Apex Mock Exams + Valley Pre-Course Exam Questions
2026/2027 | Actual Questions and Answers Latest Updated
2026/2027 (Graded A+)
• Question
"Can't ventilate, can't intubate" scenario. What is the best way to secure the airway?
Correct Answer: I. Requires an
II. emergent surgical airway
III. a) surgical cricothyrotomy
IV. b) transtracheal jet ventilation
tracheostomy and retrograde intubation are not considered emergent airways
• Question
Convert Fahrenheit to Celsius
Correct Answer: F= (C x 1.8) + 32
• Question
What are the best oxygen sources for transtracheal ventilation?
Correct Answer: I. High pressure O2 sources (TTJV
II. requires psi of at least 25)
III. 1. jet ventilator attached to anesthesia machine
IV. 2. O2 tank with a pressure regulator set to 50 psi
V. 3. O2 flush valve on the anesthesia machine
Low pressure O2 sources (self resuscitation bag or reservoir bag on the anesthesia
machine) are not used for TTJV because they cannot fill the lungs with adequate O2 flow
LA ranked from shortest DOA to longest DOA
• Question
a) procaine
b) lidocaine
c) chloroprocaine
d) bupivacaine
e) mepivacaine
f) tetracaine
g) ropivacaine
Correct Answer: shortest (lowest protein binding) : procaine, cholorprocaine (zero
protein binding)
intermediate: lidocaine, mepivacine
,longest (most protein binding): bupivacaine, ropivacaine, tetracaine
In a cirlce system, work of breathing is primarily determined by which component of the
system?
• Question
Think about Pouiselle's Law...
Correct Answer: Whatever answer choice gives you the smallest diameter--> decreased
radius/diameter increases resistance
ETT is likely the answer since it has the narrowest diameter out of the Y piece,
unidirectional valves and circuit tubing
• Question
In the 15 kg pediatric patient who experiences cardiac arrest, what is the first
defibrillation shock set at? What about the second attempt?
Correct Answer: first attempt: 2J/kg --> 30 J second attempt if necessary: 4J/kg --> 60 J
Rank the following tests of neuromuscular function based on the % of receptors that can
be occupied when the desired response is achieved
• Question
TOF 4/4 double burst stimulation without fade TV 5mL/kg biting on tongue blade for
longer than 5 seconds
Correct Answer: TV 5 mL/kg-- 80% of receptors still occupied by NMBD TOF 4/4 -- 70% of
receptors still occupied by NMBD double burst stimulation without fade -- 60% of
receptors still occupied by NMBD biting on tongue blade > 5 seconds -- 50% of receptors
still occupied by NMBD (this is the most sensitive test of reversal)
• Question
Surgery is needed within __ hours of spinal hematoma symptoms. If delayed for more
than __ hours, recovery is unlikely.
Correct Answer: 8 hours
surgical decompression needs to happen within 8 hours of spinal hematoma symptoms
or recovery is unlikely
• Question
2 causes of hypocalcemia in the operating room
Correct Answer: 1. administration of PRBCs (citrate binds calcium) 2. hyperventilation
(causes decreased ionized calcium because H+ ions get displaced from plasma proteins
and Ca takes its place)
,• Question
Equation for therapeutic index (TI)
Correct Answer: LD50/ED50
• Question
Post synaptic nicotinic receptors are found at each of the following sites EXCEPT:
a) NMJ
b) SA node
c) autonomic ganglia
d) adrenal medulla
Correct Answer: B- muscarinic receptors and adrenergic (B1) receptors are at the SA
node
Rank the following from most likely to least likely to cause a perioperative allergic
reaction
• Question
muscle relaxants antibiotics latex protamine/ blood products
Correct Answer: I. most likely: 1. muscle relaxants (50-60%)
II. 2. latex (15%)
III. 3. antibiotics (10-15%)
IV. 4. protamine/ blood products (<2-3%)
• Question
What dose of epi causes beta effects?
Correct Answer: low dose epi 0.01-0.03 mcg/kg/min --> beta effects (B1= increased HR
and contractility, B2= decreased SVR)
intermediate dose epi 0.03-0.15 mcg/kg/min --> mixed alpha and beta
high dose epi >0.15 mcg/kg/min --> alpha effects (increased SVR--> increased BP)
What is the first step of the soda lime reaction?
• Question
What are the final products of the soda lime reaction?
Correct Answer: I. First step:
II. CO2 + H2O --> H2CO3
III. (carbonic acid)
Final products: CaCO3 + NaOH (calcium carbonate and sodium hydroxide)
, • Question
What is the Aldrete Score and what does it quantify?
Correct Answer: Quantifies recovery from anesthesia
Drug eluding stent vs metal stent
• Question
How long after stent placement should another surgery be delayed?
Correct Answer: I. DES: delay surgery for 6
II. months if possible
III. metal stent: delay surgery for a minimum of 30 days
Gastroschisis vs. Ompahlocele
• Question
Where do abdominal contents spill out from? Are abdominal contents covered in a sac?
Which one is more associated with prematurity? Which one is associated with congenital
abnormalities?
Correct Answer: Gastroschisis -abdominal contents coming from right of umbilicus
-abdominal contents NOT covered by a sac -happens more commonly with prematurity
-not associated with congenital abnormalities
Ompahlocele -abdominal contents coming from midline defect -abdominal contents
covered by sac -associated with congenital abnormalities
Name some drugs that interfere with SSEP monitoring.
• Question
What drugs are safe to use when SSEP monitoring is happening?
Correct Answer: I. Drugs that impair SSEPs (decrease
II. SSEP amplitude and increase SSEP latency)
III. -volatiles, N2O
IV. -propofol
V. -barbiturates
VI. -midazolam, diazepam
Drugs that do not impact SSEP monitoring -ketamine -dexmeditomidine -opioids
-droperidol
2026/2027 | Actual Questions and Answers Latest Updated
2026/2027 (Graded A+)
• Question
"Can't ventilate, can't intubate" scenario. What is the best way to secure the airway?
Correct Answer: I. Requires an
II. emergent surgical airway
III. a) surgical cricothyrotomy
IV. b) transtracheal jet ventilation
tracheostomy and retrograde intubation are not considered emergent airways
• Question
Convert Fahrenheit to Celsius
Correct Answer: F= (C x 1.8) + 32
• Question
What are the best oxygen sources for transtracheal ventilation?
Correct Answer: I. High pressure O2 sources (TTJV
II. requires psi of at least 25)
III. 1. jet ventilator attached to anesthesia machine
IV. 2. O2 tank with a pressure regulator set to 50 psi
V. 3. O2 flush valve on the anesthesia machine
Low pressure O2 sources (self resuscitation bag or reservoir bag on the anesthesia
machine) are not used for TTJV because they cannot fill the lungs with adequate O2 flow
LA ranked from shortest DOA to longest DOA
• Question
a) procaine
b) lidocaine
c) chloroprocaine
d) bupivacaine
e) mepivacaine
f) tetracaine
g) ropivacaine
Correct Answer: shortest (lowest protein binding) : procaine, cholorprocaine (zero
protein binding)
intermediate: lidocaine, mepivacine
,longest (most protein binding): bupivacaine, ropivacaine, tetracaine
In a cirlce system, work of breathing is primarily determined by which component of the
system?
• Question
Think about Pouiselle's Law...
Correct Answer: Whatever answer choice gives you the smallest diameter--> decreased
radius/diameter increases resistance
ETT is likely the answer since it has the narrowest diameter out of the Y piece,
unidirectional valves and circuit tubing
• Question
In the 15 kg pediatric patient who experiences cardiac arrest, what is the first
defibrillation shock set at? What about the second attempt?
Correct Answer: first attempt: 2J/kg --> 30 J second attempt if necessary: 4J/kg --> 60 J
Rank the following tests of neuromuscular function based on the % of receptors that can
be occupied when the desired response is achieved
• Question
TOF 4/4 double burst stimulation without fade TV 5mL/kg biting on tongue blade for
longer than 5 seconds
Correct Answer: TV 5 mL/kg-- 80% of receptors still occupied by NMBD TOF 4/4 -- 70% of
receptors still occupied by NMBD double burst stimulation without fade -- 60% of
receptors still occupied by NMBD biting on tongue blade > 5 seconds -- 50% of receptors
still occupied by NMBD (this is the most sensitive test of reversal)
• Question
Surgery is needed within __ hours of spinal hematoma symptoms. If delayed for more
than __ hours, recovery is unlikely.
Correct Answer: 8 hours
surgical decompression needs to happen within 8 hours of spinal hematoma symptoms
or recovery is unlikely
• Question
2 causes of hypocalcemia in the operating room
Correct Answer: 1. administration of PRBCs (citrate binds calcium) 2. hyperventilation
(causes decreased ionized calcium because H+ ions get displaced from plasma proteins
and Ca takes its place)
,• Question
Equation for therapeutic index (TI)
Correct Answer: LD50/ED50
• Question
Post synaptic nicotinic receptors are found at each of the following sites EXCEPT:
a) NMJ
b) SA node
c) autonomic ganglia
d) adrenal medulla
Correct Answer: B- muscarinic receptors and adrenergic (B1) receptors are at the SA
node
Rank the following from most likely to least likely to cause a perioperative allergic
reaction
• Question
muscle relaxants antibiotics latex protamine/ blood products
Correct Answer: I. most likely: 1. muscle relaxants (50-60%)
II. 2. latex (15%)
III. 3. antibiotics (10-15%)
IV. 4. protamine/ blood products (<2-3%)
• Question
What dose of epi causes beta effects?
Correct Answer: low dose epi 0.01-0.03 mcg/kg/min --> beta effects (B1= increased HR
and contractility, B2= decreased SVR)
intermediate dose epi 0.03-0.15 mcg/kg/min --> mixed alpha and beta
high dose epi >0.15 mcg/kg/min --> alpha effects (increased SVR--> increased BP)
What is the first step of the soda lime reaction?
• Question
What are the final products of the soda lime reaction?
Correct Answer: I. First step:
II. CO2 + H2O --> H2CO3
III. (carbonic acid)
Final products: CaCO3 + NaOH (calcium carbonate and sodium hydroxide)
, • Question
What is the Aldrete Score and what does it quantify?
Correct Answer: Quantifies recovery from anesthesia
Drug eluding stent vs metal stent
• Question
How long after stent placement should another surgery be delayed?
Correct Answer: I. DES: delay surgery for 6
II. months if possible
III. metal stent: delay surgery for a minimum of 30 days
Gastroschisis vs. Ompahlocele
• Question
Where do abdominal contents spill out from? Are abdominal contents covered in a sac?
Which one is more associated with prematurity? Which one is associated with congenital
abnormalities?
Correct Answer: Gastroschisis -abdominal contents coming from right of umbilicus
-abdominal contents NOT covered by a sac -happens more commonly with prematurity
-not associated with congenital abnormalities
Ompahlocele -abdominal contents coming from midline defect -abdominal contents
covered by sac -associated with congenital abnormalities
Name some drugs that interfere with SSEP monitoring.
• Question
What drugs are safe to use when SSEP monitoring is happening?
Correct Answer: I. Drugs that impair SSEPs (decrease
II. SSEP amplitude and increase SSEP latency)
III. -volatiles, N2O
IV. -propofol
V. -barbiturates
VI. -midazolam, diazepam
Drugs that do not impact SSEP monitoring -ketamine -dexmeditomidine -opioids
-droperidol
