Basics Exam 3 Material Prodigy Flashcards by Krista Walls

Preferred site for invasive monitoring of arterial blood pressure?

Radial

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For optimal positioning in an adult, an esophageal temperature probe sensor should be positioned about ______ cm from the nose.

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How will an arterial pressure transducer that is placed below the level of the heart affect the estimate of the actual blood pressure?

It will overestimate the actual blood pressure

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Which 2 intravenous agents would be most capable of producing burst suppression on the EEG?

Etomidate
Propofol

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What would you expect to see when performing a train-of-four test on a patient with a partial depolarizing block?

All four contractions diminished equally

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For which patient would a Wright respirometer be least suited?

A spontaneously breathing pediatric patient

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The most common cause of hyperthermia in a patient under general anesthesia is

iatrogenic overwarming

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Which of the following conditions would result in underestimation of the blood pressure when using an invasive arterial catheter?

bending of the wrist in which the catheter is place

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Upon what law of physics is pulse oximetry based?

Beer-Lambert law

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During inspiration, the end-tidal carbon dioxide waveform will

decrease towards baseline

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What the optimal bispectral index range for general anesthesia?

40-60

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What is the most sensitive method for detecting a circuit disconnection?

Continuous end-tidal CO2 monitoring

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The degree of ST elevation or depression on an ECG is measured between the isoelectric line and the

J point

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Which of the following devices utilizes spectrophotometry to derive the values it produces?

pulse oximetry

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What type of EEG activity would most likely be seen during the awake state?

Low frequency, high voltage activity

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Which of the following corresponds to the opening of the tricuspid valve on a central venous pressure waveform?

The y descent

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Pulmonary capillary wedge pressure is used as an estimation of

left ventricular end-diastolic pressure

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Invasive arterial catheters tend to stop working after one to two weeks because of (2)

Atrial inflammation
Blood clots

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What does the y descent on a central venous pressure waveform represent?

Opening of tricuspid valve

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A disadvantage of traditional two-wavelength pulse oximetry under general anesthesia is that it

is not effective at providing an early warning of decreasing arterial oxygen tension under a high FiO2

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What is the effect of carboxyhemoglobin on the SpO2 estimate of a conventional pulse oximeter?

overestimation of the SpO2

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Which of the following is the most effective in maintaining normothermia under anesthesia?

Forced air warmer

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Which of the following conditions are associated with large ‘v’ waves on the central venous pressure waveform?

Tricuspid regurgitation

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Which of the following factors may lead to overestimation of the SaO2 by an SpO2 monitor?

Severe anemia

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What are the most common anatomical sites for invasive arterial monitoring line placement?

radial

What is the term for a condition where a valid alarm triggering condition exists, but no alarm is signaled by the monitor?

False-negative alarm

Most pulse oximeter manufacturers state that the accuracy of SpO2 values less than 50 percent

is entirely unreliable

Which gas analysis method requires the gas molecules to be ionized and passed through a magnetic field?

Mass spectrometry

All of the below are criteria fundamental to the presentation of visual monitoring displays except

Magnification

A terminal upswing at the end of the capnogram plateau

due to decreases in lung compliance and functional residual capacity

A chemical carbon dioxide detector changes color when exposed to

acid

Which of the following would result in an underestimation of the aortic pressure (2)

Radial artery monitoring during hypothermic cardiopulmonary bypass Air in the transducer tubing

What is one of the disadvantages of the sidestream gas analyzer?

Water accumulation

Which of the following conditions would be detected by capnography? (2)

Esophageal intubation Anesthesia circuit leak

Which of the following will result in an overestimation of the actual blood pressure?

Placing a blood pressure cuff on an extremity that is below the level of the heart

The most distal port of a pulmonary artery catheter is designed to measure the _____ and _____.

Pulmonary artery pressure Pulmonary capillary wedge pressure

The main purpose of the breathing circuit low pressure alarm is to

detect a circuit disconnection

A pulmonary embolism would characteristically result in

a decrease in the ETCO2 relative to the PaCO2

As the arterial blood pressure measurement site is moved distally, the _____ and the _____

Systolic increases Diastolic decreases

Which of the following is associated with a loss of the 'a' wave on a central venous pressure waveform? (2)

Ventricular pacing Afib

The inspiratory baseline for a carbon dioxide monitor waveform should read

0 mmHg

Impedance plethysmography is used to measure the

Respiratory rate

Where in the anesthesia circuit would you find a Wright respirometer?

In the expiratory limb

Which of the following has been demonstrated to affect the accuracy of non-invasive blood pressure monitoring?

Arm position

Which of the following are associated with cannon 'a' waves on the central venous pressure waveform? (2)

Diastolic dysfunction Complete AV block

Methemoglobinemia tends to drive the pulse oximetry measurement towards _____ regardless of the actual oxygen saturation.

85%

The administration of methylene blue will

cause a transient decrease in the pulse oximetry reading

The percent of hemoglobin that is saturated with oxygen is directly related to the

oxygen tension in the bloodstream

All of the following are types of oxygen analyzers commonly used in anesthesia except for

radioactive decay analyzers

Which is the most common site for central venous cannulation by anesthesia providers?

Right internal jugular vein

A form of human error that occurs when a practitioner becomes desensitized to alarms or alerts is referred to as

alarm fatigue

The bladder of a blood pressure cuff should have a length that is ___% of the circumference of the arm.

You have performed a train of four test and three twitches have ben abolished. You know that the degree of neuromuscular blockade is between

90-95 percent

A transcranial doppler (TCD) measures the velocity of blood flow through the

middle cerebral artery

What effect will volatile anesthetics have on somatosensory evoked potential (SSEP) monitoring?

increase latency and decrease the amplitude of the SSEPs

What factors can result in falsely high tidal volume readings when using a Wright respirometer?

The administration of nitrous oxide

62. Which monitoring technique provides information relating the oxygen supply to demand within a region?

Cerebral oximetry

Which of the following would be most appropriate for the rapid assessment of intraoperative changes in lung compliance and resistance?

Auscultation

What is the ideal location of an esophageal temperature probe?

distal third of the esophagus

Which method will assess the number of action potentials occurring in a measured muscle group?

Electromyography

Which setting on a peripheral nerve stimulator will produce an electrical stimulation once every ten seconds?

0.1 Hz

Which form of airway gas analysis involves energizing the gas sample with a laser and analyzing the intensity of light emitted when it returns to the unexcited state?

Raman scattering analysis

Electromyography is

sensitive to mechanical and thermal damage

Prioritizing alarm signals, setting intelligent alarm limits, and using different visual and audible alarm cues are ways to

combat alarm fatigue

A patient has suspected carbon monoxide poisoning. The best method for evaluating oxygen saturation in this case is

laboratory co-oximetry

73. Pulse oximetry uses ___ light and ___ light to evaluate the oxygen saturation.

red, near-infrared

What bispectral index would indicate that a patient is awake and should respond to normal voice?

100

A condition in which individuals exhibit reduced recognition of auditory alarms when subjected to a high visual workload is known as

inattentional deafness

What is the determining factor in degree of muscle stimulation when using a peripheral nerve stimulation?

Current

Which diagnostic tool would be the best at identifying systolic wall motion abnormalities during anesthesia?

transesophageal echocardiogram

The most well studied complication of perioperative hypothermia is

coagulopathy

The time that it takes for a gas analyzer to react to a change in the gas concentration passing through it is known as the

rise time

Which statement indicates an incorrect understanding of the precordial doppler?

The precordial doppler is the single most sensitive device for detecting venous air embolism

You notice that the pulse oximeter waveform of an anesthetized patient undergoing an elective colon resection varies greatly during mechanical ventilation. When you pause mechanical ventilation, the waveform appears normal. You should

administer a fluid bolus

Forced-air warmers prevent heat loss due to

radiation

84. Which of the following will produce an increase in EEG activity? (2)

Administration of Ketamine Low dose iso w/ N2O

What CVP waveform changes would you expect to see in a patient with atrial fibrillation? (2)

Absent A waves Prominent C waves

The main purpose of the breathing circuit low-pressure alarm is to detect

disconnection of the breathing circuit

Which of the following agents are least likely to alter the latency or amplitude of somatosensory evoked potentials? (2)

Ketamine Etomidate

Which of the following would you expect to increase the end-tidal carbon dioxide level?

laparoscopic insufflation of the abdomen

Temperature measurement by a foley catheter thermistor is most accurate when A: the patient is undergoing a TURP

urine flow is high

What gases can a nondiverting gas monitor analyze?

CO2, O2, N2O, and all five potent inhalation agents

Compared to the aortic root pressure, as the location of the arterial catheter gets more distal, the

diastolic pressure decreases

A disadvantage of infrared gas analysis is that the absorption bands of these two gases are close enough that it it con produce cross-interference and inaccuracy in their concentration estimations (2)

Carbon dioxide Nitrogen

Which blood pressure measuring method would be the closest alternative to invasive arterial pressure monitoring?

arterial tonometry

Which of the following actions would help prolong the life of an electrochemical oxygen analyzer sensor?

Removing the sensor from the breathing system when not being used

Some ECG monitors are able to measure respiratory rate and depth using the principle of

impedance plethysmography

When monitoring neuromuscular blockade after induction to determine optimum intubating conditions, it is recommended that you set the peripheral nerve stimulator to deliver

single twitches at 0.1 Hz

In the central venous pressure tracing, the v wave corresponds with

venous return pressure

Which electroencephalogram (EEG) findings would be consistent with light anesthesia or profound surgical stimulation?

High frequency, low voltage activity

Which pulse oximetry site would respond the slowest to changes in oxygen saturation?

Finger

Which test of neuromuscular function consists of continuous stimulation for five seconds at 50 Hz or 100 Hz?

Tetanus

Your patient's temperature is 35 degrees Celsius. What is the temperature when converted to Fahrenheit?

What is the gold standard for measuring core body temperature?

pulmonary artery catheter

You are monitoring the ETCO2 waveform during cardiopulmonary resuscitation when the value suddenly increases from 12 mmHg to 32 mmHg. This would be consistent with

return of spontaneous circulation

104. What is the term for a condition where an alarm is signaled, but there is no valid alarm triggering event?

False-positive alarm

Ideally, a pulmonary artery catheter should be positioned in

West lung zone III

Which arterial cannulation site provides the easiest access during low cardiac output states?

Femoral

107. By measuring specific frequencies that are absorbed by a pulsatile blood supply, a calculation may be made to determine the percentage of oxygenated and deoxygenated blood in that sample. This calculation is derived from which law?

Beer-Lambert

What EEG activity would be consistent with the initial onset of hypoxia?

Increased beta activity

Methemoglobinemia will cause the pulse oximeter

underestimate an oxygen saturation of 95%

What is considered a risk of using transesophageal echocardiography (TEE) by a solo practitioner during a case?

Impaired vigilance

Your anesthesia machine has a removeable oxygen sensor. You know that this device is most likely a _____ sensor.

galvanic

Which of the following would you expect to produce a large V wave on a CVP waveform?

Tricuspid regurgitation

What would constitute a significant change in a somatosensory evoked potential?

10 percent increase in latency