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CRNA Interview Questions And Correct
Answers
What are the interventions for cardiogenic shock? - answer✔-Fluids
-Vasopressors (Dopamine)
-Inotropes (Dobutamine, Milrinone for heart failure)
-IABP, ECMO
Your ventilator is peak pressure alarming. What could be the problem? - answer✔-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
Your patient needs to be intubated soon. What items do you want at the bedside? - answer✔-
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
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-stethoscope
-IVF, pressure bag
-pressors depending on status
-sedation
-appropriate sized nasogastric tubes
-x-ray on standby
What are some reasons for post operative tachycardia? - answer✔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)
What is the difference between CRNA and MDA? - answer✔-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
Do you understand "opt out"? - answer✔-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:
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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.
Discuss the role of the sympathetic nervous system. - answer✔-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
Discuss the role of the parasympathetic nervous system. - answer✔-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
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-Constricts pupils, causes salivation, slows down the heart rate, tightens the bronchi in the lungs,
enacts digestion, releases bile, makes the bladder contract
Tell us about a critical patient you had and the pathophysiology behind their disease. -
answer✔Urosepsis -> Septic Shock -> ARDS -> HFOV
How does IABP work? - answer✔-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
2. In diastole, balloon inflates & pushes blood back towards coronary arteries, improving
perfusion
-Indications: MI, CHF, defects, arrhythmia, myocarditis
What coronary is affected in an anterior lateral MI? - answer✔**Left anterior descending
coronary artery (LAD)**
-Also known as anterior wall MI, or AWMI, or anterior ST segment elevation MI, or anterior
STEMI
-Occurs when anterior myocardial tissue usually supplied by the left anterior descending
coronary artery suffers injury due to lack of blood supply.
-Poorest prognosis
How can you lower ICP? - answer✔-Elevate HOB
-Hyperventilate - to cause vasoconstriction
-Mannitol 0.25-1g/kg (elevates blood plasma osmolality, resulting in enhanced flow of water
from tissues into interstitial fluid and plasma)
