APEX-Style NASM CPT 7 — MOCK EXAM 4 EXAM
QUESTIONS AND VERIFIED CORRECT ANSWERS
LATEST 2026-2027 NEW VERSION
What is the antidote for central anticholinergic syndrome?
A. Pyridostigmine
B. Glycopyrrolate
C. Physostigmine
D. Atropine - answer>>>C. Physostigmine
Central anticholinergic syndrome caused by anticholinergics capable of crossing BBB
(atropine & scopolamine-NOT glyco)
Signs of toxicity: restlessness, combativeness, confusion, & delerium
The elderly & pts w/ uncontrolled pain are at increased risk of developing central
anticholinergic syndrome
Neostigmine, pyridostigmine, & physostigmine are cholinesterase inhibitors
(increase Ach in the synaptic cleft), but only physostigmine diffuses across BBB.
Select the statement that BEST describes the age related autonomic nervous system
changes in the elderly
A. The response to beta stimulation decreases
B. Parasympathetic tone increases
C. Baroreceptor sensitivity is unchanged
D. Sympathetic tone decreases - answer>>>A. The response to beta stimulation
decreases
Key age related ANS changes in elderly include:
, -
SNS tone increases (increased NE in plasma), however the response to beta
stimulation is reduced
PNS tone decreases
Baroreceptor sensitivity decreases
CV changes that accompany a normal pregnancy include an increased:
Select 3
SVR
SV
plasma volume
DBP
HR
SBP - answer>>>SV
plasma volume
HR
Several weeks after conception, SVR decreases with a compensatory rise in CO &
RAAS activity (sodium retention—> increased plasma volume)
A reduction in SVR causes the DBP to decline. SBP is unchanged
Key cardiovascular changes during pregnancy:
CO: (Inc 40%)
-SV (Inc 30%)
-HR (Inc 15%)
Peripheral circulation:
-SBP- no change
,-DBP- (Dec 15%)
-SVR- (Dec 15%)
Intravascular fluid volume: (Inc 35%)
-plasma volume (Inc 45%)
-erythrocyte volume (Inc 20%)
A 4 y/o pt who weighs 15kg experiences cardiac arrest. What is energy setting for
the first defibrillation attempt? - answer>>>30J
1st shock: 2 J/kg
2nd shock: 4 J/kg
Subsequent shocks: 4-10 J/kg
Choose the BEST methods to restore CO in heart transplant recipient. Select 2
Atropine
Ephedrine
Isoproterenol
500ml 0.9% NACL bolus - answer>>>Isoproterenol
500ml 0.9% NACL bolus
CO is the product of SV & HR
The transplanted heart is severed from autonomic influence, so HR is determined by
intrinsic rate of phase 4 depolarization of the SA node (100-120bpm)
Since the HR is fixed, CO becomes dependent on preload. CO adjusts according to
the position on the Starling curve—increasing preload augments CO until a point is
reached where the ventricular myocytes become overstretched & cardiac output
fails
, -
Anesthetic considerations include maintaining adequate preload to optimize the
Frank-Starling mechanism. Isoproterenol and dilute epinephrine should be available
to augment HR
Indirect acting vasopressin's, such as ephedrine, partially rely on endogenous
catecholamine stores in the post-synaptic sympathetic neuron & are therefore less
effective
Atropine reduces vagal tone by acting as a competitive antagonist of the cardiac M2
receptor. In the absence of vagal input, atropine has no effect
Choose the statements that represent an accurate understanding of the flowmeters
on the anesthesia machine. Select 2
They are the beginning of the low pressure system
The annular space is the distance b/t the needle valve & the float
The plumb bob float is read in the middle of the float
The internal diameter of the Thorpe tube is narrowest at the base. - answer>>>They
are the beginning of the low pressure system
The internal diameter of the Thorpe tube is narrowest at the base.
During anesthetic induction, the pts HR increases & his skin becomes flushed. Which
drugs are MOST likely to cause these findings? Select 3
Atracurium
Rocuronium
Vecuronium
Pancuronium
Succinylcholine
Mivacurium - answer>>>Atracurium
Succinylcholine
QUESTIONS AND VERIFIED CORRECT ANSWERS
LATEST 2026-2027 NEW VERSION
What is the antidote for central anticholinergic syndrome?
A. Pyridostigmine
B. Glycopyrrolate
C. Physostigmine
D. Atropine - answer>>>C. Physostigmine
Central anticholinergic syndrome caused by anticholinergics capable of crossing BBB
(atropine & scopolamine-NOT glyco)
Signs of toxicity: restlessness, combativeness, confusion, & delerium
The elderly & pts w/ uncontrolled pain are at increased risk of developing central
anticholinergic syndrome
Neostigmine, pyridostigmine, & physostigmine are cholinesterase inhibitors
(increase Ach in the synaptic cleft), but only physostigmine diffuses across BBB.
Select the statement that BEST describes the age related autonomic nervous system
changes in the elderly
A. The response to beta stimulation decreases
B. Parasympathetic tone increases
C. Baroreceptor sensitivity is unchanged
D. Sympathetic tone decreases - answer>>>A. The response to beta stimulation
decreases
Key age related ANS changes in elderly include:
, -
SNS tone increases (increased NE in plasma), however the response to beta
stimulation is reduced
PNS tone decreases
Baroreceptor sensitivity decreases
CV changes that accompany a normal pregnancy include an increased:
Select 3
SVR
SV
plasma volume
DBP
HR
SBP - answer>>>SV
plasma volume
HR
Several weeks after conception, SVR decreases with a compensatory rise in CO &
RAAS activity (sodium retention—> increased plasma volume)
A reduction in SVR causes the DBP to decline. SBP is unchanged
Key cardiovascular changes during pregnancy:
CO: (Inc 40%)
-SV (Inc 30%)
-HR (Inc 15%)
Peripheral circulation:
-SBP- no change
,-DBP- (Dec 15%)
-SVR- (Dec 15%)
Intravascular fluid volume: (Inc 35%)
-plasma volume (Inc 45%)
-erythrocyte volume (Inc 20%)
A 4 y/o pt who weighs 15kg experiences cardiac arrest. What is energy setting for
the first defibrillation attempt? - answer>>>30J
1st shock: 2 J/kg
2nd shock: 4 J/kg
Subsequent shocks: 4-10 J/kg
Choose the BEST methods to restore CO in heart transplant recipient. Select 2
Atropine
Ephedrine
Isoproterenol
500ml 0.9% NACL bolus - answer>>>Isoproterenol
500ml 0.9% NACL bolus
CO is the product of SV & HR
The transplanted heart is severed from autonomic influence, so HR is determined by
intrinsic rate of phase 4 depolarization of the SA node (100-120bpm)
Since the HR is fixed, CO becomes dependent on preload. CO adjusts according to
the position on the Starling curve—increasing preload augments CO until a point is
reached where the ventricular myocytes become overstretched & cardiac output
fails
, -
Anesthetic considerations include maintaining adequate preload to optimize the
Frank-Starling mechanism. Isoproterenol and dilute epinephrine should be available
to augment HR
Indirect acting vasopressin's, such as ephedrine, partially rely on endogenous
catecholamine stores in the post-synaptic sympathetic neuron & are therefore less
effective
Atropine reduces vagal tone by acting as a competitive antagonist of the cardiac M2
receptor. In the absence of vagal input, atropine has no effect
Choose the statements that represent an accurate understanding of the flowmeters
on the anesthesia machine. Select 2
They are the beginning of the low pressure system
The annular space is the distance b/t the needle valve & the float
The plumb bob float is read in the middle of the float
The internal diameter of the Thorpe tube is narrowest at the base. - answer>>>They
are the beginning of the low pressure system
The internal diameter of the Thorpe tube is narrowest at the base.
During anesthetic induction, the pts HR increases & his skin becomes flushed. Which
drugs are MOST likely to cause these findings? Select 3
Atracurium
Rocuronium
Vecuronium
Pancuronium
Succinylcholine
Mivacurium - answer>>>Atracurium
Succinylcholine
