Flashcards in c2. Equipment (1-45) Deck (45):
2.What organization published a set of anesthesia machine requirements to increase patient safety?
a. FDA (Food and Drug Administration)
b. AANA (American Association of Nurse Anesthetists)
c. OAS (Ohmeda Anesthesia Systems)
d. ANSI (American National Standards Institiute)
-d. ANSI American National Standards Institute
The ANSI published machine safety standards that provided guidelines for manufacturers regarding minimum performance, design characteristics and safety requirements for anesthesia machines.
1. How should non disposable equipment be sterilized after use on a patient with tuberculosis?
a. alcohol wash
b. disenfect with chemical such as glutaraldehyde
c. throw equipment away
d. use soap and water
b. Disenfect with gluteraldehyde
The tuberculosis bacilli can be safely removed from equipment by thorough washing with soap and use of product such as glutaraldehyde
3. What does the (ASTM) American Society for Testing and Materials regulate?
a. hospital operating rooms
b. anesthesia gas machines
c. anesthesia remimbursment
d. anesthetic personnel
-b. anesthetic gas machines
The ASTM standards have now superseded the ANSI standards. The ASTM standards are now the ones that are met by anesthesia machine manufacturers.
4. All of the following are true of pulse oximetry EXCEPT:
a. certain substances in the blood can alter readings
c. it measures functional saturation
c. it utilizes red and infrared light waves
d. it measures fractional saturation
-d. it measures fractional saturation
Pulse oximetry measures functional saturatio, which is why it can be altered when different types of abormal hemoglobins are present.
5. All of the following are TRUE of patient's with methemoglobin EXCEPT:
a. The reading will be falsely high if actual SaO2 is < 85%
b. The reading will be falsely low if actual Sao2 > 85%
c. It has no effect on pulse oximetry
d. It absorbs red and infrared light
-c. it has no effect on pulse oximetry
Methemoblobinemia influences the accuracy because it absorbs both red and infrared light. At toxic levels, the saturation tends to be 85% regardless of the actual PO2.
6.The correct width of a blood pressure cuff is:
a. 60% of the circumference of the extremity
b. 40% of the circumference of the extremity
c. 20% of the circumference of the extremity
d. 50% of the circumference of the extremity
-b 40% of the circumference of the extremity
The american heart association recommends that the bladder width of the blood pressure cuff should be approximately 40% of the circumference of the extremity. Bladder length should encircle (60%??) 80-100% of the arm circumference.
7. Falsely LOW readings will occur with with the use of blood pressure cuffs in which of the following circumstances:
a. quick deflation
b. cuff is too loose
c. extremity above the heart
d. cuff is tight
-c. extremity is above the heart
Falsely high extimates tend to occur when the cuff is too small or when the extremity is below the heart or when uneven compression is transmitted to the artery. Falsely low readings result from the opposite (extremity above heart, too big of a cuff)
8. The device that prevents reverse flow of gasses from the anesthesia machine to the pipeline or atmosphere is:
a. Diameter Index Safety System
b. check valve
c. Pin Index Safety System
d. pressure guage
-b. check valve
The check valve is located downstream from the inlet. It prevents reverse flow of gasses from the machine to the pipeline or to the atmosphere.
9. The reserve cylinders located on the anesthesia machine are size:
Anesthesia machines have reserve E cylinders if a pipeline source is not available or malfunctions
10. All the following ARE fuctions of the check valve EXCEPT:
a. it reduces the pressure in the system
b. it minimizes leakage from an open cylinder to the atmosphere if one cylinder is absent
c. it minimizes gas transfer from a cylinder at high pressure to one with a lower pressure
d. it allows uninterrupted gas flow from one cylinder to another
-a. reduces the pressure in the system
Pressure in the system is reduced by pressure reducing valves. The check valves mainly control the forward flow of gasses through the system.
11. The component of the anesthesia machine that changes the pressure of an incoming gas to a pressure suitable for use in the anesthesia machine is:
a. safety valve
b. pressure increasing valve
c. pressure regulator
d. check valve
-c. each cylinder supply source has a pressure-reducing valve known as the cylinder pressure regulator. It reduces the high and variable storage pressure to a lower more constant pressure suitable for use.
12. The system designed to prevent cylinder interchangability is:
a. cylinder regulator system
b. diameter index safety system
d. pin index safety system
-d. pin index safety system
The pin index safety system (PISS) is a safeguard introduced to eliminate cylinder interchanging and the possiblilty of accidentally placing the incorrect gas on a yoke designed for another gas.
13. If two cylinders (of the same gas) are open at the same time, the cylinder supply pressure guage will:
a. not function
b. indicate the pressure of the cylinder with the highest pressure
c. read the pressures of the two cylinders combinde
d. give an erroneous reading
-b. indicate the pressure of the cylinder with the highest pressure
The guage will indicate the pressure in the cylinder having the higher pressure when two reserve cylinders of the same gas are open at the same time.
14. The first-stage regulator reduces gas pressure to:
a. 15 psi
b. 60 psi
c. 20 psi
d. 50 psi
-d. 50 psi
The first-stage pressure regulator reduces the ga pressures from their high cylinder level to 45 to 50 psi. The second-stage of pressure regulators then reduces the pressures even further for specific gasses
15. Normal oxygen cylinder pressure is:
a. 1500 psig
b. 659 psig
c. 2200 psig
d. 745 psig
15b. How many liters is that?
-c. 2200 psig
Oxygen cylinder pressure when the tank is full reads approximately 2200 psig
(Some say 1900 psi)
15b. 660 liters
16. Nitrous oxide cylinder pressure may be as much as:
a. 2200 psig
b. 745 psig
c. 640 psig
d. 1500 psig
-b. 745 psig
The nitrous cylinder pressure (regardless of how much nitrous is in the cylinder) will read approximately 745 psig.
(as nitrous gas leaves, other inert gasses expand to take its place exerting pressure).
17. During normal operation, the reserve cylinder should be:
a. turned off
b. left on in case of pipeline failure
c. left in partial open position
d. it doesnt matter because the pipeline gas will always be preferentially used
-a. turned off
Reserve cylinders should be kept off because they will become depleted and no reserve supply will be available if there is a pipeline failure
18. The oxygen failure safety valve is controlled by:
a. oxygen pressure
b. oxygen flow
c. oxygen supply
d. the pipeline
-a. oxygen pressure
Oxygen safety valves on anesthesia machines are set to sense pressure changes below adequate levels. For example if the pressure falls below 20 psi, a valve closes that changes other gas flows as well.
19.The oxygen failure safety valve:
a. alerts only to decrased supply pressure
b. prevents a hypoxic mixture of gasses
c. responds to decreased oxygen flow
d. alerts to decreased supply volume only
-a. alerts to decreased supply of pressure
the failure safety valve senses oxygen pressure. It does not proportion gasses and therefore may not prevent the delivery of a hypoxic mixture of anesthetic gasses.
20. The oxygen failure safety valve causes the flow of anesthetic or inert gasses to cease if:
a. nitrous oxide flow exceeds oxygen flow
b. oxygen flow is less than 1L
c. the backup cylinder is nonfunctional
d. oxygen supply pressure falls to about 25 psi
-d. oxygen supply pressure falls to about 25 psig
The oxygen safety valves are set to close when the pressure falls below 25 psi
21. The second stage regulator reduces oxygen pressure to:
a. 45 psig
b. 16 psig
c. 10 psig
d. 45-55 psig
-b. 16 psig
The second stage regulators reduce oxygen pressure to 12 to 19 psi. The pressure shut off valves have a higher threshold of 20 to 30 psi. This ensures that oxygen is the last gas flow to decrease if oxygen pressure fails.
22. The second stage regulator is located:
a. at the hanger yoke
b. just after the flowmeter
c. just before the flowmeter
d. at the common gas outlet
-c.just before the flowmeter
The second stage regulator is located downstream from the oxygen supply source. This regulator supplies a constant pressure to the oxygen flow control valves regardless of fluctuating line pressures.
23. All of the following are components of the high pressure system except:
a. hanger yoke
b. oxygen flush valve
c. yoke block
d. first stage regulator
-b. oxygen flush valve
The oxygen flush valve allows direct dommunication between the high pressure circuit and low pressure oxygen circuits, It can deliver 35 to 75L/min into the breathing circuit
24. The oxygen flush valve delivers O2 at:
a. 20 L/min
b. 16 L/min
c. 45 L/min
d. 35 to 75 L/min
-d. 35 to 75 L/min
Actuation of the oxygen flush valve will result in the delivery of 35 to 75 L/min
25. All of the following are components of the low pressure system except:
a. common gas outlet
b. oxygen flush valve
d. pressure relief valve
-b. oxygen flush valve
The oxygen flush valve is considered a component of the intermediate pressure system because it allows communication between the low and high pressure systems
26. When a volatile liquid is in a closed container, molecules escape from the liquid phase to the gaseous phase. These molecules bombard the walls of the container, which is referred to as:
a. intimacy of gas-liquid interface
b. latent heat of vaporization
c. vapor pressure
d. thermal conductivity
-c. vapor pressure
The molecules bombarding the wall of the container create a pressure referred to as the saturated vapor pressure
27. Physical characteristics fundamental to vaporizer design include all except:
a. vapor pressure
b. radiant conductivity
c. latent heat of vaporization
d. specific heat
-b. radiant conductivity
The vaporizers are constructed of metals that have a high thermal conductivity that helps maintain a uniform temperature in the systems.
28. contmporary vaporizers are:
b. bubble through
c. measured flow
d. variable bypass
-d. variable bypass
Modern vaporizers are classified as variable bypass. This refers to the method for regulating output concentration.
29. Currently used vaporizers are the following excpet:
a. nonmeasured flow
b. temperature compensated
c. variable bypass
d. inside the breathing system
-d. inside the breathing system
Modern vaporizers are classified as agent specific, out of circuit because they are designed to accommodate a single agent and to be located outside of the breathing circuit.
30. The "pumping effect" occurs most often under all the following conditions except:
a. high dial settings
b. low levels of liquid in anesthetic chamber
c. low flow rates
d. during controlled or assisted respirations
-a. high dial settings
Intermittent back-pressure associated with positive-pressure ventilation or oxygen flushing can cause a higher vaporizer output than dialed setting. This is known as the pumping effect and occurs most often at low flow rates, low dial settings and low levels of anesthetic liquid in the vaporizer.
31. Intermittent back pressure resulting in increased vaporizer concentration is known as:
a. pumping effect
b. flow compensation
c. high vaporizer pressure
d. pressurizing effect
-a. pumping effect
Intermittent back-pressure caused by positive-pressure ventilation or oxygen flushing can result in higher vaporizer concentrations than the dial settings. This is known as "pumping effect".
32. The mapleson sstem in which fersh gas slow is distal to the reservior bag is the:
a. mapleson F
b. mapleson D
c. mapleson A
d. mapleson B
-C. mapleson A
The mapleson A is known as the Magill circuit, which consists of a corrugated tube, a reservior bag, and a fresh gas inflow distal to the bag.
33.With the mapleson D, rebreathing is prevented by:
a. fresh gas flows equal to the minute ventilation
b. fresh gas flows greater than two times the minute ventilation
c. short expipratory pause
d. fast expiratory pause
-b. fresh gas slows greater than 2 times the vE
Rebreathing can be prevented by high fresh gas flows, two times the vE and a long expiratory pause
34. The bain circuit is a modification of the:
a. mapleson A
b. mapleson E
c. mapleson D
d. mapleson F
-c. mapleson D
The bain circuit is a modification of the mapleson D system. Rebreathing can be prevented with fresh gas flows, two times the minute volume, similar to the mapleson D.
35. All of the following are true of the bain circuit except:
a. fresh gas enters the circuit at the patient end
b. it may be used for controlled as well as spontaneous ventilation
c. it is a coaxial circuit
d. oxygen disconnect is easily recognized
-d. oxygen disconnect is easily recognized
The hazards of the bain circuit including unrecognized disconnection or kinking of the inner fresh gas hose which leads to hypoxia (from inadequate gas flow or increased resistance).
36. The Jackson-Reese is a modification of a:
a. Mapleson E
b. Mapleson D
c. Mapleson F
d. Mapleson A
-b. Mapleson D
The Jackson-Reese is a T-piece system modification of the Mapleson D. It incorporates a relief mechanism for venting exhaled gasses.
37. All of the following are advantages of the circle system except:
a. minimized pollution
b. conservation of moisture and heat
c. can be used with low flows
d. unlikely disconnect
-d. unlikely disconnect
The circle has approximately 10 connections, all of which can disconnect or leak.
38. The end product of soda lime reaction is:
a. calcium carbonate
b. carbonic acid
c. CO2 and water
d. potassium carbonate
-a. calcium carbonate
Sodium carbonate and calcium hydroxide result in the production of calcium carbonate during the soda lime reaction.
39. The primary produce of the baralyme reaction is:
a. calcium carbonate
b. barium hydroxide
c. CO2 and water
d. potassium hydroxide
-a. calcium carbonate
Calcium carbonate os also the end product of baralyme reactions. The difference is that more water is liberated by baralyme than by sodalyme
40. The volitile agent that may become partially degraded by soda lime is:
Sevoflurane appears to break down in soda lime. It produces a toxin that has been named compound A and has been shown to be problematic in animal studies.
41. Ventilator bellows on the anesthesia machine are classified by:
a. movement on expiration
c. pneumatic ability
d. movement on inspiration
-a. movement on expiration
Ascending (standing) bellows ascend during the expiratory phase; descending (hanging) bellows descend during the expiratory phase
42. If the anesthesia scavanging system becomes plugged:
a. gases will go backward toward the patient
b. gases will be vented into the room
c. the equivalent of PEEP will occur
d. gases will vent to the vacum
-b. Obstruction of the scavenging system can cause excessive positive pressure to be transmitted to the breathing system, resulting in gases being vented into the room.
43. What color are air tanks designated?
In the U.S., medical gas cylinders have a standard color. Those of oxygen are green; air is yellow; nitrous oxide is blue; and nitrogen is black.
44. The line isolation monitor alarm indicates that:
a. a fire is imminent
b. the power supply is partially grounded
c. microshocks are present in monitoring equipment
d. power has been turned off
-b. the alarm of the line isolation monitor merely indicates that the power supply has partially reverted to a grounded system because of a single fault. Two faults are required for a shock to occur