NCCAA Certification Exam Practice
questions and answers Latest 2025/2026
Newest updated
1. Decreased systemic BP
II! II! II!
2. Increased systemic BP
II! II! II!
3. Decreased pulmonary artery wedge pressure
II! II! II! II! II!
4. Increased pulmonary artery wedge pressure
II! II! II! II! II! II!
5. Decreased CO
II! II!
6. Increased CO
II! II!
7. Decreased CVP
II! II!
8. Increased CVP
II! II!
What changes will you find with Hypovolemia? - Correct Answers 1, 3, 5, 7
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! 1. Decreased systemic BP
II! II! II!
2. Increased systemic BP
II! II! II!
3. Decreased pulmonary artery wedge pressure
II! II! II! II! II!
4. Increased pulmonary artery wedge pressure
II! II! II! II! II! II!
5. Decreased CO
II! II!
6. Increased CO
II! II!
7. Decreased CVP
II! II!
8. Increased CVP
II! II!
What changes will you find with LV dysfunction/failure? - Correct Answers 1, 4, 5
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
,II! 1. Decreased systemic BP
II! II! II!
2. Increased systemic BP
II! II! II!
3. Decreased pulmonary artery wedge pressure
II! II! II! II! II!
4. Increased pulmonary artery wedge pressure
II! II! II! II! II! II!
5. Decreased CO
II! II!
6. Increased CO
II! II!
7. Decreased CVP
II! II!
8. Increased CVP
II! II!
What changes will you find with RV dysfunction/failure? - Correct Answers 1, 3, 5, 8
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! A 12 year old male presents for an emergent exploratory laparotomy s/p MVA straight from the
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! ER. The patient is unable to move his lower extremities, but other systems seem stable. What
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! induction method is best? II! II! II!
A. RSI using succinylcholine
II! II! II! II!
B. Standard induction with Rocuronium
II! II! II! II!
C. High dose opioid induction without any muscle relaxants
II! II! II! II! II! II! II! II!
D. Inhalation induction; supplemented with Rocuronium - Correct Answers A. RSI using
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
succinylcholine
II!
II! A 3 yr old patient presents with wheezing, and a further exam reveals an inspiratory and
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! expiratory strider. Respiratory decides to administer helium at 70% in O2 instead of 100% O2. The
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! nursing student in the ICU asks you to explain why helium has more of an advantage than O2? -
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! Correct Answers Heliox decreases the density of gas which reduces the turbulence of flow
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! A 34M 70kg presents for a right throacotomy for a tumor resection. The surgeon requests that
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! one lung ventilation be utilized to assist his surgical visualization. What size DLT would you prefer?
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! - Correct Answers 39 French
II! II! II! II! II! II! II! II!
,II! A 42F undergoes subtotal thyroidectomy under general anesthesia. Upon extubation, the patient
II! II! II! II! II! II! II! II! II! II! II!
II! is unable to phonate when asked if they are having any pain. The patient quickly develops strider.
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! What is the most likely complication? - Correct Answers Bilateral RLN damage
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! A 62F in the PACU chief complaint is sever nausea and bouts of emesis following her cataract
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! surgery. PMH includes HTN, GERD, arthritis, COPD, Parkinson's disease. Which antiemetic would
II! II! II! II! II! II! II! II! II! II! II!
II! be best to treat her condition?
II! II! II! II! II!
A. Droperidol
II!
B. Metoclopramide
II!
C. Zofran
II!
D. Promethazine - Correct Answers C. Zofran
II! II! II! II! II! II! II! II! II! II!
II! A 65 yr old patient is having craniotomy for left parietal tumor. You have placed a 20g arterial line
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! in the right radial artery. The transducer is zeroed at the phlebostatic axis of the patient's right
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! side. During prep time, the surgeon requests for a modified beach chair position resulting in the
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! patient's left ventricular to be 20cm above the transducer. Once positioning and padding is
II! II! II! II! II! II! II! II! II! II! II! II! II!
II! complete, the monitor reads the invasive blood pressure as 120/80. What is the patient's true
II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! BP?
A. 105/65
II!
B. 135/95
II!
C. 70/32
II!
D. 150/100 - Correct Answers A. 105/65
II! II! II! II! II! II! II! II! II! II!
II! A 75F ASA 4 presents for a CABG. Hx of COPD, HTN, CAD/MI, IDDM, PVD. After induction of
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! general anesthesia your initial attempt at intubation is unsuccessful. You change your blade to a
II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! miller and reposition the airway; your next attempt at intubation is unsuccessful. According to
II! II! II! II! II! II! II! II! II! II! II! II! II!
II! the ASA Difficult Airway algorithm, what should your next step be?
II! II! II! II! II! II! II! II! II! II!
A.Call for help II! II!
B.Place an LMA II! II!
, C.Return to mask ventilation II! II! II!
D.Attempt a 3rd intubation - Correct Answers A. Call for help II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! A 75F patient is recovering in the PACU, and she is showing signs of delirium. Her pupils are
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! dilated and her skin is dry and flushed. You review her chart and notice that she was given
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! scopolamine preoperatively for severe N/V, and received 0.5mg of atropine intraoperatively for
II! II! II! II! II! II! II! II! II! II! II!
II! symptomatic bradycardia. What is the diagnosis/causes/treatment? II! II! II! II! II!
A. Excessive stimulation by ACh/High dose anticholinergic/Atropine
II! II! II! II! II! II!
B. Excessive antagonism at cholinergic receptors/high dose cholinesterase inhibitors/Atropine
II! II! II! II! II! II! II! II!
C. Excessive stimulation at cholinergic receptors/high dose anticholinergics/Physostigmine
II! II! II! II! II! II! II!
D. Excessive antagonism at cholinergic receptors/high dose anticholinergics/Physostigmine -
II! II! II! II! II! II! II! II! II!
Correct Answers D. Excessive antagonism at cholinergic receptors/high dose anticholinergics/
II! II! II! II! II! II! II! II! II! II! II! II! II!
Physostigmine
II!
II! A 80M 65kg presents for an AV graft. PMH includes HTN, CAD, IDDM, ESRD, ASTHMA. EF 50%.
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! Negative stress test with cardiac clearance. Preop evaluation reveals Mallampatti 3 airway with
II! II! II! II! II! II! II! II! II! II! II! II!
II! limited mouth opening and neck extension. Pt is NPO greater than 8 hours and states that he has
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! not taken his "blood pressure" meds for 2 days. Accucheck is 158. Vital signs 105 195/90 90% on
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! room air. EKG shows SR with moderate ST changes. What explains the tachycardia?
II! II! II! II! II! II! II! II! II! II! II! II!
A. Hypovolemia
II!
B. Up regulation of beta receptors
II! II! II! II! II!
C. Increased NE release
II! II! II!
D. Asthma attack - Correct Answers B. Up regulation of beta receptors
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! A 80M 65kg presents for an AV graft. PMH includes HTN, CAD, IDDM, ESRD, ASTHMA. EF 50%.
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! Negative stress test with cardiac clearance. Preop evaluation reveals Mallampatti 3 airway with
II! II! II! II! II! II! II! II! II! II! II! II!
II! limited mouth opening and neck extension. Pt is NPO greater than 8 hours and states that he has
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! not taken his "blood pressure" meds for 2 days. Accucheck is 158. Vital signs 105 195/90 90% on
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! room air. EKG shows SR with moderate ST changes. What intravenous induction agent would you
II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! avoid?
questions and answers Latest 2025/2026
Newest updated
1. Decreased systemic BP
II! II! II!
2. Increased systemic BP
II! II! II!
3. Decreased pulmonary artery wedge pressure
II! II! II! II! II!
4. Increased pulmonary artery wedge pressure
II! II! II! II! II! II!
5. Decreased CO
II! II!
6. Increased CO
II! II!
7. Decreased CVP
II! II!
8. Increased CVP
II! II!
What changes will you find with Hypovolemia? - Correct Answers 1, 3, 5, 7
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! 1. Decreased systemic BP
II! II! II!
2. Increased systemic BP
II! II! II!
3. Decreased pulmonary artery wedge pressure
II! II! II! II! II!
4. Increased pulmonary artery wedge pressure
II! II! II! II! II! II!
5. Decreased CO
II! II!
6. Increased CO
II! II!
7. Decreased CVP
II! II!
8. Increased CVP
II! II!
What changes will you find with LV dysfunction/failure? - Correct Answers 1, 4, 5
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
,II! 1. Decreased systemic BP
II! II! II!
2. Increased systemic BP
II! II! II!
3. Decreased pulmonary artery wedge pressure
II! II! II! II! II!
4. Increased pulmonary artery wedge pressure
II! II! II! II! II! II!
5. Decreased CO
II! II!
6. Increased CO
II! II!
7. Decreased CVP
II! II!
8. Increased CVP
II! II!
What changes will you find with RV dysfunction/failure? - Correct Answers 1, 3, 5, 8
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! A 12 year old male presents for an emergent exploratory laparotomy s/p MVA straight from the
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! ER. The patient is unable to move his lower extremities, but other systems seem stable. What
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! induction method is best? II! II! II!
A. RSI using succinylcholine
II! II! II! II!
B. Standard induction with Rocuronium
II! II! II! II!
C. High dose opioid induction without any muscle relaxants
II! II! II! II! II! II! II! II!
D. Inhalation induction; supplemented with Rocuronium - Correct Answers A. RSI using
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
succinylcholine
II!
II! A 3 yr old patient presents with wheezing, and a further exam reveals an inspiratory and
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! expiratory strider. Respiratory decides to administer helium at 70% in O2 instead of 100% O2. The
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! nursing student in the ICU asks you to explain why helium has more of an advantage than O2? -
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! Correct Answers Heliox decreases the density of gas which reduces the turbulence of flow
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! A 34M 70kg presents for a right throacotomy for a tumor resection. The surgeon requests that
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! one lung ventilation be utilized to assist his surgical visualization. What size DLT would you prefer?
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! - Correct Answers 39 French
II! II! II! II! II! II! II! II!
,II! A 42F undergoes subtotal thyroidectomy under general anesthesia. Upon extubation, the patient
II! II! II! II! II! II! II! II! II! II! II!
II! is unable to phonate when asked if they are having any pain. The patient quickly develops strider.
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! What is the most likely complication? - Correct Answers Bilateral RLN damage
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! A 62F in the PACU chief complaint is sever nausea and bouts of emesis following her cataract
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! surgery. PMH includes HTN, GERD, arthritis, COPD, Parkinson's disease. Which antiemetic would
II! II! II! II! II! II! II! II! II! II! II!
II! be best to treat her condition?
II! II! II! II! II!
A. Droperidol
II!
B. Metoclopramide
II!
C. Zofran
II!
D. Promethazine - Correct Answers C. Zofran
II! II! II! II! II! II! II! II! II! II!
II! A 65 yr old patient is having craniotomy for left parietal tumor. You have placed a 20g arterial line
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! in the right radial artery. The transducer is zeroed at the phlebostatic axis of the patient's right
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! side. During prep time, the surgeon requests for a modified beach chair position resulting in the
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! patient's left ventricular to be 20cm above the transducer. Once positioning and padding is
II! II! II! II! II! II! II! II! II! II! II! II! II!
II! complete, the monitor reads the invasive blood pressure as 120/80. What is the patient's true
II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! BP?
A. 105/65
II!
B. 135/95
II!
C. 70/32
II!
D. 150/100 - Correct Answers A. 105/65
II! II! II! II! II! II! II! II! II! II!
II! A 75F ASA 4 presents for a CABG. Hx of COPD, HTN, CAD/MI, IDDM, PVD. After induction of
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! general anesthesia your initial attempt at intubation is unsuccessful. You change your blade to a
II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! miller and reposition the airway; your next attempt at intubation is unsuccessful. According to
II! II! II! II! II! II! II! II! II! II! II! II! II!
II! the ASA Difficult Airway algorithm, what should your next step be?
II! II! II! II! II! II! II! II! II! II!
A.Call for help II! II!
B.Place an LMA II! II!
, C.Return to mask ventilation II! II! II!
D.Attempt a 3rd intubation - Correct Answers A. Call for help II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! A 75F patient is recovering in the PACU, and she is showing signs of delirium. Her pupils are
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! dilated and her skin is dry and flushed. You review her chart and notice that she was given
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! scopolamine preoperatively for severe N/V, and received 0.5mg of atropine intraoperatively for
II! II! II! II! II! II! II! II! II! II! II!
II! symptomatic bradycardia. What is the diagnosis/causes/treatment? II! II! II! II! II!
A. Excessive stimulation by ACh/High dose anticholinergic/Atropine
II! II! II! II! II! II!
B. Excessive antagonism at cholinergic receptors/high dose cholinesterase inhibitors/Atropine
II! II! II! II! II! II! II! II!
C. Excessive stimulation at cholinergic receptors/high dose anticholinergics/Physostigmine
II! II! II! II! II! II! II!
D. Excessive antagonism at cholinergic receptors/high dose anticholinergics/Physostigmine -
II! II! II! II! II! II! II! II! II!
Correct Answers D. Excessive antagonism at cholinergic receptors/high dose anticholinergics/
II! II! II! II! II! II! II! II! II! II! II! II! II!
Physostigmine
II!
II! A 80M 65kg presents for an AV graft. PMH includes HTN, CAD, IDDM, ESRD, ASTHMA. EF 50%.
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! Negative stress test with cardiac clearance. Preop evaluation reveals Mallampatti 3 airway with
II! II! II! II! II! II! II! II! II! II! II! II!
II! limited mouth opening and neck extension. Pt is NPO greater than 8 hours and states that he has
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! not taken his "blood pressure" meds for 2 days. Accucheck is 158. Vital signs 105 195/90 90% on
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! room air. EKG shows SR with moderate ST changes. What explains the tachycardia?
II! II! II! II! II! II! II! II! II! II! II! II!
A. Hypovolemia
II!
B. Up regulation of beta receptors
II! II! II! II! II!
C. Increased NE release
II! II! II!
D. Asthma attack - Correct Answers B. Up regulation of beta receptors
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! A 80M 65kg presents for an AV graft. PMH includes HTN, CAD, IDDM, ESRD, ASTHMA. EF 50%.
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! Negative stress test with cardiac clearance. Preop evaluation reveals Mallampatti 3 airway with
II! II! II! II! II! II! II! II! II! II! II! II!
II! limited mouth opening and neck extension. Pt is NPO greater than 8 hours and states that he has
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! not taken his "blood pressure" meds for 2 days. Accucheck is 158. Vital signs 105 195/90 90% on
II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! room air. EKG shows SR with moderate ST changes. What intravenous induction agent would you
II! II! II! II! II! II! II! II! II! II! II! II! II! II!
II! avoid?
