True Learn: Principles Of Anesthesia

Question 1

Which of the following is NOT associated with an increased risk for atlantoaxial instability?
A. Achondroplasia
B. Down syndrome
C. Rheumatoid arthritis
D. Sjogren syndrome

Answer 1

D. Sjogren syndrome

Question 2

Which of the following neuromuscular blocking drugs has the LEAST increase in dosage requirements for burn patients?
A. Atracurium
B. Mivacurium
C. Rocuronium
D. Vecuronium

Answer 2

B. Mivacurium

Question 3

Which of the following medications is MOST appropriate to reduce the risk of cerebral vasospasm following clipping of a ruptured berry aneurysm?
A. Magnesium sulfate
B. Nimodipine
C. Nitroglycerin
D. Propranolol
E. Verapamil

Answer 3

B. Nimodipine

Question 4

Intraperitoneal insufflation with carbon dioxide (CO2) for laparoscopic surgery produces an increase in systemic vascular resistance (SVR) and mean arterial blood pressure (MAP). These hemodynamic changes are the direct result of which physiologic response?
A. Decreased total lung compliance
B. Decreased venous return
C. Increased vasopressin release
D. Tachycardia

Answer 4

C. Increased vasopressin release

Question 5

Which of the following nerves innervates the cricothyroid muscle?
A. External branch of the superior laryngeal nerve
B. Internal branch of the superior laryngeal nerve
C. Recurrent laryngeal nerve
D. Glossopharyngeal nerve

Answer 5

A. External branch of the superior laryngeal nerve

Question 6

Which of the following is an absolute INDICATION for bronchial blocker use in a postoperative patient?
A. A postoperative patient following an esophagectomy
B. A postoperative patient following a pneumonectomy
C. A postoperative patient with a bilateral pneumonia
D. A postoperative patient with a bronchopleural fistula

Answer 6

D. A postoperative patient with a bronchopleural fistula

Question 7

Which of the following surgeries puts a patient at highest risk to develop anterior ischemic optic neuropathy resulting in postoperative visual loss?
A. Complex cardiac surgery in supine position
B. Radical neck dissection in semi-sitting position
C. Robotic hysterectomy in steep Trendelenburg position
D. Two-level lumbar laminectomy in prone position

Answer 7

A. Complex cardiac surgery in supine position

Question 8

During awake craniotomy for seizure focus localization, which of the following is the BEST first step for a seizure triggered by cortical stimulation?
A. Administration of methohexital
B. Administration of propofol
C. Application of warm saline to the cortex
D. Immediate securing of the airway

Answer 8

B. Administration of propofol

Question 9

Which of the following is LEAST characteristic of a latex-induced allergic reaction?
A. Contact with latex at mucosal surfaces is the most significant route of latex exposure
B. Latex induces a type III immune response
C. Onset is delayed approximately 30 minutes after exposure to latex
D. Patients with a history of a fruit allergy are at high risk of latex sensitivity

Answer 9

B. Latex induces a type III immune response

Question 10

A 78-year-old female with heart failure and a permanent pacemaker is undergoing a thyroidectomy. During the procedure, the patient becomes bradycardic. Which of the following is the MOST LIKELY cause of her bradycardia?
A. Hypocalcemia
B. Pacemaker oversensing
C. Twiddler syndrome
D. Ventricular fusion

Answer 10

B. Pacemaker oversensing

Question 11

A 30-year-old male sustains a cervical spine injury following a diving accident. He is unable to move his upper or lower extremities and displays paradoxical shallow respirations. Vital signs are as follows:
HR: 52 bpm
BP: 88/42 mm Hg
RR: 32 breaths/min
SpO2: 94%
During laryngoscopy HR falls to 22 bpm. Which of the following is the MOST likely mechanism of the bradycardia?
A. Bainbridge reflex
B. Hering-Breuer reflex
C. Increased vagal sensitivity
D. Unopposed vagal tone

Answer 11

D. Unopposed vagal tone

Question 12

Which of the following is important to ensure adequate cooling of brain parenchyma during deep hypothermic circulatory arrest?
A. Achieve a temperature of 28 degrees Celsius
B. Administer steroids prior to cooling
C. Continue cardiopulmonary bypass for 20 minutes once goal arterial blood temperature is achieved
D. Measure the bladder temperature to correlate with the brain

Answer 12

C. Continue cardiopulmonary bypass for 20 minutes once goal arterial blood temperature is achieved

Question 13

Which of the following events will result in complete loss of ipsilateral brainstem auditory evoked potentials during resection of a left-sided acoustic neuroma?
A. Surgical retraction of cranial nerve VIII
B. Acute basilar artery occlusion
C. Acute decrease in mean arterial pressure
D. Transection of cranial nerve VIII
E. Cold saline irrigation to cranial nerve VIII

Answer 13

D. Transection of cranial nerve VIII

Question 14

In healthy patients, which of the following is unlikely to change significantly between the ages of 40 and 70?
A. Albumin
B. Creatinine
C. Hemoglobin
D. Insulin

Answer 14

B. Creatinine

Question 15

Which of the following statements about hepatitis B virus exposure and transmission is CORRECT?
A. All recipients develop protective hepatitis B virus surface antibodies after initial vaccination
B. Most acute hepatitis B virus infections progress to chronic carrier status
C. Post-exposure prophylaxis includes hepatitis B virus hyperimmune globulin
D. Presence of antibodies to hepatitis B virus surface antigen indicates active infection

Answer 15

C. Post-exposure prophylaxis includes hepatitis B virus hyperimmune globulin

Question 16

An otherwise healthy 33-year-old man is scheduled for laser ablation of anal condyloma using a carbon dioxide laser. These lesions were biopsied and found to contain HPV DNA of types 6 and 11. An uncomplicated spinal anesthetic with monitored anesthesia care is performed. Which of the following statements is MOST TRUE regarding the use of a laser in this case?
A. Evacuation of the surgical plume is recommended regardless of the viral strain present
B. The energy of the laser is inversely related to the square of the distance from its source
C. The size of particles produced in the surgical plume is larger than when electrocautery is utilized
D. This laser produces visible light which can be harmful to the unprotected eye

Answer 16

A. Evacuation of the surgical plume is recommended regardless of the viral strain present

Question 17

Which of the following descriptions most correctly correlates with an ASA physical status 4 classification?
A. Diabetic patient with a hemoglobin A1c of 8.4%
B. Hypertensive patient with chest pain at rest
C. Atherosclerotic patient who suffered from a CVA two years ago
D. Elderly patient with necrotic small bowel and acute on chronic renal failure

Answer 17

B. Hypertensive patient with chest pain at rest

Question 18

A patient is undergoing shoulder surgery performed in the sitting position. The blood pressure cuff reading is at the level of the heart, which is 22 cm below the level of the patient’s external auditory meatus. The blood pressure measurement is currently 90/60 mm Hg. Which of the following represents the patient’s blood pressure at the circle of Willis?
A. 106/76 mm Hg
B. 90/60 mm Hg
C. 74/44 mm Hg
D. 68/38 mm Hg

Answer 18

C. 74/44 mm Hg

Question 19

A 53-year-old man with a history of hepatocellular carcinoma is undergoing orthotopic liver transplantation. The preanhepatic and anhepatic stages of the case have proceeded routinely, and the surgeons are ready to reperfuse the graft liver through the portal vein. Within 5 minutes of reperfusion, the patient becomings hemodynamically unstable and develops a profound widening of the QRS complex on surface electrocardiography. Which of the following is MOST likely responsible for these clinical findings in this case?
A. Fibrinolysis
B. Hyperkalemia
C. Hypocalcemia
D. Hypothermia

Answer 19

B. Hyperkalemia

Question 20

A 60-year-old male undergoes multi-vessel coronary artery bypass grafting for multivessel coronary artery disease. The procedure goes well and postoperative evaluation with TEE reveals no wall motion abnormalities or valvular dysfunction. He is currently on 0.02 mcg/kg/min of norepinephrine and last thermodilution cardiac index recorded before leaving the operating room showed a cardiac index of 2.9 L/min/m^2. A mixed venous blood sample upon arrival to the ICU is 65%. The anesthesia team informs you that they gave 2 mg of midazolam just before leaving the operating room. Thirty minutes later the patient has a mixed venous oxygen saturation of 40% with a cardiac index of 2.6 L/min/m^2, SpO2 of 97% on 40% FiO2, HR of 80 bpm, BP of 124/45 mmHg, temperature of 35.2 degC, and a hematocrit of 30%. The patient states he feels very uncomfortable and is shivering. Which of the following is the MOST appropriate intervention at this stage?
A. Administer meperidine
B. Increase the FiO2 to 100%
C. Start dobutamine
D. Transfuse 1 unit of packed red blood cells

Answer 20

A. Administer meperidine

Question 21

Which of the following intravenous fluids should be AVOIDED for intracranial aneurysm clipping?
A. 0.9% normal saline
B. 3% hypertonic
C. D5 lactated Ringers
D. Plasmalyte

Answer 21

C. D5 lactated Ringers

Question 22

Non-tunneled central venous catheters (CVC) account for the majority of catheter-related bloodstream infections (CRBSI). Which of the following is NOT a guideline published by the Center for Disease Control and Prevention (CDC) aimed at reducing and eliminating CRBSI?
A. Administer systemic antimicrobial prophylaxis routinely before insertion or during use of an intravascular catheter to prevent catheter colonization or CRBSI
B. Ensure adequate number of nursing staff levels in the ICUs
C. Evaluate the catheter insertion site daily by palpation through the dressing
D. Prepare clean skin with a > 0.5% chlorhexidine preparation with alcohol before catheter insertion

Answer 22

A. Administer systemic antimicrobial prophylaxis routinely before insertion or during use of an intravascular catheter to prevent catheter colonization or CRBSI

Question 23

What is the mechanism by which hyperbaric oxygen therapy works?
A. Enhances the release of oxygen from hemoglobin
B. Improves ventilation/perfusion mismatch
C. Increases the amount of dissolved oxygen
D. Increases the binding of oxygen to hemoglobin

Answer 23

C. Increases the amount of dissolved oxygen

Question 24

During pontine surgery in the sitting position, sudden onset of hypertension with a drop in heart rate occurs. Which of the following would be the MOST appropriate next step?
A. Aspiration from the central venous catheter
B. Atropine administration
C. Bolus dose mannitol
D. Stop surgical manipulation

Answer 24

D. Stop surgical manipulation

Question 25

A 20-year-old 80 kg male is scheduled to undergo laparoscopic cholecystectomy. You have an unanticipated difficult airway with a grade 3 view during laryngoscopy and difficulty with mask ventilation. You insert a laryngeal mask airway (LMA), size #4 Unique, and are able to ventilate. You are contemplating your next step and decide to intubate through the LMA. What is the LARGEST size endotracheal tube that can fit through this #4 Unique LMA? (I.D. = internal diameter)
A. 6.0 mm I.D.
B. 6.5 mm I.D.
C. 7.0 mm I.D.
D. 7.5 mm I.D.

Answer 25

A. 6.0 mm I.D.

Question 26

You are providing sedation for a patient undergoing a magnetic resonance imaging (MRI) scan when you suddenly notice apnea on capnography and ventricular fibrillation on the electrocardiogram. On exam, the patient has no pulse. What should you do next?
A. Begin chest compressions
B. Get your resuscitation equipment and prepare to intubate
C. Quench the magnet
D. Remove the patient from the Zone 1 area

Answer 26

A. Begin chest compressions

Question 27

A 16-year-old girl with a history of moderate-persistent asthma is admitted to the hospital for T3 through L3 fusion for treatment of adolescent idiopathic scoliosis. Prior to the surgery she self administers her home budesonide-formoterol combination inhaler. Despite this, following endotracheal intubation, the patient experiences bronchospasm which is successfully treated with positive pressure ventilation and deepening of the anesthetic. The perioperative administration of which of the following medications is MOST likely to result in further exacerbations of bronchospasm?
A. Hydrocortisone
B. Ketorolac
C. Remifentanil
D. Rocuronium

Answer 27

B. Ketorolac

Question 28

A nitrous oxide E-cylinder reads 745 psig. Which of the following BEST estimates the liters of nitrous oxide available for use?
A. 1590
B. 745
C. 345
D. Cannot determine without more information

Answer 28

D. Cannot determine without more information

Question 29

Which option below would cause a DECREASE in a patient’s mixed venous oxygen saturation (SvO2)?
A. Atrial septal defect with a left to right shunt
B. Cyanide toxicity
C. Increase in arterial oxygen saturation
D. Lateral wall myocardial infarction

Answer 29

D. Lateral wall myocardial infarction

Question 30

A 34-year-old male will be undergoing a craniotomy for an intracranial hemorrhage after a motor vehicle accident. When the patient arrives to the OR he is awake but confused and is complaining of severe pain. His BP is 190/80, has a heart rate of 49, and is breathing irregularly. Which option below describes the BEST strategy for induction of anesthesia in this patient?
A. Hyperventilate the patient to decrease his PaCO2 below 25 mmHg
B. Intravenous induction with etomidate
C. Titrate nicardipine for permissive hypotension to decrease cerebral blood flow
D. Administer opioids until the patient is comfortable and adequately sedated

Answer 30

B. Intravenous induction with etomidate

Question 31

Which of the following is LEAST likely to occur following the release of a thigh tourniquet during knee surgery after one hour of inflation?
A. Arterial pH decrease
B. Core temperature decrease
C. End-tidal carbon dioxide decrease
D. Systemic arterial pressure decrease

Answer 31

C. End-tidal carbon dioxide decrease

Question 32

Which of the following positions is MOST likely to predispose a craniotomy patient to developing a tension pneumocephalus?
A. Park bench position for temporal craniotomy
B. Prone position for occipital craniotomy
C. Seated position for posterior fossa craniotomy
D. Supine position for anterior craniotomy

Answer 32

C. Seated position for posterior fossa craniotomy

Question 33

A 7-year-old male is undergoing tonsillectomy and adenoidectomy. He is orally intubated with a regular, cuffed endotracheal tube. While using electrocautery, a fire starts in the upper airway. Which of the following could have helped reduce the risk of an airway fire?
A. Addition of nitrous oxide
B. Laser-resistant endotracheal tube
C. Moistening sponges prior to use
D. Using a propofol infusion instead of sevoflurane

Answer 33

C. Moistening sponges prior to use

Question 34

A 56-year-old female is undergoing an awake craniotomy for tumor resection. The surgery is just beginning when the patient begins to move her legs in discomfort. She complains about anal itching and intense vaginal pain. The surgeon looks to you for an explanation. Which of the following medications is associated with these symptoms?
A. Dexamethasone
B. Dexmedetomidine
C. Fentanyl
D. Phenytoin
E. Vancomycin

Answer 34

A. Dexamethasone

Question 35

A patient underwent aneurysm coiling four days prior for a subarachnoid hemorrhage. Their blood pressure is currently 160/90 mm Hg, MAP is 113 mm Hg, and heart rate is 90 bpm. Which of the following should be given if the patient is now diagnosed with severe cerebral vasospasm?
A. Hydralazine
B. Metoprolol
C. Nimodipine
D. Nitroglycerin

Answer 35

C. Nimodipine

Question 36

Which of the following is NOT a consideration for determining the likelihood of venous air embolism occurring during a neurosurgical procedure?
A. Positioning
B. Rate of entrainment of air
C. Use of nitrous oxide
D. Volume of air entrained

Answer 36

C. Use of nitrous oxide

Question 37

Which of the following is NOT typically associated with rheumatoid arthritis?
A. Atlantoaxial subluxation
B. Pericardial effusion
C. Pulmonic valve stenosis
D. Temporomandibular joint synovitis
E. Ventilation-perfusion mismatch

Answer 37

C. Pulmonic valve stenosis

Question 38

A 65-year-old male farmer is brought to the emergency department after being found unresponsive in his barn. He is hypotensive and bradycardic with a heart rate of 30 beats per minute. He is salivating and appears to be drowning in excessive secretions. The nurse suggests he may have been exposed to a pesticide. Which of the following is the most appropriate initial treatment for this patient?
A. Atropine
B. Physostigmine
C. Pralidoxime
D. Thiosulfate

Answer 38

A. Atropine

Question 39

A 54-year-old man with a history of hypertension, hyperlipidemia, and smoking presents to the hospital’s emergency department after experiencing crushing chest pain while mowing his lawn at home. Which of the following is TRUE regarding the appropriate initial therapies for this patient?
A. Supplemental oxygen should only be administered if the peripheral oxygen saturation drops below 94%
B. Oral aspirin should be given in a dose from 81 to 162 mg
C. Nitroglycerin is indicated only in a patient with evidence of right-sided myocardial infarction
D. Morphine should be given prior to nitroglycerin for the treatment of anginal pain

Answer 39

A. Supplemental oxygen should only be administered if the peripheral oxygen saturation drops below 94%

Question 40

A 26-year-old male is admitted to the ICU following a motor vehicle collision. Given the following hemodynamic variables, what is this patient’s systemic vascular resistance?
Blood pressure 150/75 mm Hg
Mean arterial blood pressure 100 mm Hg
Heart rate 90 bpm
Cardiac output 5 L/min
Central venous pressure 25 mm Hg
Intracranial pressure 15 mm Hg
Mixed venous oxygen saturation 61%
A. 800 dynes * sec/cm^5
B. 960 dynes * sec/cm^5
C. 1200 dynes * sec/cm^5
D. 1360 dynes * sec/cm^5
E. 2000 dynes * sec/cm^5

Answer 40

C. 1200 dynes * sec/cm^5

Question 41

A 66-year-old male is scheduled for emergency exploratory laparotomy and combined burr hole drainage of subdural hematoma after a motorcycle accident. His medical history is significant for atrial fibrillation, hypertension, and hypothyroidism. His home medications include warfarin, digoxin, levothyroxine, and aspirin.

Question 2 of 2 in this set

The patient’s wife indicates he has not taken his medications today. Vital signs include: BP 79/44, HR 124, pulse oximetry 95%, FiO2 0.8, and urine output 150-200 mL/hr. Which of the following medication will MOST likely treat this condition?
A. Hydrocortisone
B. Levosimendan
C. Tolvaptan
D. Vasopressin

Answer 41

D. Vasopressin

Question 42

Which of the following is LEAST appropriate for long-term management of a patient with a traumatic brain injury?
A. Maintain cerebral perfusion pressure between 50-70 mm Hg
B. Maintain intracranial pressure < 20 mm Hg
C. Maintain normothermia or mild hypothermia
D. Maintain PaCO2 between 25-30 mm Hg

Answer 42

D. Maintain PaCO2 between 25-30 mm Hg

Question 43

An otherwise healthy patient with no preoperative neurologic derangements is one hour into a posterior fossa surgery for tumor resection in the prone position. There is acute hypertension and bradycardia while the surgeon is performing retraction. Which of the following mechanisms is behind this finding?
A. Brainstem compression
B. Cerebral edema
C. Hemorrhage from the surgical site
D. Venous air embolism

Answer 43

A. Brainstem compression

Question 44

Which of the following perioperative interventions is MOST likely to decrease the incidence of hoarseness after cervical spine surgery?
A. Anterior surgical approach
B. Application of pressure dressing
C. Endotracheal tube cuff adjustment
D. Methylprednisolone administration

Answer 44

C. Endotracheal tube cuff adjustment

Question 45

An obese patient is undergoing general anesthesia. Which of the following parameters is unchanged compared to a patient with a normal body mass index?
A. Closing capacity
B. Expiratory reserve volume
C. Functional residual capacity
D. Oxygen consumption

Answer 45

A. Closing capacity

Question 46

The following arterial blood gas measurements are obtained after uneventful topicalized flexible bronchoscopic intubation with confirmed endotracheal tube placement:
pH: 7.23
pCO2: 39 mm Hg
PaO2: 216 mm Hg
HCO3: 15 mEq/L
BE: -11
SaO2: 86%
Which of the following is the first BEST treatment option?
A. Hydroxocobalamin
B. Methylene blue
C. Sodium bicarbonate
D. Sodium thiosulfate

Answer 46

B. Methylene blue

Question 47

Which of the following is an advantage of translaryngeal, subglottic jet ventilation when compared to supraglottic jet ventilation?
A. Ability to assess end-tidal carbon dioxide
B. Allows use of inhaled volatile anesthetics
C. Better visualization of surgical field
D. Higher risk of gastric insufflation

Answer 47

A. Ability to assess end-tidal carbon dioxide

Question 48

Oxygen unloading is decreased in which of the following scenarios?
A. Fetal hemoglobin
B. Hyperthermia
C. Increased 2,3-DPG concentration
D. Metabolic acidosis

Answer 48

A. Fetal hemoglobin

Question 49

A farmer presents to the Emergency Department following an episode of wheezing with respiratory distress after harvesting his crops earlier this afternoon. The provider suspects organophosphate poisoning from the insecticide spray on the crops. The patient appears in significant distress at this time. What additional sign or symptom would MOST likely be evident if organophosphate poisoning is confirmed?
A. Bradycardia
B. Constipation
C. Dry mouth
D. Miosis
E. Tachycardia

Answer 49

D. Miosis

Question 50

While delivering an anesthetic to a 34-year-old obese female for laparoscopic cholecystectomy, the oxygen supply alarm sounds and the oxygen analyzer detects a decreasing FiO2 delivery. Which of the following steps is the most appropriate NEXT STEP in management of this patient?
A. Change anesthetic from volatile to intravenous
B. Disconnect the machine from the hospital’s oxygen supply
C. Increase fresh gas flows to avoid delivery of a hypoxic mixture
D. Suspend mechanical ventilation in favor of manual hand ventilation

Answer 50

B. Disconnect the machine from the hospital’s oxygen supply

Question 51

Which of the following does NOT support the decision to bypass Phase I PACU from the OR?
A. Blood pressure within 20% of the preanesthetic level
B. Oxygen saturation ≥92% without supplemental oxygen
C. Able to move all extremities on command
D. Minimal or no nausea and vomiting

Answer 51

D. Minimal or no nausea and vomiting

Question 52

Which of the following is MOST likely involved in the oculocardiac reflex?
A. Glossopharyngeal nerve
B. Oculomotor nerve
C. Optic nerve
D. Trigeminal nerve

Answer 52

D. Trigeminal nerve

Question 53

A 70-year-old nonsmoking 70 kg male is admitted to the ICU after an exploratory laparotomy for bowel perforation secondary to bowel obstruction. He is POD 1 and the bowel is left in discontinuity. He has a nasogastric tube in place that has been draining approximately one liter of fluid daily. He has received 3 liters of normal saline for resuscitation, is on no vasopressors, and blood pressure is 110/60 mm Hg. He is currently intubated and you are attempting to wean him from the ventilator but are having trouble while on pressure support mode. He has a fentanyl infusion going at 25 mcg/hour, pupils are not pinpoint, and the patient does not appear sedated or uncomfortable. Which of the following is MOST likely cause of his failed ventilator weaning?
A. Elevated rapid shallow breathing index secondary to pain
B. Excessive fat content in his tube feeds
C. Metabolic alkalosis induced hypoventilation
D. Opioid induced hypoventilation

Answer 53

C. Metabolic alkalosis induced hypoventilation

Question 54

Which of the following is TRUE regarding the P50 in relation to the oxygen-hemoglobin dissociation curve?
A. A left shift of the oxygen-hemoglobin curve increases the P50 value
B. Decreased pH leads to a decreased P50 value
C. Increased P50 values correspond with decreased hemoglobin affinity for oxygen
D. Normal P50 is ~19 mm Hg

Answer 54

C. Increased P50 values correspond with decreased hemoglobin affinity for oxygen

Question 55

A local terrorist attack has triggered a massive casualty response at a major medical center. Over a dozen patients are expected to arrive and require operative and/or intensive care management. Additionally, it is suspected that most of the patients have had inhalational exposure to anthrax. Which of the following statements about the presentation or management of anthrax is TRUE?
A. Chest pain, dyspnea, and stridor are early symptoms of inhalational anthrax
B. Recommended treatment is with ciprofloxacin or doxycycline
C. Signs and symptoms of inhalational anthrax usually present within 4 hours of exposure
D. Untreated inhalational anthrax has a mortality of 50%

Answer 55

B. Recommended treatment is with ciprofloxacin or doxycycline

Question 56

You are caring for a 45-year-old female having cerebral aneurysm clipping for a 8 mm cerebral aneurysm of her middle cerebral artery. Prior to aneurysm clipping the patient develops hypertension and bradycardia. Evaluation of her pupils reveals dilation and the surgeon notes hemorrhage in the surgical field. Which of the following would NOT be a treatment for this clinical picture?
A. Cooling to 33 degrees Celsius
B. Administration of propofol bolus
C. Administration of adenosine bolus
D. Administration of phenylephrine bolus

Answer 56

D. Administration of phenylephrine bolus

Question 57

A competitive diver is extracted unconscious from a swimming pool and brought to your hospital. Glasgow Coma Scale score is 8 upon arrival. Which of the following is TRUE regarding the management of this patient?
A. Hemolysis is a likely complication of near-drowning
B. Maintenance of in-line cervical spine stabilization is mandated during intubation
C. Pool water aspiration should be treated initially with abdominal thrusts
D. Trendelenburg positioning should be prioritized to remove water from the lungs

Answer 57

B. Maintenance of in-line cervical spine stabilization is mandated during intubation

Question 58

Which of the following is NOT a physiologic change found in the geriatric population?
A. Decreased hepatic metabolism of medications
B. Increased sensitivity to most anesthetic agents
C. Increased minimum alveolar concentration requirement
D. Reduced vascular compliance

Answer 58

C. Increased minimum alveolar concentration requirement

Question 59

An otherwise healthy 23-year-old man presents for laparoscopic appendectomy. Anesthesia is induced with propofol and succinylcholine, and an endotracheal tube is placed without complication. Following induction, anesthesia is maintained using sevoflurane. If present, which of the following represents the MOST LIKELY initial symptom of malignant hyperthermia in this patient?
A. Core temperature greater than 38.8 degrees Celsius
B. Decrease in arterial oxygen saturation
C. Muscle rigidity despite the administration of a non-depolarizing neuromuscular blocking agent
D. Respiratory acidosis

Answer 59

D. Respiratory acidosis