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CAA Maintenance of Certification Exam
Practice Exam Questions And Correct
Answers (Verified Answers) Plus
Rationales 2026 Q&A Instant Download
Pdf
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1. Which physiologic change is most likely to occur during induction of general
anesthesia with propofol?
A. Increased systemic vascular resistance
B. Increased sympathetic activity
C. Decreased systemic vascular resistance
D. Increased myocardial contractility
Answer: Decreased systemic vascular resistance
Rationale: Propofol commonly produces vasodilation and reduces systemic
vascular resistance, which can lead to clinically significant hypotension,
particularly in patients who are hypovolemic or hemodynamically fragile.
2. Which anesthetic agent is most associated with malignant hyperthermia
triggering?
A. Propofol
B. Sevoflurane
,C. Midazolam
D. Nitrous oxide
Answer: Sevoflurane
Rationale: Volatile inhalational anesthetics, including sevoflurane, can trigger
malignant hyperthermia in susceptible individuals. Propofol, midazolam, and
nitrous oxide are not typical triggers.
3. What is the primary mechanism of action of succinylcholine?
A. Competitive antagonism at muscarinic receptors
B. Nondepolarizing blockade of nicotinic receptors
C. Persistent depolarization of the neuromuscular junction
D. Inhibition of acetylcholinesterase
Answer: Persistent depolarization of the neuromuscular junction
Rationale: Succinylcholine is a depolarizing neuromuscular blocker that initially
produces fasciculations followed by paralysis because the motor end plate
remains depolarized.
4. Which neuromuscular blocking drug is classified as a nondepolarizing
agent?
A. Succinylcholine
B. Rocuronium
C. Acetylcholine
D. Physostigmine
Answer: Rocuronium
Rationale: Rocuronium competitively blocks nicotinic acetylcholine receptors at
the neuromuscular junction and produces nondepolarizing paralysis.
5. Which medication is commonly used to reverse rocuronium-induced
neuromuscular blockade?
A. Sugammadex
B. Flumazenil
,C. Naloxone
D. Dantrolene
Answer: Sugammadex
Rationale: Sugammadex encapsulates steroidal neuromuscular blockers such as
rocuronium and vecuronium, allowing rapid reversal of their effects.
6. What is the most important immediate treatment for severe opioid-induced
respiratory depression?
A. Administer naloxone
B. Administer dantrolene
C. Administer atropine
D. Administer protamine
Answer: Administer naloxone
Rationale: Naloxone is an opioid antagonist that rapidly reverses opioid-induced
respiratory and central nervous system depression. Airway support and
ventilation remain essential when indicated.
7. Which monitoring modality provides the most direct continuous
assessment of ventilation during general anesthesia?
A. Pulse oximetry
B. Capnography
C. Electrocardiography
D. Temperature monitoring
Answer: Capnography
Rationale: Capnography continuously measures exhaled carbon dioxide and
provides important information about ventilation, airway patency, and
circulation.
8. A sudden loss of the capnography waveform during mechanical ventilation
should first prompt evaluation for:
, A. Hyperglycemia
B. Esophageal hypothermia
C. Circuit disconnection or airway obstruction
D. Metabolic alkalosis
Answer: Circuit disconnection or airway obstruction
Rationale: Abrupt disappearance of end-tidal carbon dioxide may result from
disconnection, complete airway obstruction, equipment failure, or profound
circulatory collapse. Immediate assessment is required.
9. Which factor most strongly shifts the oxyhemoglobin dissociation curve to
the right?
A. Hypothermia
B. Alkalosis
C. Decreased 2,3-DPG
D. Increased temperature
Answer: Increased temperature
Rationale: Increased temperature, increased carbon dioxide, increased hydrogen
ion concentration, and increased 2,3-DPG shift the curve to the right and
facilitate oxygen unloading to tissues.
10.Which local anesthetic is generally associated with the greatest concern for
cardiotoxicity?
A. Lidocaine
B. Bupivacaine
C. Chloroprocaine
D. Procaine
Answer: Bupivacaine
Rationale: Bupivacaine has substantial sodium-channel activity in cardiac tissue
and is particularly associated with serious cardiovascular toxicity when systemic
concentrations become excessive.
CAA Maintenance of Certification Exam
Practice Exam Questions And Correct
Answers (Verified Answers) Plus
Rationales 2026 Q&A Instant Download
___________________________________________________________________
1. Which physiologic change is most likely to occur during induction of general
anesthesia with propofol?
A. Increased systemic vascular resistance
B. Increased sympathetic activity
C. Decreased systemic vascular resistance
D. Increased myocardial contractility
Answer: Decreased systemic vascular resistance
Rationale: Propofol commonly produces vasodilation and reduces systemic
vascular resistance, which can lead to clinically significant hypotension,
particularly in patients who are hypovolemic or hemodynamically fragile.
2. Which anesthetic agent is most associated with malignant hyperthermia
triggering?
A. Propofol
B. Sevoflurane
,C. Midazolam
D. Nitrous oxide
Answer: Sevoflurane
Rationale: Volatile inhalational anesthetics, including sevoflurane, can trigger
malignant hyperthermia in susceptible individuals. Propofol, midazolam, and
nitrous oxide are not typical triggers.
3. What is the primary mechanism of action of succinylcholine?
A. Competitive antagonism at muscarinic receptors
B. Nondepolarizing blockade of nicotinic receptors
C. Persistent depolarization of the neuromuscular junction
D. Inhibition of acetylcholinesterase
Answer: Persistent depolarization of the neuromuscular junction
Rationale: Succinylcholine is a depolarizing neuromuscular blocker that initially
produces fasciculations followed by paralysis because the motor end plate
remains depolarized.
4. Which neuromuscular blocking drug is classified as a nondepolarizing
agent?
A. Succinylcholine
B. Rocuronium
C. Acetylcholine
D. Physostigmine
Answer: Rocuronium
Rationale: Rocuronium competitively blocks nicotinic acetylcholine receptors at
the neuromuscular junction and produces nondepolarizing paralysis.
5. Which medication is commonly used to reverse rocuronium-induced
neuromuscular blockade?
A. Sugammadex
B. Flumazenil
,C. Naloxone
D. Dantrolene
Answer: Sugammadex
Rationale: Sugammadex encapsulates steroidal neuromuscular blockers such as
rocuronium and vecuronium, allowing rapid reversal of their effects.
6. What is the most important immediate treatment for severe opioid-induced
respiratory depression?
A. Administer naloxone
B. Administer dantrolene
C. Administer atropine
D. Administer protamine
Answer: Administer naloxone
Rationale: Naloxone is an opioid antagonist that rapidly reverses opioid-induced
respiratory and central nervous system depression. Airway support and
ventilation remain essential when indicated.
7. Which monitoring modality provides the most direct continuous
assessment of ventilation during general anesthesia?
A. Pulse oximetry
B. Capnography
C. Electrocardiography
D. Temperature monitoring
Answer: Capnography
Rationale: Capnography continuously measures exhaled carbon dioxide and
provides important information about ventilation, airway patency, and
circulation.
8. A sudden loss of the capnography waveform during mechanical ventilation
should first prompt evaluation for:
, A. Hyperglycemia
B. Esophageal hypothermia
C. Circuit disconnection or airway obstruction
D. Metabolic alkalosis
Answer: Circuit disconnection or airway obstruction
Rationale: Abrupt disappearance of end-tidal carbon dioxide may result from
disconnection, complete airway obstruction, equipment failure, or profound
circulatory collapse. Immediate assessment is required.
9. Which factor most strongly shifts the oxyhemoglobin dissociation curve to
the right?
A. Hypothermia
B. Alkalosis
C. Decreased 2,3-DPG
D. Increased temperature
Answer: Increased temperature
Rationale: Increased temperature, increased carbon dioxide, increased hydrogen
ion concentration, and increased 2,3-DPG shift the curve to the right and
facilitate oxygen unloading to tissues.
10.Which local anesthetic is generally associated with the greatest concern for
cardiotoxicity?
A. Lidocaine
B. Bupivacaine
C. Chloroprocaine
D. Procaine
Answer: Bupivacaine
Rationale: Bupivacaine has substantial sodium-channel activity in cardiac tissue
and is particularly associated with serious cardiovascular toxicity when systemic
concentrations become excessive.
