questions

Question 1

Patient Z has his pacemaker’s rate increased from 70bpm to 140bpm. What does this do this cardiac output?
A. increases perfusion to tissues
B. This will have zero effect on cardiac output
C. Stroke volume will fall due to pacemaker stimulation
D. Stroke volume doubles bc the HR doubled thus increasing CO
E. Pt Z should talk to whom ever interrogated his pacemaker and ask refund

Answer 1

c. stroke volume will fall due to pacemaker stimulation
Changes in HR alone inversely affect SV d/t ventricular filling time decrease as length of diastole shortens.
When physiological mech during exercise cause the HR to double, CO more than doubles because SV increases.

Question 2

Does an increased or decreased cardiac output deliver more anesthetic gas to the brain?

Answer 2

decreased CO
inversely proportional
If cardiac output is slower, there is more time for anesthetic gas to jump onto the alveoli, be absorbed, and taken to the brain.

Question 3

Use the following information to calculate the patient’s SVR, and then identify whether the SVR is normal or abnormal. MAP=55, CVP=3, CO=4

Answer 3

1040, normal SVR 800-1200

(MAP-CVP)x80/CO

Question 4

A pt is hypotensive after losing lots of blood during surgery. The pts SVR is 750. Which of the following are appropriate interventions by the nurse anesthetist?
A. Vasodilator med
B. Vasopressor med
C. Blood products
D. IVF

Answer 4

B. Vasopressor med
C. blood products
d. IVF

Question 5

Which of the following are factors that could increase PVR?
A. hypocapnia
B. Acidemia
C. Vasoconstricting drugs
D. Hypercapnia
E. Vasodilating drugs
F. Strenous exercise

Answer 5

B. Acidemia
C. Vasoconstricing drugs
D. Hypercapnia

Question 6

What should you avoid in patients with mitral stenosis or mitral regurgitation?
A. Alkalemia
B. Low PVR
C. Hypercarbia
D. Vasodilating drugs

Answer 6

C. Hypercarbia

Question 7

A pts. body temp intraoperatively is 35.5 degrees celsius. What do you expect to happen to the patients SVO2?
A. Increase
B. Decrease
C. Remain the same

Answer 7

B. Decrease
Correct answer Increase?
Increase SVO2–tissue is unable to extract oxygen from the blood
Left to right shunts
Hypothermia
Sepsis
Wedged pulmonary artery catheter
Decrease SVO2–tissue is extracting a higher % of oxygen from the blood
Decreased cardiac output
Hyperthermia
Shivering
Seizures
Hemorrhage

Question 8

In which lung zone should the tip of the pulmonary catheter be placed?

Answer 8

Zone III

Question 9

As the Pa Cath advances, the SRNA is watching the waveform and notes the diastolic pressure to increase and the formation of a dicrotic notch. They know the tip of the catheter must be in which location?

Answer 9

the pulmonary artery

Question 10

Which distance would correlate with the tip of a central venous catheter in the pulmonary artery of a patient with a LEFT internal jugular central line?
A. 10cm
B. 10-20cm
C. 20-30cm
D. 40-50cm

Answer 10

40-50cm

20cm+15-30cm

Question 11

What contraindications should be considered before placing a Swan-Ganz catheter?

a. LBBB
b. pts with tricuspid or pulmonic valve replacements
c. presences of endocardial pacing leads
d. RBBB
e. all of the above

Answer 11

e. all of the above

Question 12

When should you measure CVP?

Answer 12

End-expiration

Question 13

Atrial depolarization is shown as _____ on EKG?

Answer 13

p-wave

Question 14

T/F: EKGs can determine contractility of the heart?

Answer 14

False

Question 15

What is the starting point in measuring the ST segment?

Answer 15

J junction

Question 16

T/F: If a pt has new onset ST elevation in V3-V4, the most likely culprit is the RCA

Answer 16

False

Question 17

What electrode placement acts as the ground?
A. RL-Green
B. RA-White
C. LA-Black
D. LL-Red

Answer 17

A. RL-Green

Question 18

What part of the brain controls the body’s thermoregulatory system?

Answer 18

Hypothalamus

Question 19

How does the body attempt to release heat when in a hot environment?

a. produce sweat and relax muscles
b. constrict muscles
c. shiver
d. all of the above

Answer 19

a. produce sweat and relax muscles

Question 20

In the presence of a cold external environment, what does the body do to attempt to retain heat?

a. dry out
b. shivering, muscles tense, and arrestor pilli muscles raise hair follicles
c. sweat
d. all of the above

Answer 20

b. shivering, muscles tense, and arrestor pilli muscles raise hair follicles

Question 21

Which of the following are common intra-operative complications related to hypothermia?

a. bleeding complications
b. vasoconstriction
c. shivering
d. all of the above

Answer 21

d. all of the above

Question 22

What test is used to diagnose malignant hyperthermia?
a. bone scan
b. CT scan
c xray
d. CHCT test

Answer 22

d. CHCT test

Question 23

What condition presence would be absolutely contraindicated to perform TEE?

a. septal defect
b. active upper GI bleed
c. Hx of left atrium blood clot
d. missing teeth

Answer 23

b. active upper GI bleed

Question 24

What is the typical position patient is placed for TEE?

Answer 24

left lateral decubitus

Question 25

Which ultrasound probe is most useful for a cardiac assessment?

a. linear probe
b. phased array probe
c. curved array probe

Answer 25

b. phased array probe

Question 26

TEE are commonly performed outside of the normal operating room with minimal equipment therefore it is essential to have:

a. suction
b. ambu bag
c. means to break laryngospasm
d. all of the above

Answer 26

d. all of the above

Question 27

Once the TEE probe is settled in place the esophagus-stimulation is generally less irritating? T/F

Answer 27

True