NORA

Question 1

Sedation exists as a ________.

Answer 1

continuum

Question 2

Minimal Sedation
A) Spontaneous unaffected
B) Airway unaffected
C) Normal response to stimuli
D) CV usually maintained

Options:
A) A only
B) A and B
C) B and D
D) A, B, and C
E) All of the above

Answer 2

D

Minimal Sedation
Responsiveness: Normal to verbal stimuli
Airway: Unaffected
Spontaneous Ventilation: Unaffected
CV Function: Unaffected

Question 3

Moderate Sedation
A) Unresponsive/Unarousable
B) Airway - No intervention
C) Spontaneous ventilation unaffected
D) CV usually maintained

Options:
A) A only
B) A and B
C) B and D
D) A, B, and C
E) All of the above

Answer 3

C

Moderate Sedation
Responsiveness: Purposeful response to verbal/tactile stimuli
Airway: No intervention required
Spontaneous Ventilation: adequate
CV Function: Usually maintained

Question 4

Deep Sedation
A) Unresponsive/Unarousable
B) Airway - No intervention
C) Spontaneous ventilation unaffected
D) CV may be impaired

Options:
A) A only
B) A and B
C) B and D
D) A, B, and C
E) All of the above

Answer 4

A

Deep Sedation
Responsiveness: Purposeful with REPEATED or painful stimuli
Airway: Intervention may be required
Spontaneous Ventilation: May be inadequate
CV Function: Usually maintained

Question 5

General Anesthesia
A) Unresponsive/Unarousable
B) Airway - Intervention often required
C) Spontaneous ventilation frequently inadequate
D) CV may be impaired

Options:
A) A only
B) A and B
C) B and D
D) A, B, and C
E) All of the above

Answer 5

E

General Anesthesia
Responsiveness: Unarousable
Airway: Intervention often required
Spontaneous Ventilation: Frequently inadequate
CV Function: May be impaired

Question 6

What are the 10 remote location standards of practice?

Answer 6

Preanesthesia assessment
Informed consent
POC
Implement/adjust POC
Prepare, dispense, label meds before use
Safety precautions
Monitor/Document
Minimize risk of infection (for everyone)
Time-oriented documentation
Transfer/Continuity of Care

Question 7

Traditional pharmacotherapy works by?

Answer 7

Transduction
Transmission
Modulation
Perception of pain

Question 8

Pediatric Patient Considerations include

Answer 8

Pt safety & guardianship of pt welfare
Children < 5 you at greatest risk for adverse events
Always assess for URI, fever, cough, snoring, and sputum production dt increased airway compromise

Question 9

Pediatric respiratory adverse events are dt
a) multiple drug use
b) resp depression, apnea, obstruction
c) prolonged procedures
d) decreased hr
Options:
A) A only
B) A and B
C) B and D
D) A, B, and C
E) All of the above

Answer 9

D) a, b, c

Question 10

What are some common causes of pediatric anesthesia adverse events for therapeutic or diagnostic procedures?

Answer 10

Question 11

Pediatric NPO for clear liquids (all ages)

a) 2 hrs
b) 4-6 hrs
c) 6 hrs
d) 6-8 hrs

Answer 11

a) 2 hrs

Question 12

Pediatric NPO for solid food and non clear liquids < 6 mos

a) 2 hrs
b) 4-6 hrs
c) 6 hrs
d) 6-8 hrs

Answer 12

b) 4-6 hrs

Question 13

Pediatric NPO for solid food and non clear liquids 36 months

a) 2 hrs
b) 4-6 hrs
c) 6 hrs
d) 6-8 hrs

Answer 13

c) 6 hrs

Question 14

Pediatric NPO for solid food and non clear liquids 6 mos

a) 2 hrs
b) 4-6 hrs
c) 6 hrs
d) 6-8 hrs

Answer 14

c) 6 hrs

Question 15

Pediatric NPO for solid food and non clear liquids 6-36 mos

a) 2 hrs
b) 4-6 hrs
c) 6 hrs
d) 6-8 hrs

Answer 15

c) 6 hrs

Question 16

Pediatric NPO for solid food and non clear liquids > 36 mos

a) 2 hrs
b) 4-6 hrs
c) 6 hrs
d) 6-8 hrs

Answer 16

d) 6-8 hrs

Question 17

Geriatric Patient Considerations

Answer 17

• increased age -> increased period complications, loss of function reserve & physiologic
• increased comorbidities
• decreased immunity
• increased ration of adipose -> increased storage of lipid soluble agents
• decreased metabolic function (liver/kidney) will prolong anesthesia effects
• increased cerebral atrophy -> increased sensitivity to anesthetic meds
• decreased circulation time and muscle atrophy results in decreased O2 consumption and blood flow to muscles -> decreased CO
• decreased lung compliance -> v/q mismatch
• decreased thermoregulation
• use written & verbal post instructions
• evaluate preop METS/activity level
• ensure adequate padding/positoning

Question 18

What is the optimal shock dose for cardioversion
a) 25-50J
b) 50J
c) 360J
d) 100J

Options:
A) A only
B) A and B
C) B and D
D) A, B, and C
E) All of the above

Answer 18

C) 50 to 100 J

Max 360J

Question 19

Where do you place the cardioversion pads?

Answer 19

One pad - parasternal over 2-3 ICS
One pad - over apex

Question 20

What are the indications for caridoversion
a) afib/aflutter
b) unstable VT
c) stable VT
d) ST

Options:
A) A only
B) A and B
C) B and D
D) A, B, and C
E) All of the above

Answer 20

D) a,b,c

Question 21

The DC stimulus is synced to what
A) P wave
B) R wave
C) ST wave
D) T wave

Answer 21

B) R wave

Question 22

What type of anesthesia meds will you use for cardioversion?

Answer 22

Since it is usually quick (1 minute), rapid recovery, you want quick on and off

Propofol (30-50mcg) or Etomidate -> good for low EF

Cardiovert is usually planned, but can be unplanned/emergent

Question 23

What type of anesthesia level would you use for cardioversion?

Answer 23

Deep sedation
Room air general (RAG)

Question 24

What are some considerations for cardioversion

Answer 24

NPO
Supplemental O2
Standard Monitors
Resuscitative Equipment

Can use EEG to monitor depth of sedation

Question 25

Make sure to use a muscle relaxant prior to cardioversion. T/F

Answer 25

False, not needed