateral breath sounds and asymmetrical chest expansion are all indications of what problem? A. Esophageal intubation B. Obstructed ETT C. Occluded circuit D. Endobronchial intubation

D. Endobraonchial intubation N & P 467

What color is used to represent nitrous oxide on a gas cylinder? A. Gray B. Yellow C. Purple D. Blue

D. Blue (M & M, page 51) Maggie

You look into your patients mouth during your assessment and are unable to see the soft palate. Which Mallampati class would this patient be? A. Class 1 B. Class 2 C. Class 3 D. Class 4

D. Class 4 N&P page 348 Justin

Laser Doppler flowmetry and thermal diffusion flowmetry both measure: a. CBF velocities b. Cerebral metabolism c. Integrity of motor pathways d. Cortical CBF Nagelhout and Plaus ch18, pg 326

D. Cortical CBF Kaitlin

If a laser ETT is unavailable for laser surgery, a regular ETT should be utilized but it must be wrapped with foil to prevent an airway fire. True/False

False M&M pg 24 Mandy

What drug do we give peroperatively for hyperthyroid patients? A) Lasix B) Calcium supplement C) Insulin D) Beta blockers such as propranolol and esmolol

D) Beta blockers such as Propranolol and Esmolol N&P ch19, pg 370 Dumas

T/F: Because of the unidirectional valves, apparatus dead space in a circle system is limited to the area proximal to the point of inspiratory and expiratory gas mixing at the Y-piece.

False M&M pg. 40 Jennifer

5) Identify objectives of patient education: a. Encourage patient participation in decision making b. Promote interactive communication between patient and care provider c. Increase patient compliance with perioperative care d. All of the above

D all of the above N&P pg 340 Rebecca

What is Sodium nitroprusside's onset of action & duration that allows precise titration of arterial blood pressure? A) 2-4 min / prolonged duration B) 1-2 min / prolonged duration C) 2-4 min / fleeting duration D) 1-2 min / fleeting duration

D) 1-2 min / fleeting duration Devin [M&M p.257]

Even if recovery to neuromuscular blocking agents appears clinically adequate, a small dose of neostigmine & robinol may be prudent if the time since relaxant administration is less than _____________? A) 1 hour B) 2 hours C) 3 hours D) 4 hours

D) 4 hours Devin [N&P p.178]

Nitric oxide's half-life of __________ provides sensitive endogenous control of regional blood flow. A) 60 seconds B) 30 seconds C) 10 seconds D) <5 seconds

D) <5 seconds Devin [M&M p.257]

Which of the following can be used during the changing of an ETT, or during the extubation of a difficult airway? A) Trachlite lighted stylet B) Laryngeal mask airway (LMA) C) Regular stylet D) Airway exchange catheter (AEC)

D) Airway exchange catheter (AEC) [N&P p.454] Devin

Neuromuscular agents provide: A. Analgesia B. Amnesia C. Unconsciousness D. Muscle relaxation

D. Muscle relaxation M&M Ch. 11 pg. 200 K Jensen

1. What is the function of A-beta nerve fiber type? a. Motor tone b. Pain c. Proprioception d. Touch and Pressure

D. Touch and Pressure Nagelhout and Plaus - Page 128, table 10-1 Justin

Compared to its predecessor, Pancuronium, ______________ is more liphophilic, 1.5x more potent, with an onset of action 1.5x faster (N&P ch12, pg 173). a. Roccuronium b. Mivacurium c. Cisatracurium d. Vecuronium

D. Vecuronium Kaitlin Hale

What condition could a low CVP indicate? (M & M, page 104) A. Pulmonary Hypertension B. Left atrial enlargement C. Elevated sodium levels D. Volume depleted patient

D. Volume depleted patient (M & M, page 104) Maggie

What is presystemic elimination refer to? a. When the drug is no longer going to be given. b. When the drug is eliminated from the central compartment. c. When the drug redistributes from the peripheral compartment. d. When the is eliminated by the GI system before it reaches systemic circulation.

D. When the drug is eliminated by the GI system before it reaches systemic circulation. N&P 65 Justin

How should the preanesthesia assessment that is performed in remote areas differ from the assessment that is done in the OR? A: If there are time constraints, it is ok to omit airway assessment B: If there are time constraints, it is ok to omit the H&P C: If there are time constraints, it is ok to omit looking up preoperative lab work D: There should not be any difference in preoperative assessments performed in the OR setting versus in remote locations outside of the OR

D: There should not be any difference in preoperative assessments performed in the OR setting versus in remote locations outside of the OR Reference: N&P page 1261, 1st column 1st paragraph Abe

What is the primary effect of small doses of dopamine when given at a concentration of 2 mcg/kg/min or less? A: Peripheral vasoconstriction B: Positive inotropy C: Positive dromotropy D: Vasodilation of the renal vasculature promoting diuresis

D: Vasodilation of the renal vasculature promoting diuresis Reference: M&M page 239, key concept #7 Abe

1. Major Interventional Radiology therapies include all of the following, except: (N&P ch52, pg1280) A. angiography B. embolization of blood vessels (AV malformations or epistaxis) C. delivery of chemical or physical vascular occlusive devices D. removal of thrombi E. varicose vein reconstruction F. ablation of aneurysms G. angioplasty of blood vessels with stent placement

E Hale

Transient imbalances can also lead to intraoperative rhythm disturbances. Some of these include: (N&P ch13, pg 205) a. Electrolyte or metabolic imbalance b. Laryngoscopy c. Surgical stimulation d. Central vascular catheters e. All of the above

E Hale

Which of the following is NOT an indication for fiberoptic intubation? A) An anticipated difficult airway B) Cervical spine immobilization C) Anatomic abnormalities of the upper airway D) Failed intubation attempt, but ventilation possible with a mask or SGA device E) Patient with a mallampati 1 & thyromental distance of 6 cm

E) Patient with a mallampati 1 & thyromental distance of 6 cm [N&P p.455] Devin

Which of the following would not take place in the preanesthesia assessment clinic? A: Obtain patient medical history B: Perform physical examination C: Patient teaching D: Scheduling appropriate consults & diagnostic testing E. Performing appropriate nerve blocks

E. Performing appropriate nerve blocks Reference: N&P page 335 second column, second paragraph Abe

Which of the following is not a process of pharmacokinetics? A: Absorption B: Distribution C: Metabolism D: Elimination E: Mechanism of action

E: Mechanism of action Reference: N&P page 62, 1st column 1st paragraph Abe

3) What medication is the principal pharmacological treatment for anaphylaxis and can also be used to treat ventricular fibrillation a. Epinephrine b. Adenosine c. Amiodarone d. Vassopressin

Epinephrine C. Crouse M & M pg. 246

Which of the following actions would be required if surgical fire occurred in the airway? A. Stop fresh gas flows, pull the tube, flush airway with saline or sterile water B. Check for any missing pieces of the tube C. Resume ventilation with air D. Reestablish airway and examine damage with bronchoscope E. Transfer to burn center if severe F. All of the above

F. M&M ch2 Kaitlin

Match the Following types of hypoxia with their clinical presentation characteristics. Hypoxic Hypoxia Circulatory Hypoxia Hemic Hypoxia Demand Hypoxia/Histotoxic Hypoxia a. altitude, O2 equipment failure, drug overdose, COPD exacerbation, emphysema, pulmonary fibrosis, asthma, PE, atelactesis, cyanotic congenital heart disease b. severe heart failure, dehydration, sepsis, SIRS c. anemia, carboxyhemoglobinemia, methemoglobinemia d. fever, seizures, cyanide toxicity, late sepsis, ↑ TNF

Hypoxic Hypoxia - a. altitude, O2 equipment failure, drug overdose, COPD exacerbation, emphysema, pulmonary fibrosis, asthma, PE, atelactesis, cyanotic congenital heart disease Circulatory Hypoxia - b. severe heart failure, dehydration, sepsis, SIRS Hemic Hypoxia - c. anemia, carboxyhemoglobinemia, methemoglobinemia Demand Hypoxia/Histotoxic Hypoxia - d. fever, seizures, cyanide toxicity, late sepsis, ↑ TNF M&M page 1281 Krum

5) What is the benefit of adding epinephrine to a local anesthetic a. Less systemic absorption and longer duration of action b. Faster metabolism, shorter duration of action c. Increases spread of local anesthetic d. Has no effect on local anesthetic

Less systemic absorption and longer duration of action C. Crouse M & M pg. 246

The float should be maintained between the designated markings on the waste anesthetic gas disposal (WAGD) system. Failure to do so will result in? (select 2) M&M pg 13 a. inadequate patient ventilation b. insufficient suction levels c. hyperventilation of the patient d. failure of air system

M&M pg 13 Adam A. Inadequate patient ventilation B. Insufficient suction levels

4. Where is SvO2 measured? a. Pulmonary artery b. Aorta c. Left atrium d. Pulmonary vein

Pulmonary artery NP p. 306 Jason

Reading: N&P chs. 19 & 22 and M&M chs. 18 & 19 Remember: - Keep it simple - Place name, book and page number on the definition/answer side of your question for reference. - On the last flashcard place your name as you add your questions. ...

Questions for exam 1 are due 3-2-16 at 2355

Low CVP, Low PADP, Low PAOP indicates what hemodynamic status of your patient? N&P PG 304 table 16-8 a. Hypovolemia b. LV failure c. RV failure d. Pulmonary HTN

a. Hypovolemia N&P PG 304 table 16-8 BIEBER

1) Epinephrine is an endogenous catecholamine synthesized in a. The adrenal medulla b. Liver c. heart d. Prostate

The adrenal medulla C. Crouse M & M pg. 246

True or False: Misuse of anesthesia gas delivery systems is three times more likely than failure of the device to cause equipment-related adverse outcomes.

True Page 44. Morgan and Mikhail's Mr. Ryan

2. Which of these medications are not associated with problems of assisted reproductive technologies? N&P pg 1247 a. Isoflurane b. Morphine c. Desflurane d. Sevoflurane

a. Isoflurane N&P PG1247 Adam Fieber

5. Match the following types of fiberoptic intubations (FOI) with the justification for use. a. Awake FOI 1) Predicted inability to mask ventilate, Upper airway obstruction b. Asleep FOI 2) Failed intubation, minimal cervical spine movement and refusing an awake induction c. Oral FOI 3) Facial skull fractures, facial trauma d. Nasal FOI 4) Poor mouth opening

a.) 1 b.) 2 c.) 3 d.) 4 M&M Ch 19 Pg 330-331 Mark

2.) What is the onset of action of flumazenil? a.) <1min b.) 10 min c.) 1 hour d.) 3.5 hours M&M page 290

a.) <1min Zino

4. Which of the following local anesthetics can cause toxic levels of methemoglobinemia when used as a topical spray? a. Cocaine b. Benzocaine c. Lidocaine d. Bupivacaine

b. Benzocaine M&M Ch. 16 Pg. 271 Mark Thetford

Which of the following is not a naturally occurring catecholamine? a. Dopamine b. Dobutamine c. Epinephrine d. Norepinephrine

b. Dobutamine MM: 245 Byron

What does SSEP stand for? a. So Sassy Electric Probing b. Somatosensory Evoked Potentials c. Somatosensory Electric Probing d. Sassy Sensory Electric Potentials

b. Somatosensory Evoked Potentials NP-pg. 330 Krum

Which of the following opioids is ONLY used for intraoperative anesthesia? a. Fentanyl b. Sufentanil c. Hydromorphone d. Morphine

b. Sufentanil M&M, p. 196 Lexi

The blue arrow in the above CVP waveform diagram (arrow will be pointing at the c wave) is representative of what portion of the cardiac cycle? a. Passive filling of the right atrium b. Ventricular systole and closure of the tricuspid valve c. Right atrial systole d. Opening of the tricuspid valve

b. Ventricular systole and closure of the tricuspid valve NP 299 Byron

A baseline hemoglobin and hematocrit test is desirable in any patient that is suspected to have, or has a history of this condition? a) Factor V deficiency. b) Hemophilia. c) Anemia. d) A baseline H&H should be done on every patient.

c) Anemia. M&M pg. 300 Lake

Which enzyme is released from bile ducts during conditions such as biliary obstruction or irritation that can assist in the differentiation of hepatic dysfunction from parenchymal disease versus that of cholestasis? a. Alanine Transaminase b. Aspartate Transaminase c. Alkaline Phosphatase d. Lactate Dehydrogenase

c. Alkaline Phosphatase NP: 364 Matt Byron

1. Which of the following is not one of the most common exogenous nephrotoxins associated with acute kidney injury? (M&M pg 1311) a. Aminoglycosides b. Amphotericin B c. Fentanyl d. Radiographic contrast dyes

c. Fentanyl

Which of the following pathologies would be a contraindication to a patient having a transesophageal echocardiogram (TEE)? a. Cardiac pathology b. Renal pathology c. Gastric pathology d. Pulmonary pathology

c. Gastric pathology M&M p. 116 Lexi

2. Which of the following statements is true concerning Acute Kidney Injury? (M&M pg 1311) a. Oliguric AKI accounts for 75% of cases b. Anuric is defined as a urinary volume <600 mL/d c. Nonoliguric AKI accounts for up to 50% of cases d. Nonoliguric AKI patients appear to have a higher complication rate and require longer hospital stays.

c. Nonoliguric AKI accounts for up to 50% of cases

3. All of the following statements are true regarding Fospropofol EXCEPT? a. It is a water-soluble prodrug b. Slower onset and recovery than propofol c. Produces more complete amnesia and better conscious sedation. d. All of the above are true statements. Reference: M&M pg 187

d. All of the above are true statements. Reference: M&M pg 187 Mandy

Many categories of drugs possess anticholinergic activity, all of the following contribute to potential anticholinergic syndrome EXCEPT which drugs? a. Tricyclic antidepressants b. Antihistamines c. Antipsychotics d. Antihypertensives

d. Antihypertensives M&M p. 237 Lexi

What is the clinical significance of Brainstem Auditory Evoked Potentials (BAEPs)? a. They are resistant to changes in structural pathology of the brainstem b. They are not significantly affected by barbiturates, benzodiazapines, ketamine, nitrous oxide, propothol, and muscle relaxants. c. They are resistant to alteration in anything other than structural pathology in the brainstem d. Both b & c are correct

d. Both b & c are correct (N&P pg 330) Lake

5. Which of the following is not a muscarinic side effect? a. Salivation b. Convulsions c. Vomiting d. Bronchial dilation

d. Bronchial dilation M & M, page 230 Willie

4.) A young male patient who laryngospasm and attempts to take a deep breath can lead to what? a.) Breaking of the laryngospasm b.) An adequate tidal volume c.) Nothing at all d.) Negative pressure pulmonary edema

d.) Negative pressure pulmonary edema M & M page 336- Zino

4.) What are the contraindications to neuromuscular monitoring? a.) High BP b.) Low BP c.) Nerve injury d.) There are no contraindications

d.) There are no contraindications M&M page 138 Zino

4.) Which local anesthetics depress myocardial automaticity? a.) Cocaine b.) Lidocaine c.) No local anesthetics depress the myocardial automaticity d.) All local anesthetics do

d.) all local anesthetics M&M page 273 Zino

Amedeo Avogadro was able to show that in a mole of any gas there are how many molecules? a. 6.023 b. 6.023 x 10^23 c. 6.023 x 10^24 d. 6.023 x 10^15

*b. 6.023 x 10^23* N&P Ch. 14, pg. 224 Jennifer

March 14th-20th N&P ch 16 and M&M ch 5, due 3-16-16 at 2355 Remember: - Keep it simple - Place name, book and page number on the definition/answer side of your question for reference. -place your names on the list of student that have submitted their questions.

(292 - 1.2) + (1.2 x [# next to your name]) = first page you are assigned to N&P Ch 16 pg 292-310 = 18 pages = 1.2 pages each

1. The two-compartment model is described by: (M&M pg 148) a. A curve with three exponents and three coefficients b. A curve with two exponents and two coefficients c. A curve with four exponents and six coefficients d. A curve with five exponents and two coefficients

*B. A curve with two exponents and two coefficients* Ian

1. CVP approximates what? (M&M, pg 103) A. Patient awareness B. Nutritional status C. Right atrial pressure

*C. Right atrial pressure*

2- What is the optimal level of humidity in the OR? A. 0-10% B. 10-20% C. 50-55% D. 80-90%

*C: 50-55%* M&M page 16. Fletcher

What size gauge needle is used to infiltrate the apex of the triangle with local anesthetic before inserting an internal jugular venous line? (Give answer as a whole number)

*25* M&M pg. 101 Jennifer

Which of the following are ways to maintain airway patency, and effect ventilation and thus oxygenation to the tissues? (Select all that apply) A. Mask ventilation with seal B. Placement of supraglottic airway device C. Placement of endotracheal tube D. Placement of an invasive airway E. All of the above.

*Answer: (E) All of the Above* • Nagelhout and Plaus page 437 Fletcher

Calculate the patient's cardiac output (CO) in LITERS if the stroke volume is 60 mL/beat and heart rate (HR) is 110. (Answer to the nearest tenths place)

*6.6* M&M pg. 104 Jennifer

What is the definition of Risk Management? A) Money management B) Security System C) A detection system designed to predict failures and ensure that precautions to prevent patient harm are taken D) All of the above

*A detection system designed to predict failures and ensure that precautions to prevent patient harm are taken* N&P pg 281 Dumas

3- What is the most reliable form of radiation protection? A. Shielding B. Scrubs C. Anti-radiation topical cream D. Radiation protection is not needed in the OR environment

*A: Shielding * M&M page 16. Fletcher

1- Hypothermia has been associated with .......... A. Increased incidence of wound infection B. Decreased intraoperative blood loss C. Shorter hospital stay. D. Increased metabolic rate

*A:increased incidence of wound infection* M&M page 15. Fletcher

4. How is "Fast Track" pre-oxygenation accomplished? A. Patient takes 4 Vital Capacity breaths in 30 seconds B. Patient takes 15 small, quick breaths in 30 seconds C. Patient takes one Vital Capacity breath D. Patients takes 10 vital capacity breaths in 30 seconds

*Answer: (A) patient takes 4 vital capacity breaths in 30 seconds* • Nagelhout and Plaus page 436 Fletcher

The sniffing position allows for proper aligning of which axis? (Select all that apply) A. Oral Axis B. Pharyngeal Axis C. Laryngeal Axis D. Nasal Axis

*Answer: (A,B,C)* • Nagelhout and Plaus page 436 Fletcher

What is the "Gold Standard" for ruling out fractures of the cervical spine? A. XRAY B. MRI C. CT D. Ultrasound

*Answer: (C) CT* • Nagelhout and Plaus page 435 Fletcher

5. If a healthy patient is preoxygenated appropriately how long can their highly oxygenated FRC theoretically provide oxygen to the blood? A. 5 minutes B. 15 minutes C. 2 minutes D. 12 minutes

*Answer: (D) 12 minutes* • Nagelhout and Plaus page 436 Fletcher

What is the purpose of the Safe Medical Device Act of 1990? A) Ensure patient safety B) Ensure FDA safety C) Ensure hospital cleanliness D) Ensure animal safety

*Ensure patient safety* Requires hospitals to report instances in which medical devices cause or contribute to death, serious illness, or serious injury. All medical personnel who become aware of a problem with a device must remove the equipment from contact with patients and report the problem to their supervisors. The hospital risk manager then conducts an investigation and reports the results to the FDA within 10 working days. N&P pg 282 Dumas

3. Where does Fentanyl first-pass uptake occur? (M&M pg 192) a. Liver b. Heart c. Kidney d. Lung

*Lung*

1. What opioid has the lowest lipid solubility? (M&M pg 192) a. Fentanyl b. Sufentanil c. Morphine d. Alfentanil

*Morphine*

4. Which of the following opioids has the least amount of protein binding? (M&M pg 192) a. Fentanyl b. Remifentanil c. Morphine d. Dilaudid

*Morphine*

If a leak is detected on the anesthesia machine while performing the FDA approved PreAnesthesia Checklist (PAC), what are some appropriate interventions? A) Tighten the pop-off valve B) Tighten your mom's valve C) Tighten all connections, ensure that the Y-piece is properly occluded, gas flows are closed, and the gas sampling lines in the D-Lite sensor are not still connected to the circuit D) Tighten your face mask because crap is about to hit the fan

*Tighten all connections, ensure that the Y-piece is properly occluded, gas flows are closed, and the gas sampling lines in the D-Lite sensor are not still connected to the circuit* N&P pg 282 Dumas

How many days should Cisatracurium be used by after removal from refrigeration and exposure to room temperature? a. 15 b. 21 c. 25 d. 30

*b. 21* M&M Ch. 11, pg. 217 Jennifer

What is a simple routine technique that will assess the patient breathing, mask fit is good, and oxygen is flowing? A) Preoxygenate patient before induction and observe breathing bag fluctuations B) Hyperventilate and watch CO2 decline past 30 mmHg C) Place ventilator on pressure support and walk away D) Open your cylinders two more times and pat your head at the same time

*Preoxygenate patient before induction and observe breathing bag fluctuations* During preoxygenation, (whether in emergencies, or as a matter of routine in any case), observe the breathing bag for fluctuations. Respiratory effort that is visible in the breathing bag before induction begins ensures that the patient is breathing, the mask fit is good, and oxygen is flowing. A situation in which any of these conditions is absent requires immediate attention. N&P pg 283 Dumas

What is the most critical part of a scavenging system? A) Tubing B) Circuit C) Canister D) Suction

*Suction* N&P pg 281 Dumas

4- (T or F) film badge is the most common method for measuring how much radiation you are exposed to in the OR

*TRUE* M&M page 17. Fletcher

5- (T or F) Dry air can serve as vector for infection

*TRUE* M&M page 16. Fletcher

3. The vessel-rich group includes: (Select 5) (M&M pg 144) a. Brain b. Heart c. Fat d. Skin e. Liver f. Bone g. Kidney h. Endocrine glands i. Muscle

*a, b, e, g, h Ian

A dose of 0.04 mg/kg of Vecuronium initially followed by increments of ___ mg/kg every 15-20 minutes provides intraoperative relaxation a. 0.01 b. 0.001 c. 0.1 d. 1

*a. 0.01* M&M Ch. 11, pg. 218 Jennifer

The action potential of visual evoked potentials (VEPs) varies, depending on the type of stimulus used. Flash VEPs consist of a series of negative and positive waves, with the earliest detectable response occurring around ___ ms post-stimulus. a. 30 b. 40 c. 50 d. 60

*a. 30* N&P Chapter 18, pg. 333 Jennifer

A rapid expansion or compression of a gas without equilibration of energy with the surrounding environment is called what type of process? a. Adiabatic b. Heating c. Reverse d. Normal

*a. Adiabatic* N&P Ch. 14, pg 225 Jennifer

3. Early symptoms of local anesthetic toxicity include: (select 5) (M&M pg. 271) a. Circumoral numbness b. Tongue paresthesia c. Constipation d. Death e. Dizziness f. Tinnitus g. Blurred vision

*a. Circumoral numbness* *b. Tongue paresthesia* *e. Dizziness* *f. Tinnitus* *g. Blurred vision*

2. Elimination half-life is: (M&M pg 148) a. The time it takes to infuse half of a medication drip b. The time it takes for half of a drugs potency to drop when exposed to light c. The time required for the drug concentration to fall by 50% d. The amount of time before the patient has to urinate after medication administration

*c. The time required for the drug concentration to fall by 50%* Ian

What amount of fresh gas flow is needed during controlled ventilation when using the Waters to-and-fro, otherwise known as the Mapleson C circuit? a. 2 x minute ventilation b. Equal to minute ventilation c. 3 x minute ventilation d. 2-2.5 x minute ventilation

*d. 2-2.5 x minute ventilation* M&M Pg 33 Lake

All of the following are multiple factors that could be anticipated to increase anesthesia risk outside of an operating room EXCEPT? a. Decreased availability of anesthesia personnel b. Less adjunct equipment c. Unfamiliarity with supportive staff d. An inept anesthesia provider

*d. An inept anesthesia provider* N&P Ch. 17, pg. 322 Jennifer

Anesthetics can be eliminated by all of the following ways EXCEPT? a. Biotransformation b. Transcutaneous loss c. Exhalation d. Hydroxylation

*d. Hydroxylation* M&M Chapter 8, pg. 159 Jennifer

Cannulation of the carotid artery during internal jugular venous insertion can lead to all of the following EXCEPT? a. Hematoma b. Stroke c. Airway compromise d. Hypertension

*d. Hypertension* M&M pg. 102 Jennifer

All of the following laws contribute to the universal gas law EXCEPT? a. Boyle's Law b. Charles' Law c. Gay-Lussac's Law d. Law of LaPlace

*d. Law of LaPlace* N&P Ch. 14, pg. 224 Jennifer

5. Where are Amide local anesthetics primarily metabolized? (M&M pg. 271) a. Lungs b. Kidneys c. Intestines d. Liver

*d. Liver*

Patients who are hypersensitive to bromides may exhibit an allergic reaction to which neuromuscular blocking agent? a. Succinylcholine b. Rocuronium c. Vecuronium d. Pancuronium

*d. Pancuronium* M&M Ch. 11, pg. 218 Jennifer

Measures of minimal alveolar concentration (MAC) are dependent upon anesthetic effects at what level of the CNS? a. Cortex b. Cuneate nucleus c. Hippocampus d. Spinal cord

*d. Spinal cord* M&M Chapter 8, pg. 160 Jennifer

The v waves on the central venous waveform corresponds to? a. Atrial contractions b. Tricuspid valve elevations during early ventricular contractions c. Venous return against an open tricuspid valve d. Venous return against a closed tricuspid valve

*d. Venous return against a closed tricuspid valve* M&M pg. 104 Jennifer

Patients with complex medical conditions should be evaluated at least _____ week(s) before the scheduled procedure A: 1 week B: 2 weeks C: 3 weeks D: 4 weeks

A: 1 week Reference: N&P page 335 second column, third paragraph Abe

Place the following in order from 1-6 of the ASA classification system, and when would you utilize E. Patient with mild systemic disease (no functional limitations) Patient with severe systemic disease that is a constant threat to life (functionally incapacitated) Normal Healthy Patient Patient with severe systemic disease (some functional limitations) Moribund patient who is not expected to survive without the operation Organ donation

1. Normal Healthy Patient 2. Patient with mild systemic disease (no functional limitations) 3. Patient with severe systemic disease (some functional limitations) 4. Patient with severe systemic disease that is a constant threat to life (functionally incapacitated) 5. Moribund patient who is not expected to survive without the operation 6. Organ donation E. If the procedure is an emergency, the classification is followed by E Morgan and Makhail's page 297 Krum

2. Match the following LMA with the description. a. Proseal LMA b. I-gel LMA c. Fastrach LMA d. LMA Ctrach i. The cuff does not use air to occlude airway ii. Used to facilitate endotracheal intubation iii. Uses a camera to facilitate passage of a ETT. iv. Permits use of a gastric tube to decompress stomach.

1. Proseal LMA - iv. 2. I-gel LMA- i 3. Fastrach- ii 4. LMA Ctrach- iii a. M&M page 319 Sommers

Correctly match each term with its corresponding definition. A: Endoneurium B: Perineurium C: Epineurium (Answers: A is 1, B is 2, C is 3)

1: Surrounds each individual axon 2: Surrounds a group of axons, organizing them into a structure called a fascicle 3: Surrounds a group of fascicles, organizing them into a peripheral nerve fiber Reference: N&P page 126, Figure 10-2 Abe

Approximately what proportion of patients who are scheduled for noncardiac surgery have risk factors for CAD? A: 1/3 B: 1/2 C: 3/4 D: 9/10

A: 1/3 Reference: N&P page 292 first column, fourth paragraph Abe

1. Which adrenergic receptor type is responsible for the effects of the heart? a. Beta 1 b. Beta 2 c. Beta 3 d. Beta 4

A i. N&P Pg 187 anozier

4. Alpha agonist effects will cause the blood vessels to: a. Vasoconstriction b. Vasodilation c. No clinically relevant effect

A i. N&P pg 188 anozier

Propofol formulations support the growth of bacteria and must be discarded if opened and unused _______hrs after opening? (M&M ch 9, pg 185) a. 6hrs b. 8hrs c. 12hrs d. 24hrs

A. 6hrs Hale

4. What percent of cardiac output does the vessel rich group receive? a. 75% b. 5% c. 100% d. 20%

A. 75% N&P - 81, 7-4 Justin

2) What does the term standard deviation and standard error of the mean describe? a. Population response variability b. The average of the total population c. The amount the standard has been deviated

A. N&P pg 55 Rebecca

4) In the elderly, what are responsible for the variation in response to doses of anesthetics? a. Receptor changes associated with aging and kinetic differences b. Their lifestyle c. What they've been eating all their lives d. That's just the way it is i. N&P pg 55

A. N&P pg55 Rebecca

2. What type of nerve fiber is the last to be blocked by local anesthetics? a. A-alpha b. A-delta c. Zeta d. Type C

A. A-alpha N&P 128, table 10-1 Justin

Acetylcholine is quickly hydrolyzed by acetylcholinesterase into which two products? (Select 2) A. Acetate B. Acetone C. Choline D. Chlorine

A. Acetate C. Choline M&M p. 224 K. Jensen

3. What is the objective of pharmacologic Intervention? a. Achieve a desired therapeutic response b. Provide the drugs highest in cost so we can profit more. c. That is for pharmacists to know. d. Always give PO meds intraoperatively.

A. Achieve a desired therapeutic response. N&P Page 55. Justin

What conditions will increase alveolar dead space, dilute expired CO2, and lessen end tidal CO2? SELECT THREE (M and M, page 127) A. Air embolism B Decreased cardiac output C. Hypotension D. ARDS

A. Air embolism B Decreased cardiac output C. Hypotension Maggie

What is not a consideration in the treatment of a pediatric patient with signs or symptoms of an upper respiratory infection? A. All will require ETT B. Consider use of LMA C. Humidification D. Anticholinergics

A. All will require ETT N&P pg. 364 Crouse

1. When implementing protocols preventing wrong site, wrong procedure and wrong person, the anesthesia provider is an integral part. This protocol is also known as a. Universal protocol b. Specific Protocol c. Brookside Protocol

A. universal protocol n&p pg 1261

ACh receptors have 5 protein subunits: two α, β, δ, and Ԑ. Only two are binding sites for ACh molecules. Which two are capable of binding to ACh molecules and making the conformational change to open the ion channel? A. α- both sites must be occupied B. ß and Ԑ C. δ and α D. ß and δ

A. α- both sites must be occupied M&M Ch. 11 pg. 201 K Jensen

5. Which of the anesthetic gases undergoes the least metabolism? a. Nitrous Oxide b. Halothane c. Isoflurane d. Desflurane e. Sevoflurane

Answer Nitrous. 0.004% Halothane 15% to 20% Isoflurane 0.2% Desflurane <0.1% Sevoflurane 5% Morgan and Mikhail pg. 165

True or False: There are many aspects, theories and tools used in applying Anesthesia. The anesthesia machine is the MOST crucial piece of equipment you will need to familiarize yourself with to become a proficient provider.

Answer True. Page 44. Morgan and Mikhail's Mr. Ryan

4. Anticholingeric drugs cause which of the following ophthalmic effects? (Select 2) a. Mydriasis b. Miosis c. Cycloplegia d. Presbyopia

Answer: A,C- Mydriasis and Cycloplegia Morgan & Mikhail's Clinical Anesthesiology pg. 235 Stetler

5. What is the formula used to determine the appropriate internal diameter of an oral tracheal tube for a child? a. (Age/4) + 4 b. 14 + Age/2 c. 2 + Age/4 d. 4 + Weight in kg/4

Answer: A. (Age/4) + 4 Morgan & Mikhail's Clinical Anesthesiology pg. 321 Stetler

With large hospitals that use a lot of O2, storing the O2 as liquid is cost-effective. In order to store O2 as liquid it must be kept well below what critical temperature? A. -119 C B. 0 C C. -32 C D. -100 C

Answer: A. -119C M & M, pg. 11 Stefania

3. When is intubation indicated? (Select all that apply) a. Patients who are at risk for aspiration b. Short procedures c. Minor procedures d. Surgical procedures involving the head and neck

Answer: A- Patients who are at risk for aspiration D-Surgical procedures involving the head and neck Morgan & Mikhail's Clinical Anesthesiology pg. 325 Stetler

3. The "a" wave on a CVP tracing will correlate or follow what wave on the ECG? A. P wave B. QRS complex C. QT interval D. T wave

Answer: A. P wave N & P, pg. 301 Stefania

Of the choices below, select all of the options that are considered intubation stylets- a. Trachlite Lighted Stylet- lighted stylet that, when entered into the trachea, confirms placement by giving a glow on the exterior anterior neck. Inserted blindly. Used with upper airway anomalies. (N&P ch22, pg 454) b. Eschmann Stylet (Gum Elastic Bougie)- flexible with bent distal tip that can be useful when glottis opening is difficult to visualize. Must first visualize the epiglottis or posterior arytenoid cartilages. Advance to 25cm marking at lip, then ETT is inserted over the stylet into the trachea. (N&P ch22, pg 454) c. Airway Exchange Catheter: introduced through existing ETT, ETT pulled out and new one placed over stylet. (N&P ch22, pg 454) d. King Laryngeal Tube-placed blindly into the esophagus with distal balloon to occlude the esophagus (N&P ch22, 453)

ANSWERS: A, B, C. Kaitlin

Vapor pressure of vaporizers depends on what? Select all that apply (2) a. Altitude b. Temperature c. Characteristics of the Volatile Anesthetic d. Oxygen concentration

Answer: B,C Stetler

3. Which medication is used to reverse anticholinergic actions on the brain? a. Physostigmine b. Narcan c. Atropine d. Neostigmine

Answer: A- Physostigmine Morgan & Mikhail's Clinical Anesthesiology pg. 235 Stetler

1. To become a master in upper airway management you must be well versed in: (select all that apply) a. Airway anatomy b. Equipment c. Weather patterns d. Techniques e. Troubleshooting complications of laryngoscopy, intubation and extubation. f. Measuring urinary output

Answer ABDE Morgan and Mikhail 5th Edition Chapter 19 pg 309. Mr. Ryan

The metabolism of Nitroglycerin can lead to a buildup of nitrate which can do what? a. convert hemoglobin to methemoglobin. b. convert proteins to amion acids and promote hair growth c. inactivate compound a, thus reduce the risk of complications related to sevoflurane administration. d. all of the above are true effects of nitroglycerine and excess nitrate.

Answer - a. convert hemoglobin to methemoglobin. M&M page 259 - Krum

2. Adjunctive therapy to treat respiratory failure includes ________. A. Oxygen and positive pressure therapy B. Antibiotics C. Diuretics D. Mechanical ventilation E. All of the above

Answer E. All of the above M&M pg. 1302 Blair Ryan

What is the weakest of the three electrostatic bonds? a. dipole-to-dipole, when two molecules with uneven charge bond together. b. ion-to-dipole, the uneven charge of the molecule creates polarity with a more positive or negative end to that molecule which will attract elements with an opposite charge to which it bonds. c. ion-to-ion, they are not directional and occur along the outer electron shell. They also require high melting and boiling points. An example is sodium chloride. d. All of the above are correct.

Answer - a. dipole-to-dipole, when two molecules with uneven charge bond together. Nagelhout page 214 Krum

What are the three types of electrostatic bonds? a. ion-to-ion, ion-to-dipole, dipole-to-dipole b. ion-to-bipole, bipole-to-bipole, dipole-to-bipole c. trion-to-ion, tripole-to-tripole, tripole-to-bipole d. All of the above are correct.

Answer - a. ion-to-ion, ion-to-dipole, dipole-to-dipole Nagelhout page 214 Krum

1. With only a pulse oximeter, an anesthesia care provider can measure_____. (Select 3) a. Oxygen saturation of arterial blood (SaO2) b. Oxygen saturation of venous blood (SvO2) c. Tissue perfusion (pulse amplitude) d. Diastolic blood pressure e. Heart rate

Answer ACE. Measure- oxygen saturation of arterial blood, tissue perfusion (pulse amplitude) and measure heart rate. Morgan and Mikhail Pg. 124 & 125 BR

3. The echocardiogram has many diagnostic capabilities. The Doppler function allows the administrator to ___Select the 2 correct answers_____________. A. Measure the SvO2 content of the blood in the chambers. B. Estimates stroke volume and cardiac output. C. Determine both the direction and velocity of blood flow and tissue movement. D. Noninvasively analyze the heart and guide diagnostic clinical interventions with little specialized training.

Answer B and C. Ultimately, echocardiography can provide comprehensive cardiovascular monitoring. Its routine use outside of the cardiac operating room has been hindered by both the costs of the equipment and the training required to correctly interpret the images. M&M Chapter 5 pg 116, 120 Blair Ryan

4. Which of the following drugs is an example of a mu agonist? (Select 2) a. Oxycodone b. Morphine c. Fentanyl d. Ketamine

Answer B, C: Morphine and Fentanyl Morgan & Mikhail's Clinical Anesthesiology pg. 190 Stetler

2. Use your knowledge of CVP values and match the clinical presentation with the corresponding measurements. ___A dehydrated patient with tachycardia and hypovolemia. ___ Patient with a failing right ventricle secondary to severe pulmonary hypertension. ___ A healthy patient that has a central line properly placed. A. 2-6 mm HG B. 0 mm HG C. 12-15 mm HG

Answer B. C. A M & M Chapter 5 pg 104 Blair Ryan

Glycopyrrolate is different from the other antimuscarinics as it has no effect on __________. A. Increasing Heart Rate B. Sedation C. Antisialagogue D. Bronchodilation

Answer B. Glycopyrrolate has no sedative effect as it does not cross the blood brain barrier, if intact of course. Morgan and Mikhail pg. 234

5. Which one of the following drugs has flow-dependent clearance in the liver? a. Methadone b. Alfentanil c. Propofol d. Warfarin

Answer C. Propofol. Induction of liver enzymes has no effect on Propofol clearance, because the liver so efficiently removes all of the Propofol that goes through it. Even severe loss of liver tissue, as occurs in cirrhosis, has little effect on Propofol clearance. Drugs such as Propofol have flow-dependent clearance. Morgan and Mikhail pg. 147 Blair Ryan

1. Match the following functions with the correct innervation. 1.____ Afferent (sensory) stimuli to posterior pharynx 2.____ Efferent response, gag reflex of posterior pharynx 3.____ Sensory input from hypopharynx above the vocal cords, and motor function to cricothyroid muscle of larynx. 4.____ Sensory input from subglottic area and the trachea, and motor function to all muscles of the larynx except the cricothyroid muscle. 5.____ Motor function of the diaphragm A. Recurrent laryngeal nerve B. Vagus nerve C. Phrenic nerve D. Superior Laryngeal nerve E. Glossopharyngeal nerve

Answer: 1:E glossoph., 2:B vagus, 3:D sup. laryng., 4:A recurrent lar., 5:C phrenic N&P, pg. 424 and 427 Stefania

1. Which of the following correctly describes in vitro fertilization (IVF)? A. oocytes removed, fertilization occurs in the laboratory, embryo is placed into the uterus or into the distal portion of the fallopian tubes. B. oocytes and sperm are transferred into one or both fallopian tubes for fertilization. C. fertilized embryos are placed into the fallopian tubes. D. cleaving embryos are placed into the fallopian tubes. E. oocytes and sperm are placed into the pelvic cavity.

Answer: A N & P, pg: 1274 Stefania

What is happening during the a-wave of the PAOP waveform? a. Left atrial contraction a. Left ventricular contraction a. Closure of the tricuspid valve a. Opening of the aortic valve.

Answer: A N&P 300 Justin

Which volatile agent has such a high vapor pressure that it can boil at room temperature and requires a unique delivery system that electrically heats the agent? a. Desflurane b. Sevoflurane c. Halothane d. Isoflurane

Answer: A Stetler

Which lead is recommended for monitoring P-wave morphology? A. 2 B. AVL C. 5 D. 1

Answer: A (Lead II) N&P 294 Justin

3. Which of the following is the appropriate loading dose for Ketorolac? a. 60mg IM b. 60mg IV c. 30mg IV d. 30mg IM

Answer: A 60mg IM, C 30mg IV Morgan & Mikhail's Clinical Anesthesiology pg. 286

1. Match the following drugs with their description: a. Neostigmine b. Pyridostigmine c. Atropine d. Glycopyrrolate i. Most commonly used reversal agent ii. Slow onset, long duration & slow reversal iii. Should be combined with edrophonium because of more rapid onset iv. Less initial tachycardia than atropine; No CNS effects

Answer: A = I; B = ii; C = iii; D = iv Reference: N & P pg 180 (chart) Mandy

3. Choose the pathology that lowers the α1-acid glycoprotein (AAG) levels. Increased AAG levels cause an increased binding of basic drugs. a. Pregnancy b. Trauma c. Chronic pain d. Infection e. Myocardial infarction

Answer: A. Pregnancy all of the other choices increase AAG levels. Morgan and Mikhail pg. 145 Blair Ryan

1. All of the following are factors that reduce MAC EXCEPT: A. decreased age B. hypothermia C. acute alcohol consumption D. pregnancy

Answer: A. decreased age N & P, pg: 88 Stefania

3. Which of the following describes synergism? A. The combined effect of 2 drugs is greater than the algebraic sum of their individual effects. B. The combined effect of 2 drugs is equal to the sum of their effects. C. The action of one drug opposes the action of the other. D. The effect of one drug is greater than the other.

Answer: A. the combined effect of 2 drugs is greater than the algebraic sum of their individual effects. N & P pg 59 Stefania

2. Which of the following is the correct location for muscarinic-2 receptors? A. heart and CNS B. CNS and stomach C. Glands, GI, CNS D. only CNS

Answer: A., heart and CNS (bradycardia, smooth muscle contraction) N & P, pg. 198 Stefania

4. Which of the following is the correct location for muscarinic-4 receptors? A. heart and CNS B. CNS and stomach C. glands, GI, CNS D. CNS only

Answer: A., heart and CNS (promotes dopamine release) N & P, pg. 198 Stefania

2. Which of the following is not a property of fenoldopam? A. increase in peripheral vascular resistance B. increase in renal blood flow C. diuresis D. natriuresis

Answer: A., increase in peripheral vascular resistance M & M, pg. 248 Stefania

2. Select the vessel rich tissue groups from the following. Select 4 a. Heart b. Muscle c. Brain d. Fat e. Endocrine glands f. Liver g. Skin h. Bone

Answer: ACEF. The heart, brain, endocrine glands, liver and kidneys make up the vessel rich group. Morgan and Mikhail pg. 144. Blair Ryan

1. Which anticholinergic drug is most likely to cause tachycardia? a. Scopolamine b. Atropine c. Glycopyrrolate d. None of the above

Answer: B-Atropine Morgan & Mikhail's Clinical Anesthesiology pg. 234 Stetler

1.Resistance to airway depends primarily on which characteristic of the endotracheal tube? a. Length b. Diameter c. Curvature d. Characteristics of patient's airway

Answer: B-Diameter Morgan & Mikhail's Clinical Anesthesiology pg. 321 Stetler

Oxygen flow valves are designed to deliver a minimum flow of how much oxygen in mL/min when the anesthesia machine is turned on? a. 100 b. 150 c. 50 d. 200

Answer: B Stetler

The gradient between Paco2 and Etco2 is a reflection of what? a. Metabolic Rate b. Alveolar Dead Space c. Tissue Perfusion d. Effective ventilation

Answer: B Alveolar dead space Morgan & Mikhail's Clinical Anesthesiology pg. 127 Stetler

4. Which isoenzymes are responsible for the maintenance of gastric mucosa and stimulation of platelet aggregation? a. COX-2 b. COX-1 c. Both A and B

Answer: B COX-1 Morgan & Mikhail's Clinical Anesthesiology pg. 287

3. According to Starling's law: if compliance is not abnormally decreased, left ventricular end diastolic pressure should reflect what? a. Cardiac output b. Fiber length c. Left ventricular end diastolic volume d. Stroke volume

Answer: B Fiber Length Morgan & Mikhail's Clinical Anesthesiology pg. 109 Stetler

1. Which of the following NSAIDs provides analgesia by inhibiting prostaglandin synthesis? a. Acetaminophen b. Ketorolac c. Aspirin d. Clonidine

Answer: B Ketorolac Morgan & Mikhail's Clinical Anesthesiology pg. 286

5. Which of the following medications are specific COX-2 inhibitors? (Select 3) a. Ketorolac b. Parecoxib (Dynastat) c. Celecoxib (Celebrex) d. Rofecoxib (Vioxx)

Answer: B Parecoxib, C celecoxib, D Rofecoxib Morgan & Mikhail's Clinical Anesthesiology pg. 287

2. Approximately how many half-lives does it take to fully eliminate the drug from the body? A. 1 half-life B. 4-5 half-lives C. 10-12 half-lives D. 9-10 half-lives

Answer: B, 4-5 half-lives N & P, Pg 72 Stefania

5. With IV administration of labetolol, what is the estimated ratio of alpha to beta blockade? A. 1:5 B. 1:7 C. 1:3 D. 1:2

Answer: B., 1:7 M & M, pg. 249 Stefania

1. Which of the following is the correct location for muscarinic-1 receptors? A. Heart and CNS B. CNS and stomach C. Glands, GI, CNS D. only CNS

Answer: B., CNS and stomach (inc. cognition and memory, gastric acid production) N & P, pg. 198 Stefania

3. Which of the following correctly describes zygote intrafallopian transfer (ZIFT)? A. oocytes removed, fertilization occurs in the laboratory, embryo is placed into the uterus or into the distal portion of the fallopian tubes. B. oocytes and sperm are transferred into one or both fallopian tubes for fertilization. C. fertilized embryos are placed into the fallopian tubes. D. cleaving embryos are placed into the fallopian tubes. E. oocytes and sperm are placed into the pelvic cavity.

Answer: C N & P, pg: 1274 Stefania

Infrared spectrophotometry is based on which law? a. The law of mass action b. Law of Laplace c. Beer-Lambert law d. None of the above

Answer: C Beer-Lambert law Morgan & Mikhail's Clinical Anesthesiology pg. 127 Stetler

2. The equation for stroke volume is a. Cardiac output/body surface area b. (MAP-CVP) x 80/ Cardiac output c. Cardiac Output (L/min) x 1000/Heart Rate d. None of the above

Answer: C Cardiac Output (L/min) x 1000/Heart Rate Morgan & Mikhail's Clinical Anesthesiology pg. 109 Stetler

Which of the following choices is not an antimuscarinic? A. Glycopyrolate B. Scopolamine C. Neostigmine D. Atropine

Answer: C Neostigmine three common anticholinergics: atropine, scopolamine, and Glycopyrrolate. Morgan and Mikhail pg. 233 Mr. Ryan

2. The path of the current flow from a unipolar device should not cross which of the following a. The patient's extremities b. The surgeon's field of work c. The patient's heart d. All of the above

Answer: C, The patient's heart N&P pg. 232 Stetler

5. Which type of hepatic clearance is dependent upon perfusion of the liver? A. capacity dependent drug with an extraction ratio of less than 0.3 B. drugs that rely on hepatic enzymatic enzymes with an extraction ratio of less than 0.3 C. drugs with a high extraction ratio of 0.7 or greater D. drugs that rely on protein binding with an extraction ratio of less than 0.3

Answer: C, drugs with a high extraction ratio of 0.7 or greater N & P, pg. 73 Stefania

1. Which of the following is true regarding antagonists? A. They are able to initiate the receptor protein conformational change in order to elicit a tissue response. B. They are not similar in molecular structure to their corresponding agonist drugs. C. Have receptor affinity but lack intrinsic activity or efficacy. D. Activate receptor after binding to it.

Answer: C, have receptor affinity but lack intrinsic activity or efficacy. N & P pg. 58 Stefania

3. Which of the following is not an indication for fenoldopam? A. cardiac surgery with potential risk of perioperative renal impairment B. aortic aneurysm repair with potential risk of perioperative renal impairment C. hypotension D. prevention of contrast media-induced nephropathy

Answer: C, hypotension M & M, pg. 248 Stefania

4. Which of the following definitions correctly describes MAC-BAR? A. minimum alveolar concentration B. minimum alveolar concentration of anesthetic that blunts the autonomic responses to noxious stimuli C. minimum alveolar concentration of anesthetic that inhibits responses to command in half of patients. D. it is approximately 1/3rd of MAC

Answer: C, minimum alveolar concentration of anesthetic that blunts the autonomic responses to noxious stimuli N & P, pg: 88 Stefania

2. Which of the following correctly describes the mechanism of action of barbiturates? A. NMDA antagonist B. Mu receptor agonist C. potentiation of GABAa D. alpha 2 agonist

Answer: C, potentiation of GABAa M & M, pg. 175 Stefania

2. What are two common central nervous system effects following the administration of scopolamine? a. Dizziness b. Restlessness c. Sedation d. Amnesia

Answer: C,D- Sedation and Amnesia Morgan & Mikhail's Clinical Anesthesiology pg. 235 Stetler

Antimuscarinics have what relationship to ACh muscarinic receptors. A. Agonists B. Partial Antagonists C. Competitive Antagonist D. Partial Agonist

Answer: C: Competitive Antagonist These competitively blocks binding by acetylcholine and prevents receptor activation. Morgan and Mikhail pg. 233 Mr. Ryan

5. Which of the following correctly describes tubal embryo transfer (TET)? A. oocytes removed, fertilization occurs in the laboratory, embryo is placed into the uterus or into the distal portion of the fallopian tubes. B. oocytes and sperm are transferred into one or both fallopian tubes for fertilization. C. fertilized embryos are placed into the fallopian tubes. D. cleaving embryos are placed into the fallopian tubes. E. oocytes and sperm are placed into the pelvic cavity.

Answer: D N & P, pg: 1274 Stefania

4. Match the following agents with their respective classification. a. phentolamine b. labetolol c. prazosin d. phenoxybenzamine i. alpha-1, beta-1, beta-2 blocker ii. non-selective reversible alpha blocker iii. alpha-1 blocker iv. non-selective, irreversible alpha blocker

Answer: a. ii, b. I, c. iii, d. iv M & M, pg. 249 Stefania

5. When can the relationship between pulmonary artery occlusion pressure (predicted preload) and left ventricular end-diastolic volume (actual preload) become unreliable? a. Changes in left ventricular or atrial compliance b. Changes in mitral valve function c. Changes in pulmonary vein resistance d. All of the above

Answer: D All of the above Morgan & Mikhail's Clinical Anesthesiology pg. 109 Stetler

Anticholinergic classification are separated by the receptors they inhibit. Non depolarizing NMB's block ACh from binding at the _________ receptors while the more 'typical anticholinergics' block ACh at the _______ receptors. A. Muscarinic, nicotinic B. Muscle, sympathetic C. Alpha, Beta D. Nicotinic, Mucarinic

Answer: D Nicotinic, Mucarinic the nondepolarizing neuromuscularblocking agents drugs act primarily at the nicotinic receptors in skeletal muscle. This chapter presents the pharmacology of drugs that block muscarinic receptors. Although the classification anticholinergic usually refers to this latter group, a more precise term would be antimuscarinic. Morgan and Mikhail pg. 233 Mr. Ryan

5. Which statements are true regarding drugs such as propofol? a. Severe loss of liver tissue, as with cirrhosis, will have little effect on clearance b. Drugs such as propofol have a flow-dependent clearance c. Induction of liver enzymes has no effect on propofol clearance d. All of the above are true

Answer: D all of the above are true Morgan & Mikhail's Clinical Anesthesiology pg. 147 Stetler

1. Which of the following correctly describes elimination half life? A. the time it takes for the plasma concentration of a drug to decrease by 50% after a rapid bolus injection. B. the time it takes for the plasma concentration to decrease by half after a continuous infusion C. t1/2 D. both A and C

Answer: D both A and C N & P, pg. 72 Stefania

4. Which of the following describes potentiation? A. The effect of one drug is greater than the other. B. the combined effect of 2 drugs is equal to the sum of their effects. C. the action of one drug opposes the action of the other. D. the enhancement of the action of one drug by a second drug that has no detectable action of its own.

Answer: D. the enhancement of the action of one drug by a second drug that has no detectable action of its own. N & P pg. 59 Stefania

5. Which of the following is the correct location for muscarinic-5 receptors? A. heart and CNS B. CNS and stomach C. glands, GI, CNS D. CNS only

Answer: D., CNS only (promotes dopamine release, dilation of cerebral arteries) N & P, pg. 198 Stefania

2. Which of the following correctly describes peritoneal oocytes and sperm transfer (POST)? A. oocytes removed, fertilization occurs in the laboratory, embryo is placed into the uterus or into the distal portion of the fallopian tubes. B. oocytes and sperm are transferred into one or both fallopian tubes for fertilization. C. fertilized embryos are placed into the fallopian tubes. D. cleaving embryos are placed into the fallopian tubes. E. oocytes and sperm are placed into the pelvic cavity.

Answer: E N & P, pg: 1274 Stefania

Which of the following is NOT a technique for analyzing multiple anesthetic gases a. Mass spectrometry b. Raman spectroscopy c. Infrared spectrophotometry d. Piezoelectric crystal oscillation e. All of the above are techniques for analyzing anesthetic gases

Answer: E all of the above are techniques for analyzing anesthetic gases Morgan & Mikhail's Clinical Anesthesiology pg. 127 Stetler

3) Therapeutic drug doses reflect ________ doses of a "normal" population of individuals a. Below average b. Average c. Above average d. None of the above

B N&P pg 55 Rebecca

3) Use of a J+80 ms value to measure ST- segment deviation results in what: a. Absolutely nothing b. ST points intersecting the T wave, thus producing inaccurate ST deviation values c. Creates a false positive d. None of the above i. N&P pg 293

B ST points intersecting the T wave, thus producing inaccurate ST deviation values N&P pg 293 Rebecca

4.) According to Charles Law, what two properties are directly proportional to one another? (NP, page 224) A. Pressure, volume B. Temperature, volume C. Pressure, temperature D. None of the above

B Temperature and volume Maggie

What pharmacokinetic property of propofol accounts for the rapid awakening that patients experience following a one-time IV bolus? A: Rapid metabolization B: Redistribution C: Rapid excretion D: Low potency

B: Redistribution Reference: N&P page 78, 2nd column 4th paragraph Abe

The length of a nasal airway can be estimated as the distance from the nares to the meatus of the ear. It should be approximately how many centimeters (cm)? A. 3-4 cm longer than oral airways B. 2-4 cm longer than oral airways C. 5-6 cm longer than oral airways D. 1 cm longer than oral airways

B. 2-4 cm longer than oral airways (M & M, page 314) Maggie

BIS values range from 0 to 100. A BIS value of ___________indicates adequate general anesthesia depth? A. 0-30 B. 40-60 C. 80-100 D. 20-40

B. 40-60 N&P Ch. 18 pg. 329 K. Jensen

At 20 degrees Celsius, how many liters of oxygen are there at a pressure of 1900 psi? A. 350L B. 600L C. 745 L D. 800L

B. 600L (M & M, Page 52) Maggie

3.) What is the vapor pressure of desflurane? (NP, page 223) A. 238 mmHg B. 660 mmHg C. 160 mmHg D. 130 mmHg

B. 660 mmHg Maggie

If a drug is said to have 100% bioavailability, what does that mean? a. You gave 100% of the drug. b. All of the drug given is delivered to systemic circulation. c. The drug will double in effectiveness. d. Half of the drug given will be delivered to systemic circulation.

B. All of the drug given is delivered to systemic circulation. N&P page 65 Justin

An atom that has gained an electron is called a ______. An atom that has lost an electron is called a____. A. Bond B. Anion C. Cation D. Nuclei

B. Anion C. Cation N&P Ch. 14 pg. 213. K. Jensen

3. Which of the following definitions correctly describes passive transport. A: The movement of drug molecules against a concentration gradient from an area of low concentration to an area of high concentration, which requires energy. B: The movement of drug molecules from an area of higher concentration to an area of lower concentration, which does NOT require energy. C: The process by which a drug binds to a plasma protein and passes into the cell. D: The process by which a drug is eliminated from the body.

B: The movement of drug molecules from an area of higher concentration to an area of lower concentration, which does NOT require energy Reference: N&P page 62, 1st column 3rd paragraph Abe

What is the primary site of action at which local anesthetics exert their effect? A: The myelin of a Schwann cell B: Voltage gated sodium channels located in the Nodes of Ranvier C: The nucleus of a Schwann cell D: The cytoplasm of a Schwann cell

B: Voltage gated sodium channels located in the Nodes of Ranvier Reference: N&P page 125, 1st column 3rd paragraph Abe

3.) How does lidocaine effect normal blood coagulation? a.) Substantially b.) Minimally c.) Mildly d.) Not at all

C M & M page 274 Zino

5.) What is the local anesthetic called that was successfully used to produce vasoconstriction in the treatment of epistaxis? a.) Lidocaine b.) Bupivacaine c.) Cocaine d.) Cetacaine

C M & M page 274 Zino

Elective surgery should be postponed for at least _________ after placement of a drug-eluting stent. A) 6 months B) 2 years C) 1 year D) 1 month

C) 1 year Devin [N&P p.207]

1) What is the recommended dose of Dantrolene for the treatment of Malignant hyperthermia? A) 0.5 mg/kg B) 2.0 mg/kg C) 1.0 to 2.5 mg/kg repeated every 5 minutes up to 10 mg/kg

C) 1.0 to 2.5 mg/kg repeated every 5 minutes up to 10 mg/kg N&P Ch8 Pg. 96 Jared Dumas

3) When should an H 2 -receptor antagonist be given when preparing for surgery? A) Administer 2 h before the surgery B) Administer 30 minutes before surgery is completed C) Administer at bedtime and again at least 2 h before surgery

C) Administer at bedtime and again at least 2 h before surgery M&M Chapter 17 pg 281

Of the 7 principals of CRM, which is the most important and why? A) Adaptability b/c anesthesia should adapt to the surgeons attitude to keep them happy B) Assertiveness b/c you have to be assertive to stand-up to surgeons for what is in the patient's best interest. C) Situational awareness b/c lack of situational awareness may result in loss of valuable time. D) Leadership b/c every anesthetist should be a leader among their peers instead of relying on someone else to make decisions for them.

C) Situational awareness b/c lack of situational awareness may result in loss of valuable time M&M pg 25 Mandy

What are some possible indications for a TEE? A) Chronic Kidney Disease B) End Organ Failure C) Systolic wall motion abnormalities (SWMA), vascular aneurysms, calculation of EF, ventricular preload, and measuring blood flow within heart chambers and across valves

C) Systolic wall motion abnormalities (SWMA), vascular aneurysms, calculation of ejection fraction, ventricular preload, and measuring blood flow within heart chambers and across valves N&P Ch 16 pg 308 Jared Dumas

2) In select cases can volatile agents provide adequate muscle relaxation without the use of muscle relaxants? A) No, muscle relaxation is never adequate with only volatile agents B) No, every case requires a combination of volatile + nitrous oxide + muscle relaxant C) Yes, volatile anesthetic alone may produce adequate skeletal muscle relaxation without concurrent use of muscle relaxants

C) Yes, volatile anesthetic alone may produce adequate skeletal muscle relaxation without concurrent use of muscle relaxants N&P Ch8 Pg 96 Jared Dumas

1) What is the mechanism of action of Propofol? A) Antagonize Mu/Kappa receptors B) Agonize A/B receptors C) Directly stimulates GABAA receptors and potentiates the actions of endogenous GABA

C) directly stimulates GABAA receptors and potentiates the actions of endogenous GABA N&P Ch 9 pg 107 Jared

All of the following are true regarding risks of surgical fire, except: A. The greatest risk is the open delivery of oxygen B. Situations that equal high risk are those that involve an ignition source used in close proximity to an oxidizer C. The circulating nurse is the only one in the OR that should be concerned with what to do in the case of a surgical fire D. Chemical combustion required for fire is a triad of fuel, oxidizer, and an ignition source

C. M&M ch. 2 Kaitlin

Since there are many types of anesthesia machines available. Where should the anesthesia provider look for information as to how each machine will react when main electrical power is lost. A. Google B. Morgan & Mikhail C. The individual anesthesia machine operator's manual. D. The operating room engineering manual.

C. N&P 249

3. What is the blood:gas partition coefficient of Isoflurane? a. 20 b. 6 c. 1.4 d. 8

C. 1.4 N&P - 79, 7-1 Justin

The synaptic cleft is a _____nm gap? A. 30 nm B. 44 nm C. 20 nm D. 2 nm

C. 20 nm M&M Ch. 11 pg. 201 K Jensen

Which of the statements below is TRUE about hypokinesia, akinesia, and dyskinesia? A) Hypokinesia represents contraction that is less vigorous than normal B) Akinesia depicts the absence of wall motion C) Dyskinesia is paradoxical movement (example: outward motion during systole) D) All are true statements E) None of the above statements are true

D) All are true statements Hypokinesia represents contraction that is less vigorous than normal; wall thickening is decreased. Akinesia depicts the absence of wall motion and can be associated with myocardial infarction. Dyskinesia correlates with paradoxical movement (i.e., outward motion during systole) and is a hallmark of myocardial infarction and ventricular aneurysm N&P Ch 16 pg 309 Jared Dumas

What is the precordial stethoscope used for in regards to airway monitoring? A) It can be used to detect changes in breath sounds B) Provides continuous assurance that ventilation is occurring C) Used as a valuable tool in auscultating the presence or absence of airway exchange during all phases of the anesthetic, regardless of the type administered D) All of the above

D) All of the above Devin [N&P p.315]

All of the following are true about Etomidate, except: (M&M ch 9, pg 184-185) a. Etomidate depresses the reticular activating system. b. Contains a carboxylated imidazole ring. c. Highly protein bound with rapid onset. d. Etomidate is metabolized into a potent active metabolite. e. End products of hydrolysis are excreted in the urine.

D. Etomidate is metabolized into a potent active metabolite. Hale

Patients with type 2 diabetes are more likely to have all of the following diseases except? A. Hypertension B. Coronary artery disease C. Peripheral vascular disease D. Gynecomastia

D. Gynecomastia N&P pg. 367 Crouse

Which of the following is considered to be the most important monitor or alarm used during anesthesia? A) Pulse oximetry B) End-tidal CO2 measurement C) Oxygen analyzers D) Disconnect alarms E) They are all considered to be the most important monitors or alarms

E) They are all considered to be the most important monitors or alarms Devin [N&P p.315]

Some steps that the anesthesia provider can do to avoid symptom progression or death in a patient with CHF include: (N&P ch13, pg 205) a. When appropriate, regional nerve block techniques should be considered. b. Understand that patients may have difficulty lying flat during surgery and try to accommodate. c. No single general anesthetic technique has proven superior. d. Arterial line and TEE are useful for guiding intraoperative decision making and fluid management. e. Drugs such as the inotropes, phosphodiesterase inhibitors, diuretics, and vasodilators are commonly used intraoperatively in acute episodes. Have these drugs available. f. All of the above

F Hale

Match the contributor to operating room fires to its role in the chemical combustion triad:

Fuel: alcohol, ETT tubes, chlorhexidine, surgical sponges and packs Oxidizer: oxygen, nitrous oxide Ignition source: laser, drills and burrs, fiberoptic light sources, external defibrillators M&M ch. 2 Kaitlin

True or False? CO2 E-cylinders share a common size orifice and thread with oxygen cylinders and can be inadvertently interchanged.

TRUE M&M pg 13 Adam

2.) What is the preservative responsible for allergic reactions with amide local anesthetics? a.) PABA b.) Methylparaben c.) Latex d.) Sodium

b.) Methylparaben M&M page 274 Zino

3. The vessel-rich group includes: (Select 5) (M&M pg 144) a. Brain b. Heart c. Fat d. Skin e. Liver f. Bone g. Kidney h. Endocrine glands i. Muscle

a. Brain b. Heart e. Liver g. Kidney h. Endocrine glands

3. Which anesthetic medication is not used for assisted reproductive technologies? N&P pg 1247 a. Heparin b. Lidocaine c. Fentanyl d. Bupivacaine

a. Heparin N&P PG1247 Adam Fieber

What is the recommended waiting time for non-emergent surgeries following coronary intervention? a) At least 1 month. b) 6 weeks. c) 12 months. d) There is no need to wait following coronary intervention.

a) At least 1 month. M&M pg. 299 Lake

2.) What type of patients must the anesthesia provider avoid giving scopolamine to due to its pronounced ocular effects? a) Closed- angle glaucoma b) Cataracts c) Near sightedness d) Far sightedness M&M page 236

a) Closed- angle glaucoma M&M page 236 Zino

Risk of aspiration is recognized in which of the following groups of patients? (Select all that apply, select 3) a) Pregnant women in the 2nd and 3rd trimester b) A patient who has ate a solid meal 2 days ago c) A patient who has consumed a large meal within 6 hours d) A patient with severe GERD

a) Pregnant women in the 2nd and 3rd trimester c) A patient who has consumed a large meal within 6 hours d) A patient with severe GERD M&M pg. 299 Lake

1. Motor evoked potential (MEP) monitoring can best be described as? a. A method of monitoring the functional integrity of motor tracts, particularly in the corticospinal tract b. A way of monitoring auditory tracts c. Does not use electrical or magnetic stimuli

a. A method of monitoring the functional integrity of motor tracts, particularly in the corticospinal tract. p. 331 N& P Willie

1. Which of the following situations will cause an exaggerated response to catecholamines? a. A patient taking monoamine oxidase inhibitors b. A patient taking tricyclic antidepressants c. A patient taking bronchodilators d. A patient taking multi-vitamins Morgan & Mikhail p 245

a. A patient taking monoamine oxidase inhibitors b. A patient taking tricyclic antidepressants Morgan & Mikhail p 245 Budenbender

2. Which of the following is the correct infusion rate of Phenylephrine? a. 0.15-0.75 mcg/kg/min b. 0.03-0.15 mcg/kg/min c. 1.5-7.5 mcg/kg/min d. 2-20 mcg/kg/min

a. 0.15-0.75 mcg/kg/min Nagelhout Chapter 13 page 191 table "infusion rate" David Budenbender

What MAC level is considered MAC awake? a. 0.3-0.5 b. 1.0-1.3 c. 2.0-2.5 d. >6

a. 0.3-0.5 Nagelhout and Plaus page 82 Crouse

How much of the What is the FIO2 delivered from a well fitting partial rebreathing mask with oxygen flows up to 10 L/min? a. 0.35-0.6 b. 1.0 c. 0.21-0.24 d. 0.5-0.75

a. 0.35-0.6 (M&M pg 1284) Lake

4) What is the cardiac arrest dose for epinephrine a. 0.5-1.0mg b. 10-20 mg c. 50-100 mg d. Titrate

a. 0.5-1.0mg C. Crouse M & M pg. 246

2. The definition of Train of four stimulation is? N&P pg 161 a. A series of four twitches at 2 Hz every ½ second for 2 seconds b. A series of four twitches at 10 Hz every 1 second for 2 seconds c. A series of four twitches at 30 Hz every ½ second for 3 seconds d. A series of four twitches at 1 Hz every 1 second for 4 seconds

a. A series of four twitches at 2 Hz every ½ second for 2 seconds N&P Pg 161 Fieber

3. Monitoring EtCO2 cannot detect bronchial intubation. What is the earliest sign to detect a possible bronchial intubation? a. Elevated peak inspiratory pressure b. Chest radiography c. Auscultation of breath sounds d. Increased tidal volume during manual ventilation

a. Elevated peak inspiratory pressure M&M Ch 19 Pg 328 Mark

2. What is the mechanism of action of etomidate? a. GABA modulation b. 5HT-3 c. Acetylcholine receptor d. Mu receptor

a. GABA modulation Nagelhout Page 111 Budenbender

2. Patients may have to undergo high dose radiation treatments that produce a large amount of scatter radiation. This is harmful to the care providers. Patients may be monitored via closed-circuit video. Which procedures may require anesthesia personnel to leave the room during treatment? a. Intra-operative radiation therapy b. GammaKnife or Cyberknife surgery c. Magnetic Resonance Imaging d. Computerized Tomography

a. Intra-operative radiation therapy b. GammaKnife or Cyberknife surgery Reference: N&P pg 1284 Mandy

4. Match the correct vapor pressure with the appropriate volatile anesthetic. a. Isoflurane b. Sevoflurane c. Desflurane i. 238 mmHg (Isoflurane) ii. 160 mmHg (Sevoflurane) iii. 660 mmHg (Desflurane)

a. Isoflurane (i.) b. Sevoflurane (ii.) c. Desflurane (iii.) N & P, page 223 Willie

What is the attraction of nitrogen to a magnetic field? a. It is neither attracted or repelled b. It is attracted but not repelled c. It is repelled but not attracted d. It is both attracted and repelled

a. It is neither attracted or repelled N&P p. 236 Lexi

2. What pharmacologic changes can be seen with just relatively minor modifications in a drugs structure? a. Major pharmacologic changes b. No pharmacologic changes c. Linear pharmacologic changes d. Chemical structure never effects pharmacologic effects

a. Major pharmacologic changes N & P pg. 69 Charlie

2. According to the standard airway strategy, all of the following are signs of a potentially difficult airway except? a. Mallampati I or II b. short thyromental distance c. airway tumors, history of radiation, prior airway surgery d. thick neck circumference

a. Mallampati I or II NP: 442 Jason

3. Although recently replaced by more portable analysis technologies, the dominant technology for inhaled anesthetic gas analysis has been? a. Mass Spectrometry b. Piezoelectric Gas Analysis c. Interferometric refractometry d. Raman scattering

a. Mass Spectrometry N&P Ch. 14 Pg. 233-234 Mark Thetford

5. What is a potential outcome when motor nerves are not directly monitored (anterior motor tracts)? a. Motor deficits seen with normal SSEPs b. Hyperactive motor responses c. No known adverse outcomes d. Sensory deficits with normal SSEPs

a. Motor deficits seen with normal SSEPs p. 331 N& P Willie

5. Can metoclopramide be used during an assisted reproductive technologies? N&P pg 1247 a. NO b. YES c. Doesn't matter d. Not enough data?

a. NO N&P PG1247 Adam Fieber

What is not a cardiovascular effect of Ketamine? a. Negative inotrope b. Increases systemic blood pressure c. Increases heart rate d. Increases cardiac output

a. Negative inotrope N & P pg. 115 Charlie

What two potential results or complications of incorrect or too frequent use of automated blood pressure measuring devices? a. Nerve palsies b. Accurate measurements c. Extravasation of IV fluids d. Undue pain and suffering

a. Nerve palsies c. Extravasation of IV fluids (M&M pg 92) Josh Lake

2. What are the 2 types of potentials recorded when monitoring the distal spinal cord & peripheral nerves? (Select 2) a. Neurogenic potentials b. Myogenic potentials c. Sympathetic potentials d. Mediated potentials

a. Neurogenic potentials b. Myogenic potentials p. 331 N& P Willie

1. Which of the following is NOT a goal for monitoring the neurological system? a. Possessing a thorough knowledge of drugs available for neurological conditions b. Selection of appropriate neurologic monitors c. Understanding neuro pathophysiology d. Recognizing data indicating changes in neurological conditions

a. Possessing a thorough knowledge of drugs available for neurological conditions Jason NP p. 325

The use of a semilogarithmic plot when comparing drugs with similar mechanisms of action can be helpful in determining a. Potency b. Mechanism of action c. Clearance d. Distribution

a. Potency Charlie N &P pg. 56

4. Which device utilizes a variable pitch alarm? a. Pulse oximetry b. ECG c. ETCO2 d. O2 supply low-pressure alarm

a. Pulse oximetry NP p. 313 Jason

2. What black box warning is associated with Droperidol? (M&M pg 285) a. QT prolongation and development of torsades b. Causes projectile emesis c. Known to cause sudden respiratory arrest d. Irreversibly binds to dopamine receptors causing sever nausea

a. QT prolongation and development of torsades

What is it called when two anesthetics of varying onset speeds are administered, one with a fast onset and the other with a slower onset, in order to achieve anesthetics levels of the slower gas more quickly? a. Second-gas effect b. Rebreathing c. Jet ventilation d. This is not something that is done

a. Second-gas effect Nagelhout and Plaus page 82 Crouse

Cholinesterase inhibitors work by.. a. indirectly increasing the amount of acetylcholine available to compete with the blocking agent. b. indirectly decreasing the amount of acetylcholine available to compete with the blocking agent. c. directly decreasing the amount of acetylcholine available to compete with the blocking agent. d. indirectly increasing the amount of ephedrine available to compete with the blocking agent.

a. indirectly increasing the amount of acetylcholine available to compete with the blocking agent. M&M page 225 Krum

1. How is the operating room power supply isolated from grounds? a. isolation transformers b. pole-top transformers c. equipment casings d. black insulated wiring

a. isolation transformers M&M page 18 Franklund

2. In the operating room, how is electrical equipment monitored: a. line isolation monitor b. voltmeter c. ohmmeter d. distortionmeter

a. line isolation monitor M&M page 18 Franklund

3. According to the difficult airway strategy at what point should the case be canceled? a. ventilation is adequate, but the airway is not secure b. ventilation is inadequate c. unsuccessful intubation after three attempts d. after a failed rapid sequence induction

a. ventilation is adequate, but the airway is not secure NP: 443 Jason

4.) In what concentration is glycopyrrolate packed as? a.) 0.2mg/mL b.) 2mg/mL c.) 10mg/mL d.) 25mg/mL M&M page 236

a.) 0.2mg/mL M&M page 236 Zino

1. Match the treatment modality for mental illness with the appropriate description? (Matching) a. Electroconvulsive therapy (ECT) b. Repetitive transcranial magnetic stimulation (rTMS) c. Vagus nerve stimulation (VNS) d. Magnetic seizure therapy (MST) i. Inducement of a seizure ii. Coil placed on the scalp iii. Surgically implanted stimulator iv. Higher intensity/longer duration

a:i b:ii c:iii d:iv [N&P p. 1279] Jason

Train of four peripheral nerve stimulation will deliver four sets of shock/stimulation over how many seconds? a. 5 seconds b. 2 seconds c. 3 seconds d. 4 seconds

b. 2 seconds M&M p. 139 Lexi

1. Which statement regarding Ester local anesthetics is false? (M&M pg. 270) a. Predominantly metabolized by pseudocholinesterase b. Ester hydrolysis is very slow c. Water-soluble metabolites are excreted in the urine d. Cerebrospinal fluid lacks esterase enzymes so termination of action of intrathecally injected ester local anesthetics depends on their redistribution into the bloodstream

b. *Ester hydrolysis is very slow*

2. The correct dosage of physostigmine is? a. 0.1-0.3 mg/kg b. 0.01-0.03 mg/kg c. 1-2 mg/kg d. 0.01-0.03mcg/kg

b. 0.01-0.03 mg/kg Willie M & M, page 230

What is the recommended dosing of dexmedetomidine following the initial loading dose of 1 mcg/kg that is given over 10 minutes? a. 0.1-0.6 mcg/kg/hr b. 0.2-0.7 mcg/kg/hr c. 0.3-0.8 mcg/kg/hr d. 0.5-1 mcg/kg/hr

b. 0.2-0.7 mcg/kg/hr MM: 246 Byron

What is the appropriate initial dose of ketamine for sedation and analgesia? a. 0.1-0.2 mg/kg b. 0.2-0.8 mg/kg c. 1-2 mg/kg d. 2-4 mg/kg

b. 0.2-0.8 mg/kg NP: 115 Byron

To test the tracheal tube's inflation system you should use a: (Morgan & Mikhail, pg 325) a. 20 cc syringe b. 10 cc syringe c. 60 cc syringe d. 5 cc syringe

b. 10 cc syringe

Inappropriate gain settings on the ECG monitor can lead to inaccurate readings and subsequent misdiagnosis of ST segment changes. The gain should be set to standardization, meaning that a 1 mV signal delivered to the ECG produces a ______mm calibration pulse. a. 5 mm b. 10 mm c. 15 mm d. 20 mm

b. 10 mm NP 297 Byron

What is the approximate distance to the junction of the vena cava and the right atrium from a right internal jugular vein insertion site? a. 10 cm b. 15 cm c. 20 cm d. 25 cm

b. 15 cm NP 299 Byron

Systolic wall motion abnormalities (SWMA), vascular aneurysms, calculation of ejection fraction, ventricular preload, and measuring blood flow within heart chambers and across valves are a few of the utilities of ultrasound imaging applied during TEE. Ultrasound waves are inaudible to the human ear, having a frequency greater than_____________. a. 200,000 Hz b. 20,000 Hz c. 20,000 MHz d. 200 Hz

b. 20,000 Hz (N&P ch16, pg 308) Kaitlin

1. The endotracheal tube (ETT) cuff is inflated with the least amount of air possible while forming a seal during positive pressure ventilation to prevent trauma. Over inflating the ETT cuff can damage the tracheal mucosa by impeding capillary blood flow. This occurs with ETT cuff pressure greater than? a. 5 mmHg b. 30 mmHg c. 45 mmHg d. 21 mmHg

b. 30 mmHg M&M Ch 19 Pg 328 Mark

What is generally recognized as the duration of action of lidocaine with epinephrine when used in infiltrative injection? a. 15-30 min b. 30-60 min c. 45-90 min d. 60-120 min

b. 30-60 min Byron NP 137

What is the appropriate IM dose of ketamine for induction of anesthesia? a. 2-4 mg/kg b. 4-6 mg/kg c. 6-8 mg/kg d. 10 mg/kg

b. 4-6 mg/kg NP: 115 Byron

Which of the following solubility coefficients is an indicator of an anesthetic's speed of onset? a. Oil/Gas Solubility Coefficient b. Blood/Gas Solubility Coefficient c. Fat/Blood Solubility Coefficient d. Brain/Blood Solubility Coefficient

b. Blood/Gas Solubility NP 82 Byron

Which of the following medications has both alpha and beta blocking properties? (Select 2) a. Acebutolol b. Carvedilol c. Bisoprolol d. Labetalol

b. Carvedilol d. Labetalol NP: 194 Byron

4. What is the FDA's classification of an MRI device? (Select one) a. Class I b. Class II c. Class III d. Class IV

b. Class II [N&P p. 1280] Jason Class I - lowest risk Class II - Intermediate risk Class III - Highest risk Class IV - There is no class IV / Trick Question!

All contemporary vaporizers are designed to increase agent concentration as the dial is turned which way? a. Clockwise b. Counterclockwise c. Up d. Down

b. Counterclockwise Rationale: (N&P 261) "All contemporary vaporizers are designed to increase agent concentration as the dial is turned counter clockwise (See figure 15-29). Budenbender

What test can be done to determine if a patient has pseudo cholinesterase deficiency? a. Pseudo cholinesterase assay b. Dibucaine test c. Ester tester d. Pseudo ester tester assay

b. Dibucaine test (M&M pg 207) Lake

SSEP use an electrical stimulation sent in which of the follow manors? a. From the brain out towards the periphery. b. From the periphery towards the CNS. c. From the vessel rich compartment to the vessel poor compartment. d. It's just a constant stimulation running in every direction.

b. From the periphery towards the CNS NP-pg. 330 Krum

5. Which of the following agents do not cause malignant hyperthermia? a. Succinylcholine b. Rocuronium c. Sevoflurane d. Isoflurane e. Desfulrane M&M, ch 11, pg 210

b. Rocuronium Mbom

3. Which of the following is associated with the routine ordering of lab work for preoperative assessment? (Pick 2) a. CBC is indicated for all surgery patients b. Routine testing is expensive and rarely alters perioperative management. c. Every anesthetic requires a recent CBC & Chem 7. d. Testing should be guided by history and physical

b. Routine testing is expensive and rarely alters perioperative management. d. Testing should be guided by history and physical (M & M, p. 300) Willie

2. Which of the following anticholinergic agents has an added effect of preventing motion sickness? a. Atropine b. Scopolamine c. Glycopyrrolate d. None of the above

b. Scopolamine M&M Ch. 13 Pg. 236 Mark Thetford

Soda lime present in CO2 absorbents degrades most current volatile anesthetics to some extent, which can be minimized by incorporating higher fresh gas flows. The volatile anesthetic ________ is degraded the most, whereas _________is degraded the least? a. Iso/Sevo b. Sevo/Des c. Des/Iso d. Sevo/Iso

b. Sevo/Des NP: 270 Matt Byron

If the ventilator PEEP is set and the patient expires a breath the airway pressure will reduce to? a. Atmospheric level b. Slightly greater than atmospheric level c. Slightly less than atmospheric level

b. Slightly greater than atmospheric level (M&M Page 74) Mark

Select 2 of the correct mechanical criteria for weaning/extubation: a. Tidal volume >6 mL/kg b. Vital capacity >10 mL/kg c. Minute ventilation <12 mL d. Rapid shallow breathing index <100

b. Vital capacity >10 mL/kg d. Rapid shallow breathing index <100 M&M pg. 1297 Jennifer

3. When does the greatest effect of vasodilation on core temperature occur? a. 2-3 hours after vasodilation b. Within the first hour c. Within the first 5 minutes d. After 24 hours of the vasodilating effect

b. Within the first hour N & P, page 222 Willie

2. Which is part of the second messenger system as a result of Hydralazine administration? a. c AMP b. c GMP c. Acetylcholine d. Glutamate

b. c GMP M&M, page 260 Willie

All of the following are disadvantages of using the Circle System EXCEPT: a. higher risk of disconnection or malfunction b. decreased complexity c. complications related to use of absorbent d. difficulty predicting inspired gas concentrations during low fresh gas flows

b. decreased complexity M&M pg. 40 Jennifer

The preoperative examination of the healthy asymptomatic patient should include all except which of the following: a) Vitals signs b) Airway assessment c) Extensive neurological assessment d) Cardiovascular assessment e) Pulmonary assessment

c) Extensive neurological assessment M&M pg. 299-300 Lake

Which of the following is a rare, but tragic, potential complication of cannulating the femoral artery in children? a. CVA b. TIA c. Aseptic necrosis of the head of the femur d. Neuropathy of the tibial nerve

c. Aseptic necrosis of the head of the femur (M&M pg 93) Josh Lake

The monitoring site/method of Auditory nerve evoked potentials is? a. Visual evoked potentials b. Vocal cords c. Auditory brainstem responses d. No monitory technique available N&P Ch 18 pg 332

c. Auditory brainstem responses Mbom

What primary equation do echocardiographers use to calculate intracardiac/intracavitary pressures? a. Law of LaPlace b. Poiseuille's Law c. Bernoulli's Principle d. Fick's Law

c. Bernoulli's Principle M&M p. 118 Lexi

4. In a two-compartment model, the elimination phase consists of: (M&M pg 148) a. Metabolism only b. Excretion only c. Both metabolism and excretion d. None of the above

c. Both metabolism and excretion

1. All of the following are common side effects of scopolamine except? a. Drowsiness b. Amnesia c. Bradycardia d. Restlessness

c. Bradycardia M&M Ch. 13 Pg. 236 Mark Thetford

3. Why is Glycopyrrolate unable to reverse CNS side effects of physostigmine? a. It antagonizes nicotinic receptors only b. The short half-life prevents reversal of CNS effects c. Glycopyrrolate does not cross the blood-brain barrier d. None are correct

c. Glycopyrrolate does not cross the blood-brain barrier Willie M & M, page 230

5. Which of the following is not in accordance with pharmacodynamics profiles of Etomidate a. Dose dependent CNS depression with one arm-brain circulation b. Hemodynamic stability upon induction c. Hemodynamic instability upon induction d. Minute volume decreases but respiratory rate increases

c. Hemodynamic instability upon induction Nagelhout page 111 Budenbender

Which of the following component found in blood largely determines the oxygen carrying capacity of blood? a. Ionized calcium b. Ferrous sulfate c. Hemoglobin d. Neutrophils

c. Hemoglobin (N&P pg 319) Lake

Patients taking warfarin that present for surgery are at risk for intra-operative hemorrhage. This medication should be held for 5 days prior to the procedure. Which of the following would NOT need to be "bridged" with heparin? a. Chronic atrial fibrillation b. Recent mechanical heart valve c. Hemorrhoids that resolved 2 weeks ago d. Prior thromboembolic stroke

c. Hemorrhoids that resolved 2 weeks ago Morgan and Makhail's page 298 Krum

What law describes gas solubility in liquids? a. Murphy's law b. Bernulies law c. Henry's law d. Newtons law

c. Henry's law (N&P pg 216) Lake

1. 5-HT3- receptor antagonists are generally administered at the end of surgery for this purpose: (M&M pg 285) a. Decrease incidence of post-op tachycardia b. Prevent intra-operative episodes of hypoglycemia c. Reduce the incidence of postoperative nausea and vomiting d. Decrease incidence of recall

c. Reduce the incidence of postoperative nausea and vomiting

4. Which of the following identifies the correct method of administering Edrophonium? a. Reduced doses are recommended to prevent negative effects. b. Reduced doses should be avoided to ensure adequate duration of action. c. Reduced doses should be avoided so that the actions do not subside prior to the actions of the muscle relaxant.

c. Reduced doses should be avoided so that the actions do not subside prior to the actions of the muscle relaxant. M & M, page 230 Willie

On a CVP waveform tracing, the a-wave is indicative of what portion of the cardiac cycle? a. Passive filling of the right atrium b. Ventricular systole and closure of the tricuspid valve c. Right atrial systole d. Opening of the tricuspid valve

c. Right atrial systole NP 299 Byron

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 16, p. 274 Lexi B/c its not a racemic mixture and only contains the pure S (-) isomer. Bupiv is a racemic mixture.

5. Which of the following is a FALSE statement regarding the uptake of inhalational anesthetics? a. Obesity has no clinically significant effect on uptake of inhalational anesthetics b. Longer procedures and morbid obesity allow an increase in deposition of anesthetics into fat and may prolong recovery c. The uptake of anesthetics in pregnant women is FASTER than non-pregnant women d. Nitrous oxide studies suggest placental transfer during cesarean section is slower than maternal uptake and time dependent

c. The uptake of anesthetics in pregnant women is FASTER than non-pregnant women Budenbender Nagelhout 82-83

There is a range between a drug concentration that elicits a desired therapeutic effect and a drugs concentration that elicits a toxic response, what is that range referred to as? a. Concentration window b. Toxic response window c. Therapeutic window d. Drug dosing window

c. Therapeutic window M&M - pg. 150 Lexi

4. Why is temperature monitoring warranted during general and regional anesthesia? a. Elevated temperatures are common b. Temperature documentation is required for all anesthetic care c. They cause an inhibition of thermoregulation and significant vasodilation

c. They cause an inhibition of thermoregulation and significant vasodilation N&P page 321 Willie

2. What is the purpose of using a nerve stimulator to monitor neuromuscular function before redosing NDNMB drugs during the maintenance phase? a. To prevent overdosing only b. To prevent underdosing only c. To prevent underdosing or overdosing d. To avoid litigation M&M, Ch. 11, pg 213

c. To prevent underdosing or overdosing Mbom

4. Fiberoptic intubations are routinely used and ideal for patients with a? a. Large mouth opening b. Mallampati of 1 c. Upper airway obstruction (e.g. Angioedema) d. Maximal cervical spine movement

c. Upper airway obstruction (e.g. Angioedema) M&M Ch 19 Pg 330 Mark

Patients presenting for elective surgery with hyperglycemia should have their procedure... a. canceled and the patient given diabetic teaching. b. initiated immediately and bolus' of dextrose solutions given. c. postponed to allow insulin time to take effect. d. initiated immediately and start an insulin gtt.

c. postponed to allow insulin time to take effect. Morgan and Makhail's page 298 Krum

1.) How long does it take for muscle to regenerated if a local anesthetic was accidentally injected into muscle fascia? a.) 1 week b.) 2 months c.) 2-3 weeks d.) 1 year

c.) 2-3 weeks M&M page 274 Zino

3.) What is the initial proper way to treat a laryngospasm? a.) Apply negative pressure b.) Deliver 100% N2O c.) Apply gentle positive pressure with 100% O2 d.) Apply only 50% O2

c.) Apply gentle positive pressure with 100% O2 M & M page 336- Zino

3.) What is the highest pressure generated during an inspiratory cycle? a.) Plateau pressure b.) Peak expiratory pressure c.) Peak inspiratory pressure d.) Negative pressure

c.) Peak inspiratory pressure M&M page 77 Zino

3.) The following local anesthetics are considered to be long acting (select 3). a.) Chloroprocaine b.) Cocaine c.) Tetracaine d.) Bupivicaine e.) Ropivicaine

c.) Tetracaine d.) Bupivicaine e.) Ropivicaine M&M page 272 Zino

5. Which of the following interventions will help improve oxygen delivery to the brain? a. Increasing FiO2 b. Improving CO c. Decreasing oxygen demand d. All of the above

d. All of the above M&M Ch. 6 Pg. 136 Mark Thetford

At a PaO2 of 100 mmHg, how much O2 will be dissolved in 100 mL of blood? a. 5 mL b. 0.3 mL c. 3 mL d. 0.003 mL

d. 0.003 mL (N&P pg 319) Lake

What initial doses of Fenoldopam (titrated slowly) have been associated with less reflex tachycardia compared to higher doses? a. >0.3 mcg/kg/min b. 3 mg/min c. 3 mcg/kg/min d. 0.03-0.1 mcg/kg/min

d. 0.03-0.1 mcg/kg/min M&M Chapter 15, pg 261 Jennifer

What is the duration of action of IV Fentanyl? a. 1-2 hours b. 0.5-1 hour c. 2-3 hours d. 20-30 min

d. 0.5-1 hour (N&P pg 153) Lake

1. All of the following renal function tests indicate normal renal function EXCEPT? a. 10 mg/dL Urea nitrogen b. 133 mmol/L Sodium c. 10 mg/dL Calcium d. 2.2 mg/dL Creatinine

d. 2.2 mg/dL Naglehout & Plaus Page 366 Table 19-10 David Budenbender

If we have a 1000 mL tank of gasoline, which of the following rate of water inflow would reach a time constant of 63% equilibrium to water if a 100 mL/min outflow from the tank ithin 2 minutes? a. 100 mL/min inflow b. 125 mL/min inflow c. 150 mL/min inflow d. 200 mL/min inflow

d. 200 mL/min inflow E. whaaaaaaaaaat???!!!!! you can't have gasoline in the OR!!!!!! Rational (N&P 263): Wash-in is based on the concept of time constant. On time constant (equal to capacity divided by flow) brings a system 63% of the way to equilibrium; two time constants 86%; and three time constants to 95%. Thus, ... in only 2 minutes (1000 mL ÷ 500 mL inflow), in the same way, the volume (capacity) of the functional residual capacity, hoses, and breathing circuit can be brought to equilibrium with the inflow more quickly by using a higher rate of inflow (fresh gas flow). Budenbender

Soda lime is the most commonly used absorbent. How many liters of CO2 is absorbed per 100g of absorbent? a. 100 b. 250 c. 54 d. 23

d. 23 M&M pg. 37 Jennifer

5. What increase in serum creatinine will lead to a diagnosis of Acute Kidney Injury? (M&M pg 1309) a. 10% b. 20% c. 90% d. 50%

d. 50%

After approximately what point following the cessation of smoking does the pulmonary complication rate correlate with that of a non-smoker? a. 2 weeks b. 4 weeks c. 6 weeks d. 8 weeks

d. 8 weeks NP: 361 Matt Byron

At what gas flow rate is CO2 rebreathing so minimal that a CO2 absorber is usually unnecessary? a. >2 L/M b. >3 L/M c. 4 L/M d. >5 L/M

d. >5 L/M (Page 40 M & M) Willie

A rise in airway pressure may signal all of the following except: a. Worsening pulmonary compliance b. Increase in tidal volume c. Obstruction in the breathing circuit, tracheal tube, or the patient's airway d. A leak in the circuit

d. A leak in the circuit (M&M, pg 68)

3. Which of the following is not true about YAG lasers? NP ch 14 pg238 a. Tissue penetrations 2-6mm b. Has variable intensities c. Used to ablate and destroy tissues d. Aiming beam for invisible lasers

d. Aiming beam for invisible lasers Mbom

Emergent treatment of septic shock includes which of the following? a. Supportive treatment (managing ARDS, DIC, renal failure, etc.) b. Fluid and inotropic/vasopressor management to maintain perfusion c. Timely antibiotics and treatments to remove the infective process d. All of the above

d. All of the above M&M p. 1318 Lexi

5. What are some frequent adverse events seen with fospropofol (lusedra) a. Perineal paresthesia b. Pruritus c. hypoxemia d. All of the above

d. All of the above N&P pg 106 Rebecca

5. Which of the following play a role in bioavailability of agents? (Select all that apply) a. Lipid solubility b. Solubility in aqueous and organic solutions c. Environment into which drug is introduced d. All of the above

d. All of the above Nagelhout page 66 David Budenbender

1. Which of these medications are known to cause problems with assisted reproductive technologies? a. Morphine b. Sevoflurane c. Desflurane d. All of the above

d. All of the above N&P PG1247 Adam Fieber

4. When administering opioids to a patient in the pre-op setting, it is important to monitor the patient for which of the following? a. Respiratory depression b. Nausea & vomiting c. Hypotension d. All of the above

d. All of the above Reference: M&M pg 188 Mandy

All of the following are advantages of the ASA physical status classification EXCEPT? a. Time honored b. Reproducible c. Strongly associated with perioperative risk d. All of the above are advantages of using the ASA physical status classification

d. All of the above are advantages of using the ASA physical status classification M&M pg. 297 Jennifer

3. Guidelines and individual responses to adrenergic agonist medications have given recommended doses for infusions. Which is the preferable way to approach medicating your patient? a. Mcg/kg/min b. Mcg/min c. Titrate to effect d. All of the above are appropriate Morgan & Mikhail p 245

d. All of the above are appropriate Morgan & Mikhail p 245 Budenbender

1. Which of the following statements are true regarding Sodium Nitroprusside? a. Relaxes arteriolar smooth muscle b. Relaxes venous smooth muscle c. Releases nitric oxide d. All of the above are true

d. All of the above are true Reference: M&M pg 257 Mandy

All of the following are adverse events associated with nasal intubation EXCEPT? a. Transient bacteremia b. Submucosal dissection of the nasopharynx c. Submucosal dissection of the oropharynx d. Bowel perforation

d. Bowel perforation M&M pg. 1295 Jennifer

Which of these muscles do not monitor thoracic nerves? a. Upper rectus abdominis b. Middle rectus abdominis c. Lower rectus abdominis d. Gastrocnemius N&P Ch 18 pg 332

d. Gastrocnemius Mbom

Which piece of vital sign equipment makes use of a property of matter that allows it absorb certain frequencies but not others? a. Blood pressure monitoring b. Carbon dioxide monitoring c. Heart rate monitoring d. Pulse oximetry monitoring

d. Pulse oximetry monitoring N&P p. 237 Lexi

4. Which of the following is not an indicator of the need for Mechanical ventilation? a. Tidal volume<5ml/kg b. Vital capacity <15ml/kg c. Max inspiratory force>-25cm H2O d. RR >15 M&M, ch 57, pg1288

d. RR >15 Mbom

Insulin _____________ is typically present and generally causes __________. a. Sensitivity, hypoglycemia b. Sensitivity, hyperglycemia c. Resistance, hypoglycemia d. Resistance, hyperglycemia

d. Resistance, hyperglycemia M&M p. 1318 Lexi

5. Which are factors that place increased risk for perioperative hypothermia? a. High ASA status b. Lengthy or involved procedures c. Combined regional and general techniques d. Elderly & lean body mass patients e. All of the above

e. All of the above N&P page 321 Willie

2. What are other sites for pulse oximeter probe placement? a. Toes b. Forehead c. Nose d. Ear e. All of the above N&P ch 17 pg 320

e. All of the above Mbom

Causes of increased peak inspiratory pressure (PIP), with or without increase plateau pressure, include... a. Pulmonary edema b. Trendeleberg position c. Pleural effusion d. Tension pneumothorax e. All of the above

e. All of the above M&M - CH. 4, p. 79 Lexi

Use of the Volume Control ventilation setting during anesthesia can cause large discrepancies between the set tidal volume and the actual tidal volume the patient receives. Causes of this include... a. Breathing circuit compliance b. Gas compression c. Ventilator fresh gas flow coupling d. Leaks of the anesthesia machine, the breathing circuit, or the patient's airway e. All of the above

e. All of the above M&M - CH. 4, p. 79 Lexi

Select the following patient characteristics that are present and adequate for the use of high-flow oxygen delivery. a. requirement of consistent FiO2 b. Inspiratory Flow > 40 lpm c. All of the above

e. All of the above M&M page 1282 Krum

Select the following patient characteristics that are present and adequate for the use of low-flow oxygen delivery. a. MV < 8-10 lpm b. BPM < 20 c. Vt < 800 ml d. Inspiratory Flow 10-30 lpm e. All of the above

e. All of the above M&M page 1282 Krum

2. Which of the following is associated with a difficult airway? a. Micrognathia b. Prominent upper incisors c. Large tongue d. Limited neck ROM e. All of the above

e. All of the above (M & M, p. 300) Willie

Reversal of Neuromuscular blockade can be completed by all of the following mechanism EXCEPT... a. gradual diffusion. b. redistribution. c. metabolism. d. excretion from the body. e. pharmacological reversal. f. administration of increased MAC.

f. administration of increased MAC. M&M page 225 Krum

Intermittent bolus administration of opioids during the operative period can lead to drastic fluctuations of plasma concentration leading to altered anesthetic dosing and hemodynamic changes. Continuous infusions of opioids have shown to provide increased patient safety. Select all of the following advantages of opioid infusions. a. hemodynamic stability b. decreased side effects c. reduced need for reversal agents d. reduced total opioid dose needed e. decreased recovery time f. all of the above

f. all of the above Nagelhout and Plaus page 152 Krum

Risks associated with intra-arterial catheter placement include all of the following, EXCEPT: a. Infection, thrombus, hematoma b. Vasospasm, embolization c. Injury to adjacent nerves and veins, ischemia to extremities or digits d. Loss of a limb secondary to poor collateral circulation e. Iatrogenic injuries (air embolism, intra-arterial injection of drugs) f. Acute blood loss g. All of the above are risks associated with arterial catheter placement

g. all of the above are risks associated with arterial catheter placement. (N&P ch16, pg 307) Kaitlin

2. Match the following BIS monitor reading with the clinical correlation. a. 40-60 b. <40 c. 100 d. 0

i. 40-60 = adequate general anesthesia ii. <40 = deep hypnotic state iii. 100 = awake iv. 0 = no brain activity N&P 329 mandy

1. After inserting an LMA you notice that you have an obstruction. What is the MOST likely reason for the obstruction after an LMA insertion? (choose 2) a. Tongue obstruction. b. Patient breathing against ventilator. c. Pinned down epiglottis d. Laryngospasm

i. Answer: C-Pinned down epiglottis ii. Answer: D- Laryngospasm 1. M&M page 319 sommers

4. The oxygen/nitrogen ratio controller will keep the percent of oxygen given to the patient at what? a. 33% b. 21% c. 50% d. 25%

i. Answer: D 25% ii. M&M page 58 Sommers

1. Serotonin is a powerful vasoconstrictor, except in these tissues. Pick 2. a. Brain b. Kidneys c. Lungs d. Heart e. Skeletal muscle

i. Answer: D and E ii. M&M page 284 Sommers

1. Which of the following pressure best represents the pressure found in the Pulmonary artery? a. 18/2 b. 25/8 c. 130/5 d. 25/10

i. Answer: D- 25/10 ii. M&M page 107 Sommers

2. Which of the following is NOT included in a three compartment model for an intravenous medication? a. Central compartment b. Rapid equilibrating peripheral compartment c. Slow equilibrating peripheral compartment d. Intermediate equilibrating peripheral compartment

i. Answer: D- Intermediate equilibrating peripheral compartment ii. M&M page 146 Sommers

5. Identify the Mallampati scores for each oral opening. Select from drop down box. ****Pic wont upload, sorry***

its straight forward. We know this! Morgan and Mikhail 5th Edition Chapter 19 pg 313. Mr. Ryan

What is the definition of the term "Coronary Steal"? A. A reduction in perfusion of ischemic myocardium with simultaneous improvement of blood flow to nonischemic tissue. B. A reduction in perfusion to nonischemic tissue with simultaneous improvement of blood flow to ischemic tissue C. An overall increase in blood flow to all cardiac tissue D. An overall decrease in blood flow to all cardiac tissue

• Answer A • Nagelhout and Plaus page 93 Fletcher

What is the technique for titrating Propranolol? A. 20mg bolus followed by 1mg/kg/min maintenance infusion B. Give 50mg bolus and treat the ensuing hypotension C. Administer 5-10mcg Q1min D. Begin with 0.5 mg and progressing by 0.5-mg increments every3-5min.

• Answer: D • M&M 251 Fletcher

Pharmacotherapy may be affected by all of the following genetic variations except. A. target proteins B. enzyme metabolism C. idiosyncratic effects D. Race

• Answer: D • Nagelhout & Plaus page 76 Kyle Fletcher

The genomes of any two individuals are nearly _____% identical regardless of race. A. 75% B. 85% C. 90% D. 99.9%

• Answer: D • Nagelhout and Plaus page 76 Kyle Fletcher

The influence of PEEP is contingent on all of the following except. A. Quantity of PEEP applied. B. Intravascular volume status. C. Pulmonary compliance. D. Altitude

• Answer: D *Altitude* • Nagelhout and Plaus page 303 Kyle Fletcher

5. Which statement is true regarding drugs described by multicompartment pharmacokinetics? (M&M pg 148-149) a. The offset of a drug's effect can be easily predicted from its half-lives. b. The elimination half-time is context dependent c. None of the anesthesia medications are described by multicompartment pharmacokinetics d. One can easily determine how rapidly a drug effect will disappear simply by looking at coefficients, exponents, and half-lives

*b. The elimination half-time is context dependent* Ian

What dose of Rocuronium can be used to decrease fasiculations and postoperative myalgias for precurarization prior to administration of succinylcholine? a. 0.5 mg/kg b. 0.1 mg c. 0.1 mg/kg d. 0.2 mg/kg

*c. 0.1 mg/kg* M&M Ch. 11, pg. 219 Jennifer

Choose the correct order of most soluble to least soluble inhalational agents according to the FA/FI curve. a. Halothane > Isoflurane > Sevoflurane > Desflurane > Nitrous oxide b. Halothane > Sevoflurane > Isoflurane > Desflurane > Nitrous oxide c. Halothane > Isoflurane > Sevoflurane > Nitrous oxide > Desflurane d. Halothane > Desflurane > Isoflurane > Sevoflurane > Nitrous oxide

*a. Halothane > Isoflurane > Sevoflurane > Desflurane > Nitrous oxide* M&M Chapter 8, pg. 157 Jennifer

What is an all-too common occurrence under anesthesia? a. Hypothermia b. Hypertension c. Hypotension d. Hyperthermia

*a. Hypothermia* N&P Ch. 17, pg. 323 Jennifer

Which Mapleson circuit implements a coaxial modification that places the fresh gas flow tube inside the breathing tube. a. Mapleson D b. Ayer's T-piece c. Bain circuit d. Mapleson B

*a. Mapleson D* C. bain circuit is also correct as it's the same thing, different name. M&M Pg 33 Lake

All of the following are disadvantages to using an esophageal temperature probe EXCEPT? (select 2) a. Most accurate if placed closer to the stomach b. Slight potential for oral or esophageal trauma c. Not useful in awake patients d. Hard to insert

*a. Most accurate if placed closer to the stomach* *d. Hard to insert* N&P Ch. 17, pg. 321 Jennifer

All of the following are neuromuscular relaxants that are no longer available in the United States, EXCEPT? a. Pancuronium b. Pipecuronium c. Doxacurium d. Mivacurium

*a. Pancuronium* M&M Ch. 11, pg. 219 Jennifer

Which drug is the only clinically available cholinesterase inhibitor that freely passes the blood-brain barrier? a. Physostigmine b. Pyridostigmine c. Edrophonium d. Neostigmine

*a. Physostigmine* M&M Ch. 12, pg. 230 Jennifer

4. What Amide local anesthetic is metabolized at the highest rate? (M&M pg. 271) a. Prilocaine b. Ropivicaine c. Cocaine d. Mepivicaine

*a. Prilocaine*

T/F: The Mapleson F (Jackson-Rees' modification) is a Mapleson E with a breathing bag connected to the end of the breathing tube to allow controlled ventilation and scavenging. a. T b. F

*a. T* M&M Pg 33 Lake

Which type of evoked potential monitoring is used to monitor the function of the visual pathway, which comprises the retina to the occipital cortex and everything in between? a. Visual evoked potentials b. Motor evoked potentials c. Sensory evoked potentials d. Auditory evoked potentials

*a. Visual evoked potentials* N&P Chapter 18, pg. 332 Jennifer

Select the following drugs that can potentiate neuromuscular blockade (Select 2) a. Bupivicaine b. Dantrolene c. Neomycin d. Spironolactone

*b. Dantrolene* *c. Neomycin* M&M Ch. 12, pg. 231, Table 12-4 Jennifer

What law or rule states that the anesthetic potency of inhalation agents correlates directly with their lipid solubility? a. Henry's Law b. Meyer-Overton rule c. Fick's Law d. Boyle's Law

*b. Meyer-Overton rule* M&M Chapter 8, pg. 160 Jennifer

The concentration effect is more significant with which inhalational agent? a. Isoflurane b. Nitrous oxide c. Sevoflurane d. Desflurane

*b. Nitrous oxide* M&M Chapter 8, pg. 158 Jennifer

L-cysteine is an endogenous amino acid that is often added to total parenteral nutrition regimens to enhance what two electrolytes' solubility> a. Potassium and phosphate b. Phosphate and calcium c. Calcium and potassium d. Sodium and calcium

*b. Phosphate and calcium* M&M Ch. 12, pg. 231 Jennifer

All of the following are examples of core temperature monitoring EXCEPT? a. Distal esophagus b. Proximal esophagus c. Nasopharynx d. Tympanic membrane

*b. Proximal esophagus* N&P Ch. 17, pg. 322 Jennifer

The thoracic spinal cord nerve is one of the spinal cord nerves that are most commonly monitored. Which thoracic segment would correspond with the inferior rectus abdominis muscle? a. C8-T1 b. T12 c. T9-T11 d. T7-T8

*b. T12* N&P Chapter 18, pg. 332 Jennifer

Some studies suggest that this type of temperature monitoring approximates oral and axillary temperature reasonably close. What type of monitoring are these studies referring to? a. Core temperature b. Temporal artery temperature c. Bladder temperature d. Tympanic temperature

*b. Temporal artery temperature* N&P Ch. 17, pg. 322 Jennifer

What is the recommended fresh gas flow during spontaneous ventilation while using the Bain circuit? a. Equal to minute ventilation b. 1-1.5 x minute ventilation c. 2-3 x minute ventilation d. 4-5 x minute ventialtion

*c. 2-3 x minute ventilation* M&M Pg 33 Lake

All of the following are indications for monitoring evoked potentials EXCEPT? a. Spinal tumor resections b. Plexus surgery c. Anterior fossa surgery d. Carotid endarterectomy

*c. Anterior fossa surgery* N&P Chapter 18, pg. 333 Jennifer

All of the following are factors which can potentiate neuromuscular blockade EXCEPT? a. Volatile anesthetics b. Verapamil c. Hypercalcemia d. Hypothermia

*c. Hypercalcemia* M&M Ch. 12, pg. 230, Table 12-4 Jennifer

3. The radiologic procedure best suited for assessment of the airway, head trauma, and imaging of brain tumors is a(an): (N&P ch52, pg1280) A. CT B. MRI C. Interventional radiology D. Ultrasound

A Hale

Causes of intraoperative rhythm disturbances include all of the following EXCEPT: (N&P ch13, pg 205) a. Mild scoliosis b. Coronary Artery Disease c. Secondary to Diabetes or uremia d. Valvular and congenital heart disease e. Wolff-Parkinson-White syndrome

A Hale

Sympathomimetic amine drugs exert their effects by stimulating what receptors? (select all that apply) A: Beta adrenergic receptors B: Alpha adrenergic receptors C: Dopamine adrenergic receptors D: 5HT3 Seratonergic receptors

A: Beta adrenergic receptors B: Alpha adrenergic receptors C: Dopamine adrenergic receptors Reference: N&P page 186, 1st column 3rd paragraph Abe

Which of the following gases is NOT a halogenated agent? A: Nitrous oxide B: Isoflurane C: Sevoflurane D: Desflurane

A: Nitrous oxide Reference: N&P page 78, Figure 7-1 Abe

What is the correct pin position for an air e-cylinder according to the Pin Index Safety System? A: 1:5 B: 2:5 C: 3:5 D: 4:5

A: 1:5 Reference: N&P page 247, Table 15-1 Abe

How soon after propofol has been transferred from its original container must it be discarded due to risk for microbial growth? A: 6 hours B: 30 minutes C: 1 hour D: 18 hours

A: 6 hours Reference: N&P page 104, 2nd column 1st paragraph Abe

What are two machine related factors that may affect uptake of volatile agent in the early administration of an anesthetic? (pick 2) A: Absorption of a small amount of agent into the circuit B: Total machine liter flow of the carrying gases that are chosen C: Older machines cause a slower induction D: Newer machines facilitate a quicker induction

A: Absorption of a small amount of agent into the circuit B: Total machine liter flow of the carrying gases that are chosen Reference: N&P page 78, 2nd column 2nd paragraph Abe

Under which category of the preanesthesia questionnaire would it be most appropriate to document a patient's history of temporomandibular joint problems? A: Airway B: Neurologic C: Hematologic D: Respiratory

A: Airway Reference: N&P page 339, Figure 19-1

Whenever possible, what should be done to increase patient safety and decrease the risk of mishaps resulting from lack of necessary equipment & materials in remote areas outside the OR A: An anesthesia machine and portable anesthesia cart with the listed equipment, supplies, and medications should be dedicated strictly for use in remote locations B: Just stock one room with extra supplies that can be taken to remote locations C: Just find a room that isn't being used, and take the anesthesia machine from that room D: Arrive early every morning to draw up extra medications, and prepare extra supplies to take to remote locations

A: An anesthesia machine and portable anesthesia cart with the listed equipment, supplies, and medications should be dedicated strictly for use in remote locations Reference: N&P page 1260, 2nd column 3rd paragraph Abe

Which of the following effects is epinephrine capable of inducing in lung tissue? (select 2) A: Bronchodilation via beta-2 agonism B: Decreased bronchial secretions via alpha-1 agonism C: Bronchoconstriction via M3 agonism D: Increased bronchial secretions via M3 agonism

A: Bronchodilation via beta-2 agonism B: Decreased bronchial secretions via alpha-1 agonism Reference: N&P page 186, 2nd column 4th paragraph Abe

What type of safety system is used to decrease the risk of attaching the wrong gas hose to the back of the anesthesia machine? A: Diameter Index Safety System (DISS) B: Pin Index Safety System (PISS) C: Circular Index Safety System (CISS) D: Square Index Safety System (SISS)

A: Diameter Index Safety System (DISS) Reference: N&P page 245, figure 15-2 Abe

You are caring for a patient who has a history of malignant hyperthermia. Select all of the appropriate interventions that should be taken to prepare the anesthesia machine as to avoid exposing your patient to residual trace amounts of triggering agents. (select all that apply) A: Flush the anesthesia machine with 100% O2 at 10 L/min for at least 20 min B: Replace the breathing circuit C: Replace the CO2 scrubber D: Drain, inactivate, or remove vaporizers from the anesthesia machine

A: Flush the anesthesia machine with 100% O2 at 10 L/min for at least 20 min B: Replace the breathing circuit C: Replace the CO2 scrubber D: Drain, inactivate, or remove vaporizers from the anesthesia machine Reference: N&P page 78, 2nd column 3rd paragraph Abe

Choose the statement that most accurately reflects how fresh gas flows should be adjusted to achieve a rapid induction and rapid emergence from anesthesia. A: High flows during induction, high flows during emergence B: Low flows during induction, low flows during emergence C: Low flows during induction, high flows during emergence D: High flows during induction, low flows during emergence

A: High flows during induction, high flows during emergence Reference: N&P page 78 , 2nd column 4th paragraph Abe

Which of the following gases are potent triggers of malignant hyperthermia? (select all that apply) A: Isoflurane B: Sevoflurane C: Desflurane D: Nitrous oxide

A: Isoflurane B: Sevoflurane C: Desflurane Reference: N&P page 78, 2nd column 3rd paragraph Abe

Which of the following drugs is NOT generally associated with a high incidence of injection site pain? A: Midazolam B: Diazepam C: Lorazepam D: Propofol E: Etomidate

A: Midazolam Reference: N&P page 105, Table 9-1 Abe

The periodic unmyelinated nerve segments located between Schwann cells are known as? A: Nodes of Ranvier B: Nodes of Staab C: Nodes of myelin D: Unmyelinated Nodes

A: Nodes of Ranvier Reference: N&P page 125, 1st column 3rd paragraph Abe

What is the primary effect of phenylephrine? A: Peripheral vasoconstriction with a concomitant rise in SVR and BP B: Peripheral vasodilation C: Beta-1 induced positive inotropy D: Beta-2 induced bronchodilation

A: Peripheral vasoconstriction with a concomitant rise in SVR and BP Reference: M&M page 239, key concept #2 Abe

Choose the statement that correctly describes the function of the Na+/K+/ATPase pump. A: Pumps 3 Na+ ions out of the cell for every 2 K+ ions pumped back into the cell B: Pumps 5 Na+ ions out of the cell for every 1 K+ ion pumped back into the cell C: Pumps 1 Na+ ion out of the cell for every 1 K+ ion pumped back into the cell D: Pumps 4 Na+ ions out of the cell for every 1 K+ ion pumped back into the cell

A: Pumps 3 Na+ ions out of the cell for every 2 K+ ions pumped back into the cell Reference: N&P page 125, 2nd column 5th paragraph Abe

What are the 3 main desired effects of Dexmedatomidine? A: Sedation B: Analgesia C: sympatholysis D: Increased cardiac output

A: Sedation B: Analgesia C: sympatholysis Reference: M&M page 239, key concept #4 Abe

Knowing that patients who are treated in remote areas outside the OR deserve the same safe, vigilant attention as those treated in the operating suite, what statement most completely reflects the proper preparation of remote areas where anesthesia is to be provided outside the OR. A: The anesthesia provider needs to make sure the therapeutic and diagnostic environment where anesthesia is to be performed is as familiar, as well equipped, and as safe as it is in the operating room. B: As long as emergency drugs are available, an anesthetic can be safely administered C: As long the proper airway equipment is available, an anesthetic can be safely administered D: As long as suction is available, an anesthetic can be safely administered

A: The anesthesia provider needs to make sure the therapeutic and diagnostic environment where anesthesia is to be performed is as familiar, as well equipped, and as safe as it is in the operating room. Reference: N&P page 1260, 1st column 1st paragraph Abe

Choose the statement that most accurately describes the Nernst potential. A: The electrical potential that opposes the net diffusion of ions down their concentration gradients B: The movement of substances from an area of higher concentration to an area of lower concentration C: The movement of substances from an area of lower concentration to an area of higher concentration D: The force that prevents any ionic movement

A: The electrical potential that opposes the net diffusion of ions down their concentration gradients Reference: N&P page 125, 2nd column 3rd paragraph Abe

5. Which statement most accurately describes the definition of the J-point on an ECG tracing? A: The point at which the QRS complex ends and the ST-segment begins B: The point at which the P wave ends and the PR segment begins C: The point at which the T-wave ends and the P-wave begins D: The point at which you get tired of trying to visualize where the J-point is located

A: The point at which the QRS complex ends and the ST-segment begins Reference: N&P page 292, second column, 4th paragraph Abe

Choose the statement that correctly describes the relationship between the molecular weight of an agent, and it's ability to cross cell membranes. A: The smaller the molecular size of an agent, the better it crosses the lipid barriers and membranes of tissues B: The larger the molecular size of an agent, the better it crosses the lipid barriers and membranes of tissues. C: There is no direct relationship between molecular size and membrane penetration. D: None of the above are correct.

A: The smaller the molecular size of an agent, the better Reference: N&P page 62, 1st column 3rd paragraph Abe

Choose the statement that most accurately reflects the definition of context sensitive half time. A: The time required for a 50% decrease in the plasma concentration after an infusion of a medication has been discontinued B: The time required for 50% of the drug to be eliminated from the body. C: The time at which 50% of the drug remains in the body D: The point at which steady state is achieved

A: The time required for a 50% decrease in the plasma concentration after an infusion of a medication has been discontinued Reference: N&P page 106, 1st column 1st paragraph Abe

Which of the following statements most accurately reflects the mechanism by which indirect acting adrenergic agonists interact with adrenergic receptors? A: They increase the release of endogenous norepinephrine which then binds with adrenergic receptors B: They bind directly with adrenergic receptors C: They competitively block adrenergic receptors D: They irreversibly block adrenergic receptors

A: They increase the release of endogenous norepinephrine which then binds with adrenergic receptors Reference: M&M page 239, key concept #1 Abe

You are caring for a patient who is on chronic beta blocker therapy. What might you expect to happen intraoperatively if the patient's beta blocker is held for 24-48 hours prior to surgery? A: Triggering of a withdrawal syndrome characterized by hypertension B: Acute hypotension on induction of anesthesia C: Bronchoconstriction via M3 agonism D: This is not likely to produce any significant intraoperative hemodynamic effects

A: Triggering of a withdrawal syndrome characterized by hypertension Reference: M&M page 239, key concept #11 Abe

The bonds that form between drugs and receptors typically fall into the following categories: van der Waals, hydrophobic, hydrogen, ionic, and covalent. Which of the preceding bonds is the weakest? A: Van der Waals B: Hydrophobic C: Hydrogen D: Ionic E: Covalent

A: Van der Waals Reference: N&P page 53, 2nd column 3rd paragraph

Choose the correct statement regarding ionization (pick 1). A: When the pH of a solution is equal to the pKa of a drug, the drug will be 50% ionized and 50% nonionized. B: Weak bases are highly ionized in basic solution C: Weak acids are highly ionized in acidic solution D: Ionized substances readily penetrate lipid membranes

A: When the pH of a solution is equal to the pKa of a drug, the drug will be 50% ionized and 50% nonionized. Reference: N&P page 63, 1st column 1st paragraph Abe

4) Match the signs and symptoms to the abused substance: a. Tachycardia, labile BP, headache b. Excitement, delirium, hallucinations c. Sympathomimetic and weak analgesic effects d. Respiratory depression, hypotension, bradycardia i. Cannabis (Marijuana, Hashish) ii. Hallucinogens: LSD,PCP iii. Opioids iv. Cocaine and Amphetamines

A: i-cannibis B:iv-cocaine and amphetamines C:ii-hallucinogens LSD PCP D: iii-opioids N&P pg 345 Rebecca

2. Interventional Neuroradiology involves: (choose 3) (N&P ch52, pg1280) A. diagnosis and treatment of CNS disease endovascularly. B. Delivery of medications or diseases. C. Injection of a contrast medium. D. direct vision of opaque structures such as bone and tissue.

ABC Hale

1. All of the following define cricoid pressure, EXCEPT: a. The posterior displacement of the cricoid cartilage against the cervical vertebrae with the patient in a 20 degree head-up position to prevent regurgitation and possible aspiration of stomach contents during the induction of general anesthesia. b. 20N (2kg of force) should be applied before loss of consciousness, and then pressure increased to 4kg force after loss of consciousness. c. 4kg of force applied to someone during consciousness can lead to laryngeal discomfort and retching. d. You should maintain cricoid pressure during active vomiting.

ANSWER: D. Maintaining cricoid pressure during active vomiting can actually cause esophageal rupture. (N&P ch 22, pg 449) Kaitlin

What electrostatic bond is formed between a molecule with an uneven charge and an element of an opposite constant charge? a. ion-to-dipole, the uneven charge of the molecule creates polarity with a more positive or negative end to that molecule which will attract elements with an opposite charge to which it bonds. b. ion-to-ion, they are not directional and occur along the outer electron shell. They also require high melting and boiling points. An example is sodium chloride. c. dipole-to-dipole, when two molecules with uneven charge bond together. d. All of the above are correct.

Answer - a. ion-to-dipole, the uneven charge of the molecule creates polarity with a more positive or negative end to that molecule which will attract elements with an opposite charge to which it bonds. Nagelhout page 214 Krum

What is the strongest electrostatic bond? a. ion-to-ion, they are not directional and occur along the outer electron shell. They also require high melting and boiling points. An example is sodium chloride. b. ion-to-dipole, the uneven charge of the molecule creates polarity with a more positive or negative end to that molecule which will attract elements with an opposite charge to which it bonds. c. dipole-to-dipole, when two molecules with uneven charge bond together. d. All of the above are correct.

Answer - a. ion-to-ion, they are not directional and occur along the outer electron shell. They also require high melting and boiling points. An example is sodium chloride. Nagelhout page 214 Krum

What is the mechanism of action of Nitroglycerin? a. metabolism of nitric oxide that promotes guanylyl cyclase which leads to elevated cGMP, lowered intracellular Ca++ and vascular smooth muscle relaxation. b. metabolism of nitrous oxide that promotes guanylyl cyclase which leads to lowered cGMP, increased intracellular Ca++ and vascular smooth muscle constriction. c. act as neurotransmitter in the skeletal muscle to increased GABA and promote hypertension. d. all of the above.

Answer - a. metabolism of nitric oxide that promotes guanylyl cyclase which leads to elevated cGMP, lowered intracellular Ca++ and vascular smooth muscle relaxation. M&M page 259 - Krum

What is the difference between a structural isomer and a stereoisomer? a. structural isomers have same molecular formula but the atoms are in different places on the molecule. Stereoisomer's have the same molecular formula and geometric arrangement but differ in the spatial arrangement. b. Stereoisomer's have same molecular formula but the atoms are in different places on the molecule. Structural isomers have the same molecular formula and geometric arrangement but differ in the spatial arrangement. c. They are one in the same. d. All of the above are true.

Answer - a. structural isomers have same molecular formula but the atoms are in different places on the molecule. Stereoisomer's have the same molecular formula and geometric arrangement but differ in the spatial arrangement. Nagelhout page 215 Krum

Nitroglycerin effects are seen greater in which of the following vessels? a. veins b. arteries c. lymphatic d. renal tubule

Answer - a. veins M&M page 259 - Krum

1. Opioids inhibit which type of voltage-gated channels? a. Calcium b. Sodium c. Potassium d. Chloride

Answer A) Voltage-gated calcium channels Morgan & Mikhail's Clinical Anesthesiology pg. 190 Stetler

1. What are the CARDIOVASCULAR effects of histamine? (select 3) A. Increases capillary permeability, enhancing ventricular irritability. B. Decrease capillary permeability, enhancing ventricular irritability C. Increases blood pressure D. Decreases blood pressure. E. Increases heart rate and contractility F. Decreases heart rate and contractility

Answer A, D, E Histamine reduces arterial blood pressure but increases heart rate and myocardial contractility. H 1 -Receptor stimulation increases capillary permeability and enhances ventricular irritability, whereas H 2 -receptor stimulation increases heart rate and increases contractility. M&M pg 279. Blair Ryan

2. The clinical effects of the kappa receptor are (Select 2) a. Sedation b. Respiratory depression c. Spinal analgesia d. Dysphoria

Answer A,C Sedation and spinal analgesia Morgan & Mikhail's Clinical Anesthesiology pg. 190 Stetler

5. Which lists the correct measurements of 1 atmosphere? a. 1 atm = 760 mmHg = 760 torr = 1 bar = 100 kPa = 1020 cmH2O = 14.7 lb/inch2 b. 1 atm = 1060 mmHg = 760 torr = 3 bar = 200 kPa = 1020 cmH2O = 14.7 lb/inch2 c. 4 atm = 760 mmHg = 7600 torr = 1 bar = 1300 kPa = 1820 cmH2O = 20.7 lb/inch2 d. 1 atm = 1860 mmHg = 1860 torr = 1 bar = 600 kPa = 1020 cmH2O = 1.7 lb/inch2

Answer A: 1 atm = 760 mmHg = 760 torr = 1 bar = 100 kPa = 1020 cm H2O = 14.7 lb/inch2 Nagelhout pg 220 Mr. Ryan

2. With a constant force, which syringe will generate the most pressure? A. 3-cc syringe B. 5-cc syringe C. 10 cc syringe D. 30 cc syringe

Answer A: As you increase the area to which a fixed force (20 N) is applied, the product of the equation, pressure (in atmospheres), becomes smaller. Nagelhout pg 220 Mr. Ryan

1. Regardless of volatile anesthetic, MAC is_______ per decade of age. a. Decreased by 10% b. Decreased by 6% c. Increased by 10% d. Increased by 6%

Answer B. One of the most striking physiologic Answer B. One of the most striking physiologic and pharmacologic variables that alter MAC is the 6% decrease in MAC per decade of age, regardless of volatile anesthetic. Morgan and Mikhail pg. 163

4. What is the last stage that normal gas exchange still possible? A. Only first B. Stage 2 C. Stage 3 D. Stage 4

Answer B. Stage II: Fluid fills the interstitium and begins to fill the alveoli, being initially confined to the angles between adjacent septa (crescentic filling). Near-normal gas exchange may be preserved. M&M pg. 1303 Blair Ryan

3. Atmospheric gases are ____ concentrated at higher altitude and _______concentrated at sea level. a. Gases are not effected by gravity or the effects of height. b. Less, More c. More, Less d. The pressure of gasses are only capable of manipulation in a laboratory setting.

Answer B: The cumulative effect of gravity on atmospheric gases gives rise to atmospheric pressure. Atmospheric gases are less concentrated at altitude and more concentrated at sea level. Nagelhout pg 220 Mr. Ryan

4. What tool is used to measure pressure? (Multiple correct answers) a. Thermometer b. Barometer c. Sphygmomanometer d. Manometer

Answer BCD. Nagelhout pg 220 Mr. Ryan

3. Pulmonary edema is often divided into how many stages? A. 2 B. 3 C. 4 D. 5

Answer C. 4 M&M pg. 1303 Blair Ryan

5. Pulmonary edema usually results from an ¬¬¬______________. A. increase in the net hydrostatic pressure across the capillaries (hemodynamic or cardiogenic pulmonary edema). B. an increase in the permeability of the alveolar-capillary membrane (increased permeability edema or noncardiogenic pulmonary edema). C. Both of the above D. None of the above.

Answer C. Both of the above. M&M pg. 1303 Blair Ryan

1. The primary organ for drug metabolism is the ______. a. Lungs b. Heart c. Liver d. Kidneys

Answer C. Liver Morgan and Mikhail pg. 146 Blair Ryan

2. The resting membrane potential of a neuron is________. a. -100 to -120 mV b. -35 to -45 mV c. -60 to -70 mV d. 50 to 60 mV

Answer C. Morgan and Mikhail pg 264.

Advancement of a central line catheter of greater than 10 cm beyond the expect distances to reach the intended destination without seeing a waveform would indicate? A. A longer catheter is needed B. This is a normal result C. The line needs to be flushed with high pressure D. The line is coiling up and not properly advancing

Answer D N&P 298 Charlie

If a PAC is not working properly and while withdrawing it resistance is felt what should be done? A. Administer Versed so patient does not remember B. Put a new catheter back in the same access C. Resistance is normal when removing a PAC D. Chest x-ray to rule out knotting or entanglement with the chordae tendineae

Answer D N&P 298 Charlie

Research shows that understanding PAC data among healthcare providers is valuable and that misinterpretation can lead to A. Less charting B. Better outcomes C. Less anesthetic will be needed D. Increased morbidity and mortality

Answer D N&P 298 Charlie

To accurately interpret data from a central venous line, you must be able to identify abnormal changes in all of the following except. A. Distances B. Pressures C. Waveform D. Depth

Answer D N&P 298 Charlie

1. Regardless of the disorder, the treatment of respiratory failure is ¬¬¬¬¬¬________________ while the reversible components of underlying disease are treated. A. Encouraging patient to perform incentive spirometer. B. 100% FiO2 C. Peep of > 10 D. primarily supportive

Answer D primarily supportive. Hypoxemia is treated with oxygen therapy and positive airway pressure (if FRC is decreased), whereas hypercarbia (ventilatory failure) is treated with mechanical ventilation. Other general measures may include using aerosolized bronchodilators, intravenous antibiotics, and diuretics, etc. M&M pg. 1302 Blair Ryan

1. Local anesthetics when injected or applied near neural tissue will have an effect on ______ function. Choose the correct answer. a. Motor b. Sensory c. Autonomic d. The effects can be seen on all of the above functions. And also combined effects.

Answer D. Morgan and Mikhail pg 264.

3. _____ stimuli can cause voltage- gated Na channels in peripheral nerve axons to produce and transmit membrane depolarizations. a. chemical b. mechanical c. electrical d. All of the above can cause depolarizations.

Answer D. Morgan and Mikhail pg 264.

4. Baseline concentration gradients are maintained by the _____________, and only a minuscule number of Na ions pass into the cell during an action potential. a. ATP b. guanylate cyclase c. acetylcholinesterase d. sodium-potassium pump

Answer D. Morgan and Mikhail pg 264.

5. Voltage-gated Na channels exist in which states ________. a. resting (nonconducting) b. open (conducting) c. inactivated (nonconducting) d. All of the above.

Answer D. Morgan and Mikhail pg 264.

1. What is the formula for to equal pressure (P)? a. P=MA b. P=KC c. PV=nRT d. P= F/A

Answer D. Pressure is the measured force over an area. Nagelhout page 220. Mr. Ryan

1. The tip of a properly placed central venous catheter should be located in the _____. a. Right Atrium b. Right ventricle c. Pulmonary artery d. Vena cava, distal to the opening of the right atrium.

Answer D. The catheter tip should not be allowed to migrate into the heart chambers. This could cause ectopy/ arrhythmias. M&M pg 103. Blair Ryan

5. What are two contraindications for a pulmonary artery catheter? Choose one of the following. a. Sepsis and hypovolemia b. Myocardial infarction and patients with severe burns to extremities c. Pediatrics and little people d. Wolf Parkinson white and patients with left bundle branch block.

Answer D. Wolf Parkinson white and patients with left bundle branch block. M&M Chapter 5 pg 105. Blair Ryan

3. The clinical effects of the mu receptor are a. Supraspinal analgesia b. Respiratory depression c. Physical dependence d. All of the above

Answer D: All of the above Morgan & Mikhail's Clinical Anesthesiology pg. 190 Stetler

5. The developments for measuring pulse oximetry, end tidal CO2 and end tidal concentrations of volatile gas could not be possible without which law? a. Boyle's Law b. Charles' Law c. Cook's Law d. Beer-Lambert Law

Answer D: Beer-Lambert Law. absorption of infrared light by the gases we are measuring is governed by the Beer-Lambert law. Morgan & Mikhail pg. 125 BR

4. Nitrous oxide like other volatile anesthetics can decrease which of the following? A. arterial blood pressure B. cardiac output, C. heart rate D. none of the above

Answer D: arterial blood pressure, cardiac output, and heart rate are essentially unchanged or slightly elevated in vivo because of its stimulation of catecholamines. Morgan and Mikhail pg. 165

2. Upper airway anatomy includes all of the following except (select 2): a. pharynx, b. nose, c. mouth, d. cochlea e. larynx, f. trachea, g. alveoli h. main-stem bronchi.

Answer DG Morgan and Mikhail 5th Edition Chapter 19 pg 310. Mr. Ryan

Familiarity with what things will facilitate an accurate interpretation of PAC data and central line placement? A. Relevant distance to hemodynamic anatomy B. Normal intracadiac pressures C. Pulmonary pressures D. Waveform morphology E. All of the above

Answer E N&P 298 Charlie

5. Match the following classifications of angina to their descriptions according to specific activity scale. a. Pt is able to participate in recreational activities such as skiing, basketball, & jogging b. Pt is able to only walk 4 MPH on level ground, garden, rake, or dance c. Pt is able to shower without stopping, but can only walk 2.5 MPH d. Pt is unable to perform any of the activities listed. i. Class I ii. Class II iii. Class III iv. Class IV

Answer a = i; b = ii; c = iii; d = iv Reference: N&P pg 208 box 13-14 Mandy

4) Recovery from anesthesia should be assessed at least once within how many hours after discharge from the PACU in all inpatients? A. 48 hours B. 54 hours C. 60 hours D. 72 hours

Answer is A , 48 hours M & M, page 304 Roel

2) According to practice guidelines in the US, how often are arterial blood pressure and heart rate recorded graphically no less frequently than at what interval? A. 5 minutes intervals B. 7 minute intervals C. 10 minute intervals D. 15 minute intervals

Answer is A, 5 minute intervals M & M, page 304 Roel

2) What does the P wave represent in the ECG? A. Atrial contraction B. Ventricle repolarization C. Ventricle depolarization D. Repolarization of the Purkinje fibers

Answer is A, Atrial contraction M&M, page 98 Roel

3) Why is the careful recording of the timing of events needed to avoid discrepancies between multiple simultaneous records, such as anesthesia record, nurses' notes, or cardiopulmonary resuscitation record? A. Discrepancies are targeted by malpractice attorneys as evidence of incompetence, inaccuracy or deceit B. Many hospital CFOs have made that as a standard policy C. The hospital auditor would not be pleased by inaccuracies among the various units D. As a way for quality control to determine which procedures are the most complex to record

Answer is A, Discrepancies are targeted by malpractice attorneys as evidence of incompetence, inaccuracy or deceit M & M, page 304 Roel

3) Which intercostal space at the anterior axillary line does lead V5 lie over? A. Fifth B. Sixth C. Seventh D. Eight

Answer is A, Fifth M&M, page 98 Roel

1) Approximately how many msec does a normal QRS last? A. 100 B. 105 C. 110 D. 120

Answer is D, 120 M&M, page 98 Roel

4) The routine use of the ECG allows the detection of what abnormality? A. Arrhythmias B. Electrolyte Disturbances C. Myocardial Ischemia D. All of the above

Answer is D, All of the above M&M, pages 98-99 Roel

5) What is not an element that must be proved by the plaintiff (patient) to establish negligence on the part of the defendant (physician or hospital) in a medical malpractice case? A. Duty B. Breach of Duty C. Injury D. Defamation

Answer is D, Defamation. M & M, page 305 Roel

5) Prolongation of the QT interval secondary to electrolyte imbalances or drug effects can lead to what arrhythmia? A. Second Degree Heart Block B. Atrial Flutter C. Atrial Fibrillation D. Torsade de pointes

Answer is D, Torsade de pointes. M&M, page 98 Roel

1) What are some examples of certain elements that the Centers for Medicare and Medicaid Services be included in all postoperative notes? A. Respiratory function B. Cardiovascular function C. Mental Status D. All of the above

Answer is D, all of the above M & M, page 304-305 Roel

Anesthesia complications are often associated with: (select 2) A. Inadequate preoperative planning B. Incomplete patient preparation C. Complete review of medications and allergies D. Anesthetic plan, with backup plan

Answer* A,B A. Inadequate preoperative planning B. Incomplete patient preparation M&M pg. 296 Jensen

A preoperative evaluation can identify specific characteristic of patients that may influence the outcome of anesthesia. Those specific characteristics can include: (select 3) A. Family history of malignant hyperthermia B. An infection at the proposed site for regional anesthesia C. Tracheal deviation D. No drug allergies

Answer* A,B,C A. Family history of malignant hyperthermia B. An infection at the proposed site for regional anesthesia C. Tracheal deviation M&M pg. 296 Jensen

Additional preoperative evaluations may include: (select 4) A. Imaging procedures B. Diagnostic tests C. Consultations D. Laboratory tests E. Premedication

Answer* A,B,C,D A. Imaging procedures B. Diagnostic tests C. Consultations D. Laboratory tests M&M pg. 296 Jensen

An effective preoperative evaluation should include: (select 4) A. Medical history B. Physical examination C. Mandatory stress test D. Review of medications E. Drug allergies, or contact allergies

Answer* A,B,D,E A. Medical history B. Physical examination D. Review of medications E. Drug allergies, or contact allergies M&M pg. 296 Jensen

The anesthesia provider should formulate an anesthetic plan and answer all the following questions, except: A. Will sedative-hypnotic premedication be useful? B. What type(s) of anesthesia will be used? (I.e. General, regional, MAC) C. Are there any special intraoperative management issues (i.e. Nonstandard monitors, fluids, positional, contraindication to anesthetic drugs, special techniques, or site concerns) D. How will the patient be managed post-operatively? E. What type of music will be played in the OR today?

Answer* E E. What type of music will be played in the OR today? M&M pg. 296 Jensen

2. What are the PULMONARY effects of histamine? (select 2) A. H1 cause bronchial smooth muscle constriction. B. H2 cause bronchial smooth muscle constriction. C. H2 cause mild bronchial DILATION D. H1 cause mild bronchial DILATION

Answer. A,C Histamine constricts bronchiolar smooth muscle via the H 1 receptor. H 2 -Receptor stimulation may produce mild bronchodilation. M&M pg. 279. Blair Ryan

Nitroglycerin is diluted to 100 mcg/ml and dosed in IV infusions at 0.5-10 mcg/kg/min. Which of the following is also true about the administration of Nitroglycerin? a. Nitroglycerine is stored in glass vials and special tubing used because it can be absorbed into PVC. b. Nitroglycerine must be handled with extreme caution. One drop on the floor could cause explosion of the entire OR suite. That's why it is used to blow up bridges in old western videos. c. Nitroglycerine is not associated with tolerance because the body produces such high abundance of nitric oxide precursors. d. It is best to run nitroglycerine at high rates without periods of no drug exposure to maximize the drugs long-term effectiveness.

Answer. a. Nitroglycerine is stored in glass vials and special tubing used because it can be absorbed into PVC. M&M page 259 - Krum

Depolarizing muscle relaxants act as... a. acetylcholine receptor agonists b. acetylcholine receptor competitive antagonists c. GABA receptor antagonists a. acetylcholine receptor non-competitive antagonists

Answer. a. acetylcholine receptor agonists M&M page 203 Krum

Nondepolarizing muscle relaxants function as... a. acetylcholine receptor competitive antagonists. b. acetylcholine receptor agonists. c. GABA receptor antagonists. a. acetylcholine receptor non-competitive antagonists.

Answer. a. acetylcholine receptor competitive antagonists. M&M page 203 Krum

Depolarizing Muscle relaxants are metabolized by... (pick 2) a. acetylcholinesterase in the kidneys. b. hydrolysis as the diffuse away from the neuromuscular junction. c. degradation of the molecule by protein consumption. d. enzymes in the plasma and the liver.

Answer. b. hydrolysis as the diffuse away from the neuromuscular junction. d. enzymes in the plasma and the liver. M&M page 203-204 Krum

The reversal of nondepolarizing muscle relaxing agents is primarily due to... (pick 4) a. acetylcholinesterase b. pseudocholinesterase c. redistribution d. gradual metabolism e. excretion from the body f. cholinesterase inhibitors

Answer. c. redistribution, d. gradual metabolism, e. excretion from the body, f. cholinesterase inhibitors M&M page 204 Krum

Depolarizing muscle relaxants have a structure that is similar to that of acetylcholine, which may cause the following side effect. a. Hypertension b. Redman syndrome c. Elevated Blood Pressure d. Bradycardia

Answer. d. Bradycardia M&M page 204 Krum

Select all of the following effects of nitroglycerin which lead to the reduction of myocardial oxygen demand and the increase of its oxygen supply. a. decreased venous return and preload along with decreased LVEDP b. decreased afterload c. coronary blood flow is redistributed to ischemic subendocardium d. coronary spasms can be relieved. e. all of the above.

Answer. e. all of the above M&M page 259 - Krum

3. Methemoglobin has the same absorption coefficient at both red and infrared wavelengths. The resulting 1:1 absorption ratio corresponds to a saturation reading of 85%. With this knowledge choose the 2 correct statements. a. Methemoglobinemia causes a falsely low saturation reading when SaO2 is actually greater than 85%. b. Methemoglobinemia causes a falsely low reading if SaO2 is actually less than 85%. c. Methemoglobinemia causes a falsely high saturation reading when SaO2 is actually greater than 85%. d. Methemoglobinemia causes a falsely high reading if SaO2 is actually less than 85%.

Answer: a. Methemoglobinemia causes a falsely low saturation reading when SaO2 is actually greater than 85%. d. Methemoglobinemia causes a falsely high reading if SaO2 is actually less than 85%. When reading these answers there are only 2 choices that fit the idea of the above statement. Morgan and Mikhail Pg. 125 BR

4. Most pulse oximeters are inaccurate at low SpO2, and all demonstrate a delay between changes in SaO2 and SpO2. Other causes of pulse oximetry artifact include________. Choose 3 answers correctly. a. The pulse ox is always accurate and you need to treat the reading immediately. b. Motion of the oximeter. c. Hypothermia d. Vasoconstriction causing poor perfusion. e. Using the earlobe for a reading.

Answer: b. Motion of the oximeter. c. Hypothermia d. Vasoconstriction causing poor perfusion. All of the following can cause inaccurate measurements excessive ambient light, motion, methylene blue dye, venous pulsations in a dependent limb, low perfusion (low cardiac output, profound anemia, hypothermia, increased systemic vascular resistance), malpositioned sensor, and leakage of light from the light-emitting diode to the photodiode, bypassing the arterial bed (optical shunting). Morgan and Mikhail pg. 125 BR

4. Which of the following correctly describes gamete intrafallopian transfer (GIFT)? A. oocytes removed, fertilization occurs in the laboratory, embryo is placed into the uterus or into the distal portion of the fallopian tubes. B. oocytes and sperm are transferred into one or both fallopian tubes for fertilization. C. fertilized embryos are placed into the fallopian tubes. D. cleaving embryos are placed into the fallopian tubes. E. oocytes and sperm are placed into the pelvic cavity.

Answer: B N & P, pg 1274 Stefania

4. Match the following functions as either intrinsic or extrinsic muscles of the larynx. 1. ________ adjust the position of the trachea during phonation, breathing, and swallowing. 2.________ control the tension of the vocal cords as well as the opening and closing of the glottis.

Answer: 1: EXTRINSIC muscles (stylohyoid, digastric, mylohyoid, geniohyoid, stylopharyngeus, thyrohyoid, omohyoid sternohyoid, sternothyroid), 2: INTRINSIC muscles (posterior, lateral, and medial cricoarytenoids; lateral thyroarytenoids; cricothyroids; interarytenoids; arytenoepiglottics) N&P, pg. 425 Stefania

What should the provider always do when placing precordial leads to ensure proper placement? A. Palpate the costae B. Place them blindly in the general area. C. These leads should not be used. D. Place them directly over the sternum

Answer: A Palpate the Costae N&P 294 Justin

2. Which of the following medications decreases the protein binding of Ketorolac and result in an increased amount of active unbound drug? a. Aspirin b. Acetaminophen c. Clonidine d. Doxapram

Answer: A aspirin Morgan & Mikhail's Clinical Anesthesiology pg. 286

Which form of the local anesthetic is responsible for the actual binding to the Na channel once the molecule has gained access into the cytoplasm? a. Ionized form b. Non-ionized form c. All of the above d. None of the above

Answer: A ionized form Morgan & Mikhail's Clinical Anesthesiology pg. 269 Stetler

How is an expiratory valve malfunction detected in a diverting capnograph? a. The presence of CO2 in inspired gas b. The absence of EtCO2 c. A rapid increase in EtCO2 d. All of the above

Answer: A the presence of CO2 in inspired gas Morgan & Mikhail's Clinical Anesthesiology pg. 127 Stetler

4. Accurate measurement of cardiac output using the thermodilution technique depends on? (Select 3) a. Temperature b. Volume c. Injection Technique d. Timing

Answer: A, B, C Temperature, Volume, Injection Technique Morgan & Mikhail's Clinical Anesthesiology pg. 110 Stetler

4. Which are the following are the three X-ray safety factors a. Distance from the source b. Type of X-ray c. Barriers d. Exposure time

Answer: A, C, D: Distance from source, Barriers, Exposure time N&P pg. 233 Stetler

3. Exclusion of postrenal azotemia requires which of the following? (Select two) a. Physical diagnosis b. Response to treatments c. Improved renal perfusion d. Imaging

Answer: A, D Physical diagnosis and Imaging Morgan & Mikhail's Clinical Anesthesiology pg. 1310 stetler

3. Which of the following correctly describes train of four (TOF)? A. A series of four twitches at 2 Hz every ½ second for 2 seconds. B. A series of four twitches at 2 Hz every ¼ second for 2 seconds. C. A series of four twitches at 2 Hz every ½ second for 1 second. D. A series of four twitches at 2 Hz every 1/3 second for 2 seconds.

Answer: A, a series of four twitches at 2 Hz every ½ second for 2 seconds. N & P, pg. 161 Stefania

3. Clearance is _____proportional to the dose and is ______related to the agent's half-life as well as its concentration in the central compartment. A. directly; inversely B. inversely; directly C. directly; directly D. inversely; inversely

Answer: A, directly, inversely N & P, pg. 73 Stefania

What is required in the OR when using gases and is considered a vital component of the medical gas system? A. scavenging and suction B. suction yaunker C. suction tubing D. helium tank

Answer: A, scavenging and suction M & M, pg. 10 Stefania

2. Which cartilages of the larynx make up the 3 single cartilages, and 3 paired cartilages? A. single: cricoid, thyroid, epiglottis; paired: corniculate, arytenoid, cuneiform B. single: corniculate, arytenoid, cuneiform; paired: cricoid, thyroid, epiglottis C. single: cricoid, thyroid, epiglottis; paired: arytenoid, cricothyroid, cricoarytenoids D. single: cricothyroid, thyroid, cricoid; paired: cricoarytenoid, corniculate, cuneiform

Answer: A, single: cricoid, thyroid, epiglottis; paired: corniculate, arytenoid, cuneiform N&P, pg. 424 Stefania

5. What is the cause of cannon "a" waves on the CVP tracing as a result of a junctional rhythm (lack of P waves) A. the right atrium contracting against a closed tricuspid valve. B. a large contraction of the left atrium C. no atrial contraction occurs D. large ventricular contraction

Answer: A, the right atrium contracting against a closed tricuspid valve N & P, pg. 301 Stefania

3. What are the GASTROINTESTINAL effects of histamine? (select 2) A. Histamine activation of H2 receptors in parietal cells increases gastric acid secretion. B. Histamine activation of H1 receptors in parietal cells increases gastric acid secretion. C. Stimulation of H1 receptors leads to contraction of intestinal smooth muscle. D. Stimulation of H1 receptors leads to relaxation of intestinal smooth muscle.

Answer: A,C Activation of H 2 receptors in parietal cells increases gastric acid secretion. Stimulation of H 1 receptors leads to contraction of intestinal smooth muscle. M&M pg. 279. Blair Ryan

5. What are some IMMUNOLOGICAL effects of EACH histamine receptor? (select 2) A. H1 receptors attract leukocytes and production of prostaglandin. B. H2 receptors attract leukocytes and production of prostaglandin. C. H2 receptors activate suppressor T lymphocytes. D. H1 receptors activate suppressor T lymphocytes.

Answer: A,C H1 -Receptor stimulation attracts leukocytes and induces synthesis of prostaglandin. In contrast, the H2 receptor appears to activate suppressor T lymphocytes. M&M pg. 279. Blair Ryan

Which of the following correctly describes boiling point? Select all that apply a. Is the temperature at which a liquids vapor pressure is equal to the atmospheric pressure b. Boiling point is 100 degrees celsius for all agents c. Desflurane has the lowest boiling point d. As atmospheric pressure decreases boiling point also decreases

Answer: A,C,D Stetler

3. Of the following which 3 drugs have an increased effect on MAC level, requiring more anesthetic?. Choose from the following- Opioids, Ketamine, Barbiturates, Benzodiazepines, Verapamil, Lithium, Sympatholytics, Methyldopa, Clonidine, Dexmedetomidine, Sympathomimetics, Acute Amphetamine use, Cocaine, Ephedrine.

Answer: Acute Amphetamine use, Cocaine, Ephedrine. Morgan and Mikhail pg. 164

What should the anesthesia provider do if standard lead placement interferes with the surgical field? A. Omit placing ECG monitoring B. Place them in the best positions available and document the reasoning. C. Use sterile ECG lines in the surgical field. D. Place the ECG lines all on the same site.

Answer: B N&P 294 Justin

1. _________ electrocautery devices do not require a return electrode and are less likely to cause burn or injury. a. Unipolar electrocautery b. Bipolar electrocautery c. None of the above d. All of the above

Answer: B, Bipolar electrocautery N&P pg. 232 Stetler

5. Common causes of intrinsic kidney disease include which of the following? (Select 2) a. Drugs b. Glomerular disease c. Interstitial nephritis d. Radiographic contrast agents

Answer: B, C Glomerular disease, interstitial nephritis Morgan & Mikhail's Clinical Anesthesiology pg. 1311 stetler

3. In order to reset a patient pacemaker into continuous, asynchronous mode the provider should a. Turn the pacemaker off b. Place a magnet over the pacemaker c. Do nothing, the pacemaker is already in continuous asynchronous mode

Answer: B, Place a magnet over the pacemaker N&P pg. 232 Stetler

2. All of the following are true regarding stimulation of the facial nerve EXCEPT: A. facial nerve monitoring generally involves stimulating the orbicularis oculi around the eye or the orbicularis around the lip. B. facial nerve monitoring generally involves stimulating the cervical branch of the facial nerve. C. the facial nerve is cranial nerve VII D. is the best site to measure onset.

Answer: B, facial nerve monitoring generally involves stimulating the cervical branch of the facial nerve N & P, pg. 160 Stefania

4. Which of the following correctly describes tetanus monitoring? A. 50 Hz, tetanus for 5 seconds, a 3 second pause, then single twitches of 1 Hz. B. generally consists of a rapid delivery of 30, 50, or 100 Hz stimulus for 5 seconds. C. two short bursts of 50 Hz tetanus separated by 0.75 seconds. D. a series of four twitches at 2 Hz every ½ second for 2 seconds.

Answer: B, generally consists of a rapid delivery of 30,50, or 100 Hz stimulus for 5 seconds. N & P, pg. 161 Stefania

1. All of the following are true regarding barbiturates EXCEPT: A. cerebral vasoconstrictor B. increase CBF C. decrease CBV D. decrease ICP

Answer: B, increase CBF M & M, pg. 175 Stefania

In what state is oxygen stored at room temperature? When refrigerated? A. room temp: liquid, refrigerated: compressed gas B. room temp: compressed gas, refrigerated: liquid C. room temp: compressed gas, refrigerated: solid D. room temp: liquid, refrigerated: solid

Answer: B, room temp: compressed gas, refrigerated: liquid M & M, pg. 11 Stefania

Ensuring a culture of safety is one of the best ways to avoid serious injury to a patient. A great tool to ensure this culture of safety is by: A. cleaning the OR when the patient is coming in the room B. utilizing a surgical safety checklist with the entire OR team at the beginning of the case C. utilizing a surgical safety checklist with just the circulating nurse D. drawing up all your medications before the case

Answer: B, utilizing a surgical safety checklist with the entire OR team at the beginning of the case M & M, pg. 10 Stefania

Which are disadvantages of the nondiverting capnograph? (Select 2) a. Prone to water precipitation b. The weight of the sensor can cause traction on the tracheal tube c. Higher risk for aspiration d. Generation of radiant heat can cause skin burns

Answer: B- Weight of sensor can cause traction on the tracheal tube, D- Generation of radiant heat can cause skin burns Morgan & Mikhail's Clinical Anesthesiology pg. 126 Stetler

3. In MOSTadults, where does the larynx begin and end? A. begins between C3-C4, ends at C8 B. begins between C4-C6, ends at C8 C. begins between C3-C4, ends C6 D. begins at C2, ends at C7

Answer: C, begins between C3-C4, ends at C6 N&P, pg. 424 Stefania

5. 4. Which of the following correctly describes double burst stimulation monitoring? A. 50 Hz, tetanus for 5 seconds, a 3 second pause, then single twitches of 1 Hz. B. generally consists of a rapid delivery of 30, 50, or 100 Hz stimulus for 5 seconds. C. two short bursts of 50 Hz tetanus separated by 0.75 seconds. D. a series of four twitches at 2 Hz every ½ second for 2 seconds.

Answer: C, two short bursts of 50 Hz tetanus separated by 0.75 seconds. N & P, pg. 161 Stefania

4. At which time does maintenance of cuff pressure ensure proper valve and cuff function? a. While attaching the 10mL syringe b. Following intubation of the patient c. After detaching the 10mL syringe d. All of the above

Answer: C-After detaching the 10mL syringe Morgan & Mikhail's Clinical Anesthesiology pg. 325 Stetler

2. The Beer-Lambert law is the premise incorporated for measuring_____. Choose the incorrect answer. a. Pulse oximetry b. End tidal capnography c. Vital capacity of the lungs d. End tidal concentration of volatile agents

Answer: C. Vital capacity of the lungs. As with oximetry, end tidal measurement of volatile gasses and absorption of infrared light by CO 2 is governed by the Beer-Lambert law. Morgan and Mikhail pg. 125 BR

2. What does the "x" decent on the CVP waveform represent? A. atrial contraction B. the opening of the tricuspid valve C. downward pulling of the septum during ventricular systole D. the closing of the aortic valve

Answer: C. downward pulling of the septum during ventricular systole N & P, pg. 301 Stefania

3. Which of the following is true regarding barbiturates? A. stimulate the reticular activating system B. stimulate the brainstem C. depress the reticular activating system D. stimulate the cerebellum

Answer: C., depress the reticular activating system M & M, pg. 175 Stefania

3. Which of the following is the correct location for muscarinic-3 receptors? A. heart and CNS B. CNS and stomach C. glands, GI, CNS D. only CNS

Answer: C., glands, GI, CNS (salivary secretions, bladder contraction) N & P, pg. 198 Stefania

5. MAC-BAR is approximately how many times higher than MAC? A. 1 B. 1.3 C. 2 D. 1.6

Answer: D, 1.6 N & P, pg: 88 Stefania

High pressure O2 cylinders are connected by a manifold which contain valves that decrease high pressure of O2 (2000 psig) to about what line pressure? A. 35 psig B. 60 psig C. 330 psig D. 55 psig

Answer: D, 55 psig M & M, pg. 11 Stefania

4. Which of the following is the correct formula for clearance? A. clearance=Q/E B. clearance = E/Q C. clearance = Q x E/2 D. clearance = Q x E

Answer: D, clearance = Q x E (Q=blood flow, E=extraction ratio) N & P, pg. 73 Stefania

1. All of the following are true regarding stimulation of the ulnar nerve EXCEPT: A. innervation of the adductor pollicis B. motor response causes thumb adduction C. is an extension of the medial cord of the brachial plexus D. is not the best site to measure recovery

Answer: D, is not the best site to measure recovery N & P, pg. 160 Stefania

5. Which of the following drugs are examples of chemical antagonists? A. isoproterenol induced vasodilation and norepinephrine induced vasoconstriction B. negatively charged protamine forming a covalent bond with positively charged heparin C. isoproterenol induced vasocontriction and norepinephrine induced vasodilation D. sugammadex

Answer: D, sugammadex N & P pg 59 Stefania

5. Which of the following is true regarding barbiturates? A. pentobarbital has a more rapid onset than thiopental B. thiopental has a longer DOA than thiopental C. pentobarbital is more potent than thiopental D. thiopental is more lipid soluble than pentobarbital

Answer: D, thiopental is more lipid soluble than pentobarbital M & M, pg. 176 Stefania

4. Causes of renal ischemia include which of the following? a. Hypotension b. Hypovolemia c. Impaired cardiac output d. All the above

Answer: D- All the above Morgan & Mikhail's Clinical Anesthesiology pg. 1311 stetler

2. Postrenal azotemia is DEFINITIVELY diagnosed by which of the following a. Physical examination b. Ultrasound c. Radiograph of the abdomen d. Dilation of urinary tract proximal to the site of obstruction on imaging studies

Answer: D- Dilation of urinary tract proximal to the site of obstruction on imaging studies Morgan & Mikhail's Clinical Anesthesiology pg. 1310 stetler

2. Cuff pressure of the ET tube depends on? a. Inflation volume b. Tracheal and cuff compliance c. Intrathoracic pressure d. All of the above

Answer: D-All of the above Morgan & Mikhail's Clinical Anesthesiology pg. 321 Stetler

2. Differentiate between the variables that increase from decrease MAC levels. Hyperthermia, Hypothermia, Young patients, Elderly, Chronic ETOH use, Acute ETOH intoxication.

Answer: Hyperthermia, Hypothermia, Elderly, Acute ETOH intoxication all decrease MAC, requiring less anesthetic. Young patients and chronic ETOH users have a higher MAC level and require more anesthetic. Morgan and Mikhail pg. 164

1. Arrange the following benzodiazepines in order of elimination half-life smallest to greatest. (Drag n Drop) a. Midazolam b. Lorazepam c. Diazepam

Answer: Midazolam < Lorazepam < Diazepam Jason [M&M p.181]

True or False: An increase in elevation or a decrease in ambient pressure does NOT effect the concentration of agent delivered, but DOES decrease the partial pressure of Desflurane

Answer: TRUE Stetler

4. Place the following in the correct order of routine management starting with assessment ending with extubation. 1. Airway assessment 2. Preparation and equipment check 3. Patient positioning 4. Preoxygenation 5. Bag and mask ventilation (BMV) 6. Intubation (if indicated) 7. Confirmation of endotracheal tube placement 8. Intraoperative management and troubleshooting 9. Extubation

Answer: They are currently in the correct order. Morgan and Mikhail 5th Edition Chapter 19 pg 312. Mr. Ryan

3. Match the correct findings/ presentation to each laryngeal nerve injury. 1. Unilateral injury to Superior laryngeal nerve a. Minimal effects 2. Bilateral injury to Superior laryngeal nerve b. Hoarseness, tiring of voice 3. Unilateral injury to recurrent laryngeal nerve c. Hoarseness 4. Bilateral injury to recurrent laryngeal nerve d. Stridor, respiratory distress

Answer: They are currently next to the correct answer. 1a,2b,3c,4d Morgan and Mikhail 5th Edition Chapter 19 pg 312. Mr. Ryan

The ________ is the pH at which the fraction of ionized and non-ionized drug is equal a. pKa b. Steady State c. Bioavailability d. Dissociation Equilibrium

Answer: a - pKa Morgan & Mikhail's Clinical Anesthesiology pg. 268 Stetler

1. Normal cardiac index is in L/min/m^3 a. 2.2 - 4.2 b. 3 - 6 c. <18 d. 2 - 4

Answer: a 2.2-4.2 Morgan & Mikhail's Clinical Anesthesiology pg. 109 Stetler

1. How are the following drug actions terminated?? a. Small doses of opioids? b. Larger doses? c. Multiple doses? d. Continuous infusions? i. Redistribution ii. Metabolism

Answer: a = i; b = ii; c = ii; d = ii Reference: N&P pg 148 mandy

4. Match the following: a. Beta-blockers b. Calcium Channel Blockers c. Statins d. ACE-Inhibitors i. Decreases cardiac demand via lowering the HR, BP and contractility ii. Reduces preload, afterload and increases coronary flow iii. Reduce thrombogenicity and adverse cardiac events iv. May be useful in patients with CAD and diabetes

Answer: a = i; b = ii; c = iii; d = iv Reference: N&P pg 209 box 13-15 Mandy

1. The fraction of drug ionized depends on which characteristic? a. pH b. pKa c. Temperature d. Blood flow

Answer: a pH Morgan & Mikhail's Clinical Anesthesiology pg. 147 Stetler

Which of the following will NOT affect the minimum concentration of local anesthetic that will block nerve impulse conduction? a. Characteristics of the nerve fiber (size, type, myelination) b. Strength of nerve stimulation c. Frequency of nerve stimulation d. Electrolyte concentrations

Answer: b - Strength of nerve stimulation Morgan & Mikhail's Clinical Anesthesiology pg. 268 Stetler

2. What is the term for the chemical process by which a drug molecule is altered by the body? a. Metabolism b. Biotransformation c. Excretion d. Absorption

Answer: b Biotransformation Morgan & Mikhail's Clinical Anesthesiology pg. 146 stetler

4. For drugs that have a low hepatic extraction ratio and are slowly cleared by the liver what is the rate-limiting step? a. Blood flow b. Metabolic capacity of the liver c. Drug pH d. All of the above

Answer: b metabolic capacity of the liver Morgan & Mikhail's Clinical Anesthesiology pg. 147 Stetler

The term used to describe decreased efficacy of repeated doses is? a. Tolerance b. Desensitization c. Tachyphylaxis d. Down regulation

Answer: c - Tachyphylaxis Morgan & Mikhail's Clinical Anesthesiology pg. 269 Stetler

3. What does renal elimination of drugs that exist in nonionized and ionized forms depend on? a. pH of blood b. blood flow c. urinary pH d. All of the above

Answer: c urinary pH Morgan & Mikhail's Clinical Anesthesiology pg. 147 Stetler

Onset of local anesthetic action depends on a. Lipid solubility b. Concentration of non-ionized lipid soluble form c. Concentration of ionized water soluble form d. All the above

Answer: d - All the above Morgan & Mikhail's Clinical Anesthesiology pg. 268 Stetler

3. Match the following inhalation agents with their respective MAC values: ____Sevoflurane ____Desflurane ____Isoflurane ____Nitrous 1.17, 2, 6, 104

Answer: sevo: 2, des: 6, iso: 1.17, nitrous: 104 N & P, pg: 88 Stefania

1. While working as a CRNA, you are doing a case with general anesthesia and an ETT. The patient is being ventilated with adequate VT but you notice that the baseline of the ETCO2 waveform begins to gradually rise becoming further and further from the baseline. What are the possible reasons for this occurrence? a. Poor anesthetic gas concentration in the alveoli b. There are inadequate fresh gas flows c. The CO2 absorber is exhausted or ineffective d. This is a normal finding for ventilated patients

B & C N&P 316 mandy

4. Which type of ETCO2 monitoring system has advantages that include minimal increase in deadspace and versatility in gas analysis? a. Non-diverting b. Diverting c. Sidestream d. Mainstream

B & C N&P pg 316 mandy

In regards to monitoring the airway, which of the following is NOT true? A) The presence of any sign of airway obstruction such as retractions, or seesaw motion of the chest and abdomen must be noted B) Seeing the presence of condensation in an airway device or clear mask does not indicate the presence of gas exchange C) The sense of touch can be used to perceive subtle movements of air exchange felt on the hand of the anesthetist D) The sense of smell can be the first aid in detecting a disconnected circuit or airway device when volatile agents are being used

B) Seeing the presence of condensation in an airway device or clear mask does not indicate the presence of gas exchange Devin [N&P p.315]

Which of the following is the purpose for measuring the ICP? A) To measure adequacy of hemispheric oxygenation B) To measure intracranial compliance C) To monitor electrical brain activity and detect seizures D) To monitor the integrity of sensory pathways

B) To measure intracranial compliance Devin [N&P p.326]

The measurement of arterial blood gases to determine level of CO2 provides direct measurement of what? A) Oxygenation B) Ventilation and metabolic status C) Bicarbonate level D) Anion gap

B) Ventilation and metabolic status Devin [N&P p.315]

Which of the following has been described as the most significant advancement in the way intubation is performed since the development of the laryngoscope in the 1940's? A) Trachlite lighted stylet B) Video laryngoscopy C) Combitube D) Supraglottic tube

B) Video laryngoscopy [N&P p.456] Devin

The final conduit for the delivery of anesthetic gases to the patient is provided by: A. Breathing circuits B. Breathing systems C. Mapleson D D. Nasal Trumpet

B. Breathing systems M&M pg. 29 Jensen

5. Soluble drugs stay in the blood in ______ proportion than less soluble agents, therefore, _____ of the drug is released to the tissues a. Less; greater b. Greater; less c. Less; less d. Greater; greater

B. greater; less Rebecca N&P pg79

Choose the correct definition of pharmacology. A: The study of receptors B: the study of processes by which a drug produces one or more measured physiologic responses C: The study of anesthesia D: The study of biospheres and receptor sites

B: the study of processes by which a drug produces one or more measured physiologic responses Reference: N&P page 53, 2nd column 2nd paragraph Abe

4. In reference to the American College of Radiology's MRI zones, which zone has limited access, requires explicit supervision, and can commonly be found immediately outside the MRI scanner room? (N&P ch52, pg1280) A. Zone 1 B. Zone 2 C. Zone 3 D. Zone 4

C Hale

5. Lead-glass barriers, lead aprons, lead thyroid collars, and lead-glass safety glasses all protect against what OR hazard? (N&P ch52, pg 1281) A. Blood borne pathogens B. Surgical fires C. Radiation exposure D. None of the above

C Hale

Normal ventricular wall motion _____ during systole, and the endocardial surface moves ________. A. Thins, Inward B. Thickens, Outward C. Thickens, Inward D. Thins, Outward

C N&P 309

5. Alpha blocker effects will cause the liver to : a. Increase blood b. Decrease blood sugar c. No clinically relevant effect d. Hypoglycemia

C i. N&P pg 188 anozier

An alteration associated with CHF in the structure of the ventricle is called ventricular remodeling. All of the following are true regarding ventricular remodeling, EXCEPT for: (N&P ch13, pg205) a. The chamber dilates b. The chamber hypertrophies c. The chamber atrophies d. The chamber becomes more spherical.

C Hale

A retrograde wire-guided intubation may be considered in a situation in which intubation has failed, but ventilation is possible. This procedure is NOT usually used in an emergency and often can be completed by a skilled practitioner in ____________? A) 1 to 2 minutes B) 3 to 4 minutes C) 5 to 7 minutes D) 10 to 15 minutes

C) 5 to 7 minutes [N&P p.459] Devin

5) At what percentage is a drug considered fully eliminated from the body? A) 85% B) 90% C) 95%

C) 95% a drug is regarded as being fully eliminated when approximately 95% has been eliminated from the body. Usually 4-5 half-lifes. N&P Ch 6 pg 72 Jared Dumas

4) What do you suspect is happening when your patient starts to display s/s of Local Anesthetic Systemic Toxicity (LAST) less than 60 seconds after injecting the first dose of LA subQ during facial plastic surgery? A) Accidental injection into the aqueous humor B) Accidental injection into the glossopharyngeal nerve C) Accidental IV injection

C) Accidental IV injection N&P Pg 139 BOX 10-5 Jared Dumas

2) What are the risk factors (10) that will likely cause Local Anesthetic Systemic Toxicity (LAST)? A) Gender, dexterity, internal age, onset of puberty, Height/Weight, color of hair/eyes B) Profession, Job title, Level of education, Name of University attended C) Advanced age, Heart Failure, ischemic heart disease, conduction abnormalities, metabolic (e.g., mitochondrial) disease, liver disease, low plasma protein concentration, metabolic or respiratory acidosis, and medications that inhibit sodium channels.

C) Advanced age, Heart Failure, ischemic heart disease, conduction abnormalities, metabolic (e.g., mitochondrial) disease, liver disease, low plasma protein concentration, metabolic or respiratory acidosis, and medications that inhibit sodium channels. N&P Pg 138 BOX 10-3 Jared Dumas

1) What is the first, "initial focus", intervention you do to treat Local Anesthetic Systemic Toxicity (LAST)? A) Call for help B) Give lipid emulsion C) Airway management: ventilate with 100% oxygen

C) Airway management: ventilate with 100% oxygen N&P Pg 138 BOX 10-3 Jared Dumas

5) Dexmedetomidine is highly specific to which αlpha receptors? A) Alpha 1 B) Alpha 3 C) Alpha 2

C) Alpha 2 M&M Chapter 17 pg 288

How does a TEE work? A) Shocks the heart with 150 Joules B) TEE really means electroencephalogram C) As ultrasound reflects off the moving RBCs, echos are produced, which are then recorded by the TEE transducer

C) As ultrasound reflects off the moving RBCs, echos are produced, which are then recorded by the TEE transduce N&P Ch 16 pg 309 Jared Dumas

2) By decreasing gastric fluid volume and hydrogen ion content, H2 blockers reduce the perioperative risk of __________? A) Nausea and Vomiting B) Stroke C) Aspiration Pneumonia

C) Aspiration Pneumonia M&M Chapter 17 pg 280

Jared Dumas Week 14 1) The sedative effects of H 1- receptor antagonists can potentiate what 3 other central nervous system depressants? A) Volatile agents, reversal agents, Opioids B) Opioids, Beta-Blockers, ACE inhibitors C) Barbiturates, Benzodiazepines, Opioids

C) Barbiturates, Benzodiazepines, Opioids M&M Chapter 17 pg 280

3) Why is propofol contraindicated for the treatment of LAST? A) Because propofol is lipid based B) Because propofol is only for induction C) Because propofol is a cardiovascular depressant with lipid content too low to provide benefit

C) Because propofol is a cardiovascular depressant with lipid content too low to provide benefit N&P Pg 138 BOX 10-3 Jared Dumas

3) What isoenzyme does cimetidine inhibit? A) CYP1A2 B) CYP2C9 C) Broad range CYP450

C) Broad range CYP450 N&P Ch 6 pg 72 Table 6-3 Jared Dumas

3) In the setting of marked prerenal azotemia, what drugs can precipitate AKI? A) Beta Blockers, Nitroglycerin B) ARB's, Calcium Channel blockers C) Cyclooxygenase inhibitors (e.g. ketorolac for postoperative pain control) or ACE inhibitors

C) Cyclooxygenase inhibitors (e.g. ketorolac for postoperative pain control) or ACE inhibitors M&M Chapter 57 pg 1310

2) What are the three typical causes of hypoperfusion of the kidneys? A) Ketoacidosis, Increased arterial perfusion, Diabetes B) Kidney transplant, Obesity, Smoking C) Decreased arterial perfusion pressure, Markedly increased venous pressure, Renal vasoconstriction

C) Decreased arterial perfusion pressure, Markedly increased venous pressure, Renal vasoconstriction M&M Chapter 57 pg 1309

5) What are the 2 primary reasons for propofol induced hypotension? A) Increased sympathetic tone and vasodilation B) Decreased sympathetic tone and vasoconstriction C) Decreased sympathetic tone and vasodilation

C) Decreased sympathetic tone and vasodilation N&P Ch 9 pg 108 Jared

Which of the following is NOT a function of a "Flexible Fiberoptic Bronchoscope"? A) Evaluate the airway B) Facilitate intubation of the patient with a difficult airway C) Deliver transtracheal jet ventilation D) Check ETT placement or change an existing ETT E) Perform postextubation evaluations

C) Deliver transtracheal jet ventilation [N&P p.454] Devin

5) Which of the volatile agents has the highest incidence of reflex tachycardia and hypertension? A) Isoflurane B) Sevoflurane C) Desflurane

C) Desflurane N&P Ch8 Pg 97 Table 8-5 Jared Dumas

What are doppler cardiac exams useful for? A) Determining need for heart transplant B) Determining Food Borne Allergies C) Determining etiology of regurgitation, adequacy of valve repair, need for cardiac bypass

C) Determining etiology of regurgitation, adequacy of valve repair, need for cardiac bypass N&P Ch 16 pg 309 Jared Dumas

3) What 2 factors increase protein binding? A) Smoking, Sunlight B) Increased interstitial pressure, increased osmotic pressure C) Increased protein concentration, Increased pH

C) Increased protein concentration, Increased pH N&P Ch 9 pg 107 Table 9-3 Jared

4) Why is ketorolac preferred over morphine in the perioperative period? A) Ketorolac onset time is faster than morphine B) Ketorolac has a shorter duration of action C) Ketorolac has minimal central nervous system side effects

C) Ketorolac has minimal central nervous system side effects M&M Chapter 17 pg 286

Opioid drugs produce pharmacologic activity by binding to opiate receptors primarily located in all of the following areas EXCEPT: A) Central nervous system B) Supraspinal and spinal C) Lymphatic ducts D) Several peripheral sites

C) Lymphatic ducts [N&P p.145] Devin

4) What is the administration of drugs largely determined by? A) A subtherapeutic range across multiple populations B) A therapeutic dose determined by height and weight C) A mean therapeutic dose per kilogram of body weight or body surface area calculated from a previously determined average dose for the normal population

C) a mean therapeutic dose per kilogram of body weight or body surface area calculated from a previously determined average dose for the normal population N&P Ch 5 pg 56 Jared Dumas

Inhaled nitric oxide is a ____________ that is beneficial and routinely used in the treatment of reversible pulmonary hypertension. A) selective pulmonary vasoconstrictor B) selective arteriolar vasodilator C) selective pulmonary vasodilator D) selective venous vasodilator

C) selective pulmonary vasodilator Devin [M&M p.257]

5) What is the optimal dosing approach for patients when drugs are administered by the intravenous route? A) Give a bolus over 5 minutes and see what happens B) Give 1/2 the recommended dose recommended by any given manufacturer C) Titration until the desired therapeutic response is attained

C) titration until the desired therapeutic response is attained N&P Ch 5 pg 56 Jared Dumas

All of the following are advantages of using radio frequency ID except: A) It would allow control rooms to locate personnel rather than having to use paging systems, radios, or telephones B) It would allow for ease of tracking patient flow through the entire facility. C) It would allow OR staff to keep track of surgical instruments left in the pt should the counts be disputed, rather than exposing the pt to radiation. D) All of the above E) None of the above

D) All of the above M&M Pg 27 Mandy

The simple chemical combination required for any fire is commonly referred to as the fire triad or fire triangle. This triad is composed of what? A) Nitrous, Isoflurane, Lidocaine B) Sparks, Heat, Dry conditions C) Surgiseal, Nitrous, Medical Air D) Fuel, Oxidizer, Ignition source

D) Fuel, Oxidizer, Ignition source [M&M p.22] Devin

Opiate receptors are from the rhodopsin family of _____________. A) Bradykinin B) Prostaglandins C) Ligands D) G-protein coupled receptors

D) G-protein coupled receptors [N&P p.145] Devin

You're the CRNA that was assigned to the call shift last night, you had 3 cases and are exhausted. Today, you are caring for a pt with a lengthy cardiac hx, an EF of 25% and she is having a cholecystectomy. You are so fatigued that you can't remember which is the better anesthetic to use for this pt. You seek advice from a 25 year veteran CRNA to ensure you are making the proper decision for the pt. In this scenario, you have exhibited ________. A) Poor decision-making skills B) A lack of leadership C) Poor assertiveness D) Good decision-making skills

D) Good Decision-making skills M&M pg 25 Mandy

When should a patient have a pregnancy test before surgery? A) age 45 B) age 50 C) age 55 D) Patients should be offered pregnancy testing despite history, except in patients with a history of hysterectomy or bilateral salpingo-oophorectomy

D) Patients should be offered pregnancy testing despite history, except in patients with a history of hysterectomy or bilateral salpingo-oophorectomy N&P ch19, pg 372 Dumas

Which ventilator setting delivers inspiratory breaths at a set pressure, at a decelerating flow pattern, but is only useful in patients that are spontaneously breathing? A) Volume controlled ventilation B) Pressure controlled ventilation C) Pressure controlled ventilation with volume guarantee D) Pressure support ventilation

D) Pressure support ventilation N&P pg. 275 Charlie

Which ventilator setting provides mandatory intermittent breaths that are delivered in synchrony with, and triggered by patient's spontaneous efforts? Can be pressure or volume controlled. A) Volume controlled ventilation B) Pressure controlled ventilation C) Pressure controlled ventilation with volume guarantee D) Synchronized intermittent mandatory ventilation

D) Synchronized intermittent mandatory ventilation N&P pg. 274 Charlie

Succinylcholine usually results in slight _____________. Repeat dosing in adults and any doses in children may produce sudden, abrupt ______________. Many types of arrhythmias have been reported. A) Bradycardia, Tachycardia B) Hypertension, Hypotension C) Hypotension, Hypertension D) Tachycardia, Bradycardia

D) Tachycardia, Bradycardia Devin [N&P p.176]

All of the following are true regarding Propofol EXCEPT: A) The major CV effect of propofol is a decrease in arterial BP due to a drop in SVR, preload, and contractility B) Propofol markedly impairs the normal arterial baroreflex response to hypotension C) Even when used for conscious sedation in sub-anesthetic doses, propofol inhibits hypoxic ventilatory drive and depresses the normal response to hyperbarbia D) Tolerance develops after long-term propofol infusions

D) Tolerance develops after long-term propofol infusions Devin [M&M p.185]

3. What effect do benzodiazepines NOT have? (Select one) a. Analgesic b. Antianxiety c. Amnestic d. Sedative

a. Analgesic Jason [M&M p.181]

Which of the following are recommended diagnostic tests of candidates for bariatric surgery? A. CBC (complete Blood Count) B. Glycosylated Hemoglobin C. 12-lead ECG D. Thyroid Function E. All of the above

E. All of the Above N&P page 350 Justin

5. While monitoring your patient, you notice that the plateau phase of the ETCO2 waveform is sloping. What are the possible reasons for this? a. Expired gas flow obstruction b. Ventilation perfusion mismatch c. COPD d. Kinking of the ETT e. All of the above

E. All of the above N&P 316 mandy

Which devices typically require wall-outlet electrical power? A. Mechanical ventilators B. Physiologic monitors C. Room and surgical illumination D. Air warming blankets E. All of the above

E. All of the above N&P pg 249 Rebecca

The Drager Fabius monitors: A. Volume B. Flow C. Inspired oxygen D. Pressure E. All of the above

E. All of the above N&P pg. 250 Rebecca

All ot eh following factors would place the patient at increased risk of aspiration EXCEPT: A. Inadequate depth of anesthesia B. Severe Hypotension C. Diabetes D. Opioids E. All of the above

E. All of the above N & P 466 box 22-12

What information regarding the use of a laser should the anesthesia provider know? A. Type of laser (CO2, neodymium yttrium aluminum garnet, or potassium totally phosphate) B. Wavelength C. Focal length D. Ensure warning sign is posted on door E. Availability of protective eyewear for staff and patient F. Choice of laser ETT tube G. All of the above

G. M&M ch2 Kaitlin

Match the Following types of hypoxia with their pathophysiologic characteristics. Hypoxic Hypoxia Circulatory Hypoxia Hemic Hypoxia Demand Hypoxia/Histotoxic Hypoxia a. ↓ Fio2 < 21%, Alveolar hypoventilation, Pulmonary diffusion defect, V/Q mismatch, Right → Left Shunt b. ↓ CO, Microvascular dysfunction c. ↓ Hgb content and function d. ↑ O2 consumption, inability of cells to utilize O2

Hypoxic Hypoxia - a. ↓ Fio2 < 0.21, Alveolar hypoventilation, Pulmonary diffusion defect, V/Q mismatch, R → L Shunt Circulatory Hypoxia - b. ↓ CO, Microvascular dysfunction Hemic Hypoxia - c. ↓ Hgb content and function Demand Hypoxia/Histotoxic Hypoxia - d. ↑ O2 consumption, inability of cells to utilize O2 M&M page 1281 Krum

Drug-receptor response has proven to be more complicated than previously thought. Through current research, it has been discovered that drug delivery sufficient to occupy ____ of the drug receptors is sufficient in many instances to elicit a maximum tissue response. a. 1% b. 5% c. 10% d. 15%

a. 1% NP: 58 Byron

5. What is the normal ICP range? a. 1-15 mm H2O b. 1-5 mm H2O c. 20-25 mm H2O d. 1-20 mm H2O

a. 1-15 mm H2O Jason NP p. 325

5. What is the onset time of labetalol and esmolol? N&P pg 199 a. 1-2 min b. Seconds c. 2-5 min d. 15 min

a. 1-2 min Fieber

5. What should the mg/ml concentration be when administering esmolol? M&M pg250 a. 10 b. 100 c. 200 d. 0.01

a. 10 fieber

What percentage of body weight comprises the vessel rich group? a. 10% b. 20% c. 30% d. 50%

a. 10% NP: 68 Byron

What is the approximate duration of action of following single dose administration of phenylephrine? a. 15 min b. 30 min c. 45 min d. 60 min

a. 15 min MM: 245 Byron

When left in place for ___ weeks, both orotracheal and nasotracheal tubes predispose patients to subglottic stenosis. a. 2-3 b. 3-4 c. 4-5 d. >6

a. 2-3 M&M pg. 1296

2. At what rate/dose does the body lose the ability to eliminate cyanide with a nitroprusside administration? N&P pg198 a. 2mcg/kg/min, 500 mcg/kg b. 3mcg/kg/min, 550mcg/kg c. 4mcg/kg/min, 500mcg/kg d. 5mcg/kg/min, 550mcg/kg

a. 2mcg/kg/min, 500 mcg/kg Fieber

5. 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 16, p. 274 Lexi

1. To prevent fasciculations and myalgia, 10%-15% of a nondepolrizer intubating dose can be given how many minutes before succinylcholine? a. 5 mins b. 10 mins c. 1 mins before d. at the same time M&M, ch 11, pg 213

a. 5 mins Mbom

What is the typical range of energy needed for cardioversion of a supraventricular tachycardia? a. 50-100 joules b. 200-300 amps c. 240 volts d. 1000 kilowatts

a. 50-100 joules N&P pg. 1270 Charlie

3. What enzyme catalyzes the hydrolysis of ester local anesthetics a. Plasma cholinesterase b. CYP 450 c. CYP 3A4 d. CYP 1A2

a. Plasma cholinesterase N 134 David

4. Cyanide toxicity is more likely if the cumulative dose of sodium nitroprusside is greater than _________ mcg/kg administered at a rate faster than ______ mcg/kg/min. a. 500, 2 b. 200, 5 c. 100, 5 d. 200, 2 Reference: M&M pg 258

a. 500, 2 Reference: M&M pg 258 Mandy

5. What percentage of responses makes up the standard deviation? a. 68% of response (38% to the left and 34% to the right of the mean value) b. 95% c. 99.7% d. 34% Nagelhout 5 Page 55 "In Figure 5-3, 1 SD makes up 68% of the responses (34% to the left and 34% to the right of the mean value)..."

a. 68% of response (34% to the left and 34% to the right of the mean value) Nagelhout 5 Page 55 "In Figure 5-3, 1 SD makes up 68% of the responses (34% to the left and 34% to the right of the mean value)..." Budenbender

4.Acute myocardial infarction is defined as having occurred within the last? a. 7 days b. 24 hours c. 48 hours d. 30 days

a. 7 days Jason [N&P p.204]

A given CO2 absorbent canister contains 1.1 kg of granules, with each 100 g of granules absorbing up to 15 L of CO2. The average maximum production of CO2 by an anesthetized adult is 12-18 L/hr. If total rebreathing is allowed, the expected life expectancy with continuous use before exhaustion would be? a. 8-10 hours b. 12-15 hours c. 4-6 hours d. 24 hours

a. 8-10 hours NP: 272 Matt Byron

Blood glucose management in the septic shock patient should be controlled/maintained at what value? a. <180 b. <160 c. <150 d. <110

a. <180 M&M p. 1319 Lexi

5. Many opioids undergo extensive hepatic first-pass effect. What does this mean? a. A larger dose of that drug is required when given orally compared to intravenously b. The drug is toxic to the liver when given orally c. Bioavailability and therapeutic efficacy are greatly reduced when given orally. d. None of the above statements are correct.

a. A larger dose of that drug is required when given orally compared to intravenously c. Bioavailability and therapeutic efficacy are greatly reduced when given orally. Reference: N&P pg 148 Mandy

What component differentiates a mapleson circuit from a draw over circuit? a. APL valve b. Cuffed ETT c. Raphael Robertazzi tube d. AED compatibility

a. APL valve Morgan and Mikhail's page 32 Krum

A tidal volume of 6 mL/kg and plateau pressure less than 30 cm H2O have been associated with reduced mortality in patients with what disease state? a. ARDS b. ESRD c. AIDS d. Liver failure

a. ARDS M&M pg. 1296 Jennifer

What are the ONLY two common reasons for an increase in inspired CO2? a. Absorbent granules have been exhausted b. One of the unidirectional valves are faulty c. Absorbent granules have recently been changed d. When the corrugated limb has been extended to it's maximum

a. Absorbent granules have been exhausted b. One of the unidirectional valves are faulty Rationale: (N&P 265) : "Thus there are only two common reasons for an increase in inspired CO2: the absorbent granules have been exhausted, or the unidirectional valves are faulty. Budenbender

5.Significant arrhythmias of decompensated heart failure include all of the following except? a. Afib b. Mobitz II c. SVT d. Symptomatic bradycardia

a. Afib Jason [N&P p.204]

3. The minimal induction dose of thiopental will depend on what? (select 2) MM pg177 a. Age b. Body weight c. Diet d. Mets score

a. Age b. Body weight Fieber

5. What is the phenomenon associated with electronic monitoring devices? a. Alarm fatigue b. Desensitization c. Alert fatigue d. Narcolepsy

a. Alarm fatigue NP p. 313 Jason

How is drug response measured in a quantal dose-response curve a. All-or nothing b. Percent c. Fraction d. Comparative

a. All-or nothing Charlie N &P pg. 56

1. The mechanism of action in which labetalol lowers blood pressure without reflex tachycardia is? M&M PG 249 a. Alpha and Beta effects b. Alpha effects c. Beta effects d. Muscarinic effects

a. Alpha and Beta effects fieber

4. G proteins are trimeric endoplasmic membrane proteins made up of a. Alpha, beta, gamma units b. Alpha units only c. Beta units only d. Gamma units only

a. Alpha, beta, gamma units i. M&M pg 243 Rebecca

4. After administering anesthesia for therapeutic and diagnostic procedures, how should the transfer of care be done? a. Always to qualified personnel in a manner that ensure continuity. b. To anyone in the area above the age of 18. c. Only to the parent of the patient. d. To any facility employee that says they will take report.

a. Always to qualified personnel in a manner that ensure continuity. N&P Page 1264 - Second Column, Second paragraph. Justin

Which of the following are potassium sparing diuretics? (Select 2) a. Amiloride b. Hydrochlorothiazide c. Spironolactone d. Ethacrynic Acid

a. Amiloride c. Spironolactone NP: 194 Byron

Factors that contribute to the dynamic state of west zone 3 include what? N&P pg 303 a. Application of PEEP b. Significant Diuresis c. Hemorrhage d. Change in patient position e. All of the above

a. Application of PEEP b. Significant Diuresis c. Hemorrhage d. Change in patient position e. All of the above N&P pg 303 BIEBER

4. Which of the following is NOT a method for determining intracranial pressure? a. Arterial catheters b. Fiberoptic intraparenchymal catheters c. Subarachnoid bolts d. Epidural catheters

a. Arterial catheters Jason NP p. 325

3. In computed tomography (CT), X-rays penetrate tissues differently according to? (Select one) a. Atomic number b. Atomic mass c. Isotopes d. Atomic weight

a. Atomic number [N&P p. 1279] Jason

5. Which of the following drugs should be used cautiously in patients taking? a. B-blockers b. NSAIDs c. Tylenol d. Vitamin B-12

a. B-blockers M&M Ch. 17 Pg. 288 Mark Thetford

3. Select all of the following practice points regarding the effectiveness of tocolytic therapy: (3) a. B2-agonists are effective in delaying delivery for 48 hours but have NO effect on perinatal mortality b. B2-agonists are effective in delaying delivery for 48 hours but increased effect perinatal mortality c. There is no evidence to support the use of magnesium sulfate or the nitric oxide donors such as nitroglycerin d. Indomethacin is an effective tocolytic, but concerns about possible fetal and neonatal effects

a. B2-agonists are effective in delaying delivery for 48 hours but have NO effect on perinatal mortality c. There is no evidence to support the use of magnesium sulfate or the nitric oxide donors such as nitroglycerin d. Indomethacin is an effective tocolytic, but concerns about possible fetal and neonatal effects Nagelhout Chapter 13 page 191 David Budenbender

1. What aspect of the Atracurium structure is responsible for its unique method of degradation? a. Benzylisoquinoline b. Amide group c. Alkene group d. Benzene ring

a. Benzylisoquinoline Willie M&M 216

3. Esmolol is an ultra-short acting. It works on what receptors? M&M pg250 a. Beta 1 b. Beta 2 c. Alpha 1 d. Alpha 2

a. Beta 1 Fieber

5. The plasma concentration curve is an example of a ______ curve? a. Biexponential decay curve b. Linear curve c. Randomly distributed curve d. Unrealistic curve

a. Biexponential decay curve N & P pg. 70 Charlie

2. The Rate of clearance is determined by _______ to the kidneys and liver. N&P pg 73 a. Blood Flow b. PH c. Temperature d. Diet

a. Blood Flow Fieber N&P pg 73

5. Scopolamine causes all of the following effects except? a. Bronchoconstriction b. Trachycardia c. Sedation d. Antisialagogue

a. Bronchoconstriction M&M Ch. 13 Pg. 234-236 Mark Thetford

What are potential side effects of cholinesterase inhibitors? (Select all that apply, select 3) a. Bronchospasm b. Miosis c. Bronchodilation d. Tachycardia e. Bradycardia

a. Bronchospasm b. Miosise. e. Bradycardia M&M pg 227 Lake

3. Select all of the following that are decreased by administration of etomidate: a. Cerebral blood flow b. Cerebral metabolic of oxygen consumption c. Muscle contractions d. BIS monitor values

a. Cerebral blood flow b. Cerebral metabolic of oxygen consumption d. BIS monitor values Nagelhout Page 111 Budenbender

4. To preserve brain tissue oxygenation the anesthesia care provider should maintain which of the following? (Choose all that apply) a. Cerebral perfusion pressure greater than 60 mmHg b. Intracranial pressure less than 20 mmHg c. Cerebral perfusion pressure less than 30 mmHg d. Intracranial pressure less than 40 mmHg

a. Cerebral perfusion pressure greater than 60 mmHg & b. Intracranial pressure less than 20 mmHg M&M Ch. 6 Pg. 136 Mark Thetford

1. The affinity of a drug for a specific macromolecular component of the cell and its intrinsic activity are ultimately related to its ? a. Chemical structure b. Administration route c. Dose d. Half life

a. Chemical structure N & P pg. 69 Charlie

Who achieves adequate levels of anesthesia faster? Adults or children a. Children b. Adults c. They are equal d. There is not enough information to answer

a. Children Nagelhout and Plaus page 82 Crouse

4. Which class of local anesthetics can have significantly prolonged plasma half life if the patient is saturated, inhibited, or has a genetic defect such as Duschenne's muscular dystrophy? a. Chloroprocaine b. Prilocaine c. Bupivacaine d. Ropivacaine

a. Chloroprocaine N 134 David

1. Select the two local anesthetics that have the SAME lowest half-life in minutes: a. Chloroprocaine b. Procaine c. Bupivacaine d. Ropivacaine

a. Chloroprocaine b. Procaine David N pg 134 table 10-5

1. What determines the modalities used by anesthetists beyond the minimal requirements set by the AANA? a. Clinical judgment b. Ability to communicate effectively c. Obsessive compulsive d. Ability to multitask

a. Clinical judgment NP p. 313 Jason

5. Which of the following adrenergic agonists reduce sympathetic outflow? a. Clonidine b. Dexmedatomidine c. Phenylephrine d. Norepinephrine

a. Clonidine b. Dexmedatomidine Morgan & Mikhail p 246 Budenbender

2. Which of the following are on the depth of sedation continuum of progressive changes? a. Cognition b. Respirations c. Protective reflexes d. Bowel movements

a. Cognition b. Respirations c. Protective reflexes Nagelhout page 1265 David

2. Which of the following should be used to determine the time required for a 50 percent decrease in concentration on the duration of infusion? a. Context-sensitive half-time b. Context-sensitive metabolic rate c. Half-life d. None of the above

a. Context-sensitive half-time M&M Ch. 7 Pg. 149 Thetford

4. What is an alternative to intermittent hemodialysis which can be used in the ICU setting for patients with hypotensive issues? (M&M pg 1312) a. Continuous Renal Replacement Therapy (CRRT) b. Bedside Continuous Dialysis Treatment (BCDT) c. Always Cleaning the Blood therapy (ACB) d. Constant Dialysis Therapy (CDT)

a. Continuous Renal Replacement Therapy (CRRT)

2. Labetalol's alpha and beta effects are able to produce a decrease in blood pressure without reflex tachycardia is beneficial to what patient population? M&M pg249 a. Coronary Artery disease b. Liver failure c. Diabetics d. Dialysis patients

a. Coronary Artery disease Fieber

1. What term describes blood taken from the "poor" and given to the "rich"? a. Coronary steal b. Inverse steal c. Robin Hood effect d. Paradoxical perfusion

a. Coronary steal N&P p. 93 Jason

3. What is the most accurate reflection of renal reserve or GFR? a. Creatinine clearance b. BUN levels c. Potassium d. Sodium

a. Creatinine clearance Naglehout & Plaus Page 366 "The most accurate reflection of renal reserve or GFR is creatinine clearance, which reflects the ability of the glomeruli to excrete creatinine into the urine at a given blood concentration." David Budenbender

2. What are the effects of propofol on the central nervous system? a. Decrease CBF, decrease CPP, decreased CMRO2, decreased ICP, decreased IOP b. Increased CBF, increased CPP, decreased CMRO2, decreased ICP, increased IOP c. Decreased CBF, decreased CPP, increased CMRO2, increased ICP, increased IOP d. Increased CBF, increased, CPP, increased, CMRO2, increased ICP, increased IOP

a. Decrease CBF, decrease CPP, decreased CMRO2, decreased ICP, decreased IOP N&P pg 108 table 9-4 Rebecca

How does hypothermia affect BAEPs? a. Decreased latency and prolonged interpeak intervals b. Increase latency and shorter interpeak intervals c. Hypothermia does not effect BAEPs d. Hypothermia renders BAEPs immeasurable

a. Decreased latency and prolonged inter peak intervals (N&P pg 331) Lake

1. In general Volatile agents_____ cerebral metabolic rate of O2 consumption (CMRO2) in a dose dependent manner. a. Decreases b. Increases c. Stays the same

a. Decreases Fieber N&P Pg 89

5. Which of the following are considered to be responsible for the spread and depth of spinal and epidural anesthesia being increased in pregnant women? (select all that apply) a. Decreases in thoracolumbar CSF volume b. Increased neural susceptibility of LA c. Hormonal changes causing a greater segmental spread of LA administered in epidural space during first trimester of pregnancy when little compression is evident d. ONLY result of mechanical factors

a. Decreases in thoracolumbar CSF volume b. Increased neural susceptibility of LA c. Hormonal changes causing a greater segmental spread of LA administered in epidural space during first trimester of pregnancy when little compression is evident N 134 David

In regards to the metabolism of ketamine, what is the primary pathway in the CYP-450 system is responsible for its biotransformation? a. Demethylation b. Hydroxylation c. Oxidation d. Hydrolysis

a. Demethylation NP: 113 Byron

4. Which inhalational anesthetic is NOT used to induce anesthesia in pediatric and adult patients? a. Desflurane b. Nitrous Oxide c. Sevoflurane d. Isoflurane

a. Desflurane N&P p. 94 Jason

4. Which of the following is the most common endocrine disorder? a. Diabetes mellitus b. Thyroid gland disorders c. Adrenocortical dysfunctions d. Goiters

a. Diabetes Mellitus Naglehout & Plaus Page 367 "Diabetes mellitus is the most common of endocrine disorder, affecting more than 20.8 million people..." David Budenbender

3. Which of the following is NOT a method of measuring electrical activity in the brain? a. ECG b. EEG c. EPs d. EMG

a. ECG Jason NP p. 325

Which category of patients appears to be particularly difficult to fully reverse the effects of benzodiazepines? a. Elderly b. Pregnant c. Pediatric d. Immunocompromised

a. Elderly M&M p. 290 Lexi

2. Normeperidine is the metabolite of meperidine. Which of the following patient populations is normeperidine likely to accumulate in? a. Elderly b. Decreased Renal function c. Decreased Hepatic function d. Infants

a. Elderly b. Decreased Renal function c. Decreased Hepatic function Reference: N&P pg 148 Mandy

4. Which of the following would NOT potentiate hyperkalemia with succinylcholine? a. Elderly b. Spinal cord trauma c. Thermal trauma d. Severe infection

a. Elderly N&P p. 170 Jason

Which of he following conditions cause a right shift of the Oxyhemoglobin Dissociation curve? (Select all that apply, select 4) a. Elevated CO2 b. Elevated pH c. Decreased pH d. Decreased temperature e. Elevated 2, 3-DPG f. Decreased CO2 g. Elevated temperature

a. Elevated CO2 c. Decreased pH e. Elevated 2, 3-DPG g. Elevated temperature (N&P pg 319) Lake

4. Once equilibrium is reached there will be an exponential drop in the plasma concentration noticed on the plasma concentration curve due to? a. Elimination b. Redistribution c. Acid/base balance d. Reason is unknown

a. Elimination N & P pg. 69 Charlie

1. The time required for the plasma concentration of a drug to decrease by 50 percent is termed? a. Elimination Half-life b. Half-time c. Elimination time d. Metabolic drug rate

a. Elimination Half-life M&M Ch. 7 Pg. 148 Thetford

4. What is a possible adverse reaction with the administration of Ketamine? a. Emergence delirium b. Lack of airway reflexes c. Bradycardia d. Bronchoconstriction

a. Emergence delirium N & P pg. 116 Charlie

What are conditions that indicate the use of invasive arterial blood pressure monitoring? (Select all that apply, select 4) a. End organ disease b. Provider preference c. Current hypotension d. Anticipated hypotension or wide BP deviations e. The need for multiple ABG measurements f. Anticipated hypertension

a. End organ disease c. Current hypotension d. Anticipated hypotension or wide BP deviations e. The need for multiple ABG measurements (M&M pg 92) Josh Lake

1. Which of the following are possible forms of sedation? (select 3) a. Enteral b. Parenteral (intravenous) c. Inhaled medications d. Topical

a. Enteral b. Parenteral (intravenous) c. Inhaled medications Nagelhout page 1265 David

2. Which of the following are naturally occurring catecholamines? a. Epinephrine b. Norepinephrine c. Isoproterenol d. Dobutamine

a. Epinephrine b. Norepinephrine Morgan & Mikhail p 245 Budenbender

What has the greater dead space and what is the relationship with arterial CO2? a. Face mask; increases arterial CO2 tension b. Endotracheal tube; increases arterial CO2 tension c. Face mask; decreases arterial CO2 tension d. Endotracheal tube; decreases arterial CO2 tension

a. Face mask; increases arterial CO2 tension Rationale: (N&P 263) "Conversely, because alveolar ventilation is the minute ventilation minus deadspace ventilation if the patient's minute ventilation is fixed, increasing deadspace decreases alveolar ventilation, and INCREASES arterial CO2 tension...Use of a face mask is associated with greater dead space than is the use of an endotracheal tube. Budenbender

What can cause an accumulation of local anesthetic in fetal circulation a. Fetal ph is lower than maternal pH and cause ion trapping b. Fetal pH is higher than maternal pH and prevents local from working c. Fetus is below maternal heart so LA cannot be completely circulated out of fetus d. It is not possible to get LA into fetal circulation

a. Fetal ph is lower than maternal pH and cause ion trapping Charlie N&P pg. 132

Termination of the inspiratory phase can be triggered by? a. Fixed duration of time b. Set inspiratory pressure limit c. Negative pressure limit d. Delivering a preset tidal volume

a. Fixed duration of time b. Set inspiratory pressure limit d. Delivering a preset tidal volume (M&M Page 72) Mark

A Quantal dose-response curve provides information on the _____ with which a given drug dose produces a desired therapeutic response in a patient population. a. Frequency b. Amount c. Size d. Cost

a. Frequency Fieber N&P pg 57

When the ventilator function is to be used on an anesthesia machine, the APL valve must be... a. Functionally removed b. Open and functioning c. Closed but functioning d. The APL valve does not affect ventilator use on the anesthesia machine

a. Functionally removed M&M - CH. 4, p. 77 Lexi

5. Since volatile agents have different vapor pressures it is important to fill the appropriate vaporizer with the appropriate agent. Filling a vaporizer with the wrong agent could result in which of the following? (Select 2) a. Greater concentration of anesthetic than dialed b. Smaller concentration of anesthetic than dialed c. Has no effect on concentration, but can increase PaO2 d. Can result in insignificant changes in the volatile anesthetic concentration.

a. Greater concentration of anesthetic than dialed b. Smaller concentration of anesthetic than dialed N & P, page 223 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 16, p. 274 Lexi

5. When monitoring patients, what equipment is necessary to achieve the desired level of sedation? (select 3) a. Heart rate via ECH b. Pulse oximetry c. Blood pressure every 5 minutes d. Blood pressure every 3 minutes

a. Heart rate via ECH b. Pulse oximetry c. Blood pressure every 5 minutes Nagelhout page 1265 David

5. Which is a critical outcome stemming from a CRNA's use of 3 or more ECG lead monitoring? a. Help anesthetists exercise better judgment during an anesthetic and potentially improve outcome b. 2 leads are needed when you actually understand them c. Five-cable leads don't improve outcomes d. 10 actual leads for 12 lead monitoring is phony

a. Help anesthetists exercise better judgment during an anesthetic and potentially improve outcome Nagelhout P 296 Budenbender

Adequacy of long-term blood glucose control can be easily and rapidly assess by measurement of what lab value? a. Hemoglobin A1C b. Beside blood sugar check c. Laboratory blood glucose d. All of the above

a. Hemoglobin A1C M&M pg 298 Jennifer

Prolonged exposure to doses of opiates can create __________ , a condition in which the patient experiences an increased sensitivity to a painful stimulus. a. Hyperalgesia b. Hypoalgesia c. Allodynia d. Dysesthesia

a. Hyperalgesia M&M, p. 195 Lexi

What Shape is the Graded dose response curve? a. Hyperbolic b. Hypobolic c. Isobolic d. Hypobaric

a. Hyperbolic Fieber N&P Pg. 56

5. What is the clinical indication for sodium nitroprusside? a. Hypertension b. Tachycardia c. Bradycardia d. Hypotension Reference: M&M Pg 257

a. Hypertension Reference: M&M Pg 257 Mandy

Which of the following is NOT an anesthetic concern for the patient with undiagnosed muscular dystrophy and the administration of succinylcholine? a. Hypocalcemia b. Ventricular dysrhythmias c. Myoglobinemia d. Tetanus

a. Hypocalcemia N&P p. 168 Jason

1. The hallmark signs and symptoms of cyanide toxicity include all of the following except? (Select one) a. Hypotension b. Metabolic acidosis c. Cardiac arrhythmias d. Increased venous oxygen content e. Tachyphylaxis

a. Hypotension Jason [M&M p. 255]

2. Which of the following is NOT part of the primary treatment for pediatric cardiac arrest due to hyperkalemic rhabdomyolysis? a. IV magnesium b. IV calcium c. Bicarbonate d. Glucose with insulin e. Hyperventilation

a. IV magnesium N&P p. 168 Jason

2. When vascular resistance is decreased CBF, Cerebral Blood volume, and CSFP will _________ a. Increase b. Decrease c. Stays the same

a. Increase N&P pg 89 Fieber

5. ______ Protein binding decreases barbiturate Glomerular filtration. M&M Pg 177 a. Increased b. Decreased c. Stays the same

a. Increased Fieber

5. Why is Ketamine the induction agent of choice for patients with active asthma? a. Increases pulmonary compliance and decreases pulmonary resistance b. Decreases pulmonary compliance and increases pulmonary resistance c. Has no effect on pulmonary compliance or resistance d. Blunts respiratory drive

a. Increases pulmonary compliance and decreases pulmonary resistance N & P pg. 116 Charlie

5. Hydralazine's relaxes arterioles by what mechanism of action? (Select one) a. Increasing cyclic guanosine 3'5'-monophosphate b. Increasing cyclic adenosine monophosphate c. Increasing phosphodiesterases d. Increasing the release of Calcium

a. Increasing cyclic guanosine 3'5'-monophosphate Jason [M&M p. 255]

2. What does SvO2 measure? a. Indirect measurement of oxygen delivery b. Percent of hemoglobin in the arterial blood saturated with oxygen c. The volume of blood pumped by the heart in one minute d. Volume of blood filling the atria during diastole

a. Indirect measurement of oxygen delivery NP p. 306 Jason

Which definition accurately describes the fresh gas inlet? a. Inlet that allows anesthetics mixed with O2 or air to flow from the anesthesia machine continuously to the circuit. b. Alters the flow of O2 only from the circuit to the scavenger. c. 2 are correct d. None of the above are correct

a. Inlet that allows anesthetics mixed with O2 or air to flow from the anesthesia machine continuously to the circuit. (Page 34 M & M) Willie

The 3,3,2 Rule is an assessment that evaluates various airway proportions using finger breadths. Which airway proportions are measured with this assessment? ( choose 3) a. Inter-incisor gap b. Thyromental distance (TMD) c. Mandibulohyoid distance (MHD) d. Atlanto-Occiptal joint mobility

a. Inter-incisor gap b. Thyromental distance (TMD) c. Mandibulohyoid distance (MHD) N&P Pg 433 Adam

1. What are the two main organs for drug clearance? Select 2 N&P PG 73 a. Kidneys b. Liver c. Heart d. Lungs

a. Kidneys b. Liver Fieber N&P PG 73

1. Match the following electrodes with their proper locations: a. LA electrode → b. Chest V electrode→ c. LL electrode → d. RA electrode → e. RL electrode → (This is the modified vectorcardiographic lead placement****)

a. LA electrode → a. Manubrium b. Chest V electrode→ b. Over lower body of sternum c. LL electrode → c. Left midaxillary, horizontal to the chest electrode d. RA electrode → d. Right midaxillary, also horizontal to the chest electrode e. RL electrode → e. ANY convenient location Budenbender Nagelhout page 295

What will happen if a LA is injected into acidotic, infected tissue a. LA is rendered ineffective from loss of lipid solubility b. LA strength is doubled c. LA toxicity and respiratory arrest will occur d. LA is not affected by this

a. LA is rendered ineffective from loss of lipid solubility Charlie N&P pg. 133

3. Which of these NDNMB cause histamine release? a. Mivacurium and Atracurium b. Mivacurium and pancuronium c. Atracurium and rocuronium d. Pancuronium and rocuronium M&M, ch 11, pg 213

a. Mivacurium and Atracurium Mbom

Match the supraglottic ventilation devices to their definition: a. LMA b. ProSeal and Supreme LMA c. Fastrach LMA d. ILA and Air-Q 1. sized based on weight; fully deflated cuff and place water soluble lube on posterior surface, insert midline with posterior surface against the palate of the mouth, then advanced with index finger along palatopharyngeal curve. Black line even with upper lip. Then inflate cuff. Tolerates positive pressure ventilation up to 20cmH2O. (N&P ch 22, pg 450) 2. larger and deeper bowl with no grille, gastric drainage tube parallel to the airway exiting at the mask tip, anterior pocked seating an introducer or finger during insertion, and silicone bite block. Takes an additional few seconds to place but improves airway seal by 50% allowing positive pressure ventilation up to 30cmH2O. (N&P ch 22, pg 451) 3. "intubating LMA", anatomically curved rigid airway tube, epiglottic elevating bar, guiding ramp into the floor of the mask aperture. Can be utilized with a fiberoptic bronchoscope. (N&P ch 22, pg 451) 4. comes with removable sylet to stabilize the ETT while the laryngeal mask is removed. (N&P ch22, pg 452)

a. LMA - 1 b. ProSeal and Supreme LMA - 2 c. Fastrach LMA - 3 d. ILA and AirQ - 4 Kaitlin

3. Which of the following is not a clinical effect of Ketamine a. Lacks any analgesic effects b. Causes amnesia c. Causes nystagmus d. Increases muscle tone

a. Lacks any analgesic effects N & P pg. 116 Charlie

What clinical characteristics of Morphine make it less useful for intraoperative use? (Select all that apply, select 3) a. Large patient variability b. Myocardial depression c. Lack of analgesic and sedative properties d. Delayed onset e. Delayed peak effect

a. Large patient variability d. Delayed onset e. Delayed peak effect (N&P pg 153) Lake

Drugs that are free, unbound to plasma proteins, and lipid soluble easily cross plasma membranes and therefore have __________ with __________? (Select 2) a. Large volumes of distribution b. Low volumes of distribution c. High plasma concentrations d. Low plasma concentrations

a. Large volumes of distribution d. Low plasma concentrations NP: 68 Byron

2. What is the breakdown product of atracurium as a result of Hofmann elimination? a. Laudanosine b. Atracurium-6 c. Mono-atracurium bromide d. Arachidonic acid

a. Laudanosine Willie M&M 216

3. Which of the following are requirements of ancillary personnel for areas of anesthesia deliver? a. Life support b. Volatile blood gas partition coefficients c. Volatile oil gas partition coefficients d. Meyer-Overton rule (increase lipid solubility causes increased potency

a. Life support Nagelhout page 1265 David

The graded dose response curve is plotted in what fashion? a. Linear b. Radical c. 3D d. Symmetrical

a. Linear Fieber N&p Pg 56

1. Which of the following are routes of metabolism of etomidate? a. Liver by hepatic microsomal enzymes b. Plasma esterases c. Excreted in urine d. 1st pass lung effect Nagelhout Page 110

a. Liver by hepatic microsomal enzymes b. Plasma esterases Nagelhout page 110 Budenbender

Class A Mandibular Protrusion test is defined as? a. Lower incisors can be protruded anterior to the upper incisors b. The lower Incisors can be brought edge to edge with the upper incisors c. The lower incisors cannot be brought edge to edge with the upper incisors d. None are true

a. Lower incisors can be protruded anterior to the upper incisors M&M pg 435 Adam

3. What does a line isolation monitor measure? a. Measures the potential for current flow from the isolated power supply to the ground. b. Measures the interference from other medical equipment c. Measures contact with the patient d. Measures the voltage difference between two points in an electrical circuit

a. Measures the potential for current flow from the isolated power supply to the ground. M&M page 18 Franklund

5. Which of the following is the mechanism of action and result of Clonidine? a. Mechanism of action - stimulation of central α2 causing anti-hypertension b. Result - diminished sympathetic outflow and decrease in circulating catecholamines and renin activity c. Mechanism of action - antagonism of central α2 causing anti-hypertension d. Result - increased sympathetic outflow and decrease in circulating

a. Mechanism of action - stimulation of central α2 causing anti-hypertension b. Result - diminished sympathetic outflow and decrease in circulating catecholamines and renin activity Nagelhout Chapter 13 Page 192 David Budenbender

4. On a graphic description of the dose-response relationship curve, according to Gaussian distribution curve, where would the greatest percentage of individuals fit on the curve? a. Median, median, and mode b. Mean only c. Median only d. Mode only

a. Median, median, and mode Nagelhout 5 Page 55 "Theoretically, the numbers of respondents on both sides of the mean (average dose) are equal, with the greatest percentage of individuals responding near the center of the curve. See Figure 5-2 Budenbender

3. Acute cyanide toxicity is characterized by which of the following: a. Metabolic acidosis b. Cardiac arrhythmias c. Decreased venous oxygen content d. All of the above

a. Metabolic acidosis b. Cardiac arrhythmias Reference: M&M pg 258 Mandy

3. Which intercostal space is V4 lead placed? a. Mid-clavicular line at the 5th intercostal space b. Axillary line at the 5th intercostal space c. Horizontal to the V5 on the midaxillary line d. Horizontal to V7 below the left scapula

a. Mid-clavicular line at the 5th intercostal space Nagelhout p. 296 Table 16-2 Budenbender

5. What drug would you administer to offset ketamine's hallucinogenic effects? (Select one) a. Midazolam b. Rocuronium c. Thiopental d. Morphine

a. Midazolam Jason [M&M p.182]

3.Minor risk factors of perioperative cardiovascular risk include all of the following except? a. Mild angina pectoris b. Afib c. Advanced age d. Inability to climb one flight of stairs

a. Mild angina pectoris Jason [N&P p.204]

4. What is the correct pathway (least to most) for the continuum of depth of sedation? a. Minimal sedation (Anxiolysis), Moderate sedation/analgesia (conscious sedation), Deep sedation/Analgesia, Anesthesia (general anesthesia) b. Anesthesia (general anesthesia), Minimal sedation (Anxiolysis), Moderate sedation/analgesia (conscious sedation), Deep sedation/Analgesia c. Minimal sedation (Anxiolysis), Moderate sedation/analgesia (conscious sedation), Anesthesia (general anesthesia), Deep sedation/Analgesia d. Anesthesia (general anesthesia) there is only one

a. Minimal sedation (Anxiolysis), Moderate sedation/analgesia (conscious sedation), Deep sedation/Analgesia, Anesthesia (general anesthesia) Nagelhout page 1266 David

5. What are examples of two dihydropyridine calcium channel blockers that are arterial selective vasodilators routinely used for perioperative blood pressure control in patients undergoing cardiothoracic surgery? (Select 2) a. Nicardipine b. Clevidipine c. Cardiziem d. Amlodipine

a. Nicardipine b. Clevidipine M&M Chapter 15, pg 261 Jennifer

What gas when abruptly discontinued at the end of case can cause diffusion hypoxia? a. Nitrous Oxide b. Desflurane c. Isoflurane d. Sevoflurane

a. Nitrous Oxide Nagelhout and Plaus page 82 Crouse

4. Which inhaled agent is ideal for use with assisted reproductive technologies? N&P pg 1247 a. Nitrous oxide b. Sevoflurane c. Desflurane d. Halothane

a. Nitrous oxide N&P PG1247 Adam Fieber

3. Succinylcholine administration results in a transient potassium increase of? a. O.5-1.0 mEq/L b. 0.3-0.5 mEq/L c. 3.5-5.5 mEq/L d. 5.5-6.5 mEq/L

a. O.5-1.0 mEq/L N&P p. 169 Jason

1. Which of the following is NOT a contraindication to the administration of succinylcholine? a. Obesity b. Hyperkalemia c. Non-emergent pediatrics d. Malignant Hyperthermia

a. Obesity N&P p. 167 Jason

Which of the following are indicative of increased airway pressures? a. Obstruction or kink in ETT b. Increase in pulmonary compliance c. Breathing circuit leak d. Accidental extubation

a. Obstruction or kink in ETT M&M, pg. 333 Lexi

Which of the following solubility coefficients is an indicator of an anesthetic's potency? a. Oil/Gas Solubility Coefficient b. Blood/Gas Solubility Coefficient c. Fat/Blood Solubility Coefficient d. Brain/Blood Solubility Coefficient

a. Oil/Gas Solubility Coefficient NP 82 Byron

3. Which of the following statements regarding opioids is most correct: a. Opioids have a narrow therapeutic window b. Opioids can be safely given to intubated patients regardless of the dose since the airway is controlled. c. Older patients require lower doses of opioids to control post-surgical pain d. Opioids and their metabolites are excreted primarily by the liver

a. Opioids have a narrow therapeutic window c. Older patients require lower doses of opioids to control post-surgical pain Reference: N&P pg 148 Mandy

How will placing a blood pressure cuff too loosely affect the estimate of the actual blood pressure? N&P pg 306 a. Overestimates the actual blood pressure. b. Underestimates the actual blood pressure. c. Causes intense pain to the patient. d. Low MAP

a. Overestimates the actual blood pressure. N&P pg 306 BIEBER

PADP correlates with what other hemodynamic measurement? N&P pg 302 a. PAOP b. LVEDP c. LVESP d. PASP

a. PAOP N&P pg 302 BIEBER

3. Which of the following modalities are used for imaging and detection of malignant disease, neurologic function, and cardiovascular disease? a. PET scan b. fMRI scan c. CT scan d. Interventional cardiac and neuro radiotherapy

a. PET scan Reference: N&P pg 1284 Mandy

In neonates, supplemental O2 is indicated when PaO2 is < 50 mmHg or SaO2 is < 88%. Which of the following parameters indicates the need for supplemental O2 for adults, children and infants > 1 month? a. PaO2 < 60 mm Hg, SaO2 or SpO2 < 90 % at rest on RA b. PaO2 < 50 mm Hg, SaO2 or SpO2 < 88 % at rest on RA c. PaO2 < 45 mm Hg, SaO2 or SpO2 < 85 % at rest on RA d. PaO2 < 40 mm Hg, SaO2 or SpO2 < 80 % at rest on RA

a. PaO2 < 60 mm Hg, SaO2 or SpO2 < 90 % at rest on RA M&M page 1281 Krum

Select 5 different types of non-invasive blood pressure monitoring methods. a. Palpation b. Rectal c. Auscultation d. Oscillometry e. Sublingual f. Arterial Tonometry g. Axillary h. Temporal i. Doppler

a. Palpation c. Auscultation d. Oscillometry f. Arterial Tonometry i. Doppler M&M page 89-90 Krum

5. The excretion of Drugs from the kidneys involves what three elements? N&P Pg 74 a. Passive GFR b. Active tubular secretion c. Reabsorption d. protein binding

a. Passive GFR b. Active tubular secretion c. Reabsorption Fieber N&P Pg 74

Though continuous opioid administration has shown favor over bolus dosing, what factors still remain true regarding the titration and administration of a continuous infusion of opioid? (Select 2) a. Patients response to the infusion may require discontinuing it. b. Because it's "safer" it doesn't need to be monitored. c. All patients respond differently and should be assessed regularly to avoid overdose or underdose. d. The fact that it is PCA driven will assist when the anesthetist is busy, especially during deep general anesthesia.

a. Patients response to the infusion may require discontinuing it. c. All patients respond differently and should be assessed regularly to avoid overdose or underdose. Nagelhout and Plaus page 152 Krum

3. Drugs like lidocaine, Morphine and Verapamil (high-clearance drugs) have a High extraction ratio of 0.7 or greater. These drugs rely heavily on _____ of the liver to be cleared? N&P pg 73 a. Perfusion b. temperature c. protein binding d. diet

a. Perfusion Fieber N&P pg 73

Hydralazine lowers ____ causing a drop in arterial blood pressure a. Peripheral vascular resistance b. Systemic vascular resistance c. Diastolic blood pressure d. Systolic blood pressure

a. Peripheral vascular resistance M&M Chapter 15, pg. 260 Jennifer

2.Which of the following surgeries has the highest cardiac risk? a. Peripheral vascular surgery b. Carotid endarterectomy c. Intrathoracic surgery d. Head and neck surgery

a. Peripheral vascular surgery Jason [N&P p.204]

4. What is the primary effect of phenylephrine? a. Peripheral vasoconstriction with a concomitant rise in SVR and arterial BP b. Peripheral vasoconstriction with a concomitant drop in SVR and arterial BP c. Peripheral vasoconstriction with a concomitant rise in SVR and decrease in arterial BP d. Peripheral vasodilation with a concomitant rise in SVR and arterial BP

a. Peripheral vasoconstriction with a concomitant rise in SVR and arterial BP Morgan & Mikhail p 245 Budenbender

4. Ketamine is related structurally to what drug of abuse? (Select one) a. Phencyclidine b. Cocaine c. Tetrahydrocannabinol d. Methylenedioxymethamphetamine

a. Phencyclidine Jason [M&M p.182]

1. Sodium nitroprusside contains five cyanide ions within its chemical structure. These ion on are released when metabolized by? N&P pg198 a. Plasma hemoglobin b. Ester hydrolysis c. Kidney metabolism d. Lung excretion

a. Plasma hemoglobin Fieber

Draw over anesthesia is a form of anesthetic delivery with what properties? a. Portable, low resistance to gas flow, usable with any agent, and vapor output control b. Stationary, high resistance to gas flow, compatible with N2O only, with no control of vapor output

a. Portable, low resistance to gas flow, usable with any agent, and vapor output control Morgan and Mikhail's page 32 Krum

2. Which type of heat loss is responsible for the majority encountered by patients undergoing surgery? a. Radiant heat loss b. Evaporative c. Convective d. Conductive

a. Radiant heat loss N&P page 321 Willie

1. Which of the following is considered the most significant mechanism of heat loss? a. Radiation b. Convection c. Conduction d. Evaporation

a. Radiation N & P, page 222 Willie

3. In a plasma concentration curve, what is noticed during the distribution phase of a highly lipid soluble drug. a. Rapid distribution to peripheral compartment and rapid fall in plasma concentration b. Same curve as a hydrophilic medication c. Plasma concentration is maintained high until drug is eliminated in the urine d. This curve does not accurately reflect plasma concentration changes in lipid soluble drugs

a. Rapid distribution to peripheral compartment and rapid fall in plasma concentration N & P pg. 69 Charlie

2. What is the correct reason for clearance not being a factor with ester compounds? a. Rapidly broken down in plasma and tissue so clearance is NOT a factor b. Clearance is always a important factor c. All ester local anesthetics have to be cleared by the kidneys d. They are not rapidly broken down in plasma and tissue

a. Rapidly broken down in plasma and tissue so clearance is NOT a factor N page 134 David

2. The sleep doses of highly lipid soluble barbiturates and Methohexital is determined by? M&M pg176 a. Redistribution b. Absorption c. Excretion d. Clearance

a. Redistribution Fieber

4. What process accounts for Esmolol's ultra-short acting duration of effect? (Select 2) M&M pg250 a. Redistribution b. Hydrolysis by red blood cell esterase c. Renal elimination d. Elimination by the lungs

a. Redistribution b. Hydrolysis by red blood cell esterase Fieber

2. Beta 2 stimulation causes _____ of smooth muscles causing ______ and ________. a. Relaxation, bronchodilation, vasodilation b. Constriction, vasoconstriction, bronchoconstriction c. Relaxation, bronchoconstriction, vasoconstriction

a. Relaxation, bronchodilation, vasodilation i. M&M pg 242 Rebecca

Which of the following should be done postoperatively by the anesthesiologist? (Select all that apply) a. Remain with the patient until normal vital signs have been measured b. Document the patient's recovery from anesthesia c. The patient's disposition d. None of the above

a. Remain with the patient until normal vital signs have been measured b. Document the patient's recovery from anesthesia c. The patient's disposition M&M pg. 304 Jennifer

3. SVO2 is determined by all of the following EXCEPT? a. Renal function b. Pulmonary function c. Cardiac function d. Oxygen Delivery e. Tissue perfusion f. Oxygen consumption g. Hemoglobin concentration

a. Renal function NP p. 306 Jason

2. Which of the following is NOT a neurophysiological parameter measured during surgery? a. Respirations b. Brain function c. Blood flow d. Metabolism

a. Respirations Jason NP p. 325

2. What medication would NOT be appropriate to administer for electroconvulsive therapy (ECT)? (Select one) a. Rocuronium b. Glycopyrrolate c. Ketorolac d. Etomidate

a. Rocuronium [N&P p. 1279] Jason

2. Clonidine stimulates inhibitory neurons predominantly in the final common pathway located in _____________, which decreases sympathetic outflow. a. Rostral Ventrolateral Medulla b. Apneustic Centers of Pons c. Pneumotaxic Penter of Pons d. Cerebellum

a. Rostral Ventrolateral Medulla M&M Ch. 17 Pg. 287 Mark Thetford

When a Graded dose response curve is plotted on a logarithmic scale it takes an ___ Shape. N&P Pg. 56 a. S b. C c. Lateral d. Parallel

a. S Fieber N&P Pg. 56

3. Which of the following is a form of IMV a. SIMV b. CIMV c. PIMV d. IMVV M&M, ch 57 pgs 1291

a. SIMV Mbom

Filtering capacity of the ECG monitor is a potential source of artifact. Filtering out the low end of the frequency bandwidth of the electrical signal can lead to the following types of distortion, and therefore the diagnostic mode of the monitor should be used whenever ST-analysis is a priority. (Select 3). a. ST Segment Elevation b. ST Segment Depression c. Peaked T Waves d. T Wave Inversion

a. ST Segment Elevation b. ST Segment Depression d. T Wave Inversion NP 297 Byron

4. What is the onset time of Nitroprusside? N&P pg 199 a. Seconds b. 1-2 min c. 2-5 min d. 15 min

a. Seconds Fieber

5. Muscle relaxing agents should NEVER be used without __________? a. Sedation b. Antimuscarinic c. Anticholinergic d. None of the above

a. Sedation Reference: N&P pg 182 Mandy

3. Which of the following are side effects of Phenergan can complicate the postoperative period? (pick 4) (M&M pg 285) a. Sedation b. Delirium c. Nausea d. Muscle rigidity e. Confusion f. Vision changes

a. Sedation b. Delirium e. Confusion f. Vision changes

The medications prazosin, doxazosin, and terazosin are classified as what type of medications? a. Selective alpha-1 antagonists b. Nonselective alpha antagonists c. Selective alpha-2 antagonists d. Selective alpha-2 agonists

a. Selective alpha-1 NP: 192 Byron

4. Which of the following identifies an important reason for performing an abbreviated neurological exam before administering regional anesthesia? (Pick 2) a. Serves as a baseline to identify deficits before a block is performed. b. Protection against litigation c. For the diagnosis of neurological diseases d. Patient request

a. Serves as a baseline to identify deficits before a block is performed. b. Protection against litigation (M & M, p. 300) Willie

2. Which inhalational anesthetic causes the least vasodilation? a. Sevoflurane b. Isoflurane c. Desflurane d. Nitrous Oxide

a. Sevoflurane N&P p. 93 Jason

5. What two agents are associated with emergence delirium/agitation in children? N&P pg 91 a. Sevoflurane and Desflurane b. Desflurane and Isoflurane c. Isoflurane and Sevoflurane d. N20 and Halothane

a. Sevoflurane and Desflurane N&P pg 91 Fieber

In regards to inhalational anesthetic pharmacokinetics, a volatile anesthetic with a higher blood/gas solubility coefficient will have a ______ onset compared to a volatile anesthetic with a lower blood/gas solubility coefficient. a. Slower b. Equal c. Faster

a. Slower NP 82 Byron

What effect does ventilation-perfusion abnormalities have on volatile anesthetics? a. Slows speed of onset b. Increase rate of uptake c. Decreases MAC requirements d. Has no effect on volatiles

a. Slows speed of onset Nagelhout and Plaus page 82 Crouse

A highly potent drug is associated with what type of dosing for drug effect? a. Small b. Large c. The dose amount varies d. There is no correlation with potency and drug dose for effect

a. Small M&M - pg. 150 Lexi

What is indicated by the presence of the first twitch of the train-of-four when assessing NMB administration? a. Spontaneous recovery has occurred b. You need another large dose c. Its time to extubate d. Give fentanyl

a. Spontaneous recovery has occurred M&M pg 227 Lake

Bonus Question from Nagelhout*** 6. Who wrote the lyrics to the song, "Every Breath you take, every move you make...I'll be watching you?" a. Sting b. Bon Jovi c. The Police d. Huey Lewis

a. Sting NP p. 313 Jason

5. What is the ONLY remaining DEPOLERIZING muscle relaxant licensed for use in the United States? N&P pg 163 a. Succinylcholine b. Atracurium c. Pancuronium d. Vecuronum

a. Succinylcholine N&P pg163 Fieber

1. What is one of the reasons radiologists are moving towards the trend of general anesthesia for interventional radiology cases? a. Superior imaging is obtained from motionless patients. b. The use of local anesthetic injections distort precise radiographic imaging of tissues. c. Both are true d. Neither are true

a. Superior imaging is obtained from motionless patients. Reference: N&P pg 1284 Mandy

5. What can lead to the dysfunction of a pacemaker in the operating room? a. Surgical diathermy b. Magnet c. 12 lead EKG d. Improper placement of electrodes

a. Surgical diathermy M&M page 20 Franklund

1. What is the most widely used means of stimulation to check neuromuscular blockade? N&P pg 161 a. TOF b. Single twitch c. Double burst d. Posttetanic count

a. TOF N&P pg 161 Fieber

2. What is Minimal Alveolar concentration (MAC)? a. The MAC required to achieve surgical anesthesia (immobility) in 50% of patients exposed to a noxious stimulus b. The MAC suppressing appropriate response to commands in 50% of patients; memory is usually lost at MAC-awake; approximately 0.3-0.5 MAC c. The alveolar concentration of anesthetic that blunts the autonomic response to noxious stimuli; approximately 1.6-2.0 MAC d. The greater the alveolar ventilation, the faster the patient achieves anesthesia

a. The MAC required to achieve surgical anesthesia (immobility) in 50% of patients exposed to a noxious stimulus Budenbender Nagelhout 82

4. The Use of PTC (posttetanic count) is rarely used clinically but may be used when there is no response to any of the commonly used test due to presence of 100% paralysis. The Use of PTC has value to determine? N&P 163 a. The estimated time as to when recovery will occur b. If the patient will ever wake up c. If you shock the crap out of them they will wake up. d. It makes us feel good to see something

a. The estimated time as to when recovery will occur N&P pg163 Fieber

2. Which of the following most accurately describes core temperature redistribution? a. The process of increased heat loss resulting from the vasodilating effects of volatile and regional anesthetics. b. Results from vasoconstriction that occurs when the ambient temperature is lower than the core temperature. c. Changes that occur as a result of pain stimulation originating from the CNS. d. Occurs as a result of increased metabolic demands causing increased CO2 production.

a. The process of increased heat loss resulting from the vasodilating effects of volatile and regional anesthetics. N & P, page 222 Willie

Which of the following best define the Doppler Effect? a. The shift in the frequency of sound waves when their source moves relative to the observer, like a train's whistle. b. The shift in the amplitude of sound waves when their source moves relative to the observer, like a train's conductor. c. The shift in the frequency of light waves when their source moves relative to the observer, like a train's lantern. d. The shift in the amplitude of light waves when their source moves relative to the observer, like a train's wheel.

a. The shift in the frequency of sound waves when their source moves relative to the observer, like a train's whistle. M&M page 89 Krum

4. Which of the following is responsible of for the effect of myoclonus: a. The uneven drug distribution into the brainstem or deep cerebral structures and NOT to CNS stimulation b. The uneven drug distribution into the brainstem or deep cerebral structures and increase to CNS stimulation c. The uneven drug distribution into the brainstem or deep cerebral structures and to CNS stimulation d. The uneven drug distribution into the brainstem or deep cerebral structures

a. The uneven drug distribution into the brainstem or deep cerebral structures and NOT to CNS stimulation Nagelhout page 111 Budenbender

Hazards of heated active humidifiers include which of the following? a. Thermal lung injury if inhaled gas temperatures exceed 41*C. b. Increased risk of hypothermia. c. Nosocomial infection. d. Interference with flowmeter function e. Increased risk of disconnect from circuit. f. Inaccurate pulse oximetry.

a. Thermal lung injury if inhaled gas temperatures exceed 41*C. c. Nosocomial infection. d. Interference with flowmeter function e. Increased risk of disconnect from circuit. (M&M Page 71) Mark

1. What medications were frequently administered IV for induction prior to the use of Propofol? (Select 3) MM pg176 a. Thiopental b. Thiamylal c. Methohexital d. Vecuronium

a. Thiopental b. Thiamylal c. Methohexital Fieber

The quantal dose response curve describes the Variation in response to the ______ dose within a population of seemingly similar individuals. a. Threshold b. Sub-threshold c. Minute d. Amount

a. Threshold Fieber N&P pg 57

2. The key to predicting, avoiding, and managing unforeseen reactions to anesthesia and surgery is? a. Timely human response b. Reliable monitors c. Accurate sensors d. Audible alarms

a. Timely human response NP p. 313 Jason

5. Which of the following is not true about CO2 lasers? NP ch 14 pg238 a. Tissue penetration< 10mm b. Highly absorbed by water c. Good for superficial lesions d. Used for airway surgeries

a. Tissue penetration< 10mm Mbom

3. Why should hyperventilation be used cautiously in patients with increased ICP? a. To avoid hypercarbia induced cerebral compromise b. To aid in further increasing ICP c. It should not be used cautiously because there is no effect.

a. To avoid hypercarbia induced cerebral compromise N&P pg 107 Rebecca

2. What diagnostic tool to assess cardiac function is utilized in the OR due to limited access to the chest? a. Transesophageal echocardiography b. Transthoracic Echocardiography c. Neither A or B

a. Transesophageal echocardiography M&M Ch. 5 Pg. 114 Mark

Which of the following causes of difficult intubation falls under the congenital anomalies category of conditions associated with difficult intubation? a. Treacher Collins Syndrome b. Congenital Tetrology c. Meningocele d. Omphalocele

a. Treacher Collins Syndrome M&M, pg. 336 Lexi

3. Volatile agents produce a decreased CMRO2 while accompanied by increases in CBF ______ is said to occur? a. Uncoupling b. Masking c. Coupling d. Stokes

a. Uncoupling N&P pg 89 Fieber

4. If the line isolation alarm is going off, what should you do? a. Unplug the last piece of equipment plugged in b. Turn off the ventilator c. Do nothing and notify bio-med after the surgery is completed d. Silence the alarm

a. Unplug the last piece of equipment plugged in M&M page 19 Franklund

1.Which of the following is considered a major risk factor of increased perioperative cardiovascular risk? a. Unstable angina b. Diabetes mellitus c. Advanced age d. Renal insufficiency

a. Unstable angina Jason [N&P p.204]

A cardiac pacemaker is used to treat all of the following except a. V Fib b. AV block c. Sinus nodal dysfunction d. Chronic symptomatic bradycardia

a. V Fib N&P pg. 1269 Charlie

Synchronized cardioversion can be used in all of the following cardiac dysrhythmias except a. V-fib b. A-fib c. A-flutter d. V-tach

a. V-fib N&P pg. 1269 Charlie

It has been found that patients who experience sudden cardiac death most commonly have the following two rhythms as an underlying rhythm. a. Ventricular Tachycardia b. Pulseless Electrical Activity c. Ventricular Fibrillation d. Supraventricular Tachycardia

a. VT c. VF NP: 1268 Byron

5. Activation of D1 receptors causes a. Vasodilation in the kidney, intestine, and heart b. Vasoconstriction in the kidney, intestine and the heart c. No effect on the kidney, intestine, and the heart

a. Vasodilation in the kidney, intestine, and heart i. M&M pg243 Rebecca

5. Which of the following depicts the percent of CO received by each tissue group. a. Vessel rich (75%), Muscle (19%), Fat (6%), Vessel poor (<1%) b. Vessel rich (50%), Muscle (25%), Fat (12.5%), Vessel poor (12.5%) c. Vessel rich (70%), Muscle (25%), Fat (5%), Vessel poor (<1%) d. Vessel rich (80%), Muscle (15%), Fat (5%), Vessel poor (< 1%)

a. Vessel rich (75%), Muscle (19%), Fat (6%), Vessel poor (<1%) M&M, Ch. 8, pg. 156 Willie

3. According to Standard V of the AANA Scope and Standards for Nurse Anesthesia Practice, what is the basis of practicing safe anesthesia? a. Vigilant monitoring b. Timely emergence c. Audible alarms d. Accurate charting

a. Vigilant monitoring NP p. 313 Jason

The monitoring site/method of optic nerve evoked potentials is? a. Visual evoked potentials b. Vocal cords c. Auditory brainstem responses d. No monitory technique available N&P Ch 18 pg 332

a. Visual evoked potentials Mbom

2. Which of the following statements are INCORRECT regarding the renal system? a. Blood urea nitrogen (BUN) concentrations, accurately reflex glomerular filtration rate (GFR) b. BUN levels are affected by the amount of protein ingested in the gastrointestinal tract c. BUN levels are affected by the amount of urea metabolized by the liver d. BUN is affected by the catabolic state of the patient

a. a. Blood urea nitrogen (BUN) concentrations, accurately reflex glomerular filtration rate (GFR) Naglehout & Plaus Page 366 ""Blood urea nitrogen (BUN) concentrations for example, do NOT accurately reflect glomerular filtration rate (GFR)." David Budenbender

Neuromuscular transmission relies on what chemical to bind to receptors on the motor end plate? a. acetylcholine. b. epinephrine. c. anectine. d. dopamine.

a. acetylcholine. M&M page 225 Krum

Hydralazine relaxes arteriolar smooth muscle, causing dilation of precapillary resistance vessels via increasing what second messenger? a. cGMP b. cAMP c. protein kinase A d. aAPK

a. cGMP M&M Chapter 15, pg. 260 Jennifer

Select all of the following gastrointestinal effects of opiods. (Select 3) a. decrease GI motility and peristalsis, while reducing secretory activity b. increase GI motility and peristalsis, while increasing secretory activity c. constipation and post-op ileus d. diarrhea and bowel cleansing e. dose-dependant increase in biliary duct pressure, sphincter of Oddi and urinary sphincter tone f. dose-dependant decrease in biliary duct pressure, sphincter of Oddi and urinary sphincter tone

a. decrease GI motility and peristalsis, while reducing secretory activity c. constipation and post-op ileus e. dose-dependant increase in biliary duct pressure, sphincter of Oddi and urinary sphincter tone Nagelhout and Plaus page 151 Krum

Select all of the following endocrine effects of opiods. (Select 3) a. decrease surgical stress response and suppress immune system b. increase surgical stress response and activates immune system c. stimulates the release of vasopressin and inhibits release of corticotropin and gonadotropin d. inhibits the release of vasopressin and stimulates release of corticotropin and gonadotropin e. decreases the basal metabolic rate and temperature with chronic use f. increases the basal metabolic rate and temperature with chronic use

a. decrease surgical stress response and suppress immune system c. stimulates the release of vasopressin and inhibits release of corticotropin and gonadotropin e. decreases the basal metabolic rate and temperature with chronic use Nagelhout and Plaus page 151 Krum

1. A difficult airway cart should contain all of the following except? a. defibrillator b. tube exchanger c. needle cricothyrotomy set d. stethoscope

a. defibrillator NP: 441 Jason

5. Which of the following cranial nerves does not need to be anesthetized to perform an awake oral or nasal intubation? a. facial b. trigeminal c. glossopharyngeal d. vagus

a. facial NP: 446 Jason

Select all of the following neuraxial effects of opiods. (Select 3) a. greater occurrence of pruritus and urinary retention as compared to systemic administration b. less occurrence of pruritus and urinary retention as compared to systemic administration c. greater risk of respiratory depression from low lipid soluble drugs (d/t migration of the drug to the brainstem) d. greater risk of respiratory depression from high lipid soluble drugs (d/t migration of the drug to the brainstem) e. increased occurrence of nausea and vomiting post-op f. decreased occurrence of nausea and vomiting post-op

a. greater occurrence of pruritus and urinary retention as compared to systemic administration c. greater risk of respiratory depression from low lipid soluble drugs (d/t migration of the drug to the brainstem) e. increased occurrence of nausea and vomiting post-op Nagelhout and Plaus page 151 Krum

In a study of participants up to 16 years of age, SBP has been shown to be _______ in the thigh and calf than in the arm, with DBP and MAP being _______ in the calf and thigh than in the arm. Patients most likely to exhibit inter-arm BP differences are those who are obese and have a higher HR and SBP. a. Greater, Lower b. Lower, Greater c. Greater, Greater d. Lower, Lower

a. greater, lower (N&P ch16, pg307) Kaitlin

The receptor responsible for neuromuscular transmission at the motor end plate is... a. nicotinic cholinergic. b. alcoholic adrenergic. c. cannabis alphanergic. d. all of the above.

a. nicotinic cholinergic. M&M page 225 Krum

Fill in the blanks- The goal of neuromuscular blockade reversal is to maximize _____ transmission with minimize _____ side effects. a. nicotinic, muscarinic. b. muscarinic, nicotinic. c. efferent, afferent. d. sedation, alertness.

a. nicotinic, muscarinic. M&M page 224 Krum

What are some properties of draw-over devices? (Select all that apply) a. portable b. high resistance to gas flow c. usable with any agent d. controllable vapor output

a. portable c. usable with any agent d. controllable vapor output M&M pg. 32, table 3-1 Jennifer

4. All of the following medications are appropriate for facilitating awake intubation except? a. succinylcholine b. midazolam c. bicitra d. lidocaine 2%

a. succinylcholine NP: 445 Jason

4. What are some respiratory effects seen with the administration of propofol? Select 2 a. Transient respiratory depression b. Decrease in tidal volume c. Increase in respiratory rate d. Increase in tidal volume

a. transient respiratory depression b. decrease in tidal volume N&P pg 108 Rebecca

4.) How much positive pressure is associated with increased risk for barotrauma if sustained for to long? a.) (>30 mm Hg) b.) (<30 mm Hg) c.) (<15 mm Hg) d.) Between 15-30 mm Hg

a.) (>30 mm Hg) M&M page 79 Zino

5.) How can opioid analgesia be spared in patients who receive naloxone? a.) By giving small doses that are required to maintain adequate ventilation b.) By giving the max dose c.) By giving naloxone until the patient is fully awake d.) All of the above M&M page 289

a.) By giving small doses that are required to maintain adequate ventilation Zino

5.) What type of laser is mainly used in airway surgeries? a.) CO2 laser b.) YAG laser c.) Argon laser d.) KTP laser

a.) CO2 laser N&P page 238 Zino

1.) Select the muscles that recover sooner from neuromuscular blockade than the adductor pollicis. (select 4) a.) Diaphragm b.) Rectus abdominis c.) Orbicularis oculi d.) Laryngeal adductors e.) None of the above

a.) Diaphragm b.) Rectus abdominis c.) Orbicularis oculi d.) Laryngeal adductors M&M page 139 Zino

1.) Which of the following drugs is a specific and competitive antagonists of benzodiazepines at the benzodiazepine receptors? a.) Flumazenil b.) Narcan c.) Naloxone d.) None of the above M&M page 290

a.) Flumazenil Zino

1.) What is the classic complication associated with COX-1 inhibition from NSAIDs? a.) Gastrointestinal upset b.) Cough c.) Decreased bleeding d.) No complications

a.) Gastrointestinal upset M&M page 198 Zino

4.) What is the dosage for flumazenil? a.) Gradual titration IV 0.2 mg/min until a total of 0.6-1.0 mg is reached. b.) Rapid injection of 1 mg c.) Orally until the patient awakens d.) IM injection of 5 mg one-time dose M&M page 290

a.) Gradual titration IV 0.2 mg/min until a total of 0.6-1.0 mg is reached. Zino

5.) When giving glycopyrrolate intramuscularly, the anesthesia provider expects the heart rate to? a.) Heart rate remains unchanged b.) Speeds up c.) Slows down d.) None of the above M&M page 236

a.) Heart rate remains unchanged M&M page 236 Zino

5.) COX-2 receptors are produced in response to what? a.) Inflammation b.) Cold c.) Heat d.) Doesn't respond to anything

a.) Inflammation M&M page 197 Zino

2.) What is the recommendation for inflating the endotracheal cuff when using a laser? a.) Inflate with methylene blue and NS b.) Inflate with 100% oxygen c.) Inflate with nitrous oxide d.) Leave deflated

a.) Inflate with methylene blue and NS N&P page 239 Zino

3.) What unique feature differs glycopyrrolate from atropine in that it cannot cross the blood brain barrier? a.) It's a quaternary amine b.) It's a tertiary amine c.) Isn't different from atropine d.) None of the above M&M page 236

a.) It's a quaternary amine M&M page 236 Zino

2.) How much should you inflate the TT cuff? a.) Minimum occlusive pressure b.) > 20 mm Hg c.) 5 mm Hg d.) 30 mm Hg

a.) Minimum occlusive pressure M & M page 334- Zino

3.) Which of the following drugs is a pure opiod antagonist with a high affinity for mu receptor? a.) Naltrexone b.) Flumazenil c.) Benzo's d.) Thiopental M&M page 290

a.) Naltrexone Zino

3.) What three key elements are needed to produce a fire? (select 3) a.) Oxygen b.) Fuel c.) Igniter source d.) Only oxygen

a.) Oxygen b.) Fuel c.) Igniter source N&P page 239 Zino

2.) What can be given to neonates in order to facilitate closer of the ductus arteriosus? a.) Prostaglandin inhibitors b.) NSAIDs c.) Opioids d.) Iron

a.) Prostaglandin inhibitors M&M page 197 Zino

1.) When lasers are being used during the procedure, the patient should have which of the following? (select 2) a.) Saline pads placed on the eyes b.) Laser goggles c.) Regular goggles d.) Only eye tape

a.) Saline pads placed on the eyes b.) Laser goggles N&P page 238 Zino

1.) What type of bellows on the anesthesia machine are now preferred? a.) Standing bellows b.) Hanging bellows c.) Side Ways bellows d.) Weighted bellows

a.) Standing Bellows M&M page 76 Zino

4.) What is the FIRST action the anesthesia provider must take if an airway fire presents? a.) Stop oxygen flow b.) Extubate the patient c.) Pour water over the patient d.) Call for help

a.) Stop oxygen flow N&P page 239 Zino

5.) What are other indicators of adequate neuromuscular reversal? (select 3) a.) Sustained hid lift for >5 sec b.) Ability to generate negative inspiratory pressure of at least -25 cm h2O c.) Forceful hand grip d.) Wiggling of the toes

a.) Sustained hid lift for >5 sec b.) Ability to generate negative inspiratory pressure of at least -25 cm h2O c.) Forceful hand grip M&M page 139 Zino

In patients with what conditions would the use of ketamine as an induction agent be appropriate? (Select 3) a. Shock/Cardiovascular Instability b. Bronchospasm c. Hypovolemia d. Increased ICP

a.Shock/Cardiovascular Instability b.Bronchospasm c.Hypovolemia NP: 116 Byron

A thyromental distance of less than ____ cm or ____ ordinary fingerbreadths, is associated with higher incidence of difficult intubation. a. 4,7 b. 6,3 c. 7,4 d. 8,5

b. 6,3 N&P 432 Adam

A recent guideline developed by the American College of Physicians identifies patients ___ years of age or older, those with chronic obstructive lung disease, those with markedly reduced exercise tolerance and functional dependence, and those with heart failure as potentially requiring preoperative and postoperative interventions to avoid complications. a. 50 b. 60 c. 45 d. 40

b. 60 M&M pg. 298 Jennifer

Tidal volume is delivered in a double-circuit system design by means of... a. A weighted hanging bellows, dependent on gravity b. A bellows assembly that consists of a bellows in a clear rigid plastic enclosure c. The anesthesia circuit breathing bag d. Pressurized oxygen or air at 45-50 psi

b. A bellows assembly that consists of a bellows in a clear rigid plastic enclosure M&M - Ch. 4, p. 76 Lexi

1. The two-compartment model is described by: (M&M pg 148) a. A curve with three exponents and three coefficients b. A curve with two exponents and two coefficients c. A curve with four exponents and six coefficients d. A curve with five exponents and two coefficients

b. A curve with two exponents and two coefficients

Which type of patient would be considered as high risk for thrombosis, therefore their warfarin therapy should be replaced with IV heparin or more commonly, IM heparinoids to minimize the risk? (Select all that apply) a. A patient with an aortic valve replaced with a biological valve b. A patient with an aortic valve replaced with a mechanical valve c. A patient with afib with a prior thromboembolic stroke d. A patient with a history of PE but is now resolved

b. A patient with an aortic valve replaced with a mechanical valve c. A patient with afib with a prior thromboembolic stroke M&M pg. 298 Jennifer

1. Clonidine primarily activates which adrenergic receptors? a. A1 b. A2 c. B1 d. B2

b. A2 M&M Ch. 17 Pg. 287 Mark Thetford

Fenoldopam causes rapid vasodilation by what primary mechanism of action? a. Antagonism of D1-dopamine receptors b. Agonism of D1-dopamine receptors c. Nonselective antagonism of Beta receptors d. Alpha antagonist

b. Agonism of D1-dopamine receptors M&M pg 260 Lake

1. An esophageal Doppler calculates velocity of flow within which great vessel? a. Left Anterior Descending Artery b. Aorta c. Superior Vena Cava d. Inferior Vena Cava

b. Aorta M&M Ch. 5 Pg. 114 Mark

3. If neostigmine or edrophonium are used alone, what are some side effects that may occur?? a. Tachycardia b. Arrhythmias c. Hypotension d. Hypersalivation

b. Arrhythmias c. Hypotension d. Hypersalivation Reference: N&P pg 180

What TWO things should determine recovery from neuromuscular blockade? a. Patient's ability to generate a breath with at least -25 cmH2O pressure b. Assessment of the patient's clinical presentation c. Assessment of the patient's response to peripheral nerve stimulation d. Return of function of the patient's diaphragm and orbicularis oris muscles.

b. Assessment of the patient's clinical presentation c. Assessment of the patient's response to peripheral nerve stimulation M&M p. 139 Lexi

5. Which of the following co-morbidities is a contraindication for atracurium? a. CHF b. Asthma c. Recent MI d. Aortic stenosis

b. Asthma Willie M&M 216

4. With electrocardiogram monitoring, what is one way to compromise patient safety? a. Use multiple-ECG-lead display configuration options b. Become familiar with at least one lead or pair of leads, that way you are comfortable with information presented c. Viewing greater than two ECG leads while monitoring a patient d. Five-cable lead ECG

b. Become familiar with at least one lead or pair of leads, that way you are comfortable with information presented Nagelhout P 296 Budenbender

Describe blood flow related pressure in a patient with normal cardiac pathology. a. Flow from low to high pressure b. Flow from high to low pressure c. Maintains low pressure d. Maintains high pressure

b. Flow from high to low pressure M&M p. 118 Lexi

In regards to inhalational anesthetic pharmacokinetics, when using a more soluble volatile anesthetic, increases in cardiac output will have what effect on the onset of the anesthetic? a. Increase b. Decrease c. No Difference

b. Decrease NP 82 Byron

Vapor Pressure is... a. Inversely proportional to temperature b. Directly proportional to temperature c. Not proportional to temperature

b. Directly proportional to temperature Morgan and Mikhail's page 31 Krum

Fenoldopam mesylate causes rapid vasodilation by selectively activating what receptors? a. Alpha-1 receptors b. Dopamine-1 receptors c. Beta-2 receptors d. Beta-1 receptors

b. Dopamine-1 receptors M&M Chapter 15, pg 260 Jennifer

Which of he following conditions cause a left shift of the Oxyhemoglobin Dissociation curve? (Select all that apply, select 4) a. Elevated CO2 b. Elevated pH c. Decreased pH d. Decreased temperature e. Elevated 2, 3-DPG f. Decreased CO2 g. Decreased 2, 3-DPG

b. Elevated pH d. Decreased temperature f. Decreased CO2 g. Decreased 2, 3-DPG (N&P pg 319) Lake

Volume of distribution is a proportional expression that relates the amount of drug in the body to the serum concentration. It is calculated by dividing the dose of the drug administered intravenously by the plasma concentration, and is calculated prior to what pharmacokinetic principle occurring? a. Distribution b. Elimination c. Absorption d. Metabolism

b. Elimination NP: 68 Byron

What is the gold standard for determining successful intubation immediately after inserting the ETT? a. Chest rise b. End tidal CO2 c. Condensation d. 100% SaO2

b. End tidal CO2 M&M, pg. 333 Lexi

Which of the following is an example of a structural isomer? a. Sevofour and and Nitrous Oxide b. Enflurane and Isoflurane c. Desflurane and Halothane d. All of the following are structural isomers

b. Enflurane and Isoflurane (N&P pg 215) Lake

2. You have just administered versed intravenously to your patient. What should you do next before you leave the pre-operative area? (Select one) a. Remove the patient's SPO2 monitor b. Ensure resuscitation equipment is immediately available c. Turn off the monitor d. Have the patient sign the anesthesia consent

b. Ensure resuscitation equipment is immediately available Jason [M&M p.181]

1. Which of the following drugs does NOT undergo substantial first-pass elimination? a. Aspirin b. Etomidate c. Glyceryl trinitrate d. Lidocaine

b. Etomidate Nagelhout page 66 David Budenbender

While using low flows during the maintenance phase of anesthesia, the anesthetist notes that the patient's EtCO2 has been steadily increasing. The anesthetist believes it is due to exhausted absorbent granules, but is unable to exchange them during the case. True or false? An effective strategy to treat the resulting hypercarbia would be to increase the patient's minute ventilation. a. True b. False

b. False NP: 269 Matt Byron

1. What are 2 characteristics of Edrophonium? (Select 2) a. Slow onset b. Fast onset c. Long duration of action d. Short duration of action

b. Fast onset d. Short duration of action Willie M & M, page 230

5. Methemoglobinemia is an adverse reaction caused by some local anesthetics, which can lead to tissue hypoxia. This occurs due to oxidation of the _______ form of hemoglobin to the ________ form, resulting in reduced oxygen carrying capacity and a subsequent _____ shift in the oxygen-hemoglobin dissociation curve. (Select 2 to fill in the blank) a. Ferric (Fe3+) to Ferrous (Fe2+) b. Ferrous (Fe2+) to Ferric (Fe3+) c. Right d. Left

b. Ferrous (Fe2+) to Ferric (Fe3+) d. Left Byron NP 137

5. Which of the following insulin preparations has the longest duration? a. Utralente b. Glargine c. NPH d. 70/30 (NPH/Regular)

b. Glargine Nagelhout & Plaus Page 368 Table 19-13 & Page 369 "Glargine has a prolonged duration of 20 to 24 hours, but is unique that its activity without a significant peak." David Budenbender

The normal aging process results in changes to body composition, select the two that are most representative of this change. a. Decreased Adipose Tissue b. Increased Adipose Tissue c. Increased Aqueous Body Tissue d. Decreased Aqueous Body Tissue

b. Increased adipose tissue d. Decreased aqueous body tissue NP: 1268 Byron

What is a potential Genitourinary SE of cholinesterase inhibitors? a. ED b. Increased bladder tone c. Hesitancy d. Orange colored urine

b. Increased bladder tone M&M pg 227 Lake

Which of the following are expected cardiac responses to hydralazine? Select all that apply (select 3). a. Slowed heart rate b. Increased heart rate c. Decreased cardiac output d. Increased myocardial contractility e. Increased cardiac output

b. Increased heart rate d. Increased myocardial contractility e. Increased cardiac output M&M pg 260 Lake

What are some GI side effects of cholinesterase inhibitors? (Select all that apply select 3) a. Constipation b. Increased motility c. Fecal incontinence d. Dry mouth e. Increased salivary secretions

b. Increased motility c. Fecal incontinence e. Increased salivary secretions M&M pg 227 Lake

5. When the amount of exposure to a drug is increased, the response to the drug? a. Decreases b. Increases c. Shows no effect

b. Increases M&M Ch. 7 Pg. 149 Thetford

Cholinesterase inhibitors ________ increase the amount of acetylcholine that is available to compete with anticholinergic drugs. a. Directly b. Indirectly c. Do not d. Vary in their ability to

b. Indirectly M&M p. 237 Lexi

What group of anesthetics causes an effect on latency and amplitude of BAEPs proportional to the dose? (N&P pg 331) a. Nondepolarizers b. Inhalation agents c. Depolarizing NMBs d. Opiates

b. Inhalation agents (N&P pg 331) Lake

What is true concerning use of O2 flush valve? a. It is supplied at a pressure of 2200 psi b. It has the potential to cause lung barotrauma if used when patient is connected to the breathing circuit c. It should be used routinely throughout the case to increase patient O2 saturation d. It would be a good idea to use O2 flush to blow out any OR fires

b. It has the potential to cause lung barotrauma if used when patient is connected to the breathing circuit (M&M, pg. 64)

Based on what you know about the chemical properties of fospropfol, which of the following is the reason that it has delayed onset of action? a. It is water soluble b. It is a prodrug c. Functions on a different receptor d. There is no difference in onset of action

b. It is a prodrug NP: 1268 Byron

3. Scopolamine can be used to prevent PONV via transdermal route due to which of the following? a. It's water solubility b. It's lipid solubility c. High potency d. High efficacy

b. It's lipid solubility M&M Ch. 13 Pg. 236 Mark Thetford

What are alternative lead locations for SSEP in the UE and LE if the preferred sites are not accessible? a. LE-Toes, UE-Fingers b. LE-peroneal nerve in popliteal fossa, UE-ulnar nerve at wrist or ulnar notch. c. LE- median nerve between flexor carpi radialis and palmaris longus tendons, UE- posterior tibial nerve between achilles tendon and medial maleolus. d. LE-anywhere distal to the groin, UE-anywhere distal to the axillary.

b. LE-peroneal nerve in popliteal fossa, UE-ulnar nerve at wrist or ulnar notch. NP-pg. 330 Krum

What are the preferred lead locations for SSEP in the UE and LE? a. LE-Toes, UE-Fingers b. LE-posterior tibial nerve between achilles tendon and medial maleolus, UE-median nerve between flexor carpi radialis and palmaris longus tendons. c. LE- median nerve between flexor carpi radialis and palmaris longus tendons, UE- posterior tibial nerve between achilles tendon and medial maleolus. d. LE-anywhere distal to the groin, UE-anywhere distal to the axillary.

b. LE-posterior tibial nerve between achilles tendon and medial maleolus, UE-median nerve between flexor carpi radialis and palmaris longus tendons. NP-pg. 330 Krum

A highly efficacious drug has what type of maximum physiological effect? a. Minimal b. Large c. Unpredictable d. Unknown

b. Large M&M - pg. 150 Lexi

Blood flow through the heart follows what law? a. Law of the conservation of volume b. Law of the conservation of mass c. Law of the conservation of energy d. Law of the conservation of velocity

b. Law of the conservation of mass M&M p. 116 Lexi

Where in the body does dexmedetomidine act to produce its sedative and analgesic effects? (Select 2) a. Reticular Activating System b. Locus Ceruleus c. Brain Stem d. Spinal Cord

b. Locus Ceruleus d. Spinal Cord MM: 246 Byron

Which of the following gasses if rebreathed delay induction? a. O2 b. N2O c. CO2 d. Nitrogen

b. N2O c. CO2 d. Nitrogen Rationale: (N&P 263) Patients under anesthesia may re-breathe any component of their exhalations - nitrogen, O2, CO2, N2O, and volatile agent. The effects of rebreathing each of these components differ. Rebreathing of exhaled oxygen has no ill effects. Rebreathing of exhaled nitrogen slows induction. Nitrogen that is not eliminated from the breathing circuit delays the establishment of the desire agent concentration; thus high fresh gas flows are appropriate during induction. IN contrast, rebreathing of exhaled agent during maintenance is highly desirable for cost and environmental considerations. Rebreathing of CO2 has the undesirable effect of producing respiratory acidosis, so it is best avoided. Budenbender

Which drug, in addition to Naloxone, is a pure opioid antagonist with a high affinity for Mu receptors? a. Flumazenil b. Naltrexone c. Glucagon d. Narcan

b. Naltrexone M&M p. 290 Lexi

Which of the following beta blockers also produces vasodilation due to a nitric oxide mediated action? a. Nadolol b. Nebivolol c. Bisoprolol d. Timolol

b. Nebivolol NP: 194 Byron

3. Which of the following refers to pulmonary administration? a. Injections b. Nebulizer c. Sustained release agent on skin d. Intraocular

b. Nebulizer Nagelhout page 66 David Budenbender

3. Regarding angina, which of the following medications is considered first-line therapy for acute attacks? a. Beta-blockers b. Nitrates c. ACE-Inhibitors d. Statins

b. Nitrates Reference: N&P pg 209 box 13-15 Mandy

Oscillometry is the most frequently used automated non-invasive BP monitoring method used worldwide. Select the choice that describes the mechanism of function for the oscillometry method. a. Oscillometry uses mercury or aneroid manometers which increase the accuracy of the measurements. b. Oscillometry measures oscillations in cuff pressure throughout the entire cardiac cycle and is highest at MAP. c. Oscillometry utilizes the bell or diaphragm of a stethoscope to transfer readings to the healthcare provider. d. Oscillometry measures the changing sound frequency that oscillates underneath the BP cuff.

b. Oscillometry measures oscillations in cuff pressure throughout the entire cardiac cycle and is highest at MAP. M&M page 90 Krum

4. Which gas analysis technology utilizes henry's law and piezoelectric effect? a. Mass Spectrometry b. Piezoelectric gas analysis c. Infrared absorption analysis d. Raman scattering

b. Piezoelectric gas analysis N&P Ch. 14 Pg. 233-234 Mark Thetford

5. What hematological effect is caused by activation of 5-HT2 receptors? (M&M pg 284) a. Bleeding b. Platelet aggregation c. Production of RBC's d. Sickle cell anemia

b. Platelet aggregation

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 16, p. 274 Lexi

4. Which of the following are preset with the use of PCV? (Select 2) a. Tidal volume b. Pressure c. Inspiratory time d. Airflow rate

b. Pressure c. Inspiratory time M & M, page 1294 Willie

1. Which mode is designed to augment spontaneous tidal volumes? a. Peep b. Pressure Support Ventilation c. Control volume ventilation d. None of the above

b. Pressure Support Ventilation Willie M&M, page 1293

3. Since 5-10% of morphine is excreted unchanged in the urine, renal failure may cause what type of effect leading to ventilatory depression? (select all that apply) a. Decreased duration of action b. Prolonged duration of action c. Shortened half-life d. Prolonged narcosis

b. Prolonged duration of action & d. Prolonged narcosis M&M Ch. 10 Pg. 193 Mark Thetford

2. All of the following beta-blockers are safe to use in pregnancy EXCEPT? a. Atenolol b. Propranolol c. Metaprolol d. Labetalol

b. Propranolol Reference: N&P pg 208 box 13-13 Mandy

4. Which of the following drugs actually encapsulates the neuromuscular blocking agent and forms very tight water-soluble complexes to reverse its actions?? a. Neostigmine b. Sugamadex c. Pyridostigmine d. Edrophonium

b. Sugamadex Reference: N&P pg 181 Mandy

The responsibility to provide explanation of the risk-versus-benefit for a proposed procedure is to the... a. Anesthesia Provider b. Surgeon/Proceduralist Performing c. Circulating Nurse Assigned to that room d. The witness to the consent

b. Surgeon/Proceduralist Performing Morgan and Makhail's page 297 Krum

In regards to the potential for development of postoperative pulmonary complications, which of the following represents the most important risk factor for their development? a. Age b. Surgical Site c. Duration of Anesthesia d. Obesity

b. Surgical Site NP: 361 Matt Byron

The explanation of drug interaction that is defined as the combined effect of two drugs being greater than the algebraic sum of their individual effects is referred to as what? a. Addition b. Synergism c. Potentiation d. Adaptation

b. Synergism NP: 59 Byron

The hypotension surrounding septic shock follows which of the following parameters? a. Systolic <100, MAP <65 b. Systolic <90, MAP <60 c. Systolic <80, MAP <55 d. Systemic blood pressure <50

b. Systolic <90, MAP <60 M&M p. 1317 Lexi

1. What is MAC awake? a. The MAC required to achieve surgical anesthesia (immobility) in 50% of patients exposed to a noxious stimulus b. The MAC suppressing appropriate response to commands in 50% of patients; memory is usually lost at MAC-awake; approximately 0.3-0.5 MAC c. The alveolar concentration of anesthetic that blunts the autonomic response to noxious stimuli; approximately 1.6-2.0 MAC d. The greater the alveolar ventilation, the faster the patient achieves anesthesia

b. The MAC suppressing appropriate response to commands in 50% of patients; memory is usually lost at MAC-awake; approximately 0.3-0.5 MAC Budenbender Nagelhout page 82

3. What is the most common cause of radiant heat loss in the OR? a. Cooling effect of the equipment applied. b. The cooler ambient temperature causing the transfer of body heat c. The evaporative liquids on the skin d. None of the above

b. The cooler ambient temperature causing the transfer of body heat. N&P page 321 Willie

When selecting a blood pressure cuff for your patient the anesthesia provider ensures that the bladder of the cuff meets what specific criteria to ensure accurate measurement of hemodynamics? a. The cuff bladder extends one-quarter way around the extremity and its width is 60-80% greater than the diameter of the extremity. b. The cuff bladder extends at least half way around the extremity and its width should be 20-50% greater than the diameter of the extremity. c. The cuff bladder extends three quarters of the way around the extremity and its width be 60-80% greater than the diameter of the extremity. d. The cuff bladder extends all the way around the extremity and its width be 10-20% greater than the diameter of the extremity.

b. The cuff bladder extends at least half way around the extremity and its width should be 20-50% greater than the diameter of the extremity. (M&M pg 91) Josh Lake

5. Which statement is true regarding drugs described by multicompartment pharmacokinetics? (M&M pg 148-149) a. The offset of a drug's effect can be easily predicted from its half-lives. b. The elimination half-time is context dependent c. None of the anesthesia medications are described by multicompartment pharmacokinetics d. One can easily determine how rapidly a drug effect will disappear simply by looking at coefficients, exponents, and half-lives

b. The elimination half-time is context dependent

Why is coupling gel needed when using an ultrasonic Doppler probe? a. The gel helps to lubricate the probe so it can easily be manipulated. b. The gel eliminates the reflection of sound waves that normally occurs when it hits air. c. The gel protects the probe from oxidation. d. The gel fights microbial infections to protect patient to patient contagion.

b. The gel eliminates the reflection of the sound wave that normally occurs when it hits air. M&M page 89 Krum

Because 1 cm H2O is equal to 0.74 mm Hg, blood pressure readings from an extremity elevated above the body's core will be... a. recorded higher than normal. b. recorded lower than normal. c. unchanged.

b. recorded lower than normal. M&M page 89 Krum

Open-Drop Anesthesia is so named because... a. a drop of volatile anesthetic is dripped into the airway and puts the patient to sleep with the use of a breathing circuit b. vaporization of a volatile anesthetic lowers the temperature and drops the anesthetic vapor pressure without the use of a breathing circuit c. you open the patients mouth and drop in the anesthesia with or without the use of a breathing circuit

b. vaporization of a volatile anesthetic lowers the temperature and drops the anesthetic vapor pressure without the use of a breathing circuit Morgan and Mikhail's page 31 Krum

2.) What is the major advantage of a piston driven anesthesia machine? a.) Requires more oxygen to operate b.) Delivers very accurate tidal volume to patients with low lung compliance c.) Generates more negative pressure during down stroke than bellows d.) Is louder

b.) Delivers very accurate tidal volume to patients with low lung compliance M&M page 77 Zino

5.) When should pressing the 02 flush valve be avoided? a.) During exhalation b.) During inspiration c.) During apnea d.) At the end of expiration

b.) During inspiration M&M page 79 Zino

3.) What nerve must you stimulate to contract the orbicularis oculi? a.) Ulnar nerve b.) Facial nerve c.) Trigeminal nerve d.) Vagus nerve

b.) Facial Nerve M&M page 138 Zino

1.) Intubating a patient to deep in the trachea will most likely cause the TT to end up where? a.) Left bronchus b.) Right bronchus c.) The correct position d.) The esophagus

b.) Right bronchus M & M page 335 - Zino

1.) What kind of amine is scopolamine? a.) Mono amine b.) Tertiary amine c.) Secondary amine d.) None of the above M&M page 236

b.) Tertiary amine M&M page 236 Zino

5.) If the patient is repositioned on the OR table after TT intubation and the neck flexes, which way could the tube have moved? a.) Away from the carina b.) Toward the carina c.) Doesn't move at all d.) TT moves cephlad

b.) Toward the carina M & M page 335- Zino

The battery of an AICD is designed to be able to deliver approximately how many shocks during its 3-6 year lifespan? a. 60 b. 80 c. 120 d. 240

c. 120 NP: 1268

3. The onset of Hydralazine is within? a. 5 mins b. 1 min c. 15 mins d. 3 mins

c. 15 mins M&M, page 260 Willie

What is the onset and duration of action of Hydralazine? a. 2-5 minutes and 30 minutes b. 30 seconds and 1 hour c. 15 minutes and 2-4 hours d. 20 minutes and 8 hours

c. 15 minutes and 2-4 hours M&M pg 260 Lake

4. The effects of Hydralazine last for? a. 30-45 mins b. 1-2 hours c. 2-4 hours d. 6-8 hours

c. 2-4 hours M&M, page 260 Willie

What is the onset of IV administered Fentanyl? a. Immediate b. 5-15 min c. 2-5 min d. 10-15 min

c. 2-5 min (N&P pg 153) Lake

How many types of oxygen analyzers are available? a. 1 b. 2 c. 3 d. 4

c. 3 (M&M, pg 66)

4. Remifentanil's context-sensitive half-time remains __ minutes regardless of dose, duration, hepatic dysfunction, or pseudocholinesterase deficiency.? a. 20 minutes b. 5 minutes c. 3 minutes d. 10 minutes

c. 3 minutes M&M Ch. 10 Pg. 193 Mark Thetford

4. What is the smallest dose of Decadron shown to be effective in reducing the incidence of PONV? (M&M pg 285) a. 2 mg b. 6 mg c. 4 mg d. 10 mg

c. 4 mg

What is the pressure of O2 supplied by wall lines? a. 25-30 psi b. 2200 psi c. 45-55 psi d. 745 psi

c. 45-55 psi (Morgan & Mikhail, pg. 65)

Body heat lost as the result of water vaporized to humidify dry gases accounts for what percent of the total intraoperative heat loss? a. 30% b. 15-20% c. 5-10% d. 2-3%

c. 5-10% (M&M Page 71) Mark

What is the typical dose of IV hydralazine when used to control intraoperative hypertension? a. 1-4 mg b. 50 mg c. 5-20 mg d. 25 mg

c. 5-20 mg M&M pg 260 Lake

5. When is the appropriate time to give the patient midazolam in the pre-op setting? a. After baseline vital are noted b. As soon as the patient gets to pre-op as they are usually very anxious c. After informed consent has been obtained d. The patient should NEVER be given versed pre-operatively

c. After informed consent has been obtained Reference: M&M pg 188 Mandy

What is implied by the absence of palpable single twitches following 5 seconds of tetanic stimulation at 50 hz a. Another dose of nondepolarizer is in order b. Get new batteries c. An intense block has been achieved d. Reposition and try again

c. An intense block has been achieved M&M pg 227 Lake

Where is the site of action for hydralazine? a. Capillary smooth muscle b. Veinous smooth muscle c. Arteriolar smooth muscle d. Coronary artery smooth muscle

c. Arteriolar smooth muscle M&M pg 260 Lake

Signs of anticholinergic poisoning include all of the following EXCEPT which symptom? a. Hallucinations b. Dry mouth c. Bradycardia d. Impaired vision

c. Bradycardia M&M p. 237 Lexi

3. Which of the following DOES NOT affect the composition of the inspired gas mixture? a. Fresh gas flow rate b. Volume of the breathing system c. Cardiac Output d. Absorption by the machine or breathing circuit

c. Cardiac Output M&M, Ch. 8, pg. 155 Willie

4. Scopolamine should be avoided in which of the following? a. Patient with motion sickness b. Patient with bradycardia c. Closed-angled Glaucoma d. History of PONV

c. Closed-angled Glaucoma M&M Ch. 13 Pg. 236 Mark Thetford

Slowed GI motility from opiates is known to cause contraction or spasm of the sphincter of Oddi, this spasm can mimic what pathology? a. Kidney stone b. Gall stone c. Common bile duct stone d. Pancreatitis

c. Common bile duct stone M&M, p. 195 Lexi

In regards to drug-receptor response, current understanding of receptor dynamics is that no tissue response can occur unless the following key aspect transpires: a. Drug binding to the receptor b. Delivery of drug to the receptor site c. Conformational change of the receptor protein d. Absorption of the medication

c. Conformational change of the receptor protein NP: 58 Byron

Benefits of using low fresh gas flows during the maintenance stage of anesthesia encompass all of the following except: a. Increase in circuit humidity b. Lower rate of volatile anesthetic use c. Conservation of CO2 absorbent d. Conservation of oxygen supply

c. Conservation of CO2 absorbent NP: 268-269 Matt Byron

Which of the following opioid related side effect does NOT normally go away over time in patients chronically taking opiates? a. Pain relief b. Sphincter of Oddi spasm c. Constipation d. Nausea

c. Constipation M&M, p. 195 Lexi

How should prolonged paralysis from succinylcholine as a result of abnormal pseudo cholinesterase activity be treated? a. Reversal with Neostigmine and Glycopyrolate b. Continued mechanical ventilation without sedation and TOF checks every 15 minutes c. Continued mechanical ventilation with sedation until muscle function returns to normal by clinical signs d. No special treatment is needed a nasal airway will be sufficient

c. Continued mechanical ventilation with sedation until muscle function returns to normal by clinical signs (M&M pg 207) Lake

3. All of the following are uses for echocardiography except? a. Assessment of hemodynamic factors b. Diagnosis of cardiac valve abnormalities, pericardial tamponade and hypovolemia c. Detection of a first degree heart block d. Assist with surgical intervention

c. Detection of a first degree heart block M&M Ch. 5 Pg. 115 Mark

3. Pharmacodynamics encompasses all of the following concepts except? a. Potency b. Efficacy c. Distribution d. Therapeutic window

c. Distribution M&M Ch. 7 Pg. 149 Thetford

How will hypothermia effect emergence from general anesthesia when a volatile agent has been used? a. There is not effect b. Emergence is more rapid c. Emergence is slower d. None of the above are true

c. Emergence is slower (N&P pg 216) Lake

Visualization of the ETT cuff passing through the vocal cords in conjunction with positive ETCO2 and bilateral breath sounds ensures that WHAT has not occurred? a. Airway trauma b. Laryngospasm c. Esophageal intubation d. Barotrauma

c. Esophageal intubation M&M, pg. 335 Lexi

In order for a foley catheter thermistor probe to accurately reflect body temperature, what urine characteristic must be present? a. Dilute urine b. Concentrated urine c. High urine output d. Low urine output

c. High urine output M&M p. 138 Lexi

The following are EARLY clinical signs of carbon dioxide absorbent except: a. Increase in partial pressure of EtCO2 b. Signs of SNS activation (flushing, cardiac irregularities, diaphoresis) c. Increase (and later a decrease) in HR and BP d. Color of absorbent indicator

c. Increase (and later a decrease) in HR and BP NP: 271 Matt Byron

1. What is the mechanism of action for Hydralazine? a. Increases venous capacitance b. Increases arterial vascular resistance c. Increases arterial smooth muscle relaxation d. Blocks the sympathetic tone

c. Increases arterial smooth muscle relaxation M&M, page 260 Willie

1. What type of anesthetic gas analysis measures individual ability to absorb EMR at precise frequencies in the infrared spectrum? a. Raman Scattering Analysis b. Mass Spectrometry c. Infrared Absorption Analysis d. Photoacoustic Gas Analyzer

c. Infrared Absorption Analysis N&P Ch. 14 Pg. 233-234 Mark Thetford

4. Which f the following is the delivery of radiation to the patient via a linear accelerator, and often occurs during tumor surgery? a. fMRI b. C-arm fluoroscopy c. Intraoperative radiation therapy d. Positron emission ragiography

c. Intraoperative radiation therapy Reference: N&P pg 1284 Mandy

Due to the fact that the commonly measured hepatocellular enzymes are also distributed throughout the cells of the heart, lungs, kidneys and skeletal muscle. Increases in their serum concentrations may not always be a good indicator of hepatobiliary disease. Of the following, which enzyme demonstrates the greater specificity for hepatobiliary disease? a. Aspartate Transaminase (AST) b. Alanine Transaminase (ALT) c. Lactate Dehydrogenase (LDH) d. Serum Glutamic Pyruvic Transaminase (SGPT)

c. Lactate Dehydrogenase (LDH) NP: 364 Matt Byron

4. Which of the following is NOT a factor that affects anesthetic uptake? a. Solubility b. Alveolar blood flow c. Metabolic by-products d. Partial pressure differences

c. Metabolic by-products M&M, Ch. 8, pg. 156 Willie

2. What is the definitive test used to ensure intratracheal placement of the ETT? a. Visualization of condensation in the ETT after a manual ventilated breath b. Bilateral breath sounds upon auscultation c. Monitoring capnographic tracing d. Visible chest rise

c. Monitoring capnographic tracing M&M Ch 19 Pg 328 Mark

What is the active metabolite of morphine? a. Morphine 3-glucuronide b. Morphing 9-glucuronide c. Morphine 6-glucuronide d. Morphine does not have an active metabolite

c. Morphine 6-glucuronide (N&P pg 153) Lake

How should the APL valve be adjusted for spontaneously breathing patients? a. Closed to provide positive pressure during ventilation. b. Closed to prevent resistance from ambient pressures. c. Open to ensure that circuit pressure remains negligible throughout the respiratory cycle. d. None of the above are correct.

c. Open to ensure that circuit pressure remains negligible throughout the respiratory cycle. (Page 35 M & M) Willie

Which of the following findings after cardiac testing is not a readily identifiable indicator of poor ventricular function? a. Cardiac Index < 2.2 L/m2 b. Left Ventricular End Diastolic Pressure > 18 mmHg c. Pulmonary Artery Occlusion Pressure 8-10 mmHg d. Ejection Fraction < 40%

c. PAOP 8-10 mmHg NP: 360 Matt Byron

Chemical fluorescence can be seen in many things, including all but which of the following? a. Sea life b. Neon lights c. Plant life d. Glow sticks

c. Plant life N&P p. 236 Lexi

An abrupt increase in peak inflation pressure together with sudden hypotension strongly suggests what lung condition? a. Pulmonary embolus b. Pneumonia c. Pneumothorax d. Pulmonary fibrosis

c. Pneumothorax M&M pg. 1297 Jennifer

5. Which of the following interventions is associated with a reduction in patient pre-surgical anxiety? a. Versed 1-2 mg IV b. Fentanyl 25 -100 mcg IV c. Preoperative visit from an Anesthesiologist d. Defasciculating dose of a NDNMB

c. Preoperative visit from an Anesthesiologist (M & M, p. 300) Willie

Sustained inspiratory pressure greater than 30 mm Hg during positive-pressure ventilation put the patient at risk for... a. Atelectasis b. Pneumonia c. Pulmonary barotrauma d. Infection

c. Pulmonary barotrauma M&M - CH. 4, p. 79 Lexi

5. A pulse contour device uses the arterial pressure tracing to determine all of the following except? a. Cardiac Output b. Pulse Pressure c. Pulmonary wedge pressure d. Stroke Volume

c. Pulmonary wedge pressure M&M Ch. 5 Pg. 113 Mark

What is a major concern with the use of droperidol as an antiemetic in anesthesia practice? a. PR prolongation b. Widened QRS c. QT prolongation d. ST depression

c. QT prolongation NP: 193 Byron

This ventilator mode helps to prevent the patient from "breath stacking" and "bucking" the ventilator by providing mandatory breaths while dropping airway pressure if the patient initiates a breath. Which of the following describes this ventilator mode? a. Volume Control b. Assist Control c. SIMV d. Pressure support e. PRVC

c. SIMV (M&M Page 74) Mark

Which type of shock is not specifically related to hypoperfusion? a. Neurogenic b. Cardiogenic c. Septic d. Anaphylactic

c. Septic M&M p. 1317 Lexi

5. Which of the following is used specifically for carbon dioxide analysis? a. Infrared absorption analysis b. pH optode c. Severinghaus Pco2 electrode d. Fluorescence quenching

c. Severinghaus Pco2 electrode N&P Ch. 14 Pg. 233-234 Mark Thetford

2. Which 2 anesthetics are useful for pediatric induction? a. Desflurane & Sevoflurane b. Halothane & Isoflurane c. Sevoflurane & Halothane d. Desflurane & Isoflurane

c. Sevoflurane & Halothane M&M, Ch. 8, pg. 154 Willie

1. According to the text, a blood pressure of 175/104 is indicative of which of the following? a. Prehypertension b. Stage 1 hypertension c. Stage 2 hypertension d. Stage 3 hypertension

c. Stage 2 hypertension Reference: N&P pg 208 box 13-12 Mandy

2. Which of the following are clinical signs of recovery from neuromuscular blockade? a. Train of four ratio <0.9 with fade b. Adequate vital capacity of at least 7mL/kg c. Sustained protrusion and purposeful movement of tongue d. Able to sustain head lift for at least 5 seconds

c. Sustained protrusion and purposeful movement of tongue d. Able to sustain head lift for at least 5 seconds Reference: N&P pg 180 box 12-13 Mandy

4. Which of the following refers to transdermal route? a. Injections b. Nebulizer c. Sustained release agent on skin d. Intraocular

c. Sustained release agent on skin Nagelhout page 66 David Budenbender

Gas solubility in liquids is inversely related to_________? a. Elevation b. Barometric pressure c. Temperature d. None of the above are true

c. Temperature (N&P pg 215) Lake

Which of the following is a simple method commonly used to test the safety of radial artery cannulation? a. The Schwartz test b. The McGruber test c. The Allen's test d. The Burgundy test

c. The Allen's test (M&M pg 92) Josh Lake

3. What is the MAC that blocks adrenergic responses? a. The MAC required to achieve surgical anesthesia (immobility) in 50% of patients exposed to a noxious stimulus b. The MAC suppressing appropriate response to commands in 50% of patients; memory is usually lost at MAC-awake; approximately 0.3-0.5 MAC c. The alveolar concentration of anesthetic that blunts the autonomic response to noxious stimuli; approximately 1.6-2.0 MAC d. The greater the alveolar ventilation, the faster the patient achieves anesthesia

c. The alveolar concentration of anesthetic that blunts the autonomic response to noxious stimuli; approximately 1.6-2.0 MAC Budenbender Nagelhout Page 82

4. How is SSEP able to make assumptions at the anterior motor tract? a. The nerve is a motor nerve b. The nerve is a sensory nerve c. The nerve is a mixed nerve d. SSEP cannot make assumptions

c. The nerve is a mixed nerve p. 331 N& P Willie

2. Elimination half-life is: (M&M pg 148) a. The time it takes to infuse half of a medication drip b. The time it takes for half of a drugs potency to drop when exposed to light c. The time required for the drug concentration to fall by 50% d. The amount of time before the patient has to urinate after medication administration

c. The time required for the drug concentration to fall by 50%

Which of the following is a reliable method of urinary output monitoring? a. Urinal measuring device b. Urine hat measuring device c. Urinary bladder catheterization d. All of the above

c. Urinary bladder catheterization M&M p. 137 Lexi

A patient with COPD who tends to hypoventilate would benefit from which of the following oxygen delivery system? a. Nonrebreathing mask b. Simple mask c. Venturi mask d. Nasal cannula

c. Venturi mask (M&M pg 1285) Lake

1. Which of the following agents are best avoided as a result of significant altered evoked potentials? a. Nitrous oxide b. NMB c. Volatile agents d. Opioids

c. Volatile agents M&M Ch. 6 Pg. 135 Mark Thetford

5. Which of the following takes priority when caring for a patient? a. Securing the airway b. The patient's safety c. Your own safety d. Radiation exposure Reference: N&P pg 1284

c. Your own safety Reference: N&P pg 1284 Mandy

4.) COX-1 receptors can be found where in the body? a.) Only the lungs b.) Only the kidneys c.) Throughout the body d.) Only in response to infection

c.) Throughout the body M&M page 197 Zino

5. During opioid administration a patient's arterial blood pressure will decrease as a result of all of the following except? a. Venodilation b. Decreased sympathetic reflexes c. Bradycardia d. Cardiac contractility depression

d. Cardiac contractility depression M&M Ch. 10 Pg. 194 Mark Thetford

1. Distribution is governed by organ uptake, which is determined by all of the following except? a. Tissue perfusion b. Partition coefficient of tissue or blood c. Tissue mass d. Clearance rate

d. Clearance rate M&M Ch. 16 Pg. 270 Mark Thetford

All of the following EXCEPT which group of patients is at an increased risk for aspiration? a. Patients with altered airway reflexes b. Patients with abnormal airway anatomy c. Pregnant and obese patients d. Elderly patients

d. Elderly patients M&M p. 291 Lexi

Which drug is a competitive and specific antagonist at benzodiazepine receptors? a. Naloxone b. Natrexone c. Glucagon d. Flumazenil

d. Flumazenil M&M p. 290 Lexi

Which of the following is not a phase of thermoregulation? a. Afferent thermal sensing b. Central regulation c. Efferent responses d. GI regulation N&P ch 17 pg 320

d. GI regulation Mbom

5. What type of procedure involves gamma rays, a linear accelerator, and a CyberKnife? a. Creation of gamma-powered soldiers b. Quantum Leap c. Pulsed electromagnetic field therapy d. GammaKnife therapy

d. GammaKnife therapy (The delivery of gamma radiation to cancerous tumors simultaneously in a single dose.) [N&P p. 1280] Jason

1. Which of the following is NOT considered one of the first universally accepted general anesthetics? a. Nitrous b. Ether c. Chloroform d. Halothane

d. Halothane M&M, Ch. 8, pg. 154 Willie

What is the purpose of taping the patients eyes closed? (Morgan & Mikhail, pg 327) a. It's part of the free eyelash removal service offered at NCH b. It prevents the patient from looking at you during the case c. Helps make sure the patient stays asleep, or at least looks asleep for any auditors d. Helps prevent injury to patients eyes by unintentional abrading of the cornea

d. Helps prevent injury to patients eyes by unintentional abrading of the cornea

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 16, p. 274 Lexi

What is not a common problem with O2 sensor use? a. Artifact due to colored nail polish b. Vasoconstriction at site of measurement due to cold or drugs c. Motion artifact d. Inaccurate BP N&P ch 17 pg 320

d. Inaccurate BP Mbom

3. Clonidine binds to non-adrenergic receptors, which causes a decrease in sympathetic tone that results in all of the following except? a. Decreased SVR b. Decreased HR c. Decreased BP d. Increased HR

d. Increased HR M&M Ch. 17 Pg. 287 Mark Thetford

3. All of the following factor directly influence the pharmacologic response to a drug EXCEPT: a. Age b. Body surface area c. Gender d. Intelligence quotient

d. Intelligence quotient Nagelhout Chapter 5 page 55 "The age, sex body weight, body surface area, basal metabolic rate, pathologic state, and genetic profile of an individual directly influence the pharmacologic response" Budenbender

1. An anesthetic should be administered without performing an airway assessment if which of the following occur? a. The case is an emergency b. The patient has a normal BMI c. The surgeon says it's OK to omit d. It is never acceptable to omit a pre-anesthetic airway assessment

d. It is never acceptable to omit a pre-anesthetic airway assessment (M & M p. 300) Willie

1. What is not a method to reduce laser fire risk? NP ch 14 pg239 a. Turn laser off when not in use b. Low inspired O2 concentrations c. Eye shields for patient and anesthetists d. Keep laser on at all times

d. Keep laser on at all times Mbom

2. What organ provides the greatest reservoir for distribution for local anesthetics while circulating in the blood? a. Liver b. Heart c. Fat d. Muscle

d. Muscle M&M Ch. 16 Pg. 270 Mark Thetford

The monitoring site/method of olfactory nerve evoked potentials is? a. Visual evoked potentials b. Vocal cords c. Auditory brainstem responses d. No monitory technique available N&P Ch 18 pg 332

d. No monitory technique available Mbom

1. Which of the following is an active metabolite associated with seizure activity? a. Morphine 3-glucuronide b. Morphine 6-glucuronide c. Sufentanil d. Normeperidine

d. Normeperidine M&M Ch. 10 Pg. 193 Mark Thetford

Which of the following is NOT one of the three main coronary vessels? a. Left anterior descending b. Right coronary artery c. Left circumflex d. Obtuse marginal artery

d. Obtuse marginal artery M&M p. 118 Lexi

Which of the following urinary characteristics does NOT aid in diagnosing oliguria? a. Osmolality b. Urine electrolyte levels c. Specific gravity d. Osmolarity

d. Osmolarity M&M p. 138 Lexi

5. Which of the following vent modes doesn't use volume for their I-E cycling? a. CMV b. IMV c. SIMV d. PCV M&M, ch 57 pg 1291

d. PCV Mbom

2. All of the following are recommended during the use of sodium nitroprusside infusions EXCEPT? a. Arterial monitoring line b. The use of mechanical infusion pumps c. Protection of the medication from light d. Plasma concentration levels

d. Plasma concentration levels Reference: M&M pg 257-258 Mandy

2. The following are advantages of PSV EXCEPT? a. Augments spontaneous tidal volumes b. Decreases work of breathing c. Increased patient comfort d. Prevents hyperventilation

d. Prevents hyperventilation M & M, page 1293 Willie

What is succinylcholine metabolized by? a. Liver b. Kidney c. Nonspecific cholinesterase d. Pseudo cholinesterase

d. Pseudo cholinesterase (M&M pg 207) Lake

5. Which of the following will not reduce the metabolic rate of amide local anesthetics? a. CHF b. H2 antagonists c. Liver cirrhosis d. Pseudocholinesterase deficiency

d. Pseudocholinesterase deficiency M&M Ch. 16 Pg. 270-271 Mark Thetford

4. The anesthesia care provider can employ the use of a TEE to determine all of the following except? a. Adequate filling of each chamber b. Appropriate myocardial contraction c. Cause of hypotension d. TEE may be used for all of the above

d. TEE may be used for all of the above: Adequate filling of each chamber Appropriate myocardial contraction Cause of hypotension M&M Ch. 5 Pg. 114 Mark

4. How would you describe the ventilation effect? a. The MAC required to achieve surgical anesthesia (immobility) in 50% of patients exposed to a noxious stimulus b. The MAC suppressing appropriate response to commands in 50% of patients; memory is usually lost at MAC-awake; approximately 0.3-0.5 MAC c. The alveolar concentration of anesthetic that blunts the autonomic response to noxious stimuli; approximately 1.6-2.0 MAC d. The greater the alveolar ventilation, the faster the patient achieves anesthesia

d. The greater the alveolar ventilation, the faster the patient achieves anesthesia Budenbender Nagelhout Page 82

A competitive antagonist in the presence of a pure agonist will shift the dose-response curve in what direction? a. Upward b. Downward c. To the left d. To the right

d. To the right NP: 58 Byron

1. Which of the following is not a method of classification of modern vents? a. Inspiratory characteristics b. Cycling c. Microprocessor-controlled vents d. Type of CO2 absorber M&M, ch 57, pg 1289

d. Type of CO2 absorber Mbom

4. Which of the following is not a component needed to start a fire? NP ch 14 pg239 a. Ignition source b. Oxygen c. Fuel d. Volatile gases

d. Volatile gases Mbom

2. Which of the following is not important when a fire occurs? NP ch 14 pg239 a. Source of saline b. Stop oxygen flow c. Stop ventilation d. Extubate patient e. None of the above

e. None of the above Mbom

3. The drug pancuronium has a steady state volume of distribution of 15L in a 70 kg patient, which of the following describe pancuronium? (choose two) a. The majority of pancuronium exists in the body water b. The majority of pancuronium exists in the fat tissues. c. Pancuronium has a Small volume of distribution. d. Pancuronium has a large volume of distribution.

i. Answer: A and C. ii. M&M page 146 Sommers

3. Which patient would you NOT give droperidol? a. Parkinson's b. Alzheimer's c. Gillian barre d. Manic depression

i. Answer: A- Parkinson's ii. M+M page 285 Sommers

2. Surfactant will lower surface tension more in _________ alveoli. a. Smaller b. Larger c. Not enough information to answer d. Surfactant lowers surface tension the same in all alveoli

i. Answer: A- Smaller ii. N+P page 228 Sommers

5. Which of the following is NOT included in phase I biotransformation? a. Conjugation b. Reduction c. Hydrolysis d. Oxidation

i. Answer: A- conjunction ii. M&M page 146 Sommers

1. What are the clinical manifestation of all near drownings? (choose 3) a. Hypoxemia b. Metabolic alkalosis c. Metabolic acidosis d. Respiratory acidosis e. Hypercarbia f. Cerebral edema

i. Answer: A-C-E ii. M&M page 1306 Sommers

4. Which of the following is NOT a border of the cuff for an LMA? a. Base of the tongue b. Uvula c. Pyriform sinuses d. Upper esophageal sphincter

i. Answer: B uvula 1. M&M 317 Sommers

1. All Intravenous anesthesia drugs are better modeled with at LEAST: a. One compartment model b. Two compartment model c. Three compartment model d. None of the above.

i. Answer: B- 2 compartment model ii. M&M page 146 Sommers

1. An electroencephalogram is used occasionally during a cerebral vascular surgery. Which of the following describes the purpose of the EEG? a. Detect cranial nerve damage. b. Confirm adequacy of cerebral perfusion c. To ensure adequate depth of anesthesia d. Monitor motor evoked potentials.

i. Answer: B- Confirm adequacy of cerebral perfusion ii. M&M page 129 Sommers

3. You are inserting a PA catheter, and are having a difficult time floating the catheter into the PA. which of the following action would you NOT do to facilitate floating the catheter into the PA? a. Inject icy saline into the proximal port b. Have the patient exhale as much ERV as possible c. Injecting small amount of inotropic agent. d. Elevate patient head and right lateral tilt

i. Answer: B- Have the patient exhale as much ERV as possible (patient should be made to inhale deeply) ii. M&M page 107-108 Sommers

5. All of the following are disadvantages to the BIS monitor EXCEPT: a. Cost of the monitor b. Ineffective on patients under 12 and over 80 years old c. Cost of each set of patches d. Unreliable effect of anesthesia on an individual's EEG.

i. Answer: B- Ineffective on patients under 12 and over 80 years old ii. M&M page 131 Sommers

4. What stage of inserting a PA catheter would you expect to find a complication of a right heart block? a. Central venous access b. Catheterization c. Catheter residence (presence) d. Both A and B

i. Answer: B- catheterization ii. M&M page 108 Sommers

3. What is the initial treatment for a patient involved in a fire, and have hoarseness and/or stridor? a. Flexible bronchoscope with ETT tube placed over scope for fast intubation b. Endotracheal intubation. c. Anti-inflammatory medications IV with loading dose. d. Albuterol breathing treatments, with ICU monitoring.

i. Answer: B- endotracheal intubation. ii. M&M page 1307 Sommers

2. What is the initial goal in resuscitating a near drowning patient? a. Assess and treat acid/base balance b. Establish a clear airway c. CPR d. Administering O2

i. Answer: B- establish a clear airway ii. M&M page 1306 Sommers

1. Which wave characteristic is "waves per second"? a. Amplitude b. Frequency c. Wave length d. Speed e. Wave part

i. Answer: B- frequency ii. N+P page 228 Sommers

5. When Compared to an endotracheal intubation, which of the following is an advantage of an LMA? a. Hands free operation b. Less invasive c. Increased risk of aspiration d. Protects against airway secretions.

i. Answer: B- less invasive 1. M&M page 319 Sommers the great

2. The gas line, in the anesthesia machine, from the flow meter to the common gas outlet are considered to be what pressure circuit? a. High pressure b. Intermediate pressure c. Low pressure d. They are not considered part of the anesthesia machine

i. Answer: C low pressure system ii. M&M page 54 Sommers

1. Lidocaine is a... a. Weak acid b. Strong acid c. Weak base d. Strong base

i. Answer: C weak base ii. M&M page 266 sommers

4. What is the most common SE of Zofran? a. Constipation b. Dizziness c. HA d. N/V

i. Answer: C- HA ii. M+M page 285 Sommers

3. What is the Doppler effect? a. When you hear the pulse in an extremity b. The time delay generated by using a Doppler machine c. The change in frequency of waves generated by a moving object d. Using ultrasound to assess tissues deep under skin.

i. Answer: C- The change in frequency of waves generated by a moving object. ii. N+P page 229 sommers

5. What stage of inserting a PA catheter would you expect to find a complication of Vein thrombosis? a. Central venous access b. Catheterization c. Catheter residence d. Both A and B

i. Answer: C- catheter residence. ii. M&M page 108 Sommers

2. What is the mechanism of action of droperidol? a. Serotonin antagonist b. Serotonin agonist c. Dopamine antagonist d. Dopamine agonist

i. Answer: C- dopamine antagonist ii. M+M page 285 Sommers

2. You are inserting a pulmonary artery catheter. what is the correct action if you do you see the anticipated pressure at the specific distance? a. Rotate the catheter in a clockwise direction b. Advance the catheter 10 cm and assess the pressure c. Deflate the balloon and remove the catheter d. Rotate the catheter in a counterclockwise direction

i. Answer: C- remove the catheter to prevent knotting. ii. M&M page 107 Sommers

5. What is the mechanism of action of ondansetron? a. Serotonin antagonist b. Serotonin agonist c. Dopamine antagonist d. Dopamine agonist

i. Answer: C- serotonin antagonist ii. M+M page 285 Sommers

4. What is the main goal of biotransformation? a. Making drugs water soluble. b. Making drug metabolites that have pharmacologic action. c. Promotes excretion. d. All of the above are goals of biotransformation

i. Answer: D- all of the above. ii. M&M page 146 Sommers

4. You are using the BIS monitor on your patient during general anesthesia, the BIS monitor read 60. What is your next action? a. Turn up your anesthetic gas b. Turn down your anesthetic gas c. Inform the surgeon of the BIS d. Do nothing.

i. Answer: D- do nothing ii. M&M page 130-131 Sommers

3. Which of the following is NOT a relative contraindication for an LMA? a. Full stomachs b. Low pulmonary compliance (restrictive airway disease) c. Pharyngeal obstruction d. Patients with bronchospasms

i. Answer: D-Patients with bronchospasms 1. M&M page 317-318 Sommers

5. What is a possible cause of a flow meter malfunction? a. Debris in the flow tube b. Vertical tube misalignment c. Sticking of the float in the top of the tube d. Cracked flow tube. e. All the above can cause flow tube malfunction

i. Answer: E all the above can cause flow tube malfunction. ii. M&M page 55 Sommers

2. Which of the following classes of drugs do NOT block Na+ channels? a. Local anesthetics b. Tricyclic antidepressants c. Volatile anesthetics d. Ca+ channel blockers e. All of the above block Na+ channels

i. Answer: E- All of the above block Na+ channels ii. M&M page 266 sommers

4. Which of the following is NOT indicated for treatment of an acute MI? a. O2 b. ASA c. Nitrates d. Morphine e. Cholesterol lower medication

i. Answer: E- Cholesterol lower medication ii. M&M page 1308 Sommers

2. Which of the following is a contraindication to a electroencephalogram (EEG)? a. Seizures b. Parkinson's tremor c. Atrial fibrillation d. History of cranial nerve damage e. There are no contraindications for EEG.

i. Answer: E- There are no contraindications for EEG ii. M&M page 129 Sommers

3. Do anesthesia machines have a minimum oxygen flow when the machine is on (and the flow meters are off)? What is that flow rate? a. Yes. 2 L/min b. No. O2 only flow if the provider turns gas on. c. Yes. 150 mL/min. d. Yes. 1 L/min

i. Answer: Yes. 150 mL/min ii. M&M page 58 Sommers

3. Match the phases of the ETCO2 waveform to the correct description. a. End of inspiration and very beginning of expiration b. The expiratory upstroke c. Records alveolar emptying of CO2 i. First phase ii. Second phase iii. Third phase

i. First phase -- A ii. Second phase -- B iii. Third phase -- C N&P 316 mandy

1. What is the flow meter that is positioned the most downstream to the other gases (nearest to the vaporizers)? a. Oxygen b. Nitrogen c. heliox d. air

i. answer A. oxygen ii. M&M page 57 Sommers

Which Volatile Anesthetics reduce MAP? (select 3) A. Isoflurane, B. desflurane, and C. sevoflurane D. Nitrous Oxide

• Answer A,B,C • Nagelhout and Plaus page 91 Fletcher

Which of the following substances potentiate the sedative effects of barbiturates?(select 3) A. Ethanol B. Opioids C. Caffine D. Antihistamines

• Answer A,B,D • M&M 179 Fletcher

Which Benzodiazepines are insoluble in water? (select 2) A. Lorazepam B. Thiopental C. Midazolam D. Diazepam

• Answer A,D • M&M 179 Fletcher

Which Statement regarding Barbiturates is true? A. Barbiturates are powerful analgesics B. All barbiturates are water soluble C. Barbiturates do not impair the perception of pain. D. Barbiturates raise the pain threshold.

• Answer C • M&M 178 Fletcher

In general, supporting afterload via vasoconstrictors should be deferred until what two things have proven to be ineffective? (select 2) A. Maximization of preload. B. Use of positive inotropes. C. Lower extremity elevation. D. Bicarbonate administration.

• Answer: *A. Maximization of preload. B. Use of positive inotropes. * • Nagelhout and Plaus page 304 Kyle Fletcher

Carvedilol is a: A. Mixed Beta and Alpha blocker B. Selective B1 blocker C. Selective B2 blocker D. Alpha 1 blocker.

• Answer: A • M&M page 251 Fletcher

Propranolol nonselectively blocks which receptors? A. B1 and B2 B. B1 and A1 C. A1 and A2 D. B2 and A2

• Answer: A • M&M page 251 Fletcher

The drug response of population subsets can be expected to vary around the ______ dosage. A. Mean B. LD50 C. LD95 D. Maximal

• Answer: A • N&P page 59 Kyle Fletcher

What is the definition of Tolerance? A. Increased concentration of drug is required to produce a given effect. B. Decreased concentration of drug is required to produce a given effect. C. An acquired allergy D. Enhanced clinical effect of a medication.

• Answer: A • N&P page 60 Kyle Fletcher

5. What mechanism is responsible for the cough caused by ACE inhibitors? A. Buildup of bradykinin B. Pulmonary edema C. Laryngeal edema D. Increased secretions

• Answer: A • N&P pg. 201 Fletcher

What is the intubating dose of Succinycholine? A. 1.0-1.5 mg/kg B. 2.0-3.0 mg/kg C. 0.5-1.0 mg/kg D. 3.0-4.5mg/kg

• Answer: A • Nagelhout and Plaus page 165 Fletcher

What is the intubating dose of Vecuronium? A. 0.1 mg/kg B. 0.2 mg/kg C. 0.3 mg/kg D. 0.4 mg/kg

• Answer: A • Nagelhout and Plaus page 165 Fletcher

What is the definition of Polymorphism? A. Variations in the DNA sequences that occur in at least 1 % of the population. B. Variations in the DNA sequence that occur in at least 25% of the population. C. DNA expression that changes over time D. DNA sequences that are altered by medications

• Answer: A • Nagelhout and Plaus page 76 Kyle Fletcher

What is the definition of an Agonist? A. A substance that binds to a specific receptor and triggers a response in the cell. B. A substance that binds to a receptor and inactivates the receptor. C. A substance that is repelled by a receptor D. A substance that destroys cell membranes

• Answer: A • N&P page 60 Kyle Fletcher

What percent of PEEP is transmitted to the microvasculature? A. <50% B. <80% C. <90% D. <95%

• Answer: A *<50%* • Nagelhout and Plaus page 303 Kyle Fletcher

Where is the Phlebostatic axis? A. Fourth intercostal space, Midanteroposterior level B. Fourth intercostal space, Midaxillary line C. Third intercostal space, Midaxillary line D. Third intercostal space, Midanteroposterior level

• Answer: A *Fourth intercostal space, Midanteroposterior level * • Nagelhout and Plaus page 304 Kyle Fletcher

When PVR is used clinically, it should be viewed as a gross estimate of what? A. RV afterload. B. LV afterload C. Stroke volume D. Preload

• Answer: A *RV afterload*. • Nagelhout and Plaus page 304 Kyle Fletcher

Succinylcholine is broken down via hydrolysis into what two metabolites? (select 2) A. Succinylmonocholine B. Fluoride C. Carbon D. Choline

• Answer: A&D • Nagelhout and plaus page 165 Fletcher

What is the definition of the term pharmacogenetics? A. The study of variations in human genesthat aew responsible for different responses to drug therapy B. The genetic changes that are caused by drugs C. Changes to a fetus that are caused by drugs the parents took. D. A study of a drugs absorption, distribution, metabolism, and elimination

• Answer: A. • Nagelhout & Plaus page 75 Kyle Fletcher

What is a negative side effects of propranolol that is related to its action on the B1 receptor? A. Hypotension B. Bronchospasm C. Tachycardia D. Pruritis

• Answer: B • M&M page 251 Fletcher

What is the definition of Antagonists? A. A substance that has affinity for a receptor and triggers a response in the cell B. A substance that has affinity for a receptor but no efficacy C. A substance that has a binds to a receptor and destroys the cell membrane D. A substance that instantly causes the cell to lyse.

• Answer: B • N&P page 60 Kyle Fletcher

What is the intubating dose of Rocuronium? A. 0.1-0.6 mg/kg B. 0.6-1.0 mg/kg C. 1.0-1.6 mg/kg D. 1.6-2.0 mg/kg

• Answer: B • Nagelhout and Plaus page 165 Fletcher

2. Where is Angiotensin-converting enzyme primarily located? A. In the spleen B. In the pancreas C. endothelial tissue of the lung. D. In the stomach

• Answer: C • N&P pg. 201 Fletcher

4. What is the most common reason for discontinuing ACE inhibitors? A. Insomnia B. Dyspnea C. Dry cough D. Ulcers

• Answer: C • N&P pg. 201 Fletcher

What is the main mechanism by which Volatile anesthetics reduce MAP? A. Direct Myocardial depression B. SA node depression C. Reduction in Systemic Vascular Resistance(SVR) D. AV nodal depression

• Answer: C • Nagelhout and Plaus page 91 Fletcher