Question of the Week
September 30, 2020
A preoperative patient asks what the facility is doing to prevent postoperative surgical site infections. The perianesthesia nurse is aware that according to the surgical care improvement project (SCIP), preop antibiotics should be administered:
- within 60 minutes of incision time.
- prior to induction.
- prior to leaving the holding area.
- upon arrival to the facility.
CPAN/CAPA Test Blueprint
Domain: Physiological Needs
Content Area: Domain: 3 Content Area/Task: A
Reference: Reference: Drain pg. 53
Question of the Week
September 23, 2020
In the event that a pharmacologically paralyzed patient is inadvertently extubated, the first priority of the PACU nurse is to:
- administer a muscarinic anticholinergic drug immediately.
- establish and maintain the airway and ventilation.
- administer an anticholinesterase drug immediately.
- assess for muscle recovery before reintubating.
CPAN/CAPA Test Blueprint
Domain: Physiological Needs
Content Area: Domain: 1 Content Area/Task: C
Reference: Reference: Core 276
Question of the Week
September 09, 2020
After extubation of a patient, which of the following would be considered most serious?
- Sore throat
- Impaired swallowing ability
- Inspiratory stridor
- Hoarseness
CPAN/CAPA Test Blueprint
Domain: Physiological Needs
Content Area: Assess, diagnose, plan, intervene, and evaluate in order to promote stability of the gastrointestinal system.
Reference:
Question of the Week
August 26, 2020
Which of the following interventions would be used first to maintain adequate perfusion and oxygen supply to cardiac muscles following hepatic surgery in a patient with a history of coronary artery disease:
- Ensure a hemoglobin concentration ≥ 10 g.
- Treat tachydysrhythmias and hypotension.
- Monitor oxygen saturation via pulse oximetry.
- Administer appropriate medications.
CPAN/CAPA Test Blueprint
Domain: Physiological Needs
Content Area: D. Assess, diagnose, plan, intervene, and evaluate in order to promote stability of the musculoskeletal system.
Reference:
Question of the Week
August 19, 2020
Care for a patient who receives a skin graft to the forearm includes:
- maintain dependent position of the extremity.
- changing the bandages if necessary.
- elevation of the affected extremity.
- ROM exercises for the affected extremity.
CPAN/CAPA Test Blueprint
Domain: Physiological Needs
Content Area: G. Assess, diagnose, plan, intervene, and evaluate in order to promote stability of the integumentary system.
Reference:
Question of the Week
August 12, 2020
The use of the pulse oximeter has become a routine part of PACU care. The post anesthesia nurse may decide that oximetry monitoring is indicated when the patient:
- has had minor surgery.
- has normal vital signs.
- has had regional anesthesia.
- is severely hypothermic.
CPAN/CAPA Test Blueprint
Domain: Physiological Needs
Content Area: E. Assess, diagnose, plan, intervene, and evaluate in order to promote stability of the gastrointestinal system.
Reference:
Question of the Week
August 5, 2020
The perianesthesia nurse learns that the patient takes MAO inhibitor routinely. This information is documented because of the potential lethal interaction with:
- meperidine.
- midazolam.
- succinylcholine.
- morphine.
CPAN/CAPA Test Blueprint
Domain: Physiological Needs
Content Area: L. Assess, diagnose, plan, intervene, and evaluate in order to promote stability of the fluid and electrolyte levels.
Reference:
Question of the Week
July 22, 2020
Prochlorperazine acts to treat postoperative nausea by affecting the:
- process of gastric emptying.
- chemoreceptor trigger zone.
- production of gastric acid.
- vestibular pathways.
CPAN/CAPA Test Blueprint
Domain: Physiological Needs
Content Area: Assess, diagnose, plan, intervene, and evaluate in order to promote stability of the gastrointestinal system.
Reference:
Question of the Week
July 15, 2020
Tidal volume is most precisely defined as the amount of:
- air exchange in one minute.
- gas passing into or out of the lungs in each respiratory cycle.
- gas remaining within the chest after maximal expiration.
- air exchange with full inspiration and expiration.
CPAN/CAPA Test Blueprint
Domain: Physiological Needs
Content Area: Assess, diagnose, plan, intervene, and evaluate in order to promote stability of the cardiovascular and peripheral vascular systems.
Reference:
Question of the Week
July 8, 2020
In a 3-year-old patient, postintubation croup is least likely to develop when the patient has:
- remained in a supine position for a 1-hour procedure.
- been in a supine position for 15 minutes, then in a lateral position for 45 minutes.
- coughed actively and strained prior to extubation.
- required two attempts prior to successful intubation.
CPAN/CAPA Test Blueprint
Domain: Physiological Needs
Content Area: Assess, diagnose, plan, intervene, and evaluate in order to promote stability of the respiratory system.
Reference:
Question of the Week
June 17, 2020
One of the most frequent side effects of ketamine anesthesia is:
- hallucination.
- respiratory depression.
- hypotension.
- bradycardia.
CPAN/CAPA Test Blueprint
Domain: Physiological Needs
Content Area: Assess, diagnose, plan, intervene, and evaluate in order to promote stability of the respiratory system.
Reference:
Question of the Week
June 10, 2020
The perianesthesia nurse should question the accuracy of the SpO2 measurement when caring for a patient with which of the underlying condition?
- Cushing's disease.
- hypothyroidism.
- Raynaud's disease.
- hyperthyroidism.
CPAN/CAPA Test Blueprint
Domain: Physiological Needs
Content Area: Assess, diagnose, plan, intervene, and evaluate in order to promote stability of the cardiovascular and peripheral vascular systems.
Reference:
Question of the Week
May 27, 2020
A patient 7 months pregnant is admitted for repair of a lacerated Achilles tendon. During assessment, contractions of her abdomen are noted. Which of the following positions should this patient be placed?
- Right lateral tilt position
- Left lateral tilt position
- Supine
- Trendelenburg
CPAN/CAPA Test Blueprint
Domain: Physiological Needs
Content Area: Assess, diagnose, plan, intervene, and evaluate in order to promote maintenance of normothermia.
Reference:
Question of the Week
May 20, 2020
In administering flumazenil, the perianesthesia nurse is aware that it inhibits the central effects of benzodiazepines by:
- competing for the receptor sites.
- stimulating the cerebral cortex.
- occupying the mu receptor sites.
- metabolizing the medications.
CPAN/CAPA Test Blueprint
Domain: Physiological Needs
Content Area: Assess, diagnose, plan, intervene, and evaluate in order to promote stability of the fluid and electrolyte levels.
Reference:
Question of the Week
May 13, 2020
When preparing a patient for a brachial plexus nerve block for upper extremity surgery, the perianesthesia nurse is aware that the safest and easiest approach is:
- subclavicular.
- supraclavicular.
- interscalene.
- axillary.
CPAN/CAPA Test Blueprint
Domain: Physiological Needs
Content Area: Assess, diagnose, plan, intervene, and evaluate in order to promote stability of the neurological system.
Reference:
Question of the Week
May 6, 2020
A pathological process that can interfere with accurate measurements of SpO2 when using a pulse oximeter is:
- Cushing's disease.
- hypoparathyroidism.
- Raynaud's disease.
- hyperthyroidism.
CPAN/CAPA Test Blueprint
Domain: Physiological Needs
Content Area: Assess, diagnose, plan, intervene, and evaluate in order to promote stability of the cardiovascular and peripheral vascular systems.
Reference:
Question of the Week
April 29, 2020
To decrease nausea, the perianesthesia nurse instructs the patient to:
- take deep breaths.
- take several quick breaths.
- turn their head to the side.
- utilize Reiki or imagery.
CPAN/CAPA Test Blueprint
Domain: Physiological Needs
Content Area: Assess, diagnose, plan, intervene, and evaluate in order to promote maintenance of normothermia.
Reference:
Question of the Week
April 22, 2020
In the event that a pharmacologically paralyzed patient is inadvertently extubated, the first priority of the PACU nurse is to:
- administer a muscarinic anticholinergic drug immediately.
- establish and maintain the airway and ventilation.
- administer an anticholinesterase drug immediately.
- assess for muscle recovery before reintubating.
CPAN/CAPA Test Blueprint
Domain: Physiological Needs
Content Area: Assess, diagnose, plan, intervene, and evaluate in order to promote stability of the neurological system.
Reference:
Question of the Week
April 15, 2020
The perianesthesia nurse would expect a patient with COPD to have received which of the following anesthetic agents?
- Isoflurane
- Nitrous oxide
- Enflurane
- Halothane
CPAN/CAPA Test Blueprint
Domain: Physiological Needs
Content Area: Assess, diagnose, plan, intervene, and evaluate in order to promote stability of the fluid and electrolyte levels.
Reference:
Question of the Week
February 12, 2020
The dissociative state attributed to ketamine anesthesia can be modified by the administration of a/an:
- antiarrhythmic.
- benzodiazepine.
- narcotic.
- anticonvulsant.
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:
Question of the Week
February 05, 2020
The perianesthesia nurse is aware that a dramatic decrease in the serum calcium level may be caused by removal of the:
- parathyroid glands.
- pineal gland.
- adrenal glands.
- pituitary gland.
CPAN/CAPA Test Blueprint
Domain: Physiological Needs
Content Area: Stability of the endocrine system
Reference:
Question of the Week
January 29, 2020
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:
- removing the pacifier.
- pinching the cheeks.
- turning him on his back.
- jaw thrust or chin lift
CPAN/CAPA Test Blueprint
Domain: Physiological Needs
Content Area: Stability of the respiratory system.
Reference: American Heart Association, PALS Provider Manual. 2016. Pg 37.
Question of the Week
January 22, 2020
The perianesthesia nurse recognizes that upon a patient’s arrival to the PACU, a side effect of ketamine anesthesia is:
- decreased muscle tone.
- hypotension.
- marked salivation.
- nausea and vomiting.
CPAN/CAPA Test Blueprint
Domain: Physiological Needs
Content Area: Physiological comfort (including, but not limited to, relief from pain, shivering, nausea, vomiting, temperature control and appropriate positioning.
Reference: ASPAN. 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. Pp 216, 364-366.
Question of the Week
January 08, 2020
By asking a tympanoplasty patient to wrinkle the forehead, pucker lips, smile, and squeeze eyelids together, the PACU nurse is assessing the function of cranial nerve:
- V.
- VII.
- IX.
- XII.
CPAN/CAPA Test Blueprint
Domain: Physiological Needs
Content Area: Stability of neurological system
Reference: Schick, L., & Windle, P. (2015). ASPAN Perianesthesia Nursing Core Curriculum: Preprocedure, phase I and phase II, PACU nursing (3rd ed.). Elsevier.
Question of the Week
December 18, 2019
During emergence from general anesthesia, a patient exhibits rapidly increasing symptoms of asthma. Vital signs are: BP = 190/100, HR = 144, R = 36, and SaO2 = 86%. The perianesthesia nurse anticipates giving which of the following medications initially?
- Dexamethasone
- Nebulized epinephrine
- Nebulized albuterol
- Isoproterenol
CPAN/CAPA Test Blueprint
Domain: Physiological Needs
Content Area: Appropriate medication regimen (including, but not limited to, minimal interruption of normal medication regimen and preemptive interventions)
Reference: Hodgson, K. and Kizior, R. (2017). Saunders Nursing Drug Handbook 2017. Elsevier.
Question of the Week
December 11, 2019
A patient receives an intraoperative prophylactic dose of droperidol. The PACU nurse is aware that this drug has a potentiating action when administered:
- with narcotics and barbiturates.
- with nonsteroidal anti-inflammatory drugs.
- to a patient with increased ICP.
- to a hypertensive patient.
CPAN/CAPA Test Blueprint
Domain: Physiological Needs
Content Area: Stability of the hematologic and immune systems
Reference: Drain, C. and Odom-Forren, J. (2018). Drain’s PeriAnesthesia Nursing: A critical care approach (7th ed.). Elsevier.
Question of the Week
November 06, 2019
In a patient status post thyroidectomy, the perianesthesia nurse would anticipate postoperative signs of thyrotoxic crisis to include:
- hyponatremia.
- hypothermia.
- tachycardia.
- bradycardia.
CPAN/CAPA Test Blueprint
Domain: Physiological Needs
Content Area: Stability of the endocrine system
Reference: Drain, C. and Odom-Forren, J. (2018). Drain’s PeriAnesthesia Nursing: A critical care approach (7th ed.). Elsevier.
Question of the Week
October 30, 2019
During a preoperative telephone interview, a 52-year-old patient states that he has been hospitalized twice in the past year for management of insulin-dependent diabetes mellitus. The ASA status of this patient is:
- Class I.
- Class II.
- Class III.
- Class IV.
CPAN/CAPA Test Blueprint
Domain: Physiological Needs
Content Area: Stability of the Respiratory system
Reference: Schick, L., & Windle, P. (2015). ASPAN Perianesthesia Nursing Core Curriculum: Preprocedure, phase I and phase II, PACU nursing (3rd ed.). Elsevier.
Question of the Week
October 23, 2019
Which of the following nursing interventions is most effective for a patient with a history of postoperative nausea and vomiting?
- Providing ice chips
- Administering ranitidine
- Prevention
- Avoiding administration of analgesics
CPAN/CAPA Test Blueprint
Domain: Physiological Needs
Content Area: Stability of the gastrointestinal system
Reference: Urden, L., Stacy, K., & Lough, M. (2017). Critical Care Nursing: Diagnosis and management (8th ed.). Elsevier.
Question of the Week
September 18, 2019
Preoperative instructions for oral fluid restriction for patients with no risk factors include NPO for clear liquids prior to surgery because emptying occurs within:
- 30 minutes.
- 1 hour.
- 90 minutes.
- 2 hours.
CPAN/CAPA Test Blueprint
Domain: Physiological Needs
Content Area: Stability of the gastrointestinal system
Reference: Schick, L., & Windle, P. (2015). ASPAN Perianesthesia Nursing Core Curriculum: Preprocedure, phase I and phase II, PACU nursing (3rd ed.). Elsevier.
Question of the Week
September 11, 2019
A patient in the PACU following hip arthroplasty complains of numbness to toes of affected extremity. The patient has most likely sustained an injury to the:
- peroneal nerve.
- femoral artery.
- Achilles tendon.
- sciatic nerve.
CPAN/CAPA Test Blueprint
Domain: Physiological Needs
Content Area: Stability of neurological system
Reference: Schick, L., & Windle, P. (2015). ASPAN Perianesthesia Nursing Core Curriculum: Preprocedure, phase I and phase II, PACU nursing (3rd ed.). Elsevier.
Question of the Week
September 04, 2019
According to ACLS guidelines, the dosage of drugs administered via the endotracheal tube route is:
- half the normal IV dose.
- one time the normal IV dose.
- two times the normal IV dose.
- three times the normal IV dose.
CPAN/CAPA Test Blueprint
Domain: Physiological Needs
Content Area: Stability of the fluid and electrolyte levels
Reference: American Heart Association. (2016). Advanced Cardiovascular Life Support (ACLS) Provider Manual. AMA.
Question of the Week
July 31, 2019
A potential negative side effect of positive end-expiratory pressure (PEEP) is:
- alveolar collapse.
- decreased intrapulmonary shunting.
- increased cardiac output.
- hypertension.
CPAN/CAPA Test Blueprint
Domain: Physiological Needs
Content Area: Stability of cardiovascular and peripheral vascular systems
Reference: Urden, L., Stacy, K., & Lough, M. (2017). Critical Care Nursing: Diagnosis and management (8th ed.). Elsevier.
Question of the Week
July 24, 2019
Which of the following is an indicator of readiness for extubation in a post anesthesia patient weighing 60 kg?
- Respiratory rate of 30 breaths per minute
- Tidal volume of 300 ml and a vital capacity of 900 ml
- Ability to open eyes and move extremities on command
- Ability to sustain a head lift for 3 seconds
CPAN/CAPA Test Blueprint
Domain: Physiological Needs
Content Area: Stability of the Respiratory system
Reference: Schick, L., & Windle, P. (2015). ASPAN Perianesthesia Nursing Core Curriculum: Preprocedure, phase I and phase II, PACU nursing (3rd ed.). Elsevier.
Question of the Week
July 17, 2019
A patient complains of dyspnea and chest pain after the insertion of a central-line catheter. The patient’s breath sounds are diminished. After physician notification, the priority nursing action is to:
- prepare for the insertion of a chest tube.
- obtain an order for analgesic.
- apply a positive-pressure airway ventilator.
- prepare for immediate removal of the central line.
CPAN/CAPA Test Blueprint
Domain: Physiological Needs
Content Area: Stability of respiratory system
Reference: Urden, L., Stacy, K., & Lough, M. (2017). Critical Care Nursing: Diagnosis and management (8th ed.). Elsevier.
Question of the Week
July 10, 2019
The perianesthesia nurse is aware that a dramatic decrease in the serum calcium level may be caused by removal of the:
- parathyroid glands.
- pineal gland.
- adrenal glands.
- pituitary gland.
CPAN/CAPA Test Blueprint
Domain: Physiological Needs
Content Area: Stability of the endocrine system
Reference: Odom-Forren, J. Drain’s PeriAnesthesia Nursing: A Critical Care Approach. 6th Ed. Elsevier Saunders, 2013. Pg 579.
Question of the Week
July 03, 2019
The dissociative state attributed to ketamine anesthesia can be modified by the administration of a/an:
- antiarrhythmic.
- benzodiazepine.
- antagonist.
- anticonvulsant.
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: ASPAN. 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, page 365-6.