SELF/Anesthesia and Critical Care/Spinal Anesthesia/Spinal Anesthesia Final Test

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Instructions

Work through each question carefully to choose the best answer, and submit the quiz to view your results. After completing the quiz, read through the answer explanations to review the reasoning behind both correct and incorrect options.

A 67-year-old man with severe aortic stenosis is scheduled for elective hernia repair. Which anesthetic plan is most appropriate?

	Proceed with spinal anesthesia but reduce the dose of bupivacaine to minimize sympathetic block and accept a lower block height.
	Prefer general anesthesia because severe aortic stenosis represents a high-risk fixed cardiac output state and relative contraindication to spinal anesthesia.
	Proceed with spinal anesthesia using a standard dose of hyperbaric bupivacaine, relying on fluid pre-loading and vasopressors to manage hypotension.
	Perform spinal anesthesia at the L2–L3 interspace to obtain a higher block with a smaller dose and reduce cardiovascular instability.

A woman scheduled for elective cesarean section asks what she will feel during the spinal and how long the block lasts.

	“You will lose pain and movement below the injection level, but you may feel pressure or movement; recovery should occur over 2–3 hours.”
	“You will be completely numb and should not feel anything at all; if you feel anything, the block has failed.”
	“You will be conscious only for the first part of surgery; then we give extra drugs so that you sleep.”
	“You may feel discomfort during the procedure, but this is preferable to the risks of general anesthesia.”

In a district hospital with limited monitoring, which strategy best follows spinal anesthesia guidance?

	Cancel the spinal and insist on general anesthesia only when full monitoring becomes available.
	Use manual BP readings every 10–15 minutes, rely on clinical observation, and omit pulse oximetry to save the battery.
	Proceed without routine BP checks if the patient remains conversant and appears well perfused.
	Use manual BP every 2–3 minutes early in the block, assess pulse, apply pulse oximetry, and prepare supplies in sequence on one sterile field.

Ten minutes after spinal anesthesia, sensory level reaches T6 and the patient reports dyspnea. What is the best next step?

	Sit the patient up to reverse spread and wait for improvement.
	Recognize high spinal, provide airway support, prepare for intubation, and support blood pressure.
	Administer more intrathecal local anesthetic to deepen the block.
	Reassure the patient that T6 block is expected and provide oxygen only.

Five minutes after spinal anesthesia, the patient becomes hypotensive and bradycardic but remains alert. What is the appropriate management?

	Rapid IV crystalloid bolus, vasopressor therapy, and atropine for persistent bradycardia.
	Convert to general anesthesia because the block has failed.
	Place the patient in Trendelenburg and wait for spontaneous improvement.
	Give a diuretic to reduce preload.

Four hours after spinal anesthesia, a patient has unilateral persistent weakness and numbness. What should be done?

	Reassure the patient that unilateral recovery is common.
	Administer IV fluids and encourage movement.
	Wait 4–6 more hours before escalating.
	Urgently escalate for imaging due to concern for hematoma or nerve injury.

Ten minutes after spinal anesthesia for TURP, sensory level is T10 and hip flexion persists. What should you do?

	Start the procedure; T10 is sufficient for urologic surgery.
	Convert to general anesthesia because TURP requires a higher block (T6–T8).
	Delay incision and wait for more cephalad spread.
	Redose intrathecally to increase block height.

During an urgent cesarean section, the patient asks what can go wrong with the spinal. What is an appropriate response?

	“We don’t have time for details; trust us.”
	“Spinal anesthesia has essentially no risk.”
	“You will be numb from the waist down; risks include hypotension, bradycardia, headache, urinary retention, rare nerve issues, and possible conversion to general anesthesia.”
	“The only important risk is low blood pressure.”

In an obese patient with degenerative lumbar disease, landmarks are difficult. What is the best technique?

	Use L1–L2 because degenerative changes shift structures.
	Use Tuffier’s line to identify L4 and attempt a paramedian approach at L3–L4 or L4–L5.
	Insert the needle at L5–S1 to bypass lumbar anatomy.
	Default to general anesthesia because obesity contraindicates spinal.

You feel the expected ligament “pops” but no CSF flow appears. Minor adjustments fail. What is the next step?

	Inject anyway if confident in your trajectory.
	Advance further until CSF appears.
	Inject through the stylet once resistance falls.
	Remove and reattempt at a different interspace rather than injecting blindly.

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Keywords	surgery, health
SDG	SDG03 Good health and well-being
Authors	Global Surgical Training Challenge
License	CC-BY-SA-4.0
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Language	English (en)
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Created	November 22, 2025 by Fabrice Sodogas
Last edit	March 8, 2026 by Ian-laurel
Cite as	Fadogas (2025–2026). "SELF/Anesthesia and Critical Care/Spinal Anesthesia/Spinal Anesthesia Final Test". Appropedia. Retrieved June 4, 2026.
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