NBCRNA EXAM AND STUDY GUIDE
NEWEST 2025/ 2026 TEST BANK|
COMPLETE REAL EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED
ANSWERS WITH RATIONALES) GRADED
A+| NBCRNA EXAM PREP (MOST
RECENT!!)
1. A 75 kg patient with morbid obesity (BMI 42) undergoes general
anesthesia. After RSI with succinylcholine, you cannot ventilate or intubate.
The next best step is to:
o A) Repeat succinylcholine 1.5 mg/kg
o B) Perform a surgical cricothyrotomy
o C) Insert a supraglottic airway (SGA)
o D) Attempt blind nasal intubation
o Answer: C. In a cannot-ventilate-cannot-intubate (CVC) scenario, current
difficult airway algorithms prioritize placing an SGA as a rescue device
before proceeding to a surgical airway .
2. Which drug is most likely to cause masseter muscle rigidity in children after
rapid administration?
o A) Rocuronium
o B) Vecuronium
o C) Succinylcholine
o D) Cisatracurium
o Answer: C. Succinylcholine can cause masseter muscle rigidity, especially in
children, sometimes mimicking malignant hyperthermia .
3. During one-lung ventilation, SpO₂ drops to 85%. The correct initial
maneuver is:
,o A) Increase FiO₂ to 1.0 on both lungs
o B) Apply CPAP 5 cm H₂O to non-dependent lung
o C) Clamp the pulmonary artery of the non-dependent lung
o D) Immediately resume two-lung ventilation
o Answer: D. The first step in treating hypoxemia during OLV is to return to
two-lung ventilation to restore oxygenation .
4. A patient undergoing rigid bronchoscopy develops bradycardia,
hypotension, and subcutaneous emphysema. The most likely cause is:
o A) Tension pneumothorax
o B) Vagal reflex
o C) Air embolism
o D) Laryngospasm
o Answer: A. Subcutaneous emphysema during rigid bronchoscopy suggests
barotrauma, and a tension pneumothorax can present with hypotension
and bradycardia .
5. Which inhalational agent is most associated with carbon monoxide
formation in CO₂ absorbent when desiccated?
o A) Isoflurane
o B) Sevoflurane
o C) Desflurane
o D) Halothane
o Answer: C. Desflurane reacts with desiccated CO₂ absorbent (especially
barium hydroxide lime) to produce carbon monoxide .
6. The cuff of an endotracheal tube should be inflated to a pressure of:
o A) 10-15 cm H₂O
o B) 20-30 cm H₂O
o C) 30-40 cm H₂O
o D) 40-50 cm H₂O
o Answer: B. The recommended cuff pressure is 20-30 cm H₂O (~15–22
mmHg). Higher pressures risk tracheal mucosal ischemia .
7. Which laryngoscope blade is designed to fit into the vallecula to indirectly
elevate the epiglottis?
o A) Miller
,o B) Macintosh
o C) Wis-Hipple
o D) McCoy
o Answer: B. The Macintosh blade (curved) is placed in the vallecula, lifting
the hyoepiglottic ligament to expose the glottis indirectly .
8. A patient with a difficult airway has a Mallampati class IV. This finding
predicts:
o A) Easy mask ventilation
o B) Easy intubation
o C) Difficult intubation
o D) High risk of aspiration
o Answer: C. Mallampati IV (soft palate and entire uvula not visible) predicts
difficult laryngoscopy and intubation .
9. During emergence, a patient exhibits stridor and suprasternal retractions.
The first-line treatment is:
o A) Reintubation
o B) Racemic epinephrine 0.5 ml of 2.25% via nebulizer
o C) Dexamethasone 10 mg IV
o D) Heliox
o Answer: B. Post-extubation stridor suggests laryngeal edema, and racemic
epinephrine (nebulized) causes vasoconstriction, reducing edema within
minutes .
10. Which volatile agent is most suitable for inhalation induction in a
child due to its low blood-gas solubility?
o A) Isoflurane
o B) Sevoflurane
o C) Desflurane
o D) Enflurane
o Answer: B. Sevoflurane has a blood-gas partition coefficient of 0.69,
allowing rapid induction .
Questions 11-20
, 11. A patient on an MAOI requires general anesthesia. Which indirect-
acting sympathomimetic is absolutely contraindicated?
o A) Phenylephrine
o B) Ephedrine
o C) Dopamine
o D) Norepinephrine
o Answer: B. Indirect-acting sympathomimetics like ephedrine can cause a
life-threatening hypertensive crisis in patients on MAOIs .
12. The primary mechanism by which propofol causes hypotension is:
o A) Decreased systemic vascular resistance
o B) Decreased myocardial contractility
o C) Decreased preload
o D) Bradycardia
o Answer: A. Propofol causes hypotension primarily through a decrease in
systemic vascular resistance .
13. Which neuromuscular blocker undergoes Hofmann elimination?
o A) Rocuronium
o B) Cisatracurium
o C) Succinylcholine
o D) Pancuronium
o Answer: B. Cisatracurium is degraded spontaneously by Hofmann
elimination, independent of liver/kidney function .
14. Reversal of rocuronium with sugammadex 16 mg/kg is indicated for:
o A) Moderate block (TOF 2-4 twitches)
o B) Deep block (PTC 1-2)
o C) Shallow block (TOF 4 with fade)
o D) Immediate reversal after intubation dose
o Answer: B. Sugammadex 16 mg/kg reverses deep neuromuscular blockade
(PTC > 1) .
15. Malignant hyperthermia is triggered by all EXCEPT:
o A) Sevoflurane
o B) Succinylcholine
o C) Isoflurane
NEWEST 2025/ 2026 TEST BANK|
COMPLETE REAL EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED
ANSWERS WITH RATIONALES) GRADED
A+| NBCRNA EXAM PREP (MOST
RECENT!!)
1. A 75 kg patient with morbid obesity (BMI 42) undergoes general
anesthesia. After RSI with succinylcholine, you cannot ventilate or intubate.
The next best step is to:
o A) Repeat succinylcholine 1.5 mg/kg
o B) Perform a surgical cricothyrotomy
o C) Insert a supraglottic airway (SGA)
o D) Attempt blind nasal intubation
o Answer: C. In a cannot-ventilate-cannot-intubate (CVC) scenario, current
difficult airway algorithms prioritize placing an SGA as a rescue device
before proceeding to a surgical airway .
2. Which drug is most likely to cause masseter muscle rigidity in children after
rapid administration?
o A) Rocuronium
o B) Vecuronium
o C) Succinylcholine
o D) Cisatracurium
o Answer: C. Succinylcholine can cause masseter muscle rigidity, especially in
children, sometimes mimicking malignant hyperthermia .
3. During one-lung ventilation, SpO₂ drops to 85%. The correct initial
maneuver is:
,o A) Increase FiO₂ to 1.0 on both lungs
o B) Apply CPAP 5 cm H₂O to non-dependent lung
o C) Clamp the pulmonary artery of the non-dependent lung
o D) Immediately resume two-lung ventilation
o Answer: D. The first step in treating hypoxemia during OLV is to return to
two-lung ventilation to restore oxygenation .
4. A patient undergoing rigid bronchoscopy develops bradycardia,
hypotension, and subcutaneous emphysema. The most likely cause is:
o A) Tension pneumothorax
o B) Vagal reflex
o C) Air embolism
o D) Laryngospasm
o Answer: A. Subcutaneous emphysema during rigid bronchoscopy suggests
barotrauma, and a tension pneumothorax can present with hypotension
and bradycardia .
5. Which inhalational agent is most associated with carbon monoxide
formation in CO₂ absorbent when desiccated?
o A) Isoflurane
o B) Sevoflurane
o C) Desflurane
o D) Halothane
o Answer: C. Desflurane reacts with desiccated CO₂ absorbent (especially
barium hydroxide lime) to produce carbon monoxide .
6. The cuff of an endotracheal tube should be inflated to a pressure of:
o A) 10-15 cm H₂O
o B) 20-30 cm H₂O
o C) 30-40 cm H₂O
o D) 40-50 cm H₂O
o Answer: B. The recommended cuff pressure is 20-30 cm H₂O (~15–22
mmHg). Higher pressures risk tracheal mucosal ischemia .
7. Which laryngoscope blade is designed to fit into the vallecula to indirectly
elevate the epiglottis?
o A) Miller
,o B) Macintosh
o C) Wis-Hipple
o D) McCoy
o Answer: B. The Macintosh blade (curved) is placed in the vallecula, lifting
the hyoepiglottic ligament to expose the glottis indirectly .
8. A patient with a difficult airway has a Mallampati class IV. This finding
predicts:
o A) Easy mask ventilation
o B) Easy intubation
o C) Difficult intubation
o D) High risk of aspiration
o Answer: C. Mallampati IV (soft palate and entire uvula not visible) predicts
difficult laryngoscopy and intubation .
9. During emergence, a patient exhibits stridor and suprasternal retractions.
The first-line treatment is:
o A) Reintubation
o B) Racemic epinephrine 0.5 ml of 2.25% via nebulizer
o C) Dexamethasone 10 mg IV
o D) Heliox
o Answer: B. Post-extubation stridor suggests laryngeal edema, and racemic
epinephrine (nebulized) causes vasoconstriction, reducing edema within
minutes .
10. Which volatile agent is most suitable for inhalation induction in a
child due to its low blood-gas solubility?
o A) Isoflurane
o B) Sevoflurane
o C) Desflurane
o D) Enflurane
o Answer: B. Sevoflurane has a blood-gas partition coefficient of 0.69,
allowing rapid induction .
Questions 11-20
, 11. A patient on an MAOI requires general anesthesia. Which indirect-
acting sympathomimetic is absolutely contraindicated?
o A) Phenylephrine
o B) Ephedrine
o C) Dopamine
o D) Norepinephrine
o Answer: B. Indirect-acting sympathomimetics like ephedrine can cause a
life-threatening hypertensive crisis in patients on MAOIs .
12. The primary mechanism by which propofol causes hypotension is:
o A) Decreased systemic vascular resistance
o B) Decreased myocardial contractility
o C) Decreased preload
o D) Bradycardia
o Answer: A. Propofol causes hypotension primarily through a decrease in
systemic vascular resistance .
13. Which neuromuscular blocker undergoes Hofmann elimination?
o A) Rocuronium
o B) Cisatracurium
o C) Succinylcholine
o D) Pancuronium
o Answer: B. Cisatracurium is degraded spontaneously by Hofmann
elimination, independent of liver/kidney function .
14. Reversal of rocuronium with sugammadex 16 mg/kg is indicated for:
o A) Moderate block (TOF 2-4 twitches)
o B) Deep block (PTC 1-2)
o C) Shallow block (TOF 4 with fade)
o D) Immediate reversal after intubation dose
o Answer: B. Sugammadex 16 mg/kg reverses deep neuromuscular blockade
(PTC > 1) .
15. Malignant hyperthermia is triggered by all EXCEPT:
o A) Sevoflurane
o B) Succinylcholine
o C) Isoflurane
