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Idaho CVT practice questions

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Question 1Pharmacy and Pharmacology

A prescription reads: 'Amoxicillin 500 mg PO TID x 10 days.' How many capsules of 500 mg will the patient need to complete the full course?

  1. 30 Correct answer.
  2. 20
  3. 10
  4. 40

Explanation

TID means three times daily, so the patient takes 3 doses each day. Over 10 days that is 3 × 10 = 30 doses, and at 500 mg per capsule each dose is one capsule. Therefore 30 capsules are needed.

Question 2Pharmacy and Pharmacology

Which abbreviation on a prescription is a recognized error-prone abbreviation that should be written out in full to prevent misinterpretation?

  1. BID
  2. PRN
  3. QD Correct answer.
  4. PO

Explanation

QD (once daily) is on standard do-not-use lists because the Q can be mistaken for a trailing zero or confused with QID, risking a fourfold overdose. Institutions require 'daily' to be written out. PO, BID, and PRN are not on those error-prone lists.

Question 3Pharmacy and Pharmacology

A patient is prescribed warfarin and asks the CVT why regular INR monitoring is required. What is the best explanation?

  1. INR confirms renal clearance of warfarin metabolites before each refill.
  2. INR directly measures the serum warfarin concentration to confirm absorption.
  3. INR measures the anticoagulant effect so the dose can be kept in a safe therapeutic range. Correct answer.
  4. INR assesses platelet function to detect aspirin-like antiplatelet effects.

Explanation

Warfarin inhibits vitamin K–dependent clotting factors, and the INR reflects that anticoagulant effect. Monitoring keeps the INR within the target range, balancing bleeding risk against protection from thrombosis. INR does not measure drug levels, platelet function, or renal clearance.

Question 4Pharmacy and Pharmacology

Which class of medication is most commonly associated with angioedema as an adverse effect in veterinary and human patients?

  1. Proton pump inhibitors
  2. Angiotensin-converting enzyme inhibitors Correct answer.
  3. Thiazide diuretics
  4. Beta-lactam antibiotics

Explanation

ACE inhibitors can cause bradykinin accumulation, leading to angioedema, particularly of the face and airway. This is a well-recognized class effect that warrants discontinuation if it occurs. The other listed classes are not classically linked to angioedema.

Question 5Pharmacy and Pharmacology

A drug order is written for 'insulin 10 U' and the CVT is transcribing it. Which practice best reduces the risk of a dosing error?

  1. Round the dose to the nearest whole vial.
  2. Write 'units' in full rather than the abbreviation U. Correct answer.
  3. Abbreviate micrograms as 'μg' to save space.
  4. Use a trailing zero after the dose, as in 10.0 U.

Explanation

The abbreviation 'U' can be misread as a zero or as '4', producing a tenfold error with insulin. Writing 'units' in full is a standard safety practice. Trailing zeros and the μg abbreviation are themselves error-prone practices.

Question 6Pharmacy and Pharmacology

A patient weighing 20 kg is prescribed a drug at 5 mg/kg/day divided into two doses. What is the amount of each dose?

  1. 25 mg
  2. 50 mg Correct answer.
  3. 10 mg
  4. 100 mg

Explanation

The total daily dose is 5 mg/kg × 20 kg = 100 mg per day. Dividing that into two doses gives 50 mg per dose. Confusing the daily total with the per-dose amount is the common error here.

Question 7Pharmacy and Pharmacology

Which statement correctly describes the difference between a drug's pharmacokinetics and its pharmacodynamics?

  1. Pharmacokinetics applies only to injectable drugs; pharmacodynamics applies only to oral drugs.
  2. Pharmacokinetics describes receptor binding; pharmacodynamics describes absorption and elimination.
  3. Pharmacokinetics and pharmacodynamics are interchangeable terms for drug potency.
  4. Pharmacokinetics describes what the body does to the drug; pharmacodynamics describes what the drug does to the body. Correct answer.

Explanation

Pharmacokinetics covers absorption, distribution, metabolism, and excretion-how the body handles the drug. Pharmacodynamics covers the drug's effects and mechanism at the target site. The two are complementary but distinct concepts.

Question 8Pharmacy and Pharmacology

A drug is described as having a narrow therapeutic index. What does this mean for the CVT monitoring the patient?

  1. The drug is safe across a very wide range of doses.
  2. The drug can be given without regard to timing of administration.
  3. Small changes in dose or blood level can produce toxicity or loss of efficacy. Correct answer.
  4. The drug has no measurable therapeutic effect at any dose.

Explanation

A narrow therapeutic index means the toxic dose is close to the effective dose, so small variations in plasma concentration matter. These drugs often require therapeutic drug monitoring and careful dosing. A wide margin of safety describes the opposite situation.

Question 9Pharmacy and Pharmacology

Which drug interaction is a classic concern when a patient on warfarin is started on a potent CYP2C9 inhibitor?

  1. Increased warfarin effect and bleeding risk Correct answer.
  2. Immediate neutralization of warfarin by the inhibitor
  3. Decreased warfarin effect and thrombosis risk
  4. No change in warfarin effect because the drug is renally cleared

Explanation

Warfarin's more potent S-enantiomer is metabolized largely by CYP2C9. Inhibiting that enzyme slows warfarin clearance, raising INR and bleeding risk. Close INR monitoring and possible dose reduction are needed when such a drug is added.

Question 10Pharmacy and Pharmacology

A patient is receiving digoxin and develops nausea, visual disturbances, and bradycardia. Which electrolyte abnormality most increases the risk of digoxin toxicity?

  1. Hypochloremia
  2. Hypokalemia Correct answer.
  3. Hyperkalemia
  4. Hypernatremia

Explanation

Low potassium increases digoxin binding at the sodium-potassium ATPase and enhances toxicity. Nausea, visual changes, and bradyarrhythmias are classic signs. Potassium status should be checked and corrected when digoxin toxicity is suspected.

Question 11Pharmacy and Pharmacology

Which medication should be avoided in a cat because of a well-documented risk of fatal neurotoxicity?

  1. Pyrantel pamoate
  2. Fenbendazole
  3. Praziquantel
  4. Permethrin Correct answer.

Explanation

Permethrin, a pyrethroid used in canine flea products, is highly toxic to cats and can cause tremors, seizures, and death. Cat-specific products should always be used. Praziquantel, pyrantel, and fenbendazole are commonly used safely in cats at appropriate doses.

Question 12Pharmacy and Pharmacology

A drug is supplied as a 2% solution. How many milligrams of drug are contained in 5 mL of this solution?

  1. 50 mg
  2. 10 mg
  3. 200 mg
  4. 100 mg Correct answer.

Explanation

A 2% solution contains 2 g per 100 mL, which equals 20 mg per mL. Multiplying 20 mg/mL by 5 mL gives 100 mg. Converting the percentage to mg/mL first prevents the common decimal error.

Question 13Pharmacy and Pharmacology

Which route of administration typically avoids first-pass hepatic metabolism most completely?

  1. Rectal (upper)
  2. Oral with food
  3. Intravenous Correct answer.
  4. Oral

Explanation

Intravenous administration places drug directly into the systemic circulation, bypassing the gut wall and portal circulation entirely. Oral drugs are absorbed into portal blood and undergo first-pass metabolism. Rectal absorption is partly subject to first-pass effects depending on the site.

Question 14Pharmacy and Pharmacology

A patient has been on long-term prednisone and the drug is to be discontinued. Why must the dose be tapered rather than stopped abruptly?

  1. Stopping suddenly triggers acute hepatic failure from steroid accumulation.
  2. Tapering is required only to prevent patient anxiety about stopping the medication.
  3. Prolonged exogenous steroid use suppresses the adrenal axis, so abrupt withdrawal can cause adrenal insufficiency. Correct answer.
  4. Abrupt withdrawal causes immediate rebound hypertension from sodium retention.

Explanation

Chronic glucocorticoid exposure suppresses the hypothalamic-pituitary-adrenal axis, reducing endogenous cortisol production. Abrupt cessation can precipitate an adrenal crisis, especially under stress. A gradual taper allows the axis to recover and resume normal cortisol output.

Question 15Pharmacy and Pharmacology

Which statement best explains why a drug with a short elimination half-life generally requires more frequent dosing than one with a long half-life?

  1. A short half-life indicates the drug has no receptor activity.
  2. A short half-life means the drug accumulates indefinitely in tissues.
  3. A short half-life means the drug is not absorbed from the gastrointestinal tract.
  4. Plasma concentrations fall below the therapeutic range more quickly with a short half-life. Correct answer.

Explanation

Half-life describes how quickly drug is cleared from plasma; with a short half-life, concentrations decline rapidly. To keep levels within the therapeutic window, dosing intervals must be shorter or a sustained-release form used. Half-life does not by itself indicate absorption or receptor activity.

Question 16Pharmacy and Pharmacology

A drug is 90% bound to plasma albumin. What is the primary consequence of this high degree of protein binding?

  1. High protein binding guarantees a longer duration of action regardless of dose.
  2. Only the unbound fraction is pharmacologically active and available to tissues. Correct answer.
  3. Protein binding prevents the drug from being metabolized at all.
  4. The entire bound and unbound amount is equally active at receptor sites.

Explanation

The unbound drug fraction is what crosses membranes and binds receptors, so it drives the pharmacologic effect. Highly bound drugs have a small active fraction and can be displaced by other bound drugs or by hypoalbuminemia. Bound drug acts as a reservoir but is not itself active.

Question 17Pharmacy and Pharmacology

Which adverse effect is most characteristic of aminoglycoside antibiotics such as gentamicin?

  1. Nephrotoxicity and ototoxicity Correct answer.
  2. Hepatotoxicity and photosensitivity
  3. Cataract formation and glaucoma
  4. Bone marrow suppression and alopecia

Explanation

Aminoglycosides accumulate in renal tubular cells and cochlear hair cells, causing dose-related nephrotoxicity and ototoxicity. Monitoring renal function and avoiding prolonged high exposure reduce risk. The other listed effects are not the hallmark toxicities of this class.

Question 18Pharmacy and Pharmacology

A patient is prescribed a drug that is a potent CYP3A4 inducer. What effect will this have on a co-administered drug that is a CYP3A4 substrate?

  1. Increased plasma concentration and increased risk of substrate toxicity
  2. Reduced plasma concentration and possibly loss of efficacy of the substrate drug Correct answer.
  3. No change, because induction affects only the inducing drug itself
  4. Immediate permanent inactivation of the substrate drug

Explanation

Enzyme induction increases CYP3A4 expression, so the substrate drug is metabolized faster and its levels fall. This can drop concentrations below therapeutic range and cause treatment failure. Dose adjustment or an alternative agent may be needed.

Question 19Pharmacy and Pharmacology

A patient on furosemide develops muscle weakness, cardiac arrhythmia, and a low serum potassium. Which mechanism best explains this finding?

  1. Loop diuretics increase renal potassium reabsorption in the proximal tubule.
  2. Loop diuretics cause potassium to shift into cells along with sodium.
  3. Loop diuretics directly block aldosterone receptors in the collecting duct.
  4. Loop diuretics increase distal sodium delivery, promoting potassium loss in the distal nephron. Correct answer.

Explanation

Loop diuretics block sodium reabsorption in the thick ascending limb, delivering more sodium to the distal nephron where sodium reabsorption is coupled with potassium secretion. The result is increased urinary potassium loss and hypokalemia. Aldosterone receptor blockade describes spironolactone, not loop diuretics.

Question 20Pharmacy and Pharmacology

A drug is administered by constant intravenous infusion and follows first-order elimination. Approximately how many half-lives are required to reach steady-state plasma concentration?

  1. 1
  2. 4 to 5 Correct answer.
  3. 2
  4. 10 to 12

Explanation

With first-order kinetics, steady state is approached after about four to five half-lives, when roughly 94–97% of the plateau is reached. Continuing beyond that adds little to the concentration. This principle guides when to draw therapeutic drug monitoring samples.

Question 21Pharmacy and Pharmacology

A patient is receiving both a proton pump inhibitor and clopidogrel. Why is this combination sometimes flagged as a concern?

  1. PPIs accelerate renal excretion of clopidogrel's active metabolite.
  2. PPIs increase gastric pH, which inactivates clopidogrel's antiplatelet receptor.
  3. PPIs directly bind and neutralize clopidogrel in the stomach.
  4. Some PPIs inhibit CYP2C19, which may reduce conversion of clopidogrel to its active metabolite. Correct answer.

Explanation

Clopidogrel is a prodrug requiring CYP2C19-mediated activation, and certain PPIs inhibit that enzyme. Reduced activation may lower antiplatelet effect, so an alternative acid suppressant is sometimes chosen. The interaction is metabolic, not a direct chemical neutralization.

Question 22Pharmacy and Pharmacology

Which statement correctly distinguishes a drug's agonist from an antagonist at a receptor?

  1. An agonist activates the receptor, while an antagonist blocks the receptor without activating it. Correct answer.
  2. Both agonists and antagonists activate the receptor, differing only in potency.
  3. An antagonist must be a partial agonist to have any effect.
  4. An agonist blocks the receptor, while an antagonist activates it.

Explanation

Agonists bind receptors and produce a conformational change that triggers a response. Antagonists bind without intrinsic activity and prevent agonists from activating the receptor. Partial agonists occupy an intermediate position, producing submaximal responses.

Question 23Pharmacy and Pharmacology

A prescription is written for 'metronidazole 250 mg PO BID for 7 days.' How many total milligrams will the patient receive over the course of therapy?

  1. 2,500 mg
  2. 1,750 mg
  3. 5,000 mg
  4. 3,500 mg Correct answer.

Explanation

BID means two doses per day, giving 500 mg daily. Over 7 days that totals 500 mg × 7 = 3,500 mg. Multiplying the per-dose amount by doses per day and then by days is the reliable approach.

Question 24Pharmacy and Pharmacology

Which drug is a classic example of a narrow-therapeutic-index agent that requires therapeutic drug monitoring because of serious toxicity?

  1. Amoxicillin
  2. Famotidine
  3. Acetaminophen at label doses
  4. Phenytoin Correct answer.

Explanation

Phenytoin has a narrow therapeutic range and shows nonlinear kinetics, so small dose changes can cause toxicity. Monitoring serum levels helps keep concentrations within range. Amoxicillin, label-dose acetaminophen, and famotidine do not routinely require this monitoring.

Question 25Surgical Nursing and Anesthesia

During a cesarean delivery under spinal anesthesia, the patient becomes hypotensive and reports nausea. Which intervention should the CVT anticipate first, after the anesthesia provider confirms the blood pressure reading?

  1. Administer a rapid intravenous fluid bolus and left uterine displacement Correct answer.
  2. Increase the inspired sevoflurane concentration to deepen anesthesia
  3. Give oral antiemetic and continue monitoring without other action
  4. Place the patient in Trendelenburg position to raise venous return

Explanation

Spinal-induced hypotension is managed with rapid IV crystalloid or colloid bolus, left uterine displacement to relieve aortocaval compression, and often a vasopressor such as phenylephrine. These measures restore venous return and perfusion. Trendelenburg alone does not relieve aortocaval compression and worsens aspiration risk.

Question 26Surgical Nursing and Anesthesia

Which monitoring parameter most directly reflects adequate tissue perfusion during a prolonged general anesthetic in a hypovolemic trauma patient?

  1. Neuromuscular train-of-four count
  2. Inspired oxygen fraction
  3. End-tidal carbon dioxide waveform
  4. Urine output and lactate trend Correct answer.

Explanation

Urine output and serial lactate reflect end-organ perfusion and the adequacy of cardiac output and volume resuscitation. EtCO2, FiO2, and TOF monitoring are important but do not directly measure tissue perfusion. Trending lactate downward indicates improving oxygen delivery.

Question 27Surgical Nursing and Anesthesia

A patient undergoing laparotomy under general anesthesia has a sudden drop in end-tidal CO2 from 35 to 12 mmHg with hypotension and tachycardia. Which complication should the CVT prepare for first?

  1. Bronchospasm
  2. Pulmonary embolism Correct answer.
  3. Awareness under anesthesia
  4. Malignant hyperthermia

Explanation

A sudden fall in EtCO2 combined with hypotension and tachycardia suggests a massive pulmonary embolism or abrupt loss of cardiac output. The CVT should prepare for resuscitation and possible thrombolysis or embolectomy. Malignant hyperthermia causes rising EtCO2, and bronchospasm typically raises airway pressure with a sloping waveform.

Question 28Surgical Nursing and Anesthesia

Which action should the CVT take immediately when a patient's train-of-four shows zero twitches during a surgical case where the surgeon requests ongoing relaxation?

  1. Document the finding and continue monitoring Correct answer.
  2. Extubate the patient
  3. Reduce the volatile agent to zero
  4. Administer a reversal agent

Explanation

A train-of-four count of zero indicates deep neuromuscular blockade, which is appropriate when the surgeon needs profound relaxation. The CVT should document the finding and continue monitoring rather than reverse or extubate. Reversal is only appropriate when the block is lightening and extubation criteria are met.

Question 29Surgical Nursing and Anesthesia

During a procedure under monitored anesthesia care, the patient's oxygen saturation falls to 88% despite a patent nasal cannula at 4 L/min. What is the most appropriate initial action by the CVT?

  1. Immediately intubate the patient
  2. Verify airway patency and encourage deep breathing Correct answer.
  3. Place the patient in reverse Trendelenburg
  4. Increase sedation to reduce oxygen demand

Explanation

The first step in desaturation is to confirm airway patency, check the cannula position, and encourage deep breathing or reposition the patient. Simple maneuvers often correct hypoxemia from hypoventilation or atelectasis. Intubation is reserved for failure of these measures.

Question 30Surgical Nursing and Anesthesia

Which agent is the volatile anesthetic most commonly associated with triggering malignant hyperthermia?

  1. Nitrous oxide
  2. Propofol
  3. Sevoflurane Correct answer.
  4. Dexmedetomidine

Explanation

Volatile anesthetics such as sevoflurane, isoflurane, and desflurane, along with succinylcholine, are triggers for malignant hyperthermia. Nitrous oxide, propofol, and dexmedetomidine are not triggering agents. Dantrolene is the specific treatment.

Question 31Surgical Nursing and Anesthesia

A patient with a known difficult airway is scheduled for surgery. Which preparation should the CVT anticipate?

  1. Rapid extubation without airway assessment
  2. Standard direct laryngoscopy with no additional equipment
  3. Availability of a video laryngoscope and fiberoptic bronchoscope Correct answer.
  4. Use of only a supraglottic airway

Explanation

Difficult airway management requires advanced equipment such as video laryngoscopy and fiberoptic bronchoscopy, along with a clearly communicated backup plan. The CVT should verify that these devices are functional and immediately available. Standard laryngoscopy alone is inadequate for an anticipated difficult airway.

Question 32Surgical Nursing and Anesthesia

Which finding best indicates that a patient has adequate reversal from a nondepolarizing neuromuscular blockade before extubation?

  1. Two twitches on train-of-four
  2. A train-of-four ratio greater than 0.9 Correct answer.
  3. A single twitch on train-of-four
  4. Absence of spontaneous breathing

Explanation

A train-of-four ratio greater than 0.9 indicates adequate recovery of neuromuscular function and is the accepted threshold before extubation. Two or fewer twitches indicate residual blockade. Spontaneous breathing alone does not exclude residual weakness.

Question 33Surgical Nursing and Anesthesia

During a general anesthetic, peak airway pressure rises suddenly to 45 cmH2O with decreased breath sounds on the right. Which condition should the CVT anticipate?

  1. Hypovolemia
  2. Hyperkalemia
  3. Endobronchial intubation Correct answer.
  4. Hypothermia

Explanation

A sudden rise in peak airway pressure with unilateral decreased breath sounds suggests endobronchial intubation, pneumothorax, or mucus plugging. Migration of the tube into the right mainstem bronchus is a common cause after repositioning. Hypovolemia, hyperkalemia, and hypothermia do not produce this pattern.

Question 34Surgical Nursing and Anesthesia

Which medication is the specific antidote for malignant hyperthermia?

  1. Flumazenil
  2. Naloxone
  3. Dantrolene Correct answer.
  4. Neostigmine

Explanation

Dantrolene is the specific treatment for malignant hyperthermia; it inhibits calcium release from the sarcoplasmic reticulum. Neostigmine reverses neuromuscular blockade, naloxone reverses opioids, and flumazenil reverses benzodiazepines. Early dantrolene administration improves survival.

Question 35Surgical Nursing and Anesthesia

A patient is undergoing surgery in the prone position. Which nursing action is most important to prevent pressure injury and vision loss?

  1. Allowing the arms to hang freely off the table
  2. Keeping the neck extended for the entire case
  3. Placing the chest directly on the table surface
  4. Positioning the head with eyes free of pressure and padding bony prominences Correct answer.

Explanation

In the prone position, the eyes must be free of pressure to prevent ischemic optic neuropathy, and all bony prominences should be padded. Arms should be supported, not hanging, and the neck should be neutral. Chest support should allow abdominal excursion.

Question 36Surgical Nursing and Anesthesia

Which parameter should the CVT monitor most closely when a patient receives a spinal anesthetic with a high block level?

  1. Pupil size
  2. Serum glucose
  3. Blood pressure and respiratory effort Correct answer.
  4. Urine specific gravity

Explanation

A high spinal block can cause hypotension, bradycardia, and respiratory compromise from intercostal muscle paralysis. Close monitoring of blood pressure and respiratory effort allows early intervention. Glucose, urine specific gravity, and pupil size are not the primary concerns in this setting.

Question 37Surgical Nursing and Anesthesia

Which action should the CVT take to reduce the risk of surgical site infection during the intraoperative phase?

  1. Reduce room humidity to the lowest possible level
  2. Maintain normothermia and administer prophylactic antibiotics on schedule Correct answer.
  3. Limit hand hygiene to before the first case of the day
  4. Open sterile supplies early and leave them uncovered

Explanation

Maintaining normothermia and giving prophylactic antibiotics within the recommended window reduce surgical site infection risk. Sterile supplies should remain covered until use, humidity should be maintained within standards, and hand hygiene is required throughout. These measures reflect evidence-based infection prevention.

Question 38Surgical Nursing and Anesthesia

A patient emerges from general anesthesia with stridor and increased work of breathing. Which intervention should the CVT anticipate first?

  1. Administration of a diuretic
  2. Placement in the prone position
  3. Positive-pressure ventilation with a bag-valve mask and preparation for reintubation Correct answer.
  4. Immediate extubation

Explanation

Stridor after extubation suggests laryngospasm or airway edema; initial management includes positive-pressure ventilation with a bag-valve mask and preparation for reintubation if needed. The patient is already extubated, so re-extubation is not applicable. Diuretics and prone positioning do not address upper airway obstruction.

Question 39Surgical Nursing and Anesthesia

Which statement about the use of a laryngeal mask airway during a short procedure is correct?

  1. It requires neuromuscular blockade for insertion
  2. It provides a seal over the laryngeal inlet without entering the trachea Correct answer.
  3. It protects against aspiration as effectively as an endotracheal tube
  4. It is appropriate for patients with a full stomach

Explanation

A laryngeal mask airway sits over the laryngeal inlet and does not enter the trachea, so it does not fully protect against aspiration. It is generally avoided in patients with a full stomach. Neuromuscular blockade is not required for insertion.

Question 40Surgical Nursing and Anesthesia

A patient receiving succinylcholine develops masseter muscle rigidity and rising end-tidal CO2. Which action should the CVT anticipate?

  1. Increase the volatile agent
  2. Administer a beta blocker
  3. Continue the anesthetic and monitor
  4. Discontinue triggering agents and prepare dantrolene Correct answer.

Explanation

Masseter rigidity with rising EtCO2 after succinylcholine may signal malignant hyperthermia. Triggering agents should be stopped, the anesthesia provider notified, and dantrolene prepared. Beta blockers and increased volatile agents do not treat the underlying crisis.

Question 41Surgical Nursing and Anesthesia

Which monitoring device provides the earliest indication of a disconnection in the breathing circuit?

  1. Blood pressure cuff
  2. Capnograph Correct answer.
  3. Pulse oximeter
  4. Temperature probe

Explanation

The capnograph detects a sudden loss of the waveform almost immediately after a circuit disconnection, before oxygen desaturation becomes apparent. Pulse oximetry lags behind because of the oxygen reserve in the lungs. Blood pressure and temperature changes occur later.

Question 42Surgical Nursing and Anesthesia

Which action should the CVT take before a patient receives a spinal anesthetic?

  1. Administer a general anesthetic
  2. Verify informed consent and preload intravenous fluids as ordered Correct answer.
  3. Remove all intravenous access
  4. Position the patient prone

Explanation

Before a spinal anesthetic, the CVT verifies informed consent, confirms site and procedure, and administers preload fluids as ordered to reduce hypotension. Prone positioning and general anesthesia are not part of spinal preparation, and IV access must be maintained.

Question 43Surgical Nursing and Anesthesia

During a procedure, the surgeon requests a nerve stimulator to identify motor nerves. Which response should the CVT expect if the nerve is stimulated?

  1. A rise in end-tidal CO2
  2. Immediate bradycardia
  3. Muscle contraction in the innervated area Correct answer.
  4. Pupil dilation

Explanation

A nerve stimulator delivers a small current that causes muscle contraction when a motor nerve is stimulated, helping the surgeon locate nerves. The response is localized muscle twitching, not systemic changes such as bradycardia, EtCO2 rise, or pupil dilation.

Question 44Surgical Nursing and Anesthesia

Which patient factor most increases the risk of aspiration during anesthesia induction?

  1. Well-controlled hypertension
  2. History of seasonal allergies
  3. Full stomach and delayed gastric emptying Correct answer.
  4. Mild anemia

Explanation

A full stomach and delayed gastric emptying increase the volume and acidity of gastric contents, raising aspiration risk during induction. Hypertension, mild anemia, and seasonal allergies do not directly increase aspiration risk. Rapid sequence induction may be indicated.

Question 45Surgical Nursing and Anesthesia

A patient under general anesthesia has a core temperature of 34.5°C during a long open abdominal case. Which action should the CVT take?

  1. Apply forced-air warming and warm intravenous fluids Correct answer.
  2. Administer a cold fluid bolus
  3. Discontinue monitoring of temperature
  4. Lower the room temperature further

Explanation

Perioperative hypothermia is managed with active warming such as forced-air blankets and warmed intravenous fluids. Lowering room temperature or giving cold fluids worsens hypothermia. Temperature monitoring should continue to guide therapy.

Question 46Surgical Nursing and Anesthesia

Which finding suggests that a patient is experiencing an anaphylactic reaction during anesthesia?

  1. Isolated rise in end-tidal CO2
  2. Gradual bradycardia with hypertension
  3. Sudden hypotension with rash and bronchospasm Correct answer.
  4. Decreased peak airway pressure

Explanation

Anaphylaxis during anesthesia presents with sudden hypotension, bronchospasm, rash, and sometimes edema. Epinephrine is the first-line treatment. Gradual bradycardia with hypertension, isolated EtCO2 rise, and decreased airway pressure are not typical anaphylaxis findings.

Question 47Surgical Nursing and Anesthesia

Which action should the CVT perform when preparing the operating room for a patient with a documented latex allergy?

  1. Skip the allergy verification step
  2. Use standard gloves and supplies
  3. Use latex-free supplies and schedule the case first in the morning Correct answer.
  4. Place the patient near the supply room

Explanation

For latex-allergic patients, all latex-containing supplies should be removed and latex-free products used; scheduling the case first reduces airborne latex particles. Standard gloves and supplies may contain latex. Allergy verification must never be skipped.

Question 48Surgical Nursing and Anesthesia

Which statement about pulse oximetry is correct during a case with poor peripheral perfusion?

  1. The reading may be unreliable and should be correlated with clinical signs Correct answer.
  2. It directly measures arterial oxygen tension
  3. The reading is always accurate regardless of perfusion
  4. It replaces capnography for ventilation monitoring

Explanation

Pulse oximetry depends on adequate pulsatile flow, so poor peripheral perfusion, motion, or nail polish can make readings unreliable. It estimates oxygen saturation, not arterial oxygen tension, and does not replace capnography for ventilation. Clinical correlation is essential.

Question 49Surgical Nursing and Anesthesia

During a procedure under general anesthesia, the patient's blood pressure falls and heart rate rises after insufflation of the abdomen with carbon dioxide. Which cause should the CVT consider?

  1. Increased cardiac output
  2. Hyperthyroidism
  3. Decreased venous return from increased intra-abdominal pressure Correct answer.
  4. Vagal-induced bradycardia

Explanation

Carbon dioxide insufflation raises intra-abdominal pressure, which reduces venous return and can cause hypotension with compensatory tachycardia. The CVT should monitor hemodynamics and inform the anesthesia provider. Increased cardiac output, vagal bradycardia, and hyperthyroidism do not fit this pattern.

Question 50Surgical Nursing and Anesthesia

Which action should the CVT take first when a patient's cardiac rhythm on the monitor shows ventricular fibrillation during a monitored procedure?

  1. Record the rhythm and continue monitoring for a change
  2. Increase the oxygen flow rate and reassess in two minutes
  3. Start chest compressions and call for the defibrillator Correct answer.
  4. Reposition the ECG electrodes to confirm the rhythm

Explanation

Ventricular fibrillation produces no effective cardiac output, so it is a pulseless arrest rhythm that requires immediate CPR and rapid defibrillation. The CVT should begin compressions and summon the code team and defibrillator without delay, because survival falls with every minute defibrillation is postponed. Confirm pulselessness while compressions are already underway rather than delaying care to troubleshoot the monitor.