ASET CNIM Exam 2024 Edition. All
Questions and Correct, Verified
Answers. Graded A+
_______________________________ is the single most important step taken to avoid
contamination
1. using gloves
2. using protective eyewear
3. washing hands
4. using transportation barrier - ANSWashing hands
"Hearing level" (HL) is defined as the
1. average threshold intensity of normally hearing young adults
2. intensity of along duration sound that has the same amplitude as the peak SPL of a
short duration sound
3. lowest intensity that an average ear drum can her
4. inverse of the sound pressure level - ANSaverage threshold intensity of normally
hearing young adults
A "false-negative" test
1. is the desired goal of IONM
2. means that the test results do not show an abnormality when a clinical abnormality is
present
3. means that the test results show an abnormality when no clinical abnormality exists
4. presents the N18 wave as a positive down-going response - ANSmeans that the test
results do not show an abnormality when a clinical abnormality is present
A condensation click
1. delivers the loudest sounds to the tympanic membrane
2. causes the tympanic membrane to move outward
3. causes the headphone diaphragm to displace toward the tympanic membrane
4. causes the headphone diaphragm to move away from the tympanic membrane -
ANScauses the headphone diaphragm to displace toward the tympanic membrane
A constant voltage stimulator
1. varies the current in order to maintain a preset voltage level
2. maintains a constant voltage of 100 volts
,3. varies the output in order to maintain a preset current level
4. maintains a current level of 10mA - ANSvaries the current in order to maintain a
preset voltage level
a contraindication for the use of transcranial magnetic stimulation is
1. patient obesity
2. cardiac pacemaker in place
3. MS
4. transverse myelitis - ANScardiac pacemaker in place
A decreasing body temp of the surgical patient monitored with EPs can result in
1. increasing latencies of SSEP and BAER
2. no changes
3. increased amplitude of SSEP cortical responses
4. higher electrode impedances - ANSincreasing latencies of SSEP and BAER
A differential amplifier records
1. only the first two inputs
2. the second half the two inputs
3. the power of the sum of the two inputs
4. the difference between the two inputs - ANSthe difference between the two inputs
A goal of IONM of the sensory pathways is to
1. diagnose pre-existing abnormalities
2. detect global systemic changes
3. differentiate between local and surgical manipulations vs anesthetic affects
4. detect abnormalities (electrophysiologic changes) that develop as the recordings are
take - ANSdetect abnormalities (electrophysiologic changes) that develop as the
recordings are taken
A ground loop is created when
1. 2 separate devices are attached to the same patient and have 2 separate grounding
connections
2. 2 recording electrodes are connected to 2 separate input boxes of the same
instrument
3. patient is grounded by the large electrocautery ground that resembles a loop
,4. separate equipment attached to the same patient have current-limiting grounds -
ANS2 separate devices are attached to the same patient and have 2 separate
grounding connections
A grounding device must be available so that, under normal conditions, no voltage
greater than ____________ is measured across an impedance of 1000 ohms
1. 60mV rms at 50 Hz
2. 20mV rms at 60 Hz
3. 50 mV rms at 60 Hz
4. 10 mV rms at 50 Hz - ANS20mV rms at 60hz
A major disadvantage of monitoring only posterior tibial nerve SSEP during scoliosis
surer is the inability to
1. measure the effects of distraction on the spinal cord
2. measure the effects of translation of the spinal cord
3. detect ischemic injury to the anterior spinal cord
4. monitor highly variable responses to physiological factors such as heart rate and
blood pressure - ANSdetect ischemic injury to the anterior spinal cord
A nerve cell membrane can depolarize when
1. sodium channels are closed and potassium channels are opened
2. the summation of individual action potentials exceeds the membrane threshold
3. the resting membrane threshold reaches -70mV
4. chloride channels are opened - ANSThe summation of individual action potentials
exceeds the membrane threshold
A patient in a state of surgical anesthesia using N2O is likely to have a drop in SSEP
amplitudes of
1. 50%
2. 75%
3. 30%
4. 99% - ANS75%
A patient is admitted to the operating room diagnosed with a herniated C5/6 disc. Most
appropriate nerve(s) to monitor during the resulting surgical procedure would be the
1. tibial and ulnar nerves
2. median and posterior tibial nerves
3. median and auditory nerves
4. ulnar nerve - ANSmedian and posterior tibial nerves
, A patient is admitted to the OR diagnosed with a burst fracture of the first lumbar
vertebra. The most appropriate nerve(s) to monitor would be
1. posterior tibial and auditory nerves
2. median and ulnar nerves
3. posterior tibial and ulnar nerves
4. cauda equina - ANSposterior tibial and ulnar nerves
A rarefaction click occurs when the
1. initial movement of a transducer diaphragm is towards the tympanic membrane
2. initial movement of a transducer diaphragm is away from the tympanic membrane
3. movement of a transducer diaphragm alternates in polarity relative to the tympanic
membrane every second trial
4. movement of a transducer diaphragm alternates in polarity relative to the tympanic
membrane on a random basis - ANSinitial movement of a transducer diaphragm is
away from the tympanic membrane
A recommendation to minimize stimulus artifact while recording the BAER in the OR is
to
1. use alternating clicks
2. use larger headphones
3. use rarefaction clicks
4. decrease the impedance of your stimulating electrodes - ANSuse alternating clicks
A secure method for applying surface cup electrodes requires
1. application the day before surgery
2. a conductive paste and tape
3. water resistant tape
4. collodion and compressed air - ANScollodion and compressed air
A stimulus pulse width that would tend to excite a larger population of motor fibers then
sensory fibers is
1. 0.05ms
2. 0.2ms
3. 0.5ms
4. 1ms - ANS0.05 ms
A term used to describe very low currents that may be lethal to patients with indwelling
electrodes or catheters is
Questions and Correct, Verified
Answers. Graded A+
_______________________________ is the single most important step taken to avoid
contamination
1. using gloves
2. using protective eyewear
3. washing hands
4. using transportation barrier - ANSWashing hands
"Hearing level" (HL) is defined as the
1. average threshold intensity of normally hearing young adults
2. intensity of along duration sound that has the same amplitude as the peak SPL of a
short duration sound
3. lowest intensity that an average ear drum can her
4. inverse of the sound pressure level - ANSaverage threshold intensity of normally
hearing young adults
A "false-negative" test
1. is the desired goal of IONM
2. means that the test results do not show an abnormality when a clinical abnormality is
present
3. means that the test results show an abnormality when no clinical abnormality exists
4. presents the N18 wave as a positive down-going response - ANSmeans that the test
results do not show an abnormality when a clinical abnormality is present
A condensation click
1. delivers the loudest sounds to the tympanic membrane
2. causes the tympanic membrane to move outward
3. causes the headphone diaphragm to displace toward the tympanic membrane
4. causes the headphone diaphragm to move away from the tympanic membrane -
ANScauses the headphone diaphragm to displace toward the tympanic membrane
A constant voltage stimulator
1. varies the current in order to maintain a preset voltage level
2. maintains a constant voltage of 100 volts
,3. varies the output in order to maintain a preset current level
4. maintains a current level of 10mA - ANSvaries the current in order to maintain a
preset voltage level
a contraindication for the use of transcranial magnetic stimulation is
1. patient obesity
2. cardiac pacemaker in place
3. MS
4. transverse myelitis - ANScardiac pacemaker in place
A decreasing body temp of the surgical patient monitored with EPs can result in
1. increasing latencies of SSEP and BAER
2. no changes
3. increased amplitude of SSEP cortical responses
4. higher electrode impedances - ANSincreasing latencies of SSEP and BAER
A differential amplifier records
1. only the first two inputs
2. the second half the two inputs
3. the power of the sum of the two inputs
4. the difference between the two inputs - ANSthe difference between the two inputs
A goal of IONM of the sensory pathways is to
1. diagnose pre-existing abnormalities
2. detect global systemic changes
3. differentiate between local and surgical manipulations vs anesthetic affects
4. detect abnormalities (electrophysiologic changes) that develop as the recordings are
take - ANSdetect abnormalities (electrophysiologic changes) that develop as the
recordings are taken
A ground loop is created when
1. 2 separate devices are attached to the same patient and have 2 separate grounding
connections
2. 2 recording electrodes are connected to 2 separate input boxes of the same
instrument
3. patient is grounded by the large electrocautery ground that resembles a loop
,4. separate equipment attached to the same patient have current-limiting grounds -
ANS2 separate devices are attached to the same patient and have 2 separate
grounding connections
A grounding device must be available so that, under normal conditions, no voltage
greater than ____________ is measured across an impedance of 1000 ohms
1. 60mV rms at 50 Hz
2. 20mV rms at 60 Hz
3. 50 mV rms at 60 Hz
4. 10 mV rms at 50 Hz - ANS20mV rms at 60hz
A major disadvantage of monitoring only posterior tibial nerve SSEP during scoliosis
surer is the inability to
1. measure the effects of distraction on the spinal cord
2. measure the effects of translation of the spinal cord
3. detect ischemic injury to the anterior spinal cord
4. monitor highly variable responses to physiological factors such as heart rate and
blood pressure - ANSdetect ischemic injury to the anterior spinal cord
A nerve cell membrane can depolarize when
1. sodium channels are closed and potassium channels are opened
2. the summation of individual action potentials exceeds the membrane threshold
3. the resting membrane threshold reaches -70mV
4. chloride channels are opened - ANSThe summation of individual action potentials
exceeds the membrane threshold
A patient in a state of surgical anesthesia using N2O is likely to have a drop in SSEP
amplitudes of
1. 50%
2. 75%
3. 30%
4. 99% - ANS75%
A patient is admitted to the operating room diagnosed with a herniated C5/6 disc. Most
appropriate nerve(s) to monitor during the resulting surgical procedure would be the
1. tibial and ulnar nerves
2. median and posterior tibial nerves
3. median and auditory nerves
4. ulnar nerve - ANSmedian and posterior tibial nerves
, A patient is admitted to the OR diagnosed with a burst fracture of the first lumbar
vertebra. The most appropriate nerve(s) to monitor would be
1. posterior tibial and auditory nerves
2. median and ulnar nerves
3. posterior tibial and ulnar nerves
4. cauda equina - ANSposterior tibial and ulnar nerves
A rarefaction click occurs when the
1. initial movement of a transducer diaphragm is towards the tympanic membrane
2. initial movement of a transducer diaphragm is away from the tympanic membrane
3. movement of a transducer diaphragm alternates in polarity relative to the tympanic
membrane every second trial
4. movement of a transducer diaphragm alternates in polarity relative to the tympanic
membrane on a random basis - ANSinitial movement of a transducer diaphragm is
away from the tympanic membrane
A recommendation to minimize stimulus artifact while recording the BAER in the OR is
to
1. use alternating clicks
2. use larger headphones
3. use rarefaction clicks
4. decrease the impedance of your stimulating electrodes - ANSuse alternating clicks
A secure method for applying surface cup electrodes requires
1. application the day before surgery
2. a conductive paste and tape
3. water resistant tape
4. collodion and compressed air - ANScollodion and compressed air
A stimulus pulse width that would tend to excite a larger population of motor fibers then
sensory fibers is
1. 0.05ms
2. 0.2ms
3. 0.5ms
4. 1ms - ANS0.05 ms
A term used to describe very low currents that may be lethal to patients with indwelling
electrodes or catheters is
