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1) A high spinal block may cause which of the following?
A) Increased Blood pressure
B) Increased heart rate.
C) Ineffective pain control
D) Respiratory distress
1) D
Treatment for a high spinal block includes ACLS, vasopressors and fluids. Other effects of a
high spinal include nausea and vomiting, anxiety, and upper extremity sensory changes. Spinal
blocks can cause complications if medication travels above T4.
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2) Your patient is eight years old. What communication approach would you use?
A) Engage in conversations that encourage critical thinking.
B) Use play to explain procedures, use story books and puppets.
C) Speak in simple sentences and explore using relative concepts.
D) Prepare for procedures immediately before the event. "
2) A
Children eight years old should be encouraged to use critical thinking. Using play with story
books and puppets and speaking in simple sentences works well for children ages 3 to 5.
Preparing for procedures immediately before is used for toddlers aged 1 to 2.
3) What is a normal hemoglobin and hematocrit for a female?
A) 10 grams/dl and 30%
B) 12 grams/dl and 36%
C) 6 grams/dl and 25%
D) 11 grams/dl and 34%
3) B
12 grams/dl and 36% are normal levels for a female.
4) Your patient has experienced protracted vomiting. What condition may occur?
A) Respiratory acidosis
B) Respiratory alkalosis
C) Metabolic acidosis
D) Metabolic alkalosis
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4) D
Other causes of metabolic alkalosis include diuretics, potassium deficiency, heart, kidney, and
liver failure.
The following tools assess the risk for what condition- Apfel score, POVOC score?
A) Post-operative nausea and vomiting
B) Obstructive sleep apnea
C) Pain
D) Respiratory depression
5) A
Apfel score and POVOC scores assess post-operative nausea and vomiting (PONV). The
POVOC score is used primarily in children. The tool assesses the duration of surgery, if the
surgery was strabismus, and history of post op nausea in the child or family. The koivuranta
score is another tool that may be used for adults.
6) Which of the following occurs when your patient experiences autonomic dysreflexia?
A) Sudden blood pressure elevation.
B) Sudden drop in blood pressure
C) Sudden loss of sensation below the waist
D) Sudden increase in heart rate.
6) A
Elevation of blood pressure and bradycardia occurs when a patient experience autonomic
dysreflexia. Treatment includes emptying the patient's bowel and bladder.
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7) The gold standard to test for malignant hyperthermia is:
A) Brain biopsy
B) Blood test to assess bleeding time.
C) Caffeine halothane contracture test
D) Gene mutation test "
7) C
The caffeine halothane contracture test is the gold standard test for malignant hyperthermia.
8) Which of the following is a treatment for malignant hyperthermia?
A) 20% lipids IV
B) Dantrolene
C) Propofol
D) Demerol
8) B
Dantrolene is a common treatment for malignant hyperthermia. It can also be used for
treatment of spinal cord injuries, multiple sclerosis, or cerebral palsy. Dantrolene treats
spasticity or muscle spasms.
9) Why would a patient with advanced myasthenia gravis not be appropriate for ambulatory
surgery?
A) The patient may require prolonged ventilatory support.
B) The patient may require supportive equipment that an ambulatory center may not have.
C) Treatment by thymectomy procedure prevents the patient from qualifying for ambulatory
care.
D) These patients are unable to have epidural catheters placed.
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