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Chapter 4 Quiz

1) Shivering can lead to ALL BUT ONE of the following. Indicate the exception:

  • a) Myocardial ischemia
  • b) Increased oxygen consumption
  • c) Decreased carbon dioxide production
  • d) Interference with monitor signal interpretation

2) Which ONE of the following statements about shivering is correct?

  • a) Shivering is a response controlled by the brainstem.
  • b) Shivering can occur in the absence of hypothermia.
  • c) Shivering is effectively treated with small doses of naloxone.
  • d) Shivering is an uncomfortable, though harmless, effect of anesthesia.

3) ALL BUT ONE of the following are used as intravenous antiemetics. Indicate the exception:

  • a) Prochlorperazine
  • b) Ranitidine
  • c) Dimenhydrinate
  • d) Dexamethasone

4) Which of the following is a risk factor for PONV?

  • a) History of gastroesophageal reflux
  • b) Smoking
  • c) Diabetes mellitus
  • d) Female gender

5) Which ONE of the following is part of a rational approach to post-operative nausea and vomiting?

  • a) All patients should receive pharmacologic prophylaxis.
  • b) Avoidance of anti-emetic anesthetic agents is an effective management strategy.
  • c) Prophylaxis must be given prior to induction of anesthesia for maximal effectiveness.
  • d) Dimenhydrinate remains the mainstay of PONV prevention and treatment.

6) Which ONE of the following is least likely to be the cause of hypertension in the PACU?

  • a) Pain
  • b) Airway obstruction
  • c) Prolonged spinal blockade
  • d) Full bladder

7) Which ONE of the following is a criteria that the patient must meet prior to transfer from the post-anesthetic care unit (PACU) to the ward?

  • a) Normal cognitive function
  • b) Adequate pain control
  • c) Ability to hold down food
  • d) Ability to weight-bear

8) You see a patient in the preoperative assessment clinic prior to her laparotomy for colon cancer. If the patient has an epidural inserted for post-operative pain, she is likely to experience ALL BUT ONE of the following. Indicate the exception.

  • a) Reduced adrenal activation
  • b) Hypertension
  • c) Improved respiratory function
  • d) Excellent post-operative pain control

9) Your patient’s most recent surgery was thirty years ago after which she received “conventional” nurse-administered opioid analgesia. For her upcoming lumbar spinal decompression and instrumentation, she will be receiving PCA (patient-controlled analgesia). The comparative advantages of PCA morphine include ALL BUT ONE of the following. Indicate the exception:

  • a) Less labor intensive for nurses
  • b) More opioid delivered to the patient
  • c) Improved patient satisfaction
  • d) Small doses at frequent intervals minimizing the pharmacokinetic “peaks” and “valleys”

10) ALL BUT ONE of the following is a relative contraindication to post-operative epidural analgesia. Indicate the exception:

  • a) Multiple sclerosis
  • b) Lumbar disc disease
  • c) Hypertrophic obstructive cardiomyopathy
  • d) Myasthenia gravis


Answers: 1c, 2b, 3c, 4d, 5b, 6c, 7b, 8b, 9b, 10b