1. What is the most likely cause of post-operative hypoxemia
A.
B.
C.
D.
E.
Reduced functional residual capacity
Reduced minute ventilation
Reduced diffusion capacity
Reduced intrapulmonary shunting
Reduced mucociliary action
2. A 69 year old man undergoes an emergency laparotomy for perforated ulcer. That night in the
intensive care unit, he is noted to become belligerent and confused. The most probable reason
for such behavior include:
A.
B.
C.
D.
E.
ICU psychosis
Phenothiazine overdose
Acute stroke
Narcotic overdose
Alzheimer’s dementia
3. The goals of surgical history and physical exam includes the following:
A.
B.
C.
D.
E.
Document the condition of the patient at the time of admission
Record the medical conditions which have preceded the admission
Outline the reasons for admission
Summate the studies which confirm the admission diagnosis
All of the above
4. A 29 year old woman presents with small bowel obstruction. She has had nausea and
vomiting for the past 24 hours. The most likely electrolyte abnormality(ies) would include:
A.
B.
C.
D.
E.
Hyperkalemia
Hypernatremia
Hyponatremia
Hyperchloremia
Hypokalemia
5. During an operation on a patient with Hepatitis C you are punctured by a needle. What steps
should you follow:
A.
B.
C.
D.
E.
Replace your surgical gloves
Report the event to infection control nurse
Proceed to student health for inoculation
Ignore the event
Draw blood tests to determine if the virus can be detected in you.
6. Which if the following is characteristic of early postoperative renal function in response to major
surgery?
A.
B.
C.
D.
E.
Sodium retention
Potassium excretion
Water retention
Bicarbonate re-absorption
All of the above
7. A 57 year old woman with obstructing esophageal carcinoma is placed on TPN. With 25%
dextrose and 5% amino acid solution, supplemented with electrolytes and vitamins. Five days
later she becomes lethargic and confused. Her urine output is 3400 ml/24 hrs. The most likely
diagnosis is:
A.
B.
C.
D.
E.
Intravascular fluid overload
Hypernatremia
Hypophosphatemia
Diabetes mellitus
Hyperosmolar, nonketotic dehydration
8. The first therapeutic measure to improve cardiac output and blood pressure in septic shock is
intravenous
A.
B.
C.
D.
E.
Dopamine
Dobutamine
Nitroprusside
Amrinone
Saline
9. The most common cause of hypovolemic shock is
A.
B.
C.
D.
E.
Peritonitis
Burns
Hemorrhage
Sepsis
Spinal cord injury
10. Of the following, which is best for treatment of an anaerobic infection
A.
B.
C.
D.
E.
Ampicillin
Tobramycin
Metronidazole
Tetracycline
Erythomycin
11. The most common hospital acquired infection is
A.
B.
C.
D.
E.
Pneumonia
Wound infection
Urinary tract infection
Upper respiratory infection
Suppurative phlebitis
12. Age greater than 70 is a contraindication to which of the following operations?
A.
B.
C.
D.
E.
Aortic aneurysm repair
Kidney transplant
Coronary artery bypass
Rhytidectomy
None of the above
13. Concerning surgery in the elderly population when compared to a younger population:
A.
B.
C.
D.
E.
Complications are more frequent in the elderly
Complications are less frequent in the elderly
Surgery in elderly patients has the same complication rate as surgery in younger patients
Complication of surgery are more difficult for elderly patients to overcome
Recovery from complications is quicker in elderly patients
14. The primary reason for progress notes is
A.
B.
C.
D.
E.
To satisfy documentation requirements for billing
To communicate with other health care team members
To record your critique of the patient management
To document the progress of the patient’s treatment
To provide legal protection for the treating physician
15. Hypovolemic shock is characterized by
A.
B.
C.
D.
E.
Decreased PCWP with decreased CVP and elevated PVR
Decreased PCWP with decreased CVP and decreased PVR
Normal PCWP with normal CVP and decreased PVR
Elevated PCWP with elevated CVP and decreased PVR
Elevated PCWP with elevated CVP and elevated PVR
16. Of the following, which is the best means of nutritionally supporting a patient
A.
B.
C.
D.
E.
Peripheral parenteral nutrition (PPN)
Total parenteral nutrition (TPN)
Jejunostomy tube feeding
Gastrostomy tube feeding
Peripheral intravenous dextrose
17. Delirium tremens may involve any of the following characteristics except:
A.
B.
C.
D.
E.
Visual hallucinations
Tachycardia
Muscular tremors
Forgetfulness
Dysphoria
18. Necrotizing fasciitis typically will involve which of the following organisms
A.
B.
C.
D.
E.
Streptococcus
Vibrio
Helicobacter
Candida
Pseudomonas
19. Elective surgery following myocardial infarction should be postponed for
A.
B.
C.
D.
E.
2 months
3 months
6 months
12 months
18 months
20. Alveolar hypoventilation is diagnosed most reliably by
A.
B.
C.
D.
E.
Observing the patient’s breathing
Measuring minute ventilation
Spirometry
Measuring arterial oxygen tension (PaO2)
Measuring arterial carbon dioxide tension (PaCO2)
Answer Key
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
A
A
E
E
B, C, E
E
E
E
C
C
C
E
D
D
A
D
A, B, C, E (Ok on 1st - Monday- version)
A
C
E