200+ Free CRNA (NCE) Practice Questions

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Question 1

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Which of the following factors is the primary determinant of cardiac output?

Heart rate

Stroke volume

Systemic vascular resistance

Venous return

to track

2026 Statistics

Key Facts: CRNA (NCE) Exam

89%

First-Time Pass Rate

NBCRNA 2024

100-170

Questions (CAT)

Variable length

450

Passing Score

Scaled 200-600

$203,090

Median CRNA Salary

BLS 2024

35%

General Principles

Largest domain

3 years

Program Duration

DNP/MSN programs

The NCE has an 89% first-time pass rate for graduates of accredited nurse anesthesia programs (NBCRNA 2024). The exam uses computerized adaptive testing (CAT) with 100-170 questions over 3 hours. The largest domain is General Principles of Anesthesia at 35%. CRNAs earn a median salary of $203,090/year (BLS 2024) with strong job growth.

Sample CRNA (NCE) Practice Questions

Try these sample questions to test your CRNA (NCE) exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 200+ question experience with AI tutoring.

1Which of the following factors is the primary determinant of cardiac output?

A.Heart rate

B.Stroke volume

C.Systemic vascular resistance

D.Venous return

Explanation: Stroke volume is the primary determinant of cardiac output. While heart rate contributes, stroke volume has the greatest influence on overall cardiac output. The normal stroke volume is approximately 60-80 mL per beat in adults. Cardiac output is calculated as stroke volume multiplied by heart rate. Systemic vascular resistance affects afterload, which influences stroke volume, but is not the primary determinant of cardiac output itself.

2During general anesthesia, a leftward shift of the oxyhemoglobin dissociation curve would be caused by which condition?

A.Hyperthermia

B.Hypocarbia

C.Increased 2,3-DPG

D.Metabolic acidosis

Explanation: Hypocarbia (low PaCO2) causes a leftward shift of the oxyhemoglobin dissociation curve, increasing hemoglobin's affinity for oxygen and impairing oxygen release to tissues. This is one of the factors remembered by the mnemonic "CADET face right" for rightward shifts (CO2, Acid, 2,3-DPG, Exercise, Temperature). A leftward shift decreases oxygen availability to tissues and is also caused by hypothermia, alkalosis, and decreased 2,3-DPG.

3The pulmonary artery wedge pressure (PAWP) most closely reflects pressure in which cardiac chamber?

A.Right atrium

B.Right ventricle

C.Left atrium

D.Left ventricle during systole

Explanation: The pulmonary artery wedge pressure (PAWP), also called pulmonary capillary wedge pressure, most closely reflects left atrial pressure. When the pulmonary artery catheter balloon is inflated, it creates a continuous column of blood from the catheter tip through the pulmonary capillaries to the left atrium. This measurement provides an indirect assessment of left ventricular end-diastolic pressure (preload) when the mitral valve is normal.

4Which physiological change occurs in the elderly patient that most significantly impacts anesthetic management?

A.Increased total body water

B.Decreased sensitivity to sedatives

C.Reduced functional residual capacity

D.Increased cardiac compliance

Explanation: Aging causes a progressive reduction in functional residual capacity (FRC) due to decreased chest wall compliance, loss of elastic recoil, and alterations in chest wall geometry. This leads to faster desaturation during apnea and increased risk of airway closure. Elderly patients also have decreased total body water, increased sensitivity to sedatives and anesthetics (requiring lower doses), and decreased cardiac compliance due to ventricular stiffening.

5Coronary blood flow is primarily determined by which factor?

A.Heart rate

B.Aortic diastolic pressure minus left ventricular end-diastolic pressure

C.Systemic vascular resistance

D.Pulmonary artery pressure

Explanation: Coronary blood flow occurs primarily during diastole and is determined by the pressure gradient between the aortic root (coronary perfusion pressure) and the pressure within the cardiac chambers. For the left ventricle, this is approximated by aortic diastolic pressure minus left ventricular end-diastolic pressure. Tachycardia reduces coronary perfusion time, while increases in LVEDP (as in heart failure) reduce the perfusion gradient.

6The most important factor regulating cerebral blood flow is:

A.Arterial oxygen content

B.Cerebral perfusion pressure

C.Partial pressure of arterial carbon dioxide (PaCO2)

D.Blood viscosity

Explanation: PaCO2 is the most important physiologic regulator of cerebral blood flow. For each 1 mmHg change in PaCO2 between 20-80 mmHg, cerebral blood flow changes by approximately 1-2 mL/100g/min. Hypercapnia causes cerebral vasodilation and increased CBF, while hypocapnia causes vasoconstriction and decreased CBF. Cerebral autoregulation maintains constant flow across a range of mean arterial pressures (typically 50-150 mmHg in normotensive adults).

7Which neuromuscular blocking agent has the highest vagolytic (atropine-like) effect?

A.Rocuronium

B.Vecuronium

C.Pancuronium

D.Cisatracurium

Explanation: Pancuronium has the most significant vagolytic effects among neuromuscular blocking agents, frequently causing tachycardia and occasionally hypertension. This is due to its structural similarity to atropine (both are quaternary ammonium compounds). Rocuronium has minimal cardiovascular effects. Vecuronium and cisatracurium are essentially devoid of cardiovascular effects at clinical doses.

8The glomerular filtration rate (GFR) is most accurately estimated by which measurement?

A.Serum creatinine level

B.Blood urea nitrogen (BUN)

C.Creatinine clearance

D.Urine specific gravity

Explanation: Creatinine clearance is the most accurate clinical estimate of GFR because creatinine is freely filtered at the glomerulus and not reabsorbed. While serum creatinine reflects renal function, it is influenced by muscle mass, age, sex, and diet. The Cockcroft-Gault equation and MDRD formula estimate creatinine clearance or GFR from serum creatinine. BUN is affected by protein intake, hydration status, and catabolism, making it less specific.

9The primary site of erythropoietin production in adults is:

A.Spleen

B.Liver

C.Kidney

D.Bone marrow

Explanation: The kidney is the primary site of erythropoietin (EPO) production in adults, specifically from peritubular interstitial fibroblasts in the renal cortex. EPO stimulates erythropoiesis in the bone marrow. In chronic kidney disease, decreased EPO production contributes to anemia. The liver produces approximately 10-15% of circulating EPO in adults but is the primary source in fetuses.

10Which of the following best describes the Frank-Starling mechanism?

A.Increased heart rate increases contractility

B.Increased preload increases stroke volume

C.Increased afterload decreases heart rate

D.Increased contractility decreases oxygen demand

Explanation: The Frank-Starling mechanism states that the force of cardiac contraction is proportional to the initial length of the cardiac muscle fiber (preload). As venous return increases, ventricular filling increases, stretching the myocardial fibers and resulting in a more forceful contraction and increased stroke volume. This intrinsic property allows the heart to adjust output to match venous return without neural or hormonal input.

About the CRNA (NCE) Exam

The National Certification Examination (NCE) is required for CRNA certification. The computer-adaptive test covers 4 domains: Basic Sciences (20%), Equipment/Instrumentation/Technology (20%), General Principles of Anesthesia (35%), and Anesthesia for Special Populations (25%).

Questions

100 scored questions

Time Limit

3 hours maximum (variable length CAT)

Passing Score

450 (scaled score)

Exam Fee

$725 (NBCRNA)

CRNA (NCE) Exam Content Outline

20%

Basic Sciences

Anatomy, physiology, pathophysiology, pharmacology, physics, and chemistry applied to anesthesia

20%

Equipment, Instrumentation & Technology

Anesthesia delivery systems, airway equipment, monitoring devices, and patient warming equipment

35%

General Principles of Anesthesia

Preoperative assessment, fluid management, airway management, regional anesthesia, sedation, pain management, and professional issues

25%

Anesthesia for Special Populations

Pediatric, obstetric, geriatric, cardiac, neurosurgical, and trauma/emergency anesthesia

How to Pass the CRNA (NCE) Exam

What You Need to Know

Passing score: 450 (scaled score)
Exam length: 100 questions
Time limit: 3 hours maximum (variable length CAT)
Exam fee: $725

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

CRNA (NCE) Study Tips from Top Performers

1Master the General Principles domain (35%) - this is the largest section and includes airway management, regional anesthesia, and pharmacology

2Practice anesthesia calculations: drug dosing, MAC values, fluid requirements, and hemodynamic calculations

3Understand equipment: know the anesthesia machine, vaporizers, monitors, and safety systems inside and out

4Focus on special populations: pediatric and obstetric anesthesia are heavily tested and differ significantly from adult practice

5Study pharmacology thoroughly: know MAC values, onset/duration, metabolism, drug interactions, and reversal agents

Frequently Asked Questions

What is the NCE pass rate?

The NCE first-time pass rate is approximately 89% for graduates of accredited nurse anesthesia programs (NBCRNA 2024). The exam uses computerized adaptive testing (CAT), adjusting difficulty based on your performance.

How many questions are on the NCE?

The NCE is a variable-length computerized adaptive test with 100-170 questions. Most candidates receive between 100-150 questions. The exam ends when the computer determines with 95% confidence whether you passed or failed, or when time expires.

How long should I study for the NCE?

Most SRNAs (Student Registered Nurse Anesthetists) study for 2-4 months before the NCE, completing 1,000-2,000 practice questions. Focus on understanding the 'why' behind anesthesia concepts, not just memorization. The General Principles domain (35%) deserves special attention.

What is the NCE passing score?

The NCE uses a scaled scoring system with a passing score of 450. Scores range from 200-600. The actual number of questions answered correctly is not reported - only pass/fail status and scaled score if you pass.

How much do CRNAs earn?

According to BLS 2024 data, CRNAs earn a median salary of $203,090/year, with top earners exceeding $280,000. CRNAs are among the highest-paid advanced practice nurses. Job outlook is strong with growth in outpatient surgery centers and rural healthcare.

What are the NCE content domains?

The NCE covers 4 domains: Basic Sciences (20%): anatomy, physiology, pathophysiology, pharmacology, physics; Equipment/Instrumentation/Technology (20%): anesthesia machines, airway equipment, monitors; General Principles (35%): preop assessment, airway management, regional anesthesia, fluid management; Special Populations (25%): pediatrics, OB, geriatrics, cardiac, neuro, trauma.