IHS Test 2 - Intraoperative Monitoring Parts 1 and 2

Question 1 of 51

1

Fill the blank space to complete the text.

A is the highest mandate for clinical behavior.

Explanation

Question 2 of 51

1

Select the standard of nursing practice that most applies to CRNAs.

Select one of the following:

Standard III
Standard IV
Standard V
Standard VI

Explanation

Question 3 of 51

1

Fill the blank spaces to complete the text.

Fill in the blanks for the AANA Standards for Nurse Anesthesia Practice:
Standard V
A. Monitor continuously.
B. Monitor continuously.
C. Monitor status continuously.
D. Monitor continuously.
E. Monitor and status.
F. Monitor and assess the .

Explanation

Question 4 of 51

1

Fill the blank space to complete the text.

One of the key components to patient safety is to: and surgical procedure for long periods of time.

Explanation

Question 5 of 51

1

Fill the blank space to complete the text.

are placed first and removed last.

Explanation

Question 6 of 51

1

Fill the blank spaces to complete the text.

Name two ways (in alpha order) that CRNAs monitor the respiratory system:
1.
2.

Explanation

Question 7 of 51

1

What is the standard of care for monitoring of oxygenation?

Select one of the following:

Arterial blood gas
Capnography
Pulse oximetry

Explanation

Question 8 of 51

1

The Beer-Lambert Law is a method for measuring what?

Select one of the following:

Capnography
Arterial blood gas
Pulse oximetry

Explanation

Question 9 of 51

1

Drag and drop the spectrum of light to the appropriate type.

Red: ❌ nm
Infrared: ❌ nm

Drag and drop to complete the text.

660

940

Explanation

Question 10 of 51

1

Fill the blank spaces to complete the text.

The Beer-Lambert Law and pulse oximetry measures the difference between absorbed light by relative to in a pulsatile () bed.

Explanation

Question 11 of 51

1

Fill the blank space to complete the text.

: The percentage of hemoglobin saturation with oxygen at different partial pressures of oxygen in blood is described by this S-shaped curve.

Explanation

Question 12 of 51

1

Fill the blank spaces to complete the text.

Insert the appropriate corresponding numbers for the oxygen-hemoglobin dissociation curve.

At an 02 reading of 97 percent, the Pa02 is likely .

At an 02 reading of percent, the Pa02 is usually 60.

At an 02 reading of 83 percent, the Pa02 is usually .

Explanation

Question 13 of 51

1

Fill the blank spaces to complete the text.

Your patient's pulse oximeter isn't reading well. What are some potential causes?
Low flow conditions
• →vasoconstrictionoftheperiphery
– Motion artifact
– Nail polish
– Ambient light interference –
• Fetal hemoglobin
• Hemoglobin S
– Carboxyhemoglobinemia
• 240timestheaffinityforhgbvs.O2. – Methemoglobinemia
– Methylene blue, indigo carmine

Explanation

Question 14 of 51

1

Fill the blank spaces to complete the text.

Name the three ways we verify intubation:

1.
2.
3. Confirmation of .

Explanation

Question 15 of 51

1

What is an early indicator of esophageal intubation and airway disconnect?

Select one of the following:

Arterial blood gas
Capnography
Pulse oximetry

Explanation

Question 16 of 51

1

Fill the blank space to complete the text.

continuously monitors all of the following:
– Alveolar ventilation
– Pulmonary perfusion
– Respiratory patterns
– Correct placement of endotracheal tube

Explanation

Question 17 of 51

1

Match the type of capnography with its description:

❌ (non-diverting or flow-through):
CO2 sensor located between endotracheal tube and breathing circuit

❌: (Diverting or aspiration):
Sensor is located in the main unit and CO2 is aspirated via a sampling tube connected to a T-piece adapter located between endotracheal tube and breathing circuit.

Drag and drop to complete the text.

Main-Stream Capnographs

Side-Stream Capnographs

Explanation

Question 18 of 51

1

Fill the blank spaces to complete the text.

Name two potentially fatal conditions that may first be indicated by capnographic changes:

Explanation

Question 19 of 51

1

Fill the blank space to complete the text.

Use of has markedly decreased incidence of unrecognized esophageal intubation and their associated brain injuries and deaths

Explanation

Question 20 of 51

1

Label the following image with the appropriate portions of the expiratory segment.

Drag an answer into the correct orange point.

Beginning of exhalation

Gas exhalation alveolar capillary bed

Alveolar plateau, C02-rich gas

Inspiration

Explanation

Question 21 of 51

1

Click on each orange point and write the correct answer.

Label the appropriate angle segments of the expiration of capnography.

Explanation

Question 22 of 51

1

Which of the following options describes Phase I of the expiratory segment?

Select one of the following:

Exhalation of gas from the alveolar capillary bed mixing with dead space gas
Positive slope due to continuous excretion of CO2 into alveoli
Gas exchange that is free of CO2
Used to assess extent of breathing

Explanation

Question 23 of 51

1

In capnography, what is part of the expiratory segment?

Select one of the following:

Phase 0
Phase I
Phase II
Phase III

Explanation

Question 24 of 51

1

Select from the dropdown lists to complete the text.

In capnography, the ( alpha, beta ) angle is between Phases II and III.

The ( alpha, beta ) angle is an indirect indication of the V/Q status of the lung.

The ( alpha, beta ) angle is between Phase III and descending limb of inspiratory segment.

The ( alpha, beta ) angle is used to assess the extent of rebreathing.

Explanation

Question 25 of 51

1

Fill the blank spaces to complete the text.

Fill in the blanks for the five characteristics of capnogram that should be evaluated:
-Frequency
-Rhythm
-
-Baseline
-

Explanation

Question 26 of 51

1

Fill the blank spaces to complete the text.

Your patient has low or no ETCO2 -- what are two of the major causes?

.
Causes: Hypothermia

.
Causes: Hypovolemia
Hypotension
Pulmonary embolism
Decreased cardiac output (arrest)

Explanation

Question 27 of 51

1

Select some causes of low ETCO2.

Select one or more of the following:

Altered alveolar ventilation
Increase CO2 production/delivery
Increased pulmonary perfusion
Technical errors/machine faults

Explanation

Question 28 of 51

1

Match the causes of low ETCO2 to the examples (in alpha order)

Altered Alveolar Ventilation
❌
❌
❌
❌

Technical Errors/Machine Faults
❌❌
❌

Drag and drop to complete the text.

Apnea (accidental extubation)

Hyperventilation

Increase in dead space ventilation

Partial/total airways obstruction

Esophageal intubation

Sampling line leak

Ventilator malfunction

Explanation

Question 29 of 51

1

Fill the blank spaces to complete the text.

Name the two chief causes of elevated CO2.

.

Explanation

Question 30 of 51

1

Drag and drop the cause of the elevated ETCO2 with its cause:

Increased CO2 production/delivery.
❌
❌
❌
❌
❌
❌
❌
❌
❌

Increased pulmonary perfusion
❌
❌

Drag and drop to complete the text.

Fever

Hyperthyroid storm

Laparoscopic surgeries

Malignant hyperthermia

Right-to-Left Shunts

Sepsis

Shivering

Sodium bicarbonate

Tourniquet

Increased blood pressure

Increased cardiac output

Explanation

Question 31 of 51

1

Select some examples of elevated CO2 causes.

Select one or more of the following:

Hyperventilation
Hypoventilation
Bronchial intubation
Exhausted CO2 absorber
Apnea/circuit disconnect
Malignant hyperthermia
Sepsis

Explanation

Question 32 of 51

1

You notice your patient is experiencing small breaths at various points in the ETCO2 waveform. What is NOT a potential cause of this?

Select one of the following:

Inadequate muscle paralysis
Improper ventilator settings
Excessive oxygenation
Pressure on the patient's chest

Explanation

Question 33 of 51

1

Cardiac oscillations are most prominent in what patient population?

Select one of the following:

Adult
Elderly
Pediatric
Pregnant

Explanation

Question 34 of 51

1

Fill the blank space to complete the text.

are small gas movements produced by pulsations of the aorta and heart.

Explanation

Question 35 of 51

1

Click on the orange point and write the correct answer.

This image is an example of what on a capnograph?

Explanation

Question 36 of 51

1

Fill the blank space to complete the text.

Other considerations/things that may mimic
– negative intrathoracic pressure
– low respiratory rate
– low I:E ratio
– Waning muscle relaxation

Explanation

Question 37 of 51

1

Fill the blank space to complete the text.

Phase II and III are prolonged or slanted when a patient experiences a .

Explanation

Question 38 of 51

1

You are administering anesthesia when you suddenly notice your patient's baseline is elevated. You immediately:

Select one of the following:

Check for disconnections
Look at your CO2 absorbent
Change the I:E ratio
Increase your patient's sedative

Explanation

Question 39 of 51

1

You see the capnograph below during your case. You know this is a sign of:

Select one of the following:

Exhausted CO2 absorbent
Airway obstruction
Cardiac oscillations
Inspiratory valve malfunction

Explanation

Question 40 of 51

1

Fill the blank space to complete the text.

An defect allows exhaled CO2-rich gases to be rebreathed with each inspiration.

Explanation

Question 41 of 51

1

Select from the dropdown list to complete the text.

ETC02 is indicative of ( alveolar, arterial ) CO2.

Explanation

Question 42 of 51

1

You have two CO2 readings: 38 and 43. Which one is the arterial concentration or PACO2?

Select one of the following:

38
43

Explanation

Question 43 of 51

1

Select from the dropdown list to complete the text.

The ( facial, ulnar ) nerve is the better site to monitor for onset of block because the larynx also mimics the response of the diaphragm.

Explanation

Question 44 of 51

1

Select from the dropdown list to complete the text.

The ( facial, ulnar ) nerve is the best nerve to monitor for recovery.

Explanation

Question 45 of 51

1

Match the pattern of stimulation to its stimulus.

❌ The simplest mode of stimulation; consists of a single supramaximal electrical stimulus that is delivered from every 1 to 10 seconds (1‐0.1 Hz)

❌ Four successive 200 μs stimuli at 2Hz delivered every 0.5 seconds for 2 seconds

❌ delivers two bursts (at 50Hz) of three electrical stimulations separated by 750 sec followed later by two such impulses

❌ Repetitive, high-frequency stimulation at frequencies of 50 Hz or greater for five seconds

Drag and drop to complete the text.

Single stimulus:

Train of Four:

Double Burst Stimulation:

Tetanus:

Explanation

Question 46 of 51

1

Which form of peripheral nerve monitoring is based on the concept that acetylcholine is depleted by successive stimulation?

Select one of the following:

Single stimulus
Train of four
Double-burst stimulation
Tetanus

Explanation

Question 47 of 51

1

In Train of Four stimulation, no twitches equals what kind of blockage?

Select one of the following:

75
80
90
100

Explanation

Question 48 of 51

1

Clinical relaxation usually require what percentage of neuromuscular blockage?

Select one of the following:

50 to 60 percent
60 to 70 percent
75 to 95 percent
100 percent

Explanation

Question 49 of 51

1

What PNM improves accuracy over the T4/T1 ratio by delivering a stronger stimulation and eliminating the second and third twitches?

Select one of the following:

Double burst stimulation
Single burst stimulation
Tetanus

Explanation

Question 50 of 51

1

Which PNM option may provide an indication of the time until return of the first response in the TOF and subsequent readiness for reversal of neuromuscular blockage?

Select one of the following:

Tetanus
Post-Tetanic Potentiation
Train of Four
Double-Burst Stimulation

Explanation

Question 51 of 51

1

Which of the following muscle groups are most sensitive to neuromuscular blocking agents?

Select one of the following:

Diaphragm and Masseter
Extra ocular and adductor pollicis
Diaphragm and Orbicularis oculi
Adductor pollicis and Orbicularis oculi

	Created by Rachel Nall about 8 years ago

Quiz on IHS Test 2 - Intraoperative Monitoring Parts 1 and 2, created by Rachel Nall on 29/06/2016.

IHS Test 2 - Intraoperative Monitoring Parts 1 and 2

Question 1 of 51

Fill the blank space to complete the text.

A is the highest mandate for clinical behavior.

Explanation

Question 2 of 51

Select the standard of nursing practice that most applies to CRNAs.

Select one of the following:

Explanation

Question 3 of 51

Fill the blank spaces to complete the text.

Fill in the blanks for the AANA Standards for Nurse Anesthesia Practice: Standard V A. Monitor continuously. B. Monitor continuously. C. Monitor status continuously. D. Monitor continuously. E. Monitor and status. F. Monitor and assess the .

Explanation

Question 4 of 51

Fill the blank space to complete the text.

One of the key components to patient safety is to: and surgical procedure for long periods of time.

Explanation

Question 5 of 51

Fill the blank space to complete the text.

are placed first and removed last.

Explanation

Question 6 of 51

Fill the blank spaces to complete the text.

Name two ways (in alpha order) that CRNAs monitor the respiratory system: 1. 2.

Explanation

Question 7 of 51

What is the standard of care for monitoring of oxygenation?

Select one of the following:

Explanation

Question 8 of 51

The Beer-Lambert Law is a method for measuring what?

Select one of the following:

Explanation

Question 9 of 51

Drag and drop the spectrum of light to the appropriate type. Red: ❌ nm Infrared: ❌ nm

Drag and drop to complete the text.

Explanation

Question 10 of 51

Fill the blank spaces to complete the text.

The Beer-Lambert Law and pulse oximetry measures the difference between absorbed light by relative to in a pulsatile () bed.

Explanation

Question 11 of 51

Fill the blank space to complete the text.

: The percentage of hemoglobin saturation with oxygen at different partial pressures of oxygen in blood is described by this S-shaped curve.

Explanation

Question 12 of 51

Fill the blank spaces to complete the text.

Insert the appropriate corresponding numbers for the oxygen-hemoglobin dissociation curve. At an 02 reading of 97 percent, the Pa02 is likely . At an 02 reading of percent, the Pa02 is usually 60. At an 02 reading of 83 percent, the Pa02 is usually .

Explanation

Question 13 of 51

Fill the blank spaces to complete the text.

Explanation

Question 14 of 51

Fill the blank spaces to complete the text.

Name the three ways we verify intubation: 1. 2. 3. Confirmation of .

Explanation

Question 15 of 51

What is an early indicator of esophageal intubation and airway disconnect?

Select one of the following:

Explanation

Question 16 of 51

Fill the blank space to complete the text.

continuously monitors all of the following: – Alveolar ventilation – Pulmonary perfusion – Respiratory patterns – Correct placement of endotracheal tube

Explanation

Question 17 of 51

Drag and drop to complete the text.

Explanation

Question 18 of 51

Fill the blank spaces to complete the text.

Name two potentially fatal conditions that may first be indicated by capnographic changes:

Explanation

Question 19 of 51

Fill the blank space to complete the text.

Use of has markedly decreased incidence of unrecognized esophageal intubation and their associated brain injuries and deaths

Explanation

Question 20 of 51

Label the following image with the appropriate portions of the expiratory segment.

Drag an answer into the correct orange point.

Explanation

Fill in the blanks for the AANA Standards for Nurse Anesthesia Practice:
Standard V
A. Monitor continuously.
B. Monitor continuously.
C. Monitor status continuously.
D. Monitor continuously.
E. Monitor and status.
F. Monitor and assess the .

Name two ways (in alpha order) that CRNAs monitor the respiratory system:
1.
2.

Drag and drop the spectrum of light to the appropriate type.

Red: ❌ nm
Infrared: ❌ nm

Insert the appropriate corresponding numbers for the oxygen-hemoglobin dissociation curve.

At an 02 reading of 97 percent, the Pa02 is likely .

At an 02 reading of percent, the Pa02 is usually 60.

At an 02 reading of 83 percent, the Pa02 is usually .

Name the three ways we verify intubation:

1.
2.
3. Confirmation of .

continuously monitors all of the following:
– Alveolar ventilation
– Pulmonary perfusion
– Respiratory patterns
– Correct placement of endotracheal tube

Fill in the blanks for the five characteristics of capnogram that should be evaluated:
-Frequency
-Rhythm
-
-Baseline
-

Your patient has low or no ETCO2 -- what are two of the major causes?

.
Causes: Hypothermia

.
Causes: Hypovolemia
Hypotension
Pulmonary embolism
Decreased cardiac output (arrest)

Match the causes of low ETCO2 to the examples (in alpha order)

Altered Alveolar Ventilation
❌
❌
❌
❌

Technical Errors/Machine Faults
❌❌
❌

Name the two chief causes of elevated CO2.

.

Drag and drop the cause of the elevated ETCO2 with its cause:

Increased CO2 production/delivery.
❌
❌
❌
❌
❌
❌
❌
❌
❌

Increased pulmonary perfusion
❌
❌

Other considerations/things that may mimic
– negative intrathoracic pressure
– low respiratory rate
– low I:E ratio
– Waning muscle relaxation