APEX MOCK EXAM QUESTIONS AND
CORRECT ANSWERS UPDATED
Question 1
Match each etiology of postoperative hypoxemia with its BEST example
Shunt
Diffusion limitation
Hypoventilation
Excessive fluid administration
Excessive oxygen administration
Excessive opioid administration
Correct Answer
Shunt- excessive oxygen administration (100%) can cause shunt as a function of
absorption atelectasis
Diffusion limitation- excessive fluid administration can cause pulmonary edema,
which produces a diffusion limitation.
Hypoventilation- excessive opioid admin can cause hypoventilation as a function of
respiratory depression.
Question 2
Hypocalcemia secondary to inadvertent removal of parathyroid glands during thyroid
sx is MOST likely to present how many hours after sx?
Correct Answer
24-48hrs
Presents with circumoral numbness, parasthesia fingertips, muscle cramps, Chvostek
sign, Trousseaus sign, dyspnea, inspiratory stridor, & laryngospasm. IV calcium is
definitive tx
Page 1 of 262
,Question 3
What characteristic was eliminated by the modern variable bypass vaporizer design?
A. Agent specific
B. Temperature compensation
C. In-circuit placement
D. Flow-over design
Correct Answer
C. In-circuit placement
The modern variable bypass vaporizer (iso/sevo) has following characteristics:
Variable bypass- FGF goes in 2 directions after it enters vaporizer. Some goes to the
vaporizing chamber and the rest if it bypasses the vaporizing chamber (determined
by splitting ratio). The fractions mix before the FGF exits vaporizer.
Flow-over- FGF flows over the anesthetic liquid and picks up the anesthetic vapor in
the process.
Temperature compensation- vaporizer output is NOT affected by changes in
ambient temperature
Agent specific- the vaporizer is calibrated for a specific agent, and a dosing error
will result if the wrong agent is placed into a particular vaporizer.
Out of circuit placement (not in-circuit).
Page 2 of 262
,Question 4
Which arteries arise from the left coronary artery? Select 2
Circumflex
Right marginal
Anterior interventricular
Posterior descending
Correct Answer
Circumflex
Anterior interventricular
The left and right coronary arteries are the first branches of the aorta.
The left coronary artery gives rise to the circumflex and anterior interventricular
arteries
The right coronary artery gives rise to the posterior, descending and right marginal
arteries
Question 5
What does the "a wave" on CVO tracing correspond to on the cardiac cycle (wiggers
diagram) on the area of the ventricular pressure waveform?
Correct Answer
The a wave corresponds with atrial contraction; Mitral valve closure.
Page 3 of 262
, Question 6
Expected consequences of an interscalene block include all of the following, except:
A. Anhydrosis
B. Diaphragmatic hemiparesis
C. Upper eyelid drooping
D. Pupillary dilation
Correct Answer
D. Pupillary dilation
Stellate ganglion blockage is often an unintended consequence of a brachial plexus
block where it can manifest as Horner's syndrome on the ipsilateral side
Signs include:
Miosis ( pupillary constriction)
Ptosis (upper eyelid, drooping)
Anhydrosis (inability to sweat)
Enopthalamos (an eyeball that appears sunken into the orbit)
Other etiologies of Horners syndrome include:
CVA
Dissection or aneurysm of the internal carotid artery
Demyelinating disease
Idiopathic
Trauma
Tumor
Diaphragmatic hemi paresis occurs nearly 100% of the time following interscalene
blockade. Keep this in mind w/ the patient with severe COPD.
Page 4 of 262
CORRECT ANSWERS UPDATED
Question 1
Match each etiology of postoperative hypoxemia with its BEST example
Shunt
Diffusion limitation
Hypoventilation
Excessive fluid administration
Excessive oxygen administration
Excessive opioid administration
Correct Answer
Shunt- excessive oxygen administration (100%) can cause shunt as a function of
absorption atelectasis
Diffusion limitation- excessive fluid administration can cause pulmonary edema,
which produces a diffusion limitation.
Hypoventilation- excessive opioid admin can cause hypoventilation as a function of
respiratory depression.
Question 2
Hypocalcemia secondary to inadvertent removal of parathyroid glands during thyroid
sx is MOST likely to present how many hours after sx?
Correct Answer
24-48hrs
Presents with circumoral numbness, parasthesia fingertips, muscle cramps, Chvostek
sign, Trousseaus sign, dyspnea, inspiratory stridor, & laryngospasm. IV calcium is
definitive tx
Page 1 of 262
,Question 3
What characteristic was eliminated by the modern variable bypass vaporizer design?
A. Agent specific
B. Temperature compensation
C. In-circuit placement
D. Flow-over design
Correct Answer
C. In-circuit placement
The modern variable bypass vaporizer (iso/sevo) has following characteristics:
Variable bypass- FGF goes in 2 directions after it enters vaporizer. Some goes to the
vaporizing chamber and the rest if it bypasses the vaporizing chamber (determined
by splitting ratio). The fractions mix before the FGF exits vaporizer.
Flow-over- FGF flows over the anesthetic liquid and picks up the anesthetic vapor in
the process.
Temperature compensation- vaporizer output is NOT affected by changes in
ambient temperature
Agent specific- the vaporizer is calibrated for a specific agent, and a dosing error
will result if the wrong agent is placed into a particular vaporizer.
Out of circuit placement (not in-circuit).
Page 2 of 262
,Question 4
Which arteries arise from the left coronary artery? Select 2
Circumflex
Right marginal
Anterior interventricular
Posterior descending
Correct Answer
Circumflex
Anterior interventricular
The left and right coronary arteries are the first branches of the aorta.
The left coronary artery gives rise to the circumflex and anterior interventricular
arteries
The right coronary artery gives rise to the posterior, descending and right marginal
arteries
Question 5
What does the "a wave" on CVO tracing correspond to on the cardiac cycle (wiggers
diagram) on the area of the ventricular pressure waveform?
Correct Answer
The a wave corresponds with atrial contraction; Mitral valve closure.
Page 3 of 262
, Question 6
Expected consequences of an interscalene block include all of the following, except:
A. Anhydrosis
B. Diaphragmatic hemiparesis
C. Upper eyelid drooping
D. Pupillary dilation
Correct Answer
D. Pupillary dilation
Stellate ganglion blockage is often an unintended consequence of a brachial plexus
block where it can manifest as Horner's syndrome on the ipsilateral side
Signs include:
Miosis ( pupillary constriction)
Ptosis (upper eyelid, drooping)
Anhydrosis (inability to sweat)
Enopthalamos (an eyeball that appears sunken into the orbit)
Other etiologies of Horners syndrome include:
CVA
Dissection or aneurysm of the internal carotid artery
Demyelinating disease
Idiopathic
Trauma
Tumor
Diaphragmatic hemi paresis occurs nearly 100% of the time following interscalene
blockade. Keep this in mind w/ the patient with severe COPD.
Page 4 of 262
