NBCRNA Obstetric Anesthesia 3

Question 1

Which placenta previa type presents with painless bright red vaginal bleeding and is associated with the greatest risk of hemorrhage during delivery?

Accepted Answer

Complete (total) previa

Answer

Complete placenta previa, where the placenta entirely covers the internal cervical os, presents with painless bleeding and carries the highest hemorrhage risk, typically requiring cesarean delivery.

Question 2

What is the MOST important anesthetic consideration for a patient with placenta accreta spectrum undergoing planned cesarean hysterectomy?

Accepted Answer

Plan for massive hemorrhage with large-bore IV access and blood products available

Answer

Placenta accreta spectrum carries a high risk of massive hemorrhage; preparation with large-bore IV access, arterial line, blood products, and a cell salvage device is the most critical anesthetic priority.

Question 3

A fetus delivered at 39 weeks has an Apgar score of 4 at 1 minute. What is the NEXT step in neonatal resuscitation?

Accepted Answer

Begin positive pressure ventilation

Answer

An Apgar score of 4-6 indicates a depressed neonate; positive pressure ventilation is the most critical initial intervention in neonatal resuscitation.

Question 4

Which opioid used in labor analgesia has the fastest onset and shortest duration, making it useful for IV patient-controlled analgesia during active labor?

Accepted Answer

Remifentanil

Answer

Remifentanil's ultra-short duration (context-sensitive half-life ~3 min) and fast onset make it well-suited for IV PCA in labor, though continuous monitoring is required due to maternal respiratory depression risk.

Question 5

What is the recommended sensory block level for effective epidural labor analgesia?

Accepted Answer

T10 to L1

Answer

Labor analgesia requires a sensory block from T10 (umbilicus) to L1 to cover uterine contraction pain during the first stage of labor.

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 3