NBCRNA Regional Anesthesia 3

Question 1

The level of epidural blockade required to provide anesthesia for a Cesarean section is typically:

Accepted Answer

T4 bilateral sensory block

Answer

Cesarean section requires a bilateral sensory block to T4 (nipple level) to cover peritoneal and uterine manipulation; an inadequate level results in intraoperative pain.

Question 2

Spinal headache (post-dural puncture headache) is caused by what mechanism?

Accepted Answer

CSF leakage through the dural puncture causing traction on intracranial pain-sensitive structures

Answer

CSF leak through the dural hole reduces intrathecal pressure, causing orthostatic traction on meninges and intracranial vessels, producing the characteristic positional headache.

Question 3

The epidural blood patch (EBP) treats post-dural puncture headache by:

Accepted Answer

Sealing the dural hole with autologous blood clot to stop CSF leakage

Answer

Injection of 15–20 mL of autologous blood into the epidural space forms a clot that seals the dural puncture, restoring normal CSF dynamics and relieving the headache.

Question 4

Femoral nerve block at the inguinal ligament provides analgesia for which surgical procedure?

Accepted Answer

Hip fracture and anterior thigh surgery

Answer

The femoral nerve (L2–L4) provides sensory innervation to the anterior thigh, medial leg, and knee joint, making femoral nerve block effective for hip fracture pain and anterior thigh/knee procedures.

Question 5

A thoracic epidural for post-thoracotomy analgesia is most effective because it blocks which nerves?

Accepted Answer

Intercostal nerves (T4–T8) and sympathetic chain at operative levels

Answer

Thoracic epidural analgesia blocks intercostal nerves at the surgical levels, providing superior pain relief that reduces splinting, improves respiratory mechanics, and decreases pulmonary complications.

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 Regional Anesthesia 3