NBCRNA Perioperative Patient Assessment

Question 1

The ASA Physical Status Classification System assigns ASA III to a patient who has what?

Accepted Answer

Severe systemic disease with functional limitation but not incapacitating

Answer

ASA III indicates severe systemic disease that limits activity but is not incapacitating; examples include poorly controlled DM, COPD, morbid obesity (BMI >40), and symptomatic CHF.

Question 2

A patient with a history of recent myocardial infarction (within 60 days) presenting for elective non-cardiac surgery should ideally have surgery:

Accepted Answer

Postponed at least 60 days after MI unless the surgery is truly urgent

Answer

ACC/AHA guidelines recommend delaying elective non-cardiac surgery for at least 60 days after MI to allow myocardial healing and reduce perioperative cardiac morbidity.

Question 3

The Revised Cardiac Risk Index (RCRI) includes which of the following as a risk factor?

Accepted Answer

History of ischemic heart disease, heart failure, or cerebrovascular disease, insulin-dependent diabetes, preoperative creatinine >2.0, and high-risk surgery

Answer

The 6-factor RCRI (Lee Index) predicts perioperative major adverse cardiac events using: high-risk surgery, ischemic heart disease, CHF, cerebrovascular disease, insulin-dependent DM, and Cr >2.0 mg/dL.

Question 4

Which preoperative lab is most indicated before major elective surgery in a patient on warfarin?

Accepted Answer

Prothrombin time/INR

Answer

INR directly measures the anticoagulation effect of warfarin and determines whether adequate reversal has been achieved before proceeding with surgery.

Question 5

In the preoperative airway assessment, which physical finding is most predictive of difficult bag-mask ventilation?

Accepted Answer

Beard, obesity (BMI >26), lack of teeth, age >55, and history of snoring (BONES mnemonic)

Answer

The BONES factors (Beard, Obesity, No teeth, Elderly, Snoring/OSA) identify patients likely to be difficult to ventilate with a mask, which is a separate assessment from difficult intubation.

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 Perioperative Patient Assessment