Exam 1 - Principles of Nurse Anesthesia - History of Anesthesia
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| Who was the first physician to perform a public demonstration of anesthesia? | Horace Wells
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| Why was Horace Wells' public demonstration of anesthesia unsuccessful? | His dose was insufficient
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| What did Horace Wells use to induce anesthesia? | Nitrous oxide
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| Who was credited with the discovery of nitrous oxide? | Horace Wells
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| On what day was ether first used in a public demonstration of surgery? | October 16, 1846
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| Which doctor administered anesthesia in the first public use of anesthetics for surgery? | Dr. William Thomas Green Morton
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| Where was the first successful public demonstration of anesthesia performed? | Massachusetts General Hospital in the Bullfinch Bldg
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| What was the anesthetic used and how was it delivered in the first successful public demonstration of anesthesia? | Ether. Delivered via glass inhaler
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| Who was the first surgeon who operated with Dr. Morton in the first public demonstration of anesthesia? | Dr. John Collins Warren
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| The man who coined the phrase, "Gentlemen, this is no humbug" was _____________. | Dr. John Collins Warren
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| Who is credited as giving the "greatest gift ever made to suffering humanity" and why? | Dr. William T.G. Morton for the discover of anesthesia for surgery
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| Who are the four founding doctors credited with conquering surgical pain? | Drs. Horace Wells, William T.G. Morton, Charles Jackson, Crawford Long
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| Where and when was the first operational use of ether used in Philadelphia? | Jefferson Medical College, December 23, 1846
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| Who was the first Philadelphia physician to operate on a patient with the use of ether? | Dr. Thomas Dent Mutter
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| Who was the first Philadelphia physician to perform an obstetrical delivery with ether? | Dr. John K. Mitchell
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| Who perfected a method of distilling ether by use of steam, making it safer to use for surgery? | Edward Squibb
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| What made Edward Robinson Squibb altruistic in the field of anesthesia? | Did not patent or charge for the apparatus he developed for the purification (distillation) of ether
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| Who took credit for the use of ether in minor surgical operations as early as 1841? | Dr. Crawford W. Long
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| Which physician claimed to have advised Dr. Morton on the use of, and hence the discovery of, ether for anesthesia? | Dr. Charles Jackson
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| Dr. Charles Jackson attempted to take credit for the development of what famous communicate device? | Telegraph
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| Why did some people deem anesthesia to be inappropriate? | It was seen as inappropriate to circumvent God’s law by eliminating pain
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| In what year did obstetrical analgesia gained public acceptance? | 1853
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| Who was the first physician anesthetist? | Dr. John Snow
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| What chemical was given to Queen Victoria during the birth of Prince Leopold in 1853? | Chloroform
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| Who delivered chloroform to Queen Victoria during the birth of Prince Leopold in 1853? | Dr. John Snow
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| Who was the first physician to devote his medical practice to anesthesia? | Dr. John Snow
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| What devices did Dr. John Snow advocate for in anesthesia? | Inhalers
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| When was the first school of nurse anesthesia developed? | 1909
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| Where was the first school of nurse anesthesia founded? | St. Vincent Hospital in Portland, OR
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| What was Oregon’s first “permanent” hospital? | St. Vincent Hospital
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| Which health profession was credited as the first group to provide anesthesia services in the U.S.? | Nurses
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| What was the first clinical nursing specialty? | Nurse anesthesia
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| When was the profession of nurse anesthesia first established? | Mid to late 1800s
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| Why was the profession of nurse anesthesia developed? | It was developed in response to surgeons’ request for a solution to the high morbidity and mortality attributed to anesthesia
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| How did surgeons first view nurses in anesthesia? | Professionals who could give their undivided attention to patients during surgical procedures
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| The earliest records of anesthesia administered by a nurse documented which person? | Sister Mary Bernard
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| Who was Sister Mary Bernard? | Nurse who was first documented as giving anesthetic care
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| Where did Sister Mary Bernard work? | St. Vincent’s Hospital in Erie, PA
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| What year did Sister Mary Bernard assume her duties as a nurse anesthetist? | 1877 in Erie, PA
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| Who established St. Mary’s Hospital? | Sisters of St. Francis
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| Who operated St. Mary’s Hospital and what did this facility ultimately become known as today? | Dr. William Worrell Mayo, Mayo Clinic
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| Who is called the “Mother of Anesthesia”? | Alice Magaw
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| Who coined the phrase “Mother of Anesthesia”? | Dr. William Worrell Mayo
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| What technique was Alice Magaw known for mastering? | Open-drop inhalation technique of anesthesia
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| What chemicals did open drop inhalation for anesthesia utilize? | Ether and chloroform
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| Who is the most famous nurse anesthetist of the 19th century? | Alice Magaw
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| At what hospital did Alice Magaw work? | St. Mary’s Hospital in Rochester, MN
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| Who was the first published nurse anesthetist? | Alice Magaw
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| Who was the undisputed master of the open-drop ether technique? | Alice Magaw
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| Which physician/nurse team was instrumental for showcasing professional excellence in anesthesia and surgery? | Mayo and Magaw
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| What types of physicians were initially responsible for administering anesthesia? | Junior resident physicians or the nearest practicing physician
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| Who was the first nurse credited as a specialist in anesthesia? | Sister Mary Bernard in 1877
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| When did Alice Magaw begin working as a nurse anesthetist at St. Mary’s Hospital in Rochester, MN? | 1893
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| When did Alice Magaw publish her first paper? | 1898 in the St. Paul Medical Journal
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| What institution did Agatha Hodgins establish? | The Lakeside Hospital School of Anesthesia in Cleveland, OH (1915)
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| When was the first mention of nurse anesthesia supervision by MDs? | 1917 after the reopening of the Lakeside Hospital School of Anesthesia which reopened within the Medical Practice Act
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| What was the 1st legal challenge against the use of nurses for anesthesia? | Frank v. South in 1917
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| What did the Kentucky Court of Appeals rule in Frank v. South (1917)? | Margaret Hatfield was not engaged in the practice of medicine when providing anesthesia care for Dr. Louis Frank
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| What did members of the Assoc. of Anesthetists (MD) encourage? | Sending patients only to hospitals where MDs provided anesthesia
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| Who founded the Interstate Assoc. of Anesthetists? | Dr. Francis McMechan
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| Who was the early architect of anti-nurse anesthetist sentiment? | Dr. Francis McMechan
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| What did Dr. Francis McMechan devote himself to? | Organizing the field of physician anesthesia
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| Who founded the National Assoc. of Nurse Anesthetists? | Agatha Hodgins
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| When did Agatha Hodgins found the NANA? | 1931
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| When was the first NANA meeting? | 1933
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| When was the NANA reincorporated to the AANA? | 1939
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| What was the second lawsuit against nurse anesthetist in the administration of anesthesia? | Nelson v. Chalmers (1934)
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| Nelson v. Chalmers is based on what cause? | Dagmar Nelson was practicing medicine as a nurse
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| What was the result of Nelson v. Chalmers? | Dagmar Nelson was legally administering anesthesia in concert with a surgeon. Nelson was not diagnosing or treating as defined in the Medical Practice Act.
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| What did the NANA do following Chalmers v. Nelson? | Filed an amicus curiae brief for the case
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| What decision confirmed the legality of nurse anesthesia in practice with surgeons? | Nelson v. Chalmers
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| Doctors attempted to reclaim and monopolize the remuneration of anesthesia during what period in American History? | Great Depression
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| What is the oldest nursing specialty? | Anesthesia
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| Men were permitted to serve as nurses or anesthetists in what year? | 1947
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| When did the AANA identify male members? | 1957
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| Who was the AANAs first VP? | Hilda Salomon
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| Who was the 3rd President of the AANA? | Hilda Salomon
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| Who was the first President of the Pennsylvania Assoc. of Nurse Anesthetists? | Hilda Salomon
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| What assoc. was Hilda Salomon the founder of? | Delaware Valley Assoc. of Nurse Anesthetists
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| What did Hilda Salomon advocate for? | Inclusion of all nurse anesthetists regardless of color/creed/gender
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| What award recognizes the advancement of educational standards that further the art and science of anesthesiology? | Helen Lamb Outstanding Educator Award
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| Which award is presented for the advancement of nurse anesthesia through legislative, legal and regulatory efforts? | Ira P. Gunn award
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| What are the 7 conditions for reimbursement under the Tax Equity and Fiscal Responsibility Act (1982)? | Pre-anesthesia evaluation, prescribe the anesthesia plan, participate in induction and emergence, monitor at frequent intervals, remain available throughout the procedure, provide post-op care, refrain providing care when engaged in medical direction
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| What does the HCFA stand for? | Health Care Financing Administration
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| What ratio did the HCFA choose as the CRNA:MD ratio? | 4:1
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| Why was the Tax Equity and Fiscal Responsibility Act (TEFRA) of 1982 first developed? | To control fraud and abuse within the payment system for anesthesia services
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| What did TEFRA morph into? | A standard of care
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| What did the Beecher and Todd Report show? (1954) | CRNA mortalities were less than half of those of MDAs
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| There were ________ as many CRNA participants than physicians in the Beecher and Todd report. | Twice
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| The ASA status of patients was ____________ when comparing the safety and efficacy of CRNAs to MDAs. | Similar
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| What was the first outcome study demonstrating the safety and efficacy of CRNAs? | Beecher and Todd (1954)
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| What assoc. was Hilda Salomon the founder of? | Delaware Valley Assoc. of Nurse Anesthetists
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| What did Hilda Salomon advocate for? | Inclusion of all nurse anesthetists regardless of color/creed/gender
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| What award recognizes the advancement of educational standards that further the art and science of anesthesiology? | Helen Lamb Outstanding Educator Award
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| Which award is presented for the advancement of nurse anesthesia through legislative, legal and regulatory efforts? | Ira P. Gunn award
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| What are the 7 conditions for reimbursement under the Tax Equity and Fiscal Responsibility Act (1982)? | Pre-anesthesia evaluation, prescribe the anesthesia plan, participate in induction and emergence, monitor at frequent intervals, remain available throughout the procedure, provide post-op care, refrain providing care when engaged in medical direction
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| What does the HCFA stand for? | Health Care Financing Administration
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| What ratio did the HCFA choose as the CRNA:MD ratio? | 4:1
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| Why was the Tax Equity and Fiscal Responsibility Act (TEFRA) of 1982 first developed? | To control fraud and abuse within the payment system for anesthesia services
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| What did TEFRA morph into? | A standard of care
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| What did the Beecher and Todd Report show? (1954) | CRNA mortalities were less than half of those of MDAs
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| There were ________ as many CRNA participants than physicians in the Beecher and Todd report. | Twice
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| The ASA status of patients was ____________ when comparing the safety and efficacy of CRNAs to MDAs. | Similar
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| What was the first outcome study demonstrating the safety and efficacy of CRNAs? | Beecher and Todd (1954)
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| In what year did schools of anesthesia move from hospitals to universities? | 1998
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| What was the first state to opt out of the federal physician supervision requirement? | Iowa
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| In what year did Iowa opt out of federal physician supervision requirement? | 2001
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| What does CMS stand for? (Hint: Related to healthcare financing) | Centers for Medicare and Medicaid Services
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| What important regulation for CRNAs was presented by CMS? | States could opt out of the Medicare supervision language
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| What conditions need to be met for a state opt out to occur? | Approval by Nursing and Medical Boards along with a state Governor signature
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| How many states have opted out of physician supervision? | 17
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| What are the 17 Opt Out States? | 1) Iowa 2) Nebraska 3) Idaho 4) Minnesota 5) New Hampshire 6) New Mexico 7) Kansas 8) North Dakota 9) Washington 10) Alaska 11) Oregon 12) Montana 13) South Dakota 14) Wisconsin 15) California 16) Colorado 17) Kentucky
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| Which Presidential Administration gave Governors the ability to opt out of physician supervision? | Bush Administration
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| Why was the opt out created? | Ensure safe, cost-effective anesthesia care, especially in medically underserved areas
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| On what date did the federal government rule that states could opt out of MD supervision rule? | November 13, 2001
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| What type of letter does a state’s governor have to send to the CMS to opt out? | Letter of attestation
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| What 3 provisions have to be addressed in a governor’s letter of attestation? | 1)Consultation was made with the state nursing and medical boards 2)It is in the state citizens' best interests to opt out 3)The opt out is consistent with state law
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| The Lewin study showed that CRNAs acting as sole anesthesia providers cost ________ less than the second lowest-cost anesthesia care model. | 25%
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| Which anesthesia care model did the Lewin study say was the least efficient? | 1 MD, 1 CRNA model
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| What did the findings of the Lewin study suggest in regards to anesthesia care? | There is no scientific evidence to suggest that anesthesia care is safer when a CRNA is supervised by a physician
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| The administration of anesthesia is covered under which provision of the Pennsylvania Nurse Practice Act? | 21.17
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| AANA membership provides default membership to which state nurse anesthesia organization? | Pennsylvania Association of Nurse Anesthetist
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| About how many CRNAs are currently administering anesthetics annually? | 35-45k
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| About how many anesthetics are delivered annually by CRNAs? | 32 million
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| When was the International Federation of Nurse Anesthetists established? | 1989
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| In how many countries do nurse anesthetists train and practice? | 107
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| In how many countries do nurses assist in the administration of anesthesia? | 9
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| What is provision 1 for the practicing CRNA under the PA Nurse Practice Act 21.17 | The RN has successfully completed an accredited CRNA program
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| What is provision 2 for the practicing CRNA under the PA Nurse Practice Act 21.17 | The RN has CRNA status (certified)
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| What is provision 3 for the practicing CRNA under the PA Nurse Practice Act 21.17 | The CRNA is authorized to administer anesthesia under the direction of the chief of anesthesia or under the overall direction of the surgeon or dentist
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| What is provision 4 for the practicing CRNA under the PA Nurse Practice Act 21.17 | A physician will be available in-person or electronically in the event that the operating team consists of non-physicians (i.e. dentist, CRNA)
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