CNIM FINAL EXAM AND PRACTICE EXAM LATEST
2023-2024 ACTUAL EXAM 250 QUESTRIONS AND
CORRECT DETAILED ANSWERS WITH RATIONALES
(VERIFIED ANSWERS) |ALREADY GRADED A+
Sublaminar wires will aid in which type of spinal cord manipulation?
A)Distraction and Derotation
B)Translation
C)Derotation
D)Distraction - answer-B)Translation
Which of the following is the LEAST likely to cause 60 Hz artifact?
A)Bipolar bovie
B)The OR bed remote
C)BAIR hugger
D)Pneumatic Drill - answer-D)Pneumatic Drill
During a procedure for spina bidifa where the cord is being untethered, what will the surgeon be
cutting?
A)Sensory rootlets
B)Motor rootlets
C)Cauda Equina
D)Filum terminale - answer-D)Filum terminale
The filum terminale is going to be cut since the cord is being tethered too tightly. The surgeon will
stimulate the filum to ensure it is not a nerve root. I will not generate a CMAP from any muscles because
it is not nerve. After ensuring it is safe, the surgeon will cut it.
Depolarizing:
A)Rocuronium
B)Pancuronium
,C)Fentanyl
D)Succinylcholine - answer-D)Succinylcholine
Succinylcholine is the only depolarizing neuromuscular junction blocking muscle relaxant currently in
wide use. Rocuronium and Pancuronium are nondepolarizing neuromuscular junction blockers, and
Fentanyl is a narcotic (or opioid) agent.
Minimum required vertical resolution
A)8 bits
B)16 bits
C)18 bits
D)24 bits - answer-A)8 bits
8-12bits (ACNS Guidelines)
The ________ is responsible for blood flow compensation after clamping of the internal carotid artery.
A)Artery of Adamkewicz
B)Circle of Willis
C)Basilar Artery
D)Watershed area - answer-B)Circle of Willis
What is a good way to troubleshoot your small amplitude SSEPs?
A)Decrease the intensity of the stim
B)Increase the display sensitivity
C)Increase the pulse duration
D)Decrease the number of averages - answer-C)Increase the pulse duration
Which organization sets the standards and initiatives for the National Patient Safety Goals in the US?
A)The Joint Commission
,B)HIPAA
C)OSHA - answer-A)The Joint Commission
If a 10 microvolt signal inside 50 microvolts of noise is averaged for 100 traces, the final signal to noise
ratio will be:
A)1:1
B)1:5
C)5:1
D)2:1 - answer-D)2:1
This standard describes the practice of treating all bodily fluids as if they are infected with pathogen.
A)Universal Blood Standard
B)Universal Precautions
C)Standard Protection
D)Bodily Fluid Standards - answer-B)Universal Precautions
As you move caudally down the spinal cord, the TES-DWave amplitude will _______ and the latency will
_________ .
A)increase, decrease
B)decrease, increase
C)decrease, decrease
D)increase, increase - answer-B)decrease, increase
The D-wave usually cannot be recorded below T7/T9 level because the corticospinal tract becomes
thinner as you move caudally down the cord; thus the amplitude of the Dwave will be smaller until it is
too small to record and amplify. Of course as you move caudally down the cord, the latency will increase
as well as you are recording at a further distance from stimulation. Remember the D-wave cannot be
recorded at all after the termination of the cord at the conus.
If coronal TcMEP stim cannot be performed, what is a suitable alternative site?
A)C3-C4
B)C3-Cz
, C)C1-C2
D)Cz-Fz - answer-D)Cz-Fz
What is the final exit site for the facial nerve?
A)jugular foramen
B)stylomastoid foramen
C)foramen rotundum
D)foramen magnum - answer-B)stylomastoid foramen
Which cranial nerve will be most critical to monitor during a cochlear implant insertion procedure?
A)CN 4
B)CN 5
C)CN 6
D)CN 7 - answer-D)CN 7
Disruption to which artery would cause a change in the waveform indicated by the red arrow?
A)MCA
B)ACA
C)VBA
D)AComm - answer-C)VBA
If a patient's hemoglobin is below 10g/dL, the SSEP waveform will likely:
A)Have a greater interpeak variability
B)Increase in amplitude
C)Decrease in amplitude
D)Cease to be recordable - answer-C)Decrease in amplitude
2023-2024 ACTUAL EXAM 250 QUESTRIONS AND
CORRECT DETAILED ANSWERS WITH RATIONALES
(VERIFIED ANSWERS) |ALREADY GRADED A+
Sublaminar wires will aid in which type of spinal cord manipulation?
A)Distraction and Derotation
B)Translation
C)Derotation
D)Distraction - answer-B)Translation
Which of the following is the LEAST likely to cause 60 Hz artifact?
A)Bipolar bovie
B)The OR bed remote
C)BAIR hugger
D)Pneumatic Drill - answer-D)Pneumatic Drill
During a procedure for spina bidifa where the cord is being untethered, what will the surgeon be
cutting?
A)Sensory rootlets
B)Motor rootlets
C)Cauda Equina
D)Filum terminale - answer-D)Filum terminale
The filum terminale is going to be cut since the cord is being tethered too tightly. The surgeon will
stimulate the filum to ensure it is not a nerve root. I will not generate a CMAP from any muscles because
it is not nerve. After ensuring it is safe, the surgeon will cut it.
Depolarizing:
A)Rocuronium
B)Pancuronium
,C)Fentanyl
D)Succinylcholine - answer-D)Succinylcholine
Succinylcholine is the only depolarizing neuromuscular junction blocking muscle relaxant currently in
wide use. Rocuronium and Pancuronium are nondepolarizing neuromuscular junction blockers, and
Fentanyl is a narcotic (or opioid) agent.
Minimum required vertical resolution
A)8 bits
B)16 bits
C)18 bits
D)24 bits - answer-A)8 bits
8-12bits (ACNS Guidelines)
The ________ is responsible for blood flow compensation after clamping of the internal carotid artery.
A)Artery of Adamkewicz
B)Circle of Willis
C)Basilar Artery
D)Watershed area - answer-B)Circle of Willis
What is a good way to troubleshoot your small amplitude SSEPs?
A)Decrease the intensity of the stim
B)Increase the display sensitivity
C)Increase the pulse duration
D)Decrease the number of averages - answer-C)Increase the pulse duration
Which organization sets the standards and initiatives for the National Patient Safety Goals in the US?
A)The Joint Commission
,B)HIPAA
C)OSHA - answer-A)The Joint Commission
If a 10 microvolt signal inside 50 microvolts of noise is averaged for 100 traces, the final signal to noise
ratio will be:
A)1:1
B)1:5
C)5:1
D)2:1 - answer-D)2:1
This standard describes the practice of treating all bodily fluids as if they are infected with pathogen.
A)Universal Blood Standard
B)Universal Precautions
C)Standard Protection
D)Bodily Fluid Standards - answer-B)Universal Precautions
As you move caudally down the spinal cord, the TES-DWave amplitude will _______ and the latency will
_________ .
A)increase, decrease
B)decrease, increase
C)decrease, decrease
D)increase, increase - answer-B)decrease, increase
The D-wave usually cannot be recorded below T7/T9 level because the corticospinal tract becomes
thinner as you move caudally down the cord; thus the amplitude of the Dwave will be smaller until it is
too small to record and amplify. Of course as you move caudally down the cord, the latency will increase
as well as you are recording at a further distance from stimulation. Remember the D-wave cannot be
recorded at all after the termination of the cord at the conus.
If coronal TcMEP stim cannot be performed, what is a suitable alternative site?
A)C3-C4
B)C3-Cz
, C)C1-C2
D)Cz-Fz - answer-D)Cz-Fz
What is the final exit site for the facial nerve?
A)jugular foramen
B)stylomastoid foramen
C)foramen rotundum
D)foramen magnum - answer-B)stylomastoid foramen
Which cranial nerve will be most critical to monitor during a cochlear implant insertion procedure?
A)CN 4
B)CN 5
C)CN 6
D)CN 7 - answer-D)CN 7
Disruption to which artery would cause a change in the waveform indicated by the red arrow?
A)MCA
B)ACA
C)VBA
D)AComm - answer-C)VBA
If a patient's hemoglobin is below 10g/dL, the SSEP waveform will likely:
A)Have a greater interpeak variability
B)Increase in amplitude
C)Decrease in amplitude
D)Cease to be recordable - answer-C)Decrease in amplitude
