Question 1

Which of the following medications is a specific depolarizing muscle relaxant than can produce generalized fasciculations?

Accepted Answer

A)  Succinylcholine 
B)  Mivacurium 
C)  Pancuronium 
D)  Rocuronium

Question 2

Two anesthetic gases that are included in the balanced inhalation mix during general anesthesia are:

Accepted Answer

A)  nitrous oxide and air. 
B)  nitrous oxide and oxygen. 
C)  air and oxygen. 
D)  halothane and oxygen.

Question 3

While hypothermia was historically credited as a therapeutic modality benefitting all surgery because it decreases metabolism and reduces oxygen demand,inadvertent hypothermia is now recognized as impacting many critical physiologic functions and patient outcomes.Which of the following impairments can contribute to surgical site infections?

Accepted Answer

A)  Altered drug metabolism 
B)  Impaired wound healing 
C)  Impaired platelet function 
D)  Cardiac rhythm disturbances

Question 4

At a regional MH testing center Davis Washington is undergoing a muscle biopsy for suspected genetic predisposition to malignant hyperthermia.The anesthesia provider will provide light intravenous (IV)sedation while the surgeon infiltrates the biopsy site with a local anesthetic.This will facilitate Davis' tolerance of the procedure and minimize his risk for an MH episode.What is the current correct name for this anesthesia modality?

Accepted Answer

A)  Local with anesthesia standby 
B)  Monitored anesthesia care (MA
C)  
C)  Basal narcosis 
D)  Moderate sedation

Question 5

The anesthesia department at Evergreen Medical Center has a total staff of 102 persons.These employees serve in many roles as care providers,technical assistants,materials management,clinical engineers,and clerical staff.Select the list of direct-care anesthesia providers.

Accepted Answer

A)  CRNA,anesthesia tech,anesthesia provider 
B)  CRNA,CNA,anesthesia scheduler 
C)  Anesthesia tech,anesthesiologist assistant (A
A) ,anesthesia scheduler 
D)  Anesthesia provider,AA,CRNA

Question 6

Marvin Deloitte,a 19-year-old male,received an intravenous peripheral nerve block (PNB/Bier block)for an ORIF of an ankle fracture.The anesthesia provider injected a distal dorsal vein of Marvin's right foot with 2% lidocaine,after placing a single cuffed pneumatic tourniquet circumferentially around Marvin's upper right thigh.The surgeon looked through the OR window to check on anesthesia progress as he scrubbed at the sink outside of the OR.The circulating nurse had the leg elevated and was prepping the ankle.The surgeon noticed that the cuff seemed to be deflating and that the anesthesia provider was turned away from the patient.The circulating nurse also noticed the movement under the protective towel placed over the cuff,and saw the tourniquet tubing fall to the floor.The nurse's first response should be to:

Accepted Answer

A)  alert the anesthesia provider,run for the code cart,and tell the scrub person to wrap the Esmarch bandage around the deflated cuff. 
B)  alert the anesthesia provider,reconnect the tubing to cuff and inflate,and send the surgeon for the code cart. 
C)  send the scrub person for the code cart,alert the anesthesia provider to reconnect the tubing and reinflate the cuff,and continue the skin prep. 
D)  alert the anesthesia provider,reconnect the tubing and reinflate the cuff,and send the surgeon for a replacement cuff.

Question 7

Minimizing risk factors and administering antiemetics are important preventive actions against PONV.Antiemetics are designed to interact with the four main neurotransmitters that affect PONV.These four neurotransmitters are:

Accepted Answer

A)  cholinesterase,droperidol,dopamine,sterol. 
B)  histamine,acetylcholine,serotonin,and dopamine. 
C)  acetylcholinesterase,histamine,epinephrine,aldosterone. 
D)  norepinephrine,antihistamine,serotonin,oxytonin.

Question 8

During a hypermetabolic MH crisis,the patient will eventually assume a state of metabolic acidosis.What is the desired drug used to reverse this trend?

Accepted Answer

A)  Mannitol 
B)  Dopamine 
C)  Sodium bicarbonate 
D)  Potassium chloride

Question 9

The physiologic effects resulting from the inhalation of gaseous anesthetic agents and intravenous infusion of anesthetic drugs inhibit several areas of the central nervous system (CNS).The processes by which they occur are explained by several proposed theories.Which of the options describes a plausible anesthetic mechanism of action?

Accepted Answer

A)  Inhaled opiates are absorbed by dopamine antagonist receptors in the CNS. 
B)  Sodium channels trade places with potassium ions in the cerebral cellular cytoplasm. 
C)  Endorphins undergo biotransformation into protein-soluble compounds. 
D)  Synaptic transmission of nerve impulses in the CNS is inhibited.

Question 10

A basic anesthesia monitoring device that is used during general anesthesia to confirm successful endotracheal tube placement and determine the presence of gas exchange is the:

Accepted Answer

A)  pulse oximetry device placed on the finger,toe or ear lobe to measure oxygen saturation. 
B)  stethoscope to listen to breath sounds in all lung fields. 
C)  capnometer/end-tidal CO₂ monitor to identify expired CO₂ in the breathing circuit. 
D)  postintubation arterial blood gas monitoring with a point-of-care testing device.

Question 11

The instillation of a local anesthetic into the subarachnoid space is termed:

Accepted Answer

A)  spinal anesthesia. 
B)  epidural anesthesia. 
C)  perfusion block. 
D)  stellate ganglion block.

Question 12

Many factors have contributed to the evolution and progressive growth of ambulatory surgery.Select the three anesthetic agents that promote fast induction,rapid emergence,and minimal side effects and have been credited as a significant factor in this trend.

Accepted Answer

A)  Propofol,desflurane,sublimaze 
B)  Midazolam,sevoflurane,propofol 
C)  Desflurane,sevoflurane,halothane 
D)  Sevoflurane,propofol,desflurane

Question 13

Somatosensory evoked potential (SEP)monitoring assesses neuromuscular transmission pathways during procedures where ischemia may occur because of surgical manipulation,resulting in sensory and motor function.This surveillance is most often employed in:

Accepted Answer

A)  lumbar puncture with chemotherapeutic agent injection. 
B)  carpal tunnel release. 
C)  posterior spinal fusion. 
D)  nerve biopsy when a nerve stimulator is used.

Question 14

During a surgical procedure using ketamine as the induction and maintenance agent,the perioperative nurse should:

Accepted Answer

A)  promote a safe,quiet,and low-stimulus environment of care. 
B)  maintain close proximity to the patient and anesthesia provider in case the patient has hallucinations. 
C)  have the difficult airway cart in the room in case of respiratory distress. 
D)  monitor the dosage and amount of ketamine used.

Question 15

Perioperative nurses should be familiar with all basic anesthetic monitors and normal ranges of physiologic parameters in order to:

Accepted Answer

A)  relieve the anesthesia provider for short periods of time during long procedures with stable patients. 
B)  anticipate patient and anesthesia provider needs in terms of patient status and potential emergencies. 
C)  safely use the equipment when they monitor a patient under local anesthesia. 
D)  anticipate patient and anesthesia provider needs in terms of patient status and potential emergencies,and safely use the equipment when they monitor a patient under local anesthesia.

Question 16

Ketamine is a short-acting induction and IV or IM maintenance agent.Patients are able to maintain their airways.It is a suitable agent to use with small children and burn patients.The concern with this agent is that in large doses it may cause:

Accepted Answer

A)  hallucinations. 
B)  thrombocytopenia. 
C)  respiratory depression. 
D)  hallucinations and respiratory depression.

Question 17

Miriam Glass is a 78-year-old female scheduled for compression nail insertion of a left fractured hip.She was positioned for a spinal injection to induce spinal anesthesia.During the process,the anesthesia provider inadvertently inserted the spinal needle into the subarachnoid space,not noticing the error until the entire syringe of lidocaine was emptied into the patient.Miriam immediately experienced rapid onset of hypotension,bradycardia,and apnea.Miriam's unintentional condition is called __ and now must be managed with _.

Accepted Answer

A)  total subarachnoid syndrome;mechanical ventilation 
B)  hypotensive apnea episode;tracheostomy and humidified positive end-expiratory pressure (PEEP) 
C)  cardiogenic shock;ACLS protocol 
D)  total spinal anesthesia;general endotracheal anesthesia

Question 18

A desired anesthesia experience for a child is an anesthetic agent that offers a rapid and smooth induction with good relaxation,followed by rapid emergence.Which of the listed inhalational agents is the best choice for pediatric anesthesia?

Accepted Answer

A)  Isoflurane 
B)  Nitrous oxide 
C)  Sevoflurane 
D)  Halogen

Question 19

While a sudden drop in the SpO₂ level may result from systemic hypoxia,blood flow to the distal extremity may be inadequate because of:

Accepted Answer

A)  hypothermia. 
B)  malposition. 
C)  constriction by blood pressure cuff inflation. 
D)  All of these options may decrease SpO₂ level.

Question 20

Which anesthetic agent could not be given if an IV-only anesthesia plan was employed?

Accepted Answer

A)  Thiopental 
B)  Halothane 
C)  Diazepam 
D)  Diphenhydramine

Exam 4: Anesthesia