/reference/nbcrna
NBCRNA NCE blueprint
The 4-domain breakdown for the National Certification Exam. Use this to map your study — every Q-bank item is tagged to one of these subdomains. Weights are approximate; consult the official NBCRNA handbook for exact percentages and exam length (180 questions current).
Basic Sciences
25% (≈45 questions)
Anatomy, Physiology, Pathophysiology
- Pulmonary anatomy + physiology
- Cardiovascular anatomy + physiology
- Renal physiology + AKI
- Hepatic function + drug metabolism
- CNS anatomy + autoregulation
- Endocrine system
- Hematology + coagulation
- Immune system
Pharmacology
- Pharmacokinetics + pharmacodynamics
- Induction agents
- Volatile agents + MAC
- Opioids
- Neuromuscular blockers + reversal
- Local anesthetics + LAST
- Vasoactives
- Antiemetics + adjuncts
- Antimicrobials
Chemistry, Biochem, Physics
- Acid-base chemistry
- Gas laws + vaporization
- Electromagnetism + monitor physics
- Drug receptor pharmacology
Equipment, Instrumentation, Technology
15% (≈25 questions)
Anesthesia delivery system
- Machine pre-use checkout (FDA 1993)
- Vaporizer principles
- Breathing circuits
- CO₂ absorbents
- Scavenging
- Ventilator modes
Monitors
- Standard ASA monitors
- Capnography
- Pulse oximetry
- BIS / processed EEG
- TEE / TTE
- Neuromonitoring (SSEP, MEP)
Airway equipment
- Laryngoscope blades
- Video laryngoscopy
- Supraglottic airways
- Endotracheal tubes (DLT, microlaryngoscopy)
- Bougie + tube exchanger
- Cricothyrotomy kit
General Principles of Anesthesia
30% (≈55 questions)
Preanesthesia Evaluation
- ASA classification
- Airway assessment
- Cardiac risk stratification (RCRI)
- Pulmonary risk
- Anticoagulation management (ASRA)
- ASA NPO + GLP-1 guidance
Induction → Maintenance → Emergence
- RSI vs standard induction
- Difficult airway algorithm
- Maintenance — TIVA vs volatile
- Fluid management + GDFT
- Hemodynamic management
- Emergence + extubation criteria
PACU + Postop
- Aldrete score
- PONV management
- Pain control + multimodal
- Postop respiratory failure
Regional Anesthesia
- Spinal anesthesia
- Epidural anesthesia
- Brachial plexus blocks
- LE blocks (femoral, sciatic, popliteal)
- Truncal blocks (TAP, ESP, paravertebral)
- LAST
Pain Management
- Acute postop pain
- Chronic pain syndromes
- Opioid-sparing strategies
- Multimodal analgesia
Anesthesia for Surgical Procedures + Special Populations
30% (≈55 questions)
By specialty
- General surgery
- Cardiac
- Thoracic + OLV
- Neurosurgery
- Orthopedic + tourniquet
- Trauma
- Transplant
- ENT + airway-shared
- Ophthalmology
Special populations
- Pediatric anesthesia
- Obstetric anesthesia
- Geriatric anesthesia
- Bariatric / obese patient
- Patient with cardiac disease for non-cardiac surgery
Off-site / non-OR
- MRI + scanner safety
- Endoscopy + ERCP
- Cath lab + EP
- Radiology procedures
- ECT