Chapter 2 Review Questions

1) Routine preoperative hemoglobin is NOT required for:
a) A healthy female over 50 years of age
b) A patient who has been crossmatched for surgery
c) A patient on anticoagulant medication
d) A young female patient with menorrhagia

2) Which ONE of the following is the most important determinant of peri-operative risk?
a) Patient’s underlying health
b) Length of surgery
c) Duration of surgery
d) Emergency surgery

3) Which of these patients is NOT at increased risk of aspiration?
a) A pregnant patient (32 weeks gestation) who has been NPO (nil per os) for 10 hours
b) A patient with fractured femur who has been NPO since the accident 12 hours ago
c) A healthy patient with appendicitis
d) A healthy patient who had 8 ounces of clear tea 4 hours pre-operatively

4) The following medication should be discontinued prior to surgery and anesthesia:
a) Anticonvulsants
b) Thyroid replacement
c) Monoamine-oxidase inhibitors
d) Antihypertensives

5) A patient with which ONE of the following conditions requires antibiotic prophylaxis prior to tonsillectomy?
a) Uncorrected Tetralogy of Fallot
b) Aortic stenosis
c) Uncomplicated heart transplant
d) Prophylaxis is not required for tonsillectomy

6) A patient is on prednisone 30 mg daily for rheumatoid arthritis and presents for coronary bypass surgery. Which of the following best describes their peri-operative steroid requirements?

a) 30 mg prednisone orally on day of surgery
b) 25 mg hydrocortisone IV on day of surgery
c) 25 hydrocortisone IV for 72 hours
d) 100 mg hydrocortisone IV for 72 hours

7) A 60-year old man for minor surgery has a BP of 170/100 mmHg in the pre-operative clinic. In retrospect, he admits that his blood pressure has been consistently high when he checks it at the drugstore. Assign an ASA class.
a) ASA 1
b) ASA 2
c) ASA 3
d) ASA 4

8) ALL BUT ONE of the following describes the CO2 absorber. Indicate the exception:
a) Changes colour as the soda lime becomes exhausted
b) Is required if a circle circuit is being used
c) Allows for economical use of anesthetic gases
d) Provides a waveform of exhaled carbon dioxide

9) Which ONE of the following statements regarding the peripheral nerve stimulator is true?
a) Delivers four successive impulses at a rate of 2 per second
b) Is a sensitive indicator of neuromuscular blockade
c) Must be used on the awake patient to achieve a baseline
d) Is commonly applied to the radial nerve

10) A patient is receiving a balanced anesthetic with volatile anesthetic gases, opioids and muscle relaxants. Which ONE of the following monitors is required to be in continuous use during the care of this patient?
a) Temperature probe
b) Agent-specific gas monitor
c) Peripheral nerve stimulator
d) Spirometer

11) ALL BUT ONE of the following interfere with accurate pulse oximetry measurements. Indicate the exception:
a) Nail polish
b) Peripheral vasoconstriction due to hypothermia
c) Severe anemia (Hg 60 g/L)
d) Methemoglobinemia
e) Carbon monoxide

12) ALL BUT ONE of the following conditions will cause the capnograph to give a reading that is much lower than the arterial CO2. Indicate the exception.
a) Pulmonary embolus
b) Exhausted CO2 absorber soda lime
c) Cardiac arrest
d) Severe bronchospasm

Answers: 1a, 2a, 3d, 4c, 5a, 6d, 7d, 8d, 9a, 10b, 11c, 12 b