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CPAN TEST
Following inhalation anesthesia, a pt should be monitored for hypothermia or hyperthermia. The PACU nurse is aware the regulation of temperature is disrupted because of: A. depressant effect on the hypothalamus B. stimulating effect on the cerebral cortex C. depressant effect on the cerebral cortex D. stimulating effect on the hypothalamus - ANSWERS-A. depressant effect on the hypothalamus During spinal and epidural anesthesia the pt's body temperature control mechanisms are: A. not effected B. impaired in a way that promotes temperature fluctuation C. impaired in a way that promotes hyperthermia D. impaired in a way that promotes hypothermia - ANSWERS-D. impaired in a way that promotes hypothermia The anesthetist indicates in the post operative report that the pt was reversed with edrophonium and atropine. The reason for administering atropine is: A. decreases the likelihood of vomiting B. promotes acetylcholine release C. enhance the onset of neuromuscular reversal
D. minimize muscarinic stimulation - ANSWERS-D. minimize muscarinic stimulation It is important for the perianesthesia nurse to understand that a child's ability to classify and estimate pain normally develops around the age of: A. 4 - 5 years old B. 7 - 8 years old C. 10 - 11 years old D. 13 - 14 years old - ANSWERS-A. 4 - 5 years old The pt displays an understanding of the most effective way of preventing infection by hands that are not visibly soiled in stating that: A. non latex gloves must be used B. hands must be washed with soap and water C. fingernails must be free of nail polish D. an alcohol based gel must be used - ANSWERS-D. an alcohol based gel must be used A patient arrives in the PACU AAO, but with difficulty breathing. They received single dose succinylcholine in the OR.Recovery would be expected in how many minutes? A. 15 B. 20 C. 35.
D. Lateral on the unoperated side - ANSWERS-D. Lateral on the unoperated side When caring for a diabetic patient, the major objective of the perianesthesia nurse is to prevent: A. Fluid volume excess B. fluid volume deficit C. Hyperglycemia D. Hypoglycemia - ANSWERS-D. Hypoglycemia A pt. is admitted to the PACU after receiving anesthesia. The pt. is tachypneic, has muscle rigidity, tachycardia and dysrhythmia. The perianesthesia nurse suspects: A. neuroleptic malignant syndrome B. post operative hemorrhage C. hypoxic brain damage D. malignant hyperthermia - ANSWERS-D. malignant hyperthermia The pt. arrives in the PACU post stapedectomy, complaining vertigo. The perianesthesia nurse notes that the pt.has packing retained within the ear. The perianesthesia nurse: A. does not disturb the packing B. adviseds the pt to cough C. advises the pt to blow nose D. removes the packing - ANSWERS-A. does not disturb the packing
A 70 year old pt is admitted following moderate IV sedation with morphine and midazolam. The pits unresponsive and the skin is cool and diaphoretic.VS are 95/60, 50, RR 8 and SpO2 88%on RA. Following O2 administration, no improvement is noted. The nurse anticipates administering: A. atropine 0.5mg to 1.0mg B. naloxone 0.1mg to 0.2mg C. naloxone 0.6mg to 2.0mg D. atropine 1.5mg to 2.0mg - ANSWERS-B. naloxone 0.1mg to 0.2mg Following a rhytidectomy, one of the earliest indications of complications is: A. severe unilateral pain B. ptosis with periorbital edema C. a positive Chvostek's sign D. discoloration of facial tissue - ANSWERS-A. severe unilateral pain What risk factors woulda let the perianesthesia nurse of a patients decreased chance of PONV? A. Use of opioids, length of procedure B. Female, non smoker, use of opioids C. Male smoker, history of motion sickness D. Female hypertension, history of PONV - ANSWERS-B. Female, non smoker, use of opioids
The perianesthesia nurse tells the pt. that their planned surgical procedure is an unwise choice of treatment. The is in violation of the patient's: A. autonomy B. advocacy C. justice D. beneficence - ANSWERS-A. autonomy When caring for a pt., the perianesthesia nurse fails to give his/her name to the pt. The nurse is violating which of the following : A. Nurse Practice Act B. Clinical Practice Guidelines C. Patient's Bill of Rights D. Joint Commission Policy - ANSWERS-C. Patient's Bill of Rights Pain management for a postoperative pt. with a former history of heroin abuse should include: A. butorphanol B. naloxone C. morphine D. ketamine - ANSWERS-A. butorphanol A perianesthesia nurse in phase I PACU, may care for which of the following patients?
A. One unconscious adult, stable with artificial airway & one conscious stable, free of complications B. One unconscious pt., hemodynamically stable with a stable airway, over the age of 8 , and one conscious pt. C. Two unconscious, stable 5 & 8 yrs. of age D. One pt. on mechanical life support and one stable pt. - ANSWERS- B. One unconscious pt., hemodynamically stable with a stable airway, over the age of 8 , and one conscious pt. The most common allegation of medical malpractice claims occurring in the PACU is failure to: A. obtain adequate orders B. provide discharge teaching C. monitor the pts. psychological status D. document appropriately - ANSWERS-C. monitor the pts. psychological status The patient has been given ketamine as part of the anesthesia regimen. The perianesthesia nurse recognizes that caring for them includes: A. immediate implementation of a stir - up regimen B avoiding early tactile and verbal stimulation C. avoiding the use of benzodiazepines D. obtaining an order for restraints PRN - ANSWERS-B avoiding early tactile and verbal stimulation
After arrival in the PACU following a radical neck dissection, the pt. becomes tachypneic with tracheal deviation and oxygen desaturation. The perianesthesia nurse suspects: A. anterior cervical edema B. vocal cord paralysis C. tension pneumothorax D. cervical facet displacement - ANSWERS-C. tension pneumothorax The pt. is admitted to the PACU with a laryngeal mask airway (LMA) in place. The perianesthesia nurse understands that a properly placed LMA : A. conforms to the hypopharynx B. passes through the glottic opening C. prevents aspiration D. prevents laryngospasm - ANSWERS-A. conforms to the hypopharynx A pt. in the PACU has ABG lab values of PH = 7.25, Pco2 + 50, pO2 = 99%, HCO3 = 12. The pt. received pancuronium intra op. The perianesthesia nurse observes for which possible neuromuscular blockade interaction? A. Inhibition of the setup of the block B. Reversal of the effect of the block C. Prolongation of the duration of the block D. increase in the level of the block - ANSWERS-C. Prolongation of the duration of the block
A pt. arrives in the PACU following a coronary artery bypass graft. The pt. is on a ventilator with the following settings: Vt = 650ml, FiO2 = 100%, AC mode set RR = 10, and PEEP = 5cm. Critical ABG results are: PH =m 7.24, Pco2 = 56, pO2 = 80, HCO3 = 22, SaO2 = 91%. The perianesthesia nurse anticipates which of the following interventions? A. Increasing the Vt and the RR B. Decreasing the PEEP an FiO C. Increasing the Vt and decreasing the RR D. Increasing the PEEP and the RR - ANSWERS-A. Increasing the Vt and the RR A pt. arrives in the PACU following a coronary artery bypass graft. The pt. is on a ventilator with the following settings: Vt = 650ml, FiO2 = 100%, AC mode set RR = 10, and PEEP = 5cm. Critical ABG results are: PH =m 7.24, Pco2 = 56, pO2 = 80, HCO3 = 22, SaO2 = 91%. The perianesthesia nurse anticipates which of the following interventions? A. metabolic acidosis B. metabolic and respiratory acidosis C. respiratory acidosis D. uncompensated respiratory alkalosis - ANSWERS-C. respiratory acidosis
A pt. experiences a sudden rise in temperature post shock wave lithotripsy. The PACU nurse suspects: A. ureteral obstruction B. malignant hyperthermia C. sepsis D. renal contusion - ANSWERS-C. sepsis A family reports overhearing hospital staff members discussing a combative pt who required restraint. The liability issue of concern is: A. personal accountability B. medical malpractice C. invasion of privacy D. defamation of character - ANSWERS-C. invasion of privacy The perianesthesia nurse has given the pt. instructions regarding taking medications on the day of surgery. Which statement indicates that the pt understands the prep teaching? A. I will only have a small amount of water with the medications I take on the morning of surgery B. Since I have A-Fib, I need to take my warfarin on the morning of surgery C. I will take my vitamins and herbal supplements on the morning of surgery D. Since I am diabetic, I need to take my insulin and eat breakfast everyday - ANSWERS-A. I will only have a small amount of water with the medications I take on the morning of surgery
A pt in phase II is complaining of nausea and refusing medication. Which essential oil may be inhaled to treat post operative nausea and vomiting? A. Rose B. Sandlewood C. Lemongrass D. Peppermint - ANSWERS-D. Peppermint Which of the following positions would be indicated for a lower left lobectomy? A. Flat bed rest B. Turned to operative side only C. Turned to non operative side only D. Sami Fowler's position with turning to either side - ANSWERS-D. Sami Fowler's position with turning to either side A pt. with an implantable cardiovascular defibrillator (ICD) arrives in the PACU with a magnet over the generator.. The perianesthesia nurse should: A. Remove the magnet so the ICD is activated B. Remove the magnet so the ICD is deactivated C. educate the pt on the care of the magnet D. adjust the placement of the magnet - ANSWERS-A. Remove the magnet so the ICD is activated
D. Extravasation of the medication - ANSWERS-C. Successful therapeutic block The perianesthesia nurse receives a pt post total parathyroidectomy. The pt is awake and oriented with a patent airway but complains tingling around the mouth, slight hoarseness, and is mildly apprehensive. The perianesthesia nurse suspects: A.vocal cord irritation B. hypocalcemia C. hypercalcemia D. compromised airway - ANSWERS-B. hypocalcemia The perianesthesia nurse receives a pt post total parathyroidectomy. The pt is awake and oriented with a patent airway but complains tingling around the mouth, slight hoarseness, and is mildly apprehensive. The perianesthesia nurse's next action is to: A. instruct the pt to remain silent to rest vocal cords B. have pt say "e" to check for nerve damage C. call surgeon and anticipate an order to check for calcium level D. administer pain medication and look for signs of hemorrhage - ANSWERS-C. call surgeon and anticipate an order to check for calcium level A 5 year old arrives in the PACU following general anesthesia. The pt has a croupy cough, inspiratory stridor and intercostal retractions are noted. Humidified oxygen is being administered at 8L/min via blow by. Initially the Perianesthesia nurse anticipates:
A. administration of nebulizer racemic epinephrine B. assist the pt's breathing with BMV C. maintaining the pt's head in a sniff position D. suctioning the pt's oropharynx - ANSWERS-A. administration of nebulizer racemic epinephrine A post operative pediatric tympanoplasty is asked to wriggle the forehead, pucker lips, smile and squeeze eyelids together. The PACU nurse is assessing the function of cranial nerve A. V B. VII C. IX D. XII - ANSWERS-B. VII Evaluation call are made to an ambulatory pt during the 24 hour period after discharge can provide effective postoperative follow up. This nursing action is most important to : A. transfer after care to a public health nurse B. give the pt a chance to ask questions and identify problems in the care given C. advertise the center's ambulatory surgery program D. facilitate readmission in the event of complications - ANSWERS- B. give the pt a chance to ask questions and identify problems in the care given
