NBCRNA Pharmacology for Nurse Anesthetists 2

Question 1

Which local anesthetic is most associated with cardiac toxicity due to its high protein binding and sodium channel blocking properties?

Accepted Answer

Bupivacaine

Answer

Bupivacaine has a high affinity for cardiac sodium channels and dissociates very slowly, making cardiotoxicity severe and difficult to treat.

Question 2

What is the reversal agent for benzodiazepine-induced sedation?

Accepted Answer

Flumazenil

Answer

Flumazenil is a competitive benzodiazepine receptor antagonist that reverses sedation, amnesia, and respiratory depression caused by benzodiazepines.

Question 3

Dexmedetomidine produces sedation and analgesia primarily through which mechanism?

Accepted Answer

Alpha-2 adrenergic receptor agonism

Answer

Dexmedetomidine acts on alpha-2 adrenergic receptors in the locus coeruleus and spinal cord to produce sedation, anxiolysis, and analgesia without respiratory depression.

Question 4

Which volatile anesthetic is contraindicated in patients at risk for malignant hyperthermia?

Accepted Answer

All potent volatile agents

Answer

All potent volatile anesthetic agents (halothane, isoflurane, desflurane, sevoflurane) are known triggers for malignant hyperthermia in susceptible individuals.

Question 5

What is the primary mechanism by which neostigmine reverses non-depolarizing neuromuscular blockade?

Accepted Answer

Acetylcholinesterase inhibition

Answer

Neostigmine inhibits acetylcholinesterase, increasing the concentration of acetylcholine at the neuromuscular junction to competitively overcome the non-depolarizing blockade.

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 Pharmacology for Nurse Anesthetists 2