CMSRN FREE CMSRN Anesthetist Questions and Answers 2 — Questions and Answers
Question 1: A patient receiving epidural analgesia develops sudden hypotension and bradycardia. Which intervention should the medical-surgical nurse prioritize?
- Administer IV fluid bolus and position the patient supine (Correct answer)
- Immediately remove the epidural catheter
- Administer a vasopressor without IV fluids
- Elevate the head of the bed to 90 degrees
Correct answer: Administer IV fluid bolus and position the patient supine
Sympathetic blockade from epidural analgesia causes vasodilation and hypotension, so IV fluid bolus and supine positioning restore venous return and blood pressure.
Question 2: Which assessment finding in a post-anesthesia patient most strongly suggests malignant hyperthermia?
- Rapidly rising end-tidal CO2 and muscle rigidity (Correct answer)
- Mild shivering and cool extremities
- Bradycardia with hypertension
- Decreased urine output and peripheral edema
Correct answer: Rapidly rising end-tidal CO2 and muscle rigidity
Malignant hyperthermia classically presents with unexplained rise in end-tidal CO2, skeletal muscle rigidity, and rapidly increasing body temperature.
Question 3: A medical-surgical nurse is monitoring a patient who received spinal anesthesia. At what dermatomal level does a spinal block pose the greatest risk for respiratory compromise?
- T4 and above (Correct answer)
- T10 and below
- L2 to L4
- S1 to S3
Correct answer: T4 and above
Spinal blocks reaching T4 or higher can impair intercostal muscle function and potentially affect the phrenic nerve, leading to respiratory compromise.
Question 4: Which laboratory value is most critical to monitor in a patient receiving prolonged propofol infusion for procedural sedation?
- Triglyceride level (Correct answer)
- Serum sodium
- Hemoglobin A1c
- Prothrombin time
Correct answer: Triglyceride level
Propofol is formulated in a lipid emulsion, and prolonged infusion can cause hypertriglyceridemia and propofol infusion syndrome.
Question 5: A patient with a history of obstructive sleep apnea is ordered opioid analgesia postoperatively. Which nursing action is most appropriate?
- Use continuous pulse oximetry and capnography monitoring (Correct answer)
- Administer the full prescribed opioid dose on schedule
- Discontinue supplemental oxygen to improve respiratory drive
- Position the patient flat to prevent orthostatic hypotension
Correct answer: Use continuous pulse oximetry and capnography monitoring
Patients with obstructive sleep apnea are at increased risk for opioid-induced respiratory depression and require continuous monitoring of oxygenation and ventilation.
Question 6: During emergence from general anesthesia, a patient becomes agitated, thrashing, and attempting to remove the IV line. What is this phenomenon called and how should the nurse respond?
- Emergence delirium; ensure patient safety, reorient, and administer prescribed short-acting sedative if needed (Correct answer)
- Anaphylaxis; administer epinephrine immediately
- Opioid withdrawal; administer naloxone
- Seizure activity; administer benzodiazepines and call a code
Correct answer: Emergence delirium; ensure patient safety, reorient, and administer prescribed short-acting sedative if needed
Emergence delirium is a transient state of agitation occurring during recovery from general anesthesia, managed with safety measures, reorientation, and short-acting sedation if necessary.
CMSRN FREE CMSRN Anesthetist Questions and Answers 2
A patient receiving epidural analgesia develops sudden hypotension and bradycardia.
Which intervention should the medical-surgical nurse prioritize?