CPAN FINAL EXAM NEWEST 2024 ACTUAL EXAM COMPLETE 200 QUESTIONS AND CORRECT DETAILED ANSWER, Exams of Nursing

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CPAN FINAL EXAM NEWEST 2024 ACTUAL EXAM

COMPLETE 200 QUESTIONS AND CORRECT

DETAILED ANSWERS (VERIFIED ANSWERS)

When educating the client on what to expect during the administration of spinal anesthesia, the perianesthesia nurse understands that the progression of blockage occurs in the following order:

1. sensory, motor, autonomic
2. motor, sensory, autonomic
3. autonomic, sensory, motor
4. motor, autonomic, sensory - ANSWER> 3 After extubation of a client, which of the following would be considered most serious?
5. Sore throat
6. Impaired swallowing ability
7. Inspiratory stridor
8. Hoarseness - ANSWER> 3 Which of the following interventions would be used first to maintain adequate perfusion and oxygen supply to cardiac muscles following hepatic surgery in a client with a history of coronary artery disease:
9. Ensure a hemoglobin concentration ≥ 10 g.
10. Treat tachydysrhythmias and hypotension.
11. Monitor oxygen saturation via pulse oximetry.
12. Administer appropriate medications. - ANSWER> 1 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 client:
13. has had minor surgery.
14. has normal vital signs.
15. has had regional anesthesia.
16. is severely hypothermic. - ANSWER> 4

The perianesthesia nurse is aware that a dramatic decrease in the calcium may be cause by removal of the:

1. pituitary gland.
2. thyroid gland.
3. parathyroid gland.
4. adrenal glands. - ANSWER> 3 Tidal volume is most precisely defined as the amount of:
5. air exchange in one minute.
6. gas passing into or out of the lungs in each respiratory cycle.
7. gas remaining within the chest after maximal expiration.
8. air exchange with full inspiration and expiration. - ANSWER> 2

In administering flumazenil, the perianesthesia nurse is aware that it inhibits the central effects of benzodiazepines by:

1. competing for the receptor sites.
2. stimulating the cerebral cortex.
3. occupying the mu receptor sites.
4. metabolizing the medications. - ANSWER> 1 A pathological process that can interfere with accurate measurements of SpO2 when using a pulse oximeter is:
5. Cushing's disease.
6. hypoparathyroidism.
7. Raynaud's disease.
8. hyperthyroidism. - ANSWER> 3 In the event that a pharmacologically paralyzed client is inadvertently extubated, the first priority of the PACU nurse is to:
9. administer a muscarinic anticholinergic drug immediately.
10. establish and maintain the airway and ventilation.
11. administer an anticholinesterase drug immediately.
12. assess for muscle recovery before reintubating. - ANSWER> 2 In caring for a preschool-aged child, the perianesthesia nurse is aware that the child's primary cause of anxiety prior to surgery is:
13. fear of the medical equipment.
14. striving for approval.
15. loss of privacy.
16. separation from parents. - ANSWER> 4 One of the most frequent side effects of ketamine anesthesia is:
17. hallucination.
18. respiratory depression.
19. hypotension.
20. bradycardia. - ANSWER> 1 In providing preoperative teaching to a client requesting spinal anesthesia, the perianesthesia nurse is aware that an absolute contraindication for spinal anesthesia is:

1. client refusal.
2. chronic back pain.
3. multiple sclerosis.
4. sickle cell anemia. - ANSWER> 1

A PACU nurse identifies an increased number of postoperative infections and utilizes a quality improvement tool to collect more data. When deficiencies are noted in the Phase I area, the nurse next considers:

1. developing a poster board on commonly used antibiotics.
2. presenting staf f with an in-service on infection control.
3. apprising the infectious disease service of the occurrences.
4. notifying the OR clinical specialist. - ANSWER> 2 A staf f nurse denied a merit increase expresses vigorous support for management and its policies instead of showing anger. The nurse's behavior is characterized as:
5. identification.
6. reaction formation.
7. sublimation.

4. rationalization. - ANSWER> 2 A standard of practice for post anesthesia nursing is established by which acceptable levels of nursing action?
5. Promoting independent nursing judgment
6. Specifying the nursing goal while defining appropriate nursing measures
7. Identifying the nursing actions that meet JCAHO criteria
8. Prescribing the nursing intervention relative to standing orders - ANSWER> 2 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:
9. removing the pacifier.
10. pinching the cheeks.
11. turning him on his back.
12. jaw thrust or chin lift - ANSWER> 4 A post-op client awaiting transport to a surgical floor is awake and responds appropriately to commands. The perioperative nurse instructs the client to flex and extend his/ her lower extremities; the purpose of this is to:

1. ensure that the client follows commands.
2. prevent the complication of venous stasis.
3. accelerate emergence from anesthesia.
4. assess if client is ready for discharge. - ANSWER> 2 A geriatric client's advanced age puts them at an increased risk for post- operative:
5. anorexia.
6. hypothermia.
7. nausea.
8. pain. - ANSWER> 2 During emergence from general anesthesia, a client 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?
9. Dexamethasone
10. Nebulized epinephrine
11. Nebulized albuterol
12. Isoproterenol - ANSWER> 3 A PACU education/research committee should have three commitments, which must include all of the following except:
13. development of innovative thinking.
14. freedom of inquiry.
15. individual progress of each nurse.
16. excellence in practice. - ANSWER> 3 The dissociative state attributed to ketamine anesthesia can be modified by the administration of a/an:
17. antiarrhythmic.
18. benzodiazepine.
19. narcotic.
20. anticonvulsant. - ANSWER> 2

A client with streptococcal group A pharyngitis arrives in Phase I PACU. The perianesthesia nurse plans that the nurse to client

ratio should be:

1. two nurses to one client.
2. one nurse to two clients.
3. one nurse to one client.
4. one nurse to three clients. - ANSWER> 3 A 35-year-old client arrives in the Phase I PACU crying and repeatedly asks, "Can't my mother come in here with me?" The perianesthesia nurse:
5. informs the client that visitation is prohibited in the PACU.
6. reassures the client and administers an analgesic.
7. allows a brief visit at a time appropriate for client, visitors, and staff.
8. sedates the client secondary to postanesthetic confusion. - ANSWER> 3

In a client status post thyroidectomy, the perianesthesia nurse would anticipate postoperative signs of thyrotoxic crisis to include:

1. hyponatremia.
2. hypothermia.
3. tachycardia.
4. bradycardia. - ANSWER> 3 Which of the following nursing interventions is most effective for a client with a history of postoperative nausea and vomiting?
5. Providing ice chips
6. Administering ranitidine
7. Prevention
8. Avoiding administration of analgesics - ANSWER> 3 A perianesthesia nurse is providing discharge instructions to a client who asks questions about the phenazopyridine prescription. The nurse explains that it:
9. needs to be taken on an empty stomach.
10. provides relief from urgency and burning sensation.
11. helps minimize bleeding and formation of blood clots.
12. treats bacteria present in the urinary tract. - ANSWER> 2 A client in the PACU following hip arthroplasty complains of numbness to toes of affected extremity. The client has most likely sustained an injury to the:
13. peroneal nerve.
14. femoral artery.
15. Achilles tendon.
16. sciatic nerve. - ANSWER> 1 Surgery is scheduled for 0830. The client reports drinking 6 ounces of water at 0600 with medications. Following American Society of Anesthesiologists (ASA) minimum fasting guidelines for n.p.o., the perianesthesia nurse:

1. continues with the preoperative check-in process.
2. medicates the client for nausea.
3. informs the client that the case may be cancelled.
4. notifies the surgeon. - ANSWER> 1 A client who speaks limited English is preparing for gallbladder surgery. The perianesthesia nurse is aware that the appropriate interpreter to utilize for this client is:
5. an interpreter who is married to the client's sister.
6. an interpreter who has a contract with the facility.
7. the client's English-speaking husband.
8. the client's bilingual significant other. - ANSWER> 2 A potential negative side effect of positive end-expiratory pressure (PEEP) is:
9. alveolar collapse.
10. decreased intrapulmonary shunting.
11. increased cardiac output.
12. hypertension. - ANSWER> 2 A client complains of dyspnea and chest pain after the insertion of a central-line catheter. The client's breath sounds are diminished. After physician notification, the priority nursing action is to:
13. prepare for the insertion of a chest tube.
14. obtain an order for analgesic.
15. apply a positive-pressure airway ventilator.
16. prepare for immediate removal of the central line. - ANSWER> 1 The dissociative state attributed to ketamine anesthesia can be modified by the administration of a/an:
17. antiarrhythmic.
18. benzodiazepine.
19. antagonist.
20. anticonvulsant. - ANSWER> 2 Care for a client who receives a skin graft to the forearmincludes:

1. maintain dependent position of the extremity.
2. changing the bandages if necessary.
3. elevation of the affected extremity.
4. ROM exercises for the affected extremity. - ANSWER> 3 The perianesthesia nurse learns that the client takes MAO inhibitor routinely. This information is documented because of the potential lethal interaction with:
5. meperidine.
6. midazolam.
7. succinylcholine.
8. morphine. - ANSWER> 1 Use of meperidine with an MAOI can lead to hypertension, convulsions, and coma. Prochlorperazine acts to treat postoperative nausea by affecting the:
9. process of gastric emptying.
10. chemoreceptor trigger zone.
11. production of gastric acid.
12. vestibular pathways. - ANSWER> 2 In a 3-year-old client, postintubation croup is least likely to develop when the client has:
13. remained in a supine position for a 1 - hour procedure.
14. been in a supine position for 15 minutes, then in a lateral position for 45 minutes.
15. coughed actively and strained prior to extubation.
16. required two attempts prior to successful intubation. - ANSWER> 1 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:
17. removing the pacifier.
18. pinching the cheeks.

3. turning him on his back.
4. hyperextending the jaw. - ANSWER> 2 The perianesthesia nurse should question the accuracy ofthe SpO2 measurement when caring for a client with which of the underlying condition?
5. Cushing's disease.
6. hypothyroidism.
7. Raynaud's disease.
8. hyperthyroidism. - ANSWER> 3 Signs and symptoms of Raynaud's disease include: Cold fingers or toes. Color changes in your skin in response to cold or stress. Numb, prickly feeling or stinging pain upon warming or stress relief. A client 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 client be placed?
9. Right lateral tilt position
10. Left lateral tilt position
11. Supine
12. Trendelenburg - ANSWER> 2 Because your liver is on the right side of your abdomen, lying on your left side helps keep the uterus of f that large organ. Sleeping on the left side also improves circulation to the heart and allows for the best blood flow to the fetus, uterus, and kidneys. When preparing a client for a brachial plexus nerve block for upper extremity surgery, the perianesthesia nurse is aware that the safest and easiest approach is:
13. subclavicular.
14. supraclavicular.
15. interscalene.
16. axillary. - ANSWER> 4

The axillary approach to the brachial plexus is considered the safest of the four approaches because of reduced risk to surrounding structures such as the risk of phrenic nerve blockade and/or pneumothorax, but the general risks of accidental intravascular and intraneural injection still exists. To decrease nausea, the perianesthesia nurse instructs the client to:

1. take deep breaths.
2. take several quick breaths.
3. turn their head to the side.
4. utilize Reiki or imagery. - ANSWER> 1 The perianesthesia nurse would expect a client with COPD tohave received which of the following anesthetic agents?
5. Isoflurane
6. Nitrous oxide
7. Enflurane
8. Halothane - ANSWER>4. Halothane also has excellent bronchodilatory properties and remains an acceptable alternative for induction Isoflurane - Isoflurane is a good bronchodilator, but it is not ideal for induction of anesthesia since it is more pungent than sevoflurane and halothane and has a slower onset than sevoflurane. Sevoflurane - We prefer sevoflurane for inhalation induction since it has the most pronounced bronchodilatory properties of the available agents. Desflurane - We avoid desflurane during induction of anesthesia in clients with COPD. Because of its extreme pungency, desflurane may increase secretions and cause coughing, laryngospasm, and/or bronchospasm during induction, particularly in current smokers, and it may increase airway resistance. In a preoperative visit, information to be collected by the perianesthesia nurse includes:

1. type of surgery to be performed, previous surgical history and verification of payment source.
2. cardiac status, vaccination status, respiratory status, and location of client's family postoperatively.
3. surgical procedure, whether the client has signed the consent form, and type of anesthesia to be used.
4. preexisting diseases, laboratory values, neurological status, current medications, and allergies. - ANSWER> 4 A client calls the preoperative center asking whether to continue taking his daily dose of clonidine. The perianesthesia nurse is aware that clonidine should be:
5. taken only if the surgeon deems it necessary.
6. stopped at least 3 days preoperatively.
7. stopped at least 5 days preoperatively.
8. taken daily as prescribed. - ANSWER> 4 Six hours postoperatively, a client has not voided and his bladder is palpably distended. The client refuses catheterization.If the nurse catheterizes the client against his wishes, this is considered:
9. tort.
10. assault.
11. malpractice.
12. battery. - ANSWER> 4 A preoperative client is admitted to the holding area prior to joint surgery. The client 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:
13. within 60 minutes of incision time.
14. prior to induction.
15. prior to leaving the holding area.
16. upon arrival to the facility. - ANSWER> 1 The perianesthesia nurse is aware that a dramatic decrease in the serum calcium level may be caused by removal of the:

1. parathyroid glands.
2. pineal gland.
3. adrenal glands.
4. pituitary gland. - ANSWER> 1 The perianesthesia nurse recognizes that upon a client's arrivalto the PACU, a side effect of ketamine anesthesia is:
5. decreased muscle tone.
6. hypotension.
7. marked salivation.
8. nausea and vomiting. - ANSWER> 3 increased salivation due to stimulation of muscarinic receptors (can be contolled using an antimuscarinic) Other Side Effects: catatonia amnesia deficits in working and episodic memory (associated with frequent use) analgesia elevated heart rate, cardiac output & blood pressure post-op disorientation sensory & perceptual illusions vivid dreams ulcerative cystitis (associated with chronic drug use) Contraindications: By asking a tympanoplasty client to wrinkle the forehead, pucker lips, smile, and squeeze eyelids together, the PACU nurse is assessing the function of cranial nerve:
9. V.
10. VII.
11. IX.
12. XII. - ANSWER> 2 The Faces Pain Rating Scale measurement tool is most appropriate for:

1. a 2 - year-old toddler.
2. an 8 - year-old child.
3. a 15 year-old child.
4. an infant. - ANSWER> 2 A client receives an intraoperative prophylactic dose of droperidol. The PACU nurse is aware that this drug has a potentiating action when administered:
5. with narcotics and barbiturates.
6. with nonsteroidal anti-inflammatory drugs.
7. to a client with increased ICP.
8. to a hypertensive client. - ANSWER> 1 The perianesthesia nurse should utilize which of the following screening tools to identify clients at risk for obstructive sleep apnea?
9. STOP-Bang Questionnaire
10. Aldrete Scoring Tool
11. Ramsey Sedation Scale
12. Pasero Opioid Induced Sedation Scale - ANSWER> 1 YES/NO questions to the following: Snoring ?Do you Snore Loudly (loud enough to be heard through closed doors or your bed-partner elbows you for snoring at night)? Tired ?Do you often feel Tired, Fatigued, or Sleepy during the daytime (such as falling asleep during driving or talking to someone)? Observed ?Has anyone Observed you Stop Breathing or Choking/Gasping during your sleep? Pressure ?Do you have or are being treated for High Blood Pressure? Body Mass Index more than 35 kg/m 2? Age older than 50?

Neck size large? (Measured around Adams apple)Is your shirt collar 16 inches / 40cm or larger? Gender = Male? The perianesthesia nurse receives a call inquiring about a client who is in surgery. The perianesthesia nurse's initial action is to:

1. transfer the call to the O.R. desk.
2. advise to call back later.
3. provide the information.
4. inform the family of the call. - ANSWER> 4 During a preoperative telephone interview, a 52-year-old client states that he has been hospitalized twice in the past year for management of insulin- dependent diabetes mellitus. The ASA status of this client is:
5. Class I.
6. Class II.
7. Class III.
8. Class IV. - ANSWER>3. ASA 1: A normal healthy client. ASA 2: A client with a mild systemic disease. ASA 3: A client with a severe systemic disease that is not life- threatening. ASA 4: A client with a severe systemic disease that is a constant threat to life. ASA 5: A moribund client who is not expected to survive without the operation. The client is not expected to survive beyond the next 24 hours without surgery. ASA 6: A brain-dead client whose organs are being removed with the intention of transplanting them into another client. During a preoperative interview a client admits to being allergic to avocados. The nurse is aware that this client may be at risk for an allergic reaction to:
9. propofol.
10. midazolam.
11. latex.

4. gluten. - ANSWER> 3 Around half of all people with latex allergy have allergic reactions when eating particular foods, including avocado, banana, chestnut, kiwifruit, passionfruit, plum, strawberry and tomato. This is because some of the proteins in latex that cause latex allergy are also present in these fruits. Client information about what to expect following a spinal anesthetic includes:
5. remaining flat for 12 hours afterwards.
6. anticipating a headache as a common complication.
7. a loss of sensation of temperature in the legs.
8. pain control for 12 hours. - ANSWER> 3 Preoperative instructions for oral fluid restriction for clients with no risk factors include NPO for clear liquids prior to surgery because emptying occurs within:
9. 30 minutes.
10. 1 hour.
11. 90 minutes.
12. 2 hours. - ANSWER> 4 According to ACLS guidelines, the dosage of drugs administered via the endotracheal tube route is:
13. half the normal IV dose.
14. one time the normal IV dose.
15. two times the normal IV dose.
16. three times the normal IV dose. - ANSWER> 3 Which of the following places the client at the highest risk of postoperative nausea and vomiting (PONV)?
17. Type of surgery.
18. Smoking status.
19. Duration of surgery.
20. Female gender. - ANSWER> 4

Anxious parents are at the bedside of a toddler who is crying, kicking, and thrashing following bilateral myringotomy with insertion of tympanostomy. The perianesthesia nurse informs the parents that this behavior is:

1. the emergence excitement phase after anesthesia.
2. a temper tantrum often seen in toddlers.
3. associated with the surgical procedure.
4. uncommon in children of this age. - ANSWER> 1 Which of the following is an indicator of readiness for extubation in a post anesthesia client weighing 60 kg?
5. Respiratory rate of 30 breaths per minute
6. Tidal volume of 300 ml and a vital capacity of 900 ml
7. Ability to open eyes and move extremities on command
8. Ability to sustain a head lift for 3 seconds - ANSWER> 3 Characteristics of Sevoflurane include all of the following except:
9. Sweet smelling, good for induction
10. Lowers ICP
11. Useful in ambulatory settings
12. Less airway irritation than other inhalation agents - ANSWER> 2 Characteristics of Nitrous Oxide include all of the following except:
13. Depress CNS
14. Non-irritating to the respiratory system
15. Can be mixed with room air
16. Minimal cardiovascular effects - ANSWER> 3 The primary process of elimination for inhalation agents is:
17. Hepatic
18. Renal
19. Pulmonary
20. Fat cells - ANSWER> 3 The stage of anesthesia during which their client is at most risk to harm themselves is:

1. Stage I
2. Stage II
3. Stage III
4. Stage IV - ANSWER> 2 Pharmacokinetic properties of inhalation agents include all except:
5. Cardiac output
6. Age
7. Blood solubility
8. Gender - ANSWER> 4 Pharmacokinetics: factors that affect how the drug is distributed in the body Recovery and emergence are dependent upon:
9. The duration of anesthesia
10. Use of additional medications
11. Physical status of the client
12. All of the above - ANSWER> 4 Nursing Considerations in caring for the client receivinginhalation agents include:
13. Depression of laryngeal and pharyngeal reflexes
14. Dysrhythmic effects
15. Analgesic requirements
16. All of the above - ANSWER> 4 Postoperative shivering due to intraoperative vasodilation is a consideration with:
17. Halothane
18. Desflurane
19. Isoflurane
20. Enflurance
21. All of the above - ANSWER> 5 Seizure activity may be enhanced by the administration of:

1. Enflurane
2. Nitrous oxide
3. Sevoflurane
4. Halothane - ANSWER> 1 In normal neuromuscular transmission, the enzyme/neurotransmitter released at the neuromuscular junction resulting in depolarization is:
5. Acetylcholinesterase
6. Pseudocholinesterase
7. Acetylcholine
8. Plasma cholinesterase - ANSWER> 3 Succinylcholine is:
9. Reversed by neostigmine
10. Reversed by edrophonium
11. A non-depolarize game neuromuscular blocker
12. Metabolized by plasma cholesterase - ANSWER> 4 There is no reversal for succinylcholine A short-acting non-depolarizing muscle relaxant is:
13. Pancuronium
14. Doxacurium
15. Rocuronium
16. Atracurium - ANSWER> 4 Malignant Hyperthermia (MH) may be triggered by which agent?
17. Pancuronium
18. Succinylcholine
19. Fentanyl
20. Sodium pentothal - ANSWER> 2 Which of the following anesthetic agent is safe inhalation for use in MH susceptible clients?

1. Desflurance
2. Isoflurane
3. Halothane
4. Nitrous Oxide - ANSWER> 4 All other are volatile agents Initial dosing with dantrolene is:
5. 1mg/kg
6. 10mg/kg
7. 2.5mg/kg
8. 25mg/kg - ANSWER> 3 MH deaths may be prevented with:
9. Proper preoperative screening
10. Education and preparation
11. Identification of individuals at risk
12. All of the above - ANSWER> 4 Which of the following can mimic MH (select all that apply)?
13. Thyroid storm
14. Myasthenia Gravis
15. Horner' season syndrome
16. Sepsis
17. Cocaine overdose - ANSWER>1, 4, 5 Tachycardia, fever Increased end-tidal CO2 and tachycardia are early indications of an MH crisis.
18. True
19. False - ANSWER> 1 MH is a hypermetabolic state MH only occurs in the operating room.

1. True
2. False - ANSWER> 2 MH can happen anytime Must monitor client 1 hours in PACU/Phase I and additional 1 hours in phase II Given that MH is a high-risk, low frequency event, perianesthesia nurse should take advantage of several methods available for ongoing competency training. MHAUS recommends:
3. Contacting MH hotline consultants for training support
4. Completing a monthly MH quiz
5. Reviewing case scenarios
6. Conducting mock MH drills - ANSWER> 4 During the perianesthesia nurse is performing an assessment, the nurse knows that MH is an inherited disorder that affects:
7. Homeostatic thermoregulation
8. The baroreceptors of the heart
9. Muscle metabolism
10. Cardiopulmonary gas exchange - ANSWER> 3 MHAUS recommends core temp monitoring for all clients undergoing general anesthesia lasting more than minutes.
11. 120
12. 90
13. 30
14. 60 - ANSWER> 3 A client with know susceptibility to MH has just undergone a surgical procedure suing "safe" anesthesics. The client should be monitored in the Phase I PACU for at least:
15. until discharge criteria is met
16. 60 minutes
17. 30 minutes

4. 90 minutes - ANSWER> 2 A client with know susceptibility to MH has just undergone a surgical procedure suing "safe" anesthesics. The client should be monitored in the Phase II PACU for at least:
5. 1 - 1.5 hours
6. 3 - 3.5 hours
7. 2 - 2.5 hours
8. Until Phase II discharge criteria is met - ANSWER> 1 Rhabdomyolysis is an indication of:
9. Hyperthermia
10. Carbon dioxide
11. Hyperkalemia
12. Release of dead muscle fibers into the bloodstream - ANSWER> 4 Although a MH event can be triggered at the first exposure of a client to anesthesia, the average client will demonstrate the first signs of MH after anesthetics4
13. 2
14. 4
15. 5
16. 3 - ANSWER> 4 3 states with high incidents of MH are:
17. Alaska, Hawaii, and Oregon
18. Florida, Mississippi, and Louisiana
19. Wisconsin, Michigan, and West Virginia
20. Main, Massachusetts, and Rhode Island - ANSWER> 3 Signs that a MH crisis is resolving include declining ETCO2, declining temp, and:
21. Decreasing HR
22. Spontaneous return of circulation
23. Increasing HR

4. Spontaneous return of ventilation - ANSWER> 1 The goals of therapy for client experiencing MH include prompt administration and dantrolene, treatment of hyperkalemia, rapid cooling, and:
5. Rapid extubation
6. Initiation of cardiopulmonary bypass
7. Hyperventilation
8. Treatment of hyperglycemia - ANSWER> 3 MH cart must be availble wherever anesthesia is administered. Kits store in the cart include all of the following except:
9. Transducer kits for arterial cannulation
10. Central venous pressure sets
11. Esophageal or core temp monitoring kit
12. Lumbar puncture kit - ANSWER> 4 Agents known to be safely administered to clients with MH susceptibility include:
13. Propofol
14. Desflurane
15. Isoflurane
16. Sevoflurane - ANSWER> 1 Dantrolene belongs to the drug class:
17. Antipyretic
18. Nucleoside reverse transcriptase inhibitor
19. Antihypercaonia agent
20. Skeletal muscle relaxant - ANSWER> 4 A 24y/o adopted male client engaged to be married in the fall has been told that he is at risk for MH. He is anxious about the possibility of passing on this susceptibility to any offspring. The nurse interviewing this client knows that the most definitive test for MH is:
21. Serial serum studies

2. Thermoregulation challenge test
3. Caffeine-halothane contracture test
4. Genetic testing - ANSWER> 3 Dantrolene sodium require dilution. The most appropriate diluent is:
5. Sterile water with a bacteriostatic agent
6. Sterile saline with a bacteriostatic agent
7. Sterile saline without a bacteriostatic agent
8. Sterile water without a bacteriostatic agent - ANSWER> 4 Common signs of MH that follow an increase in ETCO2 include tachycardia, tachypnea, and:
9. Muscle spasm
10. Complete pharyngeal relaxation
11. Sudden drop in ETCO2
12. Piloerection - ANSWER> 1 Complications after an acute MH crisis include:
13. Acute hepatic failure
14. Acute renal failure
15. Permanent muscle contractures
16. Cardiomyopathy - ANSWER> 2 Temperature elevation associated with MH:
17. Occurs after the client is brought to the Phase I PACU
18. Often occurs immediately
19. Occurs before a rise un ETCO2 but after masseter spasms
20. Occurs as a late sign of MH event - ANSWER> 4 Adverse effects of dantrolene include transient muscle weakness, GI upset, ventilatory compromise and:
21. Phlebitis
22. Oliguria
23. Hyperactivity
24. Polycythemia - ANSWER> 1