The month of October is interview season! Today, Jenny Finnell provides you with CRNA school interview questions to help you practice and prepare to ace your CRNA school interview! While it is true that different schools may have different questions and not all schools will include clinical-style interview questions, Jenny strongly advises against overlooking knowledge-based questions. Right before the end of the topic, she covers some common personal questions and how you can answer those, too. Remember, DON’T FREAK OUT, because getting an interview means you are qualified for acceptance and that the school sees potential in you! So tune in to this episode and dive right into the possible interview questions that you might get asked. At the bottom of this page you’ll find a list of the questions and answers shared in this episode!
Get access to planning tools, mock interviews, valuable CRNA Faculty guidance, and mapped-out courses that have been proven to accelerate your CRNA success! Become a member of CRNA School Prep Academy: https://www.crnaschoolprepacademy.com/join
Book a mock interview, personal statement critique, resume review and more at https://www.TeachRN.com
Join the CSPA email list: https://www.cspaedu.com/podcast-email
Send Jenny an email or make a podcast request!
Hello@CRNASchoolPrepAcademy.com
—
Watch the episode here
Listen to the podcast here
CRNA Interview Practice Questions
Hello, future CRNA. We are in the midst of interview season, so I’m here with some CRNA school interview questions to help you prepare. In this episode, we are going to reveal some clinical-style questions with answers, and some common questions that you may get asked in your interview. That is what this episode’s going to be all about. Grab a pen and paper and let’s get into the show. These questions are all from the CRNA interview clinical question and answer study guide that we have made, which has over 88 clinical CRNA interview questions with answers. You can purchase the full guide. I can’t go over the whole 88 questions on this episode. It’d probably be about five hours long if we did that. I am going to try to hit some heavy hitters on here for you and cover a nice wide variety.
This is going to be an episode that you want to re-read when you have a piece of paper and pen handy. It’s going to be a great episode for you to read, nonetheless. If you’re able to take notes, you’re going to be a little more well-served long-term from this episode. If you are interested at the end of this episode to purchase the whole guide to prepare you for your upcoming interview, you can do so.
I want to wish you the best of luck on your upcoming interview. I know you’re probably like, “Jenny, I’m freaking out.” I totally get it. Congratulations, because the fact that you got an interview means that you’re qualified for acceptance. They saw potential in you. You have to believe in your own potential. Try to get the mindset right and look at it as this is an opportunity to learn and grow and see what this is like. All CRNA schools are a little different as far as the style of the interview. Not all schools will even ask you clinical-style interview questions. If that is you, while I still think this episode’s going to be incredibly valuable, especially long-term, as you start your CRNA journey, know that not all schools are going to ask you pathophysiology pharmacology questions.
While you should not neglect that knowledge base because there’s always potential, you should understand the style you’re getting ready to go into. If they’re going to ask you more personal questions, at the end, I cover some common personal questions and different tidbits on how to answer those. I’ll wing it because I don’t have that in the study guide. I don’t want to leave you out if you’re getting ready to experience a very heavy personal interview. At the end of the episode, I’ll cover some common personal questions that you may get asked, and some of the different variations and personal questions that I have heard throughout the years of mentoring students.
O2 Versus PaO2
Without further ado, let’s go ahead and get into it. First, we are going to cover the question. Please explain the difference between SaO2 and PaO2. SaO2 is the percentage of hemoglobin binding sites that are occupied with O2 oxygen. PaO2 is the pressure exerted by the oxygen, O2, on the arterial wall. Your PaO2 or your pressure is measured in millimeters of mercury. The normal adult is within a range of 82 to 100. The normal PaO2 in an adult is 80 to 100 millimeters of mercury. I want to emphasize the unit of measurement, millimeters of mercury. If they ask you some clinical question and you rattle out a number, they may come back and say, “In what unit of measurement?”
If you haven’t quite paid attention to that, you could be like, “I knew the number, but I didn’t remember the unit of measurement.” To have a fully correct answer, you need to remember the unit of measurement. The PaO2 is measured as millimeters of mercury. Normal is 80 to 100 millimeters of mercury. The SaO2 is measured as a percentage. The normal adult percentage is right around 90% to 100% SaO2.
The PaO2 requires an arterial blood sample, while a SaO2 can be acquired by placing a non-invasive sensor on the skin also known as the pulse oximeter. Note here, that oxygen saturation, the SaO2, does not differentiate between oxygen or carbon monoxide as they both bind to hemoglobin. You can have carbon monoxide poisoning, and on your pulse oximeter, you could be registering a 100% O2, and you’re like, “I don’t know why you look so blue, sir.”
Hypoxia Versus Hypoxemia
Know that, unfortunately, the pulse oximeter doesn’t differentiate between the two. That could be a little curve ball they throw you potentially. Let’s move on to the next question. What is the difference between hypoxia and hypoxemia? The definition of hypoxia is low levels of oxygen in body tissues.. Hypoxemia, the emia, means blood. Hypoxemia means low levels of oxygen in the blood.
Hypoxia is low levels of oxygen in the body. Hypoxemia means low levels of oxygen in the blood. Click To TweetPathophysiology Of ARDS
Relatively basic, but the emia is the differentiating factor that can trigger your brain to differentiate the two. We’re moving on. Go ahead and tell me about the pathophysiology of ARDS, which is Adult Respiratory Distress Syndrome. ARDS is very complicated, and there’s probably more to it here, but I explain it in three stages to make it easier.
Keep in mind that if they ask you about ARDS, this could lead to then explain sepsis. They go hand in hand, but ARDS is a special type of sepsis. Make sure you’re differentiating between the two and not blending them together. If they have you explain the difference, be able to do so. Let’s go into the three stages of ARDS, which is exudative, which is damage to the alveolar epithelium and the vascular endothelium, which causes it to produce leakage of water. Your lungs can then fill with that leakage. It also leaks protein and different inflammatory mediators, red blood cells into the interstitium and the alveolar lumen. It is filling your alveolar sacs with fluid and different types of inflammatory mediators, red blood cells, protein, etc.
Type 1 alveolar cells are irreversibly damaged. That space is replaced by the deposition of the proteins, fibrin, and cellular debris producing membranes while injury to the surfactant-producing Type 2 cells contributes to alveolar collapse. There are two different types of damage going on. There are damaging Type 1 alveolar cells, which are irreversibly damaged. That space is then replaced by proteins, fibrin, and cellular debris.
There’s also injury to the surfactant-producing Type 2 cells, which then causes the alveolar to collapse. You may know surfactant in infants. That’s why preemie babies get steroids to try to start producing that surfactant because, otherwise, their lungs very easily collapse. They get severe atelectasis, pneumonia, hypoxia, and things of that nature that can happen from atelectasis. ARDS is a situation where that is occurring. Not only are you filling up the alveolar with the fluid, and different types of inflammatory mediators, but you’re also damaging the Type 2 surfactant-producing cells, which then unfortunately allows the alveolar to collapse and not remain open easily.
In patients who have ARDS, you’ll see them on very high levels of PEEP to try to combat the lack of surfactant and the collapse of the alveolar cells. You then have the exudative phase then you have the proliferative phase, which is where the Type 2 cells proliferate with some epithelial cell regeneration, which can cause a fibroblastic reaction and remodeling. You then have the very last, the third stage, which is fibrotic, which involves collagen deposition in the alveolar vascular and interstitial beds with the development of micro cysts.
Painting a grim picture here, but it self-festers into being a damaging process to your lungs, where very little healthy lung is left, if any. It’s incredibly hard to get a patient to recover from this because it creates this vicious cycle that severely damages the cells to the point where they’re of no return. Those are the three stages of ARDS. In ARDS, the sooner you intervene and correct the underlying cause, the better the outcome will be. If you get to the second and third phases, the outcomes are probably going to be relatively poor. What are some optimal vent settings then for ARDS? They may ask. Those are low tidal volumes, between 4 to 6 millimeters per kilo to prevent volume trauma.
The alveoli are sensitive because they’re already maxed with pus and fluid. Their surfactants are damaged. They don’t have much elasticity anymore. If you’re blowing large tidal volumes in there, you’re going to further damage the cells. They typically do low volume and keep their airway pressures low because they’re going to be unnaturally high because of having the lack of surfactant and being full of fluid and things of that nature.
You want to watch your plateau pressures. You always want to try to aim to keep that below 30 centimeters of water. You want low tidal volumes, probably higher respiratory rates. You want to watch your airway pressure to keep your plateau pressure under 30 centimeters of water. That is ARDS. Keep in mind that they could lead to sepsis from there. The pathophysiology of sepsis is pretty complicated. I do go into that in some of the next questions. That is in this guide.
Calculating Normal Values
I’m going to jump ahead a little bit. Let’s go into cardiac numbers, and that’s always a good one. What are the normal values and how to calculate the following? They could give you one of these. They could give you several of these. You may have a written test that has this on it. It could vary in the format. They could ask you these types of questions. These are all good formulas to put in that memory bank of yours. First would be the Coronary Perfusion Pressure, the CPP.
Coronary perfusion pressure is your diastolic blood pressure minus the wedge pressure. Understanding the normal wedge pressure is key too, to knowing where you’re going to fall in this range for coronary perfusion pressure. However, normal coronary perfusion pressure will fall between 4 to 12 millimeters of mercury. The millimeters of mercury is important to the unit of measurement. To get a wedge pressure, you need a swan for that.
If you have the PA catheter, and maybe you’re not wedging it to get that number, you can always look at the diastolic of your PA pressure, and it will be relatively in line with what your wedge pressure will be. That was a little bit of a hack or a trick that we would use and when I did open heart, if I didn’t want to wedge it or see if that was good.
It was pretty relatively in line with what your wedge pressure would be. A little hack there, nothing that would be important for this, but I figured I’d share it since it’s on my mind. Let’s go into normal cardiac output. What’s the normal cardiac output? It is 4 to 8 liters per minute. Knowing liters per minute is key. If you said 4 to 8, they may be like, “4 to 8 what?” Knowing that it’s liters per minute is the big takeaway here.
Another one that would be good to know would be the normal cardiac index. Your cardiac index is your cardiac output divided by your body surface area. They may then go into what’s the body surface area formula or cardiac output formula. Make sure that when they’re asking you these types of questions, they can dig into it more. You have to go deep with how many formulas you know and break them down. If they ask you what the cardiac index is, what normal cardiac index would be, say if you were a nurse who had experience with swans and things of that nature, you probably would know. If maybe you’re a neuro nurse and maybe they want to throw you a curve ball and they ask you this too. I’ve heard of that type of situation occurring.
The normal cardiac index is 2.5 to 4 liters a minute per meter squared. Keep in mind it’s liters per minute per meter squared. The extra unit of measurement there at the end would be very important for you to mention to get a fully correct answer. One that is common is the map. How do you calculate map? Calculating map is your diastolic pressure. What you do is you take your systolic pressure minus your diastolic pressure, you take 1/3 and you divide it by that. It is your diastolic blood pressure plus your systolic blood pressure minus your diastolic pressure divided by three. The normal map is usually greater than 65. They could give you, “Your patient’s systolic is 150. Your diastolic is 95. Tell me what their map is.”
They could have you calculate it out in your head. Keep in mind that it could be fair game. I would practice this. I wouldn’t just memorize these formulas. I would practice calculating maps and different formulas. That way, if they give you some numbers, you can go ahead and do that. They may give you a piece of paper and a pen and at least let you write it out. Some of them may want you to try to do it in your head. It’s important to not only know these formulas but actually practice doing the formulas. It will help you memorize the formulas, too, honestly. It’s a good practice either way. Let’s do your cerebral perfusion pressure. That could be confusing because of coronary perfusion pressure. They’re both CPP.
If they say, “Tell me what CPP is,” which I doubt they will, you’d have to say, “Are you talking about Coronary Perfusion Pressure or Cerebral Perfusion Pressure?” Cerebral perfusion pressure is your map. The formula is you went over your arterial pressure minus your ICP. They could potentially give you an ICP and say, “Go ahead and calculate the cerebral perfusion pressure.” First, you’d have to calculate the map, then you’d have to minus it from your ICP and then tell them if that’s a normal range or not. Normal cerebral perfusion pressure is between 60 and 80 millimeters of mercury. These are examples of different situations you could find yourself in if they have you calculating different types of formulas like this. Be ready and prepared to work them out for different situations.
We’re going to jump ahead again. What EKG lead is used to monitor for arrhythmias? Usually, Lead II is the one that is the most common on the EKG to monitor arrhythmias. If you look at your EKG next time you’re at work, see what EKGs you’re automatically populated on your monitor. You’ll usually always see one of the leads. It’s the best one to pick up for arrhythmias. EKG lead is used to monitor for ischemia in the left ventricle. It is very specific. If you have all the EKG leads and the replacements memorized, you probably pretty quickly know that it’s V5, but maybe you don’t know. This might be a key area for you to brush up on. To monitor for ischemia in the left ventricle, you’re looking at V5 as the EKG lead that you want to be looking at.
Inferior Wall In The Heart
We’re going to jump ahead again. What does inferior mean when talking inferior wall in the heart? It is the inferior myocardial tissue and is supplied by the right coronary artery. The RCA supplies the inferior myocardial tissue. The inferior wall refers to the underside of the left ventricle. Where are the carotid arteries? They could give you a picture of the heart and have you label it. That is another good thing that you should be practicing.
You can do that. I have an unlabeled picture of a heart that you can practice, but if they ask you, “Where are the carotid arteries?” they’re located on both sides of the neck that supply blood to the brain, face, and neck. You need to learn the branches of the aorta, which is the brachiocephalic trunk and subclavian arteries. If you look at the aorta in the different branches, I encourage you to review that. If they have you identify, whether that be a fill-in, you can accurately identify those branches.
Increased ICP And Anemia
Let’s go into what are some things that could increase ICP. Those are tumor, subarachnoid hemorrhage, intervascular hemorrhage, subdural hematoma, stroke, aneurysm, hypertension, infection, meningitis, or encephalitis. Increased cerebral spinal fluid, head trauma resulting in bleeding and swelling of the brain, hydrocephalus, Valsalva maneuvers, which is interesting, coughing, suctioning, noxious stimuli, seizure activity and lowering the head of the bed, gravity, increasing blood pressure, they could ask you.
If you don’t name all those, I won’t beat yourself up if you got asked that type of question, but knowing a good chunk of those would be good to know. This has been asked more than once at a particular school. I don’t know if a lot of schools ask this question, but it comes up at least at some CRNA school interviews. I’m going to go ahead and mention it here. Why does renal failure cause anemia?
If you weren’t a MICU nurse, renal failure causes all kinds of like chain effects, but you’ll always see anemic renal failure patients. There’s a reason for it because erythropoietin or EPO is produced in the kidneys and it’s the hormone responsible for signaling bone marrow to produce red blood cells. I was asked in my interview where red blood cells were produced. I said liver. That was wrong. It was bone marrow. I questioned it. It’s so funny, but it was a rapid-fire type of question.
Blood Components
They didn’t ask me about erythropoietin, but they did ask me where red blood cells were made in the body. That is the bone marrow. Anyways, chronic kidney disease results in decreased production of erythropoietin, causing anemia. Which blood component is more likely to cause infection and why? When you’re giving blood, what blood component is more likely to cause infection and why? The answer would be platelets. It’s because they have a high leukocyte content within the platelets. They result in the highest rates of transmitted infection.
Chronic kidney disease results in decreased production of erythropoietin, causing anemia. Click To TweetWhere are platelets made? Bone marrow. We’re going to jump ahead. We’re going to wrap this up here. Knowing the normal range for ABG, I would think it would be a relatively standard thing that you should be knowing going into your interview. I also think you should be studying ABGs in general and being able to identify what type of ABG they are, whether they’re metabolic, respiratory, whether they’re compensated uncompensated, that type of thing. Make sure you’re practicing your ABGs. There is an entire ABG lecture inside CRNA School Prep Academy. For those of you who are in the guarantee program, we had a very special guest lecturer, Nicole Kupchik, come and give you guys a great presentation on CO2 as well.
I know it’s random. We’re talking about ABGs, but she’s so good at explaining capnography. It’s a great piece of information for you to gather. I would encourage you to re-watch that lecture. Also don’t forget to review the ABG lecture that CRNA School Prep Academy provides you as well. You would have access to the ABG lecture regardless of being a guaranteed student or not. It’s in the critical care learning library. I wanted to point out to the guarantee students who are reading that you also have access to that special capnography lecture that is also would be good to listen to before your interviews. Let’s cover what the oxyhemoglobin curve is and how this affects the O2 affinity to hemoglobin.
Shift to the right versus a shift to the left of the oxyhemoglobin curve. When the curve shifts to the left, when hemoglobin hangs onto or holds onto O2, an alkalosis occurs with low PCO2 because PCO2 itself is an acid. With low PCO2 or hyperventilation, you’re going to have low PCO2 and alkalosis. You’re going to have a left shift, which is where your hemoglobin’s going to hang onto that O2. It can also be caused by hypothermia, low 2,3-DPG. Remember that one. That’s found in your blood. These conditions result in higher SaO2, but the tissues do not get adequate O2 readily. Remember how there’s a difference between hypoxia and hypoxemia? Even though your SaO2 will read high, your tissues have hypoxemia.
Your hemoglobin’s holding onto that O2. It’s not dispersing it to the tissues. Equally, a left shift is pretty bad. You’re hypoxemic. Your tissues are lacking adequate oxygenation. The opposite occurs in a right shift. When you shift to the right on the oxyhemoglobin curve, your hemoglobin releases O2 to the tissues very readily. It doesn’t hold onto it. This occurs in acidosis, with hypoventilation, fever high 2,3-DPG. These conditions result in somewhat lower SaO2, but tissues get O2 readily, less O2 for transport to all the tissues. Let’s go of it so quickly that the hemoglobin then is void of oxygen.
Certain parts of your body don’t get oxygen because it’s already been let go of. Think of it as oxygen travels through your body and gets pumped out of your heart. If you have a shift to the right, your hemoglobin is readily releasing that oxygen right away. By the time it makes it to some of your other organs like kidneys for example, when you’re in a septic type state, not only do you get vasoconstriction, but your blood, by the time it gets there, is very void of oxygen thing. In certain conditions, acidosis can lead to peripheral ischemia, where you don’t deliver oxygen because you have a limited carrying capacity of oxygen through your body. They’re both complex, but try to get your brain straight around them if they ask about it because it can get confusing. That’s a great thing to study.
Autonomic Nervous System
Let’s go into one of the last questions here. See if I can find a good one for the last question. I like this one. People often ask questions about the autonomic nervous system or find it challenging. It is challenging to learn about the autonomic nervous system. What is the autonomic nervous system? Sympathetic versus parasympathetic. Sympathetic, think of things like fight or flight. You dilate your pupils. You inhibit the saliva. You don’t want to eat. If you’re going to fight a bear, you want to run, increase your heartbeat, you relax your airways so you can breathe and run. You inhibit GI activity. Your gut motility slows down. Think of trauma patients who come in. They always say they’re full stomachs because their GI activity shuts down because their body goes in the sympathetic surge.
It inhibits your gallbladder. You’re not going to be digesting anything because you don’t care. You want to survive. You secrete epinephrine and norepinephrine and you relax your bladder. Those are things that happen during the sympathetic surge. The relaxing bladder sounds weird, but when you urinate, you contract your bladder. Relaxing your bladder doesn’t mean you pee yourself. Maybe you pee yourself initially when you see the grizzly bear and then you stop. Relaxing has the opposite effect where you don’t have the urge to pee. We look at parasympathetic, where you get constricted pupils. Think of being sleepy and tired. You don’t care what you have to look at.
You want to close your eyes. It stimulates saliva because you’re hungry. You want to eat like that comfort food. You have a low heartbeat. You have constricted airways because you’re only yawning at this point. You’re not trying to breathe fast. You’re stimulating your GI activity to digest that food, rest, and digest. You’re stimulating your gallbladder for the same reason to produce the insulin or start stimulating your pancreas to produce insulin and all those good things, then you can track your bladder. You go to sleep at night. You have to pee a million times if you’re like me. That gives you a brief overview.
This next one is pretty cool. You are a pilot operating the autonomic nervous system. What drugs would you give to activate the sympathetic nervous system and the parasympathetic nervous system? What drugs would you give to antagonize both systems? Let’s start here. The sympathetic nervous system, as an agonist, you’re looking at things that are stimulating the sympathetic nervous system now, such as epinephrine, norepinephrine, and dopamine. The sympathetic nervous system is antagonists, the ones that are blocking the sympathetic outflow.
You’re looking at things like beta-blockers and alpha-blockers. You then have your parasympathetic nervous system agonist, which is what’s stimulating your parasympathetic. You have your muscarinic agonist such as pilocarpine, methyl chlorine, and things that you like typically probably wouldn’t give. Anyway, they’re muscarinic agonists. You then have the acetylcholinesterase inhibitors.
That also works to agonize the parasympathetic nervous system. They cause stimulation. For parasympathetic nervous system antagonist, ones that block the parasympathetic nervous system, you have things like atropine. What does atropine do? Atropine doesn’t cause bradycardia. Atropine causes tachycardia. It’s stopping the parasympathetic and allowing your heart rate to go high. That was pretty cool. What are some of the receptors associated with the sympathetic system? You’re looking at alpha, beta, and dopa, and that sums it up. I hope you guys enjoyed this episode. I’m wishing you the best in your upcoming CRNA interview. If you want access to the whole 88 clinical questions, you can go ahead and purchase that.
Emotional Intelligence Questions
I promised some EI questions at the end too to mix it up a little bit. I almost forgot. Let’s quickly cover some emotional intelligence-type questions. Some of the most common questions that you’re going to get as far as personality questions go could be things like dealing with conflict. What do you see that is potentially a negative? What’s a weakness? They may not ask it that way. Instead of saying, “Tell me about a weakness of yours,” they may say, “What would your coworker say about you that they don’t like about you?” This puts it in a different, uglier frame, which sometimes can trip people up a little bit because they’re like, “I know what I’d say about myself, but I have no idea what my coworker would say.”
It can throw you off a little bit. Be prepared for that. Similarly, they can ask you about a time you had a conflict with a coworker or maybe had a challenging situation with a patient and family member and how you handled that. This is why it’s good to be documenting these experiences. Not violating HIPAA of any kind, but when you have a challenging day or a challenging case, document it, and write it down. You’d be surprised at how muddy the waters get the longer time goes and trying to remember the nitty-gritty details. If you have these experiences in the ICU leading up to your interview, make sure you’re documenting them. Make sure you’re giving them an ending. There is something called the STAR method, which stands for Situation, Task, Action, and Result.
If you focus on using the STAR method while you’re telling a story or about a clinical scenario, it allows you to give a very concrete to-the-point example that makes sure you have a conclusion and your result. A lot of times, people get so wrapped up in the details. They either lose them by the time they get to the result or they leave a cliffhanger because they got so drawn out on all the details. Give a real specific situation, task, action, and the result that you got from it. If you stick with that type of method, telling stories will be a much easier task.
That’s common for them to ask you a situational type of question, something that you dealt with, asking you for perspective on what others think about you, what your negatives would be, and what your positives would be. They could also throw you a complete curve ball. I’ve had some students report questions such as, “How many golf balls would fit on a school bus?” those random questions. “If you could be any kitchen appliance, what would you be? If you could be any animal, what would you be?” It seems random, but the importance of these questions is to see if you can think on your toes when you get a random question like that and to give them not only an example but a reason why.
“Why would you be that animal? Why would you be that kitchen appliance?” Those ones are rarer. They do still occur. I’ve heard some questions like, “What would you do if you flunked out of CRNA school?” I’ve had students tell me they’ve been asked just to throw you a curve ball to see like, “I’m going to put you on the hot seat and under pressure and with a very uncomfortable question for you to answer.” Equally, in my own interview, I was told, “What if I tell you that we’ve already made a decision and we’re not going to select you? How would you handle that?”
That was a question I had to answer in my own interview. Very commonly, programs will say, “Unfortunately, we’re not able to select you. You’re not going to be able to go forward, but what would you plan to do over this next year if you weren’t selected?” or something like that, or the fact that you weren’t selected. You have to give them the rationale like what you would do. It’s a downer. They want to see like, “Are they going to get upset? Are you going to get defensive?” Make sure you’re keeping jokes to a minimum if you’re a funny person. Cool. I’m envious. I wish I had some funny bone in me, but I’m a person who doesn’t understand jokes, so I usually laugh awkwardly because I don’t understand the punchline.
I wish I were also equally amusing sometimes. Be careful. Make sure things are appropriate. Read the room. If the tone of the room is very serious, then I’d probably stay serious versus trying to crack some jokes. I had a girlfriend of mine, that’s how she handles stress is she cracks jokes and she giggles a lot. I love her to death, by the way. She’s a CRNA now. That being said, under pressure, she is always making light of something or giggling and joking. They took that the wrong way. Several of her interviews, she did have to interview several times before she got into CRNA school.
That’s not a big deal, but try to check it and keep it in line for your actual interview and be aware of these little nuances. I’ve done interviews with students who get nervous. They click their pen and they don’t even know they’re doing it. It’s so distracting for the person asking you questions. If I was nervous, I would not want to do this. I would feel super awkward if I was nervous to sit like this where I’m slouched back on my chair with my arm around the edge of the chair like I’m chilling. Don’t do that.
Keep your hands crossed on the table, hips square in front of you, and shoulders back. It will give you the most professional look versus being hunched over or anything other than that. They’re assessing body language too. These emotional intelligence style interviews, they’re typically also heavily looking at body language. They all do that, but they’re assessing for things like that that you may not even be aware of. As far as actual other questions go, a lot of times, I’ve heard students or programs tell me that they do a great job when they’re interviewing. We get to the very end of the interview and we say, “Do you have any questions for us?” They say, “No, I don’t have any questions.”
They like to see students who have put some thought into some unique questions. It shows that they’ve done a little more thorough research, diving, and digging essentially to want to know more. That can be hard because sometimes these schools give you this pre-interview, open house experience where they answer all the common questions and you might be like, “That was like everything I thought of.” Sometimes your questions have to be a little bit more unique to be able to combat that. You don’t want to ask a question that they covered in the previous open house that you went through prior to your interview or something openly discussed on their website because that could paint a picture that you’re not paying attention to. You do have to be thoughtful when you think of questions to ask them.
I’ve had programs tell me similar things when they get to the very end of the interview and they say things like, “Between you and one other student, why should we pick you?” They have nothing to say. They don’t have any reason. I get that it is an awkward position to be put in, but to have nothing to say, it’s like you’re throwing yourself right off the bus. Why would they pick you? You should have a reason why you would thrive in their program and what makes you special and unique. Don’t be afraid to embellish. Don’t be afraid to brag. They are saying brag about you. “I’m asking you to brag about you. Why would we want you?” Have something thoughtful to say.
You have to be thoughtful when you think of questions to ask them.They like to see students who have put some thought into some unique questions. Click To TweetThat’s common. “Why this program?” That’s another one that’s often asked too. Have a reason. Maybe the cohorts are small. Maybe the faculty have been recognized for something important to you. Maybe they provide independent CRNA practice for your clinical rotations or have something more robust. It’s okay if it’s location and money, but don’t let that be your only why you picked the program. Have it be something a little bit more meaningful to the actual faculty to help you put a little more thought into it other than cost and location.
The other difficult question is they like to ask clinical style questions as far as, “Tell me about a time you had a difficult clinical situation. How did you handle it? Tell me about a time that you had a big failure in your life. What do you see as a failure?” Some people are like, “I don’t think I’ve had any failures.” The reality is you probably have something that felt hard for you at some point. Even if you get to the point where you’re like, “I don’t have anything, Jenny. I have no idea,” ask around. Ask one of your closest friends. Ask your mother, your sister, and your brother, “Is there a time that I got emotionally upset over something? It is because I can’t think of anything that I felt like I’ve failed at. Do you have the insight on me that you think that you would see that I felt that way?”
Sometimes you block out stressful things. Sometimes you move on from them where you’re like, “I didn’t even think about that, but you’re right. I guess that was a big deal to me at the time. It isn’t anymore, but I completely block that out.” Getting insight from friends and family can be an easy way to bring that to light. Have a thoughtful answer for that, what you did about it, what you’ve done about it, and what you’re still doing about it.
Another thing that is important, too, is this: If you have something on your transcripts or resume, maybe you’re not current in ICU, something like that, that they think is a big deal or you’re in the wrong unit, you’re not in a preferred unit, or you’re in the ER for example, they may ask you harshly like, “Why did you choose not to get true ICU experience and go to the ER instead? Why are you not current in ICU?” I had someone tell me during their interview that they were doing great for the whole interview. They got this one question where they said, “Tell me why we should pick you when you’re the only applicant we’re interviewing who’s not current in the ICU.”
That would be hard to answer. Think that through. If that’s you, if you’re not current in the ICU, why? What would you say if they confronted that? Especially if they left it open-ended, “Are there any other questions or anything else you would like to share?” Maybe if they ask you what weaknesses of yours or times you failed, that’s a good time to bring up something that may not be seen in the ideal light on the faculty side of things. It’s time for you to clear the air. It’s the fact that your academic performance at one point in your life was not the best.
This is what you’ve done to overcome it. You saw it as a failure back then, but now it’s become a strength because you’ve built a lot of resilience and discipline to make things right and to go the extra mile stretching your ability to learn and grow and not seeing it as a failure, but as something that was something obstacle you had to overcome and you have. It might be a time to clear the air. It could be a good time. You don’t always get the opportunity to do this.
They’re going to make assumptions. Humans do. That’s what humans do. It’s almost better to address the elephant in the room versus ignoring it. That way, you can make sure you’re both on the same page. I hope that the last end of the episode helped give you some ideas on some personal type questions they could ask. All schools are a little different. Some do a blend of clinical with some personal. Some do mostly personal while others mostly do clinical. I would say the majority of schools seem to be trending a lot toward emotional intelligence-style tests.
I know a lot of schools will even have you take an emotional style test before you even come in for the interview and they have your scores so they can evaluate your scores. It wouldn’t hurt. There’s a quiz that I always recommend. It’s an insightful personality quiz called 16Personalities. It’s free. That’s why I recommend it a lot. It gives you some insight into your character and what makes you work. It’s very accurate as long as you don’t select neutral. If you select neutral, it has nothing to go by. Stick to one side or the other when you’re answering the questions. It will help give you more accurate results. That’s 16Personalities.
It’s a great free resource for you to help and get more insight into who you are as a person to allow you to hopefully come into your interview well-prepared and well-thought for some of these personal questions. You all take care and best of luck. Keep me posted. I love celebrating with you. Whatever happens, happens. I know you’re probably worried beyond belief, but this is not the end. This is only the beginning. Keep your chin up and keep going. Plenty of us have had no’s before we got a yes, including myself. It will be okay.
I almost forgot to share something important with you. If you have not already, you can have access to mock interviews with SRNAs of various different programs through TeachRN (formerly called Nurses Teach Nurses). If you go to www.TeachRN.com, you can book a mock interview through that website. There is a lot to pick from. You can choose testimonials or previous students who had mock interviews. It is a great resource for you. Getting a mock interview by a student who has been through a CRNA interview process is an incredibly great way to practice for your interview. I hope you take us up on that resource. Thank you for reading. We will see you next episode.
Important Links
Get access to planning tools, mock interviews, valuable CRNA Faculty guidance, and mapped-out courses that have been proven to accelerate your CRNA success! Become a member of CRNA School Prep Academy: https://www.crnaschoolprepacademy.com/join
Book a mock interview, personal statement critique, resume review and more at https://www.TeachRN.com
Join the CSPA email list: https://www.cspaedu.com/podcast-email
Send Jenny an email or make a podcast request!
Hello@CRNASchoolPrepAcademy.com
Questions And Answers From This Episode:
Please explain the difference between SA02 and PA02?
SaO2 is the percentage of hemoglobin binding sites that are occupied with O2. PaO2 is the pressure exerted by O2 on the arterial wall.
PAO2 is measured as mmHg (adult normal = 80 – 100 mmHg) and SaO2 is measured as a percentage (adult normal = 90 -100%). PaO2 requires an arterial blood sample while SaO2 can be acquired by placing a noninvasive sensor on the skin.
Note: Oxygen saturation (SaO2) does not differentiate between oxygen (O2) or carbon monoxide (CO) as both bind to hemoglobin
What is the difference between hypoxia and hypoxemia
Hypoxia – low levels of oxygen in body tissues
Hypoxemia – low levels of oxygen in the blood
Tell me the pathophysiology of ARDS
3 stages:
Exudative – damage to the alveolar epithelium and vascular endothelium produces leakage of water, protein, and inflammatory and red blood cells into the interstitium and alveolar lumen. Type I alveolar cells are irreversibly damaged and the denuded space is replaced by the deposition of proteins, fibrin, and cellular debris, producing hyaline membranes, while injury to the surfactant-producing type II cells contributes to alveolar collapse
Proliferative – type II cells proliferate with some epithelial cell regeneration, fibroblastic reaction, and remodeling
Fibrotic – involving collagen deposition in alveolar, vascular, and interstitial beds with the development of microcysts
ARDS optimal vent settings?
Low tidal volume 4-6 ml/kg to prevent volutrauma
Low airway pressures – plateau pressure <30 cmH2O
What are the normal values of & how to calculate:
Coronary Perfusion Pressure = DBP (diastolic BP) – PCWP (normal = 4-12 mmHg)
MAP = DP + 1/3(SP-DP) (normal MAP: >65)
CPP = MAP – ICP (normal CPP: 60-80 mmHg)
What EKG lead is used to monitor arrhythmias?
Lead II
What does inferior mean when we are talking inferior wall?
Inferior myocardial tissue is supplied by the RCA (right coronary artery); the inferior wall refers to the underside of the left ventricle
Where are the carotid arteries?
Located on both sides of the neck that supply blood to the brain, face, and neck
Learn the branches off the aorta: brachiocephalic trunk, subclavian arteries.
What increases ICP?
Tumor, subarachnoid or intraventricular hemorrhage, subdural hematoma, stroke, aneurysm, hypertension, infection such as meningitis or encephalitis
Increased cerebrospinal fluid (CSF)
Head trauma resulting in bleeding and swelling in the brain Hydrocephalus Valsalva maneuvers, coughing, suctioning, noxious stimuli, seizure activity, lowering the head of the bed
Why does renal failure cause anemia?
Erythropoietin (EPO) is produced in the kidneys and is the hormone responsible for signaling bone marrow to produce red blood cells. CKD results in decreased production of EPO.
Which blood component is more likely to cause infection and why?
Platelets, high leukocyte content
Platelets result in the highest rates of transfusion-transmitted infection
Where are platelets made?
Bone marrow
What is the oxyhemoglobin curve (shift to the right vs. shift to the left) and how does this affect the O2 affinity to hemoglobin?
Curve shifts LEFT when Hb holds onto O2
Alkalosis
Low PaCO2
Hypothermia
Low 2,3-DPG
These conditions result in higher SaO2, but tissues do not get adequate O2 readily
Curve shifts RIGHT when Hb releases O2 to tissues
Acidosis
High PaCO2
Fever
High 2,3-DPG
These conditions result in somewhat lower SaO2, but tissues get O2 readily
What is the autonomic nervous system: sympathetic vs. parasympathetic?
Sympathetic: dilate pupils, inhibit saliva, increase heartbeat, relax airways, inhibit GI activity, inhibit gallbladder, secrete epi and norepi, relax bladder
Parasympathetic: constrict pupils, stimulate saliva, low heartbeat, constrict airways, stimulate GI activity, stimulate the gallbladder, contract bladder
You are a pilot operating the Autonomic nervous system, what drugs would you give to activate the SNS and PNS? And what drugs would you give to antagonize both systems?
SNS agonists: epinephrine, norepinephrine, dopamine
SNS antagonists: beta-blockers, alpha-blockers
PNS agonists: muscarinic agonists (bethanechol, cevimeline, pilocarpine, methacholine) and acetylcholinesterase inhibitors (rivastigmine, donepezil, galantamine)
PNS antagonists: atropine
What are the receptors associated with sympathetic?
Alpha, beta, dopa
