NBCRNA Actual Exam Solved
Reviewed Combined Questions
With Revised Correct Detailed
NEW Answers & Rationales
!! >Latest Update>>
1. Which type of pneumocystis produce surfactant? - ANSWER type 2
2. Three types of pneumocytes? - ANSWER type 1 - 3
type 1 - cover 80% of alveolar surface
type 3 - macrophages that fight lung infection
3. What nerve? - ANSWER medial rectus: adducts the eyeball (CN III)
corrugator supercilii: moves the eyebrow (CN VII)
adductor pollicis: adducts the thumb (ulnar nerve)
orbicularis oculi: closes the eyelid (CN VII)
4. Nerve stimulator placement:
black and red where? - ANSWER Positive and proximal - red to the head
distal and black
,5. The risk of pulmonary aspiration increases when the TOF ratio measured at
the adductor pollicis is less than? - ANSWER 0.9
6. Most sensitive bedside assessments of recovery: - ANSWER head lift >
5 sec
leg lift > 5 sec
holding tongue depressor btw teeth against force
7. What is the best acetylcholinesterase inhibitor to antagonize a block with
90% twitch suppression? - ANSWER Neostigmine
8. Neostigmine antagonizes rocuronium by? - ANSWER decreasing
acetylcholine hydrolysis
9. Neostigmine is a... - ANSWER cholinesterase inhibitor that reversibly
binds to acetylcholinesterase at the NMJ - this inhibits acetylcholine
hydrolysis allowing more ACh to compete with the NMBA at the nicotinic
receptor
- competitve antagonism!
10.Produces reversible inhibition of AchE by forming a carbamyl ester complex
at esteratic site? - ANSWER Neostigmine
pridostigmine
physostigmine
11.Forms an electrostatic bond at the anionic site and a noncovalent hydrogen
bond at the esteratic site. - ANSWER Edrophonium
, - hydrogen bonds are weak so DoA is short
12.Produces non-reversible inhibition of AchE by forming a stable complex
with the esteratic site. New acetylcholinesterase must be synthesized,
which explains this extended DoA.... - ANSWER Organophosphates
13.Match the acetylcholinesterase inhibitor to its dose:
Neostigmine
Edrophonium
Pyridostigmine - ANSWER Neostigmine: 0.05mg/kg
Edrophonium 1mg/kg
Pyridostigmine 0.3 mg/kg
14.In PACU, 85 year old female received scopolamine and is agitated and
confused, what is the best treatment and why?
15.dose? - ANSWER physostigmine
- scopolamine crosses the BBB and may cause central anticholinergic
syndrome
16.15-60 mcg/kg - only inhibitor that crosses the BBB, antidote for
antimuscarinic OD
, 17.What can central anticholinergic syndrome mimic? - ANSWER slow
emergence from anesthesia
18.What 2 acetylcholinesterase inhibitor in clinical use prolongs the DoA of
sux? - ANSWER neostigmine
pyridostigmine
19.Onset of action for the following anticholinesterase inhibitors?
edrophonium
neostigmine
pyridostigmine - ANSWER edrophonium: 1-2 min
neostigmine: 7-11 min
pyridostigmine: up to 16 min
20.Naturally occurring tertiary amines? - ANSWER atropine
scopolomine
- lipophilic
- easily diffuse lipid membranes like BBB, GI tract and placenta
21.Robinul is a ? - ANSWER quaternary ammonium derivate that ionizes
in the plasma
- doesn't cross easily
22.What is cycloplegia? what causes it? - ANSWER paralysis of the ciliary
muscle in the eye, resulting in the loss of accommodation
Reviewed Combined Questions
With Revised Correct Detailed
NEW Answers & Rationales
!! >Latest Update>>
1. Which type of pneumocystis produce surfactant? - ANSWER type 2
2. Three types of pneumocytes? - ANSWER type 1 - 3
type 1 - cover 80% of alveolar surface
type 3 - macrophages that fight lung infection
3. What nerve? - ANSWER medial rectus: adducts the eyeball (CN III)
corrugator supercilii: moves the eyebrow (CN VII)
adductor pollicis: adducts the thumb (ulnar nerve)
orbicularis oculi: closes the eyelid (CN VII)
4. Nerve stimulator placement:
black and red where? - ANSWER Positive and proximal - red to the head
distal and black
,5. The risk of pulmonary aspiration increases when the TOF ratio measured at
the adductor pollicis is less than? - ANSWER 0.9
6. Most sensitive bedside assessments of recovery: - ANSWER head lift >
5 sec
leg lift > 5 sec
holding tongue depressor btw teeth against force
7. What is the best acetylcholinesterase inhibitor to antagonize a block with
90% twitch suppression? - ANSWER Neostigmine
8. Neostigmine antagonizes rocuronium by? - ANSWER decreasing
acetylcholine hydrolysis
9. Neostigmine is a... - ANSWER cholinesterase inhibitor that reversibly
binds to acetylcholinesterase at the NMJ - this inhibits acetylcholine
hydrolysis allowing more ACh to compete with the NMBA at the nicotinic
receptor
- competitve antagonism!
10.Produces reversible inhibition of AchE by forming a carbamyl ester complex
at esteratic site? - ANSWER Neostigmine
pridostigmine
physostigmine
11.Forms an electrostatic bond at the anionic site and a noncovalent hydrogen
bond at the esteratic site. - ANSWER Edrophonium
, - hydrogen bonds are weak so DoA is short
12.Produces non-reversible inhibition of AchE by forming a stable complex
with the esteratic site. New acetylcholinesterase must be synthesized,
which explains this extended DoA.... - ANSWER Organophosphates
13.Match the acetylcholinesterase inhibitor to its dose:
Neostigmine
Edrophonium
Pyridostigmine - ANSWER Neostigmine: 0.05mg/kg
Edrophonium 1mg/kg
Pyridostigmine 0.3 mg/kg
14.In PACU, 85 year old female received scopolamine and is agitated and
confused, what is the best treatment and why?
15.dose? - ANSWER physostigmine
- scopolamine crosses the BBB and may cause central anticholinergic
syndrome
16.15-60 mcg/kg - only inhibitor that crosses the BBB, antidote for
antimuscarinic OD
, 17.What can central anticholinergic syndrome mimic? - ANSWER slow
emergence from anesthesia
18.What 2 acetylcholinesterase inhibitor in clinical use prolongs the DoA of
sux? - ANSWER neostigmine
pyridostigmine
19.Onset of action for the following anticholinesterase inhibitors?
edrophonium
neostigmine
pyridostigmine - ANSWER edrophonium: 1-2 min
neostigmine: 7-11 min
pyridostigmine: up to 16 min
20.Naturally occurring tertiary amines? - ANSWER atropine
scopolomine
- lipophilic
- easily diffuse lipid membranes like BBB, GI tract and placenta
21.Robinul is a ? - ANSWER quaternary ammonium derivate that ionizes
in the plasma
- doesn't cross easily
22.What is cycloplegia? what causes it? - ANSWER paralysis of the ciliary
muscle in the eye, resulting in the loss of accommodation
