Moderate Sedation Certification Test
Questions and Correct Answers
Question 1
Mallampati Airway Assessment
Correct Answer
- Accurate predictor of subtle anatomic causes of
difficult intubation
- Classification is made per visualization of the soft palate, uvula, anterior and
posterior tonsillar pillars
Question 2
Diazepam (Valium) Pediatric Dose
Correct Answer
0.1 to 0.3 mg/kg
Question 3
Mallampati Class III
Correct Answer
-Visualize soft palate and base of uvula
-Need anesthesia consultation
Page 1 of 65
,Question 4
Physical characteristics that can indicate potential for difficult airway management
Correct Answer
-Obesity
-Short, thick neck
-Limited neck ROM
-Deviated trachea
-Hypognathic (recessed) jaw
-Hypergnathic (Protruding) jaw
-Small mouth opening (<3cm)
-High arched palate
-Macroglossia (Large tongue)
-Protruding teeth
-Loose teeth or dentures
-Non visible uvula
-Tonsillar hypertrophy
Question 5
Physical Examination: Cardiac Considerations
Correct Answer
1. H/O myocardial infarction
-Assess for angina
-Assess for SOB: at rest; w/ exercise/activity; paroxysmal nocturnal dyspnea
-Signs of CHF
-Elective procedures postponed at least 6 months post-MI
2. Will the patient be able to lie flat for procedure?
-Paroxysmal nocturnal dyspnea
3. Subacute Bacterial Endocarditis Prophylaxis before and after procedure necessary
-Valvular heart disease
4. HTN-Controlled? Compliance?
5. Recent Cardiac Sx
6. Dysrhythmias
7. Pacemaker or Automatic Internal Defibrillator?
Page 2 of 65
,Question 6
Morphine IM
Correct Answer
-Onset in 20-60 minutes
-Peaks in 30-60 minutes
-Lasts 4-7 hours
Question 7
Diprivan Adverse Reactions
Correct Answer
-Respiratory depression, apnea, hiccup, bronchospasm, laryngospasm
-Hypotension, HTN, arrhythmia, tachycardia, bradycardia
-N/V, abdominal cramps
Question 8
Emergency Medications
Correct Answer
-Atropine
-Lidocaine
-Ephedrine
-Succinylcholine
Question 9
Levels of Sedation Analgesia
Correct Answer
1. Minimal Sedation
2. Moderate Sedation/Analgesia
3. Deep Sedation/Analgesia
4. General Anesthesia
Page 3 of 65
, Question 10
Deep Sedation/Analgesia
Correct Answer
1. Patient responds to repeated or painful stimulation
2. May require intervention to maintain patent airway
3. Spontaneous ventilation may be inadequate
4. Cardiovascular function is usually maintained
Question 11
Morphine Side Effects
Correct Answer
-Possible histamine release
-All opioid side effects most possible with morphine
Question 12
Midazolam (Versed) IM
Correct Answer
-Onset 5-15 minutes
-Peak 15-60 minutes
-Lasts 2-6 hours
Question 13
Propofol Concerns
Correct Answer
-Responses unpredictable
-Airway management requirements are extremely demanding
-No reversal agents
Page 4 of 65
Questions and Correct Answers
Question 1
Mallampati Airway Assessment
Correct Answer
- Accurate predictor of subtle anatomic causes of
difficult intubation
- Classification is made per visualization of the soft palate, uvula, anterior and
posterior tonsillar pillars
Question 2
Diazepam (Valium) Pediatric Dose
Correct Answer
0.1 to 0.3 mg/kg
Question 3
Mallampati Class III
Correct Answer
-Visualize soft palate and base of uvula
-Need anesthesia consultation
Page 1 of 65
,Question 4
Physical characteristics that can indicate potential for difficult airway management
Correct Answer
-Obesity
-Short, thick neck
-Limited neck ROM
-Deviated trachea
-Hypognathic (recessed) jaw
-Hypergnathic (Protruding) jaw
-Small mouth opening (<3cm)
-High arched palate
-Macroglossia (Large tongue)
-Protruding teeth
-Loose teeth or dentures
-Non visible uvula
-Tonsillar hypertrophy
Question 5
Physical Examination: Cardiac Considerations
Correct Answer
1. H/O myocardial infarction
-Assess for angina
-Assess for SOB: at rest; w/ exercise/activity; paroxysmal nocturnal dyspnea
-Signs of CHF
-Elective procedures postponed at least 6 months post-MI
2. Will the patient be able to lie flat for procedure?
-Paroxysmal nocturnal dyspnea
3. Subacute Bacterial Endocarditis Prophylaxis before and after procedure necessary
-Valvular heart disease
4. HTN-Controlled? Compliance?
5. Recent Cardiac Sx
6. Dysrhythmias
7. Pacemaker or Automatic Internal Defibrillator?
Page 2 of 65
,Question 6
Morphine IM
Correct Answer
-Onset in 20-60 minutes
-Peaks in 30-60 minutes
-Lasts 4-7 hours
Question 7
Diprivan Adverse Reactions
Correct Answer
-Respiratory depression, apnea, hiccup, bronchospasm, laryngospasm
-Hypotension, HTN, arrhythmia, tachycardia, bradycardia
-N/V, abdominal cramps
Question 8
Emergency Medications
Correct Answer
-Atropine
-Lidocaine
-Ephedrine
-Succinylcholine
Question 9
Levels of Sedation Analgesia
Correct Answer
1. Minimal Sedation
2. Moderate Sedation/Analgesia
3. Deep Sedation/Analgesia
4. General Anesthesia
Page 3 of 65
, Question 10
Deep Sedation/Analgesia
Correct Answer
1. Patient responds to repeated or painful stimulation
2. May require intervention to maintain patent airway
3. Spontaneous ventilation may be inadequate
4. Cardiovascular function is usually maintained
Question 11
Morphine Side Effects
Correct Answer
-Possible histamine release
-All opioid side effects most possible with morphine
Question 12
Midazolam (Versed) IM
Correct Answer
-Onset 5-15 minutes
-Peak 15-60 minutes
-Lasts 2-6 hours
Question 13
Propofol Concerns
Correct Answer
-Responses unpredictable
-Airway management requirements are extremely demanding
-No reversal agents
Page 4 of 65
