CPAN® Question of the Week

Each Wednesday at 6am ET, ABPANC will post a CPAN® and a CAPA® study question. Use these questions to test your knowledge, display in your unit and discuss with your colleagues. The answer, along with the next week’s question, will be posted the following Wednesday at 6am.

For each question, we will post the reference from ABPANC’s Study References List (Appendix D), as well as the domain and content area information from the Test Blueprint. For more questions and answers, you can purchase up to 4 Practice Exams.

If you would like to have the question delivered to your inbox each week you can sign up for the Study Question of the Week program.

THIS WEEK'S QUESTION | February 15, 2017

A patient develops laryngospasm in the PACU. The priority intervention is:

  • 1. positive pressure ventilation.
  • 2. to administer ventolin via a nebulizer.
  • 3. to reintubate the patient.
  • 4. to administer 40 mg furosemide IV.

CPAN/CAPA Test Blueprint

Domain: Physiological Needs

Content Area: Stability of respiratory System


Check back next week for the answer!

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Previous Questions & Answers

QUESTION OF THE WEEK | February 08, 2017

A patient is admitted to PACU following shoulder arthroplasty with an interscalene block using bupivacaine. The monitor shows bradycardia with premature ventricular complexes. The patient also complains of lightheadedness and circumoral numbness. The nurse prepares for the administration of:

  • 1. morphine
  • 2. lidocaine
  • 3. lipids
  • 4. adenosine

CPAN/CAPA Test Blueprint

Domain: Physiological Needs

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

Reference:

Odom-Forren, J. Drain’s PeriAnesthesia Nursing: A Critical Care Approach. 6th Ed. Elsevier Saunders, 2013. pg 321-322

QUESTION OF THE WEEK | February 01, 2017

After 30 minutes in the PACU, a patient post thyroidectomy develops a prolonged Q-T interval and decreased blood pressure. The perianesthesia nurse assesses this as:

  • 1. hypocalcemia.
  • 2. hypermagnesemia.
  • 3. hypokalemia.
  • 4. hyperkalemia.

CPAN/CAPA Test Blueprint

Domain: Physiological Needs

Content Area: Stability of endocrine system

Reference:

Urden, L., et al. Thelan’s Critical Care Nursing, Diagnosis and Management, 7th Ed. Elsevier, 2014. pg 313-315.

QUESTION OF THE WEEK | January 25, 2017

A patient with a history of substance abuse has been in the PACU for 45 minutes and has received analgesics as ordered. The patient now reports a pain rating of 8 on a scale of 0 to 10. The perianesthesia nurse recognizes:

  • 1. the patient's increased analgesic requirements.
  • 2. a drug seeking behavior.
  • 3. that physical withdrawal  is appropriate in the perioperative period.
  • 4. an immediate need for behavioral counseling.

CPAN/CAPA Test Blueprint

Domain: Physiological Needs

Content Area: Physiological comfort (including, but not limited to, relief from pain, shivering, nausea and vomiting; and appropriate positioning)

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 117

QUESTION OF THE WEEK | January 18, 2017

A patient is admitted to PACU status post shoulder arthroscopy with an interscalene block. The perianesthesia nurse demonstrates the priority nursing care, which is to:

  • 1. check for bladder distention.
  • 2. monitor for orthostatic hypotension.
  • 3. protect the affected arm.
  • 4. avoid analgesics in immediate post-op period.

CPAN/CAPA Test Blueprint

Domain: Behavioral and Cognitive Needs

Content Area: Provide patient/family/significant other education and evaluate understanding related to the perianesthesia/procedural experience

Reference:

Odom-Forren, J. Drain’s PeriAnesthesia Nursing: A Critical Care Approach. 6th Ed. Elsevier Saunders, 2013. pg 335.

QUESTION OF THE WEEK | January 11, 2017

A patient awakens in the PACU status-post laparoscopic assisted vaginal hysterectomy. The patient is sweating and appears pale. The heart rate is 110 beats/min, respiratory rate is 28, and temperature is 98.4 F. The perianesthesia nurse recognizes that if left untreated, a potential complication this condition could precipitate is:

  • 1. hypertension.
  • 2. aspiration.
  • 3. bronchospasm.
  • 4. non-cardiogenic pulmonary edema.

CPAN/CAPA Test Blueprint

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 405.

QUESTION OF THE WEEK | January 04, 2017

The condition of a patient in the PACU has changed from stable to unstable. The patient’s spouse asks for an update.  The perianesthesia nurse should:

  • 1. provide information about the patient's condition to the spouse.
  • 2. refuse to provide information.
  • 3. check with the nursing supervisor.
  • 4. check to see whether permission has been given by the patient.

CPAN/CAPA Test Blueprint

Domain: Behavioral and Cognitive Needs

Content Area: Provide and maintain patient privacy and confidentiality

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 24.

QUESTION OF THE WEEK | December 28, 2016

A healthy 18 year-old patient is admitted to the PACU after undergoing a right tibial internal fixation. The patient is in a long leg cast. The right toes are cool and pale, and the patient describes tingling in the right-lower extremity. After several doses of narcotics, the patient still rates the pain as a 10 on a scale of 1 to 10. The PACU nurse would appraise this as:

  • 1. displacement of the internal fixation.
  • 2. compartment syndrome.
  • 3. hemorrhage at the site.
  • 4. low threshold to pain.

CPAN/CAPA Test Blueprint

Domain: Physiological Needs

Content Area: Stability of musculoskeletal system

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 468.

QUESTION OF THE WEEK | December 21, 2016

A morbidly obese patient who is difficult to arouse is admitted to the PACU, receiving O2 by face mask at 6L/min.  Vital signs are: BP =180/110, HR =120, RR = 12, and SaO2 100%.  The ECG monitor shows frequent episodes of multifocal premature ventricular contractions (PVCs).  The perianesthesia nurse would suspect:

  • 1. hypercarbia.
  • 2. hyperthermia.
  • 3. hypocarbia.
  • 4. hyperkalemia.

CPAN/CAPA Test Blueprint

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 1109.

QUESTION OF THE WEEK | December 14, 2016

An elderly patient received propofol, midazolam and fentanyl intraoperatively. The chart reveals that the patient took alprazolam the morning of the surgery. The perianesthesia nurse anticipates that the patient is at risk of:

  • 1. increased PONV.
  • 2. malignant hyperthermia.
  • 3. emergence delirium.
  • 4. hypertension.

CPAN/CAPA Test Blueprint

Domain: Physiological Needs

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

Reference:

Odom-Forren, J. Drain’s PeriAnesthesia Nursing: A Critical Care Approach. 6th Ed. Elsevier Saunders, 2013. Pg 269.

QUESTION OF THE WEEK | December 07, 2016

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 Test Blueprint

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 519-524.

QUESTION OF THE WEEK | November 30, 2016

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.

CPAN/CAPA Test Blueprint

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.

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