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The nurse providing conscious sedation to a patient:
1. will not have duties that interfere with monitoring of the patient.
2. may circulate as long as monitor alarms are set.
3. may administer propofol for short procedures.
4. may monitor ASA IV patients
1.
Domain: Safety Needs
Content Area: Protect patient from harm and take preventive measures related to the use of
protective safety devices and equipment (including, but not limited to, padded side rails, safety
straps, restraints)
Reference: American Society of PeriAnesthesia Nurses. Perianesthesia Nursing Standards,
Practice Recommendations, and Interpretive Statements 2015 - 2017. ASPAN, Cherry Hill, NJ,
2015. Pg 63.
In caring for a patient at risk for noncardiogenic pulmonary edema, the perianesthesia nurse
understands that the best method for prevention is to:
1. elevate head in high fowler's position.
2. maintain blood pressure below 180 systolic.
3. prevent fluid overload by limiting IV fluids in the elderly.
4. maintain airway and administer supplemental O2.
CPAN/ CAPA Exam (Latest Update
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A patient with type 2 diabetes mellitus is admitted the day of surgery with a glucose of 610
mg/dl. The perianesthesia nurse is aware that the patient may be at risk for:
1. diabetic ketoacidosis.
2. hypercalcemia.
3. diabetes insipidus.
4. hyperkalemia.
1. DKA
Domain: Physiological Needs
Content Area: Stability of Endocrine System
Reference: Fleisher, L. and Roizen, M. Essence of Anesthesia Practice, 3rd Ed. Elsevier Health
Sciences, December, 2011. Pg 122.
The perianesthesia nurse is aware that which drug is contraindicated in the pregnant patient?
1. Acetaminophen
2. Famotidine
3. Ondansetron
4. Ketorolac
4. Ketolorac
Domain: Physiological Needs
Content Area: an appropriate medication regimen (including, but not limited to, minimal
interruption of normal medication regimen, preemptive interventions)
CPAN/ CAPA Exam (Latest Update
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Reference: Hodgson, B., and Kizior, R. Saunders Nursing Drug Handbook 2015. Saunders
(Elsevier), 2015. Pg 660-661
During discharge planning of a patient who has received 6 units of regular recombinant human
insulin (Humulin) subcutaneously, the perianesthesia nurse recognizes that the PEAK action will
occur in:
1. 1-5 hours.
2. 5-7 hours.
3. 10-20 minutes.
4. 30-45 minutes
1. 1 to 5 hours
Domain: Physiological Needs
Content Area: stability of endocrine system
Reference: Hodgson, B., and Kizior, R. Saunders Nursing Drug Handbook 2015. Saunders
(Elsevier), [Link] 622-623.
A patient in the PACU who received general anesthesia is awake and alert with stable vital signs.
When the perianesthesia nurse removes the patient's oxygen the O2 saturation periodically drops
to 88%. The perianestheisa nurse's next best action is to:
1. notify the anesthesia provider
2. administer albuterol nebulizer
3. begin the stir-up regimen
CPAN/ CAPA Exam (Latest Update
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4. perform chin lift
3. begin the stir-up regimen
Domain: Physiological Needs
Content Area: Stability of respiratory system
Reference: Urden, L., et al. Thelan's Critical Care Nursing, Diagnosis and Management, 7th Ed.
Elsevier, 2014. pg 1103.
During a pre-op assessment, a patient reports taking his morning dose of medical marijuana. The
perianesthesia nurse understands that:
1. recent use may impair ability to give consent.
2. no action is needed due to home medication regimen.
3. it is acceptable if there are no physical signs of marijuana intoxication
4. recent use will decrease post-op agitation
1. recent use may impair ability to give consent
Domain: Safety Needs
Content Area: Deliver, document, and communicate care based on accepted national standards of
perianesthesia nursing practice and applicable laws, guidelines, and regulations
Reference: Fleisher, L. and Roizen, M. Essence of Anesthesia Practice, 3rd Ed. Elsevier Health
Sciences, December, 2011. pg 616-617.
Of the following patients, which is MOST APPROPRIATE for fast track to the Phase II area?
CPAN/ CAPA Exam (Latest Update
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1. A 50 year old female who underwent a screening colonoscopy who is responsive to verbal
stimuli
2. A 40 year old who is awake, alert and pain free following a spermatocelectomy
3. A 17 year old female who is awake, alert and complaining of level 5 pain after open reduction
of a wrist fracture
4. A 76 year old inpatient who had a debridement of a heel wound under intravenous anesthesia
2. A 40 year old who is awake, alert and pain free following a spermatocelectomy.
Domain: Safety Needs
Content Area: Facilitate patient access to an environment that accommodates physical, mental,
and emotional abilities/limitations
Reference: American Society of PeriAnesthesia Nurses. Perianesthesia Nursing Standards,
Practice Recommendations, and Interpretive Statements 2015 - 2017. ASPAN, Cherry Hill, NJ,
2015. Pg 66-67.
The preoperative nurse is aware that the BEST method to prepare a 5 year old child for surgery is
to provide:
1. video to be reviewed more than once with explanation and demonstration on the day of
surgery.
2. a phone call to the guardian 5-7 days prior to surgery with explanation of the preoperative
process.
3. pictures, diagrams and models for practice and handling of actual equipment.
4. an opportunity for the child to speak with nurse without the guardian present.
3. pictures, diagrams and models for practice and handling of actual equipment.
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Domain: Behavioral and Cognitive Needs
Content Area: Provide patient/family/significant other education and evaluate understanding
related to preparations for procedures/surgery.
Reference: American Society of PeriAnesthesia Nurses. Schick, L. and Windle, P., (Editors)
Third Edition. Perianesthesia Nursing Core Curriculum - Preoperative, Phase I and Phase II
PACU Nursing. WB Saunders, St. Louis, MO., 2015. 203-204.
A 12 year old with known sickle cell disease and autism has undergone an inguinal hernia repair.
The perianesthesia nurse is aware that the MAIN surgical risk to this patient is:
1. hypoxia from anesthesia.
2. end-organ damage.
3. renal insufficiency.
4. toxicity from heavy metal.
1. hypoxia from anesthesia.
Domain: Physiological Needs
Content Area: Stability of Respiratory System
Reference: Hockenberry, M., Wilson, D. Wong's Nursing Care of Infants and Children. 10th Ed.
CV. Mosby, 2015. pg 1348.
The perianesthesia nurse is aware that one major advantage of propofol over other intravenous
induction agents is:
CPAN/ CAPA Exam (Latest Update
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1. predictability of action.
2. rapid patient recovery.
3. increased cerebral perfusion.
4. no airway requirements
2. rapid patient recovery.
Domain: Physiological Needs
Content Area: Stability of respiratory system
Reference: Litwack, K. Clinical Coach for Effective Perioperative Nursing Care, F.A. Davis Co.,
2009. pg 48
A week before a patient's surgery, it was noted in the history and physical assessment that the
patient has acute bronchitis. The perianesthesia nurse's BEST action is to:
1. proceed with surgery.
2. get an order for an antibiotic.
3. notify the surgeon.
4. postpone the surgery.
3. notify the surgeon.
Domain: Physiological Needs
Content Area: Stability of respiratory system
Reference: American Society of PeriAnesthesia Nurses. Perianesthesia Nursing Standards,
Practice Recommendations, and Interpretive Statements 2015 - 2017. ASPAN, Cherry Hill, NJ,
2015. pg 34
CPAN/ CAPA Exam (Latest Update
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Postoperative instructions for symptoms of compartment syndrome include:
1. pain aggravated by passive flexion of the affected limb.
2. skin turgor resembling loose flaccid soft tissue.
3. strong bounding pulses in the affected limb.
4. hypersensitivity to touch in the affected limb.
1. pain aggravated by passive flexion of the affected limb.
Domain: Behavioral and Cognitive Needs
Content Area: Provide patient/family/significant other education and evaluate understanding
related to discharge care (including, but not limited to, ambulation, diet, wound care, physical
therapy, effects on sexuality, pain management, catheter care, equipment and medical devices,
routine course, and/or potential complications).
Reference: American Society of PeriAnesthesia Nurses. Schick, L. and Windle, P., (Editors)
Third Edition. Perianesthesia Nursing Core Curriculum - Preoperative, Phase I and Phase II
PACU Nursing. WB Saunders, St. Louis, MO., 2015. pg 1021-1022.
A patient arrives in Phase I PACU receiving oxygen by nasal cannula at 2 liters per minute. The
wave forms on pulse oximetry are initially normal with an oxygen saturation of 100%. Ten
minutes after arrival to Phase I the alarm is sounded and the nurse notes that the monitor has
stopped tracking the pulse. The perianesthesia nurse should FIRST:
1. increase the oxygen flow rate to the nasal cannula.
2. move the probe from the finger to the earlobe.
3. encourage patient to cough and deep breathe.
4. evaluate the patient for adverse physiological changes.
CPAN/ CAPA Exam (Latest Update
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4. evaluate the patient for adverse physiological changes.
Domain: Physiological Needs
Content Area: Stability of respiratory system
Reference: Odom-Forren, J. Drain's PeriAnesthesia Nursing: A Critical Care Approach. 6th Ed.
Elsevier Saunders, 2013. pg 357.