Mixed Deck — All ABA Topics Flashcards

A patient develops ventilator-associated pneumonia (VAP). Which bundle element has the STRONGEST evidence for prevention?

Answer: Subglottic secretion drainage with specialized ETT

Subglottic secretion drainage using specialized endotracheal tubes significantly reduces VAP incidence by preventing aspiration of oropharyngeal secretions.

Which of the following is a component of the 'Universal Protocol' established by The Joint Commission to prevent wrong-site surgery?

Answer: Surgical site marking before the procedure

The Universal Protocol's three elements are pre-procedure verification, surgical site marking, and a 'time-out' immediately before the procedure; site marking is a core component.

Which federal agency is primarily responsible for enforcing the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule?

Answer: Office for Civil Rights (OCR) within HHS

The HHS Office for Civil Rights enforces the HIPAA Privacy and Security Rules and investigates complaints of violations.

A patient with a full stomach requires rapid sequence induction (RSI). The CORRECT sequence is:

Answer: Preoxygenate → propofol → rocuronium → cricoid pressure → intubate with no bagging

RSI requires preoxygenation, induction agent (propofol or etomidate), succinylcholine or high-dose rocuronium, Sellick maneuver, and intubation without positive pressure ventilation.

Epidural analgesia for labor uses which nerve roots as the PRIMARY target for pain relief during the first stage of labor?

Answer: T10-L1

First-stage labor pain from uterine contractions and cervical dilation is transmitted via T10-L1 visceral afferents; second-stage pain also involves S2-S4.

The ultrasound-guided TAP (transversus abdominis plane) block targets the nerve plexus located between which two muscle layers?

Answer: Internal oblique and transversus abdominis muscles

The TAP block deposits local anesthetic in the fascial plane between the internal oblique and transversus abdominis muscles, blocking T10-L1 abdominal wall afferents.

When using a pulse oximeter, which hemoglobin species causes falsely HIGH SpO2 readings in cases of carbon monoxide poisoning?

Answer: Carboxyhemoglobin

Carboxyhemoglobin (COHb) absorbs light similarly to oxyhemoglobin at 660 nm, causing pulse oximetry to overestimate true SaO2.

Which federal law most directly governs the disposal of unused controlled substances (e.g., fentanyl) after a surgical case?

Answer: Controlled Substances Act (CSA) and DEA regulations

The CSA and corresponding DEA regulations specify required procedures for the disposal and waste documentation of Schedule II controlled substances used in clinical settings.

A closed-loop anesthesia delivery system uses which type of feedback signal to adjust propofol infusion rate?

Answer: Processed EEG depth-of-anesthesia index

Closed-loop propofol systems use processed EEG indices (e.g., BIS or entropy) as the feedback variable to titrate infusion rate.

Which phase of hepatic drug metabolism involves conjugation reactions such as glucuronidation?

Answer: Phase II reactions

Phase II metabolism involves conjugation reactions (glucuronidation, sulfation, acetylation) that typically increase drug water solubility for renal excretion.

Under OSHA standards, an anesthesiologist exposed to a needlestick injury involving a known HIV-positive patient must be offered post-exposure prophylaxis (PEP) within:

Answer: 72 hours

PEP is most effective when started as soon as possible and should be initiated within 72 hours of a potential HIV exposure.

The ASA practice guidelines on sedation and analgesia recommend that practitioners administering deep sedation should have skills to perform which rescue intervention?

Answer: Bag-mask ventilation and tracheal intubation

Practitioners providing deep sedation must be capable of rescuing patients from general anesthesia, which requires proficiency in bag-mask ventilation and tracheal intubation.

During inhalation anesthesia, the blood:gas partition coefficient primarily determines:

Answer: Speed of induction and recovery

A lower blood:gas partition coefficient means less agent must dissolve in blood before equilibrium with alveolar gas is achieved, resulting in faster induction and recovery.

Which factor primarily determines the duration of action of a single bolus dose of local anesthetic?

Answer: Protein binding

Protein binding determines duration of local anesthetic action; agents with higher protein binding (bupivacaine, ropivacaine) dissociate slowly from sodium channels and have prolonged duration.

Which of the following scenarios MOST clearly represents a breach of patient confidentiality under HIPAA and professional ethics?

Answer: Mentioning a celebrity patient's surgery to a non-treating colleague

Disclosing a patient's protected health information to someone not involved in their care—regardless of celebrity status—is an unauthorized disclosure violating confidentiality.

Which ASA standard requires that the breathing circuit be assessed for the ability to deliver adequate oxygen and ventilation before each anesthetic?

Answer: ASA Standard III — Ventilation

ASA Standard III on ventilation requires that the ability to provide adequate ventilation be verified, including assessment of the breathing circuit, before each anesthetic.

Which of the following scenarios represents a violation of the ethical principle of non-maleficence in anesthesia?

Answer: Administering a drug known to be harmful to a specific patient population without clinical justification

Non-maleficence obligates providers to avoid knowingly causing harm; administering a harmful drug without justification directly violates this principle.

When conducting a preoperative evaluation, which communication strategy best ensures a patient with low health literacy understands the anesthesia plan?

Answer: Use plain language, teach-back method, and visual aids when appropriate

Plain language combined with the teach-back method confirms patient comprehension and is the evidence-based standard for health literacy challenges.

The oxygen flush valve on an anesthesia machine delivers oxygen at a flow rate of approximately:

Answer: 35–75 L/min

The oxygen flush valve bypasses flowmeters and vaporizers, delivering 35–75 L/min of 100% oxygen directly to the breathing circuit.

When documenting activities related to communication & documentation skills, which practice is considered essential for ABA certification holders?

Answer: Maintaining comprehensive records that include procedures, observations, results, and any anomalies

Comprehensive documentation that includes procedures, observations, results, and any anomalies is essential in communication & documentation skills. This supports quality assurance, enables peer review, and satisfies regulatory and audit requirements.