DAANCE Office Anesthesia Emergencies 5

Question 1

A patient sedated with midazolam and fentanyl has a Glasgow Coma Scale score of 8. The dental anesthesia assistant should FIRST:

Accepted Answer

Open the airway and apply supplemental oxygen

Answer

A GCS of 8 indicates severe altered consciousness; the immediate priority is airway management and oxygenation before any pharmacological reversal.

Question 2

Which sign BEST distinguishes laryngospasm from simple airway obstruction due to soft tissue in a sedated patient?

Accepted Answer

Paradoxical chest and abdominal movement with no air movement despite ventilation attempts

Answer

Laryngospasm produces paradoxical chest and abdominal movements (see-saw pattern) and complete resistance to positive-pressure ventilation, distinguishing it from partial soft-tissue obstruction.

Question 3

Which medication is the definitive treatment for laryngospasm that fails to resolve with CPAP and positive-pressure ventilation?

Accepted Answer

Succinylcholine 0.1–0.2 mg/kg IV

Answer

A small dose of succinylcholine (0.1–0.2 mg/kg IV) is used to break laryngospasm that does not respond to airway maneuvers and CPAP.

Question 4

A patient with a known sulfa allergy is scheduled for IV sedation. Which drug should be avoided due to potential cross-reactivity?

Accepted Answer

Propofol

Answer

Propofol contains a sulfite preservative in some formulations and has a para-aminobenzoic acid (PABA) component; it is generally avoided in patients with sulfa or egg/soy allergies.

Question 5

During moderate sedation monitoring, a patient's blood pressure drops from 130/80 to 78/50 mmHg after IV midazolam and fentanyl. The BEST immediate intervention is:

Accepted Answer

Place patient in Trendelenburg, administer IV fluid bolus, and reduce further sedation agents

Answer

Mild-to-moderate sedation-related hypotension is first managed with positioning, IV fluid bolus, and stopping further sedative administration before vasopressors.

DAANCE - Dental Anesthesia Assistant National Certification Examination Practice Test

DAANCE - Dental Anesthesia Assistant National Certification Examination Practice Test

DAANCE Office Anesthesia Emergencies 5