Which statement is FALSE about PEEP?

Increases the risk of atelectasis

To guard against disconnections the CRNA can observe the piston ventilator for all EXCEPT?

Viewing the to-and-fro movement

Disconnections can be seen in a piston with fresh gas decoupling because

The manual breathing bag remains in the circuit

Discrepancies in Tv can be attributed to

Differences in unidirectional valves

Capnograpy CO2 not returning to baseline can be the result of?

Malfunctioning unidirectional valve

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Ventilator systems

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Questions 133

Answers

1
In PCV, the ____is adjusted to obtain the desired TV?
I:E ratio
Volume
RR
Pressure
2
Tricuspid regurgitation can be diagnosed by noticing a prominent____ wave as the blood regurges
X-Y
V-Y
C-X
A-C
3
Measuring human oxygenation was first performed on
Spanish deep sea divers
South African textile workers
German pilots
In hospitals in Japan
4
This is an example of?
Excessive suctioning in an open scavenger
Exhausted CO2 absorber
Increased FGF
Y piece disconnection
5
Which phase should never have CO₂present?
2
3
1
6
Which mode helps maintain tidal volume in the face of changing lung compliance.
PCV
VCV
PS
PCV-VG
7
In which setting is compliance for one breath used to adjust the pressure for the next breath
SIMV
VCV
PCV
PCV-VG
8
Which part of the anesthesia sweep occurs twice?
Circulation
Oxygen analyzer
Ventilator
Airway
9
Which is a potential cause of Paw Low (low pressure alarm)?
Low pressure in ETT cuff
Mucus plug
Patient/ ventilator dyssynchrony
Air trapping
10
The _____ generates the P wave
Purkinje fibers
SA node
Bundle of his
AV node
11
BP should be assessed at least every ___mins during maintenance anesthesia?
5
1
8
3
12
Which is measures the beginning of the P wave to the first deflection of the Q wave?
PR interval
PR segment
13
Which is the most common preventable equipment-related failure to ventilation?
Incompetent unidirectional valves
Disconnections
Piston ventilator malfunction
low pressure leaks
14
Continuos monitoring of CV status via ECG is required for any patient receiving?
Any procedure that requires an artificial airway
Sedation deeper that conscious sedation
any anesthesia
GA
15
Tidal volume should be between?
6-8 ml/kg
2-3 ml/Kg
8-11 ml/kg
3-5 ml/kg
16
Phase 1 of the Korotkoff sound sounds like a?
Soft thud
A blowing or swishing sound
A softer blowing sound that disappears
Sharp Thud
17
Phase _____ marks the beginning of expiration and the end of inspiration.
4
1
2
3
18
The first blood pressure was recorded on a _____?
horse
Hamster
swine
A monkey named bubbles
19
The ____ controls the amount of time during each expiratory cycle during spontaneous breathing.
pressure mode
volume mode
trigger window
positive pressure produced by the diaphragm
20
The ____ takes the place of the anesthetist hand?
APL valve
FGF
Ventilator
ambu-bag
21
The delay between the P wave and Q wave takes place at the?
SA node
AV node
Bundle of His
Purkinje fibers
22
How should an I:E ratio be adjusted to prevent air trapping in obstructive airway disease?
1:3
1:6
1:4
1:2
23
Fixed alarms included? (Pick 2)
O2 sensor
Apnea
Disconnection
Pressure
24
Which statement is FALSE about PEEP?
Decreases V/Q mismatch
Decreases venous return
Used in patients with ARDS and pneumonia
Increases the risk of atelectasis
25
Which mode can ONLY be used in the spontaneously breathing patient?
PCV
PSV
SIMV
VCV
26
Alarm fatigue is considered which type of error?
Human
Mechanical
Systems
Inconceivable
27
Multiple study cite an FIO2 of ____ to decrease in oxygentoxicity
.94
30%
21%
.4
28
Which vent mode can deliver higher TV in patients with with low compliance (Pregnant, ARDS)?
VCV
PCV
29
Which uses the collision of photons and gas causing the photon to change its energy?
Polychromatic
Raman
Mass
Monochromatic
30
In modern equipment Apnea (disconnect) alarms are enabled with the first breath sensed? T or F
False
True
31
To guard against disconnections the CRNA can observe the piston ventilator for all EXCEPT?
Pt's chest rise and fall
Viewing the to-and-fro movement
The movement of the manual breathing bag
Capnography
32
Disconnections can be seen in a piston with fresh gas decoupling because
The spill valve will alarms
The manual breathing bag remains in the circuit
The piston will fall to the bottom of the vent
There is no negative relief valve.
33
Which has a decelerating flow pattern?
VCV
PCV
34
Discrepancies in Tv can be attributed to
Leaks around the cuff
Differences in unidirectional valves
Setting small TV using an adult bellow assembly
FGF augmentation
35
An obese patient has extremely large upper arms. It is Ok to place the cuff on the forearm?
False
True
36
What structure creates natural PEEP?
Larynx
Epiglotis
Pharynx
Bronchial tree
37
The Anesthesia Sweep is described as COVERABCD. Assessing the patients color is which letter?
R
B
C
A
38
The Piston-ventilator is incapable of which ventilator mode?
Its capable of all modes
VCV
PSV-Pro
PSV-VG
39
Carboxyhemoglobin O₂ will vary widely due to the absorbance of only which type of light
infrared
artificial
Ambient
red
40
This is an example of?
Fowling up
Do it 3x and its a turkey
Goosed it!!!
Peacocking
41
The presence of obstructive airway disease may require_____ in order to prevent air trapping?
Increased respiratory rate
Increased inspiratory ratios
Increased FGF
Increased expiratory ratios
42
What is this called?
ST interval
QRS complex
J- point
isometric line
43
Shunt fraction > ___% the anesthesia provider should use PEEP
50
40
45
24
44
Direct arterial blood pressure reading is indicated with all of the following EXCEPT?
Laproscopic surgery
Expected wide swings in BP
When there is a need for multiple ABGs
Cardiopulmonary bypass
45
Room air Fio2 is ___%?
100
21
30
19
46
Which leads have proven to detect ST elevation the earliest and most frequent?
v4, v5, v6
v1, v2, v3
v1, v2, v5
v3, v4, v5
47
Mechanical requirements for ventilation include all EXCEPT?
Length of surgery
How hungry the CRNA is
Patients position
Type of surgery
48
Capnograpy CO₂not returning to baseline can be the result of?
Malfunctioning unidirectional valve
High FgF
MH
Decreased cardiac output
49
Pressure required to overcome tissue resistance & inflated alveoli
Peak pressure
Plateau pressure
PIP
PEEP
50
CVP waveform is typically used to measure?
Fluid status
Mitral valve defects
MAP
ABGs
51
Which is false about the VCV mode?
Constant flow
Volume limited
Time cycled
Pressure limited
52
CVP can used to assess all EXCEPT?
Atrial dysrhythmias
ischemic
Aortic valve function
Tamponade
53
Which is true about cuff size
Too big gives you an abnormally high reading
Too small will give you an abnormally high reading
54
Which setting is better for one lung ventilation
PSV
PCV
VCV
55
Volumes in VCV should be between?
3-6 ml/kg
10-12 ml/kg
10-15 ml/kg
6-8 ml/kg
56
The ____ ventilator uses an electrical motor
Descending
Piston
Ascending
57
Which is the appropriate vent mode for a with emphysema, is obese, and has a LMA?
PCV
VCV
58
A disadvantages to left and right internal jugular CVP catheters is ?
Trauma to brachial plexus
Unpredictable anatomy
Pneumothorax
Difficult to thread catheter
59
Which is a potential trigger of Paw High (high airway pressure) alarms?
Pmax set too low
esophageal intubation
Chest wound allowing air to escape
TV set too low
60
A right deviation is a deflection greater than_____?
90
-30
120
-180
61
The 3 lead is capable of monitoring which of the following?
All Bipolar leads
SVT
BBB
Sufficient for ST-segment changes
62
The cuff is appropriately sized when the width is ____ percent of the circumference of the arm
75%
40%
60%
80%
63
Which blood pressure reading is performed by inflating a cuff on a finger until it reads zero
Oscillating method
Finometer
Digometer
Digital occlusion method
64
Which form of inhaled anesthetic monitoring ionizes gas to fall on a magnetic plate?
Ionized spectrometry
Raman Scattering Spectrometry
Mass spectrometry
Monochromatic spectrometry
65
Respiratory rate should be adjusted to?
CO
O2
BP
PaCO2
66
What grade is this?
1
4
2
3
67
All of the following are factors that will alter Pulse Ox values except?
Methemoglobin
Caboxygemoglobin
IV contrast
Methylene Blue
68
Esophageal stethoscope should be place behind the heart in the lower____ of the esophagus?
1/8
3/4
2/3
1/3
69
Which is the proper sequence of flow in PCV?
Low flow, followed by high flow
The flow is uniform
High flow followed by low flow
70
The presence of obstructive airway disease may require_____ in order to prevent air trapping?
Increased expiratory ratios
Increased respiratory rate
Increased inspiratory ratios
Increased FGF
71
Which modes support spontaneous breathing? (Pick 2)
PCV-VG
PSV
VCV
SIMV
72
The Anesthesia Sweep is described as COVERABCD. Assessing which med to use pertains to?
C
A
B
D
73
Which represents the V/Q status of the lung?
beta
Phase ll
Phase ll
Alpha
74
What grade is this?
1
3
4
2
75
Which is true about the VCV mode?
Inspiration is terminated when 60 to 100 cm H2O is reached
The desired pressure is set, volume is only monitored
Pressure limited
Inspiration is only stopped when the set pressure is reached
76
In the event of a oxygen pipeline failure the Piston‐ventilator will continue to work? T or F
True
False
77
The expiratory upstroke of the capnogram takes place in which phase?
1
2
4
3
78
A gradual increase in ETCO₂caused by all of the following except?
decreased metabolism
partial airway obstruction
MH
Hypoventilation
79
which lead is placed at the 5th intercostal space, midclavicular line?
v6
LL
v5
v4
80
The ____ lead is the gold standard for Cardiac monitoring
15
5
3
12
81
The negative pressure relief valve opens at a pressure of
10 cm H20
-8 cm H20
8 cm H20
3 cm H20
82
The precordial leads should be placed via?
percussion
palpation
auscultation
visualization
83
Deflection greater than -30 is a _____deviation?
left
right
84
____emits infrared light with wavelenght of 7 to 13μm and can measure VA and CO₂ simultaneously
Polychromatic Spectrometry
Monochromatic spectrometry
85
Peak airway pressure is the total pressure needed to deliver the tidal volume. It depends on?
airway resistance
chest wall factors
type of ventilator
lung compliance
86
Evoked potentials are usually described as all of the following Except?
Direction of impulse
Site of stimulus
Latency
Amplitude
87
Which is false about Plateau pressures?
Takes place at the end of expiration
Static pressure measured
Gas flow ceases
Measurement of lung stiffness
88
l, AVL, V5, V6 are the _____ leads
Inferior
Posterior
Lateral
Anterior
89
BP cuff length should be ____ of the circumference of the arm?
100-120%
80-100%
40%
60-70%
90
The purpose of IRV (inverse ratio ventilation) is to?
Decrease auto-PEEP
Improve the duration of alveolar compliance in expiration
expiratory time to be greater than inspiratory time
Improve oxygenation
91
ll, lll, and AVF are the ____leads?
lateral
Inferior
Posterior
Anterior
92
Reducing the TV from 12 ml/kg to 6 ml/kg reduces mortality by _____%
32
39
25
20
93
The Anesthesia Sweep is described as COVERABCD. Assessing RR pertains to letter?
V
A
O
B
94
____ law relates concentrations ofsolute to intensity of light transmitted through solutions
Beers-Lambert
Korotkoff- Raman
Simon-Garfunkel
Murphy's
95
In PCV, tital volume are uncontrolled and increase when? (Pic 2)
Airway resistance falls
The presence of Klinefelter's disease
FRC decreases
Compliance increases
96
Methehemoglobin can absorb infrared and red light almost equally conforming an O₂sat of ____%
75
94-100
50
85
97
The Fio2 of someone on 6L NC is?
37%
33%
29%
45%
98
With VCV, the TV is adjusted to_____ and the ____ is adjusted to maintain a desired ETCO_2.
Prevent atelectasis, RR
Meet the trigger window, and pressure
Prevent atelectasis, pressure
Prevent barotrauma, RR
99
Two boxes between QRSs is a heart rate of?
300
150
100
75
100
Evaluate and document BP and HR at least every____
5min
3min
10min
15min
101
Any substance that absorbs light at the same____ will lead to measurement errors
Frequency
Rate
wavelength
Profile
102
The positive pressure relief valve inside the piston ventilator opens at a pressure of ?
30 cm H20
20 cm H20
40 cm H20
75 cm H20
103
Latency refers to?
The peak of the displayed waveform from baseline
The time between the stimulus and the generated potential
104
Which mode combines the advantages of PCV, yet dynamically compensates for changes in the lung?
PCV-VG
PCV
VCV
PSV
105
Which is a potential disadvantage of the Piston driven ventilator?
less accurate delivery of TV
NEEP
Incapable of all ventilator modes
requires O2 when central supply pressure drops
106
The piston ventilator has how many diaphragms
1
2
4
3
107
Which is associated with the QRS complex
Purkinje fibers
SA node
AV node
Bundle of his
108
The first step in determining the cause of a high pressure alarm is?
Attempt to manually ventilate patient
Check patient for bronchospasms
Check soda lime for plastic lid still in place
Assess scavenging system
109
The tympanic membrane temperature measures the temperature of the?
Facial artery
External jugular vein
Subclavian artery
Carotid artery
110
Which of the following can cause the low pressure alarm to sound?
Bronchospasms
Tube in R mainstem
Y piece disconnection
Pneumothorax
111
The typical pressure setting for PCV is ____ cm H₂0?
40
45
35
20
112
Which is NOT a way a pt can loose heat?
Radiation
Conduction
Isolation
Convection
113
____developed modern bloodpressure discovering the difference between systolic anddiastolic BP
SamuelSiegfried Karl Ritter von Basch
Dr. Nikolari Korotkoff
Dr. Sauchin Gupta
Dr. Amanda Hugandkis
114
If spontaneous breaths are triggered too often in SIMV, the trigger window should be set more?
Negative
Positive
115
Which method of BP measuring uses the turbulence of blood flow
Oscillometric
Finometer
Korotkoff
Direct arterial pressure monitoring
116
Which phase is a mixture of anatomical and alveolar dead space gases
2
1
4
3
117
The Anesthesia Sweep is described as COVERABCD. Assessing the monitors pertains to which letter
D
A
V
R
118
This an example of which type of I:E flow?
Accelerating
Square
Decelerating
119
Capnography measures ETCO₂ and capnogram? T or F
False
True
120
The presence of obstructive airway disease may require_____ in order to prevent air trapping?
Increased respiratory rate
Increased FGF
Increased inspiratory ratios
Increased expiratory ratios
121
The Anesthesia Sweep is described as COVERABCD. Assessing the placement of the ETT is letter?
B
E
A
C
122
PEEP should be adjusted to?
BP and O2
FGF
Trigger window
HR and CO2
123
Pneumatically driven ventilators do not require drive gas? T or F
True
False
124
The capnomerty_____?
Measures ETCO2 and the capnogram
Measures by a capnometer
Is a direct reflection of the PaCO2
Provides CO2 concentrations and respiratory waveforms
125
Benefits to piston ventilators include all of the following EXCEPT?
Great precision of TV
Fewer compliance losses
its quiet
It provides in an automatic peep of 3-5 cm H20
126
BP should be assessed every ___ mins on induction?
1
5
3
15
127
The _____ lead is the standard for monitoring patients with suspected pre-op MI
3
15
5
12
128
With VCV, the _____ is uncontrolled.
inspiratory pressure
expiratory pressure
inspiratory volume
expiratory volume
129
Ventilation systems are categorized by all of the following except?
Semi-rebreathing
Semi-closed
Semi-open
Closed
130
Two wavelengths of light; ____ red and ___ infrared?
145, 980
360, 720
440, 950
660, 940
131
Normal frontal plane complex is ____ to ____?
30 to -120
-30 to 90
-30 to -90
0 to 30
132
Hypothermia has all the following effects except?
Impaired coagulation times
Increased oxygen utilization
Protection from dysrhythmias
Delay recovery from anesthesia
133
A lack of ETCO₂would trigger which alarm? Pick 2
Mechanical
Pressure alarm
Disconnection
Apnea

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