CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers, Exams of Nursing

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CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers Lower motors neurons primarily exit the cord through the: 1 dorsal nerve roots 2 ventral nerve roots 3 dorsal columns 4 dorsal root ganglia - Correct Answer ✅Ventral Nerve Roots Which one of the following is an excitatory neurotransmitter? 1 GABA 2 Glutamate 3 Glycine 4 Phenylalanine - Correct Answer ✅Glutamate Which one of the following is an inhibitory neurotransmitter? 1 GABA 2 Serotonin 3 Dopamine 4 Phenlalanine - Correct Answer ✅GABA CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers The layers of protective tissue which surround the CNS are called: 1 the ventricles 2 the meninges 3 Cerebrospinal fluid 4 The Skull - Correct Answer ✅the meninges What separates the motor and sensory strips? 1 Sylvian Fissure 2 Central Sulcus 3 Frontal Sulcus 4 Sagittal Fissure - Correct Answer ✅Central Sulcus The interconnecting blood vessels at the base of the brain make up: 1 the circle of Willis 2 the Carotid exchange 3 the circle of Milford CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers The nerve roots that extend below the spinal cord make up the: 1 cauda equina 2 spina bifida 3 Filum Terminale 4 Conus Medularis - Correct Answer ✅cauda equina The nerve root entry levels for the ulnar nerve are: 1 C1-4 2 C5-T1 3 C5-6 4 C8-T1 - Correct Answer ✅C8-T1 The nerve root entry levels for posterior tibial nerve are: 1 C5-T1 2 L1-4 3 L4-S3 4 S1-S5 - Correct Answer ✅L4-S3 CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers The tibial and common peroneal nerves form from what nerve? 1 Sural 2 Saphenous 3 Femora 4 Sciatic - Correct Answer ✅Sciatic Stimulation of the MN at the wrist will activate which muscle? 1 Abductor digiti minimi 2 Abductor pollicis brevis 3 Biceps 4 Deltoid - Correct Answer ✅Abductor pollicis brevis Stimulation of the peroneal nerve is performed: 1 across the medial malleolus 2 across the lateral malleolus 3 across the head of the fibula CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers 4 in the medial third of the antecubital space - Correct Answer ✅Across the head of the fibula The resting membrane potential of a neuron is primarily maintained by: 1 passive diffusion of charged ions 2 the sodium-potassium pump 3 action potentials 4 the opening of sodium channels - Correct Answer ✅the Sodium-Potassium pump A typical resting membrane potential of a neuron is: 1 +20 mV inside the cell 2 -20 mV inside the cell 3 +70 mV inside the cell 4 -70 mV inside the cell - Correct Answer ✅-70mV inside the cell What is the initial event that occurs when the action potential threshold of a neuron is reached? CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers What is the most common result of anterior spinal artery occlusion? 1 loss of Erb's point response 2 loss of N13 3 motor deficits 4 loss of proprioception - Correct Answer ✅motor deficits Which of the following has the greatest effect on SSEP monitoring? 1 Fentanyl 2 Diazepam 3 Pavulon 4 Sevoflurane - Correct Answer ✅Diazepam MAC stands for: 1 minimum anesthetic consciousness 2 maximum alveolar compromise 3 minimum alveolar concentration CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers 4 minimum anesthetic concentration - Correct Answer ✅minimum alveolar concentration Opioids are used primarily for: 1 Analgesia 2 Neuromuscular blockade 3 amnesia 4 anesthesia - Correct Answer ✅Analgesia Midazolam is what type of drug? 1 Opioid 2 neuromuscular blocker 3 halogenated gas 4 benzodiazepine - Correct Answer ✅Benzodiazepine Which of the following drugs has an appreciable effect on peripheral nerve APs? 1 Sufentanil CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers 2 Vecuronium 3 Desflurane 4 none of the above - Correct Answer ✅none of the above Which of the following is a barbiturate? 1 Remifentanyl 2 Methohexital 3 Curare 4 Nitrous Oxide - Correct Answer ✅Methohexital Desflurane has a more rapid onset and recovery than Isoflurane bc: 1 Des has a lower blood solubility than Iso 2 Des has a higher blood solubility than Iso 3 Des is injected directly into the blood stream 4 a MAC of Des is several times that of Iso - Correct Answer ✅Desflurane has a higher blood solubility than Isoflurane CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers 2 all cortical responses are affected equally 3 later cortical peaks are affected more than earlier peaks 4 motor pathways are unaffected by anesthesia - Correct Answer ✅later cortical peaks are affected more than earlier peaks Which of the following peaks will be most affected by Desflurane? 1 P37 2 P100 3 N20 4 Wave V - Correct Answer ✅P100 For spontaneous EMG monitoring, which is the most appropriate drug to use at induction? 1 Curare 2 Pavulon 3 Succinylcholine 4 Norcuron - Correct Answer ✅Succinylcholine CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers Which of the following are known to increase evoked potential amplitudes? 1 Nitrous Oxide 2 Ketamine 3 Halothane 4 Sufentanil - Correct Answer ✅Ketamine Fentanyl infusion will: 1 have no effect on amplitude or latency 2 decrease amplitude only 3 increase amplitude and increase latency 4 increase latency and decrease amplitude - Correct Answer ✅increase latency and decrease amplitude Which of the following can increase SSEPs amplitude? 1 Fentanyl 2 Etomidate 3 Isoflurane CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers 4 0.5 MAC of halothane - Correct Answer ✅0.5 MAC of halothane What is the most important step to seting up BAEPs? 1 Cleaning the ear canal with Betadine 2 Placing the foam inserts 3 Sealing the ear closed 4 Filling the tubing with saline - Correct Answer ✅Placing the foam inserts If you have a lot of high freq. noise in your BAEPs, you can: 1 change your filter from 10 to 30 Hz 2 change your filter from 10 to 200 Hz 3 change your filter from 2500 to 150 Hz 4 change your filter from 2500 to 1500 Hz - Correct Answer ✅Change your filter from 2500 to 1500 Hz If a sound intensity is increased from 20 dB to 40 dB, then the sound pressure has increased by a factor of: 1 20 CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers 2 Thalamic tumor 3 Cerrvical spinal cord tumor 4 Tympanomastoidectomy - Correct Answer ✅CPA tumor What is considered criteria for alarm when monitoring BAEPs intraoperatively? 1 Dec latency of IV 2 Inc I-V interpeak latency or disappearance of wave V 3 Dec interpeak latency of waves I-V 4 Inc amplitude of wave V - Correct Answer ✅Increased I-V interpeak latency or disappearance of wave V Where is the BAEP wave V generated? 1 Medulla 2 Midbrain 3 Thalamus 4 Temporal lobe - Correct Answer ✅Midbrain CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers What is the very large amplitude potential following the BAEP waves I-V at approx. 15 ms? 1 Large latency potential 2 Postauricular myogenic response 3 Middle latency potential 4 Wave VI - Correct Answer ✅Postauricular myogenic response BAEPs can no longer be successfully performed after resection of the: 1 Tympanic Membrane 2 Ossicles 3 Acoustic Nerve 4 Vestibular Nerve - Correct Answer ✅Acoustic Nerve CNS depressants cause: 1 minimal effects in BAEPs 2 Prolonged I-V latencies 3 Prolonged III-V latencies CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers 4 Inc absolute latencies with no change in interpeaks. - Correct Answer ✅Minimal effects in BAEPs BAEPs are appropriate for monitoring: 1 Spinal Cord function 2 Brainstem function 3 Facial Nerve 4 Motor Function - Correct Answer ✅Brainstem function The Brainstem Auditory EPs (BAEPs) typically involves what type of stimulus? 1 Tone burst 2 Electrical pulse 3 Click sound 4 White noise - Correct Answer ✅Click Sound During a posterior fossa resection of an acoustic neuroma, you observe the loss of wave II only in the BAEP. You should: 1 Inform the surgeon. This indicates significant damage to the VIIIth Nerve CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers 4 Tympanic Membrane - Correct Answer ✅Cranial Nerve VIII The prominent wave for monitoring of BAEPs is: 1 Wave I 2 Wave V 3 ECoG 4 Wave III - Correct Answer ✅Wave V According to the Guidelines, what are the optimal filter settings for recording BAEPs? 1 10-30 Hz to 2500-3000 Hz 2 100-300 Hz to 3000-5000 Hz 3 100 Hz to 500 Hz 4 50-100 Hz to 5000-10000 Hz - Correct Answer ✅10-30 Hz to 2500-3000 Hz If the VIIIth nerve were transected lateral to the brainstem, you may get: 1 Inc I-III latency CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers 2 Loss of wave V only 3 Absence of waves III-V 4 No change - Correct Answer ✅Absence of waves III-V Of the choices below, the optimal repetition rate for BAEPs is: 1 11.4 Hz 2 30 Hz 3 56 Hz 4 122 Hz - Correct Answer ✅56 Hz According to the Guidelines, what is the acceptable sweep for BAEPs? 1 25 msec 2 20-30 msec 3 10-15 msec 4 5 msec - Correct Answer ✅10-15 msec To eliminate crossover, the Guidelines suggest a masking level of: CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers 1 60 dB SPL 2 60 dB HL 3 60 dB SL 4 60 dB nHL - Correct Answer ✅60 dB HL Of the choices below, the most appropriate BAEP interstimulus interval is: 1 10-20 mS 2 33-90 mS 3 0.02 mS 4 1-5 mS - Correct Answer ✅33-90 mS What is the most common reason for loss of BAEPs during retromastoid microvascular decompression? 1 Cut the cochlear nerve 2 Injury to the facial nerve 3 Opening of the dura 4 Compromise vascular supply - Correct Answer ✅Compromise vascular supply CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers Lack of after-discharges indicates: 1 Stimulation is not over a functional motor or language area 2 The stimulus is adequate to activate motor or language areas 3 The stimulus is inadequate to activate motor or language areas 4 The stimulus is likely below the threshold of seizure activation - Correct Answer ✅The stimulus is likely below the threshold of seizure activation When no phase reversal is present in an anterior-posterior cortical grid recording: 1 The grid is over the pre-central gyrus 2 The max amplitude response is closest to the central sulcus 3 The grid is over the post-central gyrus 4 The grid should be turned 90 degrees in order to find the phase reversal - Correct Answer ✅The maximum amplitude response is closest to the central sulcus What drugs would you use for language mapping? 1 Sevoflurane CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers 2 Pavulon 3 Thiopental 4 Fentanyl - Correct Answer ✅Fentanyl What is the advantage of using bipolar recording pairs for monitoring of CN spontaneous EMG? 1 Avoids far-field recording of nearby muscle activity 2 Is more sensitive to irritation of cranial nerves 3 Maximizes amplitude of recorded EMG 4 Less affected by neuromuscular blockade - Correct Answer ✅Avoids far- field recording of nearby muscle activity The facial nerve CMAP response has a latency of apprx.: 1 3 msec 2 5 msec 3 7 msec 4 10 msec - Correct Answer ✅7 msec CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers The trigeminal nerve EMG response has a latency of approx.: 1 1-2 msec 2 3-5 msec 3 6-8 msec 4 9-11 msec - Correct Answer ✅3-5 msec Random spike discharges can be heard from a speaker during facial nerve dissection in all of the following, except: 1 Irrigation 2 heating effects 3 traction on the nerve 4 during electrocautery - Correct Answer ✅During electrocautery CN XII can be monitored using electrodes inserted into the: 1 Vocalis muscle 2 Trapezius muscle 3 Tongue CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers Which of the following electrodes is regarded as an effective stimulator during facial nerve recordings? 1 Silver disk electrode 2 Spinal epidural electrode 3 Bipolar concentric EMG needle 4 Nasopharyngeal probe - Correct Answer ✅Bipolar concentric EMG needle Which would you monitor for a microvascular decompression of the 5th CN? 1 Sternocleidomastoid muscle 2 Masseter muscle 3 Superior oblique muscle 4 Medial rectus muscle - Correct Answer ✅Masseter muscle CN IV can be monitored using electrodes inserted into the: 1 Lateral rectus 2 Inferior oblique CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers 3 Superior oblique 4 Trochlea - Correct Answer ✅Superior oblique What is the advantage to using an insulated bipolar electrode for intracranial facial nerve stimulation? 1 Prevent burn to surgeon's hand 2 Prevent cranial nerve damage 3 Prevent current shunting to other cranial nerves 4 Required by JCAHO - Correct Answer ✅Prevent current shunting to other cranial nerves What type of electrode is recommended for monitoring facial nerve? 1 Needle 2 Surface 3 Ring electrode 4 Gold electrode - Correct Answer ✅Needle Which of the following could be used to monitor facial nerve EMG? CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers 1 Temporalis 2 Mentalis 3 Stylopharyngeus 4 Streptococcus - Correct Answer ✅Mentalis The integrity of the facial nerve in acoustic neuroma Sx is determined by: 1 Spontaneous EMG 2 Proximal CMAP 3 Distal CMAP 4 Stagnara wake-up test - Correct Answer ✅Proximal CMAP What CNs should be ideally monitored for Cerebellopontine (CP) angle tumors? 1 V and VII 2 VII and VIII 3 VIII and IX 4 VII, VIII, and XII - Correct Answer ✅VII and VIII CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers 4 0.3-70 Hz, 30 mm/sec, 30 uV/mm - Correct Answer ✅0.3-70 Hz, 15 mm/sec, 3uV/mm A dec. in the power spectral edge indicates: 1 Nothing 2 Insufficient brain perfusion 3 Inc. anesthesia 4 A greater proportion of EEG power at the lower frequencies - Correct Answer ✅A greater proportion of EEG power at the lower frequencies The watershed area lies b/t: 1 Anterior cerebral artery and middle cerebral artery 2 Posterior cerebral artery and middle cerebral artery 3 Anterior cerebral artery and anterior communicating artery 4 Posterior cerebral artery and posterior communicating artery - Correct Answer ✅Anterior cerebral artery and middle cerebral artery Most strokes associated with CEA occur: CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers 1 Before cross-clamping 2 During cross-clamping 3 After the cross-clamping is released 4 10-30 days after leaving the hospital - Correct Answer ✅After the cross- clamping is released Which of the following, along with sodium amytal, is used to determine language localization? 1 SSEP 2 BAEP 3 WADA 4 ABLB - Correct Answer ✅WADA Processed EEG: Spectral Edge is a function of: 1 Beta and alpha vs. time 2 Amplitude and latency vs. time 3 Power and frequency vs. time CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers 4 Radiographic interpretation - Correct Answer ✅Power and frequency vs. time EEG will most likely disappear at what body temp? 1 36' C 2 28' C 3 16' C 4 23' C - Correct Answer ✅16' C What is the max. time in which to expect EEG changes, following cross clamping of the carotid? 1 30 sec 2 1 min 3 2 min 4 5 min - Correct Answer ✅2 minutes All of the following are benefits of EEG monitoring during CEA, except: 1 Detection of occlusion-associated ischemia CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers 4 The insulation is stripped off at least 5 cm - Correct Answer ✅The wires are directed away from the sterile field What is the max allowable chassis leakage current? 1 10 uA 2 20 uA 3 .1 mA 4 10 mA - Correct Answer ✅.1 mA What is the max allowable leakage current from the isolated amplifier inputs through the patient leads? 1 10 uA 2 100 uA 3 1 mA 4 10 mA - Correct Answer ✅10 uA If you receive a shock from the chassis of your machine during monitoring, you should first: CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers 1 Call biomed 2 Turn off the machine 3 Save and print your data 4 Disconnect the patient - Correct Answer ✅Disconnect the patient How frequently should the EP machines be calibrated and safety tested? 1 Only when there is a problem 2 Every 6 months 3 Once a year 4 Once every two years - Correct Answer ✅Every 6 months Having poor ground resistance represents a safety problem bc: 1 No, it really is not a safety issue 2 Any current leaking to the chassis may find a path to ground through your body 3 The machine might not function properly CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers 4 It may affect other electrical equipment that have connections to Earth ground - Correct Answer ✅Any current leaking to the chassis may find a path to ground through your body How should needle electrodes be discarded? 1 It doesn't matter as long as they are not contaminated with blood 2 Carefully discarded in a plastic or metal trash can 3 Only in a red puncture proof sharps container 4 Toss onto the OR floor so Housekeeping can sweep them up - Correct Answer ✅Only is a red puncture proof sharps container How is TB transmitted? 1 It is sexually transmitted 2 By airborne droplets 3 By contact with blood 4 Via skin to skin contact - Correct Answer ✅By airborne droplets What is the most important means of preventing the spread of infections? CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers 3 It will mean that more current could be delivered to the patient if the ground fails 4 It may interfere with the operation of other devices in the OR - Correct Answer ✅It will mean that more current could be delivered to the patient if the ground fails Platinum electrodes are used to record epidural potentials bc: 1 They eliminate the possibility of allergic reactions 2 They have better impedance than other metal electrodes 3 They yeild larger responses 4 Other elements cause neurotoxicity when current is passed through them - Correct Answer ✅Other elements cause neurotoxicity when current is passed through them When an electrode falls on the floor you: 1 Leave it until the end of the surgery 2 Notify the circulator when they are not busy 3 Immediately pick it up and dispose of it in a sharps container CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers 4 Cover it with a sterile drape - Correct Answer ✅Immediately pick it up and dispose of it in a sharps container Impedance is: 1 Opposition to direct current flow 2 Voltage times current 3 Opposition to alternating current flow 4 Not an important issue with regard to electrodes - Correct Answer ✅Opposition to alternating current flow What is a benefit to using epidural electrodes? 1 They are highly sensitive 2 They can be placed by the technician 3 They are placed in the sterile field 4 They are more sensitive to anesthetic changes - Correct Answer ✅They are highly sensitive CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers The left to right pre-auricular points are measured at 30cm. The C3 electrode is located: 1 9 cm medial to the left pre-auricular point 2 6 cm medial to the left pre-auricular point 3 18 cm medial to the right pre-auricular point 4 9 cm medial to the right pre-auricular point - Correct Answer ✅9 cm medial to the left pre-auricular point You want to have matching impedances so that: 1 Vertical resolution will be optimized 2 Horizontal resolution will be optimized 3 You can maximize your common mode rejection 4 You can minimize your common mode rejection - Correct Answer ✅You can maximize your common mode rejection When doing a C5 decompression involving the axillary nerve, which muscle should you record form? 1 Trapezius CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers 4 Active input - Correct Answer ✅Non-inverting input If you get artifact in your subcortical channel, you: 1 Ask anesthesia to inc gases 2 Ask the surgeon to move retractors 3 Disable the subcortical channel 4 Use a spare CS5 electrode - Correct Answer ✅Use a spare CS5 electrode The minimum required CMRR of a differential amplifier is: 1 10,000:1 2 1,000:1 3 80:1 4 10:1 - Correct Answer ✅10,000:1 The input impedance of a differential amplifier should be: 1 At least 80 decibels 2 Less than 5000 Ohms CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers 3 At least 100 Mega ohms 4 At least 10,000 ohms - Correct Answer ✅At least 100 Mega ohms A differential amp with a gain of 1,000,000 has a 0.2 uV signal at its positive input and a 0.8 uV signal at its negative input. The output will be: 1 An upward peak of 0.6V 2 A downward peak of 0.6V 3 An upward peak of 1V 4 A downward peak of 1V - Correct Answer ✅A downward peak of 0.6 V Common Mode Rejection: 1 Is the rejection of sweeps that contain noise outside a specified amplitude 2 Is the cancellation of signals that are common to both inputs of the amplifier 3 Is the elimination of signals outside a band of frequencies 4 Is the rejection of aliased signals caused by insufficient resolution - Correct Answer ✅Is the cancellation of signals that are common to both inputs of the amplifier CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers A 10 Hz signal passing through a 10 Hz lowcut filter will be: 1 Reduced in frequency to approximately 7 Hz 2 Affected in no way 3 Reduced in amplitude by approximately 30% 4 Eliminated - Correct Answer ✅Reduced in amp by approximately 30% A major advantage of digital filters over analog filters is: 1 They reduce or eliminate freq above or below a given cutoff 2 They require digitization of the analog signal 3 They operate faster than analog filters 4 They impose no phase effects on the recorded signal - Correct Answer ✅They impose no phase effects on the recorded signal Why is platinum used in epidural electrodes? 1 Other metals become toxic when they contact the spinal cord. 2 Platinum is cost effective CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers 3 1024 4 2048 - Correct Answer ✅1024 What is the minimum required vertical resolution of an EP system? 1 8 bits 2 16 bits 3 80 bits 4 256 bits - Correct Answer ✅8 bits A match must be made between the size of the recorded signal and the range of the A/D converter to: 1 Prevent aliasing of the signal 2 Accurately represent the amplitude of the signal 3 Prevent unnecessary artifact rejection 4 Accurately measure the latency of a peak - Correct Answer ✅Accurately represent the amplitude of the signal Nyquist Frequency: CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers 1 One half the sampling rate of the EP system 2 One half the frequency of the recorded signal 3 Twice the frequency of the recorded signal 4 Sampling rate above which causes aliasing - Correct Answer ✅Twice the frequency of the recorded signal If the inter-stimulus interval (ISI) of your system is 20 uS, then the highest frequency signal that can be resolved is: 1 50 KHz 2 25 KHz 3 20 KHz 4 100 KHz - Correct Answer ✅25 KHz Why do we use electrodes with the same metals? 1 To ensure high impedance 2 To ensure low impedance 3 To prevent electrode polarization CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers 4 To get electrode polarization - Correct Answer ✅To prevent electrode polarization Your initial signal amplitude is 0.5 uV inside a background noise of 2 uV, what will the signal to noise ratio be after 400 averages? 1 0.25 2 1 3 5 4 100 - Correct Answer ✅5 The stimulation rate is determined by the: 1 Analysis time 2 Number of stimulations 3 Stimulus intensity 4 Nerve conduction velocity - Correct Answer ✅Analysis time A 60 Hz notch filter should not be used for EP recording bc of: 1 The ringing artifact that comes from distortion of the stimulus artifact CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers 3 Fubar syndrome 4 Gullaime-Barre syndrome - Correct Answer ✅L'hermittes sign Brown-Sequard syndrome: 1 Degeneration of cortical neurons 2 Myopathy 3 Vascular disease 4 Hemi-spinal cord lesion - Correct Answer ✅Hemi-spinal cord lesion Which of the following is most likely assoc. with abnormal tibial nerve SSEPs? 1 Romberg sign 2 Anterior cord syndrome 3 Meniere's disease 4 Homonymous hemianopsia - Correct Answer ✅Romberg sign Tinel's sign: CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers 1 Cortex 2 Peripheral nerve 3 Spinal cord 4 Muscle - Correct Answer ✅Peripheral nerve Ankylosis: 1 Nerve root compression 2 Swollen ankle 3 Fused Joint 4 Mild scoliosis - Correct Answer ✅Fused Joint A positive Babinski reflex could indicate: 1 Severe spinal cord trauma 2 A fractured rib 3 Regeneration of damaged nerve fibers 4 A normal finding in an adult - Correct Answer ✅Severe spinal cord trauma CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers Kyphosis: 1 Side to side curvature of the spine 2 Convex curvature of the spine 3 Concave curvature of the spine 4 Fractured spine - Correct Answer ✅Convex curvature of the spine Which of the following will result in significantly elevated SSEPs latencies? 1 Positive patellar reflex 2 Brown-Sequard syndrome 3 Charcot-Marie Tooth Disease 4 Carotid Stenosis - Correct Answer ✅Charcot-Marie Tooth Disease Dyskinesia: 1 Abnormal movement 2 Abnormal sensation 3 Ringing in ears 4 Seizures - Correct Answer ✅Abnormal movement CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers If you are doing a C6 decompression, which should you monitor? 1 Ulnar nerve and median nerve 2 Tibial nerve and peroneal nerve 3 Sural and radial 4 Ulnar and tibial nerve only - Correct Answer ✅Ulnar and tibial nerve only If you cannot evaluate motor twitch, you: 1 Inc intensity until the peripheral response no longer increases 2 Inc pulse duration 3 Leave intensity at 20 mA 4 Inc intensity until any discernible response is present - Correct Answer ✅Inc intensity until the peripheral response no longer increases What are IOM techs NOT to do? 1 Record critical surgical events 2 Tell surgeon of changes CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers 3 Check electrode impedances 4 Interpret the changes - Correct Answer ✅Interpret the changes When securing tibial nerve stimulators, you want to make sure: 1 The tape and hands are wrapped around the whole ankle 2 The electrodes are both by the lateral malleolus 3 The electrodes are kept 1 mm apart 4 The anode is distal to the cathode - Correct Answer ✅The anode is distal to the cathode When you stimulate the tibial nerve, where do you want to record your TOF? 1 Gastrocnemius 2 Abductor Hallucis Brevis 3 Extensor Hallucis Brevis 4 Tibialis Anterior - Correct Answer ✅Abductor Hallucis Brevis Which of the following have the greatest effect on the latency of SSEPs? CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers 1 Anesthesia level 2 Neuromuscular block 3 Patient gender 4 Limb length - Correct Answer ✅Limb length During a scoliosis Sx, you recognize a gradual latency increase of 3.5 msec in the tibial nerve cortical response. The subcortical response appears to be shifted out almost as much. All response amplitudes are unchanged. What is the appropriate action to take? 1 Ignore the change, it means nothing. 2 Inform the surgeon immediately that changes consistent with spinal cord injury may have occurred. 3 Check the latencies of the post fossa and median nerve responses to see if they are also shifted, indicating a possible temp effect. Verify this by checking the patient's body temp. 4 Ask the anesthetist to reduce the gases. You are seeing changes consistent with increased depth of anesthesia. - Correct Answer ✅Check the latencies of the post fossa and median nerve responses to see if they are also shifted, CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers For peroneal nerve stim, the ground should be placed: 1 Foot 2 Calf 3 Ankle 4 Thigh - Correct Answer ✅Thigh When testing SSEPs from the upper extremity, an electrode placed at Erb's point will record activity generated from: 1 Brachial plexus 2 Lumbar plexus 3 Cauda Equina 4 Thalamocortical radiations - Correct Answer ✅Brachial plexus SSEPs recordings are thought to be generated by which of the following sensory tracts? 1 Corticospinal tract 2 Lateral spinothalamic tract CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers 3 Posterior columns and medial lemniscus 4 Lateral geniculate - Correct Answer ✅Posterior columns and medial lemniscus Which montage would you use to confirm a change in the Cz'-Fz cortical response to tibial nerve stimulation? 1 Cpc-Cpi 2 Popliteal fossa 3 Erb's point 4 CS5-Fz - Correct Answer ✅Cpc-Cpi In order to reduce stimulus artifact, the ground electrode should be placed: 1 On the scalp 2 On the limb between the stimulating and recording electrodes 3 On the contralateral limb 4 On the foot - Correct Answer ✅On the limb between the stimulating and recording electrodes CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers SSEPs/TCeMEPs monitoring during scoliosis Sx may replace the need for the: 1 O'Hara clonus test 2 Stagnara wake-up test 3 Ruben hematocrit test 4 Removal of hardware - Correct Answer ✅Stagnera wake-up test SSEPs are less reliable in patients with: 1 Severe scoliosis 2 History of nicotine abuse 3 A tethered spinal cord 4 Neuromuscular disease - Correct Answer ✅Neuromuscular disease Monitoring somatosensory function may fail to recognize change in: 1 Anterior spinal cord function 2 Dorsal column function 3 Peripheral nerve function CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers A loss of SSEPs responses would most likely occur ______ to the surgical site. 1 Rostral 2 Caudal 3 Anterior 4 Posterior - Correct Answer ✅Rostral Why are SSEPs and TCeMEPs used simultaneously? 1 Spinal cord damage can occur in only one tract causing loss of MEP but not SSEP. 2 Because MEPs indicate spinothalamic tract function 3 Because SSEPs monitoring alone is not very sensitive to changes in spinal cord function 4 All of the above - Correct Answer ✅Spinal cord damage can occur in only one tract causing loss of MEP but not SSEP When placing the tibial nerve stimulator, you should not: 1 Use paste and conducting gel CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers 2 Secure the tape and bands around the whole ankle 3 Place the electrodes an inch apart 4 Place the cathode behind the medial malleolus - Correct Answer ✅Secure the tape and bands around the whole ankle Which procedure would require intraoperative spinal cord monitoring? 1 Cerebellar mass 2 Kyphoscoliosis 3 Abdominal hernia 4 Fractured tibia - Correct Answer ✅Kyphoscoliosis When placing popliteal fossa (PF), you want the active electrode: 1 Above the PF crease 2 Below the PF crease 3 Lateral to the PF 4 Medial to the PF - Correct Answer ✅Above the PF crease CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers Stimulating the tibial nerve contracts: 1 Toe flexors 2 Toe extensors 3 Gastrocnemius 4 Tibialis anterior - Correct Answer ✅Toe flexors Dec in cortical tibial nerve responses with preservation of subcortical responses is most often caused by: 1 Blood loss 2 Anesthesia 3 Spinal cord lesioning 4 Hypothermia - Correct Answer ✅Anesthesia Stimulating the median nerve at the wrist yields an Erb's point response at 10 mS and a NCV of 60 m/s. What is the distance between the cathode and the Erb's point recording electrode? 1 50 cm 2 60 cm CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers 4 Median nerve cortical - Correct Answer ✅Popliteal Fossa The central conduction time for median nerve SSEPs is: 1 N9-N20 2 P14-P23 3 P14-N20 4 N13-N18 - Correct Answer ✅P14-N20 A patient with a body temp of 30 degrees C will have: 1 Inc latencies 2 Inc latencies, dec amps 3 Dec latencies 4 Dec latencies, dec amps - Correct Answer ✅Increased latencies What is the preferred alternate when the tibial nerve is unavailable? 1 Peroneal 2 Sciatic CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers 3 Femoral 4 Ulnar - Correct Answer ✅Peroneal In an epidural response, what is the advantage of the bipolar response? 1 Presence of myogenic activity 2 Improved in-phase cancellation of noise components 3 Needles are far apart 4 Large cardiac artifact - Correct Answer ✅Improved in-phase cancellation of noise components There were epidural recordings to tibial nerve stimulation from T5 and from C7. The T5 had a stable response throughout the tumor surgery, while the C7 had no response and then a great one after the tumor removal. Where was the tumor? 1 Caudal to T4 and Rostral to C7 2 Rostral to T6 and Caudal to C7 3 Caudal to T5 4 Rostral to C7 - Correct Answer ✅Rostral to T6 and caudal to C7 CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers Which component would be most affected by a tumor by the intersection of the spinal cord and medulla? 1 N13 2 P31 3 EP 4 N20 - Correct Answer ✅N13 What is an appropriate filter for a short latency SSEPs cortical response? 1 1-100 Hz 2 10-3000 Hz 3 100-1000 Hz 4 0.1-250 Hz - Correct Answer ✅10-3000 Hz The lumbar potential is generated from: 1 Pre-synaptic responses 2 Post-synaptic responses CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers 4 Negate the effects of neuromuscular blockade - Correct Answer ✅Overcome anesthetic suppression of synaptic transmission in the motor pathway The D-wave is recorded from the: 1 Peripheral nerve 2 Peripheral limb muscle 3 Spinal cord 4 Cerebral cortex - Correct Answer ✅Spinal Cord Which of the following is NOT a safety concern regarding the use of TCeMEPs? 1 Patient's history of seizure disorder 2 Patient has a pacemaker 3 Patient history of cerebral palsy 4 Activation of biting muscles during stim - Correct Answer ✅Patient history of cerebral palsy CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers Which of the following is true of transcranial magnetic stim? 1 Stim is painful 2 The technique is invasive 3 The myogenic response is resistant to anesthetic effects 4 Responses are sensitive to positioning of the magnetic coils - Correct Answer ✅Responses are sensitive to positioning of the magnetic coils One of the risks of a wake up test is: 1 Dec blood pressure 2 Accidental extubation 3 Cardiac problems 4 Muscle fatigue - Correct Answer ✅Accidental extubation What is the period of a 200Hz signal? 1 200 mS 2 50 mS 3 5 mS CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers 4 2 mS - Correct Answer ✅5 mS How many waves of a 60 Hz signal should you see in a 250 mS sweep? 1 4 2 12 3 15 4 20 - Correct Answer ✅15 A 60 Hz artifact would most likely be caused by: 1 Pneumatic drill 2 Blanket warmer 3 Infusion pump 4 Ultrasonic aspirator - Correct Answer ✅Infusion pump What will be the frequency of a signal, if in a 30 mS sweep the interval between each cycle of the signal is 0.04 mS? 1 2.5 KHz CNIM PRACTICE EXAM 1 Questions and Answers (239 Questions) Verified Answers