General Anesthesia Dr. Hong Someth (part3)

101. Which one of the following is NOT the symptoms of accidental intra-arterial injection?
σ½ A bright-red flash of blood in the cannula
σ¾ A dark red blood clots under the skin
σ½ Pulsatile movement of blood in the IV line
σ½ Intense pain or burning at the site of injection
102. How to prevent intra-arterial cannulation during IV sedation?
σ½ Always palpate a vessel before applying the IV cuff
σ½ Check the colour of blood in the cannula and look for a pulse of blood in the IV tubing
σ½ Ask the patient if there is pain or coldness going down the arm when you first inject a saline test
σ¾ All of the above
103. How to prevent extravascular drug administration during IV sedation?
σ½ Always test the IV by injecting first some saline or water for injection
σ½ Inject a few drops of Diazepam into the vein first
σ½ If a saline drip is being used, hold the IV bag below the patients' heart
σ¾ Always test the IV by injecting first some saline or water for injection and . If a saline drip is being used, hold the IV bag below the patients' heart
104. Which one of the following is NOT the required equipment for IV sedation?
σ½ Pulse Oximeter
σ¾ Thermometer
σ½ Blood pressure monitor
σ½ Bag-valve-mask and oxygen cylinder
105. What are the required drugs for IV sedation?
σ½ Midazolam and Flumazenil
σ½ Adrenalin 1:1000
σ½ Other essential emergency drugs
σ¾ All of the above
106. Which one of the following is NOT the prerequisites for sedation?
σ¾ Blood tests
σ½ Knowledge of the agents to be used
σ½ Consent
σ½ Adequate equipment & materials
107. What are the guiding principles for sedation of children?
σ½ Supervision by medical personnel
σ½ Cooperative children
σ½ Trained & skilled in both airway management and cardiopulmonary resuscitation
σ¾ Supervision by medical personnel and Trained & skilled in both airway management and cardiopulmonary resuscitation
108. What advanced knowledge for primary practitioner in conscious sedation?
σ½ Capable of providing bag mask ventilation and, ultimately, endotracheal intubation
σ½ Understand pharmacology of sedating medications
σ½ Maintain advanced pediatric airway skills
σ¾ All of the above
109. Which one of the following is NOT the basic knowledge for supported personnel?
σ½ Be trained in, and capable of providing basic life support
σ¾ Know how to do tracheotomy
σ½ Assist in any supportive or resuscitation measures
σ½ Know how to use resuscitation equipment & supplies in the event of an emergency
110. What happens when insulin is injected to a hypoglycaemic patient?
σ½ The patient will recover from hypoglycaemia
σ½ Blood glucose level will rise up
σ¾ The patient might die
σ½ The patient's blood pressure will go down
111. What does S O A P M E stand for?
σ½ Supply, Order, Accident, Pain, Management, Emergency
σ¾ Suction, Oxygen, Airway, Pharmacy, Monitors, Equipment
σ½ Safe, Old, Analgesics, Prescription, Malignancy, Effectiveness
σ½ Sedationists of Oral Association for Pediatric Malformation and Epilepsy
112. What is Naxolone used for?
σ½ For reversing Benzodiazepines
σ½ For pain control
σ¾ For reversing opioids, eg. Morphine
σ½ For anti-inflammatory
113. You have been asked to administer conscious sedation to a healthy, 25 year old female patient in the dental school clinic. She has dental phobia and requires a simple dental extraction. The most appropriate statements in this context include:?
σ½ The patient must be able to understand and respond purposefully to verbal commands, throughout the period of sedation
σ½ The end point is maintenance of a purposeful response after repeated or painful stimulation
σ¾ Sedation with IV Midazolam is unlikely to be associated with over-sedation if titrated slowly
σ½ Sedative drugs are administered as a single bolus
114. A 75 years old man of ASA (American Society of Anesthesiologists) III status is scheduled for surgical removal of retained roots in the maxilla under IV sedation. The most appropriate statements regarding this procedure include:?
σ½ After an initial dose of midazolam, an additional dose is recommended if analgesia is inadequate
σ½ Administration of a specific analgesic agent is likely to be needed for pain
σ½ If midazolam and fentanyl are administered, then fentanyl should be given after the peak effect of midazolam is observed
σ¾ Midazolam dose for elderly patient with ASA III should be reduced
115. Which one of the following statement is NOT TRUE in relation to the use oral sedation?
σ¾ Patient commonly complain of post operative headache
σ½ An acceptable level of anxiolytic action is obtained when the drug is given one hour preoperatively
σ½ There is a profound amnesic action and no side affects
σ½ Oral Midazolam is considered as minimal sedation
116. Which one of the following statement is TRUE about Midazolam?
σ½ It has interaction with orange juice
σ¾ Midazolam injectable solution can be mixed with sweet drinks or Paracetamol syrup
σ½ Normally, we titrate Midazolam in 5mg (5ml) increments every 5 minute while we talk to the patient
σ½ The half-life of Midazolam is 10 to 20 hours
117. Which one of the following statement is NOT TRUE about monitoring during sedation?
σ½ Pulse oximeter measures oxygen saturation in arterial blood using infrared light
σ½ Oxygen saturation (SpO2) is the amount of oxygen carried by hemoglobin, compared with the total oxygen-carrying capacity of hemoglobin; expressed as percentage
σ½ Pulse oximeter with the alarm set is better than the finger-clip without the alarm
σ¾ Record pulse and oxygen saturation every 35 minutes
118. Dental extraction may be most appropriately performed under conscious sedation in the following patients:?
σ½ A patient with known allergy to local anaesthetic
σ½ A cooperative patient for extraction of four impacted wisdom teeth
σ¾ A severely mentally handicapped adult
σ½ A 3-yr-old child for extraction of a single tooth
119. During a minor procedure under sedation and analgesia, the patient is breathing slowly with some snoring, is not easily aroused, and does not respond to verbal commands. At which level of sedation is this patient?
σ½ Twilight sedation
σ½ Moderate sedation
σ¾ Deep sedation
σ½ Irreversible sedation
120. Which of the following defines moderate sedation?
σ½ A medically controlled state of depressed consciousness from which the patient does not respond to verbal or tactile stimuli
σ¾ CNS depression produced by sedatives that allow patients to tolerate unpleasant procedures while maintaining the ability to respond to verbal or tactile stimuli
σ½ The administration of morphine to treat post-operative pain
σ½ The administration of a sedative/hypnotic agent to facilitate sleep
121. Patients being evaluated for procedure-related sedation need: ?
σ½ A history and physical
σ½ An ASA physical status assignment
σ½ A consent
σ¾ all of the above
122. All of the following are monitoring requirements for the sedated patient EXCEPT?
σ½ Blood pressure
σ¾ Capillary refill
σ½ Pulse oximetry
σ½ respiratory rate
123. What parameter must be monitored continuously during sedation?
σ¾ State of consciousness (breathing)
σ½ Pulse oximetry
σ½ Blood pressure
σ½ Cardiac output
124. The first and most important action when a patient starts to vomit during a procedure is to?
σ½ Apply restraints
σ¾ Give supplemental O2
σ½ Give a reversal agent
σ½ Reposition to lateral decubitus
125. The first response for an obstructed airway is to: ?
σ½ Suction the patient
σ½ Tntubate the patient
σ½ Insert an oral airway
σ¾ Perform a chin lift/neck extension
126. Guidelines for patients at discharge after sedation should include: ?
σ½ Written release of the hospital from responsibility
σ½ Discussion of all potential adverse effects of moderate sedation
σ¾ Discussion of the effects of sedation and a warning about operating a motor vehicle
σ½ A mandatory follow-up visit with the physician who performed the procedure
127. Which of the following statements about the use of benzodiazepines for moderate sedation is true?
σ½ Adjustment in dosing is needed when giving an opioid
σ¾ Should always be reversed by flumazenil
σ½ Should always be reversed by naloxone
σ½ Should always be given by the oral route
128. Infants and small children are particularly susceptible to complications during sedation. The unique anatomy of which body system contributes to this susceptibility:?
σ½ Neurological
σ½ Gastrointestinal
σ¾ Respiratory
σ½ Renal
129. A Post-Anesthesia Recovery Score is: ?
σ¾ An objective measure used to determine a patient's suitability for discharge
σ½ The same as an ASA Physical Status Classification
σ½ A neurological assessment of LOC
σ½ A physician test of how well a patient will tolerate narcotics
130. When can the patients be discharged to home after procedure-related sedation?
σ½ After they can walk
σ½ After they can drink water
σ¾ After all the vital signs have returned to normal
σ½ All of the above
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