NIFA PERIOPERATIVE EXAMINATION TEST 2026
FULL QUESTIONS AND ANSWERS
◉ Anesthesia in high risk patients, intolerant of general? Answer:
Regional/local
◉ Regional anesthesia injected? Answer: Anywhere along a nerve
pathway
◉ IV regional AKA. Answer: Bier Block
◉ Bier Blocks. Answer: most often used for upper extremity nerve
blockades.
◉ Epidural anesthetic is injected where? Answer: space between the
ligamentum flavum (connective tissue which links the individual
vertebrae together. It connects inside the vertebral structure, posterior to
the central canal.) and the dura
It is not injected into the spinal canal
,◉ After spinal anesthesia, potential for what? Answer: Hypotension due
to vasodilation
◉ Anesthesia alternatives for pts intolerant certain types of anesthesia,
healthy pts or high risk patients. Answer: Local alone or in combo with
IV analgesics (fentanyl) and amnesiacs (versed) can be used.
◉ How to avoid anesthesia complications. Answer: preop evaluation is
important. Unforseen complications can occur despite thorough preop
interviews/assessment. possible malignant hyperthermia
◉ Most consistent physiological indication of malignant hyperthermia.
Answer: end-tidal CO2
◉ Tx malignant hyperthermia. Answer: Recognition is crucial to tx.
Once detected:
Immediately stop surgery
If stopping is not possible-triggering agents should be stopped and
replaced with safe agents.
Follow written protocol for continued treatment.
Dantrolene, 100% O2 and use iced saline to cool the patient.
◉ How many stages of Anesthesia? Answer: 4
, ◉ Stage 1 of anesthesia. Answer: Initial Administration.
actual administration of anesthetic. Only a few seconds between initial
admin of drug and unconsciousness.
◉ Stage 2 of anesthesia. Answer: Excitement.
Patient is unconscious. It is the time from loss of consciousness to the
loss of eyelid reflexes. Involuntary movements may occur at this time.
◉ Stage 3 of anesthesia. Answer: Intrasurgery
This is the time of surgical anesthesia. Patient has rapid eye movement
and breathing may be labored until the muscles completely relax. This
would be the time that surgery would begin.
◉ Stage 4 of anesthesia. Answer: Possibility of respiratory failure.
Characterized by respiratory failure, leading to circulatory failure.
Without breathing apparatus and heart support, the patient can die.
◉ How many phases of anesthesia? Answer: 3
◉ Phase 1 of anesthesia. Answer: Induction
begins with administration of anesthesia and lasts until surgical incision
is made.
◉ Phase 2 anesthesia. Answer: Maintenance
FULL QUESTIONS AND ANSWERS
◉ Anesthesia in high risk patients, intolerant of general? Answer:
Regional/local
◉ Regional anesthesia injected? Answer: Anywhere along a nerve
pathway
◉ IV regional AKA. Answer: Bier Block
◉ Bier Blocks. Answer: most often used for upper extremity nerve
blockades.
◉ Epidural anesthetic is injected where? Answer: space between the
ligamentum flavum (connective tissue which links the individual
vertebrae together. It connects inside the vertebral structure, posterior to
the central canal.) and the dura
It is not injected into the spinal canal
,◉ After spinal anesthesia, potential for what? Answer: Hypotension due
to vasodilation
◉ Anesthesia alternatives for pts intolerant certain types of anesthesia,
healthy pts or high risk patients. Answer: Local alone or in combo with
IV analgesics (fentanyl) and amnesiacs (versed) can be used.
◉ How to avoid anesthesia complications. Answer: preop evaluation is
important. Unforseen complications can occur despite thorough preop
interviews/assessment. possible malignant hyperthermia
◉ Most consistent physiological indication of malignant hyperthermia.
Answer: end-tidal CO2
◉ Tx malignant hyperthermia. Answer: Recognition is crucial to tx.
Once detected:
Immediately stop surgery
If stopping is not possible-triggering agents should be stopped and
replaced with safe agents.
Follow written protocol for continued treatment.
Dantrolene, 100% O2 and use iced saline to cool the patient.
◉ How many stages of Anesthesia? Answer: 4
, ◉ Stage 1 of anesthesia. Answer: Initial Administration.
actual administration of anesthetic. Only a few seconds between initial
admin of drug and unconsciousness.
◉ Stage 2 of anesthesia. Answer: Excitement.
Patient is unconscious. It is the time from loss of consciousness to the
loss of eyelid reflexes. Involuntary movements may occur at this time.
◉ Stage 3 of anesthesia. Answer: Intrasurgery
This is the time of surgical anesthesia. Patient has rapid eye movement
and breathing may be labored until the muscles completely relax. This
would be the time that surgery would begin.
◉ Stage 4 of anesthesia. Answer: Possibility of respiratory failure.
Characterized by respiratory failure, leading to circulatory failure.
Without breathing apparatus and heart support, the patient can die.
◉ How many phases of anesthesia? Answer: 3
◉ Phase 1 of anesthesia. Answer: Induction
begins with administration of anesthesia and lasts until surgical incision
is made.
◉ Phase 2 anesthesia. Answer: Maintenance
