CRNA Interview Clinical and Pharmacology Questions
Clinical and pharmacology questions CRNA panels ask ICU nurses, from program topic lists and FDA labels: pressors, sedation, paralytics, ABGs, drip math.
CRNA Interview Clinical and Pharmacology Questions
The clinical part of a CRNA interview tests your ICU, not anesthesia. The programs that publish their topics list ventilator management, ABGs, vasoactive pharmacology, lab values and hemodynamics (Otterbein), drug therapies, receptor sites and invasive monitoring (Emory), and chemistry, physiology, pharmacology and dosing calculations (Keiser).
The pages that rank for this search are forum threads, flashcard sets and paid study guides, and none we read cites a drug label or a program's topic list. Our view: skip the anesthesia textbooks and learn every drip and device on your own unit down to the mechanism. Otterbein's own clinical guide says its reading list focuses "on pharmacology and physiology and not anesthesia techniques." The behavioral half of the interview is on the sibling page, CRNA school interview questions and answers.
Every program page and FDA label quoted below was checked on November 7, 2026. Drug mechanisms are quoted from the label posted on DailyMed, not from a prep company.
What programs say the clinical portion covers
| Program | Published topics |
|---|---|
| Otterbein–OhioHealth FAQ | "Clinical knowledge includes (but is not limited to) ventilator management, ABGs, vasoactive pharmacology, lab values, hemodynamics, cardiac, respiratory and neurophysiology." |
| Otterbein clinical preparation guide (2022 in file name, still linked) | Physiology, homeostasis, physics, mathematics, differential diagnosis, the autonomic nervous system, respiratory and cardiac physiology; also "Lab values/interventions to correct abnormal values", "Shock states", "EKG interpretation and interventions", "Electrolytes" |
| Emory prep guide | "Commonalities and differences between the various vasoactive medications including the pharmacological actions and the specific receptor sites affected"; "Invasive technologies, their correct usage and normal values, when appropriate" |
| Keiser | "chemistry, anatomy, physiology, pharmacology, dosing calculations, or other critical care competencies" |
| Rutgers | "a short assessment tool and knowledge evaluations during the interview process" |
| UAMS | Written "responses to specific questions during their on-campus interview session" |
Otterbein's second guide, for non-clinical attributes, repeats the clinical list. Under "Pharmacology" it sets the scope in one line: "The MOA/Dosing/Indications/etc. for all ICU drugs". All ICU drugs, not anesthesia drugs.
Keiser makes a related point for admitted students. Its answer to "What should I study or review before classes start?" includes: "We advise not to pre-emptively study anesthesia concepts on your own to avoid misconceptions." That line is about the months before the program starts, not the interview. It points the same way.
The answer structure: mechanism, bedside picture, action
Answer every clinical question in three steps:
- Mechanism. Name the receptor or process, in the label's words if you can.
- Bedside picture. What you would see on the monitor and at the bedside.
- Action. What you would do within your role and your unit's protocol, and who you would call.
Our view: the step you skip is the one the follow-up will test.
Constructed example: the norepinephrine question
Constructed example, written by us, not a real applicant statement. The question (constructed): "Your septic patient is on a high dose of norepinephrine and the MAP is 58. What's going on, and what do you do?"
Norepinephrine is mainly an alpha agonist, so it raises pressure by vasoconstriction, with some beta effect on the heart. If the MAP is still low at a high dose, I'd first make sure the drug is getting in: the line, the pump, the bag. Then I'd look at what the vasoconstriction is costing: the extremities, urine output, the lactate trend. I'd watch the heart rate too, because the label describes reflex vagal slowing as resistance rises. Then I'd call the provider with the trend and the dose, and ask whether a second agent or more fluid is the plan. I wouldn't keep titrating up past our protocol's ceiling on my own.
That answer is 111 words. The mechanism comes from the norepinephrine label: "Norepinephrine is a peripheral vasoconstrictor (alpha-adrenergic action) and an inotropic stimulator of the heart and dilator of coronary arteries (beta-adrenergic action)." The heart-rate line comes from the same label: "The elevation in resistance and pressure result in reflex vagal activity, which slows the heart rate and increases stroke volume." The answer leaves the choice of second agent to the provider, which is where it belongs for an ICU nurse.
Vasopressors and inotropes: a receptor table
Emory asks you to know the "commonalities and differences" between vasoactive drugs and "the specific receptor sites affected". This table quotes each FDA label's mechanism section. The follow-up column is our constructed set of questions to prepare.
| Drug (label) | Mechanism, quoted from the label | Follow-up to prepare (constructed) |
|---|---|---|
| Norepinephrine | "a peripheral vasoconstrictor (alpha-adrenergic action) and an inotropic stimulator of the heart" | Why might the heart rate fall as the pressure rises? |
| Epinephrine | "acts on both alpha (α)- and beta (β)-adrenergic receptors" | How does it differ from norepinephrine at the bedside? |
| Phenylephrine | "an α-1 adrenergic receptor agonist" | What happens to cardiac output when you raise SVR alone? |
| Vasopressin | "causes vasoconstriction by binding to V1 receptors on vascular smooth muscle"; "stimulates antidiuresis via stimulation of V2 receptors" | Which receptor does it act on, and how is that different from the catecholamines? |
| Dopamine | "activating dopamine D1 and D2 receptors, beta 1 receptors and alpha 1 receptors"; effects "are dependent on dopamine dose" | What changes as you turn it up? |
| Dobutamine | "a direct-acting inotropic agent whose primary activity results from stimulation of the β-receptors of the heart" | What would you watch in the pressure when you start it? |
| Milrinone | "a positive inotrope and vasodilator"; "a selective inhibitor of peak III cAMP phosphodiesterase isozyme in cardiac and vascular muscle" | The label calls its mode of action different from the catecholamines'. How? |
Otterbein's guide gives the relationship behind several of these follow-ups: "Flow and resistance or cardiac output and SVR are inversely related." If you can explain each drug's effect on SVR and on contractility, you can work the follow-ups out from first principles.
Sedation, paralytics and reversal
These are drugs an ICU nurse may hang or see given at the bedside. Prepare to say how you used each one and what you watched for.
| Drug (label) | Mechanism or key warning, quoted from the label | Follow-up to prepare (constructed) |
|---|---|---|
| Propofol | "positive modulation of the inhibitory function of the neurotransmitter GABA through the ligand-gated GABA A receptors" | Why is your propofol patient hypotensive? |
| Dexmedetomidine | "a relatively selective centrally acting alpha 2 -adrenergic agonist with sedative properties" | Why does the heart rate fall? |
| Ketamine | "a non-selective, non-competitive antagonist of the N-methyl-D-aspartate (NMDA) receptor" | When would you choose it over propofol? |
| Succinylcholine | "a depolarizing neuromuscular blocker"; boxed warning on "HYPERKALEMIC RHABDOMYOLYSIS IN PEDIATRIC PATIENTS" | When would it be dangerous? |
| Rocuronium | "It acts by competing for cholinergic receptors at the motor end-plate." | How is this block different from succinylcholine's? |
| Sugammadex | "forms a complex with the neuromuscular blocking agents rocuronium and vecuronium" | Which blockers does it reverse, and which does it not? |
| Dantrolene | "dissociates the excitation-contraction coupling, probably by interfering with the release of Ca ++ from the sarcoplasmic reticulum" | What is it for, and what triggers that? |
The labels answer two follow-ups worth preparing. On propofol in the ICU, the label says rate changes should be "made slowly (>5 min) in order to minimize hypotension". On dexmedetomidine, it lists "hypotension, bradycardia, and dry mouth" as the most common adverse reactions in adults. For "when would succinylcholine be dangerous", the contraindications section lists "Skeletal muscle myopathies", "After the acute phase of injury following major burns, multiple trauma, extensive denervation of skeletal muscle, or upper motor neuron injury" and "Known or suspected genetic susceptibility to malignant hyperthermia". A strong answer names one of those and the ICU patient you have cared for who fits it.
ABGs, ventilators and lab values
Otterbein's clinical guide prints the ABG questions it wants you to be able to answer, organized by the four parts of the gas, with the note "for the questions below, we will focus on acidosis":
pH - What does pH measure? What are the two main sources of excess hydrogen ions? What are the negative impacts of too many or too little concentration of hydrogen ions? What are the three main buffers (one is not truly a buffer but more of a distractor) of hydrogen ions?
paCO2 - What is the cause of excess CO2 in the blood? Is the excess CO2 able to exit the body?
HCO3 - What is the purpose of HCO3-? Why is it consumed?
The paO2 questions follow: "What is the disruption point that this measures?" and "What is a measure of tissue hypoxia? How do we correct this level?"
Our recommendation: answer each of those questions out loud, then attach one of your own patients to each part. When the panel hands you a gas, say each value against your lab's reference range, name the primary problem and whether the body is compensating, then say what you would do at the bedside. Say the steps in order, the same order Otterbein's questions follow.
For ventilators, Otterbein's non-clinical guide names the level: "Ventilator modes and interventions", then "i.e. volume control vs. pressure control, PEEP, PS, etc." A constructed prompt to prepare: "Why did you change the vent?" Answer it with a real change you made or watched on your unit: the problem, the setting that changed, and what the next gas showed.
For labs, Emory's guide asks you to know "why they are used, normal ranges, implications for out of range values, the units of measurement, and factors that can alter these values and affect their validity." Use your own hospital's reference ranges. Ranges differ between labs, so give your lab's numbers and say whose they are.
Rhythm strips and scenarios
Otterbein lists "EKG interpretation and interventions" and, under shock states, "Identify the various shock states", "Interventions to correct" and where "disruption of oxygen delivery to the tissues" happens. Emory adds a review habit for codes: "After a code situation review your BLS, ACLS, PALS, etc. What went right? Were there any deviations from the standard algorithms - what was the rationale for deviation and the outcome?"
Our constructed scenario bank, with what a strong ICU answer includes:
| Scenario (constructed) | What the panel is likely to push on | What your answer should contain |
|---|---|---|
| Septic shock on two pressors | Mechanism of each drip; perfusion | The table above, plus the trend you would report |
| Fresh post-op cardiac surgery patient whose pressure is falling | How you tell one cause from another | What you check, in order, and who you call first |
| Ventilated patient whose oxygenation is getting worse | The last vent change and why | One gas, one setting, one decision |
| A new rhythm on the monitor | The rhythm name and the ACLS step | The rhythm, whether the patient is stable, your next action |
The scenarios are built from Otterbein's topic headings. Answer them from patients you have had.
Dosing calculations by hand
Keiser lists "dosing calculations" by name. Otterbein's guide says: "If a computer is completing the calculation for you, you still need to be able to do the calculation on your own." Three constructed practice problems, using concentrations taken from the labels. The arithmetic is ours.
Problem 1 (mcg/min to mL/h). The norepinephrine label dilutes one vial "(4 mg in 4 mL) to 1,000 mL" to make "a 4 mcg per mL dilution". The label's "Typical maintenance intravenous dosage is 2 to 4 mcg per minute." At 3 mcg/min: 3 ÷ 4 = 0.75 mL/min × 60 = 45 mL/h (our arithmetic).
Problem 2 (mcg/kg/min to mL/h). The dobutamine premix label lists "250 mg/250 mL (1 mg/mL)", which is 1,000 mcg/mL. The label says optimal rates are "usually 2 to 20 µg/kg/min". For a 70 kg patient at 5 mcg/kg/min: 5 × 70 = 350 mcg/min × 60 = 21,000 mcg/h ÷ 1,000 = 21 mL/h (our arithmetic).
Problem 3 (working backward). The pump reads 15 mL/h of the 4 mcg/mL norepinephrine dilution. What dose is the patient getting? 15 × 4 = 60 mcg/h ÷ 60 = 1 mcg/min (our arithmetic).
Do these on paper, out loud, and state the units at every step.
How to study in the weeks before
Emory's guide gives the method. Our recommendation: make it a habit on every shift. Ask: "Why is a particular therapy being prescribed (rationale)? What alternative therapies could be proposed? What are the underlying mechanism(s) of action that should be considered? For medication therapies, what side effects should you anticipate and what actions should be taken if these side effects occur?"
A plan built on that habit (our recommendation):
- List every drip, sedative and device used on your unit in the last month.
- For each drug, read the mechanism section of its label on DailyMed and write it in one line.
- Each shift, predict one gas before it comes back, as Otterbein's guide suggests: "Before you draw a blood gas, try to predict what it will be when it comes back."
- Twice a week, have a coworker give you a scenario from the table above and answer it in the three steps.
- Do the three drip problems without a calculator until they take under a minute each.
Emory's guide also says to keep "focusing on both breadth and depths of topics, not focusing solely on your clinical area of practice expertise." If you work in a CVICU, spend one of those weeks on neuro and respiratory patients.
Questions about CRNA clinical interview questions
Do I need to know anesthesia drugs?
Know the ones you give in the ICU (propofol, dexmedetomidine, ketamine, paralytics) as ICU drugs. Otterbein's guide says its reading focuses on "pharmacology and physiology and not anesthesia techniques".
Will they show me an EKG strip?
At programs that list it, expect it. Otterbein lists "EKG interpretation and interventions" among its preparation areas.
Is there a written test?
At some programs. Rutgers describes "knowledge evaluations during the interview process" and UAMS asks for written answers during the on-campus session. Dates and formats by program are in CRNA interview format and timeline by program.
Should I memorize normal values?
Know your own lab's ranges and units. Emory's guide lists "normal ranges" and "the units of measurement" among what to review for each lab value.
What if I don't know the answer?
Say so, then say how you would keep the patient safe while you found out. The sibling page on CRNA interview questions covers how to handle a wrong answer.
Review the writing you send next
The clinical habits above are the same evidence your written answers need: what you assessed, what you decided and why. Get a free Quick Review of your CRNA essay answers: it checks whether each answer fits its question and shows your critical-care preparation through decisions you made, not lists of drips and devices.
More CRNA guides:
- CRNA school interview questions and answers: the behavioral half, with constructed answers.
- CRNA school requirements by program: ICU, CCRN, GRE and essays at 25 programs.
- How to become a CRNA: requirements, timeline and where the essay sits.
The nursing essays hub has the rest of the nursing application guides.
Sources
Retrieved November 7, 2026, except where noted. FDA labels were read on DailyMed (National Library of Medicine).
- Otterbein University–OhioHealth, Nurse Anesthesia BSN to DNP: FAQ list of clinical interview topics.
- Otterbein University–OhioHealth, Applicant Preparation Guide for Clinical Application (2022 in file name): topic areas, ABG questions, SVR line, math and blood-gas habits, reading-list scope.
- Otterbein University–OhioHealth, Applicant Preparation Guide for Non-Clinical Attributes (2022 in file name): ventilator and "all ICU drugs" lines.
- Emory Nell Hodgson Woodruff School of Nursing, Certified Registered Nurse Anesthesia: interview prep guide.
- Keiser University, Doctor of Nurse Anesthesia Practice: competency-based interview; pre-program study advice.
- Rutgers School of Nursing, Nurse Anesthesia Admissions: knowledge evaluations.
- UAMS College of Nursing, Nurse Anesthesia Program Admissions Requirements: written answers on site.
- DailyMed labels (sections 12.1 Mechanism of Action unless noted): norepinephrine (also dilution and maintenance dose), epinephrine, phenylephrine, vasopressin, dopamine, dobutamine in dextrose (also concentration and rates), milrinone, propofol (also 5.8 ICU sedation), dexmedetomidine (also adverse reactions), ketamine, succinylcholine (also boxed warning and contraindications), rocuronium, sugammadex, dantrolene.
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