APEX MOCK EXAM 1 WITH ANSWERS,

APEX MOCK EXAM 1 WITH ANSWERS
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Match each West zone of the lung with its corresponding
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pressures: |\




Zone 1
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Zone 2
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Zone 3
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Zone 4 - CORRECT ANSWERS ✔✔Zone 1: P alveolar> P
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arterial> P venous> P interstitial (dead space)
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Zone 2: P arterial> P alveolar> P venous> P interstitial
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(matched V/Q) |\




Zone 3: P arterial> P venous> P Alveolar> P interstitial
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(shunt)
Zone 4: P arterial> P interstitial> P venous> P alveolar
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(increase pressure in the interstitium-pulm edema)
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Which interventions are MOST appropriate in the "cant
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ventilate can't intubate" scenario? Select 2
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Percutaneous transtracheal jet ventilation |\ |\ |\ |\




Tracheostomy
Surgical cricothyrotomy
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Retrograde intubation - CORRECT ANSWERS |\ |\ |\ |\ |\



✔✔Percutaneous transtracheal jet ventilation |\ |\ |\ |\

,Surgical cricothyrotomy |\ |\




Surgical cricothyrotomy and transtracheal jet ventilation
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can reestablish ventilation very quickly, and are
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appropriate options in the cant Ventilate can't intubate |\ |\ |\ |\ |\ |\ |\ |\



scenario. |\




Retrograde intubation is best used one ventilation as |\ |\ |\ |\ |\ |\ |\ |\



possible. It takes 5 to 7 minutes to complete in the hands
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of an experience practitioner. This is often performed for
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the patient with a suspected or known difficult airway in a
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controlled setting before the induction of Anesthesia. It is
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also useful in the patient with an unstable cervical spine.
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At what point during laparoscopic cholecystectomy is a
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gas embolism most likely to occur?
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A. Initial abdominal insufflation.
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B. During the cholangiogram
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C. The risk is the same throughout the procedure.
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D. Dissection of gallbladder from the liver bed. - CORRECT
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ANSWERS ✔✔A. Initial abdominal insufflation.
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There is a risk of air embolism if a trocar is inadvertently
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placed into a blood vessel, or any time when intravascular
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pressure falls below intraabdominal pressure.
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,Gas embolism creates an airlock in the right heart, and
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thus obstructs forward flow.
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Signs and symptoms include : decreased EtCO2,
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increased EtN, increased PAP, pulmonary edema,|\ |\ |\ |\ |\ |\



decreased blood pressure, hypoxia, dysrhythmias, |\ |\ |\ |\ |\



cyanosis, and a mill wheel murmur. |\ |\ |\ |\ |\ |\




TEE is the most sensitive indicator of gas embolism.
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The risk of gas embolism is greatest during initial
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insufflation of the abdomen, especially those with |\ |\ |\ |\ |\ |\ |\



previous abdominal surgery . |\ |\ |\




Which finding places a child at the GREATEST risk for
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laryngospasm?
A. Upper respiratory infection.
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B. Upper airway surgery.
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C. Exposure to secondhand tobacco smoke.
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D. Gastro esophageal reflux. - CORRECT ANSWERS ✔✔A.
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Upper respiratory infection.
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Noxious stimulation of the internal branch of the superior,
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laryngeal, nerve and precipitate laryngospasm. This
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complication can lead to complete airway obstruction |\ |\ |\ |\ |\ |\ |\



negative pressure pulmonary edema, aspiration of gastric
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contents, cardiac arrest, and death.
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The risk of laryngospasm is greatest in the child with an
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upper respiratory infection 9.6/100
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, The Distractors were the other risk factors for
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laryngospasm: |\




-Preoperative risk factors include exposure to secondhand |\ |\ |\ |\ |\ |\



smoke and GERD.
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-Intra-operative risk factors include upper airway surgery, |\ |\ |\ |\ |\ |\ |\



mechanical irritant (secretions), airway manipulation |\ |\ |\ |\ |\



during light planes of anesthesia, and the excitement
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phase during an inhalation induction.
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Which lung volume increases as a function of aging? -
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CORRECT ANSWERS ✔✔Aging is associated with the loss |\ |\ |\ |\ |\ |\ |\ |\



of lung elastic recoil. Said another way, There is an
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increased lung compliance. Lung elastic recoil is integral
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to the maintenance of airway diameter. Loss of this
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property causes a small airways to collapse prematurely.
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This causes gas trapping, and gas trapping increases
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RESIDUAL VOLUME. |\




A Morbidly obese patient is undergoing removal of an
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infected hip hardware under general anesthesia. Midway
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through the procedure you observe the following vital
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signs. What is the MOST likely diagnosis?
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Increased HR |\




hypotension |\




Increased CVP |\




Drop in ETCO2 |\ |\