-absorbent canister, the greatest amount of carbon monoxide is produced by
which of the following volatile agents?
1. C. Pipeline gases are supplied at pressures between 45 and 55 psi. This is in
contrast to cylinder gas pressures, which are much higher, and are reduced by
pressure regulators to less than 50 psi.
2. D. The fail-safe valve automatically closes nitrous oxide (and other gases) to
prevent delivery of hypoxic gas mixture to the patient. The fail-safe valve is
designed to be activated when oxygen pressure falls below 25 psi.
3. C. The oxygen-flush valve provides gas flow at pipeline pressures of about 45 to
55 psi at 35 to 75 L/min. The high flow of oxygen is provided directly to the common
gas outlet, bypassing the flowmeters and vaporizers. One should be careful when
using the oxygen-flush valve, as high gas flows at high pressures can cause lung
4. A. Gas flowmeters are calibrated for a particular gas. Gas flow rate depends on its
viscosity at low laminar flows, and its density at high turbulent flows. Flowmeters
are tapered in shape, with the diameter the smallest near the bottom of the tube.
5. B. The oxygen flowmeter is situated nearest to the gas outlet. This is because, if a
leak develops in the flowmeter tubes, a hypoxic gas mixture can be delivered to the
patient. To minimize this, the oxygen flowmeter is positioned downstream and
6. D. Modern vaporizers are agent-specific and temperature-compensated. Also,
specific fillers are available for each volatile agent, which prevent filling on the
wrong agent. A constant concentration of agent is delivered, unaffected by
temperature or flow rates. Temperature compensation is achieved by a metallic strip
composed of two different metals, which expands/contracts to deliver a constant
7. A. The Tec 6 desflurane vaporizer is electrically heated to 39°C and pressurized to
2 atm. This is done because desflurane boils at room temperature at sea level (1
atm). The heating and pressurization optimizes the delivery of desflurane.
8. B. Vaporizers are located between the flowmeters (upstream) and the common gas
outlet (downstream). In other words, vaporizers are located outside the circle system.
This decreases the likelihood of delivery of high vapor concentrations when using the
9. A. An ascending bellow collapses when disconnection occurs. A descending
bellow, however, continues to fill by gravity when disconnection occurs. Therefore,
ascending bellows are preferred for anesthesia ventilators.
10. B. NIOSH recommends limiting operating-room concentration of nitrous oxide to
25 ppm. Minimizing operating-room pollution is important to prevent health-related
effects in health-care providers. Waste-scavenging systems are utilized to decrease
11. D. NIOSH recommends limiting operating-room concentration of volatile agents to
2 ppm. Minimizing operating-room pollution is important to prevent health-related
effects in health-care providers. Waste-scavenging systems are utilized to decrease
12. C. The capacity of an “E” cylinder of oxygen is about 625 to 700 L. The pressure
in a full cylinder is about 1,800 psi at 20°C. Cylinders are color-coded, with oxygen
being green, nitrous oxide being blue, and air being yellow.
13. D. Pressure in a half-full “E” cylinder of nitrous oxide will still be 745 psi. Nitrous
oxide is present in the cylinder as a liquid, and therefore, the volume remaining in the
cylinder does not reflect the pressure in the cylinder. Capacity of an “E cylinder” of
nitrous is about 1590 L. It is not until three-fourth of the gas is consumed (about 400
L remaining) that the pressure in the cylinder begins to fall. Therefore, the reliable
way to determine the remaining nitrous oxide in the cylinder is to weigh the cylinder.
The empty weight of the cylinder is stamped on the cylinder.
14. B. Cylinder manufactures have adopted the pin index safety system, which
prevents attachment of wrong gas cylinder to the anesthesia machine. The diameter
index safety system prevents attachment of the wrong gas hose from the wall supply.
Hanger yoke assembly is the method of attachment of gas cylinders to the anesthesia
15. B. A line-isolation monitor, when alarming, indicates that a single fault has
occurred between the power line and the ground. As soon as the alarm is triggered,
the equipment should be checked, especially the last equipment that was plugged in.
A single fault does not cause an electrical shock, as two faults are required to
16. A. The highest content of soda lime is calcium hydroxide (75%). Other constituents
include sodium (3%) and potassium hydroxide (1%), water (20%), and silica, which
is added to produce hardness. An indicator dye, such as ethyl violet, is added to
indicate the degree of exhaustion.
17. D. End products of the reaction occurring in a soda lime CO2 canister are
carbonates, sodium hydroxide (regeneration), water, and heat. Following are the
18. B. Advantages of a circle system include the use of low fresh gas flow rates
because of the presence of a CO2
-absorbent canister. However, if the CO2 absorbent
is exhausted during a surgical procedure, the fresh gas flow rate has to be increased.
A minimum fresh gas flow rate of 5 L/min will make the use of the absorbent
unnecessary. Newer anesthesia machines allow changing the CO2
during the surgical procedure, if necessary.
19. D. Advantages of the circle system include economy (low fresh gas flow rates,
decreased use of volatile agents), conservation of heat and humidity, and decreased
operating-room pollution. Disadvantages of circle system include greater size,
decreased portability, increased risk of disconnection, and increased resistance to
20. A. While resuscitation devices such as Ambu bags or bag-mask units have
nonrebreathing valves, neither the Mapleson (only has adjustable pressure-limiting
valve) nor the circle system (only has unidirectional valves and does allow
valve has low resistance, but can become obstructed by exhaled moisture. Ambu
bags have a reservoir system to prevent room air entrapment and are able to deliver
21. D. One advantage of the circle system ventilation when compared to the Mapleson
system is the presence of unidirectional valves (inspiratory and expiratory valves).
With the use of such valves, the volume of dead-space ventilation is limited only to
that volume distal to Y-piece (including the endotracheal tube), where inspiratory and
expiratory gases mix and converge, regardless of the length of tubing proximal to the
Y-piece (to the anesthesia machine).
22. C. Malfunction in either of the unidirectional valves within a circle system could
result in the accumulation and eventual CO2
rebreathing that may result in
23. A. During spontaneous ventilation/breathing of the patient, the Mapleson circuit
providing for the most efficacy ranges from A > D > C > B (in the order of
24. A. The efficiency of Mapleson systems drops from D > B > C > A for controlled
ventilation. The Mapleson D circuit is most efficient during controlled ventilation, as
its fresh gas flow drives expired air away from the patient and toward the
25. A. Sevoflurane is degraded by soda lime, resulting in the production of a
potentially nephrotoxic compound A. Compound A production is increased by using
low fresh gas flow rates, using high concentrations of sevoflurane, and for long hours
26. D. Desflurane produces the highest amount of carbon monoxide in the CO2
absorbent canister, which can increase carboxyhemoglobin blood concentration.
Production of carbon monoxide is increased by using low fresh gas flow rates, high
concentrations of volatile agent, and a dry absorbent.
Darren Hyatt, Ala Nozari, and Edward Bittner
1. To help encourage universal quality and safety practices, the ASA has adopted and
mandates the use of all the following monitors during general anesthesia, except
C. Continuous visual display of an ECG
D. A peripheral nerve stimulator
2. Current ASA standards require that during anesthesia, systemic blood pressure and
heart rate be evaluated at least every
3. Lead II of an ECG is represented by placing the
A. Positive electrode on the right arm and the negative electrode on the left leg
B. Negative electrode on the right arm and the positive electrode on the left leg
C. Positive electrode on the right arm and the negative electrode on the left arm
D. Negative electrode on the right arm and the positive electrode on the left arm
4. During the course of a complicated cardiac case, the surgeon informs you that he is
worried about damage to the right coronary artery in a patient with a right-dominant
coronary system. During reperfusion, you are looking for signs of ischemia, and are
5. Use of lead V5 alone on ECG results in the detection of _____ (%) of ischemic
6. You are taking over a case from another anesthesia provider with a patient in the
beach chair position and a history of moderate carotid artery disease. You are told
during pass-off that the patient’s blood pressures have consistently been 90/50 mm
Hg. You notice the blood pressure cuff on the left arm is one or two sizes small and
barely stays on the patient. A blood pressure cuff that is too small will
A. Incorrectly underestimate the true blood pressure
B. Incorrectly overestimate the true blood pressure
C. Randomly both over- and underestimate the true blood pressure
D. Not give an incorrect blood pressure, but will be uncomfortable in an awake
7. When performing the oscillometric method to measure blood pressure, for example,
when you do not have a stethoscope or automated blood pressure cuff, it is important
to remember that you will not be able to measure the
D. Diastolic or mean arterial blood pressure
8. The diastolic blood pressure recorded with an automated blood pressure cuff using
the oscillometric method will be
A. Approximately 10 mm Hg higher when compared to direct arterial measurement
B. Approximately 10 mm Hg lower when compared to direct arterial measurement
C. Equal to direct arterial measurement
9. When measuring blood pressure manually and listening for Korotkoff sounds, the
diastolic blood pressure is measured at the onset of
10. You are preparing for an emergent mitral valve repair that will need to be done on
cardiopulmonary bypass (CPB). While on CPB
A. A pulse oximeter can be used to monitor oxygen saturation
B. A noninvasive blood pressure cuff can be used to monitor perfusion pressures
C. An arterial line can be used to measure perfusion pressures
11. The incidence of distal ischemia resulting from arterial cannulation is less than
12. When considering the advantages and disadvantages of different sites for arterial
cannulation such as radial, ulnar, femoral, brachial, and dorsalis pedis, the
A. Radial artery provides the principal source of blood to the hand
B. Cannulation of ulnar artery is commonly associated with damage to the median
C. Dorsalis pedis artery is commonly used during emergencies and low-flow states
D. Cannulation of the femoral artery risks local and retroperitoneal hematoma
13. Systolic blood pressures are generally higher and diastolic blood pressures are
generally lower in which of the following conditions?
A. The further you are from the heart when using a direct arterial measurement
B. The closer you are to the heart when using a direct arterial measurement
C. When using an automated noninvasive blood pressure cuff compared to a direct
D. When recording from an over dampened arterial tracing
14. While taking care of a patient, you notice that the arterial monitor transducer has
slipped off its stand and is hanging approximately 30 cm lower than where it was
originally leveled. This would correspond to a blood pressure reading that is
A. 30 mm Hg lower than the actual pressure
B. 30 mm Hg higher than the actual pressure
C. 22 mm Hg lower than the actual pressure
D. 22 mm Hg higher than the actual pressure
15. An important consideration in using the subclavian approach for central venous
A. Ease of compressibility if a hematoma or laceration develops
B. Lower risk of pneumothorax when compared to internal jugular approach
C. Ability of the vessel to remain patent in the setting of hypovolemia
D. Increased risk of damaging the brachial plexus when compared to internal
16. When interpreting a CVP waveform, the end of systole best coincides with the
17. When interpreting a CVP waveform, the beginning of systole is best represented by
18. After placing a central line in an unstable patient in the ICU, you notice the initial
CVP tracing shows very prominent C–V waves. If an echocardiogram was then
obtained, you might expect to find
B. Significant tricuspid regurgitation
19. You receive a patient from the emergency department with multiple stab wounds to
the upper abdomen. The patient is unstable, and needs to emergently come to the
operating room with minimal to no time for fluid resuscitation. After placing a central
line, you notice loss of the Y descent on the CVP tracing, as well as universally
elevated filling pressures. If you were to then do an echocardiogram, you might
expect to find which of the following?
B. Significant tricuspid regurgitation
C. Descending thoracic aortic dissection
20. The risk of complication from pulmonary artery catheter placement is less than
21. Insertion of a pulmonary artery catheter can be beneficial in the management of all of
A. Helping to determine cardiogenic versus noncardiogenic pulmonary edema
B. Following cardiac output in an unstable patient with acute-onset tricuspid
C. Following the response to therapy in a patient with severe pulmonary
D. Following response to therapy in an unstable septic patient using mixed venous
22. During placement of a pulmonary artery catheter, you are watching the pressure
tracing, as shown. At the point indicated by the arrow, the catheter tip is located in
23. The tip of a pulmonary artery catheter typically enters the pulmonary artery at
24. Typical mixed venous oxygen tension in a healthy adult is
25. A pulmonary artery catheter is placed to help guide management of hypotension.
Cardiac output is found to be markedly decreased with low central venous,
pulmonary artery, and pulmonary artery occlusion pressures. Systemic vascular
resistance is moderately elevated. Of the options listed below, the most beneficial
intervention at this time would be to
C. Start an infusion of milrinone
D. Start an infusion of epinephrine
26. A pulmonary artery catheter is placed to help guide management of an obese patient
with a known history of poorly controlled obstructive sleep apnea who is admitted
with refractory hypotension. Cardiac output and pulmonary artery occlusion
pressures are markedly decreased, while central venous and pulmonary artery
pressures are markedly increased. Of the options listed below, the most beneficial
intervention at this time would be to
C. Start an infusion of milrinone
D. Start an infusion of epinephrine
27. Normal systemic vascular resistance ranges between ______ (dynes)(s)/cm5
28. Normal pulmonary vascular resistance ranges between ______ (dynes)(s)/cm5
29. The cardiac index in a healthy adult ranges between ______ L/min/m2
30. Serious complications with transesophageal echocardiography (TEE), such as oral or
pharyngeal injury or esophageal rupture, have an incidence as high as
31. When evaluating regurgitant lesions with transesophageal echocardiography, the
Nyquist limit should be set between ______ cm/s:
32. When evaluating flow at a specific point during echocardiography, you would use
D. Pulse-wave or continuous-wave Doppler
33. Pulse oximetry illuminates tissue samples with two wavelengths of light in order to
calculate oxygen saturation. These wavelengths are ______ nm:
34. The accuracy of pulse oximetry can be significantly reduced by all of the following,
A. Intravenous bolus of methylene blue
B. Intravenous bolus of heparin
35. A patient with carboxyhemoglobin will have a pulse oximetry reading that
A. Converges around a saturation of 85%
B. Converges around a saturation of 65%
C. Converges around a saturation of 45%
36. A patient with methemoglobinemia will have a pulse oximetry reading that
A. Converges around a saturation of 85%
B. Converges around a saturation of 65%
C. Converges around a saturation of 45%
37. For the removal of a complex spinal cord tumor, the surgeon expresses concern of
damage to the anterior spinal artery. The monitoring that would be helpful to
determine viability of the anterior spinal cord intraoperatively would include
C. Somatosensory-evoked potentials
D. Bispectral index or Sedline monitoring
38. A sudden drop in somatosensory-evoked potentials (SSEPs) would cause you to be
A. Damage to the anterior spinal artery
B. Damage to the posterior spinal arteries
C. An insufficient depth of anesthesia
D. The inadvertent administration of a neuromuscular blocking agent
39. During cervical spine surgery for the resection of an intradural mass, the patient
begins to cough. The concentration of isoflurane is subsequently increased. With
respect to somatosensory-evoked potential (SSEP) monitoring, you would expect
A. Amplitude and latency to decrease
B. Amplitude and latency to increase
C. Amplitude to decrease and latency to increase
D. Amplitude to increase and latency to decrease
40. While monitoring somatosensory-evoked potentials, an increase in amplitude is
noted. Of the options listed below, the most likely medication to have caused this
increase in amplitude would be
41. If somatosensory-evoked potentials change significantly, the anesthesia provider
B. Hyperventilating the patient
42. In the capnogram below, the segment that correlates with the exhalation of anatomic
dead space is represented by points
43. In the capnogram (Fig. 4-2), the segment correlating with inspiration is represented
44. Capnography can help detect all of the following, except
45. The capnograph depicted in Figure 4-3 is most likely a result of
B. Bronchospasm or airway obstruction
D. Elimination of neuromuscular blockers
46. Approximately 30 minutes after the induction of general anesthesia in a healthy adult
patient, you notice that core body temperature has dropped by a full degree Celsius.
47. According to the American Society of Anesthesiologists, temperature monitoring is
B. Never required, but recommended
C. Required for all general anesthetics, however not required for sedation
D. Up to the discretion of the anesthesia provider
48. Detrimental effects of hypothermia include all of the following, except
A. Increasing cerebral oxygen consumption
B. Increasing surgical site infections
C. Impairment of platelet function
D. Increasing the duration of action of muscle relaxants
49. During a complex mitral valve replacement, it is determined that the patient will
benefit from brief protective hypothermia. Of the options listed below, core
temperature is best measured via the
50. While monitoring a patient for return of neuromuscular function after using
rocuronium, you notice the patient has regained four twitches using train of four
stimulations. With four twitches on train of four stimulations, the patient may still
have blockage of acetylcholine receptors of up to
1. D. ASA standards mandate the use of pulse oximetry, capnography, an oxygen
analyzer in the breathing system, disconnect alarms, a visual display of an ECG,
systemic blood pressure and heart rate monitoring, and temperature monitoring (when
clinically indicated) for all cases. The use of a peripheral nerve stimulator is not a
2. B. During the delivery of anesthesia, the current standard of care is to measure
systemic blood pressure and heart rate every 5 minutes at a minimum. The clinical
scenario and phase of the operation may mandate more frequent monitoring, which is
up to the judgment of the anesthesia provider.
3. B. Lead I correlates with the placement of the negative electrode on the right arm
and the positive electrode on the left arm. Lead II correlates with the placement of the
negative electrode on the right arm and the positive electrode on the left leg. Lead III
correlates with the placement of the negative electrode on the left arm and the
positive electrode on the left leg.
4. C. The understanding of coronary anatomy and regions of ischemia on an ECG is
fundamental. The right coronary artery provides perfusion to the inferior of the heart
in approximately 80% of patients who are considered to be right-dominant (the
The anterior wall is supplied by the left anterior descending artery, and is represented
roughly by leads V1–V4. The lateral wall of the heart is supplied primarily by the
left circumflex artery, and is represented by I, AvL, V5, and V6.
5. C. The use of the V5 lead results in the detection of 75% of ischemic episodes.
This can be increased to 90% with the addition of the V4 lead, and up to 96% with
the addition of leads II and V4.
6. B. A properly-sized noninvasive blood pressure cuff should encompass 40% of the
circumference of the arm. A cuff that is too small will result in a reading that is
incorrectly high, whereas a cuff that is too large will result in a lower-than-accurate
pressure. This is particularly worrisome in this patient when considering her cerebral
perfusion pressure, since she already has a history of carotid artery disease and is in
7. B. When using the oscillometric method to measure blood pressure, the cuff is
inflated until no oscillations on the sphygmomanometer are seen. The cuff is then
slowly deflated until oscillations are seen, which represents the systolic blood
pressure. As the cuff continues to be deflated, you note the point where maximal
oscillations occur. This point of maximal oscillation represents the mean arterial
pressure. It is not possible to measure a diastolic blood pressure with the
8. A. The DINAMAP (device for indirect noninvasive automatic mean arterial
pressure) method for measuring blood pressure uses an automated cuff that measures
oscillometric variations with reduction in cuff pressure to calculate systolic, mean,
and diastolic pressures. In general, diastolic measurements with DINAMAP are
about 10 mm Hg higher with automated as opposed to direct arterial measurement,
whereas systolic and mean pressures tend to correlate well.
9. D. Korotkoff sounds are used to interpret blood pressure when using a stethoscope
and a noninvasive blood pressure cuff, and is described in 5 phases of sound. Phase
1 heralds the onset of the first sound heard and correlates with the systolic blood
pressure. Phase 5 occurs at the cuff pressure at which the sound first disappears, and
is the phase recommended by the American Heart Association to correspond most
reliably with the diastolic heart sound. In cases where Phase 5 does not occur (the
sound never fully disappears), Phase 4 is then used to represent the diastolic blood
pressure, and is described as a thumping or muting of the sound just before diastole.
Phases 2 and 3 have no clinical significance.
10. C. Both pulse oximetry and noninvasive blood pressure cuffs require pulsatile
blood flow in order to obtain measurements. These monitors will not be effective
during CPB when blood flow is artificially sustained with a more continuous flow.
This can also be the case with some patients on left ventricular assist devices, and
venous to arterial extracorporeal membrane oxygenation devices, where pulsatile
11. C. Complications from arterial cannulation include distal ischemia (<0.1%),
infection, and hemorrhage. Common sites for cannulation include radial, brachial,
axillary, dorsalis pedis, and femoral arteries. Common indications for direct blood
pressure monitoring include cardiopulmonary bypass, when wide swings in BP are
expected, when rigorous control of BP is necessary, and when there is need for
multiple arterial blood gas measurements.
12. D. The ulnar artery is the principal source of blood flow to the hand. Hence radial
artery cannulation is much more commonly used for invasive blood pressure
monitoring. Cannulation of the brachial artery risks damage to the median nerve. The
femoral artery is often used in emergencies, since it is a large vessel and can still be
identified in low flow states. Cannulation of the femoral artery risks both local and
retroperitoneal hematoma. Dorsalis pedis artery cannulation, while not ideal since it
is far from the central circulation, can reliably measure mean arterial pressure.
13. A. Systolic blood pressures are generally higher and diastolic blood pressures are
generally lower the further you are from the heart when using direct invasive arterial
measurement. For example, when comparing a dorsalis pedis arterial measurement to
a femoral arterial measurement, the dorsalis pedis will record higher systolic and
lower diastolic pressures compared to the femoral line. However, the mean arterial
pressures will be approximately the same. A noninvasive automated blood pressure
cuff will tend to correlate with systolic arterial blood pressures, but the diastolic
pressure will be approximately 10 mm Hg lower when measured via the direct
invasive arterial monitor. An over dampened arterial line tracing will tend to reduce
systolic pressures and increase diastolic pressures.
14. D. For every 30 cm in height that a transducer is moved up and down, there is a
corresponding change of 22 mm Hg in the blood pressure reading (1 cm H2O = 0.74
15. C. Risks and benefits of different central cannulation sites are important for an
anesthesia provider to understand. The internal jugular approach has good landmarks,
predictable anatomy, and the convenience of being easily accessible at the head of
the bed. Disadvantages include risk of carotid artery puncture, trauma to the brachial
plexus, and risk of pneumothorax with lower placements. The left internal jugular
vein carries the added risk of damage to the thoracic duct, and can be more difficult
to pass a pulmonary artery catheter when needed. The external jugular vein can also
be cannulated, and its superficial location makes it an easy target, but it can be more
difficult to thread a catheter centrally. The subclavian approach has the benefit of
also having good landmarks, as well as remaining relatively patent in a hypovolemic
patient. The subclavian however does carry the highest risk of pneumothorax, and
can be difficult to compress if a hematoma or laceration occurs.
16. C. In the CVP waveform depicted below, the A wave represents atrial contraction,
the C wave represents bulging of the tricuspid valve into the atrium during the
beginning of systole, the X decent occurs during systole and corresponds to atrial
relaxation, the V wave represents filling of the atrium while the tricuspid valve is
closed, and the Y descent occurs when the tricuspid valve opens and the atrium starts
17. B. In the CVP waveform depicted in Figure 4-4, the A wave represents atrial
contraction, the C wave represents bulging of the tricuspid valve into the atrium
during the beginning of systole, the X decent occurs during systole and corresponds
to atrial relaxation, the V wave represents filling of the atrium while the tricuspid
valve is closed, and the Y descent occurs when the tricuspid valve opens and the
18. B. During systole in a patient with tricuspid regurgitation, part of the ejected
volume flows backward into the atrium. Instead of seeing a small C wave that
normally represents the bulging of the tricuspid valve, a much larger C wave would
be seen as blood flows retrograde into the right atrium and toward the transducer.
This retrograde blood flow would continue throughout the systole, and would,
therefore, also increase the V wave size, since this is a systolic component of the
CVP trace. During cardiac tamponade, there will be elevated pressures throughout
the entire waveform, as well as loss of the Y descent. In patients with atrial
fibrillation, there will be a loss of the A wave, since there is no longer a uniform
atrial contraction, and an overall increase in the C wave size, since filling pressures
elevate to compensate and improve ventricular filling. With AV dissociation, there
are large and exaggerated A waves (often called “cannon” A waves), which represent
atrial contraction against a closed tricuspid valve.
19. A. See the answer explanation of Question 18. It would be highly unlikely to have
elevated filling pressures in a bleeding trauma patient who has not yet been
resuscitated. Aortic dissections can cause cardiac tamponade, but only if they
involve the aortic root and then extend into the pericardium.
20. B. While the incidence of complications is infrequent, some of the complications
can carry severe morbidity and mortality risks. In addition to universal complications
associated with central line placement, some additional pulmonary artery catheter
complications include dysrhythmias (most common), catheter knotting, cardiac valve
injury, pulmonary artery rupture, development of complete heart block in a patient
with preexisting left bundle branch block, pulmonary thromboembolism or air
embolism, bacteremia, endocarditis, and sepsis.
21. B. As well as knowing some valuable indications, it is important to know some of
the limitations of a pulmonary artery catheter before subjecting a patient to risks. For
example, the measurement of cardiac output in patients with tricuspid regurgitation or
ventricular septal defects is inaccurate due to dilution of the injectate. Pulmonary
artery occlusion pressure can also inaccurately represent left ventricular end
diastolic pressure in patients with mitral stenosis, left atrial myxomas, pulmonary
venous obstruction, elevated alveolar pressures, and decreased left ventricular
compliance. Other common errors in measurement that are not patient dependent can
include an inaccurate volume or temperature of the injectate solution.
22. B. A pulmonary artery catheter is placed while monitoring the pressure changes
measured at the tip of the catheter. The first section shows a traditional CVP
pulmonary artery, and a return to a traditional CVP waveform when entering the
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