NBCRNA Cheat Sheet 2026

The 30 highest-yield NBCRNA facts, distilled from real exam questions. Print it, save it as a PDF, or study it here — free, no sign-up.

1. On the anesthesia machine, the fail-safe valve is designed to prevent the delivery of hypoxic gas mixtures by doing what? → Proportionally reducing nitrous oxide flow when oxygen pressure drops
2. Chronic kidney disease (CrCl <30 mL/min) affects anesthetic management primarily because it impairs elimination of what drugs? → Renally cleared drugs including morphine-6-glucuronide, neostigmine, and pancuronium
3. The treatment of choice for severe LAST with cardiovascular collapse is: → Lipid emulsion therapy (Intralipid 20%)
4. Pulmonary embolism (PE) occurring intraoperatively presents with which characteristic hemodynamic pattern? → Sudden hypotension, increased airway pressure, and decreased ETCO2
5. Obstructive sleep apnea (OSA) increases perioperative risk primarily due to increased sensitivity to what? → Opioids and sedatives causing upper airway obstruction and hypoxia
6. According to current ASA fasting guidelines, clear liquids may be consumed up to how many hours before elective anesthesia in adults? → 2 hours
7. LAST (Local Anesthetic Systemic Toxicity) initial CNS symptoms include which finding? → Perioral numbness and metallic taste, progressing to seizures
8. Which drug is MOST appropriate to treat refractory hypotension in a patient who took lisinopril (Prinivil, Zestril) on the day of surgery? → Vasopressin
9. Train-of-four (TOF) monitoring is used to assess what? → Degree of neuromuscular blockade
10. In a double-lumen endotracheal tube, which lumen is used when the bronchial cuff is positioned in the left mainstem bronchus during a right thoracotomy? → Tracheal lumen ventilates the right lung
11. Intraoperative hypotension most commonly defined as MAP <65 mmHg is most rapidly treated with which initial intervention? → IV fluid bolus and phenylephrine or ephedrine based on heart rate
12. Which inhalation anesthetic has the lowest blood-gas partition coefficient, resulting in the fastest induction and emergence? → Desflurane
13. Which opioid has the fastest onset due to its high lipid solubility and is most commonly used for intraoperative analgesia infusions? → Remifentanil
14. Which local anesthetic is most commonly used for spinal anesthesia in obstetric patients undergoing cesarean delivery? → Bupivacaine 0.75% hyperbaric
15. Horner syndrome (ptosis, miosis, anhidrosis) occurring after a brachial plexus block indicates what? → Local anesthetic spread to the cervical sympathetic chain
16. High-flow nasal cannula (HFNC) used during preoxygenation before RSI provides apneic oxygenation by what mechanism? → Delivering continuous oxygen flow to maintain FRC oxygen reservoir during apnea
17. Awake fiberoptic intubation is the preferred technique in which type of patient? → Known or anticipated difficult airway with full stomach risk
18. Dexmedetomidine produces sedation and analgesia primarily through which mechanism? → Alpha-2 adrenergic receptor agonism
19. The adductor canal block (subsartorial block) provides primarily what type of analgesia for knee surgery? → Sensory analgesia with preserved quadriceps strength
20. The Bain circuit (Mapleson D modification) is a co-axial design where the inner tube carries what? → Fresh gas flow to the patient end
21. The BEST indicator for CAD in the pre-operative assessment for vascular surgery patients is: → exercise tolerance.
22. Etomidate is preferred for induction in hemodynamically unstable patients primarily because it does what? → Minimally affects cardiovascular function
23. The classic presentation of a 'high spinal' or 'total spinal' includes which combination of findings? → Severe hypotension, bradycardia, and respiratory arrest
24. Which preoperative lab is most indicated before major elective surgery in a patient on warfarin? → Prothrombin time/INR
25. PONV (postoperative nausea and vomiting) prophylaxis is most effective when using what approach? → Multimodal combination antiemetic therapy targeting different receptor mechanisms
26. The circle breathing system uses soda lime to do what? → Absorb carbon dioxide from exhaled gases
27. Ketamine produces dissociative anesthesia primarily through which receptor mechanism? → NMDA receptor antagonism
28. Postoperative cognitive dysfunction (POCD) is most strongly associated with which patient population? → Elderly patients (>65 years) undergoing major surgery
29. Hypothermia (core temp <36°C) in the perioperative period increases the risk of which specific surgical complication? → Surgical site infection, coagulopathy, and increased blood loss
30. Which technique is used to minimize the risk of accidental esophageal extubation during patient positioning after intubation? → Auscultation and capnography confirmation after every position change