CRNFA Anesthesia and Patient Safety in the OR

Question 1

Which volatile anesthetic agent is most strongly associated with triggering malignant hyperthermia in susceptible patients?

Accepted Answer

Succinylcholine and all volatile halogenated agents (e.g., sevoflurane, desflurane)

Answer

Malignant hyperthermia is triggered by succinylcholine and all halogenated volatile anesthetic agents; nitrous oxide, propofol, and ketamine are safe in MH-susceptible patients.

Question 2

The CRNFA observes sudden masseter muscle rigidity after succinylcholine administration during intubation. This finding should prompt concern for which emergent condition?

Accepted Answer

Malignant hyperthermia

Answer

Masseter muscle rigidity (jaw rigidity) following succinylcholine is an early and classic warning sign of malignant hyperthermia and requires immediate activation of the MH protocol.

Question 3

Dantrolene sodium is the definitive treatment for malignant hyperthermia. What is the initial recommended IV bolus dose?

Accepted Answer

2.5 mg/kg, repeated up to 10 mg/kg total if needed

Answer

The initial dantrolene dose is 2.5 mg/kg IV bolus, repeated every 5 minutes up to 10 mg/kg (or until symptoms resolve) for malignant hyperthermia treatment.

Question 4

During surgery, the anesthesiologist announces end-tidal CO2 of 68 mmHg, temperature of 39.8°C rising, and tachycardia of 148 bpm. The CRNFA's first action should be to:

Accepted Answer

Suspend the operation, assist the team to activate the MH protocol, and call for dantrolene

Answer

Rising end-tidal CO2, hyperthermia, and tachycardia are cardinal signs of MH; the team must suspend surgery, switch to MH-safe anesthesia, and administer dantrolene immediately.

Question 5

The purpose of pre-oxygenation (denitrogenation) before induction of general anesthesia is to:

Accepted Answer

Extend the safe apnea window by maximizing lung oxygen reserves before intubation

Answer

Pre-oxygenation with 100% O2 for 3–5 minutes replaces nitrogen in functional residual capacity with oxygen, extending the safe apneic window from ~1 minute to 3–8 minutes.

CRNFA - Certified Registered Nurse First Assistant Practice Test

CRNFA - Certified Registered Nurse First Assistant Practice Test

CRNFA Anesthesia and Patient Safety in the OR