California CRNA Certification Fast-Track 2025–
2026: 100 Essential Exam Questions with
Rationales
1. Question: What is the minimum passing scaled score for the NBCRNA National
Certification Examination (NCE)?
Answer: 450
Rationale: NBCRNA uses a scaled scoring system; a score of 450 is the pass threshold.
2. Question: How many total questions (including scored + unscored) does the CRNA NCE
typically contain?
Answer: 100–170
Rationale: The exam range is 100 to 170 questions; of these ~30 are unscored/pretest
items.
3. Question: Which of the following is not required by the California Board of Registered
Nursing (BRN) when applying for Nurse Anesthetist certification?
a) Verification of CRNA certification by a national organization
b) Transcripts from nurse anesthesia academic program
c) A letter of recommendation from your clinical preceptor
d) Active, clear California RN license
Answer: c) A letter of recommendation from your clinical preceptor
Rationale: The BRN requires items (a), (b), and (d) among others; it does not formally
require a letter of recommendation from a clinical preceptor in its standard list.
4. Question: True or False: In California, a CRNA must practice under physician
supervision at all times.
Answer: False
Rationale: California law allows nurse anesthetist services to be provided without
physician supervision under certain circumstances.
5. Question: A patient with restrictive lung disease would most likely show which
pulmonary function test (PFT) abnormality? (Select 3)
A) ↓ Forced Vital Capacity (FVC)
B) ↓ Total Lung Capacity (TLC)
C) ↓ FEV₁ / FVC ratio
D) ↑ Residual Volume (RV)
E) ↓ Functional Residual Capacity (FRC)
Answer: A, B, E
Rationale: In restrictive disease, FVC, TLC, and FRC are decreased. The FEV₁/FVC
ratio is typically normal or increased (not decreased)
6. Question: What three axes must be aligned for successful laryngoscopy and intubation?
Answer: Oral axis, pharyngeal axis, tracheal axis
Rationale: Successful direct laryngoscopy is achieved by aligning the oral, pharyngeal,
and tracheal axes
,7. Question: Which of the following is not among the CRNA exam content domains?
a) Basic Sciences
b) Equipment, Instrumentation & Technology
c) General Principles of Anesthesia
d) Nursing Management & Administration
Answer: d) Nursing Management & Administration
Rationale: The NBCRNA outlines key domains: Basic Sciences; Equipment,
Instrumentation, and Technology; General Principles of Anesthesia; and Anesthesia for
Surgical Procedures & Special Populations. “Nursing Management & Administration” is
not a core domain in the NCE blueprint
8. Question: What is the main effect of a nondepolarizing neuromuscular blocker?
a) Preventing acetylcholine release from the motor nerve terminal
b) Blocking acetylcholine from binding nicotinic receptors at the motor end plate
c) Causing prolonged depolarization of the motor end plate
d) Enhancing magnesium-mediated actin-myosin coupling
Answer: b) Blocking acetylcholine from binding nicotinic receptors at the motor end
plate
Rationale: Nondepolarizers competitively block the nicotinic receptor, preventing
acetylcholine binding.
9. Question: Which of the following anesthetic gases is most soluble in blood (i.e. highest
blood:gas partition coefficient)?
a) Nitrous oxide
b) Sevoflurane
c) Isoflurane
d) Halothane
Answer: d) Halothane
Rationale: Among common inhalational agents, halothane has a relatively high blood
solubility, thus slower onset and offset.
10. Question: A patient’s hemodynamics: Stroke Volume = 60 mL, Heart Rate = 80 bpm.
What is the cardiac output?
Answer: 4,800 mL/min (or 4.8 L/min)
Rationale: CO = SV × HR = 60 mL × 80 = 4,800 mL/min.
11. Question: In the lateral decubitus position during anesthesia, the dependent lung receives
which zone of blood flow (West’s zones)?
Answer: Zone III
Rationale: The dependent lung under positive pressure ventilation tends to function in
Zone III (highest perfusion).
12. Question: Which of the following drugs would you use in thyroid storm? (Select 3)
A) Sodium iodide
B) Propranolol
C) Levothyroxine
D) Hydrocortisone
E) Methylene blue
Answer: A, B, D
Rationale: Management typically includes iodide (to block hormone release), beta
, blockers (e.g. propranolol) to control sympathetic effects, and steroids (e.g.
hydrocortisone) for adrenal support. Levothyroxine and methylene blue are not indicated.
13. Question: The alternative item formats document includes sample multiple‐selection,
calculation, and short answer questions. True or False?
Answer: True
Rationale: NBCRNA publishes sample “alternative item formats” that include those
question type
14. Question: To yield eligibility for California Nurse Anesthetist Certification, a CRNA
applicant must submit to the BRN proof of certification from which national body?
Answer: Council on Certification/Recertification of Nurse Anesthetists (or successor
national certifying body)
Rationale: The BRN requires verification of nurse anesthetist certification from a
national certifying organization (e.g. NBCRNA).
15. Question: In California law (AB 876 proposed amendment), a “trainee” must satisfy
certain requirements to provide anesthesia services. Which of these is one such
requirement?
a) Be enrolled in an accredited doctoral program of nurse anesthesia
b) Must have 10 years of ICU experience
c) Must practice under remote tele-supervision only
d) Must never administer anesthesia to pediatric patients
Answer: a) Be enrolled in an accredited doctoral program of nurse anesthesia
R rationale: The amendment text defines a “trainee” as someone enrolled in an
accredited doctoral nurse anesthesia program.
16. Question: Which of the following physiologic changes is expected during pregnancy
(second trimester) relevant to anesthetic management?
a) ↓ Minute ventilation
b) ↑ Cardiac output
c) ↑ Functional residual capacity (FRC)
d) ↓ Blood volume
Answer: b) ↑ Cardiac output
Rationale: Pregnancy induces increased cardiac output, decreased FRC, increased blood
volume, and increased minute ventilation.
17. Question: The concept of MAC (Minimum Alveolar Concentration) describes the
alveolar concentration of anesthetic at which ____% of patients do not move in response
to a standardized surgical stimulus.
Answer: 50%
Rationale: MAC is defined as the concentration at which 50 % of patients will not move
in response to a surgical stimulus.
18. Question: Which of the following is a contraindication to succinylcholine?
a) Hyperkalemia
b) Malignant hyperthermia susceptibility
c) Burns > 24 hours
d) All of the above
Answer: d) All of the above
Rationale: Succinylcholine is contraindicated in hyperkalemia, MH-susceptible patients,
and in patients with burns, neuromuscular disease, or prolonged immobilization.
2026: 100 Essential Exam Questions with
Rationales
1. Question: What is the minimum passing scaled score for the NBCRNA National
Certification Examination (NCE)?
Answer: 450
Rationale: NBCRNA uses a scaled scoring system; a score of 450 is the pass threshold.
2. Question: How many total questions (including scored + unscored) does the CRNA NCE
typically contain?
Answer: 100–170
Rationale: The exam range is 100 to 170 questions; of these ~30 are unscored/pretest
items.
3. Question: Which of the following is not required by the California Board of Registered
Nursing (BRN) when applying for Nurse Anesthetist certification?
a) Verification of CRNA certification by a national organization
b) Transcripts from nurse anesthesia academic program
c) A letter of recommendation from your clinical preceptor
d) Active, clear California RN license
Answer: c) A letter of recommendation from your clinical preceptor
Rationale: The BRN requires items (a), (b), and (d) among others; it does not formally
require a letter of recommendation from a clinical preceptor in its standard list.
4. Question: True or False: In California, a CRNA must practice under physician
supervision at all times.
Answer: False
Rationale: California law allows nurse anesthetist services to be provided without
physician supervision under certain circumstances.
5. Question: A patient with restrictive lung disease would most likely show which
pulmonary function test (PFT) abnormality? (Select 3)
A) ↓ Forced Vital Capacity (FVC)
B) ↓ Total Lung Capacity (TLC)
C) ↓ FEV₁ / FVC ratio
D) ↑ Residual Volume (RV)
E) ↓ Functional Residual Capacity (FRC)
Answer: A, B, E
Rationale: In restrictive disease, FVC, TLC, and FRC are decreased. The FEV₁/FVC
ratio is typically normal or increased (not decreased)
6. Question: What three axes must be aligned for successful laryngoscopy and intubation?
Answer: Oral axis, pharyngeal axis, tracheal axis
Rationale: Successful direct laryngoscopy is achieved by aligning the oral, pharyngeal,
and tracheal axes
,7. Question: Which of the following is not among the CRNA exam content domains?
a) Basic Sciences
b) Equipment, Instrumentation & Technology
c) General Principles of Anesthesia
d) Nursing Management & Administration
Answer: d) Nursing Management & Administration
Rationale: The NBCRNA outlines key domains: Basic Sciences; Equipment,
Instrumentation, and Technology; General Principles of Anesthesia; and Anesthesia for
Surgical Procedures & Special Populations. “Nursing Management & Administration” is
not a core domain in the NCE blueprint
8. Question: What is the main effect of a nondepolarizing neuromuscular blocker?
a) Preventing acetylcholine release from the motor nerve terminal
b) Blocking acetylcholine from binding nicotinic receptors at the motor end plate
c) Causing prolonged depolarization of the motor end plate
d) Enhancing magnesium-mediated actin-myosin coupling
Answer: b) Blocking acetylcholine from binding nicotinic receptors at the motor end
plate
Rationale: Nondepolarizers competitively block the nicotinic receptor, preventing
acetylcholine binding.
9. Question: Which of the following anesthetic gases is most soluble in blood (i.e. highest
blood:gas partition coefficient)?
a) Nitrous oxide
b) Sevoflurane
c) Isoflurane
d) Halothane
Answer: d) Halothane
Rationale: Among common inhalational agents, halothane has a relatively high blood
solubility, thus slower onset and offset.
10. Question: A patient’s hemodynamics: Stroke Volume = 60 mL, Heart Rate = 80 bpm.
What is the cardiac output?
Answer: 4,800 mL/min (or 4.8 L/min)
Rationale: CO = SV × HR = 60 mL × 80 = 4,800 mL/min.
11. Question: In the lateral decubitus position during anesthesia, the dependent lung receives
which zone of blood flow (West’s zones)?
Answer: Zone III
Rationale: The dependent lung under positive pressure ventilation tends to function in
Zone III (highest perfusion).
12. Question: Which of the following drugs would you use in thyroid storm? (Select 3)
A) Sodium iodide
B) Propranolol
C) Levothyroxine
D) Hydrocortisone
E) Methylene blue
Answer: A, B, D
Rationale: Management typically includes iodide (to block hormone release), beta
, blockers (e.g. propranolol) to control sympathetic effects, and steroids (e.g.
hydrocortisone) for adrenal support. Levothyroxine and methylene blue are not indicated.
13. Question: The alternative item formats document includes sample multiple‐selection,
calculation, and short answer questions. True or False?
Answer: True
Rationale: NBCRNA publishes sample “alternative item formats” that include those
question type
14. Question: To yield eligibility for California Nurse Anesthetist Certification, a CRNA
applicant must submit to the BRN proof of certification from which national body?
Answer: Council on Certification/Recertification of Nurse Anesthetists (or successor
national certifying body)
Rationale: The BRN requires verification of nurse anesthetist certification from a
national certifying organization (e.g. NBCRNA).
15. Question: In California law (AB 876 proposed amendment), a “trainee” must satisfy
certain requirements to provide anesthesia services. Which of these is one such
requirement?
a) Be enrolled in an accredited doctoral program of nurse anesthesia
b) Must have 10 years of ICU experience
c) Must practice under remote tele-supervision only
d) Must never administer anesthesia to pediatric patients
Answer: a) Be enrolled in an accredited doctoral program of nurse anesthesia
R rationale: The amendment text defines a “trainee” as someone enrolled in an
accredited doctoral nurse anesthesia program.
16. Question: Which of the following physiologic changes is expected during pregnancy
(second trimester) relevant to anesthetic management?
a) ↓ Minute ventilation
b) ↑ Cardiac output
c) ↑ Functional residual capacity (FRC)
d) ↓ Blood volume
Answer: b) ↑ Cardiac output
Rationale: Pregnancy induces increased cardiac output, decreased FRC, increased blood
volume, and increased minute ventilation.
17. Question: The concept of MAC (Minimum Alveolar Concentration) describes the
alveolar concentration of anesthetic at which ____% of patients do not move in response
to a standardized surgical stimulus.
Answer: 50%
Rationale: MAC is defined as the concentration at which 50 % of patients will not move
in response to a surgical stimulus.
18. Question: Which of the following is a contraindication to succinylcholine?
a) Hyperkalemia
b) Malignant hyperthermia susceptibility
c) Burns > 24 hours
d) All of the above
Answer: d) All of the above
Rationale: Succinylcholine is contraindicated in hyperkalemia, MH-susceptible patients,
and in patients with burns, neuromuscular disease, or prolonged immobilization.
