Principles Final - ANE 660 Test With
Complete Solutions
What are current NPO guidelines? (5) - ANSWER -No gum or candy after midnight
-Clear liquids up to 2 hours before surgery
-Breast milk up to 4 hours
-No formula, milk, or light meals for at least 6 hours before
-Prescribed meds with sip of water 1 hour before
Oropharynx:
Extends from _ to level of _
Contains? ((4) - ANSWER Extends from uvula to level of hyoid bone
Contains uvula, tongue, epiglottis, palatine tonsil
What cannot be measured by the riva-rocci method? - ANSWER DBP and MAP
The three paired cartilages are: - ANSWER Arytenoid, cuneiform, corniculate
Glossopharyngeal controls what reflex? - ANSWER Gag
(gag on my glosso)
What are the S&S of TRALI? (6) - ANSWER -Noncardiogenic pulmonary edema
-Fever
-Dyspnea
-Fluid in ETT
-Severe hypoxemia
-CXR will show pulmonary edema (No circulatory overload)
Explain the concept of METS? (3) - ANSWER -Metabolic requirement of the task (MET)
-A patient who is unable to perform 4-5 METs at a higher risk of complications
- 1 MET = consumption of 3.5 mL/O2/kg
What muscle group adducts the vocal cords? - ANSWER Lateral cricoarytenoid
,What is the motor innervation of the cricoid muscle? - ANSWER External branch of the
superior laryngeal nerve
Propofol is metabolized? and excreted by? - ANSWER M- Liver
E - Kidneys
What are the induction doses of:
Versed
Etomidate
Ketamine
Propofol
Thiopental - ANSWER Versed: 0.1 - 0.3 mg/kg
Etomidate: 0.2-0.3 mg/kg
Ketamine: 1-2 mg/kg
Propofol: 2-3 mg/kg
Thio: 3-5 mg/kg
Which of the following have analgesic properties:
- Etomidate
- Ketamine
- Precedex
- Propofol - ANSWER Ketamine & Precedex
Butorphanol, Nabbuphine, Noloxone, and Naltrexone are all [agonist/antagonist] of the
Mu receptor? - ANSWER Antagonist
What products are okay to use for Jehovah's Witnesses? (5) - ANSWER -Non-blood
volume expanders
-Drugs that improve hemostasis
-Albumin-free EPO
-Recombinant products (Albumin-free coagulation factors)
-Topical hemostatic agents (Collagen, gelatin)
Risk of MI (%) (5) - ANSWER - MI over 6 months = 6%
,- MI 3-6 mo = 15%
- W/in 3 mo = 30%
- If reinfarct occurs, mortality is 50%
- Highest risk of reinfarct = w/in 30 days (wait 4-6 weeks for elective surg)
The narrowest portion of the airway? - ANSWER Glottis
What products are unacceptable to use for Jehovah's Witnesses? (6) - ANSWER -Whole
blood
-PRBCs
-WBC's
-Platelets
-Plasma
-Autologous Blood
If your patient has an AICD, what should happen prior to surgery? (3) - ANSWER It
should be interrogated preoperatively
disable the anti-tachycardia function
Determine underlying rhythm and rate
How do you calculate MABL (Maximum Allowable Blood Loss)? - ANSWER MABL = EBV x
(Starting HCT - Target HCT) / (Starting HCT)
What Mallampati class is: soft palate, uvula, and tonsil pillars are visible? - ANSWER
Class I
How do you calculate EBV (Estimated Blood Volume) for a man? What do you have to do
to this equation if the patient is obese? - ANSWER Take the males weight in kg and
multiple that by 75 ml/kg
(Woman it is 65ml/kg)
If they are an obese adult subtract 5 ml/kg
What Mallampati class is: The soft palate and partial uvula are visible? - ANSWER Class
II
Know the current ASA protocol for discharge from the PACU (5) - ANSWER -Requiring
that patients to urinate before discharge: only for select patients
-Requiring that patients drink clear fluids without vomiting: Only for select patients
, -Requiring that patients have a responsible individual to accompany them home after
discharge: everyone
-Requiring a minimum mandatory stay in recovery: Mandatory stay should not be
required.
- Pts should be observed until no longer at risk for cardioresp depression
What are strong risk factors for PONV? - ANSWER Female, non smoker, hx of PONV, hx
motion sickness, post op opioid use, intraop use of volatile anesthetic agents
What Mallampati class is: the soft palate and base of the uvula are visible? - ANSWER
Class III
How do you determine size of BP cuff? (4) - ANSWER - Width should be at least 40% of
arm circumference
-Bladder length should be 80% of circumference
- Too small - false high
- Too big - false low
What Mallampati class is: The soft palate is not visible? - ANSWER Class IV
How do you perform an Allen test? (5) - ANSWER -Compress the radial and ulnar artery
-Pt makes fist to exsanguinate the palm
-Release pressure on ulnar artery
-Palm should flush quickly
(if > 10 secs may have compromised collateral flow)
- Thumb flush:
w/in 5 sec - good
5- 10 - questionable
>10 insufficient collateral circ
Complete Solutions
What are current NPO guidelines? (5) - ANSWER -No gum or candy after midnight
-Clear liquids up to 2 hours before surgery
-Breast milk up to 4 hours
-No formula, milk, or light meals for at least 6 hours before
-Prescribed meds with sip of water 1 hour before
Oropharynx:
Extends from _ to level of _
Contains? ((4) - ANSWER Extends from uvula to level of hyoid bone
Contains uvula, tongue, epiglottis, palatine tonsil
What cannot be measured by the riva-rocci method? - ANSWER DBP and MAP
The three paired cartilages are: - ANSWER Arytenoid, cuneiform, corniculate
Glossopharyngeal controls what reflex? - ANSWER Gag
(gag on my glosso)
What are the S&S of TRALI? (6) - ANSWER -Noncardiogenic pulmonary edema
-Fever
-Dyspnea
-Fluid in ETT
-Severe hypoxemia
-CXR will show pulmonary edema (No circulatory overload)
Explain the concept of METS? (3) - ANSWER -Metabolic requirement of the task (MET)
-A patient who is unable to perform 4-5 METs at a higher risk of complications
- 1 MET = consumption of 3.5 mL/O2/kg
What muscle group adducts the vocal cords? - ANSWER Lateral cricoarytenoid
,What is the motor innervation of the cricoid muscle? - ANSWER External branch of the
superior laryngeal nerve
Propofol is metabolized? and excreted by? - ANSWER M- Liver
E - Kidneys
What are the induction doses of:
Versed
Etomidate
Ketamine
Propofol
Thiopental - ANSWER Versed: 0.1 - 0.3 mg/kg
Etomidate: 0.2-0.3 mg/kg
Ketamine: 1-2 mg/kg
Propofol: 2-3 mg/kg
Thio: 3-5 mg/kg
Which of the following have analgesic properties:
- Etomidate
- Ketamine
- Precedex
- Propofol - ANSWER Ketamine & Precedex
Butorphanol, Nabbuphine, Noloxone, and Naltrexone are all [agonist/antagonist] of the
Mu receptor? - ANSWER Antagonist
What products are okay to use for Jehovah's Witnesses? (5) - ANSWER -Non-blood
volume expanders
-Drugs that improve hemostasis
-Albumin-free EPO
-Recombinant products (Albumin-free coagulation factors)
-Topical hemostatic agents (Collagen, gelatin)
Risk of MI (%) (5) - ANSWER - MI over 6 months = 6%
,- MI 3-6 mo = 15%
- W/in 3 mo = 30%
- If reinfarct occurs, mortality is 50%
- Highest risk of reinfarct = w/in 30 days (wait 4-6 weeks for elective surg)
The narrowest portion of the airway? - ANSWER Glottis
What products are unacceptable to use for Jehovah's Witnesses? (6) - ANSWER -Whole
blood
-PRBCs
-WBC's
-Platelets
-Plasma
-Autologous Blood
If your patient has an AICD, what should happen prior to surgery? (3) - ANSWER It
should be interrogated preoperatively
disable the anti-tachycardia function
Determine underlying rhythm and rate
How do you calculate MABL (Maximum Allowable Blood Loss)? - ANSWER MABL = EBV x
(Starting HCT - Target HCT) / (Starting HCT)
What Mallampati class is: soft palate, uvula, and tonsil pillars are visible? - ANSWER
Class I
How do you calculate EBV (Estimated Blood Volume) for a man? What do you have to do
to this equation if the patient is obese? - ANSWER Take the males weight in kg and
multiple that by 75 ml/kg
(Woman it is 65ml/kg)
If they are an obese adult subtract 5 ml/kg
What Mallampati class is: The soft palate and partial uvula are visible? - ANSWER Class
II
Know the current ASA protocol for discharge from the PACU (5) - ANSWER -Requiring
that patients to urinate before discharge: only for select patients
-Requiring that patients drink clear fluids without vomiting: Only for select patients
, -Requiring that patients have a responsible individual to accompany them home after
discharge: everyone
-Requiring a minimum mandatory stay in recovery: Mandatory stay should not be
required.
- Pts should be observed until no longer at risk for cardioresp depression
What are strong risk factors for PONV? - ANSWER Female, non smoker, hx of PONV, hx
motion sickness, post op opioid use, intraop use of volatile anesthetic agents
What Mallampati class is: the soft palate and base of the uvula are visible? - ANSWER
Class III
How do you determine size of BP cuff? (4) - ANSWER - Width should be at least 40% of
arm circumference
-Bladder length should be 80% of circumference
- Too small - false high
- Too big - false low
What Mallampati class is: The soft palate is not visible? - ANSWER Class IV
How do you perform an Allen test? (5) - ANSWER -Compress the radial and ulnar artery
-Pt makes fist to exsanguinate the palm
-Release pressure on ulnar artery
-Palm should flush quickly
(if > 10 secs may have compromised collateral flow)
- Thumb flush:
w/in 5 sec - good
5- 10 - questionable
>10 insufficient collateral circ
