Recovery: residual neuromuscular block: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Recovery: residual neuromuscular block

Sample item

Which bedside measurement most reliably suggests adequate recovery from nondepolarising neuromuscular blockade before extubation?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Train-of-four ratio at least 0.9

Quantitative train-of-four monitoring with a ratio of at least 0.9 best reduces risk of clinically important residual weakness. Oxygen saturation can remain normal despite inadequate airway muscle function.

Option by option

  • A. Ability to open eyes once

    A brief voluntary movement does not exclude residual block.

  • B. Train-of-four ratio at least 0.9 (correct)

    Correct. A TOF ratio of 0.9 or higher is the accepted recovery target.

  • C. Absence of visible fasciculations

    Fasciculations relate to depolarising block and do not prove recovery.

  • D. Normal pulse oximetry on supplemental oxygen

    Supplemental oxygen can mask hypoventilation from weakness.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is B, Train-of-four ratio at least 0.9. Quantitative train-of-four monitoring with a ratio of at least 0.

Why is "Ability to open eyes once" not the answer?

A brief voluntary movement does not exclude residual block.

Why is "Absence of visible fasciculations" not the answer?

Fasciculations relate to depolarising block and do not prove recovery.

Why is "Normal pulse oximetry on supplemental oxygen" not the answer?

Supplemental oxygen can mask hypoventilation from weakness.

What concept does this question test?

It tests Recovery: residual neuromuscular block in Anaesthesia. 9 best reduces risk of clinically important residual weakness. Oxygen saturation can remain normal despite inadequate airway muscle function.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Recovery: residual neuromuscular block?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.