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NEWEST NBCRNA EXAM WITH COMPLETE SOLUTIONS 100% VERIFIED 2026-2027!! Pharmacologic characteristics that BEST describe the effect of naloxone at opioid receptors include: (select 2) A. affinity. B. intrinsic activity. C. reversibility. D. stereo selectivity. A,c Abnormal placental implantation beyond the endometrium include: (select 2) A. Abruptio placentae B. Placenta accreta C. Placenta increta D. Placenta previa Bandc Characteristics of Eaton-Lambert syndrome include (select 3): A. Positive response to anti cholinesterase agents B. Improved strength with activity C. Reduced acetylcholine release D. Destruction of acetylcholine receptors E. Postjunctional defect F. Sensitivity to all muscle relaxers B,C, F Considerations for the management of a patient with myotonic dystrophy under general anesthesia should include a (an): A. anticholinesterase reversal B. midazolam premedication C. short-acting nondepolarizer D. succinylcholine infusion c Which neuromuscular blocking agent is a benzylisoquinoline compound? A. Vecuronium B. Succinylcholine C. Pancuronium D. Mivacurium D Which is the first sign of magnesium toxicity when used for seizure prophylaxis in preeclampsia? A. Respiratory depression B. Hypotension C. Cardiac conduction defects D. Loss of deep tendon reflexes D Intrathecal narcotic administration is associated with: A. loss of proprioception. B. skeletal muscle weakness. C. altered pain perception. D. sympathetic nervous system denervation. c The BEST indicator for CAD in the pre-operative assessment for vascular surgery patients is: A. electrocardiogram. B. history and physical. C. presence of S3 gallop. D. exercise tolerance. D Which are the hemodynamic goals during anesthetic management of the patient with hypertrophic cardiomyopathy? (select 2) A. Decrease contractility B. Decrease preload Place the Muscles in the Left Column and Actions in the Right Column. In order to revise your selection, click on the box and select the blue arrow that appears on the bottom right corner to deselect your original answer. Muscle: Cricothyroid Muscle: Lateral cricoarytenoid Muscle: Thyroarytenoid Muscle: Posterior cricoarytenoid Action: Adducts Action: Relaxes Action: Elongates Action: Abducts Match the appropriate laboratory test to the coagulation-related event. Place the Laboratory Tests in the Left Column and Events in the Right Column. In order to revise your selection, click on the box and select the blue arrow that appears on the bottom right corner to deselect your original answer. Lab Test: Bleeding time Lab Test: Prothrombin time Lab Test: Partial thromboplastin time Lab Test: D-dimer Event: Warfarin administration Event: Active fibrinolysis Event: Heparin infusion Event: Nonsteroidal antiinflammatory use Match each blood gas partition coefficient with its corresponding inhalation agent. Place the Coefficients in the Left Column and Inhalation Agent in the Right Column. In order to revise your selection, click on the box and select the blue arrow that appears on the bottom right corner to deselect your original answer. Coefficient: 1.46 Coefficient: 0.46 Coefficient: 0.69 Coefficient: 0.42 Inhalation Agent: Sevoflurane Inhalation Agent: Nitrous Oxide Inhalation Agent: Isoflurane Inhalation Agent: Desflurane Match the image of each needle to its name. Place the Needle Names in the Left Column and Images in the Right Column. In order to revise your selection, click on the box and select the blue arrow that appears on the bottom right corner to deselect your original answer. Needle: Sprotte Needle: Whitacre Needle: Tuohy Needle: Quincke Match the twitch response with its corresponding nerve origin. Place the Twitch Responses in the Left Column and Nerve Origins in the Right Column. In order to revise your selection, click on the box and select the blue arrow that appears on the bottom right corner to deselect your original answer. Twitch: Adductor twitch Twitch: Quadriceps twitch Twitch: Dorsiflexion Twitch: Plantar Flexion Nerve Origin: Obturator Nerve Origin: Tibial Nerve Origin: Peroneal Nerve Origin: Femoral In the figure below, click on the nerve that may be compressed during mediastinoscopy. In order to revise your selection, click on the center of the crosshairs to deselect your original answer. In supine position under mechanical ventilation, a normal tidal volume, in milliliters, for an 80-kg adult is: 240. 400. 600. 950. 600 Ventilation-perfusion changes seen in the anesthetized patient in the lateral position are caused by an increase in: (select 2) A. blood flow to the dependent lung. B. blood flow to the nondependent lung. C. ventilation to the dependent lung. D. ventilation to the nondependent lung. A,D The MOST appropriate treatment for a 75-kg male who develops a laryngospasm that cannot be relieved with continuous positive-pressure ventilation is the administration of: lidocaine (Xylocaine), 100 mg. ketamine (Ketalar), 100 mg. rocuronium (Zemuron), 30 mg. succinylcholine (Anectine), 20 mg. succinylcholine (Anectine), 20 mg. Which factors are responsible for sore throat following laryngeal mask airway (LMA) use? (select 2) A. Cuff overinflation B. Long surgical duration C. Positive pressure ventilation D. Use of air in inspired gas mixture A,B A patient with diabetic nephropathy is undergoing a radiologic procedure with radiocontrast dye under general anesthesia. What actions by the anesthesia provider will limit the renal effects of the dye? A. Administration of ketorolac (Toradol) B. Prehydration with IV fluids C. Pretreatment with N-acetylcysteine D. Use of hypotensive technique B Which letter indicates the area where a cricothyrotomy incision or puncture is made? c Which hemodynamic goals are MOST important in patients with aortic stenosis? (select 3) Adequate preload Avoidance of tachycardia Decreased afterload Decreased contractility Lower pulmonary hypertension Maintaining mean arterial pressure Adequate preload Avoidance of tachycardia Maintaining mean arterial pressure What is the proper function of Magill forceps when aiding in a nasal intubation? Assist in retracting the uvula Grasp the endotracheal tube Stabilize the tongue in midline position Open the nasal cavity Grasp the endotracheal tube Recommendations when using a forced air warmer in the operating room to keep a patient normothermic will include:(Select 2.) monitoring the patient’s temperature. normal SaO2 . respiratory alkalosis. Hypercarbia hypoxemia Following the administration of an interscalene block, the patient reports dyspnea. This MOST likely results from the paralysis of which cervical nerves? First Second Third Fourth Fifth Sixth Third Fourth Fifth A mainstem intubation is MORE likely to occur with: neck extension. neck flexion. supine position. Trendelenburg position. neck flexion. Trendelenburg position. A 48-year-old woman is scheduled to have an exploratory laparotomy. She has a 3-day history of nausea and vomiting and reports abdominal bloating and pain. She has a history of hypertension, gastroesophageal reflux, and a total abdominal hysterectomy 10 years ago. Medications are lisinopril, omeprazole, acetaminophen, and ginseng. Diagnostic data include hemoglobin, 11 g/dL; hematocrit, 37%; sodium, 132 mEq/L; potassium, 2.8 mEq/L; and chloride, 96 mEq/L. She is 162 cm tall and weighs 60 kg. Blood pressure is 132/80 mm Hg, heart rate is 98/min, room air oxygen saturation is 98%, respiratory rate is 21/min, and temperature is 37.9°C. Which medication would need to be discontinued 2 weeks prior to surgery? Acetaminophen Ginseng Lisinopril (Prinivil, Zestril) Omeprazole (Prilosec) Ginseng A 48-year-old woman is scheduled to have an exploratory laparotomy. She has a 3-day history of nausea and vomiting and reports abdominal bloating and pain. She has a history of hypertension, gastroesophageal reflux, and a total abdominal hysterectomy 10 years ago. Medications are lisinopril, omeprazole, acetaminophen, and ginseng. Diagnostic data include hemoglobin, 11 g/dL; hematocrit, 37%; sodium, 132 mEq/L; potassium, 2.8 mEq/L; and chloride, 96 mEq/L. She is 162 cm tall and weighs 60 kg. Blood pressure is 132/80 mm Hg, heart rate is 98/min, room air oxygen saturation is 98%, respiratory rate is 21/min, and temperature is 37.9°C. What would be the MOST appropriate muscle relaxant for the induction of this patient? Cisatracurium (Nimbex), 6 mg Rocuronium (Zemuron), 36 mg Succinylcholine (Anec Succinylcholine (Anectine), 60 mg A 48-year-old woman is scheduled to have an exploratory laparotomy. She has a 3-day history of nausea and vomiting and reports abdominal bloating and pain. She has a history of hypertension, gastroesophageal reflux, and a total abdominal hysterectomy 10 years ago. Medications are lisinopril, omeprazole, acetaminophen, and ginseng. Diagnostic data include hemoglobin, 11 g/dL; mEq/L. She is 162 cm tall and weighs 60 kg. Blood pressure is 132/80 mm Hg, heart rate is 98/min, room air oxygen saturation is 98%, respiratory rate is 21/min, and temperature is 37.9°C. Given the history of nausea and vomiting, what drugs would be MOST appropriate to decrease the risk postoperatively? (select 2) Dexamethasone (Decadron) Diphenhydra Dexamethasone and scopolamine Contraction of which muscle during peripheral nerve stimulation is the preferred site for the monitoring of neuromuscular blockade reversal during extubation? A. Adductor Pollicis B. Corrugator Supercilii C. Flexor carpi ulnaris D. Orbicularis Oculi A Recovery from relaxant is best measured in the hand via stimulation of the ulnar nerve with contraction of the adductor pollicis of the thumb. The hand muscles are more sensitive than the diaphragm to relaxants. Relaxant onset with induction is best monitored via the facial nerve with stimulation of the orbicularis oculi of the eye or corrugator supercilii of the eyebrow With a train of four count of 4, what percentage of postsynpatic receptors are potentially occupied by nondepolarizing neuromuscular blocking agents? a.75 b. 80 c. 85 d. 90 Answer: A Rationale: Once 70%-75% of the receptors are blocked, T4 decreases. When 80% of the receptors are blocked, T4 disappears. As the percent of receptors blocked reaches 80%-85%, the train-of-four becomes 2. Once there is 85%-90% occupancy, T2 disappears. If 95% of the receptors are blocked, train-of-four becomes 0. A glucose-6-phosphate dehydrogenase (G6PD) deficient patient presents for surgery requiring a general anesthetic. Which medications should be avoided? (select 2) a. fentanyl b. metoclopramide (reglan) c. propofol (diprivan) d. sevoflurane (ultane) Answers: B, D Rationale: G6PD deficiency is an enzyme present in high levels in young erythrocytes. Without G6PD, red blood cells' average duration is reduced by 50% to 60 days. The G6PD deficient red blood cells cannot protect themselves from oxidative damage; thus, anesthetic drugs that decrease G6PD should be avoided. Medications that should be avoided include isoflurane (Forane), sevoflurane, metoclopramide, penicillin, and methylene blue. Methylene blue administration can have life-threatening consequences to a patient with G6PD deficiency and methemoglobinemia. Clinical signs of carbon dioxide absorbent exhaustion include: (select 2) a. color change b. hypothermia c. hypoventilation d. increased bleeding at surgical site Answers: A, D Rationale: Clinical signs of carbon dioxide absorbent exhaustion include color change, hyperventilation, respiratory acidosis, increased partial pressure of carbon dioxide, and increased bleeding at the surgical site. 
