2015 CAPA® Answers

QUESTION OF THE WEEK | December 30, 2015

Before providing preoperative written instructional materials to a patient, the perianesthesia nurse should assess the literature for:

  • 1. passive voice use with pronouns.
  • 2. length of content.
  • 3. inclusion of illustrations.
  • 4. reading difficulty level.

Domain: Behavioral and Cognitive Needs

Content Area: Assess patient/family significant others for ability to learn, learning style (for example, kinetic, auditory, visual) readiness to learn, and barriers to learning

Reference:

Litwack, K. Clinical Coach for Effective Perioperative Nursing Care, F.A. Davis Co., 2009. Pg 42.

QUESTION OF THE WEEK | December 23, 2015

While preparing a 6-year-old in the pre-op area, the perianesthesia nurse understands that a MAJOR source of anxiety and fear for this patient is:

  • 1. separation from parents.
  • 2. loss of autonomy.
  • 3. needles and injection.
  • 4. awakening from anesthesia.

Domain: Behavioral and Cognitive Needs

Content Area: Provide psychosocial assistance for patient/family/significant other (for example coping mechanisms, spiritual, and emotional support)

Reference:

Wong, D. Nursing Care of Infants and Children. 9th Ed. CV. Mosby, 2011. Pg 965.

QUESTION OF THE WEEK | December 16, 2015

Which medication should the perianesthesia nurse encourage the patient to take prior to surgery?

  • 1. Fexofenadine
  • 2. Furosemide
  • 3. Amitriptyline
  • 4. Clonidine

Domain: Physiological Needs

Content Area: Appropriate medication regimen (including, but not limited to, minimal interruption of normal medication regimen, preemptive interventions)

Reference:

Fleisher, L. and Roizen, M. Essence of Anesthesia Practice, 3rd Ed. Elsevier Health Sciences, December, 2011. Pg 583.

QUESTION OF THE WEEK | December 09, 2015

A perianesthesia nurse distinguishes best available clinical practice that promotes safe and quality patient care by the conscientious use of:

  • 1. evidence based care.
  • 2. medical based research.
  • 3. patient driven care plans.
  • 4. qualitative research.

Domain: Safety Needs

Content Area: Appropriate resources and referrals (including, but not limited to, medical equipment, pharmaceutical care, pastoral care, nutritional education, physical/occupational therapy, case management/social services)

Reference:

Odom-Forren, J. Drain’s PeriAnesthesia Nursing: A Critical Care Approach. 6th Ed. Elsevier Saunders, 2013. Pg 97-98.

QUESTION OF THE WEEK | December 02, 2015

Following ultrasonically guided transperineal interstitial brachytherapy seed implantation, discharge instructions to the patient include:

  • 1. no heavy lifting for four weeks.
  • 2. instructing the family to place warm packs on the perineum.
  • 3. no special radiation precautions.
  • 4. inspecting the perineum every 15 minutes for the first 2 hours.

Domain: Behavioral and Cognitive Needs

Content Area: Discharge care (including, but not limited to, wound care, diet, ambulation, 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. andWindle, P., (Editors) Third Edition. Perianesthesia Nursing Core Curriculum – Preoperative, Phase I and Phase II PACU Nursing. WB Saunders, St. Louis, MO., 2015. Pg 881, 1209.

QUESTION OF THE WEEK | November 25, 2015

The greatest intraoperative risk of a patient with type I (insulin-dependent) diabetes mellitus is:

  • 1. fluid volume excess.
  • 2. hyperglycemia.
  • 3. hypokalemia.
  • 4. hypoglycemia.

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 118.

QUESTION OF THE WEEK | November 18, 2015

The perianesthesia nurse knows that the importance of understanding the values, beliefs, and health practices of people with differing racial and ethnic diversity can be met through:

  • 1. acculturation process.
  • 2. cultural competency.
  • 3. assimilation identity.
  • 4. use of universal patient care.

Domain: Behavioral and Cognitive Needs

Content Area: Recognize and respect patient/family/significant other diversity (for example, cultural, religious, physical, age-related, cognitive, and language differences)

Reference:

Wong, D. Nursing Care of Infants and Children. 9th Ed. CV. Mosby, 2011. Pg 23.

QUESTION OF THE WEEK | November 11, 2015

Preoperative administration of metoclopramide for the ambulatory surgery patient is intended to:

  • 1. reduce gastric acidity.
  • 2. reduce lower esophageal muscle tone.
  • 3. stimulate gastric emptying.
  • 4. decreases esophageal motility.

Domain: Physiological Needs

Content Area: Appropriate medication regimen (including, but not limited to, minimal interruption of normal medication regimen, preemptive interventions)

Reference:

Hodgson, B., and Kizior, R. Saunders Nursing Drug Handbook 2015. Saunders (Elsevier), 2015. Pg 774.

QUESTION OF THE WEEK | November 04, 2015

Following a carpal tunnel release under IV regional anesthesia, the patient complains of dizziness, tinnitus, and inability to focus. The perianesthesia nurse suspects:

  • 1. allergic reaction.
  • 2. local anesthesia toxicity.
  • 3. hypertensive crisis.
  • 4. orthostatic hypotension.

Domain: Physiological Needs

Content Area: Stability of Neurological System

Reference:

Fleisher, L. and Roizen, M. Essence of Anesthesia Practice, 3rd Ed. Elsevier Health Sciences, December, 2011. Pg 428.

QUESTION OF THE WEEK | October 28, 2015

In a preoperative visit, essential information to be collected by the nurse includes:

  • 1. type of surgery to be performed, previous surgical history, age, and next of kin.
  • 2. patient’s knowledge of the procedure, whether the patient has signed the consent form, and type of anesthesia to be used.
  • 3. preexisting diseases, laboratory values, patient and family history, current medications, and mobility issues.
  • 4. cardiac status, vaccination status, respiratory status, and location of patient’s family postoperatively.

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:

Litwack, K. Clinical Coach for Effective Perioperative Nursing Care, F.A. Davis Co., 2009. Pg 6-8.

QUESTION OF THE WEEK | October 21, 2015

Reviewing preoperative laboratory results for an ambulatory patient with a history of COPD, the ambulatory surgery nurse anticipates finding:

  • 1. decreased HCT.
  • 2. decreased platelets.
  • 3. elevated potassium.
  • 4. elevated bicarbonate.

Domain: Physiological Needs

Content Area: Normal and abnormal diagnostic values

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 510.

QUESTION OF THE WEEK | October 07, 2015

When a patient is admitted to the PACU Phase I bypass or fast-track, the perianesthesia nurse identifies the appropriate candidate who:

  • 1. reports pain scale of 4/10.
  • 2. is drowsy but easily arousable.
  • 3. has motivation to progress.
  • 4. underwent vitrectomy.

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. Schick, L. andWindle, P., (Editors) Third Edition. Perianesthesia Nursing Core Curriculum – Preoperative, Phase I and Phase II PACU Nursing. WB Saunders, St. Louis, MO., 2015. Pg 70.

QUESTION OF THE WEEK | September 30, 2015

Which instruction does the ambulatory surgery nurse give a 36-year-old patient post dilatation and curettage for grade 2 dysplasia?

  • 1. Tampons may be used after 24 hours.
  • 2. Notify the physician of cramping and low back pain.
  • 3. Notify the physician of heavier-than-usual menstrual flow.
  • 4. Resume tub baths and douching in 48 hours.

Domain: Behavioral and Cognitive Needs

Content Area: Discharge care (including, but not limited to, wound care, diet, ambulation, physical therapy, effects on sexuality, pain management, catheter care, equipment and medical devices, routine course, and/or potential complications)

Reference:

Odom-Forren, J. Drain’s PeriAnesthesia Nursing: A Critical Care Approach. 6th Ed. Elsevier Saunders, 2013. Pg 619.

QUESTION OF THE WEEK | September 23, 2015

According to American Society of Perianesthesia Nurses (ASPAN) Perianesthesia Standards, equipment for Phase II Level of care include:

  • 1. a blood pressure machine and suction.
  • 2. various types of airways and suction.
  • 3. irrigation trays and nasogastric supplies.
  • 4. reversal agents and an artificial airway.

Domain: Safety Needs

Content Area: Immobility and/or positioning

Reference:

American Society of PeriAnesthesia Nurses. Perianesthesia Nursing Standards, Practice Recommendations, and Interpretive Statements 2015 – 2017. ASPAN, Cherry Hill, NJ, 2015. Pg 52.

QUESTION OF THE WEEK | September 16, 2015

The perianesthesia nurse is aware that in a 3-year-old patient, post-intubation croup can be prevented when the patient is kept calm and administered:

  • 1. non-steroidal medications.
  • 2. humidified O2 and cool mist.
  • 3. muscle relaxant.
  • 4. steroid therapy.

Domain: Physiological Needs

Content Area: Stability of respiratory system

Reference:

Fleisher, L. and Roizen, M. Essence of Anesthesia Practice, 3rd Ed. Elsevier Health Sciences, December, 2011. Pg 106.

QUESTION OF THE WEEK | September 09, 2015

Six hours postoperatively, a patient has not voided and his bladder is palpably distended. The patient refuses catheterization. If the nurse catheterizes the patient against his wishes, this is considered:

  • 1. tort.
  • 2. assault.
  • 3. malpractice.
  • 4. battery.

Domain: Safety Needs

Content Area: Regulatory, legal, and ethical guidelines

Reference:

American Society of PeriAnesthesia Nurses. Schick, L. andWindle, P., (Editors) Third Edition. Perianesthesia Nursing Core Curriculum – Preoperative, Phase I and Phase II PACU Nursing. WB Saunders, St. Louis, MO., 2015. Pg 23.

QUESTION OF THE WEEK | September 02, 2015

After a procedure under general anesthesia, a patient was admitted to PACU. The perianesthesia nurse knows that a SpO2 of 88% on room air is most likely due to:

  • 1. lack of supplemental oxygenation during transport.
  • 2. no administration of a reversal agent intraoperatively.
  • 3. being instructed by the anesthesiologist to deep-breathe.
  • 4. being ventilated by the anesthesiologist prior to transfer.

Domain: Physiological Needs

Content Area: Stability of cardiovascular/peripheral vascular/ hematological systems

Reference:

Odom-Forren, J. Drain’s PeriAnesthesia Nursing: A Critical Care Approach. 6th Ed. Elsevier Saunders, 2013. Pp 415-417.

QUESTION OF THE WEEK | August 26, 2015

To assess a surgery patient’s educational needs, the nurse should give the most consideration to which of the following?

  • 1. The organization’s anesthesia guidelines and protocol.
  • 2. The anesthetic’s side effects and possible complications.
  • 3. What the patient and companion want and need to know.
  • 4. The anesthesiologist’s orders and recommendations.

Domain: Behavioral and Cognitive Needs

Content Area: Recognize and respect patient/family/significant other diversity (for example, cultural, religious, physical, age-related, cognitive, and language differences)

Reference:

American Society of PeriAnesthesia Nurses. Schick, L. andWindle, P., (Editors) Third Edition. Perianesthesia Nursing Core Curriculum – Preoperative, Phase I and Phase II PACU Nursing. WB Saunders, St. Louis, MO., 2015. Pg 70.

QUESTION OF THE WEEK | August 19, 2015

The perianesthesia nurse learns that the patient takes MAO inhibitor routinely. This information is documented because of the potential lethal interaction with:

  • 1. midazolam.
  • 2. meperidine.
  • 3. succinylcholine.
  • 4. morphine.

Domain: Physiological Needs

Content Area: Appropriate medication regimen (including, but not limited to, minimal interruption of normal medication regimen, preemptive interventions)

Reference:

Hodgson, B., and Kizior, R. Saunders Nursing Drug Handbook 2015. Saunders (Elsevier), 2015.

QUESTION OF THE WEEK | August 12, 2015

Before distributing preoperative written instructional materials, the peri-operative nurse should assess that the literature:

  • 1. is written at a fifth-grade reading level.
  • 2. is written at an eighth grade reading level.
  • 3. contains a Power Point presentation.
  • 4. includes pictures or illustrations.

Domain: Behavioral and Cognitive Needs

Content Area: Assess patient/family/significant other's ability to learn, learning style (for example kinetic, auditory, visual), readiness to learn, and barriers to learning

Reference:

Litwack, K. Clinical Coach for Effective Perioperative Nursing Care, F.A. Davis Co., 2009. Pg 42.

QUESTION OF THE WEEK | August 05, 2015

A preoperative patient asks the perianesthesia nurse what the facility is doing to prevent postoperative surgical site infections. With knowledge of the surgical care improvement project (SCIP), the nurse informs the patient that preoperatively antibiotics should be administered:

  • 1. within 60 minutes of incision time.
  • 2. within 90 minutes of incision time.
  • 3. prior to leaving the holding area.
  • 4. upon arrival to the facility.

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:

Odom-Forren, J. Drain’s PeriAnesthesia Nursing: A Critical Care Approach. 6th Ed. Elsevier Saunders, 2013. Pg 50.

QUESTION OF THE WEEK | July 29, 2015

A patient calls the preoperative center asking whether to continue taking his daily dose of beta-blocker. The perianesthesia nurse is aware that betablockers should be:

  • 1. held on day of surgery.
  • 2. stopped at least 3 days preoperatively.
  • 3. taken daily as prescribed.
  • 4. stopped at least 5 days preoperatively.

Domain: Behavioral and Cognitive Needs

Content Area: Provide patient/family/significant other education and evaluate understanding related to preparations for procedures/surgery

Reference:

Fleisher, L. and Roizen, M. Essence of Anesthesia Practice, 3rd Ed. Elsevier Health Sciences, December, 2011. Pg 583.

QUESTION OF THE WEEK | July 22, 2015

The dissociative state attributed to ketamine anesthesia can be modified by the administration of:

  • 1. antiarrhythmic.
  • 2. benzodiazepine.
  • 3. antagonist.
  • 4. anticonvulsant.

Domain: Physiological Needs

Content Area: Appropriate medication regimen (including, but not limited to, minimal interruption of normal medication regimen, preemptive interventions)

Reference:

Urden, L., et al. Thelan’s Critical Care Nursing, Diagnosis and Management, 7th Ed. Elsevier, 2014. 161.

QUESTION OF THE WEEK | July 13, 2015

Following a hernia repair, a 3-month-old is admitted to the PACU positioned on his side with a pacifier in his mouth. The airway becomes obstructed by the tongue. The obstruction can be alleviated by:

  • 1. removing the pacifier.
  • 2. pinching the cheeks.
  • 3. turning him on his back.
  • 4. jaw thrust or chin lift.

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 283

To view question and answers from 2015 please click here.