Which of the following would be most likely to result in neonatal depression when administered to a healthy parturient during an uncomplicated labor and vaginal delivery?
(A) Nitrous oxide 60% in oxygen supplemented with halothane 0.5% for 10 minutes before delivery
(B) Ketamine 20 mg intravenously 30 minutes before delivery
(C) Meperidine 100 mg intramuscularly 2 hours before delivery
(D) Thiopental 100 mg intravenously 30 minutes before delivery
(E) Nitrous oxide 60% in oxygen supplemented with enflurane 0.7% for 10 minutes before delivery
Two opened oxygen cylinders, one full and one empty, are attached to an anesthesia machine. The check valve to the empty cylinder fails. This is expected to result in
(A) activation of the fail-safe device
(B) cessation of oxygen flow to the anesthesia circuit
(C) filling of the empty cylinder with a mixture of all gases supplied to the anesthesia machine
(D) increase in the temperature of the empty cylinder
(E) interruption of gas delivery from the central oxygen source
At the time of cesarean delivery, thick dark meconium is noted and the newborn is flaccid, apneic, bradycardic, and cyanotic. The most appropriate initial action is
A 64-year-old patient with chronic obstructive pulmonary disease sustained fractures of ribs 4 through 8 on the left one hour ago. Examination shows agitation, heart rate of 120 bpm, respiratory rate of 30/min, and blood pressure of 180/100 mmHg. PaO2 is 70 mmHg and PaCO2 is 35 mmHg on room air. Radiographs of the chest show no abnormalities. Which of the following is the most appropriate immediate management?
(A) Continuous epidural analgesia using local anesthetics
(B) Mechanical ventilation
(C) Infusion of midazolam
(D) Patient-controlled analgesia with morphine sulfate
During cardiopulmonary bypass at a nasopharyngeal temperature of 28°C and a hematocrit of 20%, temperature-corrected PaCO2 is 50 mmHg and uncorrected PaCO2 is 60 mmHg. The most appropriate management is to
(A) administer additional opioid
(B) administer packed red blood cells to increase hematocrit to 25%
A 26-year-old woman has weakness on extension of the right knee one day after uneventful vaginal delivery under spinal anesthesia with lidocaine. The most likely cause is
(A) femoral nerve injury from thigh abduction
(B) obturator nerve injury from obstetric forceps
(C) peroneal nerve compression from the leg support
(D) saphenous nerve injury from the stirrups
(E) chemical arachnoiditis following the spinal anesthetic
A
During cardiopulmonary bypass, the perfusionist notes that the mixed venous oxygen saturation has decreased from to 55%. Which of the following is the most likely cause?
(A) Administration of a nitroprusside bolus
(B) Administration of a thiopental bolus
(C) Decrease in rectal temperature from 34°C to 28°C