Principles Of Pediatric Anesthesia Quiz! Trivia
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There are many instances where children must be given anaesthesia, but due to how fragile they are several ways that it can be done, either through gas flowing through a mask or a needle. As an anaesthetist, you should know how to handle different kids and their reaction to some of these methods and effects of the drugs. BY taking this quiz, you will be able to assess your knowledge. Check them out!
- 1.
What should be your first action when preparing to do a pre-op assessment on a 3 yr old child?
- A.
Review the chart
- B.
Introduce yourself to the child’s parents and obtain a thorough history
- C.
Introduce yourself to child, and attempt to play a game or comfort them
- D.
Get your blow gun ready, and load it with a ketamine dart.
Correct Answer
A. Review the chartExplanation
The first action when preparing to do a pre-op assessment on a 3 yr old child should be to review the chart. This is important to gather information about the child's medical history, any previous surgeries, allergies, or any other relevant information that may impact the pre-op assessment and anesthesia plan. Reviewing the chart helps in ensuring the safety and well-being of the child during the procedure.Rate this question:
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- 2.
Which of the following is the most common reason for the cancellation of pediatric procedures?
- A.
Asthma Exacerbation
- B.
Upper Respiratory Infections
- C.
Non-compliance with NPO requirements
- D.
Instability due to illness
Correct Answer
B. Upper Respiratory InfectionsExplanation
Upper respiratory infections are the most common reason for the cancellation of pediatric procedures. This is because these infections can cause complications during the procedure, such as difficulty breathing or increased risk of infection. It is important to ensure that the child is in good health before proceeding with any medical procedure to minimize any potential risks or complications.Rate this question:
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- 3.
You are assessing 4 yr old Madelyn prior to her going in for enucleation of her left eye. When you see her in pre-op she appears to be a little under the weather. She is sneezing and has yellow mucus coming to her nose. You listen to her lungs and hear a slight wheeze while her mom says she began to run a temperature late last night. She appears fine and is watching and giggling at a children’s show on a portable DVD player her mother brought to calm her. What do you do for this patient?
- A.
Give a dose of Tylenol and a respiratory treatement pre-op before continuing with procedure.
- B.
It is only an eye surgery, not thoracic so she will be fine.
- C.
Talk to the surgeon regarding possibly cancelling the surgery
- D.
That depends entirely upon whether Madelyn was a premature baby or has any other coexisting diseases.
Correct Answer
C. Talk to the surgeon regarding possibly cancelling the surgeryExplanation
Based on the symptoms described, including sneezing, yellow mucus, wheezing, and a temperature, it suggests that Madelyn may have an upper respiratory infection or a possible respiratory illness. These symptoms may indicate that Madelyn is not in optimal health for the surgery, as it could increase the risk of complications during and after the procedure. Therefore, it would be appropriate to talk to the surgeon about the possibility of cancelling the surgery until Madelyn's condition improves.Rate this question:
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- 4.
You are going to do a pre-op on 5 yr old Trevor who is going in today for a repair of an inguinal hernia. When you go to assess him pre-op you see he is sniffly. His mother says he has seasonal allergies and has a constant runny nose. You go to look at Trevor and indeed his little nose is red and he has clear mucus coming from his nose, but no fever or wheezes. He does not appear to be otherwise ill and in fact, is playing with his stuffed dinosaur. Is it safe to proceed with the procedure?
- A.
Not enough information to decide at this time.
- B.
No, he is displaying signs of an upper respiratory infection.
- C.
Only safe to proceed if pt is given a respiratory treatment and an arterial line inserted to closely monitor hemodynamic stability.
- D.
Yeah, he’s fine. We can proceed!
Correct Answer
D. Yeah, he’s fine. We can proceed!Explanation
Based on the given information, Trevor's sniffles and runny nose are attributed to his seasonal allergies rather than an upper respiratory infection. He does not have a fever or wheezes, and he appears to be otherwise healthy and engaged in play. Therefore, it is safe to proceed with the procedure.Rate this question:
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- 5.
A 7 yr old child must not eat solid food for how many hours prior to procedure?
- A.
6 hours
- B.
8 hours
- C.
3 hours
- D.
4 hours
Correct Answer
B. 8 hoursExplanation
A 7-year-old child must not eat solid food for 8 hours prior to a procedure. This is important because eating solid food within this time frame can increase the risk of aspiration during the procedure. Aspiration occurs when food or liquid enters the airway and can lead to serious complications. Therefore, it is necessary to ensure that the child's stomach is empty before the procedure to minimize the risk of aspiration and ensure their safety.Rate this question:
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- 6.
Which of the following would not be an appropriate way to reduce intra-op heat loss in the pediatric patient?
- A.
Use of an overhead radiant heating unit
- B.
Use of a water mattress, with circulating warm water
- C.
Use cloths dipped in 40o C water and place onto child’s head during procedure
- D.
Use a Bair hugger placed on the child’s body
Correct Answer
C. Use cloths dipped in 40o C water and place onto child’s head during procedureExplanation
Using cloths dipped in 40°C water and placing them onto a child's head during a procedure would not be an appropriate way to reduce intra-op heat loss in a pediatric patient. This is because placing warm cloths on the head can lead to excessive heat loss through the scalp, which is a large surface area for heat transfer. It is important to use methods that provide controlled and regulated heat to the patient, such as the use of an overhead radiant heating unit, a water mattress with circulating warm water, or a Bair hugger placed on the child's body.Rate this question:
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- 7.
What type of breathing circuit would you choose for a child weighing less than 10 kg?
- A.
Small semi-closed Circuit
- B.
Mapleson A
- C.
Standard adult semi closed system
- D.
Jackson-Rees Circuit
Correct Answer
D. Jackson-Rees CircuitExplanation
The Jackson-Rees Circuit would be the most appropriate choice for a child weighing less than 10 kg. This circuit is specifically designed for pediatric patients and provides controlled ventilation with low resistance. It allows for precise control of oxygen and anesthetic gas delivery, making it suitable for small patients. The other options mentioned, such as the Small semi-closed Circuit, Mapleson A, and Standard adult semi closed system, are not specifically designed for pediatric patients and may not provide the same level of control and safety.Rate this question:
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- 8.
What type of circuit would you choose for a pediatric patient weighing more than 10 kg?
- A.
Small semi-closed Circuit
- B.
Mapleson A
- C.
Standard adult semi closed system
- D.
Jackson-Rees Circuit
Correct Answer
A. Small semi-closed CircuitExplanation
A small semi-closed circuit would be the most suitable choice for a pediatric patient weighing more than 10 kg. This type of circuit provides a more controlled and precise delivery of anesthesia, which is important for pediatric patients who require smaller doses. Additionally, the small circuit size helps to minimize the dead space and reduce the risk of rebreathing carbon dioxide. Therefore, it is a safer and more efficient option for pediatric patients in this weight range.Rate this question:
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- 9.
When setting an adult vent for pediatric use in pressure-controlled mode, which of the following would be inappropriate?
- A.
Set I:E ratio 1:2
- B.
Pop off limit to vent to 30 cm H2O
- C.
VT to minimum of 200 ml/kg/min
- D.
All the above are correct
Correct Answer
B. Pop off limit to vent to 30 cm H2OExplanation
Setting the pop off limit to vent to 30 cm H2O would be inappropriate when setting an adult vent for pediatric use in pressure-controlled mode. The pop off limit is the maximum pressure at which the ventilator will release excess pressure. In pediatric patients, the pop off limit should be set lower to prevent barotrauma and ensure the safety of the patient. Therefore, setting the pop off limit to 30 cm H2O would not be appropriate in this scenario.Rate this question:
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- 10.
What would be an appropriate size LMA for an infant weighing 9 kg?
- A.
0.5
- B.
1
- C.
1.5
- D.
2.5
Correct Answer
C. 1.5Explanation
An appropriate size LMA for an infant weighing 9 kg would be 1.5. The size of the LMA is determined based on the weight of the patient, and in this case, the infant weighs 9 kg. The LMA size 1.5 is suitable for infants in this weight range, providing a secure airway and effective ventilation during medical procedures.Rate this question:
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- 11.
What would be an appropriate size LMA for a child weighing 27 kg?
- A.
3
- B.
1.5
- C.
4
- D.
2.5
Correct Answer
D. 2.5Explanation
An appropriate size LMA for a child weighing 27 kg would be 2.5. The size of the LMA is determined based on the weight of the child, and in this case, a child weighing 27 kg would require a size 2.5 LMA.Rate this question:
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- 12.
What would be an appropriate sized ETT for a 3 yr old child weighing 18 kg?
- A.
4.5
- B.
4
- C.
3.5
- D.
3
Correct Answer
A. 4.5Explanation
An appropriate sized endotracheal tube (ETT) for a 3-year-old child weighing 18 kg would be 4.5. The size of the ETT is determined based on the weight and age of the child, as well as other factors such as the size of the child's airway. In this case, a 4.5 ETT would be suitable for the child's weight and age.Rate this question:
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- 13.
What would be an appropriate size ETT for a 9 yr old child weighing 33 kg?
- A.
5
- B.
6
- C.
4.5
- D.
7
Correct Answer
B. 6Explanation
An appropriate size endotracheal tube (ETT) for a 9-year-old child weighing 33 kg would be 6. The size of the ETT is determined based on the age, weight, and height of the patient. In this case, a size 6 ETT is suitable for a child of this age and weight. The ETT should be of the appropriate size to ensure proper ventilation and oxygenation during anesthesia or respiratory support.Rate this question:
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- 14.
What size laryngoscope blade would you choose to intubate a 3 yr old child?
- A.
1 mil
- B.
2 mac
- C.
1.5 mil
- D.
0 mac
Correct Answer
C. 1.5 milExplanation
The correct answer is 1.5 mil. When intubating a 3-year-old child, a laryngoscope blade size of 1.5 mil would be appropriate. Laryngoscope blades are used to visualize the vocal cords and facilitate the insertion of an endotracheal tube during intubation. The size of the blade is chosen based on the patient's age, size, and anatomical characteristics. In this case, a 1.5 mil blade would likely provide a good fit and optimal visualization for intubating a 3-year-old child.Rate this question:
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- 15.
What size laryngoscope blade would you choose to intubate an 8 yr old child?
- A.
1.5 mil
- B.
3 mac
- C.
2.5 mil
- D.
2 mac
Correct Answer
D. 2 macExplanation
The correct answer is 2 mac. The Macintosh (mac) blade is commonly used for intubation in children. The size of the blade is determined by the age and size of the child. In this case, for an 8-year-old child, a 2 mac blade would be appropriate. The mac blade is designed to lift the epiglottis and provide a clear view of the vocal cords, making intubation easier and safer.Rate this question:
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- 16.
In order to work well EMLA cream must be applied at least how many minutes prior to IV start?
- A.
45 minutes
- B.
2 hours
- C.
30 minutes
- D.
15 minutes
Correct Answer
A. 45 minutesExplanation
EMLA cream needs to be applied at least 45 minutes prior to an IV start in order to work effectively. Applying the cream 45 minutes in advance allows enough time for the numbing agents in the cream to penetrate the skin and desensitize the area. This ensures that the patient does not experience pain or discomfort during the IV insertion. Applying the cream too close to the procedure may not provide sufficient numbing effect, leading to potential discomfort for the patient.Rate this question:
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- 17.
What is an appropriate hourly maintenance fluid rate for a child weighing 15 kg?
- A.
60 ml
- B.
50 ml
- C.
25 ml
- D.
15 ml
Correct Answer
B. 50 mlExplanation
An appropriate hourly maintenance fluid rate for a child weighing 15 kg is 50 ml. This is because maintenance fluid requirements are usually calculated based on body weight, and a commonly used formula is 4-2-1, which means 4 ml/kg/hr for the first 10 kg, 2 ml/kg/hr for the next 10 kg, and 1 ml/kg/hr for every kg above 20 kg. Therefore, for a child weighing 15 kg, the appropriate hourly maintenance fluid rate would be 50 ml.Rate this question:
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- 18.
When doing a pedi drug set up, it is recommended to draw up your drugs in ‘unit dose’ syringes.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
Drawing up drugs in 'unit dose' syringes during a pedi drug set up is recommended because it ensures accurate dosing and minimizes the risk of medication errors. Unit dose syringes contain pre-measured amounts of medication, which eliminates the need for manual calculations and reduces the chances of overdosing or underdosing. This practice also promotes patient safety by preventing contamination and cross-contamination of medications. Additionally, using unit dose syringes simplifies the administration process, saves time, and improves efficiency in pediatric medication management.Rate this question:
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- 19.
What would be an appropriate dose of pre-op versed for a 6 yr old child weighing 24 kg?
- A.
24 mg IV
- B.
6 mg PO
- C.
12 mg PO
- D.
48 mg PO
Correct Answer
C. 12 mg POExplanation
An appropriate dose of pre-op versed for a 6-year-old child weighing 24 kg would be 12 mg PO. PO stands for "per os" which means orally. This means that the child should take the medication by mouth. It is important to consider the weight and age of the child when determining the appropriate dose to ensure safety and effectiveness of the medication.Rate this question:
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- 20.
The majority of pediatric cardiac arrests occur when?
- A.
Induction
- B.
Maintenance
- C.
Emergence
- D.
Rates are equal during all 3 phases
Correct Answer
A. InductionExplanation
Pediatric cardiac arrests primarily occur during the induction phase. This phase refers to the initial administration of anesthesia and the process of preparing the patient for surgery. It involves the use of medications and techniques to induce unconsciousness and ensure a smooth transition to the maintenance phase. During induction, there is a higher risk of cardiac arrest due to factors such as the administration of anesthesia drugs and the stress of intubation. Therefore, it is crucial for healthcare providers to closely monitor the patient's vital signs and be prepared to respond quickly in case of any complications.Rate this question:
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- 21.
Most pediatric arrests are due to ________ causes in children.
- A.
Cardiac
- B.
Respiratory
- C.
Congenital defects
- D.
Circulatory collapse
Correct Answer
B. RespiratoryExplanation
Most pediatric arrests are due to respiratory causes in children. This means that the majority of cardiac arrests in children are caused by problems with the respiratory system. This could include conditions such as choking, asthma, pneumonia, or other respiratory illnesses that can lead to a lack of oxygen and ultimately cardiac arrest. It is important to identify and address respiratory issues in children to prevent potential cardiac arrests.Rate this question:
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- 22.
What is the most common cause of respiratory arrest in pediatric patients?
- A.
Airway Obstruction
- B.
Difficult intubation
- C.
Laryngospasm
- D.
Bronchospasm
Correct Answer
C. LaryngospasmExplanation
Laryngospasm is the most common cause of respiratory arrest in pediatric patients. Laryngospasm occurs when the vocal cords in the throat spasm and close off the airway, preventing air from entering the lungs. This can be triggered by various factors such as irritation, infection, or an allergic reaction. Laryngospasm can quickly lead to respiratory distress and ultimately respiratory arrest if not promptly treated. It is important to recognize the signs of laryngospasm and intervene immediately to open the airway and restore breathing in pediatric patients.Rate this question:
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- 23.
Which of the following is not a risk factor associated with cardiac arrests in the pediatric patient?
- A.
Emergency Surgery
- B.
ASA 3-5
- C.
Congenital Airway Deformities
- D.
Children 1-4 yrs old
Correct Answer
D. Children 1-4 yrs oldExplanation
Children 1-4 years old is not a risk factor associated with cardiac arrests in pediatric patients. This age group is generally considered to have a lower risk compared to other age groups. Risk factors such as emergency surgery, ASA 3-5 (American Society of Anesthesiologists physical status classification), and congenital airway deformities are known to increase the risk of cardiac arrests in pediatric patients.Rate this question:
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- 24.
You are going to do a pre-op on a 6 yr old patient about to undergo a Left nephrectomy to remove a tumor.You walk into the room and find a very nervous little boy clutching a bear and hiding under the covers, the father also looks very upset and nervous. What should your approach be to do this pre-op?
- A.
Approach the parent and attempt to calm him first
- B.
Come back later when both are feeling a bit better
- C.
Approach the child, and attempt to calm him first.
- D.
Give the child some versed.
Correct Answer
A. Approach the parent and attempt to calm him firstExplanation
In this scenario, the best approach would be to first address the parent's anxiety and nervousness. By calming the parent, it will create a more stable and supportive environment for the child. Once the parent is calmer, they can then help in reassuring the child and making them feel more comfortable. This approach recognizes the importance of the parent's role in providing emotional support to the child and establishes a foundation of trust and cooperation for the pre-op procedure.Rate this question:
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- 25.
A child with a recent URI would be at an increased risk for all of the following except:
- A.
Laryngospasm
- B.
Pneumonia
- C.
Atelectasis
- D.
Wheezing
Correct Answer
B. PneumoniaExplanation
A child with a recent URI (upper respiratory infection) would be at an increased risk for laryngospasm, atelectasis, and wheezing. This is because a URI can cause inflammation and congestion in the upper airways, leading to narrowing and obstruction of the air passages. Laryngospasm refers to the sudden closure of the vocal cords, which can occur due to irritation and inflammation caused by the URI. Atelectasis refers to the collapse of a part or the entire lung, which can occur due to blockage of the air passages. Wheezing is a common symptom of airway narrowing and obstruction. However, pneumonia is not directly related to a URI. Pneumonia is an infection that primarily affects the lungs, usually caused by bacteria or viruses. While a URI can increase the risk of developing pneumonia, it is not a direct consequence of a recent URI.Rate this question:
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- 26.
A healthy pediatric patient with no pre-existing congenital anomalies does not need any preop lab tests if the procedure is expected to have minimal blood loss.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
For a healthy pediatric patient with no pre-existing congenital anomalies, preoperative lab tests may not be necessary if the procedure is expected to have minimal blood loss. This is because in such cases, the risk of complications or abnormalities is low, and the benefits of performing the tests may not outweigh the potential discomfort or inconvenience for the patient. However, it is important to note that the decision to omit preop lab tests should be made by a healthcare professional based on a thorough assessment of the patient's medical history and the specific procedure being performed.Rate this question:
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- 27.
You are auscultating heart sounds on a 7 yr old child and hear a short, soft, systolic murmur. How would you classify this murmur?
- A.
Pathologic
- B.
Detrimental
- C.
Innocent
- D.
None of above
Correct Answer
C. InnocentExplanation
Based on the given information, the murmur heard in the 7-year-old child is described as short and soft. A short, soft, systolic murmur is typically considered innocent or benign in children. Innocent murmurs are common in children and are usually harmless, often due to the normal flow of blood through the heart. Therefore, the correct classification for this murmur would be innocent.Rate this question:
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- 28.
What pre-op medication would you choose for a 3 week old child, who weighs 4 kg, undergoing surgery to correct a pyloric stenosis?
- A.
Ketamine 8 mg IM
- B.
Versed 0.4mg IM
- C.
Fentanyl lollipop 40 mcg PO
- D.
Atropine 0.08 mg IM
Correct Answer
D. Atropine 0.08 mg IMExplanation
Atropine is the correct choice for pre-op medication in a 3-week-old child undergoing surgery to correct pyloric stenosis. Atropine is commonly used to reduce salivation and respiratory secretions, and it also helps to prevent bradycardia during anesthesia. The dose of 0.08 mg IM is appropriate for a child of this age and weight. Ketamine, Versed, and Fentanyl are not typically used as pre-op medications in infants of this age.Rate this question:
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- 29.
When monitoring the pediatric patient, where should the precordial stethoscope be placed?
- A.
Left sternal border 2nd or 3rd intercostals space
- B.
Right sterna border 2nd or 3rd intercostals space
- C.
Left midclavicular line 5th intercostals space
- D.
Depends upon what you are trying to monitor
Correct Answer
A. Left sternal border 2nd or 3rd intercostals spaceExplanation
The precordial stethoscope should be placed on the left sternal border in the 2nd or 3rd intercostal space when monitoring a pediatric patient. This location allows for optimal auscultation of heart sounds and helps to accurately assess the patient's cardiac function. Placing the stethoscope on the right sternal border or in a different intercostal space may not provide clear and accurate heart sounds. The left midclavicular line in the 5th intercostal space is typically used for auscultating lung sounds, not heart sounds.Rate this question:
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- 30.
You are the SRNA for a 2 week old child undergoing repair of a patent PDA. Which of the following is not true regarding proper monitor placement?
- A.
A precordial stethoscope should be used to evaluate heart tone, rate, and murmurs.
- B.
O2 sat probe should be placed on the left hand for the procedure
- C.
Twitch monitor should be placed along ulnar nerve at the wrist
- D.
The only change to ECG monitoring is the use of pediatric ECG leads and changing alarm limits.
Correct Answer
B. O2 sat probe should be placed on the left hand for the procedureExplanation
The O2 sat probe should not be placed on the left hand for the procedure. This is because during the repair of a patent PDA, the left hand may be used for arterial line placement or for obtaining blood samples. Placing the O2 sat probe on the left hand may interfere with these procedures and compromise patient care.Rate this question:
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- 31.
The best way to administer an IV fluid bolus to an infant is through use of a pressure bag to administer fluid quickly.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
Administering an IV fluid bolus to an infant through the use of a pressure bag is not the best way. Infants have delicate veins that can be easily damaged by the high pressure exerted by a pressure bag. A more appropriate method is to use a syringe or an infusion pump to administer the fluid slowly and carefully, taking into consideration the infant's size and condition.Rate this question:
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- 32.
Which of the following children would likely experience the greatest amount of separation anxiety?
- A.
A 4 month old child
- B.
An 11 month old child
- C.
A 5 yr old child
- D.
A 13 yr old child
Correct Answer
B. An 11 month old childExplanation
An 11 month old child would likely experience the greatest amount of separation anxiety because this is the age when separation anxiety typically peaks. At this stage, infants have developed a strong attachment to their primary caregiver and may become distressed when separated from them. They may cry, cling, or display other signs of anxiety when the caregiver is not present. This is a normal and temporary phase of development that typically improves as the child grows older.Rate this question:
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- 33.
What would be the ideal position for induction of a 4 yr old child who is frightened and refuses to lie flat on the OR table?
- A.
Use a couple nurses to make the child lie down and then induce
- B.
Stand next to the child, as they sit on the side of the OR table and then apply the mask to induce.
- C.
Have the child sit in center of OR table while you sit nearby and wrap your arm around child to induce via mask inhalation.
- D.
Use reason, tell the child if they do not lie down you will have to give them a shot instead.
Correct Answer
C. Have the child sit in center of OR table while you sit nearby and wrap your arm around child to induce via mask inhalation.Explanation
The ideal position for induction of a frightened 4-year-old child who refuses to lie flat on the OR table is to have the child sit in the center of the OR table while the healthcare professional sits nearby and wraps their arm around the child to induce anesthesia via mask inhalation. This approach allows the child to feel secure and supported while receiving the anesthesia, which can help alleviate their fear and anxiety.Rate this question:
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- 34.
Which of the following is not true regarding use of Brutane?
- A.
You should apply face mask using two hands in order to have a tight grip
- B.
Children induced this way are more prone to larnygospasm
- C.
You should have sux and atropine drawn up and within easy reach
- D.
This technique is not appropriate for hysterical children
Correct Answer
D. This technique is not appropriate for hysterical childrenExplanation
The given answer states that the technique of using Brutane is not appropriate for hysterical children. This implies that using Brutane may not be effective or suitable for managing hysterical children.Rate this question:
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- 35.
For a normal inhalational induction your N2O should be at ______ and your O2 should be at ________ to start out with.
- A.
70%, 30%
- B.
50%, 50%
- C.
40%, 60%
- D.
0 %, 100 %
Correct Answer
A. 70%, 30%Explanation
For a normal inhalational induction, the N2O concentration should be at 70% and the O2 concentration should be at 30% to start out with. This is because a higher concentration of N2O helps to provide analgesia and reduce the patient's awareness during the induction process. On the other hand, a lower concentration of oxygen is used to prevent the risk of fire or explosion.Rate this question:
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- 36.
What size IV catheter would be best to use on a 3 yr old child?
- A.
24
- B.
22
- C.
20
- D.
18
Correct Answer
B. 22Explanation
A size 22 IV catheter would be the best choice for a 3-year-old child. IV catheters are used to administer fluids or medications directly into the bloodstream. The size of the catheter is determined by the gauge, which refers to the diameter of the needle. A size 22 gauge is smaller than a size 24 and larger than a size 20 or 18. In pediatric patients, it is important to use a smaller gauge to minimize discomfort and potential complications. Therefore, a size 22 IV catheter would be the most appropriate choice for a 3-year-old child.Rate this question:
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- 37.
During an inhalational induction, once your pediatric patient is tubed your first priority should be…
- A.
Inserting the precordial stethoscope
- B.
Applying nerve monitor to assess paralysis
- C.
Starting an IV
- D.
Turning up the sevo higher
Correct Answer
C. Starting an IVExplanation
Starting an IV is the correct answer because once the pediatric patient is tubed during an inhalational induction, it is important to establish intravenous access as a priority. This is necessary for administering medications, fluids, and emergency drugs if needed. It allows for immediate access to the bloodstream in case of any complications or emergencies during the procedure.Rate this question:
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- 38.
Which of the following is incorrect regarding maintenance of survival position?
- A.
The jaw and chin should be rotated downward to further open the airway
- B.
Using tips of your fingers, jaw thrust should be applied bilaterally
- C.
Fingers should be placed on bony prominence of face
- D.
Downward pressure should not be applies to mask, instead lift jaw up to form tight seal
Correct Answer
D. Downward pressure should not be applies to mask, instead lift jaw up to form tight sealExplanation
The correct answer is that downward pressure should not be applied to the mask, instead, the jaw should be lifted up to form a tight seal. This is because applying downward pressure to the mask can cause air to leak out and prevent a proper seal from forming. Lifting the jaw up helps to align the airway and ensure that the mask fits securely over the face, allowing for effective ventilation.Rate this question:
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- 39.
You are the SRNA for a 6 yr old child coming in from the ER for an emergent appendectomy. Which of the following is the best choice for induction?
- A.
Inhalational induction as patient Is not likely to cooperate with IV placement
- B.
IV must be placed prior to procedure for safe induction.
- C.
IM induction with ketamine
- D.
None of above are appropriate
Correct Answer
B. IV must be placed prior to procedure for safe induction.Explanation
The best choice for induction in this scenario is to place an IV prior to the procedure for safe induction. This is because an appendectomy is an emergent surgery and requires a rapid and controlled induction of anesthesia. Inhalational induction may not be suitable as the patient is not likely to cooperate with IV placement. IM induction with ketamine is not the best choice as it may not provide the required depth of anesthesia and control during the procedure. Therefore, the safest and most appropriate option is to place an IV prior to the surgery.Rate this question:
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- 40.
The first step in the pediatric RSI sequence is….
- A.
Preoxygenation with spontaneous ventilation
- B.
Application of cricoids pressure
- C.
Pretreatment with atropine
- D.
Delivery of induction agent
Correct Answer
C. Pretreatment with atropineExplanation
Pretreatment with atropine is the first step in the pediatric Rapid Sequence Intubation (RSI) sequence. Atropine is administered to pediatric patients to prevent bradycardia during intubation, especially in those who are at risk or have a history of bradycardia. It is given prior to the administration of the induction agent to ensure that the patient's heart rate remains stable during the procedure. This step is crucial in maintaining the patient's hemodynamic stability and preventing complications.Rate this question:
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- 41.
What would be an appropriate IM stun dose ketamine for a 14 yr old boy weighing 40 kg?
- A.
320 mg
- B.
200 mg
- C.
160 mg
- D.
80 mg
Correct Answer
D. 80 mgExplanation
An appropriate IM stun dose of ketamine for a 14-year-old boy weighing 40 kg would be 80 mg. This dose is determined based on the weight of the patient and is considered safe and effective for inducing anesthesia or sedation.Rate this question:
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- 42.
The MAC for all anesthetic agents are highest at what age?
- A.
6-12 months
- B.
4-6 yrs
- C.
1-4 yrs
- D.
0-6 months
Correct Answer
A. 6-12 monthsExplanation
The correct answer is 6-12 months. The MAC (Minimum Alveolar Concentration) refers to the concentration of anesthetic agent required to prevent movement in 50% of patients when exposed to a noxious stimulus. The MAC for anesthetic agents is highest in infants between 6-12 months of age. This means that a higher concentration of anesthetic agent is needed to achieve the desired effect in this age group compared to other age groups.Rate this question:
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- 43.
Which of the following inhalational anesthetic agents may cause bradycardia, vasodilation and myocardial depression in infants?
- A.
Desflurane
- B.
Isoflurane
- C.
Sevoflurane
- D.
Opioids
Correct Answer
B. IsofluraneExplanation
Isoflurane is an inhalational anesthetic agent that may cause bradycardia, vasodilation, and myocardial depression in infants. This is because isoflurane has a direct effect on the cardiovascular system, leading to a decrease in heart rate (bradycardia), relaxation of blood vessels (vasodilation), and depression of the heart muscle (myocardial depression). These effects can be particularly pronounced in infants due to their immature cardiovascular system. Therefore, isoflurane should be used with caution in this population to avoid potential complications.Rate this question:
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- 44.
Which of the inhalational agents had the highest incidence of emergence delirum?
- A.
Sevoflurane
- B.
Isoflurane
- C.
Desflurane
- D.
Halothane
Correct Answer
C. DesfluraneExplanation
Desflurane has the highest incidence of emergence delirium among the given inhalational agents. Emergence delirium is a common side effect that occurs during the recovery phase after anesthesia. It is characterized by confusion, agitation, disorientation, and sometimes aggressive behavior. Desflurane is known to have a more rapid onset and offset compared to other inhalational agents, which may contribute to a higher incidence of emergence delirium. Additionally, desflurane has a pungent odor and can irritate the airways, potentially leading to increased agitation and delirium in some patients.Rate this question:
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- 45.
You are the nurse for a premature child who was born at full term. The child is now 10 weeks old and doing very well. The child is having a minor procedure and was maintained with fentanyl 2mcg/kg and 0.5 MAC Isoflurane. The childs mother wants to know when the child can come home. What do you tell her?
- A.
As soon as I wheel her out of the OR you can take her!
- B.
We will watch her in the PACU for 2-3 hours after the procedure and then she may go home.
- C.
We will keep her for 48-72 hours just to monitor her for safety.
- D.
We will most likely keep her overnight on a pulse oximeter just to watch her.
Correct Answer
D. We will most likely keep her overnight on a pulse oximeter just to watch her.Explanation
The correct answer is "We will most likely keep her overnight on a pulse oximeter just to watch her." This answer is the most appropriate because it acknowledges the need for monitoring the child after the procedure. Premature babies may have a higher risk of complications and it is important to observe their vital signs, including oxygen saturation levels, to ensure their safety. Keeping the child overnight on a pulse oximeter allows healthcare providers to closely monitor her and intervene if necessary.Rate this question:
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- 46.
High dose opioid therapy during maintenance of anesthesia may be appropriate for which of the following?
- A.
Child with cardiac instability who requires surgical intervention
- B.
Pt who will be extubated after surgery and requires pain control
- C.
A healthy 2 yr old who is no longer at risk for post-op apnea
- D.
A child with respiratory insufficiency who may not have sufficient gas exchange for inhalational agents.
Correct Answer
A. Child with cardiac instability who requires surgical interventionExplanation
High dose opioid therapy during maintenance of anesthesia may be appropriate for a child with cardiac instability who requires surgical intervention because opioids can provide effective analgesia and sedation while minimizing the stress response and hemodynamic instability associated with surgery. Opioids have minimal effects on the cardiovascular system and can help maintain hemodynamic stability in patients with cardiac instability. Additionally, opioids have a predictable and reversible effect, making them a suitable choice for patients who may need rapid adjustment of anesthesia depth.Rate this question:
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- 47.
Which of the following children is the best candidate for a deep extubation?
- A.
An 18 month old child who just had a minor procedure, no past HX and spontaneous ventilation for whole case.
- B.
A 9 yr old healthy child with asthma (no attacks in one year and no wheezes) having a minor elective procedure, spontaneous ventilation maintained throughout procedure
- C.
An 5 yr old healthy child with no medical history, needed paralysis during procedure but has now been fully reversed.
- D.
A 7 yr old child who came for emergent appendectomy
Correct Answer
B. A 9 yr old healthy child with asthma (no attacks in one year and no wheezes) having a minor elective procedure, spontaneous ventilation maintained throughout procedureExplanation
The 9-year-old healthy child with asthma is the best candidate for a deep extubation because they have had no asthma attacks in one year and no wheezes. This indicates good control of their asthma and suggests that they are less likely to have complications during extubation. Additionally, the child is undergoing a minor elective procedure and has maintained spontaneous ventilation throughout the procedure, further supporting their suitability for a deep extubation.Rate this question:
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- 48.
Which of the following properly describes the Sundown Sign?
- A.
When toddlers become confused at night and start climbing out of bed.
- B.
A sign commonly seen in pts with a PPFO where the pt will turn blue (sundown) while coughing or bucking and creating a temporary shunt.
- C.
Contraction of the inferior rectus muscle of the eye causing the eyeball to look downward toward the toes.
- D.
Just before waking up when the child begins to move and both feet point down as their back arches upward due to stimulation from ETT.
Correct Answer
C. Contraction of the inferior rectus muscle of the eye causing the eyeball to look downward toward the toes.Explanation
The Sundown Sign is properly described as the contraction of the inferior rectus muscle of the eye causing the eyeball to look downward toward the toes. This sign refers to the downward movement of the eyeball and is often seen in certain medical conditions or neurological disorders. It is important to understand this description in order to recognize and interpret the Sundown Sign correctly in clinical practice.Rate this question:
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- 49.
You are the SRNA for 22 month old Collin who is about to be extubated. During emergence he starts to vigorously cough and then becomes cyanotic. You have 100% O2, and make sure he is not hypoventilating. You suction his airway to check form any obstruction and find there is no obstruction, yet little Collin still remains blue. What is wrong?
- A.
Laryngospasm
- B.
Bronchospasm
- C.
Pulmonary Hypertension
- D.
PPFO
Correct Answer
D. PPFO -
- 50.
Which of the following is not helpful in preventing laryngospasm?
- A.
Suction secretions immediately after extubation
- B.
Extubate deep
- C.
Extubate totally awake
- D.
Immediately after extubation, stretch the larynx
Correct Answer
A. Suction secretions immediately after extubationExplanation
Suctioning secretions immediately after extubation can actually be helpful in preventing laryngospasm, as it helps to clear the airway and reduce the risk of blockage. Therefore, this option is not the correct answer.Rate this question:
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Quiz Review Timeline +
Our quizzes are rigorously reviewed, monitored and continuously updated by our expert board to maintain accuracy, relevance, and timeliness.
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Current Version
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Apr 16, 2024Quiz Edited by
ProProfs Editorial Team -
Feb 28, 2009Quiz Created by
Scottishduffy
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