BASIC Sample Questions.pdf

BASIC Exam Sample Questions

1. Which of the following nerves should MOST likely be blocked for an operation at the medial

aspect of the lower leg?

A. Femoral

B. Common peroneal

C. Tibial

2. A patient is scheduled to undergo laparoscopic cholecystectomy. Thirty minutes after receiving

premedication with morphine and midazolam, she suddenly develops right upper quadrant

abdominal pain and nausea. Which of the following drugs is the MOST appropriate therapy for

this patient’s pain?

A. Flumazenil

B. Ketorolac

C. Naloxone

3. A 68-year-old woman with primary hyperparathyroidism is scheduled to undergo

parathyroidectomy. Her serum calcium concentration is 15 mg/dL. IV administration of which of

the following substances is the MOST appropriate initial management?

A. Magnesium sulfate

B. Normal saline

C. Methylprednisolone

4. Which of the following tests MOST reliably predicts the likelihood that a patient will develop

malignant hyperthermia?

A. Calcium uptake assay in skeletal muscle biopsy

B. Genetic testing of the ryanodine receptor

C. Caffeine-halothane contracture test

5. O

100 mL/min is bubbled through a vaporizer containing an anesthetic with a vapor pressure

of 150 mmHg, and this mixture is added to a fresh gas flow of 5 L/min. Which of the following

values BEST represents the delivered anesthetic concentration?

A. 0.25%

B. 0.5%

C. 2.5%

6. An adult patient with mild hypothermia is anesthetized with 1 MAC of isoflurane. Which of the

following physiologic mechanisms is MOST effective for maintaining body temperature in this

patient?

A. Nonshivering thermogenesis

B. Shivering thermogenesis

C. Vasoconstriction

7. A 72-year-old man has just received midazolam for an endoscopic procedure of the upper

gastrointestinal tract. Sedation is easily antagonized by flumazenil. Although the endoscopist

asks to send the patient home in 1 hour, which of the following factors BEST explains why this

patient should remain hospitalized for observation?

A. Flumazenil has low affinity for benzodiazepine receptors

B. Flumazenil has moderate intrinsic agonist activity

C. Midazolam has a longer duration of action than flumazenil

8. Which of the following factors exerts the GREATEST effect on the extent of spread of local

anesthetic following subarachnoid block with hyperbaric bupivacaine?

A. Added epinephrine

B. Patient position

C. Total dose of drug

9. A 17-year-old boy develops pulmonary edema after resolution of postoperative laryngospasm.

While breathing 100% O

, SpO

is 80%. Which of the following strategies is the MOST

appropriate management?

A. Administration of albuterol

B. Administration of furosemide

C. Positive-pressure ventilation

10. A 61-year-old man receives a spinal anesthetic for transurethral resection of the prostate

(TURP). Forty-five minutes after the start of the procedure, he suddenly develops nausea,

diaphoresis, and sharp pain in the left shoulder. Which of the following etiologies is the MOST

likely cause?

A. Angina pectoris

B. Bladder perforation

C. Inadequate spinal sensory level

11. A 36-year-old woman is receiving general anesthesia for a diagnostic laparoscopy in the

Trendelenburg position with CO

insufflation. During a 15-minute period after induction, her

SpO

decreases from 99% to 90% and the partial pressure of ETCO

increases from 38 to 43

mmHg. FiO

is 0.3; all ventilator settings have been constant. Which of the following etiologies

is the MOST likely cause of the decrease in SpO

A. CO

embolus

B. Compression of the vena cava

C. Right mainstem endobronchial intubation

12. Two hours after a laparoscopic cholecystectomy, a 45-year-old woman with obesity is

receiving IV PCA with morphine. Her SpO

is 90% on room air. Which of the following

etiologies is the MOST likely cause of her hypoxemia?

A. Absorption of CO

from the abdomen

B. Hypoventilation

C. Increased dead space

13. In a patient receiving pressure support ventilation, pressure support breaths are triggered by

which of the following preset factors?

A. A decrease in airway pressure

B. An increase in airway pressure

C. An increase in inspiratory flow rate

14. A healthy 42-year-old man has an increase in heart rate from 60 bpm to 120 bpm during

induction of anesthesia. Which of the following factors is MOST likely to satisfy the increased

metabolic demand of the myocardium?

A. Decreased coronary artery resistance

B. Increased coronary perfusion pressure

C. Increased O

extraction by the myocardium

15. Which of the following laboratory values is MOST likely to confirm adequate synthetic hepatic

function?

A. Partial thromboplastin time

B. Prothrombin time

C. Serum alanine aminotransferase concentration

16. Which of the following strategies BEST prevents ventricular dysrhythmias in a patient

undergoing extracorporeal shock wave lithotripsy?

A. Beta-adrenergic blockade

B. ECG synchronization

C. Epidural blockade to T4

17. Compared with a semiclosed circle system, a Bain circuit exhibits which of the following

characteristics?

A. Less rebreathing of CO

B. A lower fresh gas flow requirement

C. More rapid change in inspired gas concentration

18.

The capnograph waveform shown above was obtained from a patient undergoing hip surgery

in the lateral position. Which of the following BEST explains the findings between point A and

point B?

A. Excessive tidal volume

B. Incompetent expiratory valve

C. Patient position

19. A 67-year-old man who developed a rash with past administration of penicillin is undergoing

open reduction of a femur fracture. The surgeon asks if cefazolin can be administered to this

patient. Which of the following actions is MOST appropriate for the anesthesiologist to

perform?

A. Administer cefazolin

B. Administer hydrocortisone, followed by cefazolin

C. Administer vancomycin instead of cefazolin

20. Which of the following factors DECREASES the MAC of isoflurane?

A. Acute cocaine intoxication

B. Chronic ethanol abuse

C. Symptomatic hyponatremia

21. Which of the following outcomes BEST describes the primary toxic effect of bupivacaine on the

cardiovascular system?

A. Blockade of norepinephrine release

B. Coronary vasoconstriction

C. Delay of ventricular repolarization

22. Which of the following conditions MOST likely causes a rightward shift in the oxyhemoglobin

dissociation curve?

A. Carboxyhemoglobinemia

B. Decreased 2,3-diphosphoglycerate concentration

C. Hyperthermia

23. Which of the following findings is most likely to be DECREASED in a patient with clinical

hypothyroidism?

A. MAC

B. Myocardial contractility

C. Peripheral vascular tone

24. Which of the following anesthetic drugs is MOST likely to be associated with longer seizure

duration when used for electroconvulsive therapy?

A. Etomidate

B. Methohexital

C. Propofol

25. Which of the following drugs does NOT cause enhanced activity of the GABA receptor?

A. Etomidate

B. Ketamine

C. Propofol

26.

Which of the following systems will MOST likely prevent rebreathing of CO

regardless of the

mode of ventilation?

A. A

B. B

C. C

27.

Which of the following components is MISPLACED in the circle system shown in the above

illustration?

A. Fresh gas inlet

B. CO

absorber

C. Expiratory valve

28. A new IV anesthetic is found to have a very large volume of distribution. This drug is MOST

likely to have which of the following properties?

A. Low lipid solubility

B. High rate of ionization

C. Low plasma protein binding

29. Which of the following drugs has the LONGEST duration of action in a patient with renal

failure?

A. Neostigmine

B. Rocuronium

C. Succinylcholine

30. Instillation of local anesthetic into the trachea via the cricothyroid membrane is MOST likely to

block which of the following nerves?

A. Hypoglossal

B. Internal branch of the superior laryngeal

C. Recurrent laryngeal

31. Gagging that occurs during awake intubation is BEST prevented by local anesthetic block of

which of the following nerves?

A. Superior laryngeal

B. Glossopharyngeal

C. Hypoglossal

32. Which of the following factors is the MOST likely explanation for the initial reduction in core

temperature during general anesthesia?

A. Ablation of thermoregulatory vasoconstriction

B. Evaporative heat loss in the respiratory tract

C. Redistribution of heat from the core to the periphery

33. A 65-kg, 70-year-old man in the PACU is breathing spontaneously at 20 breaths/minute

through an ETT connected to a T-piece with a fresh gas flow of 5 L/min and an FiO

of 0.5. His

tidal volume is 350 mL. Over 1 hour, his SpO

decreases from 98% to 84%, and then improves

to 92% when FiO

is increased to 1.0. Which of the following etiologies is the MOST likely

cause of his hypoxemia?

A. Decreased FRC

B. Increased dead space ventilation

C. Room air admixture during inspiration

34. A 40-year-old man who is scheduled for repair of a tendon laceration of the left hand has

complete anesthesia in the median, radial, and ulnar nerve distributions after supraclavicular

block. Two hours of tourniquet inflation are required for completion of the procedure. The most

appropriate NEXT step is an additional block of which of the following nerves?

A. Axillary

B. Intercostobrachial

C. Musculocutaneous

35. Which of the following mechanisms is PRIMARILY responsible for emergence after a single

dose of propofol?

A. Redistribution

B. Metabolism

C. Excretion

36. An anesthesia machine is set to deliver O

2 L/min, nitrous oxide 2 L/min, and sevoflurane.

After 30 minutes of stable anesthesia, which of the following complications is the most likely

cause of a DECREASE in the O

analyzer reading from 50% to 30%?

A. A leak in the ventilator bellows

B. Accumulation of water on the O

sensor membrane

C. Presence of the O

analyzer in the expiratory limb

37. An induction dose of ketamine is MOST likely to have which of the following effects?

A. Analgesia

B. Decreased cerebral metabolic rate

C. Preservation of laryngeal reflexes

38. As compared with an IV dose of morphine, which of the following factors is the most likely

explanation for the DECREASED duration of action of an IV dose of fentanyl?

A. Greater lipid solubility

B. Increased hepatic metabolism

C. Shorter elimination half-life

39. Which of the following definitions BEST describes what the standard error of the mean shows?

A. The precision of the population mean

B. The range of the sample values

C. The deviation about the median of the study group

40. Pulse oximetry accurately reflects SaO

in which of the following situations?

A. Administration of indocyanine green

B. Carboxyhemoglobinemia

C. 40% fetal hemoglobin concentration

41. A patient with a fasting blood glucose of 100 mg/dL is receiving a 4-hour general anesthetic for

repair of tendon lacerations. Which of the following blood glucose concentrations is MOST

likely expected on emergence?

A. Marked hypoglycemia

B. Mild hyperglycemia

C. Mild hypoglycemia

42. Which of the following drugs INCREASES gastric pH while decreasing gastric volume?

A. Glycopyrrolate

B. Metoclopramide

C. Ranitidine

43. Which of the following characteristics of nitrous oxide MOST likely explains why its alveolar

and inspired concentrations equilibrate more rapidly than those of desflurane?

A. Delivery at a higher inspired concentration

B. Creation of a second gas effect

C. Lower blood gas solubility

44. Which of the following goals is the PRIMARY purpose of denitrogenation prior to anesthetic

induction?

A. Improving matching of ventilation and perfusion

B. Increasing O

reserve in the FRC

C. Maximizing arterial O

content

45. A 32-year-old woman sustains an injury to the left recurrent laryngeal nerve during

thyroidectomy. Which of the following postoperative findings is MOST likely in this patient?

A. Adduction of the left vocal cord at rest

B. Aphonia

C. Aspiration caused by glottic incompetency

46. Which of the following values, in mmHg, is the expected mixed venous O

tension in a normal

adult after breathing 100% O

for 10 minutes?

A. 45

B. 95

C. 150

47. Which of the following drugs has the SHORTEST elimination half-life?

A. Flumazenil

B. Lorazepam

C. Midazolam

BASIC Exam Answer Key

Question # Key Question # Key Question # Key Question # Key

1 A 13 A 25 B 37 A

2 C 14 A 26 B 38 A

3 B 15 B 27 A 39 A

4 C 16 B 28 C 40 C

5 B 17 C 29 A 41 B

6 C 18 C 30 C 42 C

7 C 19 A 31 B 43 A

8 B 20 C 32 C 44 B

9 C 21 C 33 A 45 A

10 B 22 C 34 B 46 A

11 C 23 B 35 A 47 A

12 B 24 A 36 B