1.  Before initiating a BD/DNC examination, the cause of coma must be known and capable of causing irreversible brain injury.

A. True
B. False

2.  Which of the following must be corrected before proceeding with BD/DNC testing?

A. Hypothermia (core temperature below guideline threshold)
B. Significant hypotension
C. Sedative medications that may confound the examination
D. Severe metabolic abnormalities
E. All of the above

3.  Which finding is NOT consistent with brain death?

A. No pupillary response
B. No corneal reflex
C. Flexor withdrawal of the leg to painful stimulation
D. No cough reflex

4.  The presence of spinal reflexes automatically excludes the diagnosis of brain death.

A. True
B. False

5.  Which cranial nerve reflexes are typically assessed during the neurologic examination?

A. Pupillary
B. Corneal
C. Oculocephalic (when appropriate)
D. Oculovestibular
E. Gag and cough
F. All of the above

6.  During an apnea test, an arterial blood gas is drawn at 8–10 minutes. Which combination of results confirms a positive apnea test supporting brain death?

A. pH < 7.35 and PaCO₂ ≥ 50 mm Hg
B. pH < 7.30, PaCO₂ ≥ 60 mm Hg, or a 20 mm Hg increase over baseline normal PaCO₂.
C. pH < 7.40 and PaCO₂ ≥ 45 mm Hg
D. Any pH level, provided the PaCO₂ has doubled from baseline

7.  A physician is conducting an apnea test, and at minute 4, the patient's systolic blood pressure drops to 95 mm Hg and the pulse oximeter reads 83%. What is the correct immediate action?

A. Continue the test for the full 8 minutes to ensure accurate CO2 accumulation
B. Reconnect the ventilator, immediately draw an arterial blood sample, and analyze the ABG
C. Turn the oxygen flow up to 15 L/min via the nasal cannula and continue observing
D. Immediately order a confirmatory nuclear isotope angiography and abandon the ABG

8.  Which of the following clinical scenarios is considered a "pitfall" that interferes with the clinical diagnosis of brain death, necessitating an ancillary test?

A. Present deep tendon reflexes
B. Spontaneous sweating and tachycardia
C. Severe facial trauma or preexisting pupillary abnormalities
D. Absence of diabetes insipidus

9.  As soon as it is anticipated that a patient will meet the criteria for Imminent Death, what is the required timeframe for Timely Notification to the Organ Procurement Organization (OPO)?

A. Within 30 minutes of meeting criteria.
B. Within 1 hour
C. Within 6 hours of meeting criteria.
D. Within 24 hours meeting criteria.

10.  According to the Kettering Health policy, at what point is organ donation typically discussed with the patient's family?

A. As soon as a poor prognosis per the physician is identified.
B. Only after the patient has been pronounced brain dead.
C. Prior to the determination of donor suitability.
D. When the patient's GCS score falls below 5.