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7835 Exam III (minus Module 8) > Mod10: April's Practice questions > Flashcards

Mod10: April's Practice questions Flashcards

1
Q

Where should the kidney rest be placed in the lateral position to prevent compression of the IVC?

A. under iliac crest

B. above iliac crest

C. under the 12th rib

D. lateral to the kidneys

A

A. under iliac crest

B. above iliac crest

C. under the 12th rib

D. lateral to the kidneys

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2
Q

What will increase in the head down position?

A. FRC

B. CV

C. Vt

D. lung capacities

A

A. FRC

B. CV (Closing Volume )

C. Vt

D. lung capacities

The closing capacity is the volume in the lungs at which its smallest airways, the respiratory bronchioles, collapse.

Closing capacity= closing volume + residual volume

The alveoli lack supporting cartilage and so depend on other factors to keep them open

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3
Q

Valsalva maneuver should be delivered at what pressure?

A. 10-20 cmH2O

B. 20-30 cmH2O

C. 30-40 cmH2O

D. 40-50 cmH2O

A

A. 10-20 cmH2O

B. 20-30 cmH2O

C. 30-40 cmH2O

D. 40-50 cmH2O

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4
Q

Valsalva maneuvers may cause a decrease in (select two)

A. VR

B. FRC

C. CV

D. BP

A

A. VR

B. FRC

C. CV

D. BP

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5
Q

Supine positioning causes an increase in all of the following except:

A. right atrial filling pressure

B. CO

C. VR

D. HR

A

A. right atrial filling pressure

B. CO

C. VR

D. HR

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6
Q

Under anesthesia and mechanical ventilation, the dependent lung:

A. has better ventilation than the independent lung

B. has better perfusion than the independent lung

C. has better ventilation compared to spontaneous breathing

D. has better ventilation and perfusion than the independent lung

A

A. has better ventilation than the independent lung

B. has better perfusion than the independent lung

C. has better ventilation compared to spontaneous breathing

D. has better ventilation and perfusion than the independent lung

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7
Q

All are causes of postop visual loss (PLV) except:

A. hypertension

B. excessive blood loss

C. ischemic optic neuropathy

D. central retinal arterial occlusion

A

A. hypertension

B. excessive blood loss

C. ischemic optic neuropathy

D. central retinal arterial occlusion

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8
Q

The most commonly injured nerve in the arm is the ________ nerve.

A. radial

B. median

C. ulnar

D. brachial

A

A. radial

B. median

C. ulnar

D. brachial

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9
Q

Elderly patients with a hip fracture may have to be placed in what position for a spinal placement?

A. lateral

B. prone

C. sitting

D. supine

A

A. lateral

B. prone

C. sitting

D. supine

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10
Q

Compression of the abdomen on a Wilson frame table can cause (select two)

A. decrease in FRC

B. decrease in VR

C. increase in BP

D. decrease in HR

A

A. decrease in FRC

B. decrease in VR

C. increase in BP

D. decrease in HR

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11
Q

What must have adequate padding to prevent nerve injury on a Fracture Table?

A. perineal post

B. back rest

C. abdomen

D. neck

A

A. perineal post

B. back rest

C. abdomen

D. neck

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12
Q

For every 1 cm rise of the head in the beach chair position, there is a 0.75 mmHg drop in blood pressure

A. True

B. False

A

A. True

B. False

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13
Q

Blood pressure in the brain is about ________ lower than blood pressure in the arm in the beach chair position.

A. 8-24 mmHg

B. 12-16 mmHg

C. 8-10 mmHg

D. 20-24 mmHg

A

A. 8-24 mmHg

B. 12-16 mmHg

C. 8-10 mmHg

D. 20-24 mmHg

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14
Q

Select three risk associated with the use of a pneumatic tourniquet.

A. bleeding

B. pain

C. low RR

D. metabolic changes

E. bradycardia

F. pulmonary embolism

A

A. bleeding

B. pain

C. low RR

D. metabolic changes

E. bradycardia

F. pulmonary embolism

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15
Q

Insufflation pressure for a pneumatic tourniquet placed on the arm should be:

A. equal to SBP

B. 100 mmHg above baseline of SBP

C. 50 mmHg above baseline of DBP

D. 50 mmHg above baseline of SBP

A

A. equal to SBP

B. 100 mmHg above baseline of SBP

C. 50 mmHg above baseline of DBP

D. 50 mmHg above baseline of SBP

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16
Q

Using a pneumatic tourniquet for longer than two hours places the patient at risk for (select two):

A. transient muscle dysfunction

B. untreatable pain

C. peripheral nerve damage

D. alkalosis

A

A. transient muscle dysfunction

B. untreatable pain

C. peripheral nerve damage

D. alkalosis

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17
Q

Bleeding during tourniquet pain is commonly due to intramedullary blood flow in long bones.

A. True

B. False

A

A. True

B. False

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18
Q

The deflation of the tourniquet can cause an increase in all except:

A. heart rate

B. EtCO2

C. blood pressure

D. serum lactate

A

A. heart rate

B. EtCO2

C. blood pressure

D. serum lactate

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19
Q

What fibers are responsible for burning and aching pain?

A. A-delta fibers

B. beta fibers

C. D fibers

D. C fibers

A

A. A-delta fibers

B. beta fibers

C. D fibers

D. C-fibers

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20
Q

Under what anesthetic condition is the patient least likely to experience tourniquet pain?

A. General

B. spinal

C. epidural

D. IV regional

A

A. General

B. spinal

C. epidural

D. IV regional

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21
Q

If bone cement is absorbed systemically, what would you expect to see? (select two)

A. increase in SVR

B. vasoconstriction

C. vasodilation

D. CV instability

A

A. increase in SVR

B. vasoconstriction

C. vasodilation

D. CV instability

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22
Q

Select two ways to minimize effects associated with bone cement syndrome.

A. restrict fluids

B. increase FiO2 prior to cementing

C. maintain FiO2 < 30%

D. maintain adequate IV volumes

A

A. restrict fluids

B. increase FiO2 prior to cementing

C. maintain FiO2 < 30%

D. maintain adequate IV volumes

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23
Q

Select three signs and symptoms of a fat embolism under anesthesia

A. decreased PA pressures

B. bradycardia

C. tachycardia

D. ST changes

E. hypoxia

F. hypocarbia

A

A. decreased PA pressures

B. bradycardia

C. tachycardia

D. ST changes

E. hypoxia

F. hypocarbia

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24
Q

An increase in the A-a gradient means:

A. not as much oxygen is leaving from the blood to the alveoli

B. not as much oxygen is not leaving from the alveoli to the blood

C. both A and B

A

A. not as much oxygen is leaving from the blood to the alveoli

B. not as much oxygen is leaving from the alveoli to the blood

C. both A and B

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25
Q

An increase in the A-a gradient will cause:

A. hypoxia

B. respiratory acidosis

C. decreased lung compliance

A

A. hypoxia

B. respiratory acidosis

C. decreased lung compliance

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26
Q

What laboratory finding would you expect to find in a patient with a fat embolism?

A. decreased serum lipase

B. decreased H/H

C. prolonged clotting time

D. increased serum K

A

A. decreased serum lipase

B. decreased H/H

C. prolonged clotting time

D. increased serum K

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27
Q

The triad of a fat embolism (dyspnea, confusion and petechiae) is seen how long after a long bone fracture?

A. 24 hours

B. 48 hours

C. 72 hours

D. 5 days

A

A. 24 hours

B. 48 hours

C. 72 hours

D. 5 days

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28
Q

What position holds the greatest risk for VAE?

A. supine

B. sitting

C. prone

D. lateral

A

A. supine

B. sitting

C. prone

D. lateral

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29
Q

Venous air embolisms cause an increase in (select two)

A. dead space

B. blood pressure

C. ETCO2

D. ETN2

A

A. dead space

B. blood pressure

C. ETCO2

D. ETN2

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30
Q

Late signs of a venous air embolism include all of the following except:

A. decrease in ETCO2

B. cyanosis

C. tachycardia

D. Mill Wheel murmur

A

A. decrease in ETCO2

B. cyanosis

C. tachycardia

D. Mill Wheel murmur

•Late signs

•Hypotension

•Tachycardia

•Cardiac dysrhythmias

•Cyanosis

•“Mill wheel” murmur

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31
Q

Select two ways to manage a VAE intra-op.

A. FiO2 100%

B. compress neck veins

C. right lateral decubitus position

D. restrict volume/fluids

A

A. FiO2 100%

B. compress neck veins

C. right lateral decubitus position

D. restrict volume/fluids

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32
Q

Risk factors for a thromboembolic event include (select three)

A. minor infection

B. age > 60

C. immobile < 4 days

D. previous DVT

E. obesity

F. no use of oral contraceptives

A

A. minor infection

B. age > 60

C. immobile < 4 days

D. previous DVT

E. obesity

F. no use of oral contraceptives

Risk factors:

Severe infection - > 60 y/o - Tourniquet use

Immobile > 4 days - Previous miscarriage

Oral contraceptives - Previous DVT

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33
Q

Hypotension with increased CVP indicates:

A. hypoxia

B. tachycardia

C. RV failure

D. LV failure

A

A. hypoxia

B. tachycardia

C. RV failure

D. LV failure

34
Q

The blood gas in a patient with a PE would show:

A. severe hypoxemia with respiratory alkalosis

B. mild hypoxemia with respiratory alkalosis

C. mild hypoxemia with respiratory acidosis

D. hypoxemia with respiratory acidosis

A

A. severe hypoxemia with respiratory alkalosis

B. mild hypoxemia with respiratory alkalosis

C. mild hypoxemia with respiratory acidosis

D. hypoxemia with respiratory acidosis

35
Q

The gold standard for diagnosing a PE is:

A. CXR

B. spiral CT

C. V/Q scan

D. pulmonary angiography

A

A. CXR

B. spiral CT

C. V/Q scan

D. pulmonary angiography

36
Q

Pulmonary embolisms only come from DVTs or from within the lungs themselves.

A. True

B. False

A

A. True

B. False

37
Q

Select two contraindications for thrombolytic therapy.

A. PE

B. GI bleed 3 months ago

C. recent surgery

D. active bleeding

A

A. PE

B. GI bleed 3 months ago

C. recent surgery

D. active bleeding

38
Q

Select a disadvantage to regional anesthesia.

A. increased PONV

B. increased risk for thromboembolism

C. increased risk for falls

D. increased blood loss

A

A. increased PONV

B. increased risk for thromboembolism

C. increased risk for falls

D. increased blood loss

39
Q

Neuraxial anesthesia will decrease:

A. factor VIII

B. von Willebrand factor

C. stress hormones

D. all of the above

A

A. factor VIII

B. von Willebrand factor

C. stress hormones

D. all of the above

40
Q

INR must be less than what value in order to proceed with regional anesthesia?

A. 1.5

B. 2.0

C. 2.5

D. 1.0

A

A. 1.5

B. 2.0

C. 2.5

D. 1.0

41
Q

Patients on antiplatelet therapy are at risk for what under regional anesthesia?

A. spinal or epidural hematoma

B. hypotension

C. DIC

D. all of the above

A

A. spinal or epidural hematoma

B. hypotension

C. DIC

D. all of the above

42
Q

All are branches of the sciatic nerve except:

A. femoral nerve

B. popliteal nerve

C. saphenous nerve

D. common peroneal nerve

A

A. femoral nerve

B. popliteal nerve

C. saphenous nerve

D. common peroneal nerve

The saphenous nerve is a terminal branch of the femoral nerve and the only innervation of the foot not a part of the sciatic system

43
Q

Seven total nerves must be blocked in order to perform an ankle procedure under regional anesthesia.

A. True

B. False

A

A. True

B. False

Five nerves supply sensation to the foot:

  1. Saphenous nerve (only one Not part of the sciatic system)
  2. Deep peroneal nerve
  3. Common peroneal nerve
  4. Superficial peroneal nerve
  5. Posterior tibial nerve
44
Q

Which patient would you avoid performing a supraclavicular block on?

A. 80 year old with HTN

B. 50 year old with COPD

C. 45 year old obesity

D. 20 year old with anemia

A

A. 80 year old with HTN

B. 50 year old with COPD

C. 45 year old obesity

D. 20 year old with anemia

45
Q

An axillary block will block:

A. forearm

B. hand

C. elbow

D. all of the above

A

A. forearm

B. hand

C. elbow

D. all of the above

46
Q

What type of muscle pain might the patient complain of with an infraclavicular block?

A. neck muscles

B. pectoralis

C. biceps

D. trapezoids

A

A. neck muscles

B. pectoralis

C. biceps

D. trapezoids

47
Q

Blocking of the femoral nerve will block:

A. anterior aspect of thigh and knee, medial aspect of leg

B. foot and ankle

C. foot and lower part of the leg

D. ankle and distal toe

A

A. anterior aspect of thigh and knee, medial aspect of leg

B. foot and ankle

C. foot and lower part of the leg

D. ankle and distal toe

48
Q

Select two ways to minimize blood loss in hip fracture repairs.

A. volatile agents

B. beta-blockers

C. induced hypertensive technique

D. opioids

A

A. volatile agents

B. beta-blockers

C. induced hypertensive technique

D. opioids

49
Q

TXA and amicar work by:

A. competitively inhibiting the binding site of plasminogen

B. inhibiting serine protease

C. inhibiting coagulation

A

A. competitively inhibiting the binding site of plasminogen

B. inhibiting serine protease

C. inhibiting coagulation

50
Q

The most common viral infection associated with blood product administration is:

A. CMV

B. HIV

C. HPV

D. HCB

A

A. CMV

B. HIV

C. HPV

D. HCB

51
Q

Acute normovolemic hemodilution is the process of collecting the patient’s blood weeks before the planned procedure

A. True

B. False

A

A. True

B. False

52
Q

Nonimmune-mediated transfusion reactions include all of the following except:

A. transfusion-associated CV overload

B. posttransfusion purpura

C. metabolic derangements

D. iron overload

A

A. transfusion-associated CV overload

B. posttransfusion purpura

C. metabolic derangements

D. iron overload

53
Q

EPO administration pre-op would be indicated for:

A. a renal failure patient

B. COPD

C. CAD

D. hypotension

A

A. a renal failure patient

B. COPD

C. CAD

D. hypotension

54
Q

If a patient comes in with a long bone injury, what type of spinal cord injury would you be concerned about?

A. cervical

B. thoracic

C. lumbar

D. sacral

A

A. cervical

B. thoracic

C. lumbar

D. sacral

55
Q

Transection above T1 will cause

A. paraplegia

B. diaphragmatic paralysis

C. quadriplegia

D. decrease in respiratory function

A

A. paraplegia

B. diaphragmatic paralysis

C. quadriplegia

D. decrease in respiratory function

56
Q

The most common cause of death for a C4 injury is:

A. MI

B. stroke

C. respiratory failure

A

A. MI

B. stroke

C. respiratory failure

57
Q

Select three criteria that must be met in order to clear a cervical spine injury.

A. fully alert

B. no drugs or alcohol

C. minor neck pain

D. possible head injury

E. lethargic but following commands

F. no neck pain

A

A. fully alert

B. no drugs or alcohol

C. minor neck pain

D. possible head injury

E. lethargic but following commands

F. no neck pain

58
Q

Blind nasal intubations for acute spinal cord injuries are contraindicated in what condition?

A. LeFort fractures

B. thoracic fractures

C. increased ICP

D. active bleeding

A

A. LeFort fractures

B. thoracic fractures

C. increased ICP

D. active bleeding

59
Q

Spinal cord shock last for:

A. 5-10 days

B. 1 week

C. 1-3 weeks

D. 1 month

A

A. 5-10 days

B. 1 week

C. 1-3 weeks

D. 1 month

60
Q

What would you expect the heart rate to be in a patient experiencing spinal cord shock?

A. 40-60 bpm

B. 60-70 bpm

C. 80-100 bpm

D. 100-120 bpm

A

A. 40-60 bpm

B. 60-70 bpm

C. 80-100 bpm

D. 100-120 bpm

61
Q

What induction agent would benefit a patient experiencing spinal cord shock?

A. propofol

B. etomidate

C. thiopental

D. ketamine

A

A. propofol

B. etomidate

C. thiopental

D. ketamine

62
Q

At what point can you no longer use succinylcholine after a SCI?

A. 6 hours

B. 18 hours

C. 24 hours

D. 48 hours

A

A. 6 hours

B. 18 hours

C. 24 hours

D. 48 hours

63
Q

_______ activity occurs above the lesion in autonomic hyperreflexia, while _____ activity occurs below.

A. SNS, PNS

B. PNS, SNS

C. SNS, SNS

D. PNS, PNS

A

A. SNS, PNS

B. PNS, SNS

C. SNS, SNS

D. PNS, PNS

64
Q

If using precedex during a procedure that involves use of the wake up test, what is the loading dose?

A. 0.6 mcg/kg over 10 minutes

B. 0.8 mcg/kg over 10 minutes

C. 1.0 mcg/kg over 10 minutes

D. 1.2 mcg/kg over 10 minutes

A

A. 0.6 mcg/kg over 10 minutes

B. 0.8 mcg/kg over 10 minutes

C. 1.0 mcg/kg over 10 minutes

D. 1.2 mcg/kg over 10 minutes

65
Q

________ latency or ________ amplitude means that the patient is less responsive to stimulation.

A. increased, decreased

B. increased, increased

C. decreased, increased

D. decreased, decreased

A

A. increased, decreased

B. increased, increased

C. decreased, increased

D. decreased, decreased

66
Q

Select two factors that would alter SSEP.

A. hypertension

B. hypotension

C. hyperthermia

D. hypercarbia

A

A. hypertension

B. hypotension

C. hyperthermia

D. hypercarbia

67
Q

Inhalation agents will increase both latency and amplitude

A. True

B. False

A

A. True

B. False

68
Q

Regional anesthesia for the repair of a shaft humeral fracture is most likely to cause damage to which nerve?

A. brachial

B. axillary

C. ulnar

D. radial

A

A. brachial

B. axillary

C. ulnar

D. radial

69
Q

What regional techniques are commonly used for surgery to the upper arm and shoulder? (select two)

A. interscalene

B. supraclavicular

C. infraclavicular

D. brachial

A

A. interscalene

B. supraclavicular

C. infraclavicular

D. brachial

70
Q

All are the major nerves of the brachial plexus except:

A. axillary

B. median

C. ulnar

D. radial

A

A. axillary

B. median

C. ulnar

D. radial

71
Q

The interscalene block usually leaves the ______ nerve unblocked.

A. median

B. ulnar

C. radial

D. peroneal

A

A. median

B. ulnar

C. radial

D. peroneal

72
Q

If using the axillary approach for an elbow, distal humerus or proximal forearm, what nerve should you be aware of that will not be blocked?

A. median

B. muscular

C. musculocutanous

D. maxillary

A

A. median

B. muscular

C. musculocutanous

D. maxillary

73
Q

A pneumothorax after regional anesthesia to the forearm is typically seen:

A. 4-8 hours after discharge

B. 2 hours after discharge

C. 6-12 hours after discharge

D. 12-24 hours after discharge

A

A. 4-8 hours after discharge

B. 2 hours after discharge

C. 6-12 hours after discharge

D. 12-24 hours after discharge

74
Q

What block would not be effective for wrist surgery?

A. beir block

B. axillary approach

C. interscalene

D. supraclavicular

A

A. beir block

B. axillary approach

C. interscalene

D. supraclavicular

75
Q

How long can a continuous brachial plexus block catheter be left in?

A. 2 days

B. 2-4 days

C. 4-7 days

D. 2 weeks

A

A. 2 days

B. 2-4 days

C. 4-7 days

D. 2 weeks

76
Q

Only patients who received motor blockade to the upper extremities can be discharged right away.

A. True

B. False

A

A. True

B. False

77
Q

What lab would you want to order before a hip arthroplasty?

A. type and cross

B. type and screen

C. electrolytes

D. platelets

A

A. type and cross

B. type and screen

C. electrolytes

D. platelets

78
Q

What type of local anesthetic is appropriate for a hip procedure? (select two)

A. isobaric

B. hyperbaric

C. hypobaric

A

A. isobaric

B. hyperbaric

C. hypobaric

79
Q

What two blocks are needed to block the entire leg for an ACL repair?

A. lumbar plexus block

B. common peroneal nerve block

C. sciatic nerve block

D. saphenous serve block

A

A. lumbar plexus block

B. common peroneal nerve block

C. sciatic nerve block

D. saphenous serve block

80
Q

All of the following cause vasoconstriction/vasospasm except:

A. hyperthermia

B. hypotension

C. hypothermia

D. decreased perfusion presure

A

A. hyperthermia

B. hypotension

C. hypothermia

D. decreased perfusion presure

7835 Exam III (minus Module 8) (21 decks)

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