FLORIDA BOARD OF NURSING NURSE
ANESTHETIST NATIONAL EXAM WITH
ACTUAL QUESTIONS AND VERIFIED
ANSWERS, PLUS EXPLAINED
RATIONALES/EXPERT VERIFIED FOR
GUARANTEED 100% PASS 2026/LATEST
UPDATE/INSTANT DOWNLOAD PDF
1.
A 67-year-old patient with severe aortic stenosis is scheduled for open
abdominal surgery. Preoperative echocardiography demonstrates a valve
area of 0.7 cm², mean gradient of 48 mmHg, and preserved left
ventricular ejection fraction. Which intraoperative hemodynamic
strategy is MOST appropriate?
A. Maintain tachycardia to reduce left ventricular filling time
B. Maintain adequate preload, sinus rhythm, and systemic vascular
resistance
C. Reduce systemic vascular resistance substantially to facilitate forward
flow
D. Produce controlled hypotension to decrease myocardial oxygen
consumption
Answer: B
Rationale: Severe aortic stenosis creates a fixed obstruction to left
ventricular outflow. Cardiac output becomes highly dependent on
adequate preload, sinus rhythm, and maintenance of coronary
perfusion pressure. Sudden decreases in systemic vascular resistance
can cause profound hypotension because the stenotic valve limits the
ability to increase forward cardiac output. Tachycardia is undesirable
because it reduces diastolic filling and coronary perfusion time.
1
,2.
A patient receives a rapid bolus of propofol during induction. Shortly
afterward, blood pressure decreases from 135/75 mmHg to 78/42
mmHg. Which mechanism BEST explains the hypotension?
A. Increased sympathetic nervous system activity
B. Increased systemic vascular resistance
C. Peripheral vasodilation with myocardial depression
D. Increased venous return caused by venoconstriction
Answer: C
Rationale: Propofol commonly produces hypotension through arterial
and venous vasodilation, decreased sympathetic vascular tone, and
some degree of myocardial depression. The resulting reduction in
systemic vascular resistance and venous return can substantially
decrease blood pressure, particularly in elderly, hypovolemic, or
cardiovascularly compromised patients.
3.
A patient with severe chronic obstructive pulmonary disease is
mechanically ventilated after induction. Which ventilator strategy is
MOST appropriate?
A. High respiratory rate with minimal expiratory time
B. Low tidal volume with prolonged expiratory time
C. High inspiratory flow with zero expiratory time
D. Very high PEEP to eliminate all airway collapse
Answer: B
Rationale: Patients with obstructive lung disease require sufficient
expiratory time to minimize dynamic hyperinflation and intrinsic
2
,PEEP. A lower respiratory rate and appropriate inspiratory flow can
lengthen expiratory time. Excessive respiratory rates may cause air
trapping, increased intrathoracic pressure, hypotension, and
worsening ventilation.
4.
A patient undergoing general anesthesia suddenly develops increased
end-tidal CO₂, tachycardia, generalized muscle rigidity, and rapidly
increasing temperature. Which treatment should be initiated
immediately?
A. Dantrolene
B. Protamine
C. Flumazenil
D. Physostigmine
Answer: A
Rationale: The combination of rapidly increasing end-tidal CO₂,
tachycardia, muscle rigidity, and hyperthermia strongly suggests
malignant hyperthermia. Dantrolene is the definitive pharmacologic
treatment because it reduces calcium release from the sarcoplasmic
reticulum by acting on skeletal-muscle excitation-contraction
coupling.
5.
A patient receives succinylcholine during rapid-sequence induction.
Which patient has the greatest risk of developing severe hyperkalemia
following succinylcholine administration?
A. Healthy adult with controlled hypertension
B. Patient with chronic stable hypothyroidism
3
, C. Patient with a recent major burn injury
D. Patient with mild gastroesophageal reflux disease
Answer: C
Rationale: Major burns produce upregulation of extrajunctional
acetylcholine receptors. Succinylcholine can then cause a substantial
potassium efflux and life-threatening hyperkalemia. The risk becomes
clinically important after the initial period following injury and may
persist for an extended period during receptor upregulation.
6.
A patient with increased intracranial pressure requires induction of
anesthesia. Which combination is MOST appropriate for minimizing
secondary cerebral injury?
A. Hypotension, hypoxemia, and hypercarbia
B. Adequate oxygenation, controlled ventilation, and maintenance of
cerebral perfusion pressure
C. Severe hypocapnia and profound systemic hypotension
D. Hyperthermia and increased anesthetic concentration
Answer: B
Rationale: Patients with intracranial hypertension are particularly
vulnerable to secondary brain injury. Adequate oxygenation,
avoidance of significant hypercarbia, maintenance of adequate mean
arterial pressure, and preservation of cerebral perfusion pressure are
fundamental objectives. Excessive hypocapnia can reduce cerebral
blood flow and potentially worsen ischemia.
7.
4
ANESTHETIST NATIONAL EXAM WITH
ACTUAL QUESTIONS AND VERIFIED
ANSWERS, PLUS EXPLAINED
RATIONALES/EXPERT VERIFIED FOR
GUARANTEED 100% PASS 2026/LATEST
UPDATE/INSTANT DOWNLOAD PDF
1.
A 67-year-old patient with severe aortic stenosis is scheduled for open
abdominal surgery. Preoperative echocardiography demonstrates a valve
area of 0.7 cm², mean gradient of 48 mmHg, and preserved left
ventricular ejection fraction. Which intraoperative hemodynamic
strategy is MOST appropriate?
A. Maintain tachycardia to reduce left ventricular filling time
B. Maintain adequate preload, sinus rhythm, and systemic vascular
resistance
C. Reduce systemic vascular resistance substantially to facilitate forward
flow
D. Produce controlled hypotension to decrease myocardial oxygen
consumption
Answer: B
Rationale: Severe aortic stenosis creates a fixed obstruction to left
ventricular outflow. Cardiac output becomes highly dependent on
adequate preload, sinus rhythm, and maintenance of coronary
perfusion pressure. Sudden decreases in systemic vascular resistance
can cause profound hypotension because the stenotic valve limits the
ability to increase forward cardiac output. Tachycardia is undesirable
because it reduces diastolic filling and coronary perfusion time.
1
,2.
A patient receives a rapid bolus of propofol during induction. Shortly
afterward, blood pressure decreases from 135/75 mmHg to 78/42
mmHg. Which mechanism BEST explains the hypotension?
A. Increased sympathetic nervous system activity
B. Increased systemic vascular resistance
C. Peripheral vasodilation with myocardial depression
D. Increased venous return caused by venoconstriction
Answer: C
Rationale: Propofol commonly produces hypotension through arterial
and venous vasodilation, decreased sympathetic vascular tone, and
some degree of myocardial depression. The resulting reduction in
systemic vascular resistance and venous return can substantially
decrease blood pressure, particularly in elderly, hypovolemic, or
cardiovascularly compromised patients.
3.
A patient with severe chronic obstructive pulmonary disease is
mechanically ventilated after induction. Which ventilator strategy is
MOST appropriate?
A. High respiratory rate with minimal expiratory time
B. Low tidal volume with prolonged expiratory time
C. High inspiratory flow with zero expiratory time
D. Very high PEEP to eliminate all airway collapse
Answer: B
Rationale: Patients with obstructive lung disease require sufficient
expiratory time to minimize dynamic hyperinflation and intrinsic
2
,PEEP. A lower respiratory rate and appropriate inspiratory flow can
lengthen expiratory time. Excessive respiratory rates may cause air
trapping, increased intrathoracic pressure, hypotension, and
worsening ventilation.
4.
A patient undergoing general anesthesia suddenly develops increased
end-tidal CO₂, tachycardia, generalized muscle rigidity, and rapidly
increasing temperature. Which treatment should be initiated
immediately?
A. Dantrolene
B. Protamine
C. Flumazenil
D. Physostigmine
Answer: A
Rationale: The combination of rapidly increasing end-tidal CO₂,
tachycardia, muscle rigidity, and hyperthermia strongly suggests
malignant hyperthermia. Dantrolene is the definitive pharmacologic
treatment because it reduces calcium release from the sarcoplasmic
reticulum by acting on skeletal-muscle excitation-contraction
coupling.
5.
A patient receives succinylcholine during rapid-sequence induction.
Which patient has the greatest risk of developing severe hyperkalemia
following succinylcholine administration?
A. Healthy adult with controlled hypertension
B. Patient with chronic stable hypothyroidism
3
, C. Patient with a recent major burn injury
D. Patient with mild gastroesophageal reflux disease
Answer: C
Rationale: Major burns produce upregulation of extrajunctional
acetylcholine receptors. Succinylcholine can then cause a substantial
potassium efflux and life-threatening hyperkalemia. The risk becomes
clinically important after the initial period following injury and may
persist for an extended period during receptor upregulation.
6.
A patient with increased intracranial pressure requires induction of
anesthesia. Which combination is MOST appropriate for minimizing
secondary cerebral injury?
A. Hypotension, hypoxemia, and hypercarbia
B. Adequate oxygenation, controlled ventilation, and maintenance of
cerebral perfusion pressure
C. Severe hypocapnia and profound systemic hypotension
D. Hyperthermia and increased anesthetic concentration
Answer: B
Rationale: Patients with intracranial hypertension are particularly
vulnerable to secondary brain injury. Adequate oxygenation,
avoidance of significant hypercarbia, maintenance of adequate mean
arterial pressure, and preservation of cerebral perfusion pressure are
fundamental objectives. Excessive hypocapnia can reduce cerebral
blood flow and potentially worsen ischemia.
7.
4
