CST Anesthesia & Surgical Positioning 2 — Questions and Answers
Question 1: Which local anesthetic has the longest duration of action and is commonly used for spinal and epidural blocks?
- Lidocaine
- Procaine
- Bupivacaine (Correct answer)
- Chloroprocaine
Correct answer: Bupivacaine
Bupivacaine is an amide local anesthetic with a long duration of action (3–10 hours), making it preferred for prolonged regional and neuraxial blocks.
Question 2: Epinephrine is added to local anesthetic solutions primarily to:
- Increase the potency of the anesthetic
- Prolong duration by causing local vasoconstriction (Correct answer)
- Prevent allergic reactions
- Speed systemic absorption
Correct answer: Prolong duration by causing local vasoconstriction
Epinephrine causes vasoconstriction at the injection site, slowing systemic absorption and prolonging the anesthetic effect.
Question 3: Capnography (end-tidal CO2 monitoring) is primarily used intraoperatively to confirm:
- Oxygen saturation levels
- Correct endotracheal tube placement and ventilation adequacy (Correct answer)
- Blood pressure stability
- Cardiac rhythm
Correct answer: Correct endotracheal tube placement and ventilation adequacy
A consistent CO2 waveform on capnography confirms the endotracheal tube is in the trachea and that ventilation is effective.
Question 4: Which reversal agent is used to antagonize non-depolarizing neuromuscular blocking agents at the end of surgery?
- Naloxone
- Flumazenil
- Neostigmine (Correct answer)
- Physostigmine
Correct answer: Neostigmine
Neostigmine inhibits acetylcholinesterase, increasing acetylcholine at the neuromuscular junction to competitively overcome non-depolarizing blockade.
Question 5: A laryngeal mask airway (LMA) is best classified as:
- An endotracheal device inserted through the vocal cords
- A supraglottic airway device that sits above the larynx (Correct answer)
- A nasopharyngeal airway adjunct
- A device used only during bronchoscopy
Correct answer: A supraglottic airway device that sits above the larynx
The LMA is a supraglottic airway that creates a seal around the laryngeal inlet without passing through the vocal cords.
Question 6: Monitored Anesthesia Care (MAC) is most appropriately selected when:
- The patient requires complete muscle relaxation
- The procedure is major abdominal surgery
- The patient needs sedation and analgesia while remaining responsive (Correct answer)
- General endotracheal anesthesia has failed
Correct answer: The patient needs sedation and analgesia while remaining responsive
MAC provides sedation, analgesia, and anxiolysis for procedures where the patient should be able to follow commands and maintain their own airway.
Question 7: Which volatile inhalation anesthetic is commonly associated with the least airway irritation and is preferred for inhalation induction in pediatric patients?
- Desflurane
- Isoflurane
- Sevoflurane (Correct answer)
- Halothane
Correct answer: Sevoflurane
Sevoflurane has a non-pungent odor and minimal airway irritation, making it the agent of choice for inhalation induction in children.
CST Anesthesia & Surgical Positioning 2
Which local anesthetic has the longest duration of action and is commonly used for spinal and epidural blocks?