CNOR - Certification Anesthesia and Sedation Principles Questions and Answers

Question 1

A patient under general anesthesia with succinylcholine and a volatile anesthetic develops sudden tachycardia, masseter muscle rigidity, and a sharp increase in end-tidal CO2. What is the perioperative nurse's priority action?

Accepted Answer

Notify the anesthesia professional and prepare to stop the triggering agents.

Answer

The immediate priority in managing a suspected malignant hyperthermia (MH) crisis is to alert the anesthesia professional to stop the administration of all triggering agents (e.g., volatile anesthetics, succinylcholine). This action is the first and most crucial step to halt the underlying hypermetabolic process. Subsequent actions, while also critical, include administering dantrolene, initiating cooling measures, and obtaining lab work.

Question 2

Which of the following best describes the emergence phase of general anesthesia?

Accepted Answer

The period when anesthetic agents are discontinued and the patient begins to awaken, continuing until airway reflexes return.

Answer

Emergence is the phase that begins when anesthetic agents are stopped, leading to the patient awakening and regaining consciousness and protective airway reflexes. The other options describe induction, the broader recovery period including PACU stay, and the maintenance phase, respectively.

Question 3

A patient is scheduled for a procedure under Monitored Anesthesia Care (MAC). What is a key characteristic that distinguishes MAC from moderate (conscious) sedation?

Accepted Answer

An anesthesia professional must be present and prepared to convert to general anesthesia if needed.

Answer

The defining characteristic of Monitored Anesthesia Care (MAC) is the continuous presence of a qualified anesthesia professional (anesthesiologist or CRNA). This provider is skilled in managing the patient's airway and is prepared to deepen the level of sedation or convert to a general anesthetic if the patient's condition or surgical needs change, a requirement not present for nurse-administered moderate sedation.

Question 4

A patient who received spinal anesthesia 24 hours prior calls the hospital complaining of a severe headache that is significantly worse when sitting up and relieved by lying flat. The perioperative nurse should recognize these symptoms as characteristic of which complication?

Accepted Answer

Post-dural puncture headache (PDPH)

Answer

The hallmark symptom of a post-dural puncture headache (PDPH) is its positional nature; it intensifies in an upright position and is alleviated by lying supine. This is caused by the leakage of cerebrospinal fluid from the puncture site in the dura mater, which reduces the fluid cushion around the brain.

Question 5

During a procedure with sedation, the perioperative nurse observes a sudden drop in the end-tidal CO2 (EtCO2) waveform on the capnography monitor, which quickly becomes a flat line. This finding is the earliest and most reliable indicator of what condition?

Accepted Answer

Apnea or total airway obstruction

Answer

Capnography provides a real-time, breath-by-breath measurement of ventilation. A sudden loss of the EtCO2 waveform indicates that the patient is no longer exhaling carbon dioxide, which is the most immediate sign of apnea or a complete airway obstruction. This change is detected much earlier by capnography than by pulse oximetry, which can lag for several minutes.

CNOR - Certification Exam Practice Test

CNOR - Certification Exam Practice Test

CNOR - Certification Anesthesia and Sedation Principles Questions and Answers