Exam 1 Review Questions PDF

**Which prep solution results in fewer incidences of nerve injuries because it creates a durable bacterial barrier?**\ A) Povidone-iodine\ B) Isopropyl alcohol\ C) Chlorhexidine gluconate (CHG)\ D) Hydrogen peroxide\ **Answer: C) Chlorhexidine gluconate (CHG)** **What is the gold standard treatment...

**Which prep solution results in fewer incidences of nerve injuries because it creates a durable bacterial barrier?**\ A) Povidone-iodine\ B) Isopropyl alcohol\ C) Chlorhexidine gluconate (CHG)\ D) Hydrogen peroxide\ **Answer: C) Chlorhexidine gluconate (CHG)** **What is the gold standard treatment for a postdural puncture headache?**\ A) IV fluids\ B) Caffeine\ C) Epidural blood patch\ D) Acetaminophen\ **Answer: C) Epidural blood patch** **Which local anesthetic is associated with TENS and CES when injected intrathecally via a microcatheter?**\ A) Bupivacaine\ B) Ropivacaine\ C) Lidocaine\ D) Chloroprocaine\ **Answer: C) Lidocaine** **What are two qualities of needles that cause a PDPH?**\ A) Blunt tip and smaller size\ B) Cutting needle and larger size\ C) Beveled tip and flexible shaft\ D) Short length and plastic composition\ **Answer: B) Cutting needle and larger size** **What nerves innervate the diaphragm and comprise the phrenic nerve?**\ A) T1-T3\ B) C3-C5\ C) L1-L3\ D) T6-T9\ **Answer: B) C3-C5** **What respiratory muscles are impaired from a high thoracic epidural?**\ A) Diaphragm and scalene\ B) External and internal intercostals, abdominal muscles\ C) Sternocleidomastoid and serratus anterior\ D) Latissimus dorsi and pectoralis major\ **Answer: B) External and internal intercostals, abdominal muscles** **What are the first signs that neuraxial anesthesia is positioned appropriately?**\ A) Bradycardia\ B) Hypotension due to sympathectomy\ C) Hyperreflexia\ D) Increased intracranial pressure\ **Answer: B) Hypotension due to sympathectomy** **What are the 3 meningeal layers from superficial to deep?**\ A) Pia, dura, arachnoid\ B) Dura, arachnoid, pia\ C) Arachnoid, pia, dura\ D) Dura, pia, arachnoid\ **Answer: B) Dura, arachnoid, pia** **What meningeal layer adheres to the spinal cord?**\ A) Dura\ B) Pia\ C) Arachnoid\ D) Periosteum\ **Answer: B) Pia** **What meningeal layer limits movement of drugs in and out of the CSF?**\ A) Dura\ B) Pia\ C) Arachnoid\ D) Perineurium\ **Answer: C) Arachnoid** **Why does autonomic blockade occur in neuraxial anesthesia?**\ A) Due to blocked transmission of C fibers\ B) Due to blocked transmission of B fibers\ C) Due to inhibition of alpha motor neurons\ D) Due to enhanced activity of the parasympathetic nervous system\ **Answer: B) Due to blocked transmission of B fibers** **What causes nausea and vomiting after neuraxial anesthesia?**\ A) Anxiety\ B) Hypotension\ C) Opioid stimulation of the CTZ\ D) All of the above\ **Answer: D) All of the above** **What are two factors that increase the spread of epidural anesthesia?**\ A) Pregnancy and old age\ B) High-dose opioids and obesity\ C) Hypertension and low CSF volume\ D) Hypothermia and dehydration\ **Answer: A) Pregnancy and old age** **What medication can cause delayed respiratory depression when administered neuraxially?**\ A) Fentanyl\ B) Morphine\ C) Lidocaine\ D) Ketamine\ **Answer: B) Morphine** **What factors determine the spread of local anesthetics in spinal anesthesia?**\ A) Baricity and patient position\ B) Volume and lipid solubility\ C) Duration of procedure and patient weight\ D) Temperature and specific gravity\ **Answer: A) Baricity and patient position** **What is a characteristic of a patient that contraindicates neuraxial techniques?**\ A) History of migraines\ B) Taking long-acting antithrombotic or antiplatelet medication\ C) Controlled hypertension\ D) Chronic back pain\ **Answer: B) Taking long-acting antithrombotic or antiplatelet medication** **What are absolute contraindications to neuraxial anesthesia?**\ A) Patient refusal\ B) Infection at the site of injection\ C) Increased intracranial pressure\ D) All of the above\ **Answer: D) All of the above** **What are relative contraindications to neuraxial anesthesia?**\ A) Hypertension\ B) Spine surgery\ C) History of asthma\ D) Diabetes\ **Answer: B) Spine surgery** **What is the first-line medication to administer when a patient codes after administration of a local anesthetic?**\ A) Atropine\ B) Epinephrine\ C) Amiodarone\ D) Naloxone\ **Answer: B) Epinephrine** **What type of local anesthetics are more ionized in acidic environments?**\ A) Acidic drugs\ B) Basic drugs\ C) Neutral drugs\ D) Ester-based anesthetics\ **Answer: B) Basic drugs** **What types of channels do local anesthetics affect?**\ A) Sodium, potassium, calcium, and GPCR\ B) Chloride and sodium\ C) Magnesium and potassium\ D) Sodium and hydrogen\ **Answer: A) Sodium, potassium, calcium, and GPCR** **How do nerve bundles appear in the periphery on ultrasound?**\ A) Hypoechoic\ B) Hyperechoic\ C) Anechoic\ D) Isoechoic\ **Answer: B) Hyperechoic** **What are risk factors for nerve injuries associated with regional anesthesia?**\ A) Diabetes and hypertension\ B) Obesity and cigarette smoking\ C) Male gender\ D) All of the above\ **Answer: D) All of the above** 24. **What innervates the lateral rectus muscle?**\ A) Oculomotor nerve (CN III)\ B) Trochlear nerve (CN IV)\ C) Abducens nerve (CN VI)\ D) Optic nerve (CN II)\ **Answer: C) Abducens nerve (CN VI)** 25. **What innervates the superior oblique muscle?**\ A) Oculomotor nerve (CN III)\ B) Trochlear nerve (CN IV)\ C) Abducens nerve (CN VI)\ D) Facial nerve (CN VII)\ **Answer: B) Trochlear nerve (CN IV)** 26. **What are the efferent and afferent branches of the oculocardiac reflex?**\ A) Efferent = Vagus (CN X), Afferent = Ophthalmic division of Trigeminal (CN V1)\ B) Efferent = Trochlear (CN IV), Afferent = Abducens (CN VI)\ C) Efferent = Facial (CN VII), Afferent = Glossopharyngeal (CN IX)\ D) Efferent = Hypoglossal (CN XII), Afferent = Vestibulocochlear (CN VIII)\ **Answer: A) Efferent = Vagus (CN X), Afferent = Ophthalmic division of Trigeminal (CN V1)** 27. **What type of eye protection is used for argon lasers?**\ A) Clear\ B) Green\ C) Orange\ D) Blue\ **Answer: C) Orange** 28. **What type of eye protection is used for Nd:YAG lasers?**\ A) Green\ B) Orange\ C) Red\ D) Clear\ **Answer: A) Green** 29. **What type of eye protection is used for CO₂ lasers?**\ A) Green\ B) Clear\ C) Orange\ D) Red\ **Answer: B) Clear** 30. **What types of masks should be used whenever lasers are used in the OR?**\ A) Surgical mask\ B) N-95\ C) Simple face mask\ D) No mask required\ **Answer: B) N-95** 31. **What are the standard OR fire precautions?**\ A) Keep the OR humidified\ B) Use only non-flammable materials\ C) Let prep dry for at least 3 minutes\ D) Use oxygen at the highest FiO₂ possible\ **Answer: C) Let prep dry for at least 3 minutes** 32. **What are the high-risk OR fire precautions?**\ A) Stop supplemental oxygen at least 1 min before and during electrocautery with an open oxygen system\ B) Use high-flow low FiO₂\ C) Use wet sponges and have sterile water or saline available\ D) All of the above\ **Answer: D) All of the above** 33. **When should a tonsillectomy or bilateral myringotomy with tubes (BMT) be postponed?**\ A) If the patient has mild nasal congestion\ B) If the patient has active chest symptoms (e.g., fever and rhonchi)\ C) If the patient is younger than 3 years old\ D) If the patient has seasonal allergies\ **Answer: B) If the patient has active chest symptoms (e.g., fever and rhonchi)** 34. **When should you preoxygenate with FiO₂ less than 30% during a tracheostomy procedure?**\ A) If the patient has COPD\ B) If the surgeon is using electrocautery to enter the trachea\ C) If the patient has a history of difficult airway\ D) If the patient is morbidly obese\ **Answer: B) If the surgeon is using electrocautery to enter the trachea** 35. **When should you remove the endotracheal tube (ETT) during a tracheostomy procedure?**\ A) As soon as the trachea is incised\ B) Before the surgeon places the tracheostomy tube\ C) After the surgeon connects the tracheostomy tube to the anesthesia circuit\ D) Before the patient is fully awake\ **Answer: C) After the surgeon connects the tracheostomy tube to the anesthesia circuit** 36. **When should the ETT cuff be deflated during a tracheostomy?**\ A) Before the incision is made\ B) Prior to tracheal transection\ C) After the tracheostomy tube is secured\ D) After the patient is extubated\ **Answer: B) Prior to tracheal transection** 37. **When would you extubate deep?**\ A) When the patient is at risk of aspiration\ B) When you want to avoid bucking\ C) When the patient has excessive secretions\ D) When the patient is in a prone position\ **Answer: B) When you want to avoid bucking**