OMSA Recertification Exam QUESTIONS WITH COMPLETE 100% VERIFIED SOLUTIONS 2024/2025, Exams of Health sciences

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OMSA Recertification Exam QUESTIONS

WITH COMPLETE 100% VERIFIED

SOLUTIONS 2024/

Passage of air into lungs follows the course: Nose/mouth, nasopharynx, oropharynx, larynx, trachea palpebral The eyelash reflex is a form of the ____ reflex It is ok to use the patients family to watch the patient in recovery while we do the next procedure T or F False Elderly patients require _____medications than younger adults Less The trachea is _____ to the esophagus. When pt is supine the trachea will be ____ to the esophagus Anterior, Supine 3 questions to ask in recovery in this order

1. Does pt. need help maintaining airway?
2. What is their O2 sat. on room air?
3. Is the pt. awake? The stage of anesthesia where surgery can be performed is: 3 The most ideal airway management is Endotracheal intubation Pediatric pt. Mom calls saying Johnny came down with cold you should tell her Wait until pedo pt. gets better, then call us and we can schedule in 2 weeks Children have _____ heart rates and _____ blood pressure when compared to adults Higher, lower Side effect of succinylcholine to be careful of is: A muscle relaxant, side effects of Anectine include muscle relaxation resulting in respiratory depression to the point of apnea Bronchospasm tx is Beta 2 agonist such as albuterol & epinephrine

Bronchospasm occurs when Constriction of smooth muscle walls of the bronchioles Your sedated pt. vomits mid-way thru procedure, what do you do Roll the pt to his right side and suction airway Treatment of respiratory depression is: Narcan 0.4mg/ml IV ASA guidelines for pre-op fasting

• clear liquids: 2 hrs
• breast milk: 4 hrs
• infant formula, non-human milk, light meal ( carbs only ): 6 hours
• before adult elective anesthesia: NPO after midnight Most surgeons prefer 8hr npo bronchospasm can de diagnosed by Expiratory wheeze and difficulty in positive pressure ventilation Narcan danger is Narcan May wear off before respiratory depressive effects of narcotics wear off laryngospasm Protective reflex closure of the vocal cords to prevent foreign materials from entering the lungs The most common cause if airway obstruction is Base of tongue falling back and occluding airway heart sounds MTAP The locations of best auscultation for each heart valve are labeled with "M", "T", "A", and "P". First heart sound: caused by atrioventricular valves - Mitral (M) and Tricuspid (T). Second heart sound caused by semilunar valves - Aortic (A) and Pulmonary/Pulmonic (P). Angina treatment Nitroglycerin (Nitro-bid, Nitrostat)
• sublingual, oral, inhalant or transdermal patch. Used to prevent ischemia in stable angina, some variant used in acute attacks in all forms of angina. Side effects: headache, dizziness, orthostatic hypotension, nausea Precautions: Be aware of extreme side affects with acute, sublingual administration. Make certain patient has sublingual nitroglycerin.

Difference between Angina and MI Angina is chest pain due to inadequate oxygenation relieved by Nitroglycerin while MI is not relieved by Nitroglycerin and Infaction means death of the heart muscle Which patient needs antibiotic premedication? 70 yr old with prosthetic valve answer No on 28yr old with a repaired atrial septal defect repaired at birth No on 20yr old who reports childhood heart murmur What causes heart murmur?

• congenital
• anatomical heart defects
• Infectious inflammatory, or other disease processes Left sided heart failure often leads to right sided heart failure symptoms of left sided heart failure Orthopnea is shortness of breath that's worse when lying flat and Pulmonary Edema. Paroxysmal Nocturnal Dyspnea is when the patient wakes up in the middle of the night gasping for breath. Because most patients have left and right failure together, rales (fluid on the lungs) may get mixed with peripheral edema and hepatomegaly. Symptoms like an S3 heart sound and Jugular Venous Distension are signs of acute exacerbation. Symptoms of right heart failure JVD, weight gain, peripheral edema, pitting edema, hepatomegaly, peripheral edema, ascites What do beta blockers do? decrease heart rate and blood pressure necrosis death of tissue What causes heart murmur Turbulence in the blood flow across the heart valves Inchemia meaning Inadequate blood supply 2 kinds of strokes ischemic and hemorrhagic Pneumonic for diagnosing a stroke FAST face arm speech time The blood pressure limit which is generally considered the upper limit of normal is?

140/

T or F: Prophylaxis is indicated for pt. W/history of CABG coronary artery bypass grafting False High Blood pressure my increase risk of Heart attacks and stroke PT IN HYPERTENSIBE CRISIS: How should the nurse intervene? Place PT in semi-Fowler's position, Admin:02, Admin IV Nitropress, Cardene IV nicardipine, or other infusion drug as prescribed, monitor BP ever 5- 15 mins until diastolic pressure is below 90 and less than 75, then monitor bp every 30min Observe for neurologic or cardiovascular complications such as seizures; numbness, weakness, or tingling, dysrhythmias or chest pain HEADACHE Tx for patient having hypertensive crisis includes A beta blocker and a vasodilator Cause of hypotension include all the following except Seizures not cause Causes excessive meds, allergic reaction, cardiac dysrhythmias Symptoms of hypotension include all following except Chest pain not symptom Symptoms: dizziness, Orthostatic hypotension, fainting T wave represents repolarization of ventricles Sequence of impulses through the heart

1. SA node
2. AV Node
3. bundle of His
4. Purkinje Fibers P wave represents depolarization of the atria T or F Sinus arrhythmia is the same as asystole False ____ is more dangerous than the _______ Multifocal PVC's; unifocal PVC's Best treatment for VF Defibrillation QRS complex depolarization of the ventricles Intrinsic rate of SA node

60 - 100 bpm Your patient has an irregular irregular pulse. She most likely has: Atrial fibrillation Most common rhythm of cardiac arrest is: Ventricular fibrillation vagal maneuvers tx SVT, blowing on thumb (valsalva), ice to face, holding breath then bearing down, massaging carotid on one side of neck. if they do not work, give IV adenosine (antiarrythmic) First med for pt. In V fibb Epinephrine 1 mg IV A pt. having narrow complex tachycardia is complaining of chest pain. You notice bp falling and an altered level of consciousness your next move is Sedate pt then perform synchronized cardioversion 2nd med used in tx of V Fibb is Amiodarone T or F all bradycardia w/rate <50 should be given Atropine .5 mg False T or f you can defribillate asystole False Pt's in v fibb have a pulse t or f False Oxygen is carried by red blood cells Hairlike projections on the cells within the trachea are called Cilia - help move mucus and debris away from the lungs The _____ bronchus is straighter and wider than the ____ bronchus is narrower and more angles more acutely Right straighter wider Left narrow angled Order of airflow in upper respiratory system 1 nasopharyngeal 2 oropharnx 3 laryngopharynx 4 trachea Control of Respiration is dependent on The level of carbon dioxide in the blood Foreign bodies are usually aspirated down what mainstem bronchus

Right because it is straighter Anatomical structure where cricothyrotomy is performed Through cricothyroid membrane Inspiration is more of an ____ process, where expiration is more of an ____ process Inspiration active Expiration passive gas exchange in lungs external respiration is exchanged in the alveoli lower respiratory system airflow order Trachea Right and left mainstrm bronchi Bronchioles Alveoli Rescue inhalers are usually Bronchodilators asthma is a disease of? Bronchoconstriction Pulse oximetry readings can be affected by all except Asthma meds don't affect Pulse oximetry factors 1)pt movement 2)fingernail polish 3)chronic exposure to nicotine Minimum amount oxygen during n 22% O Asthma meds include and don't include Include: B2 agonist (bronchodilator Corticosteroids Antihistamines Don't include: A(Alpha) agonist LMA is the most ideal, preferred method of airway maintenance False Ideally pt should stop smoking for ____ before elective surgery 8 weeks or 2months Can you insert LMA on conscious pt. with intact gag reflex False

normal adult respiratory rate on room air 96% at least Increase saliva is due to Stimulation of parasympathetic System Main organ that eliminates drugs Kidneys Main organ that processes drugs and changes chemical structure Liver Normally a nerve cell is polarized this means There are more positive ions on the outiside of the cell membrane and more negative ions on the inside Anesthetic agents act by Interfering with depolarization of the membrane The stimulus for respiration is Increasing co2 levels 2 components if the ANS are Parasympathetic and Sympathetic Nerve conduct impulses by Depolarization of the nerve membrane Nervous pt. You probably want to give this patient an anesthetic agent targeted at Center for emotion Increased heart rate and blood pressure are due to stimulation of the Sympathetic system Morphine is stronger than fentanyl. False Fentanyl is 80-100x stronger Nitrous Oxide (N2O) Is stored in blue tanks Produces euphoria and promotes relaxation Should always be used w/o Is non-flammable liquid Atropine, Glycopyrrolate two anticholinergics used as preanesthetics Sometimes given to reduce salivary secretions Steroids are used for reduction of tissue inflammation and swelling function of narcotics Minimize or eliminate pain Benzodiazepines are reverses by

Romazicon (flumazinil) Action of Benzodiazepines is to Relax and sedate patient Oxygen Is stored in green tanks Should be given cautiously to pt. w/copd Administer 30% or higher w/other inhaled agents Should be administered to every pt undergoing Sedation or GA Brevital can cause respiratory depression True Brevital (methohexital) CLASSIFICATION: SEDATIVE (USA BARBITURATE) TYPES TREATED: SEDATION, GENERAL ANESTHESIA (SHORT ACTING) May predispose Laryngospasm Acetominophen Tylenol; and antipyretic analgesic, causes liver damage, esp. with alcohol Propofol (Diprivan) Sedative hypnotic, short-acting acts in wakefulness center Contraindication: eggs, soy Women & children require more per pound Ketamine (Ketalar) can cause respiratory depression general anesthetic classified in Dissociative Anesthetic False: minimal effects on ventilatory early signs of local anesthetic toxicity overdose Anxiety, talkative, disoriented Intra-arterial injection injection into an artery 10cc 1% procaine Dilutes anesthetic relieves pain reduces spasm Ice pack, Ambulance, to hospital STAT plebitis inflammation of a vein Tx pressure, moist heat and elevation Vein preferred for IV site OMFSA

Antecubital fossa Less severe venipuncture complications include Phlebitis inflammation, clotting thrombosis, and extravasation infiltration of fluids causing ecchymosis When inserting catheter which artery is at risk Brachial Artery The danger of intra-arterial injection is Intense chemical inflammation destroying the inner layer of artery, preventing blood to limb Symptoms of hyperventilation Rapid heart rate, heavy breathing, drowsiness, dizziness, weakness, etc Caused by decrease in co Medications to treat bronchospasm Beta agonist Stridor is a high-pitched, inspiratory crowing sound commonly associated with: Laryngospasm What is the normal blood glucose level 70 - 110 mg/dL What is the problem w/performing sx. on a pt whose blood sugar is too high They will have difficulty with wound healing What is the function of glucagon To release glucose from the cells into the bloodstream What does the Thyroid do Produces hormones, two that regulate metabolism and growth What are the two type of diabetes Type 1: beta cells don't produce insulin at all Type II: insulin binds to the cells, but the glucose gates font open What are the symptoms of diabetes Frequent urination, increased thirst, weight loss Polyphagia (always hungry ) Polydypsea always thirsty Polyuria frequent urination What is the function of insulin To drive glucose into cells What is endocrinology study of glands that secrete hormones that regulate the body What is the danger of doing surgery on a patient who is adrenally suppressed They may experience a drop in blood pressure and shock In anaphylactic shock, the 2 most important considerations are

1. the drop in blood pressure
2. Laryngeal edema Indications for Coumadin Stroke or cerebral vascular accident Patients w/liver disease should be given higher doses of anesthetic False anaphylactic shock severe allergic reaction that causes respiratory distress due to swelling of the upper airways T helper cells (CD4) Important blood level to inquire about in a HIV patient Allergic reaction meds Benadryl and Decadron