NBCRNA Anesthetic Complications and Crisis Management 3

Question 1

In the management of 'cannot intubate, cannot oxygenate' (CICO), needle cricothyrotomy provides oxygenation but not ventilation unless connected to what?

Accepted Answer

High-pressure oxygen source (jet ventilation) to allow exhalation via upper airway

Answer

A small-bore needle cricothyrotomy cannot provide adequate tidal ventilation with standard flows; high-pressure jet ventilation is required, and exhalation must occur via the (partially obstructed) upper airway.

Question 2

Intraoperative hypertension requiring treatment is most commonly caused by what?

Accepted Answer

Inadequate analgesia and depth of anesthesia during painful stimulation

Answer

The most common intraoperative cause of hypertension is inadequate anesthetic depth or analgesia during surgical stimulation, causing sympathetic activation with increased heart rate and blood pressure.

Question 3

A patient develops 'awareness under anesthesia' (unintended intraoperative awareness). The CRNA's primary obligation is to:

Accepted Answer

Immediately acknowledge, fully inform the patient, provide psychological support, and document the incident

Answer

Professional ethical and legal standards require disclosure of awareness events; prompt acknowledgment, empathy, psychological follow-up, and documentation are mandatory components of the response.

Question 4

PONV (postoperative nausea and vomiting) prophylaxis is most effective when using what approach?

Accepted Answer

Multimodal combination antiemetic therapy targeting different receptor mechanisms

Answer

Combining antiemetics with different mechanisms (5-HT3 antagonist + dexamethasone + scopolamine patch) provides additive efficacy; each agent reduces PONV by ~26%, and combinations dramatically reduce overall risk.

Question 5

Hypothermia (core temp <36°C) in the perioperative period increases the risk of which specific surgical complication?

Accepted Answer

Surgical site infection, coagulopathy, and increased blood loss

Answer

Even mild perioperative hypothermia causes vasoconstriction (tissue hypoxia promoting infection), impairs platelet function, and reduces clotting factor activity, leading to wound infections and increased surgical blood loss.

NBCRNA - National Board of Certification and Recertification for Nurse Anesthetists Practice Test

NBCRNA - National Board of Certification and Recertification for Nurse Anesthetists Practice Test

NBCRNA Anesthetic Complications and Crisis Management 3