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An E-cylinder of oxygen with a service pressure of 1,900 PSI contains how many liters of
oxygen?
1,590
190
660
330
660
Justification
A filled E-cylinder of oxygen has a service pressure of 1,900 PSI and contains 660 L of
oxygen. An E-cylinder that is half empty (service pressure of 950 PSI) would contain
half that volume, or 330 L of oxygen.
,Which neuromuscular monitoring technique is appropriate for the evaluation of time to
recovery from a deep blockade with rocuronium (Zemuron)?
Double-burst stimulation
Posttetanic count stimulation
Tetanic stimulation
Train-of-four stimulation
Posttetanic count stimulation
Justification
Deep blockade secondary to nondepolarizing neuromuscular blocking agents is
characterized by no twitch response in a train-of-four (0/4), but with the presence of a
posttetanic count =1 twitch. Posttetanic count stimulation is useful in helping to estimate
the amount of time until reappearance of a train-of-four response (=1/4 twitches).
Because there is no response to train-of-four and single-twitch stimulation under the
condition of deep neuromuscular blockade, these modes of stimulation cannot be used
to determine the degree of block. The time until return of the first response to train-of-
four stimulation is related to the number of posttetanic twitch responses present.
,What is responsible for an abrupt decrease in end-tidal carbon dioxide (ETCO2) to
near zero with the absence of an ETCO2 waveform?
Malfunction of unidirectional inspiratory valve
Exhausted carbon dioxide absorbent material
Loss of suction on the scavenge system
Anesthesia circuit disconnection
Anesthesia circuit disconnection
Justification
The sudden decrease in ETCO2 and absence of an ETCO2 waveform would occur
with an anesthesia circuit disconnect, discontinuing the sampling of expired carbon
dioxide. The malfunction of the unidirectional inspiratory valve and exhausted carbon
dioxide absorbent material would result in an increase in ETCO2 (increasing ETCO2
waveform).
, Which muscle relaxant is MOST appropriate in patients with advanced liver disease?
Rocuronium (Zemuron)
Pancuronium (Pavulon)
Cisatracurium (Nimbex)
Vecuronium (Norcuron)
Cisatracurium (Nimbex)
Justification
Cisatracurium is metabolized by Hofmann elimination. All other choices have some
degree of liver metabolism