OMSA Study Guide Questions With 100% Correct Answers, Exams of Advanced Education

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Pathway of Blood Flow from Lungs Carrying Oxygen - Correct Answer-Through the Pulmonic vein to the Left Atrium, through Mitral Valve, to the Left Ventrical , through the Aortic Valve to the Aorta. (P,LA,MV, LV,AV,A) Pathway of Blood flow Through the Heart - Correct Answer- Superior and Inferior Vena Cava to Right Atrium, through Tricuspid Valve into Right Ventrical, past the Pulmonic Valve to the Pulmonary Artery How many Chambers does the heart have? What are the upper and the lower chambers called? - Correct Answer-Heart has 4 Chambers. The Upper are called Atria and the lower are Ventricles. Name 2 systems that compromise the Autonomic Nervous System. - Correct Answer-Parasympathetic and symapthetic. Beta one controls the - Correct Answer-Heart

Angina - Correct Answer-Insufficient blood flow though the coronary arteries Tricuspid Valve - Correct Answer-Located between the right artium and the right ventricle Mitral Valve - Correct Answer-Located between the left atrium and the left ventricle Stimulation of the Vagus will - Correct Answer-Decrease the Heart Rate Pathway of the Conduction System through the Heart - Correct Answer-SA node the the AV node to the Bundle of His to the Bundle Branches and finally to the Purkinjie Fibers Left sided Heart failure often leads to: - Correct Answer-Right sided Heart Failure Which Patient will need antibiotic Premedication - Correct Answer-A 70year old patient with a prosthetic valve

Symptoms of left sided heart failure include: - Correct Answer- Shortness of breath and pulmonary edema Symptoms of right sided heart failure include: - Correct Answer-Ascites (abdominal swelling) and pitting edema (swelling in body: ankles ,feet , lower body) What does ISCHEMIA mean? - Correct Answer-Not ENOUGH blood supply What causes a heart murmur - Correct Answer-Turbulence (quivering) in the blood flow across the heart valves The first heart sound is caused by; - Correct Answer-The closing of the mitral and tricuspid valve Angina is treated with what medication? - Correct Answer- Nitroglycerin What mnemonic is used for a patient having a myocardial infarction? - Correct Answer-MONA

The two kinds of Heart Failure - Correct Answer-Right and Left What is angina? - Correct Answer-Insufficient oxygen in the coronary arteries to the heart muscle causing sudden, severe substernal pain radiating to the left arm What is Myocardial Infarction? - Correct Answer-It implies necrosis. Death of the Heart Muscle. What do Beta Blockers do? - Correct Answer-Decrease Heart Rate and Blood Pressure Patients experiencing a hypertension crisis may complain of - Correct Answer-A Headache Two types of stories are - Correct Answer-Ischemia and Hemorrhagic Mnemonic diagnosis for a stroke - Correct Answer-FAST: Face, Arm, Speech, Time

Causes of Hypotension - Correct Answer-*Allergic Reaction * Cardiac Dysrhythmias * Excessive Medication ****** Not Caused By Seizures Hypertensive Crisis Treatment - Correct Answer-Beta blocker and vasodilator Blood Pressure General "normal" - Correct Answer-140/ High Blood Pressure can increase the risk of ... - Correct Answer-Heart attack and a Stroke T wave is caused by? - Correct Answer-Repolarization of the ventricles Sinus Arrhythmia - Correct Answer-Heart beat changes pace when you inhale and exhale. Asystole - Correct Answer-No electrical activity, Flat line P wave is caused by? - Correct Answer-Depolarization of the atria

Atrial Fibrillation - Correct Answer-Patient has irregularly irregular pulse QRS complex is caused by? - Correct Answer-Depolarization of the ventricles What is the correct sequence of IMPULSES through the heart?

• Correct Answer-SA node, AV node, Bundle of His, Purkinjie Fibers Premature Ventricular Contractions (PVC) - Correct Answer- Extra beats which occure from an ectopic focus of the Ventricle wall. Multifocal is more dangerous than the unifocal. The instrinsic rate of the SA node - Correct Answer-60- beats per minute Best Treatment for ventricular fibrillation - Correct Answer- Defibrillation

Most common Rhythm of cardiac arrest - Correct Answer- Ventricular fibrillation Patient is not breathing and you cant find a pulse - Correct Answer-Start Chest Compressions FIRST MEDICATION for a patient in Ventricular fibrillation(No Pulse) - Correct Answer-Epinephrine 1 mg IV (2ND Amiodarone) SECOND MEDICATION for a patient in Ventricular Fibrillation (No pulse) - Correct Answer-Amiodarone (1st Epinephrine 1 mg IV) What is the rate of compression while performing CPR? - Correct Answer-100 per min Bradycarida - Correct Answer-slow heart rate (less than 60 bpm)

Vagal Maneuvers can be used to diagnose - Correct Answer- Supraventricular Tachycardia The ___ bronchus is straighter and wider while the ___ bronchus is narrower and angles more acutely. - Correct Answer-right, left Respiration control is dependent on - Correct Answer-the level of CO2 in the blood Airflow pathway in the Lower Respiratory System - Correct Answer-Trachea, Right and Left mainstem Bronchi, Bronchioles, Alveoli Anatomic structure where a cricothyrotomy is performed - Correct Answer-Through the cricothyroid membrane Hairlike projections on the cell within the trachea are called; - Correct Answer-cilia What mainstem bronchus do foreign bodies usually aspirate to - Correct Answer-The Right Mainstem Bronchus

Gas Eschange (o2 goes from the air toh the blood and CO goes from blood to air) happens? - Correct Answer-Alveoli Inspiration is an - Correct Answer-Active process Expiration is a - Correct Answer-passive Pathway of airflow in the Upper Respiratory System - Correct Answer-Nasopharynx, oropharynx, larygopharynx (larynx), trachea Patient should stop smoking how long before an elective surgical procedure? - Correct Answer-8 weeks Asthma Medications - Correct Answer-Corticosteroids, B Agonist ( Bronchodilators), Antihistamines Pulse Oximeter readings can be affected by - Correct Answer- Patient Movement, Fingernail polish, Chronic exposure to nicotine

With nitrous oxide at its maximum rate, at least how much oxygen should be concurrently delivered? - Correct Answer- 22% Asthma is a disease of - Correct Answer-Bronshcoconstriction Treatment of respiratory depression from and overdose of narcotics and benzodiazipines are - Correct Answer-Naloxone and Flumazenil respectively Treatment of emesis is to turn the patient to the - Correct Answer-Right Initial Treatment for a laryngospasm - Correct Answer-Suction the oropharynx Symptoms of hyperventilation are caused by - Correct Answer-The decrease in the blood CO Severe Hypotension Symptoms - Correct Answer-Dizziness, Orthostatic Hypotension, and Fainting

Medication to treat a Bronchospasm - Correct Answer-Beta Agonists What are normal Blood Glucose levels? - Correct Answer-70- 100 Whats the problem with a patients Blood Sugar is to high? - Correct Answer-They will have difficulty with wound healing Where is insulin Produced? - Correct Answer-Pancreas What is Endocrinology? - Correct Answer-It is the study of glands that secrete hormones that regulate the body Type 1 Diabetes - Correct Answer-Beta cells do NOT produce insulin at ALL. Patient needs to take insulin Type II Diabetes - Correct Answer-type of diabetes in which the body produces insulin but the insulin cannot be used by body cells because the glucose gates dont open

What is the function of insulin? - Correct Answer-lower blood sugar by taking the glucose into the cells What does Thyroid do? - Correct Answer-Produces hormones that control metabolism and growth The Danger of doing surgery on a patient who is adrenally suppressed? - Correct Answer-May experience a drop in blood pressure and shock What is the function of Glucagon? - Correct Answer-To release glucose from the cells into the bloodstream. An important blood level to inquire about in an HIV positive patient is; - Correct Answer-T helper cell count An Extreme allergic reaction is called - Correct Answer- Anaphylactic Shock Indications for patient to be on Coumadin (blood thinner) - Correct Answer-Stroke or cerebral vascular accident

Anaphylactic Shock 2 most important considerations are - Correct Answer-1. drop in blood pressure

2. Laryngeal Edema (swelling of the throat ) Medications to treat a allergic reactions are - Correct Answer- Benadryl and Decadron Less severe venipuncture complications include - Correct Answer-Phlebitis and Exrtavasation Phlebitis - Correct Answer-Inflammation of the vien When inserting the catheter what artery is at risk? - Correct Answer-Brachial Artery Which is the preferred vein for the IV site for surgery? - Correct Answer-Antecubital Fossa Treatment of an intra-arterial injection - Correct Answer-10 cc 1% Procaine

Treatment for phlebitis includes - Correct Answer-pressure, moist heat and elevation What is the danger of an intra-arterial injection - Correct Answer-Intense chemical inflammation destroying the inner layer of the artery, preventing blood supple to the limb Nervous Patient. Probably want to give this patient an anesthetic angent targeted at - Correct Answer-The Center Fort Emotion The main organ that eliminates the drugs - Correct Answer- Kidney Increase in salivation is due to stimulation of the - Correct Answer-Parasympathetic System Normally a nerve cellis POLARIZED. - Correct Answer-There are more positve ions on the ouside of the cell membrane and more negative ions on the inside of the cell. Anesthetic agents act by - Correct Answer-Interfering with the depolarization of the membrane

The stimulus for respiration is - Correct Answer-increasing CO levels Nerves conduct impulses by - Correct Answer-Depolarization of the nerve membrane The main organ that processes the anesthetic drugs and changes the chemical structure of the drug is the - Correct Answer-Liver Two components of the Autonomic Nervous system - Correct Answer-PArasympathetic and sympathetic Increased heart rate and blood Pressure are due to stimulation of the - Correct Answer-Smpathetic system The functions of narcotis to is to - Correct Answer-minimize and eliminatepain Diffusion Hypoxia - Correct Answer-Shutting off nitrous and allowing the patient to breath room air

Fentanyl is stronger than - Correct Answer-Mophine Steroids are used to - Correct Answer-decrease swelling and inflammation Atropine - Correct Answer-For Bradycardic patients and to reduce salivary secretions The action of benxodiazipines - Correct Answer-RElaz and sedate the patient Benzodiazipines are reveresed by - Correct Answer-Romazicon Local Anesthetic Overdose signs - Correct Answer-Anxiety, Talkative, Disoriented Ketamine - Correct Answer-Dissociative Anesthetic Propofol - Correct Answer-Dedative Hypnotic *Patient can have a soy or egg allergie

Brevital - Correct Answer-Canuse Respiratory depression *May cause a Laryngospasm *Classifed as a Barbiturate Acetominophen - Correct Answer-Its toxicity affects the liver Versed - Correct Answer-Is classified as a Benzodiazepine Cause Respiratiory Depression - Correct Answer-opiods Benzodiazepines and Alkylphenols The trachea is ___ to the esophagus. This means when the patient is lyning supine the trachea will be ____to the esophagus - Correct Answer-anterior , Supperiorr Treatment of bronchospasm - Correct Answer-Beta 2 Agonists such as Albuterol & Epinephrine Bronchospasm occurs when - Correct Answer-Constrictionof smooth muscle walls of the bronchioles

ASA Guidlines for NPO - Correct Answer-No solids 6 hr and or clear liquids up to 2 hours Treatment for respiratory depression - Correct Answer-Nardan .4mg IV Patient vomists mid-procedure - Correct Answer-Roll the patient to his RIGHT SIDE and suction airway Passage of air into the lungs - Correct Answer-nose/mouth, nasopharynx, oropharynx, larynx, trachea If patient doesnt take his antihypertensive Medication before surgery - Correct Answer-Rebound hypertension Treatment for hypertensive crisis - Correct Answer-Beta Blocker Teatment for overdose of benzodiazipines - Correct Answer- Romazicon / Flumazinal

PREliminary Treatment of patient with Hypetension - Correct Answer-Fluid Challange NS Dysrhythmia Symptoms - Correct Answer-Chest pain, Shortness of Breath and dizziness and hypotension Supraventricular Tachycardia (SVT) - Correct Answer-Heart is not pumping enough blood into body. Ectopic focus above the ventricals. Treatment medication is Adenosine Cardiac FibrillationRhythms Where Patients Do NOT have a Pulse - Correct Answer-Asystole, Pulseless Ventricular Tachycardia, Pulseless Electrical Activity and Ventricular Syptomatic Bradycardia - Correct Answer-Atropine Patient is Asystole - Correct Answer-Start CPR and give Epinephrine 1 mg Ventricular fibrillation Treatment - Correct Answer- Defibrillation

Treatment for syncope - Correct Answer-02 Trendelenburg Position Cause of Syncope - Correct Answer-Slowed Heart Rate and blood Pressure Mild Allergic Reaction Treatment - Correct Answer-Benadryl Life Threatening Anapylaxis Treatment - Correct Answer- Epinephrine IF a diabetic patient takes thier medications as usual the morning of surgery (sedation pt should be NPO) we should worry about - Correct Answer-Hypoglycemia Moderate allergic Reaction in addition to Benadry - Correct Answer-Decadron Anaphylaxis - Correct Answer-Severe allergic reaction Common Presentation of an allergic reaction - Correct Answer-itchy red rash

morphine - Correct Answer-anaglesia, drowsiness, mental clouding also cnstipation nausea skin rash and can become bradycardic Demerol (Demerol) - Correct Answer-*Synthetic Narcotic *One tenth as potent as morphine *Mild histamine release *May cause hypotension Patient is experiencing an asthma "attack" - Correct Answer- Beta Agonists Congestive heart failure include - Correct Answer-Shortness of breath and swollen ankles Drugs are excreted from the body after leaving which organ - Correct Answer-kidney A patient has taken 20 mg of Prednisone (steroid) daily for over 30 yr due to her rheumatoid arthritis. Dr is planning on removing a diff impacted tooth. Preoperative concern -

Correct Answer-Patient will not be able to handle a "flight or fight" response from a stressfull procedure P wave in EKG - Correct Answer-Artial REpolarization Regular sugar levels - Correct Answer-less than 100mg fasting less than 140 mg after eating