10 Random Questions
During a right lower lobe resection, SpO2 decreases from 99% to 70% after institution of one-lung ventilation. FiO2 is 1.0. The most appropriate management is to
- (A) administer an inhaled bronchodilator
- (B) apply continuous positive airway pressure to the right lung
- (C) apply positive end-expiratory pressure to the left lung
- (D) increase tidal volume
- (E) reinflate the right lung
Each of the following conditions is a cause of agitation in a patient following transurethral resection of the prostate EXCEPT
- (A) bladder distention
- (B) glycine absorption
- (C) inadequate analgesia
- (D) serum sodium concentration of 127 mEq/L
- (E) systolic pressure of 60 mmHg
A 57-year-old man has back pain, a heart rate of 90 bpm, decreased pulse in the left arm, and blood pressure of 200/110 mmHg. During infusion of nitroprusside, heart rate increases to 115 bpm and blood pressure decreases to 140/80 mmHg. The most appropriate management at this time is administration of
- (A) droperidol
- (B) nifedipine
- (C) normal saline solution
- (D) propranolol
- (E) verapamil
A 55-kg, 70-year-old woman with mild chronic renal failure is unresponsive 20 hours after an uneventful coronary artery bypass grafting procedure. Anesthetic drugs included fentanyl 3000 mcg, diazepam 35 mg, and pancuronium 20 mg. Which of the following is the most appropriate next step in management?
- (A) Administration of edrophonium
- (B) Administration of flumazenil
- (C) Administration of naloxone
- (D) CT scan of the head
- (E) Measurement of core body temperature
Compared with halothane, desflurane has which of the following characteristics?
- (A) Greater potency
- (B) A higher boiling point
- (C) Increased blood solubility
- (D) Less airway irritability
- (E) Less biodegradation
A 70-year-old man who has just undergone an abdominal aortic aneurysm repair under halothane anesthesia develops hypertension, dyspnea, and cyanosis shortly after awakening in the recovery room. Administration of furosemide 20 mg intravenously improves the cyanosis within 10 minutes. This immediate effect of furosemide is best explained by
- (A) inotropic effect from electrolyte shifts
- (B) decreased preload through diuresis
- (C) increased peripheral venous capacitance
- (D) decreased pulmonary vascular resistance
- (E) increased coronary blood flow
Which of the following EEG findings is expected during maintenance anesthesia with high-dose fentanyl (50 ju-g/kg), nitrous oxide, and oxygen?
- (A) Low-frequency high-voltage activity
- (B) Nondominant hemispheric slowing
- (C) Predominant alpha activity
- (D) Prominent beta activity
- (E) Spindle-shaped bursts
In a patient with 20% pulmonary shunt and a PaO2 of 60 mmHg, cardiac output suddenly decreases from 5 L/min to 3 L/min. Oxygen consumption is unchanged. As a result, the PaO2 will
- (A) increase slightly because of decreased shunt blood flow
- (B) decrease slightly because of decreased mixed venous PO2
- (C) increase because of decreased affinity of hemoglobin for oxygen
- (D) decrease because of an increased dead space to tidal volume ratio
- (E) increase because of increased pulmonary oxygen uptake per milliliter of blood
The Mapleson A system (Magill circuit) illustrated
- (A) is functionally equivalent to the Bain circuit
- (B) prevents rebreathing more effectively during controlled ventilation than during spontaneous ventilation
- (C) provides better humidification than the Mapleson D system
- (D) requires a fresh gas flow equal to minute ventilation to prevent rebreathing during spontaneous ventilation
- (E) results in less rebreathing during controlled ventilation than the Mapleson C system
Postoperatively, a patient is being mechanically ventilated by a constant-flow, pressure-cycled ventilator with the following initial settings: inspiratory/expiratory (I/E) ratio of 1:2, peak inspiratory pressure (PIP) of 25 cmH2O, and rate of 10/min. One hour later, the I/E ratio is 1:4. Which of the following would ensure that the minute ventilation is the same as that initially set?
- (A) Inflate the endotracheal tube cuff to prevent leakage
- (B) Double the respiratory rate
- (C) Decrease the expiratory pause until the I/E ratio is 1.0
- (D) Increase the PIP until the I/E ratio is 1:2
- (E) Increase the PIP to 50 cmH20