CNIM II Exam with all Correct & 100% Verified Answers |Actual
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According to the ACNS guidelines, baseline data should be established
A- Prior to incision
B- Prior to induction
C- Prior to instrumentation
D- Following positioning, but prior to surgical manipulation of nervous system ✔Correct
Answer-D
According the ACNS guidelines, what is the recommended placement of the ground for a
cervical procedure?
A- Neck
B-Hand
C-Forearm
D-Shoulder ✔Correct Answer-C
If all waveforms for the upper left SSEP attenuate except for the erb's channel waveform, what
should you do?
A- continue monitoring without alarm
B- Notify the surgeon immediately
C- check the stimulating electrodes
D-check the computer settings ✔Correct Answer-B
A sudden loss of wave V of the ipsilateral BAEP during micro vascular decompression for
trigeminal neuralgia is most consistent with
A- dislodging of tubing/transducer from ear canal
B- traction on the vestibulocochlear nerve
C- ischemic injury
D- increase in dosage of inhaled anesthetics ✔Correct Answer-C
Waveform changes should be reported to the surgeon as quickly as possible when
A- Critical structures are approached surgically
B- cautery is in use
C- a physician opinion is needed
D- monopolar cautery is in use ✔Correct Answer-A
Which for the following should be reported to the surgeon
A- Loss of response
B- Increase in stimulus intensity
C- change in time base
D- switch to back up electrodes ✔Correct Answer-A
,When monitoring BAEPs intraoperative, it is recommended to warn the surgeon when an
increase of which of the following occurs?
A- Latency of wave V of less than 1.0 msec
B- latency of wave I of 1 msec
C- Interpeak latency of I-V of 1.0 msec or less
D- Latency of wave V of 1.0 msec or greater ✔Correct Answer-C
The warning signal for deteriorating EP's during surgical monitoring is
A- Latency shortening more than 10%
B- Amplitude reduction to 10 % of control amplitude
C- Amplitude reduction more than 50% of control amplitude
D-Amplitude enhancement more than 100% of control amplitude ✔Correct Answer-C
An objective measure meaningful change to use to warn the surgeon is the
A- Interpeak latency decrease
B- latency decrease
C- 50% amplitude decrease
D- 10% amplitude decrease ✔Correct Answer-C
During a lumbar decompression, the CZ-FPZ left lower extremity cortical waveform amplitude
drops below 50% of baseline while the C3-C4 left lower extremity cortical waveform amplitude
maintains unchanged, what is the appropriate action to take
A- Check the impedances
B- check the subcortical waveform for any changes
C- Notify the surgeon immediately
D- Continue monitoring without alarming surgeon ✔Correct Answer-D
For procedures requiring hypothermia induced cerebral protection, the IOM tech can note
hypothermia is achieved with the loss of
A- P37
B- P22
C- P14
D- N20 ✔Correct Answer-C
How many waves of a 60 hz signal should you see in a 500 ms sweep
A- 5
B-15
C-12
D-30 ✔Correct Answer-D
Which of the following would most affect the ability to obtain BAER recordings?
A- Monopolar Coagulator
B- Inhalational gas
,C- Pneumatic drill
D- Retractor ✔Correct Answer-A
Which of the following may cause a temporary threshold shift of the BAER recording?
A- Warm irrigation
B- Drill
C- Cautery
D-CUSA ✔Correct Answer-B
Which of the following is most likely to cause electrical interference for evoked potential
waveforms in the operation room?
A- Pneumatic drill
B- Electrocautery
C- Lights
D- Twitch monitor ✔Correct Answer-B
Which of the following is a source of intraoperative physiologic artifacts?
A- Blood warmer
B- Pulse
C- Electrooculogram
D- Cell saver ✔Correct Answer-B
How many waveforms would be present for a 60 Hz artifact on a screen with a 40msec time
base?
A- 15
B- 4.8
C- 2.4
D- 6 ✔Correct Answer-C
Stimulus artifact during SSEPS can be decreased by
A- lowering the impedances of ground and stimulating electrodes
B- using subdermal needle electrodes instead of sticky pads
C- Moving electrodes to a more proximal stimulation site
D- Increasing neuromuscular blockade ✔Correct Answer-A
Why is it important to braid electrode wires in the operating room
A- To reduce the amplifier's common mode rejection
B- to reduce interference from ambient noise
C- to shorten the overall length
D- To avoid interfering with the surgeon's movements ✔Correct Answer-B
When deciding between an 8ft and 20 connector cable for a 32-channel system, why is the 8ft
cable preferred?
A- Decreased electrical interference
, B- Impedance
C- Requires less power
D-CMRR ✔Correct Answer-A
Which of the following is the largest bio-potential source of artifact for the BAEP?
A- Muscle
B- Heart Beat
C- Sweat
D-Pulse ✔Correct Answer-A
What would be the primary precaution one should take to decrease electrical interference in he
OR?
A- Set up the equipment at the corner of the operating room
B- Asking the OR nurse to unplug all electrical equipment that are in your way
C- Using single electrode wires only when setting up the patient
D- Twisting or braiding the electrode wire when setting up the patient ✔Correct Answer-D
The most troublesome source of artifact in pre-operative, pre-induction clinical EP recordings is
A- Ventilation
B-60 Hz
C- Sweat
D- Muscle ✔Correct Answer-D
Which TcMEP montage may be beneficial during a posterior fossa procedure when he patient is
in the sitting position and intracranial air over the hemispheric convexities can interfere with
coronal trans cranial electrical stimulation?
A- CZ-FZ
B- C1-2
C- C3-C4
D- C3- CZ ✔Correct Answer-A
Which electrode type has the lowest impedance?
A- Corkscrew electrodes
B- Gold cup electrodes
C- Subdermal needle electrodes
D- Stainless steel cup electrodes ✔Correct Answer-A
While running upper SSEPs, your CPc-CPz and CPc-CPi channels have good waveforms but both
CPz-Cs5 channels are rejecting all the runs. What should you do?
A- Check the Cs5 electrode
B- Nothing. you need the cortical channels
C- Check the ground
D- Check the CPz electrode ✔Correct Answer-A
Complete Update |Already Graded A+ (Just Released)
According to the ACNS guidelines, baseline data should be established
A- Prior to incision
B- Prior to induction
C- Prior to instrumentation
D- Following positioning, but prior to surgical manipulation of nervous system ✔Correct
Answer-D
According the ACNS guidelines, what is the recommended placement of the ground for a
cervical procedure?
A- Neck
B-Hand
C-Forearm
D-Shoulder ✔Correct Answer-C
If all waveforms for the upper left SSEP attenuate except for the erb's channel waveform, what
should you do?
A- continue monitoring without alarm
B- Notify the surgeon immediately
C- check the stimulating electrodes
D-check the computer settings ✔Correct Answer-B
A sudden loss of wave V of the ipsilateral BAEP during micro vascular decompression for
trigeminal neuralgia is most consistent with
A- dislodging of tubing/transducer from ear canal
B- traction on the vestibulocochlear nerve
C- ischemic injury
D- increase in dosage of inhaled anesthetics ✔Correct Answer-C
Waveform changes should be reported to the surgeon as quickly as possible when
A- Critical structures are approached surgically
B- cautery is in use
C- a physician opinion is needed
D- monopolar cautery is in use ✔Correct Answer-A
Which for the following should be reported to the surgeon
A- Loss of response
B- Increase in stimulus intensity
C- change in time base
D- switch to back up electrodes ✔Correct Answer-A
,When monitoring BAEPs intraoperative, it is recommended to warn the surgeon when an
increase of which of the following occurs?
A- Latency of wave V of less than 1.0 msec
B- latency of wave I of 1 msec
C- Interpeak latency of I-V of 1.0 msec or less
D- Latency of wave V of 1.0 msec or greater ✔Correct Answer-C
The warning signal for deteriorating EP's during surgical monitoring is
A- Latency shortening more than 10%
B- Amplitude reduction to 10 % of control amplitude
C- Amplitude reduction more than 50% of control amplitude
D-Amplitude enhancement more than 100% of control amplitude ✔Correct Answer-C
An objective measure meaningful change to use to warn the surgeon is the
A- Interpeak latency decrease
B- latency decrease
C- 50% amplitude decrease
D- 10% amplitude decrease ✔Correct Answer-C
During a lumbar decompression, the CZ-FPZ left lower extremity cortical waveform amplitude
drops below 50% of baseline while the C3-C4 left lower extremity cortical waveform amplitude
maintains unchanged, what is the appropriate action to take
A- Check the impedances
B- check the subcortical waveform for any changes
C- Notify the surgeon immediately
D- Continue monitoring without alarming surgeon ✔Correct Answer-D
For procedures requiring hypothermia induced cerebral protection, the IOM tech can note
hypothermia is achieved with the loss of
A- P37
B- P22
C- P14
D- N20 ✔Correct Answer-C
How many waves of a 60 hz signal should you see in a 500 ms sweep
A- 5
B-15
C-12
D-30 ✔Correct Answer-D
Which of the following would most affect the ability to obtain BAER recordings?
A- Monopolar Coagulator
B- Inhalational gas
,C- Pneumatic drill
D- Retractor ✔Correct Answer-A
Which of the following may cause a temporary threshold shift of the BAER recording?
A- Warm irrigation
B- Drill
C- Cautery
D-CUSA ✔Correct Answer-B
Which of the following is most likely to cause electrical interference for evoked potential
waveforms in the operation room?
A- Pneumatic drill
B- Electrocautery
C- Lights
D- Twitch monitor ✔Correct Answer-B
Which of the following is a source of intraoperative physiologic artifacts?
A- Blood warmer
B- Pulse
C- Electrooculogram
D- Cell saver ✔Correct Answer-B
How many waveforms would be present for a 60 Hz artifact on a screen with a 40msec time
base?
A- 15
B- 4.8
C- 2.4
D- 6 ✔Correct Answer-C
Stimulus artifact during SSEPS can be decreased by
A- lowering the impedances of ground and stimulating electrodes
B- using subdermal needle electrodes instead of sticky pads
C- Moving electrodes to a more proximal stimulation site
D- Increasing neuromuscular blockade ✔Correct Answer-A
Why is it important to braid electrode wires in the operating room
A- To reduce the amplifier's common mode rejection
B- to reduce interference from ambient noise
C- to shorten the overall length
D- To avoid interfering with the surgeon's movements ✔Correct Answer-B
When deciding between an 8ft and 20 connector cable for a 32-channel system, why is the 8ft
cable preferred?
A- Decreased electrical interference
, B- Impedance
C- Requires less power
D-CMRR ✔Correct Answer-A
Which of the following is the largest bio-potential source of artifact for the BAEP?
A- Muscle
B- Heart Beat
C- Sweat
D-Pulse ✔Correct Answer-A
What would be the primary precaution one should take to decrease electrical interference in he
OR?
A- Set up the equipment at the corner of the operating room
B- Asking the OR nurse to unplug all electrical equipment that are in your way
C- Using single electrode wires only when setting up the patient
D- Twisting or braiding the electrode wire when setting up the patient ✔Correct Answer-D
The most troublesome source of artifact in pre-operative, pre-induction clinical EP recordings is
A- Ventilation
B-60 Hz
C- Sweat
D- Muscle ✔Correct Answer-D
Which TcMEP montage may be beneficial during a posterior fossa procedure when he patient is
in the sitting position and intracranial air over the hemispheric convexities can interfere with
coronal trans cranial electrical stimulation?
A- CZ-FZ
B- C1-2
C- C3-C4
D- C3- CZ ✔Correct Answer-A
Which electrode type has the lowest impedance?
A- Corkscrew electrodes
B- Gold cup electrodes
C- Subdermal needle electrodes
D- Stainless steel cup electrodes ✔Correct Answer-A
While running upper SSEPs, your CPc-CPz and CPc-CPi channels have good waveforms but both
CPz-Cs5 channels are rejecting all the runs. What should you do?
A- Check the Cs5 electrode
B- Nothing. you need the cortical channels
C- Check the ground
D- Check the CPz electrode ✔Correct Answer-A
