NBCRNA Pharmacology for Nurse Anesthetists 3

Question 1

Which drug is the treatment of choice for acute malignant hyperthermia crisis?

Accepted Answer

Dantrolene

Answer

Dantrolene inhibits ryanodine receptor-mediated calcium release from the sarcoplasmic reticulum, directly treating the hyperthermia and muscle rigidity of MH.

Question 2

The opioid reversal agent naloxone works by which mechanism?

Accepted Answer

Competitive opioid receptor antagonism

Answer

Naloxone competitively antagonizes mu, kappa, and delta opioid receptors, rapidly reversing opioid-induced respiratory depression, sedation, and analgesia.

Question 3

Which induction agent is contraindicated in patients with porphyria?

Accepted Answer

Thiopental

Answer

Barbiturates such as thiopental induce delta-aminolevulinic acid (ALA) synthase, precipitating acute porphyric crises in susceptible patients.

Question 4

Etomidate is preferred for induction in hemodynamically unstable patients primarily because it does what?

Accepted Answer

Minimally affects cardiovascular function

Answer

Etomidate provides reliable hypnosis with minimal cardiovascular depression, making it the induction agent of choice for patients with cardiovascular compromise.

Question 5

Which volatile agent is most associated with compound A formation and potential nephrotoxicity, particularly at low fresh gas flows?

Accepted Answer

Sevoflurane

Answer

Sevoflurane reacts with carbon dioxide absorbents (especially desiccated barium hydroxide lime) to produce compound A, a nephrotoxic degradation product.

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 3