CRNA interview EXAM (2025) QUESTIONS AND (DETAILED
ANSWERS) WITH COMPLETE SOLUTIONS
1 What are the interventions for cardiogenic shock?: -Fluids
-Vasopressors (Dopamine)
-Inotropes (Dobutamine, Milrinone for heart failure)
-IABP, ECMO
2. Your ventilator is peak pressure alarming. What could be the problem?: -
Normal plateau pressure - Kink in tubing, patient biting tube, mucous plug,
bronchospasm, ETT too small
-If high plateau pressure - there is an issue with lung compliance ie: developing
PNA, pulmonary edema, auto PEEP, pneumothorax, right main stem, ARDS, ILD
3. Your patient needs to be intubated soon. What items do you want at the
bedside?:
-suction
-appropriate-sized bag and mask
-oxygen source
,-appropriate size endotracheal tubes including a size larger and one size smaller -
laryngoscope and appropriate-sized laryngoscope blades (including one size
smaller and one size larger)
-endotracheal tube-securing equipment (tape or other)
-stylet
-syringe
-pillow, blanket roll -
stethoscope
-IVF, pressure bag
-pressors depending on status
-sedation
-appropriate sized nasogastric tubes
-x-ray on standby
4. What are some reasons for post operative tachycardia?: Postoperative sinus
tachycardia is often attributed to catecholamine release in response to surgical
stress or anemia.
-Pain
-Hypovolemia
-Anemia
-Drug induced
-Cardiac problem (MI, tamponade)
-Pulmonary problem (Pneumothorax, PE)
-
,5 What is the difference between CRNA and MDA?: -Schooling: MDA is a
licensed medical doctor with 12 years of schooling, CRNA requires 6-7 years of
schooling
-In most states, nurse anesthetists cannot administer anesthesia without the
supervision of a board certified doctor (19 states removed - Texas still requires)
-Similar job roles & responsibilities
-Rural areas more commonly have CRNAs, hospitals have both
6. Do you understand "opt out"?: -The federal requirement has been that CRNAs
must be supervised by a physician. The November 13, 2001 rule allows states to
"opt-out" or be "exempted" from the federal supervision requirement.
-For a state to "opt-out" of the federal supervision requirement, the state's governor
must send a letter of attestation to CMS. The letter must attest that:
1. The state's governor has consulted with the state's boards of medicine and
nursing about issues related to access to and the quality of anesthesia services in
the state; and
2. That it is in the best interests of the state's citizens to opt-out of the current
federal physician supervision requirement; and 3. That the opt-out is consistent
with state law.
7. Discuss the role of the sympathetic nervous system.: -Subdivision of the
autonomic nervous system - "fight or flight"
-Involved in preparing the body for stress-related activities, slows bodily processes
that are less important in emergencies such as digestion
-Patho: The amygdala will send a distress signal to the hypothalamus. Impulses
are then transmitted through the SNS to the adrenal glands, which then pumps
adrenaline into the blood stream.
-
, -Increase heart rate, Dilation of the pupil, Secretion of sweat glands, Increased
alertness, Slowing down or stopping digestion, Relaxation of the bladder
-There are two types of neurons within the sympathetic nervous system: the
preganglionic neurons (originate in brain and spinal cord) and the postganglionic
neurons (outside spinal cords), or ganglion cells.
Neurotransmitters involved: Acetylcholine, Epi, Norepi
8 Discuss the role of the parasympathetic nervous system.: -Subdivision of the
autonomic nervous system - "rest and digest" - keeps the basic functions of your
body working as they should.
-PSNS starts in your brain and extends out via long fibers that connect with special
neurons near the organ they intend to act on
-Constricts pupils, causes salivation, slows down the heart rate, tightens the bronchi
in the lungs, enacts digestion, releases bile, makes the bladder contract
9. Tell us about a critical patient you had and the pathophysiology behind
their disease.: Urosepsis -> Septic Shock -> ARDS -> HFOV
10. How does IABP work?: -The IABP consists of a thin, flexible tube called a
catheter. Attached to the tip of the catheter is a long balloon. The other end of the
catheter attaches to a computer console which has a mechanism for inflating and
deflating the balloon at the proper time when your heart beats.
-An IABP allows blood to flow more easily into your coronary arteries. It also helps
your heart pump more blood with each contraction.
-How it works:
1. Deflated in systole (heart contracts) so blood can be ejected with less resistance
& also has a vacuum effect pulling blood forward
-
ANSWERS) WITH COMPLETE SOLUTIONS
1 What are the interventions for cardiogenic shock?: -Fluids
-Vasopressors (Dopamine)
-Inotropes (Dobutamine, Milrinone for heart failure)
-IABP, ECMO
2. Your ventilator is peak pressure alarming. What could be the problem?: -
Normal plateau pressure - Kink in tubing, patient biting tube, mucous plug,
bronchospasm, ETT too small
-If high plateau pressure - there is an issue with lung compliance ie: developing
PNA, pulmonary edema, auto PEEP, pneumothorax, right main stem, ARDS, ILD
3. Your patient needs to be intubated soon. What items do you want at the
bedside?:
-suction
-appropriate-sized bag and mask
-oxygen source
,-appropriate size endotracheal tubes including a size larger and one size smaller -
laryngoscope and appropriate-sized laryngoscope blades (including one size
smaller and one size larger)
-endotracheal tube-securing equipment (tape or other)
-stylet
-syringe
-pillow, blanket roll -
stethoscope
-IVF, pressure bag
-pressors depending on status
-sedation
-appropriate sized nasogastric tubes
-x-ray on standby
4. What are some reasons for post operative tachycardia?: Postoperative sinus
tachycardia is often attributed to catecholamine release in response to surgical
stress or anemia.
-Pain
-Hypovolemia
-Anemia
-Drug induced
-Cardiac problem (MI, tamponade)
-Pulmonary problem (Pneumothorax, PE)
-
,5 What is the difference between CRNA and MDA?: -Schooling: MDA is a
licensed medical doctor with 12 years of schooling, CRNA requires 6-7 years of
schooling
-In most states, nurse anesthetists cannot administer anesthesia without the
supervision of a board certified doctor (19 states removed - Texas still requires)
-Similar job roles & responsibilities
-Rural areas more commonly have CRNAs, hospitals have both
6. Do you understand "opt out"?: -The federal requirement has been that CRNAs
must be supervised by a physician. The November 13, 2001 rule allows states to
"opt-out" or be "exempted" from the federal supervision requirement.
-For a state to "opt-out" of the federal supervision requirement, the state's governor
must send a letter of attestation to CMS. The letter must attest that:
1. The state's governor has consulted with the state's boards of medicine and
nursing about issues related to access to and the quality of anesthesia services in
the state; and
2. That it is in the best interests of the state's citizens to opt-out of the current
federal physician supervision requirement; and 3. That the opt-out is consistent
with state law.
7. Discuss the role of the sympathetic nervous system.: -Subdivision of the
autonomic nervous system - "fight or flight"
-Involved in preparing the body for stress-related activities, slows bodily processes
that are less important in emergencies such as digestion
-Patho: The amygdala will send a distress signal to the hypothalamus. Impulses
are then transmitted through the SNS to the adrenal glands, which then pumps
adrenaline into the blood stream.
-
, -Increase heart rate, Dilation of the pupil, Secretion of sweat glands, Increased
alertness, Slowing down or stopping digestion, Relaxation of the bladder
-There are two types of neurons within the sympathetic nervous system: the
preganglionic neurons (originate in brain and spinal cord) and the postganglionic
neurons (outside spinal cords), or ganglion cells.
Neurotransmitters involved: Acetylcholine, Epi, Norepi
8 Discuss the role of the parasympathetic nervous system.: -Subdivision of the
autonomic nervous system - "rest and digest" - keeps the basic functions of your
body working as they should.
-PSNS starts in your brain and extends out via long fibers that connect with special
neurons near the organ they intend to act on
-Constricts pupils, causes salivation, slows down the heart rate, tightens the bronchi
in the lungs, enacts digestion, releases bile, makes the bladder contract
9. Tell us about a critical patient you had and the pathophysiology behind
their disease.: Urosepsis -> Septic Shock -> ARDS -> HFOV
10. How does IABP work?: -The IABP consists of a thin, flexible tube called a
catheter. Attached to the tip of the catheter is a long balloon. The other end of the
catheter attaches to a computer console which has a mechanism for inflating and
deflating the balloon at the proper time when your heart beats.
-An IABP allows blood to flow more easily into your coronary arteries. It also helps
your heart pump more blood with each contraction.
-How it works:
1. Deflated in systole (heart contracts) so blood can be ejected with less resistance
& also has a vacuum effect pulling blood forward
-
