CRNA Exam
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CRNA Exam is a trademark of its owner, which is not affiliated with and does not endorse Test Treasure Publication or TTP Prep.
10 sample questions for the CRNA Exam, with the correct answer and an explanation for each. No account needed. Try each one before you open the answer.
Sections covered on the exam: Anatomy and Physiology for Anesthesia, Pathophysiology, Regional and Local Anesthesia, Anesthesia for Special Populations, Applied Chemistry, Physics and Anesthesia Math, Airway Equipment, Monitoring, Warming, Infusion and Imaging Technology, Professional Practice, Ethics, Safety and Infection Control, Preoperative Assessment, Testing Data and Positioning, Fluids, Blood Products and Hemodynamic Management, Sedation, TIVA, Pain Management, ERAS and Postanesthesia Care, Airway Management.
Question 1 · Anatomy and Physiology for Anesthesia
A 74-year-old man with severe aortic stenosis is monitored with a radial arterial line, a central venous catheter and a pulmonary artery catheter after induction for hip fracture repair. The following values were recorded five minutes after induction.
| Variable | Value |
|---|---|
| Arterial BP | 100/45 mmHg |
| Central venous pressure | 12 mmHg |
| Pulmonary capillary wedge pressure (used as LVEDP) | 25 mmHg |
| Heart rate | 88/min |
Answer: C. 20 mmHg
Left ventricular coronary perfusion pressure is diastolic BP minus LVEDP: 45 - 25 = 20 mmHg, because the left ventricle is perfused mainly in diastole against its own end-diastolic pressure. Using MAP (about 63 mmHg) minus LVEDP gives 38 mmHg, and subtracting CVP instead of LVEDP gives 33 or 51 mmHg. The very low value explains why diastolic hypotension is so dangerous in aortic stenosis.
Question 2 · Anesthesia for Special Populations
Answer: D. Open the backup oxygen cylinder and disconnect the oxygen pipeline
A falling inspired O2 with normal pipeline pressure suggests a pipeline crossover. The backup cylinder must be opened and the pipeline hose disconnected, because the machine preferentially draws from the higher-pressure pipeline (50 psig versus about 45 psig after the cylinder regulator). Higher flows or the flush deliver more of the wrong gas, and the proportioning system cannot detect what gas is in the oxygen line.
Question 3 · Professional Practice, Ethics, Safety and Infection Control
Answer: A. Remove the endotracheal tube and stop the flow of all airway gases
In an airway fire the immediate steps, done together, are removing the tube and stopping all airway gases to eliminate fuel and oxidizer, then pouring saline into the airway. Ventilation then resumes by mask, followed by bronchoscopy to assess injury and reintubation. Continuing to ventilate through a burning tube or increasing oxygen feeds the fire and blows flame into the lower airway.
Question 4 · Regional and Local Anesthesia
A parturient with a functioning labor epidural receives a top-up for urgent cesarean delivery. After 15 mL of 2% lidocaine with epinephrine and bicarbonate through the catheter, she becomes anxious and reports difficulty breathing. Two minutes later: BP 70/40, HR 48, weak hand grip, whispered speech, SpO2 91% on room air, and she is becoming difficult to arouse.
Answer: B. Ventilate with 100% oxygen, intubate, and treat hypotension and bradycardia
Hand weakness, difficulty speaking, profound hypotension, bradycardia and declining consciousness after an epidural dose point to a high or total spinal from intrathecal catheter migration. Management is airway support and intubation with 100% oxygen, left uterine displacement, fluids and vasopressors such as ephedrine or epinephrine, and atropine as needed. Lipid emulsion treats systemic toxicity, which presents with CNS excitation or arrhythmias rather than ascending motor block; sitting up worsens hypotension, and no opioid was given.
Question 5 · Professional Practice, Ethics, Safety and Infection Control
Answer: D. Keep spontaneous ventilation, avoid relaxants and have rigid bronchoscopy ready
General anesthesia, supine positioning and loss of muscle tone can cause complete airway or vascular compression in anterior mediastinal mass, so spontaneous ventilation is preserved, neuromuscular blockers avoided, the patient kept semi-upright, and a rigid bronchoscope, position changes and possibly cardiopulmonary bypass or ECMO standby are arranged. Paralysis with positive pressure removes the negative intrathoracic pressure that keeps the airway open.
Question 6 · Anatomy and Physiology for Anesthesia
Answer: D. Right coronary artery
In a right-dominant circulation, the right coronary artery supplies the inferior wall and gives rise to the AV nodal artery in most people and the SA nodal artery in about 60%. Inferior ST elevation with bradycardia and AV nodal block therefore points to the right coronary artery. The left anterior descending artery supplies the anterior wall and septum, and the circumflex supplies the lateral wall in a right-dominant system.
Question 7 · Anesthesia for Special Populations
Answer: D. Liquid remains; contents can be estimated only by weighing the cylinder
Nitrous oxide's critical temperature (about 36.5 °C) is above room temperature, so it is stored as a liquid in equilibrium with its vapor at about 745-750 psig. The pressure stays constant until the liquid is gone, when only about one-quarter of the contents (around 400 L) remains, so contents must be estimated by weight. Oxygen, a compressed gas, is the one whose pressure falls in proportion to contents.
Question 8 · Professional Practice, Ethics, Safety and Infection Control
Answer: D. Meet with the patient to reconsider the order and document the agreed plan for the OR
ASA and AANA guidance call for required reconsideration of DNR orders before anesthesia, not automatic suspension or rigid enforcement. The CRNA and team discuss options with the patient or surrogate, such as full resuscitation, procedure-directed limits or goal-directed limits, and document the plan. Refusing care is not appropriate when a plan consistent with the patient's goals can be agreed upon.
Question 9 · Regional and Local Anesthesia
A parturient had a labor epidural with an unintended dural puncture using a 17-gauge Tuohy needle. On postpartum day 2 she reports a frontal-occipital headache that is severe when sitting and nearly gone when lying flat, with neck stiffness and muffled hearing. She has taken scheduled acetaminophen, caffeine and oral fluids for 24 hours without relief and cannot care for her newborn. She has no fever and a normal neurologic exam.
Answer: A. Epidural blood patch with about 15-20 mL of sterile autologous blood
This is a classic post-dural puncture headache after a large-bore puncture, and conservative therapy has failed while the headache is disabling; an epidural blood patch with about 15-20 mL of autologous blood, injected until back pressure or discomfort, is the definitive treatment with high success rates. Prolonged conservative care leaves her incapacitated, the positional pattern argues against migraine, and bed rest does not speed dural healing.
Question 10 · Professional Practice, Ethics, Safety and Infection Control
A 49-year-old woman is in the neuro ICU 14 hours after transsphenoidal resection of a pituitary macroadenoma. She is alert and thirsty, and her nurse reports the following trend. Urine osmolality at 1000 is 110 mOsm/kg and blood glucose is 132 mg/dL.
| Time | Urine output (mL/h) | Serum Na (mEq/L) | Urine specific gravity |
|---|---|---|---|
| 0600 | 120 | 142 | 1.010 |
| 0800 | 340 | 147 | 1.003 |
| 1000 | 410 | 150 | 1.002 |
Answer: A. Desmopressin with replacement of free water losses
Large volumes of dilute urine (specific gravity about 1.002, urine osmolality 110) with rising serum sodium after pituitary surgery indicate central diabetes insipidus from loss of ADH; treatment is desmopressin plus matched hypotonic fluid replacement. SIADH, the opposite disorder, is treated with fluid restriction, and hypertonic saline would worsen hypernatremia.
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