Nurse anesthetist screening questions: NBCRNA certification, supervision models, case mix and call
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Nurse anesthetist screening questions should confirm NBCRNA certification and the APRN or nurse anesthetist license for the job state, then find out which practice model the CRNA works in (medically directed care team, medically supervised, or independent where the state has opted out), the case mix they handle without help, regional and line skills, call, and any non-compete that could block the start. As of October 2026, NBCRNA is moving all CRNAs to its Maintaining Anesthesia Certification (MAC) Program, and the CMS supervision rule still depends on whether the state has opted out.
Licensing for advanced practice nurses in general is covered in the nurse practitioner screening questions, including the APRN Compact's status and DEA registration. This page adds what is specific to anesthesia. If the client is also hiring anesthesia techs, see the anesthesia technician screening questions.
Which CRNA job is it?
| Practice model or setting | What changes | Ask the candidate |
|---|---|---|
| Medically directed care team (hospital) | An anesthesiologist directs several rooms; CRNA manages the case within that model | "What ratio did your group run, and who did inductions?" |
| Medically supervised or surgeon-supervised | Supervision by the operating practitioner or an anesthesiologist, with more CRNA autonomy | "Who supervised you, and how often was an anesthesiologist in the building?" |
| Independent practice (opt-out state, rural or critical access hospital) | CRNA is the only anesthesia provider, takes all call, handles emergencies alone | "When were you last the only anesthesia provider in the building, and for what cases?" |
| Ambulatory surgery center or office | High volume, short cases, sedation and blocks, fast turnovers | "How many cases a day, and which blocks did you place?" |
| Obstetrics | Labor epidurals, urgent cesareans, in-house call | "How many labor epidurals a month, and what is your plan for a failed spinal?" |
| Pain or non-operating-room anesthesia | Endoscopy, cath lab, MRI, interventional pain procedures | "Which locations outside the OR did you cover?" |
The requirements that decide eligibility
As of October 2026. We checked these on NBCRNA's own pages and in the federal regulations. State nursing boards set APRN licensure and practice rules; check the job state's board and the client's medical staff bylaws.
- Initial certification. NBCRNA's NCE resources say graduates of accredited nurse anesthesia programs are eligible for the National Certification Examination, which can be taken up to four times in the year after the program ends. It is a variable-length computerized adaptive test of 100 to 170 questions, with three hours at most.
- Continued certification. NBCRNA's continued certification page describes the MAC Program: a four-year timeline with MAC Check (an assessment that replaces the CPC Assessment), 60 Class A continuing education credits and 40 Class B professional development credits; core modules are no longer required, and all CRNAs will be enrolled in the MAC Program by 2026. NBCRNA's CPC page says CRNAs renewing in 2026 and 2027 still complete their CPC renewal requirements. Verify status with NBCRNA's credential verification tool.
- State license. Check what the job state's board of nursing requires of nurse anesthetists on top of the RN license, such as an APRN license, and verify each one on the board's lookup. The APRN Compact was not yet in effect as of September 2026, according to the nurse practitioner page, so plan on a license in each state.
- CMS supervision and opt-out. Under 42 CFR 482.52, a hospital CRNA must be supervised by the operating practitioner or by an anesthesiologist who is immediately available, unless the state has an exemption under paragraph (c): a governor's letter to CMS, written after consulting the state's boards of medicine and nursing, attesting that opting out is in the best interests of residents and consistent with state law. The client's state law and bylaws can still require more.
- Medical direction. Under 42 CFR 415.110, an anesthesiologist medically directing CRNAs may direct no more than four anesthesia services concurrently and must, among other steps, perform the pre-anesthetic exam, prescribe the plan, personally participate in the most demanding parts such as induction and emergence, and remain physically present and available for emergencies. This shapes how much the CRNA does alone.
Knockout questions
| Question | Strong answer | Red flag |
|---|---|---|
| 1. Is your NBCRNA certification current, and where are you in your renewal cycle? | Current, with the cycle end date, and aware of the MAC transition. | Unsure whether certification is current. |
| 2. Which state licenses do you hold (RN and APRN or CRNA), and will you hold [state] by the start date? | Lists each with expiry; an application filed for the job state. | No application, for a start in six weeks. |
| 3. Has any board or facility restricted your license or privileges? | A clear no, or a direct explanation. | Hesitation or "it was resolved" with no detail. |
| 4. This role is [model, ratio, call frequency, OB coverage]. Does that fit? | A clear yes, or a stated limit. | Wants no call for a call-heavy role. |
| 5. Do you have a non-compete or notice period with your current employer? | Discloses it and the dates. | "I'll deal with it later." |
Clinical depth questions
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"Which cases do you do comfortably without anyone else in the room, and which do you want help with?"
- Strong answer: an honest list (for example, general cases, orthopedics with blocks, OB) and an honest limit (complex pediatrics, open-heart) matched to the client's case mix.
- Red flags: "Everything," from someone whose recent work was a high-ratio care team.
-
"Which regional blocks do you place, and roughly how many a month?"
- Strong answer: names blocks by type, ultrasound use, and numbers that fit their setting.
- Red flags: blocks claimed only from training.
-
"Walk me through an unanticipated difficult airway in an ambulatory center."
- Strong answer: calls for help early, follows a difficult airway algorithm, uses the equipment available, knows when to wake the patient.
- Red flags: no plan beyond "it doesn't happen."
-
"Tell me about your last malignant hyperthermia drill or event."
- Strong answer: knows the cart, dantrolene preparation and the team roles.
- Red flags: has never seen the cart.
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"Which lines do you place: arterial, central, ultrasound-guided IVs?"
- Strong answer: specific, with recent numbers.
- Red flags: claims central lines in a group where anesthesiologists placed them all.
Practice model, call and contract questions
| Question | Strong answer | Red flag |
|---|---|---|
| What ratio and model did you last work in, and how did inductions and emergence work? | Explains the model and who was present for which parts. | Cannot describe it. |
| What does call look like for you: in-house or home, response time, frequency? | Specific numbers and what a typical call night involved. | Avoids call entirely, for a role that needs it. |
| Which anesthesia records system have you charted in? | Names it; charts in real time. | Back-charts after cases routinely. |
| What do you need in pay, schedule and time off? | Specific numbers and priorities. | No number. Ask expectations, not history; see salary expectation questions. |
| Locum: how many assignments, and did any end early? | Numbers, places and reasons. | Several early ends with shifting reasons. |
Non-competes matter for CRNAs because several states limit them for this profession. The Pennsylvania non-compete page covers Act 74 of 2024, which voids non-competes that certified registered nurse anesthetists signed after it took effect on January 1, 2025, except that an employer may enforce one of up to a year when the practitioner was not dismissed, and the New Mexico page covers that state's limit for CRNAs. Other states have their own rules; check the job state's non-compete page and have counsel read the agreement before an offer.
How CRNA experience gets overstated
- Independence from a care team. Years in a 1:4 directed model presented as solo rural practice.
- Case types from training. Cardiac or pediatric cases done as a student, not since certification.
- Blocks by observation. "Familiar with" a block they have never placed.
- OB coverage that was daytime epidurals only, with no urgent cesareans.
A 20-minute phone-screen flow
- Minutes 0 to 3: model, setting, case mix, call and start date.
- Minutes 3 to 7: knockouts; certification, each license and non-compete.
- Minutes 7 to 15: solo comfort, blocks, airway and lines.
- Minutes 15 to 20: call, records system, pay and next steps.
Scoring
Pass or fail
- NBCRNA certification current and verified.
- Licensed in the job state, or a realistic route before the start date.
- No undisclosed restriction on license or privileges.
- Fits the practice model, call and case mix; no non-compete blocking the start.
Scored 0 to 2 each (10 possible)
- Case mix match and honest limits.
- Regional and line skills for the client's cases.
- Emergency readiness: airway, MH, obstetric emergencies.
- Practice model experience at the client's level of autonomy.
- Charting and communication with surgeons and anesthesiologists.
Legal cautions for CRNA screens
Ask about the job's demands (long cases, call nights, lifting and positioning patients) and ability to meet them, with or without accommodation, not about health, substance use treatment history or pregnancy; those questions are not allowed before an offer under the EEOC's guidance. Questions about board actions and privilege restrictions are fine when asked of every candidate. See illegal interview questions, and for later rounds the interview guide for nurses.
Questions people ask
How do I verify a CRNA's certification?
Use the National Board of Certification and Recertification for Nurse Anesthetists' credential verification tool on its portal, then check the APRN or nurse anesthetist license on the job state's board of nursing. As of October 2026, NBCRNA is moving all CRNAs from its legacy Continued Professional Certification program to the Maintaining Anesthesia Certification (MAC) Program.
What does the CMS opt-out mean for CRNAs?
Under the Medicare hospital rule at 42 CFR 482.52, a CRNA must be supervised by the operating practitioner or by an anesthesiologist who is immediately available, unless the state has an exemption. A state gets one when its governor sends CMS a letter, after consulting the state's boards of medicine and nursing, attesting that opting out is in residents' best interests and consistent with state law. State law and facility rules still apply.
What is a medical direction ratio in anesthesia?
In Medicare's rule at 42 CFR 415.110, an anesthesiologist medically directing CRNAs may direct no more than four anesthesia services at once and must perform specific steps for each, including the pre-anesthetic exam, the plan, participation in the most demanding parts such as induction and emergence, and being present for emergencies. Ask the client which model and ratio it runs.
How many times can a nurse anesthesia graduate take the certification exam?
NBCRNA says the National Certification Examination can be taken up to four times in the year after completing a nurse anesthesia educational program. It is a variable-length computerized adaptive test of 100 to 170 questions with a three-hour maximum.
Can a hospital enforce a non-compete against a CRNA?
It depends on the state. Pennsylvania's Act 74 of 2024 and New Mexico's statute, for example, limit non-competes for certified registered nurse anesthetists, and other states have their own rules. Read the candidate's agreement early and send questions to counsel.