Which of the following is most effective for maintaining core body temperature in an adult during general anesthesia for foot surgery?
(A) Heating inspired gas to 28°C
(B) Warming intravenous fluids to 30°C
(C) Increasing ambient temperature to 28°C
(D) Placing a warming blanket beneath the patient
(E) Placing four 200-watt warming bulbs within 76 cm of the wound
C
A 4-year-old child has just undergone a one-hour tonsillectomy with a volatile anesthetic, nitrous oxide, and oxygen. Which of the following will result in the most rapid emergence?
You see a flash of fire from the endotracheal tube of a patient undergoing carbon dioxide laser excision of laryngeal polyps. The immediate response should be to
(A) discontinue the fresh gas flow
(B) increase the nitrous oxide concentration
(C) spray water down the endoscope
(D) insert wet pads into the pharynx
(E) remove the endotracheal tube
E
A moderately obese 38-year-old woman is using patient-controlled morphine analgesia one day after open cholecystectomy. While breathing room air, oxygen saturation is 85%, Pa02 is 48 mmHg, PaC02 is 42 mmHg, and pH is 7.36. In addition to administration of oxygen, the most effective management is to
(A) decrease the dosage of opioids
(B) change to epidural morphine
(C) administer an inhaled bronchodilator
(D) initiate 4 cm of nasal continuous positive airway pressure
(E) initiate incentive spirometry therapy
E
A sensory level of T2 is achieved after administration of spinal anesthesia. Which of the following lung volumes is LEAST likely to be affected?
A 75-year-old man is confused, restless, and disoriented two days after an aortic aneurysm repair. Serum sodium concentration is 112 mEq/L, serum osmolality is low, and urine is hypertonic. The most appropriate treatment is
(A) restriction of fluid intake
(B) administration of isotonic saline solution
(C) administration of hypertonic (3%) saline solution
(D) administration of spironolactone
(E) infusion of mannitol 25 g
C
A 25-year-old woman undergoes a difficult open cholecystectomy during anesthesia with isoflurane, nitrous oxide, fentanyl, and vecuronium. Five units of blood are administered intraoperatively. Two days later, the patient has mildly increased serum transaminase concentrations and markedly increased alkaline phosphatase and direct bilirubin concentrations. Which of the following is the most likely cause?
Failure to block the musculocutaneous nerve adequately during the axillary approach to brachial plexus block will result in inadequate anesthesia of the