Anesthesia practice questions

Answer: B) A capnography waveform with each breath

• AIncorrect. That isn't reliable.
• BCorrect. It shows exhaled CO2.
• CIncorrect. That isn't reliable.
• DIncorrect. That isn't reliable.

Answer: D) Induction agent

• AIncorrect. It's an induction agent.
• BIncorrect. It's an induction agent.
• CIncorrect. It's an induction agent.
• DCorrect. An injectable neurosteroid anesthetic.

Answer: B) From the tip of the incisors to the thoracic inlet

ET tubes are premeasured from the incisors to the thoracic inlet. This keeps excess tube from adding mechanical dead space outside the mouth and prevents the tip from entering a bronchus.

• AIncorrect. A tube that ends at the larynx would sit only at the glottis. It could easily slip out, and the cuff would not seal inside the trachea.
• BCorrect. The tube is measured from the incisors to the thoracic inlet (point of the shoulder). Tube sticking out past the incisors adds mechanical dead space, and a tip that passes the thoracic inlet risks endobronchial intubation.
• CIncorrect. The angle of the mandible is cranial to the trachea, so a tube cut to this length would be far too short to sit securely in the trachea.
• DIncorrect. This length would carry the tip well past the thoracic inlet and the tracheal bifurcation, risking endobronchial (one-lung) intubation.

Answer: A) A precise, dialed-in concentration of the one inhalant agent it is calibrated for

A precision vaporizer is calibrated to one specific volatile agent's vapor pressure, so it delivers an accurate, set percentage of that inhalant in the carrier gas. Filling it with a different agent gives the wrong concentration.

• ACorrect. A precision vaporizer is calibrated to the vapor pressure of one specific volatile agent. It delivers the percentage set on the dial accurately across a range of flow rates and temperatures.
• BIncorrect. Precision vaporizers are agent-specific. If a vaporizer is filled with an agent it was not calibrated for, the delivered concentration will be wrong.
• CIncorrect. The flowmeter controls the oxygen flow rate. The vaporizer adds a controlled concentration of inhalant to the carrier gas that passes through it.
• DIncorrect. Vaporizers turn volatile liquid inhalants into vapor. Injectable drugs are given by syringe or infusion pump.

Answer: B) ASA III

In the ASA scheme, ASA II is mild systemic disease, ASA III is severe but not life-threatening systemic disease, ASA IV is severe disease that is a constant threat to life, and ASA V is moribund.

• AIncorrect. ASA II is a patient with mild systemic disease, not severe systemic disease.
• BCorrect. ASA III is a patient with severe systemic disease that is not life-threatening. Older descriptions call this disease that limits activity but is not incapacitating.
• CIncorrect. ASA IV is a patient with severe systemic disease that is a constant threat to life. The stem says the disease is not a constant threat to life.
• DIncorrect. ASA V is a moribund patient who is not expected to survive with or without the operation.

Answer: B) It is part of the patient's legal medical record, documenting drugs, doses, vital signs and events

The anesthetic record is a legal part of the medical record. It documents drugs, doses, regular vital-sign readings and any events, and it helps plan future anesthesia for that patient.

• AIncorrect. Controlled-drug logs are a separate requirement. An anesthetic record is kept for every anesthetic event, whichever drugs are used.
• BCorrect. The anesthetic record becomes part of the patient's medical and legal documentation. It also guides future anesthetic planning for that patient.
• CIncorrect. Its purpose is clinical and legal documentation, not billing. A summary in the discharge note doesn't replace the full intraoperative record.
• DIncorrect. Vital signs should be recorded at regular intervals (commonly every 3 to 5 minutes) throughout every anesthetic, not only when problems happen.

Answer: C) It provides preemptive analgesia and lowers the doses of induction and inhalant agents needed

Opioid premedication provides preemptive analgesia and some sedation. It also lowers the doses of induction and inhalant agents needed, which is part of balanced anesthesia.

• AIncorrect. Opioids give analgesia and some sedation, but they do not produce the muscle relaxation and unconsciousness needed for intubation. An induction agent is still required.
• BIncorrect. Opioids tend to cause bradycardia. If heart rate needs to be supported, an anticholinergic is given.
• CCorrect. Opioids given before surgery provide analgesia before the painful stimulus. They also reduce how much induction drug and inhalant is needed to keep a surgical plane, which limits cardiovascular and respiratory depression. This is the basis of balanced anesthesia.
• DIncorrect. Opioids depress breathing; they do not stimulate it. Ventilation still has to be monitored and supported as needed.

Answer: D) Intubate and give breaths until breathing resumes

• AIncorrect. That worsens apnea.
• BIncorrect. Ventilation is needed.
• CIncorrect. That deepens anesthesia.
• DCorrect. Apnea is common after propofol.

Answer: A) Stage II

• ACorrect. Patients pass through it during induction and recovery.
• BIncorrect. That's the surgical plane.
• CIncorrect. That's overdose.
• DIncorrect. That's voluntary movement and disorientation.

Answer: B) Normal and healthy

• AIncorrect. That's ASA V.
• BCorrect. Lowest anesthetic risk.
• CIncorrect. That's ASA III or IV.
• DIncorrect. That's ASA II.