AORN Anesthesia Basics 2 ā Questions and Answers
Question 1: Which anesthetic agent is most commonly associated with malignant hyperthermia when used in susceptible patients?
- Propofol
- Succinylcholine (Correct answer)
- Ketamine
- Midazolam
Correct answer: Succinylcholine
Succinylcholine (and volatile inhalation agents) are the primary triggers of malignant hyperthermia in genetically susceptible individuals.
Question 2: The perioperative nurse notes a patient's SpO2 is 94% on room air pre-operatively. What is the most appropriate initial action?
- Proceed with the surgical prep immediately
- Notify the anesthesia provider and document the finding (Correct answer)
- Administer supplemental oxygen without notifying anyone
- Cancel the surgery without consulting the surgeon
Correct answer: Notify the anesthesia provider and document the finding
A SpO2 of 94% is below the normal threshold and must be reported to the anesthesia provider for evaluation before proceeding.
Question 3: What does the term 'balanced anesthesia' refer to?
- Using only one drug to achieve all anesthetic goals
- Combining multiple agents to achieve analgesia, amnesia, muscle relaxation, and unconsciousness (Correct answer)
- Balancing anesthetic depth with patient blood pressure
- Using equal doses of opioids and benzodiazepines
Correct answer: Combining multiple agents to achieve analgesia, amnesia, muscle relaxation, and unconsciousness
Balanced anesthesia uses a combination of drugsāeach targeting a specific componentāto minimize side effects while achieving all desired anesthetic effects.
Question 4: Which reversal agent is used to reverse the effects of benzodiazepines administered during procedural sedation?
- Naloxone
- Neostigmine
- Flumazenil (Correct answer)
- Sugammadex
Correct answer: Flumazenil
Flumazenil competitively antagonizes benzodiazepine receptors and is used to reverse benzodiazepine-induced sedation.
Question 5: A patient undergoing regional anesthesia reports sudden dizziness, tinnitus, and a metallic taste in the mouth. What should the perioperative nurse suspect?
- Vasovagal syncope
- Hypoglycemia
- Local anesthetic systemic toxicity (LAST) (Correct answer)
- Anaphylaxis
Correct answer: Local anesthetic systemic toxicity (LAST)
These are classic early CNS signs of local anesthetic systemic toxicity, which can progress to seizures and cardiovascular collapse if untreated.
Question 6: What is the primary purpose of pre-oxygenation (denitrogenation) before general anesthesia induction?
- To reduce patient anxiety before losing consciousness
- To extend the safe apnea period by increasing oxygen reserves in the lungs (Correct answer)
- To prevent postoperative nausea and vomiting
- To speed up the induction of anesthesia
Correct answer: To extend the safe apnea period by increasing oxygen reserves in the lungs
Pre-oxygenation replaces nitrogen in the FRC with oxygen, extending the time before desaturation occurs during apnea at induction.
Question 7: Which monitoring parameter is considered the gold standard for confirming correct endotracheal tube placement?
- Chest auscultation
- Chest rise visualization
- End-tidal CO2 (ETCO2) capnography (Correct answer)
- Pulse oximetry
Correct answer: End-tidal CO2 (ETCO2) capnography
Continuous ETCO2 waveform capnography is the gold standard for confirming and monitoring endotracheal tube placement throughout the procedure.
AORN Anesthesia Basics 2
Which anesthetic agent is most commonly associated with malignant hyperthermia when used in susceptible patients?