Comorbidities & Home Medications
Which value represents the normal Hemoglobin A1C range?
A. Less than 3.7%
B. Less than 5.7%
C. Less than 6.7%
D. 8% or greater
B. Less than 5.7%
Which of the following comorbidities would likely be a contraindication for an interscalene block?
A. Asthma
B. COPD
C. Obesity
D. Pregnancy
B. COPD
Interscalene nerve blocks cause phrenic nerve involvement in ~100% of cases, causing ipsilateral hemidiaphragmatic paralysis. This may result in dyspnea, hypoxemia, and respiratory distress in patients with severe respiratory disease and reduced pulmonary reserve.
(Elisha et al., 2023, p. 1153)
What commonly prepared for respiratory complication may accompany an intraoperative pulmonary embolism?
A. Laryngospasm
B. Bronchospasm
C. Cardiovascular collapse
D. Awareness
B. Bronchospasm
Bronchospasm is a commonly experienced respiratory complication associated with intraoperative pulmonary embolism. This is brought on by the release of inflammatory mediators.
(Elisha et al., 2023, p. 659)
Which intervention/criteria should be chosen when extubating a difficult airway?
A. Extubation in stage 3
B. Extubation while the patient's Vt is <5ml/kg
C. Awake extubation with reintubation supplies available
D. Extubation in stage 2
C. Awake extubation with reintubation supplies available
In the sitting position, the patient's MAP is 70 mmHg. If the patient's NIBP cuff is located 13 inches below the level of the circle of Willis, what is the cerebral pressure?
Correct answer: 44 mmHg
The differential gradient between NIBP cuff pressures and the circle of Willis is ~2 mmHg per inch of height differential. These differences can be significant and lead to cerebral hypoperfusion and ischemia if not recognized.
Cerebral perfusion calculation:
NIBP cuff MAP - (height difference in inches x 2 mmHg)
70 mmHg - (13 in x 2 mmHg) = 44 mmHg
(Elisha et al., 2023, p. 1037)
Which of the following is the primary mechanism by which gastroesophageal reflux occurs?
A. Chronic decrease in lower esophageal sphincter pressure
B. Ileus
C. Spasm of the gastric fundus
D. Transient relaxation of the lower esophageal sphincter
D. Transient relaxation of the lower esophageal sphincter
The brachial plexus in the interscalene groove lies between which 2 muscles?
A. Middle and posterior scalene
B. Sternocleidomastoid and anterior scalene
C. Trapezius and posterior scalene
D. Middle and anterior scalene
D. Middle and anterior scalene muscles
The nerve roots of the brachial plexus emerge between the anterior and middle scalene muscles into the interscalene groove, where they begin to form the brachial plexus trunks as they descend.
(Elisha et al., 2023, p. 1152)
What is the recommended dose of amiodarone for the treatment of a PE-induced stable ventricular dysrhythmia?
A. 150 mg over 15 min
B. 150 mg over 10 min
C. 100 mg over 10 min
D. 300 mg over 15 min
B. 150 mg over 10 min
(Vargo Anesthesia)
Select two out of four ethical/religious considerations that should be considered for an Amish patient: (Select 2)
A. Limit specific utilization of technological devices
B. Promote music and television time for mental stimulation
C. Allow bishop visitation if patient expressed desire
D. Limit visitors to promote rest
A. Limit specific utilization of technological devices, C. Allow bishop visitation if patient expressed desire
Which of the following factors does not increase the risk for gastric aspiration?
A. Lithotomy position
B. Reverse Trendelenburg position
C. Diabetes mellitus
D. Pregnancy
B. Reverse Trendelenburg position
Which three nerve roots of the brachial plexus are targeted by an interscalene block? (Select 3)
A. C4
B. C5
C. C6
D. C7
E. C8
F. T1
B. C5, C. C6, D. C7
Interscalene nerve blocks target the brachial plexus cervical nerve roots of C5-C7 (superior and middle trunks).
(Elisha et al., 2023, p. 1152)
Which vasopressor is preferred for the hemodynamic management of a patient experiencing PE-induced cardiovascular depression?
A. Ephedrine
B. Vasopressin
C. Phenylephrine
D. Norepinephrine
D. Norepinephrine
Norepinephrine supports myocardial contractility and improves cerebral and end-organ perfusion via vasoconstriction. Additionally, norepinephrine is a vasopressor nurses on postoperative units are more familiar with.
(Elisha et al., 2023, p. 660)
The classic triad of Horner's syndrome includes which three symptoms? (Select 3)
A. Ptosis
B. Mydriasis
C. Exophthalmos
D. Anhidrosis
E. Hyperhidrosis
F. Miosis
A. Ptosis, D. Anhidrosis, F. Miosis
Horner's syndrome occurs from the blockade of sympathetic output from the stellate ganglion (~C7). The common triad of Horner's syndrome is ptosis, miosis, and anhidrosis. Additionally, patients may experience posterior regression of the eye (enophthalmos).
(Elisha et al., 2023, p. 1153)
What conditions comprise the biochemical triad of diabetic ketoacidosis?
A. Proteinuria, hyperglycemia, acidemia
B. Ketonemia, hyperglycemia, alkalemia
C. Acidemia, ketonemia, hyperglycemia
D. Proteinuria, ketonemia, acidemia
C. Acidemia, ketonemia, hyperglycemia
Which two out of the four postoperative treatment plan options are appropriate for a patient who developed a PE following surgery?
(Select 2)
A. Tissue plasminogen inhibitor
B. Tissue plasminogen activator/Catheter-Directed Thrombolysis
C. Administration of FFP/platelets
D. Supportive measures
B. Tissue plasminogen activator/Catheter-Directed Thrombolysis, D. Supportive measures