CNIM PRACTICE QUESTIONS WITH
CORRECR & VERIFIED ANSWERS.
GRADED A+
___________ is the single most important step taken to avoid contamination.
a. washing hands
b. using a transportation barrier
c. using gloves
d. using protective eyewear - ANSa. washing hands
"Case specific monitoring" should include:
a. the number of channels you will use for each case
b. the modality(s) you will monitor for a specific case
c. the anesthetic regimen used for each case
d. the machine you will use for each case - ANSb. the modality(s) you will monitor for a
specific case
"Electrode impedance" is defined as opposition to:
a. direct current flow
b. alternating current flow
c. differential current flow
d. 60 Hz artifact - ANSb. alternating current flow
"Hearing Level" (HL) is defined as the:
a) average threshold intensity of normally hearing young adults
b) Intensity of long duration sound that has the same amplitude as the peak SP of a
short duration sound
c) Lowest intensity that an average eardurm can hear
d) Inverse of the sound pressure level - ANSa) average threshold intensity of normally
hearing young adults
"Hearing level" (HL) is defined as the:
a. lowest intensity that an average ear drum can hear
b. average threshold intensity of normally hearing young adults
c. inverse of the sound pressure level
d. intensity of a long duration sound that has the same amplitude as the peak SPL of a
short duration sound - ANSb. average threshold intensity of normally hearing young
adults
"Separation of joint surfaces without rupture of their binding ligaments and without
displacement" defines which term:
a. derotation
,b. decompression
c. distraction
d. traction - ANSc. distraction
30-50% reduction in D-wave response amplitude coupled with unchanged TcMEP
responses predicts which neurological outcome?
a. unchanged
b. permanent paralysis
c. transient paralysis
d. hemiparesis - ANSa. unchanged
A "ground loop" is created when:
a. Two recording electrodes are connected to two separate input boxes of the same
instrument
b. The patient is grounded by the large electrocautery ground that resembles a loop
c. Two separate devices are attached to the same patient and have two separate
grounding connections
d. Separate equipment attached to the same patient have current-limiting grounds -
ANSc. Two separate devices are attached to the same patient and have two separate
grounding connections
A bipolar stimulator allows the surgeon to:
a) Be more specific in identifying structures
b) Stimulate larger areas
c) Use a higher stimulus intensity
d) Use a shorter stimulus duration - ANSa) Be more specific in identifying structures
A Carotid Endarterectomy is performed to remove __________ from the artery
a. red blood cells
b. plaque
c. white blood cells
d. edema - ANSb. plaque
A condensation click:
a. causes the tympanic membrane to move outward
b. causes the headphone diaphragm to move away from the tympanic membrane
c. causes the headphone diaphragm to displace toward the tympanic membrane
d. delivers the loudest sounds to the tympanic membrane - ANSc. causes the
headphone diaphragm to displace toward the tympanic membrane
A constant voltage stimulator:
a. varies the current in order to maintains a preset voltage level
b. maintains a current level of 10 mA
c. maintains a constant voltage of 100 volts
,d. varies the output in order to maintain a preset current level - ANSa. varies the current
in order to maintain a preset voltage level
A contraindication for the use of transcranial magnetic stimulation is:
a) patient obesity
b) a cardiac pacemaker in place
c) multiple sclerosis
d) transverse myelitis - ANSb) cardiac pacemaker in place
A decrease in body temperature has what effect(s) on evoked potentials?
a. increase in latency of cortical SSEPs
b. variable effects depending on patient age and sex
c. no changes
d. increase latency, decrease amplitude of SSEPs - ANSd. increase latency, decrease
amplitude of SSEPs
A decreasing body temperature of the surgical patient monitored with EPs can result in:
a. no remarkable changes
b. increasing latencies of the SSEP and BAEP
c. increased amplitude of SSEP cortical responses
d. higher electrode impedances - ANSb. increasing latencies of the SSEP and BAEP
A differential amplifier, amplifies and records:
a. only the first two inputs
b. the power of the sum of the two inputs
c. the second half of the two inputs
c. the second half of the two inputs
d. the difference between the two inputs - ANSd. the difference between the two inputs
A drop in the temperature of the patient's legs can cause:
a. an increase in the amplitude of the L3S response
b. a decrease in the amplitude of the SSEP waveforms
c. a prolongation of SSEP peak latencies
d. an increase in the conduction velocity of the tibial nerve - ANSc. a prolongation of
SSEP peak latencies
A goal of intraoperative monitoring of the sensory pathways is to:
a. diagnose preexisting abnormalities
b. differentiate between local surgical manipulations versus anesthetic affects
c. detect global systemic changes
d. detect abnormalities (electrophysiologic changes) that develop as the recordings are
taken - ANSd. detect abnormalities (electrophysiologic changes) that develop as the
recordings are taken
A good method to justify your policies is to:
, a. justify your policies with guidelines and/or peer reviewed literature
b. have your manual certified
c. use someone else's manual that you trust - ANSa. justify your policies with guidelines
and/or peer reviewed literature
A grounding device must be available so that, under normal conditions, no voltage
greater than __________ is measured across an impedance of 1000 ohms
a. 60 mV rms at 50 Hz
b. 50 mV rms at 60 Hz
c. 10 mV rms at 50 Hz
d. 20 mV rms at 60 Hz - ANSd. 20 mV rms at 60 Hz
A grounding system must be available at each nonflammable anesthetizing location
such that no voltage greater than:
a) 20 uV rms at 60 hz shall be measured across an impedance of 1000 ohms
b) 20 mV rms at 60 hz shall be measured across an impedance of 1000 ohms
c) 50 mV rms at 60 hz shall be measured across an impedance fo 1000 ohms
d) 50 uV rms at 60 hz shall be measured across an impedance of 1000 ohms - ANSb)
20 mV rms at 60 hz shall be measured across an impedance of 1000 ohms
A major disadvantage of monitoring only the posterior tibial nerve SSEP during scoliosis
surgery is the inability to:
a. detect ischemic injury to the anterior spinal cord
b. monitor highly variable responses to physiological factors such as heart rate and
blood pressure
c. measure the effects of distraction on the spinal cord
d. measure the effects of translation on the spinal cord - ANSa. detect ischemic injury to
the anterior spinal cord
A nerve cell membrane can depolarize when:
a) Sodium channels are closed and potassium channels are opened
b) The summation of individual action potentials exceeds the membrane threshold
c) the resting membrane threshold reached -70 mV
d) chloride channels are opened - ANSb) The summation of individual action potentials
exceeds the membrane threshold
A patient can become the pathway of least resistance and therefore electrically
susceptible to shock when:
a) Depth electrodes are used
b) Not all equipment attached to the patient is connected to a common ground
c) The electrode test is utilized
d) The recording instrument is turned on - ANSb) Not all equipment attached to the
patient is connected to a common ground
CORRECR & VERIFIED ANSWERS.
GRADED A+
___________ is the single most important step taken to avoid contamination.
a. washing hands
b. using a transportation barrier
c. using gloves
d. using protective eyewear - ANSa. washing hands
"Case specific monitoring" should include:
a. the number of channels you will use for each case
b. the modality(s) you will monitor for a specific case
c. the anesthetic regimen used for each case
d. the machine you will use for each case - ANSb. the modality(s) you will monitor for a
specific case
"Electrode impedance" is defined as opposition to:
a. direct current flow
b. alternating current flow
c. differential current flow
d. 60 Hz artifact - ANSb. alternating current flow
"Hearing Level" (HL) is defined as the:
a) average threshold intensity of normally hearing young adults
b) Intensity of long duration sound that has the same amplitude as the peak SP of a
short duration sound
c) Lowest intensity that an average eardurm can hear
d) Inverse of the sound pressure level - ANSa) average threshold intensity of normally
hearing young adults
"Hearing level" (HL) is defined as the:
a. lowest intensity that an average ear drum can hear
b. average threshold intensity of normally hearing young adults
c. inverse of the sound pressure level
d. intensity of a long duration sound that has the same amplitude as the peak SPL of a
short duration sound - ANSb. average threshold intensity of normally hearing young
adults
"Separation of joint surfaces without rupture of their binding ligaments and without
displacement" defines which term:
a. derotation
,b. decompression
c. distraction
d. traction - ANSc. distraction
30-50% reduction in D-wave response amplitude coupled with unchanged TcMEP
responses predicts which neurological outcome?
a. unchanged
b. permanent paralysis
c. transient paralysis
d. hemiparesis - ANSa. unchanged
A "ground loop" is created when:
a. Two recording electrodes are connected to two separate input boxes of the same
instrument
b. The patient is grounded by the large electrocautery ground that resembles a loop
c. Two separate devices are attached to the same patient and have two separate
grounding connections
d. Separate equipment attached to the same patient have current-limiting grounds -
ANSc. Two separate devices are attached to the same patient and have two separate
grounding connections
A bipolar stimulator allows the surgeon to:
a) Be more specific in identifying structures
b) Stimulate larger areas
c) Use a higher stimulus intensity
d) Use a shorter stimulus duration - ANSa) Be more specific in identifying structures
A Carotid Endarterectomy is performed to remove __________ from the artery
a. red blood cells
b. plaque
c. white blood cells
d. edema - ANSb. plaque
A condensation click:
a. causes the tympanic membrane to move outward
b. causes the headphone diaphragm to move away from the tympanic membrane
c. causes the headphone diaphragm to displace toward the tympanic membrane
d. delivers the loudest sounds to the tympanic membrane - ANSc. causes the
headphone diaphragm to displace toward the tympanic membrane
A constant voltage stimulator:
a. varies the current in order to maintains a preset voltage level
b. maintains a current level of 10 mA
c. maintains a constant voltage of 100 volts
,d. varies the output in order to maintain a preset current level - ANSa. varies the current
in order to maintain a preset voltage level
A contraindication for the use of transcranial magnetic stimulation is:
a) patient obesity
b) a cardiac pacemaker in place
c) multiple sclerosis
d) transverse myelitis - ANSb) cardiac pacemaker in place
A decrease in body temperature has what effect(s) on evoked potentials?
a. increase in latency of cortical SSEPs
b. variable effects depending on patient age and sex
c. no changes
d. increase latency, decrease amplitude of SSEPs - ANSd. increase latency, decrease
amplitude of SSEPs
A decreasing body temperature of the surgical patient monitored with EPs can result in:
a. no remarkable changes
b. increasing latencies of the SSEP and BAEP
c. increased amplitude of SSEP cortical responses
d. higher electrode impedances - ANSb. increasing latencies of the SSEP and BAEP
A differential amplifier, amplifies and records:
a. only the first two inputs
b. the power of the sum of the two inputs
c. the second half of the two inputs
c. the second half of the two inputs
d. the difference between the two inputs - ANSd. the difference between the two inputs
A drop in the temperature of the patient's legs can cause:
a. an increase in the amplitude of the L3S response
b. a decrease in the amplitude of the SSEP waveforms
c. a prolongation of SSEP peak latencies
d. an increase in the conduction velocity of the tibial nerve - ANSc. a prolongation of
SSEP peak latencies
A goal of intraoperative monitoring of the sensory pathways is to:
a. diagnose preexisting abnormalities
b. differentiate between local surgical manipulations versus anesthetic affects
c. detect global systemic changes
d. detect abnormalities (electrophysiologic changes) that develop as the recordings are
taken - ANSd. detect abnormalities (electrophysiologic changes) that develop as the
recordings are taken
A good method to justify your policies is to:
, a. justify your policies with guidelines and/or peer reviewed literature
b. have your manual certified
c. use someone else's manual that you trust - ANSa. justify your policies with guidelines
and/or peer reviewed literature
A grounding device must be available so that, under normal conditions, no voltage
greater than __________ is measured across an impedance of 1000 ohms
a. 60 mV rms at 50 Hz
b. 50 mV rms at 60 Hz
c. 10 mV rms at 50 Hz
d. 20 mV rms at 60 Hz - ANSd. 20 mV rms at 60 Hz
A grounding system must be available at each nonflammable anesthetizing location
such that no voltage greater than:
a) 20 uV rms at 60 hz shall be measured across an impedance of 1000 ohms
b) 20 mV rms at 60 hz shall be measured across an impedance of 1000 ohms
c) 50 mV rms at 60 hz shall be measured across an impedance fo 1000 ohms
d) 50 uV rms at 60 hz shall be measured across an impedance of 1000 ohms - ANSb)
20 mV rms at 60 hz shall be measured across an impedance of 1000 ohms
A major disadvantage of monitoring only the posterior tibial nerve SSEP during scoliosis
surgery is the inability to:
a. detect ischemic injury to the anterior spinal cord
b. monitor highly variable responses to physiological factors such as heart rate and
blood pressure
c. measure the effects of distraction on the spinal cord
d. measure the effects of translation on the spinal cord - ANSa. detect ischemic injury to
the anterior spinal cord
A nerve cell membrane can depolarize when:
a) Sodium channels are closed and potassium channels are opened
b) The summation of individual action potentials exceeds the membrane threshold
c) the resting membrane threshold reached -70 mV
d) chloride channels are opened - ANSb) The summation of individual action potentials
exceeds the membrane threshold
A patient can become the pathway of least resistance and therefore electrically
susceptible to shock when:
a) Depth electrodes are used
b) Not all equipment attached to the patient is connected to a common ground
c) The electrode test is utilized
d) The recording instrument is turned on - ANSb) Not all equipment attached to the
patient is connected to a common ground
