NCCAA CERTIFICATION EXAM
PRACTICE QUESTIONS AND
ANSWERS
What is the major motor nerve for the intrinsic muscles of the larynx? - Correct Answers
-Recurrent Laryngeal Nerve
Which sensory nerve is stimulated to produce laryngospasm & which muscles are
responsible for laryngospasm? - Correct Answers -Internal branch of Superior
Laryngeal Nerve & Lateral cricoartyenoids
A 42F undergoes subtotal thyroidectomy under general anesthesia. Upon extubation,
the patient is unable to phonate when asked if they are having any pain. The patient
quickly develops strider. What is the most likely complication? - Correct Answers -
Bilateral RLN damage
Gas exchange within the tracheobronchial tree begins at what generations? - Correct
Answers -17-19
Which description of alveoli distribution is most correct? A) Alveoli are largest at the
base of the lung. B) The smallest alveoli are found at the apex of the lung. C) The
largest alveoli are found throughout the lung. D) Alveoli are smallest at the base of the
lung - Correct Answers -D) Alveoli are smallest at the base of the lung
Which description of pneumocytes is most correct? A) Type I pneumocytes are round
and more numerous than Type II. B) Type II pneumocytes produce Type I pneumocytes
which form tight junctions. C) Type I pneumocytes contain the majority surfactant. D)
Type II pneumocytes are round and form tight junctions to prevent permeability. -
Correct Answers -B) Type II pneumocytes produce Type I pneumocytes which form
tight junctions
During an acute apneic event which receptors are responsible for responding to
increases in PaCO2 (H+ ions)? - Correct Answers -Central chemoreceptors
Where are the peripheral chemoreceptors located & what nerve(s) mediate information?
- Correct Answers -Carotid/aortic bodies & Glossopharyngeal nerve and Vagus nerve
,Peripheral chemoreceptors are most sensitive to what changes? - Correct Answers -
Decreased PaO2
Which of the following is associated with an increase in P50? A) Decreased H+ ions. B)
Fetal Hemoglobin. C) Decreased temperature. D). Sickle Cell. - Correct Answers -D)
Sickle Cell
All of the following are associated with the shifting of the oxyhemoglobin dissociation
curve to the left except? A) Pulmonary circulation environment. B) Hypoventilation. C)
Decreased 2,3-DPG. D) Hypocapnia. - Correct Answers -B) Hypoventilation
A patient is given 200mcg of fentanyl on induction. What happens tot he oxyhemoglobin
dissociation curve and the carbon dioxide blood dissociation curve? - Correct Answers -
The oxyhemoglobin dissociation curve shifts to the right.
The carbon dioxide dissociation curve shifts up and to the left
If an ABG reads PaO2 = 58mmHg with a patient breathing 21% FiO2. What is the
source of this blood and what would you except SaO2 to be?
A.Mixed venous blood / 70%
B.Arterial blood / 60%
C.Arterial blood / 90%
D.Mixed venous blood / 90% - Correct Answers -C. Arterial blood/ 90%
What is the PaO2 when SaO2 is 50% - Correct Answers -26-27mmHg
Intrapulmonary pressure becomes more positive during which phase of breathing? -
Correct Answers -Expiration
What is the O2 content of whole blood if Hgb= 10g/dL, PaO2=60mmHg, and SaO2
=90% - Correct Answers -12.5 mL/dL
In what form is CO2 carried primarily in blood? - Correct Answers -HCO3 (bicarbonate)
What ion is bicarbonate exchanged for at the red blood cell to maintain
electroneutrality? - Correct Answers -Chloride ions
What is included in anatomic dead space? - Correct Answers -Volume of gas in
conducting airways
What is the complication if a patient has a portion of the lung that's V/Q ratio is 0. -
Correct Answers -The patient has an absolute shunt. (Right to left shunt) Perfusion
without Ventilation
, In West Zone 2, perfusion is determined by which pressure? - Correct Answers -
Arterial-Alveolar pressure gradient
When a patient is anesthetized and paralyzed, then placed in the lateral decubitus
position a V/Q mismatch occurs. What is happening with the dependent lung that is
causing this mismatch? - Correct Answers -The dependent lung receives increased
perfusion but is poorly ventilated
A patient breathing room air has a PaO2 = 50mmHg and PAO2= 100mmHg. Why is this
patient hypoxic? - Correct Answers -There is a V/Q mismatch
What is the purpose of preoxygenating prior to induction of anesthesia? - Correct
Answers -To fill the FRC
Vital capacity is composed of:
A) expiratory reserve volume and inspiratory capacity
B) Tidal volume, inspiratory reserve volume and expiratory reserve volume
C) Total lung capacity minus residual volume
D) All of the above - Correct Answers -D) All of the above
Which parameters can NOT be directly obtained from spirometry? - Correct Answers -
FRC and Total lung capacity
Which parameter does not change with age? - Correct Answers -FRC
FRC= CC in which scenarios? - Correct Answers -In supine position by mid 40's and in
upright position by mid 60's of age
What are the most correct controlled ventilation volume control settings for a healthy
70kg female for an ORIF of the right radius?
A) TV 600mL RR 8
B) TV 500mL RR 8
C) TV 850mL RR 10
D) TV 1000mL RR 5 - Correct Answers -B) TV 500mL RR 8
What is the alveolar oxygen tension given the following information?
At sea level
Room air
PaCO2=27mmHg - Correct Answers -116mmHg
What is the metabolic oxygen rate for a normothermic anesthetized patient? - Correct
Answers -250mL/min
The following results from spirometry pulmonary function test revealed:
FEV1= 4.2L
FVC= 5.1L
PRACTICE QUESTIONS AND
ANSWERS
What is the major motor nerve for the intrinsic muscles of the larynx? - Correct Answers
-Recurrent Laryngeal Nerve
Which sensory nerve is stimulated to produce laryngospasm & which muscles are
responsible for laryngospasm? - Correct Answers -Internal branch of Superior
Laryngeal Nerve & Lateral cricoartyenoids
A 42F undergoes subtotal thyroidectomy under general anesthesia. Upon extubation,
the patient is unable to phonate when asked if they are having any pain. The patient
quickly develops strider. What is the most likely complication? - Correct Answers -
Bilateral RLN damage
Gas exchange within the tracheobronchial tree begins at what generations? - Correct
Answers -17-19
Which description of alveoli distribution is most correct? A) Alveoli are largest at the
base of the lung. B) The smallest alveoli are found at the apex of the lung. C) The
largest alveoli are found throughout the lung. D) Alveoli are smallest at the base of the
lung - Correct Answers -D) Alveoli are smallest at the base of the lung
Which description of pneumocytes is most correct? A) Type I pneumocytes are round
and more numerous than Type II. B) Type II pneumocytes produce Type I pneumocytes
which form tight junctions. C) Type I pneumocytes contain the majority surfactant. D)
Type II pneumocytes are round and form tight junctions to prevent permeability. -
Correct Answers -B) Type II pneumocytes produce Type I pneumocytes which form
tight junctions
During an acute apneic event which receptors are responsible for responding to
increases in PaCO2 (H+ ions)? - Correct Answers -Central chemoreceptors
Where are the peripheral chemoreceptors located & what nerve(s) mediate information?
- Correct Answers -Carotid/aortic bodies & Glossopharyngeal nerve and Vagus nerve
,Peripheral chemoreceptors are most sensitive to what changes? - Correct Answers -
Decreased PaO2
Which of the following is associated with an increase in P50? A) Decreased H+ ions. B)
Fetal Hemoglobin. C) Decreased temperature. D). Sickle Cell. - Correct Answers -D)
Sickle Cell
All of the following are associated with the shifting of the oxyhemoglobin dissociation
curve to the left except? A) Pulmonary circulation environment. B) Hypoventilation. C)
Decreased 2,3-DPG. D) Hypocapnia. - Correct Answers -B) Hypoventilation
A patient is given 200mcg of fentanyl on induction. What happens tot he oxyhemoglobin
dissociation curve and the carbon dioxide blood dissociation curve? - Correct Answers -
The oxyhemoglobin dissociation curve shifts to the right.
The carbon dioxide dissociation curve shifts up and to the left
If an ABG reads PaO2 = 58mmHg with a patient breathing 21% FiO2. What is the
source of this blood and what would you except SaO2 to be?
A.Mixed venous blood / 70%
B.Arterial blood / 60%
C.Arterial blood / 90%
D.Mixed venous blood / 90% - Correct Answers -C. Arterial blood/ 90%
What is the PaO2 when SaO2 is 50% - Correct Answers -26-27mmHg
Intrapulmonary pressure becomes more positive during which phase of breathing? -
Correct Answers -Expiration
What is the O2 content of whole blood if Hgb= 10g/dL, PaO2=60mmHg, and SaO2
=90% - Correct Answers -12.5 mL/dL
In what form is CO2 carried primarily in blood? - Correct Answers -HCO3 (bicarbonate)
What ion is bicarbonate exchanged for at the red blood cell to maintain
electroneutrality? - Correct Answers -Chloride ions
What is included in anatomic dead space? - Correct Answers -Volume of gas in
conducting airways
What is the complication if a patient has a portion of the lung that's V/Q ratio is 0. -
Correct Answers -The patient has an absolute shunt. (Right to left shunt) Perfusion
without Ventilation
, In West Zone 2, perfusion is determined by which pressure? - Correct Answers -
Arterial-Alveolar pressure gradient
When a patient is anesthetized and paralyzed, then placed in the lateral decubitus
position a V/Q mismatch occurs. What is happening with the dependent lung that is
causing this mismatch? - Correct Answers -The dependent lung receives increased
perfusion but is poorly ventilated
A patient breathing room air has a PaO2 = 50mmHg and PAO2= 100mmHg. Why is this
patient hypoxic? - Correct Answers -There is a V/Q mismatch
What is the purpose of preoxygenating prior to induction of anesthesia? - Correct
Answers -To fill the FRC
Vital capacity is composed of:
A) expiratory reserve volume and inspiratory capacity
B) Tidal volume, inspiratory reserve volume and expiratory reserve volume
C) Total lung capacity minus residual volume
D) All of the above - Correct Answers -D) All of the above
Which parameters can NOT be directly obtained from spirometry? - Correct Answers -
FRC and Total lung capacity
Which parameter does not change with age? - Correct Answers -FRC
FRC= CC in which scenarios? - Correct Answers -In supine position by mid 40's and in
upright position by mid 60's of age
What are the most correct controlled ventilation volume control settings for a healthy
70kg female for an ORIF of the right radius?
A) TV 600mL RR 8
B) TV 500mL RR 8
C) TV 850mL RR 10
D) TV 1000mL RR 5 - Correct Answers -B) TV 500mL RR 8
What is the alveolar oxygen tension given the following information?
At sea level
Room air
PaCO2=27mmHg - Correct Answers -116mmHg
What is the metabolic oxygen rate for a normothermic anesthetized patient? - Correct
Answers -250mL/min
The following results from spirometry pulmonary function test revealed:
FEV1= 4.2L
FVC= 5.1L
