NBCRNA Obstetric Anesthesia 2

Question 1

Which intrathecal opioid is most commonly added to spinal bupivacaine to improve intraoperative analgesia for cesarean delivery?

Accepted Answer

Fentanyl

Answer

Intrathecal fentanyl (10-25 mcg) is commonly added to spinal bupivacaine to improve intraoperative visceral analgesia without prolonged respiratory depression risk.

Question 2

A parturient develops a total spinal block after epidural catheter injection. What is the FIRST priority in management?

Accepted Answer

Secure the airway with rapid sequence intubation

Answer

Airway management is the immediate priority in total spinal block because apnea and unconsciousness are life-threatening; securing the airway takes precedence over other interventions.

Question 3

Which of the following does NOT contribute to the increased risk of difficult intubation in obstetric patients?

Accepted Answer

Increased lower esophageal sphincter tone

Answer

Pregnancy decreases lower esophageal sphincter tone (due to progesterone), which increases aspiration risk rather than intubation difficulty.

Question 4

A patient with severe preeclampsia develops a seizure intrapartum. Which drug is the treatment of choice?

Accepted Answer

Magnesium sulfate IV bolus

Answer

Magnesium sulfate is the drug of choice for treating and preventing eclamptic seizures; it reduces neuromuscular excitability and cerebral vasospasm.

Question 5

What finding indicates early magnesium toxicity in a preeclamptic patient receiving magnesium sulfate infusion?

Accepted Answer

Loss of deep tendon reflexes

Answer

Loss of deep tendon reflexes (patellar reflex) occurs at serum magnesium levels of 7-10 mEq/L and is the earliest clinical sign of magnesium toxicity.

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 Obstetric Anesthesia 2