Download PACU & CPAN Content Questions and Answers: Verified Latest 2024-2025 and more Exams Pathophysiology in PDF only on Docsity!
PACU & CPAN CONTENT QUESTIONS AND
CORRECT ANSWERS VERIFIED LATEST 2024 -
2025 GRADE A +
A 65 yr. male comes in for testing, scheduled for a radical prostatectomy in 3 days. He has a 45pk/yr of smoking. He also has some medicines for "heart palpitations" Tests needed for this pt include: - CORRECT ANSWER>>>EKG, hgb/hct, bmp, type&screen the following statements about pain management apply: - CORRECT ANSWER>>>- preoperative discussion about pain expectations/management can decrease anxiety
- discussion should start in the physician's office
- the patient has a role in his/her management of pain and comfort the perianesthesia comprehensive health history includes all of the following except: - CORRECT ANSWER>>>vital signs the perianestheisa nurse's goal of preoperative preparation for the patient is: - CORRECT ANSWER>>>- to decrease the potential for complications
- reduce anxiety in the patient
- impart accurate and timely communication to the healthcare team airway sounds associated with laryngospasm may include all of the following except: - CORRECT ANSWER>>>diminished breath sounds which of the following are included in respiratory assessment of the patient in the immediate postoperative period - CORRECT ANSWER>>>- work of breathing
- CBC, chemistries, ABGs
- location of incision site classic signs and symptoms associated with pneumothorax include: - CORRECT ANSWER>>>chest pain, tracheal shift, dyspnea the dichrotic notch of the arterial waveform is associated with closure of the: - CORRECT ANSWER>>>aortic valve the most common cause of PEA in the perianesthesia setting is hypovolemia - CORRECT ANSWER>>>true risks and complications associated with central venous cannulation include: - CORRECT ANSWER>>>pneumothorax
the most common cause of decreased CVP in the pacu is:
- CORRECT ANSWER>>>hypovolemia opioids can cause pupillary constriction: - CORRECT ANSWER>>>true the glasgow coma scale is the most reliable indicator of change in LOC and neurological status - CORRECT ANSWER>>>true the normal value for ICP is: - CORRECT ANSWER>>>0 - 20 signs of increased icp include the following: - CORRECT ANSWER>>>- restlessness, bradycardia, increased systolic BP, widening pulse pressure the following position is appropriate for an infratentorial craniotomy patient: - CORRECT ANSWER>>>flat in bed normal urine output is considered to be: - CORRECT ANSWER>>>0.5mL - 1.0 mL/kg/hr volume output does not include: - CORRECT ANSWER>>>interstitial fluid shifts
when calculating urine output with continuous bladder irrigation: - CORRECT ANSWER>>>irrigant is subtracted from the total output one early sign of leaking from the anastomosis site following robotic-assisted prostatectomy is: - CORRECT ANSWER>>>high volume output in the JP over a short period of time for the adult patient, an early sign of hypoventilation which can lead to hypoxia and cardiac arrest is: - CORRECT ANSWER>>>slow, shallow respirations the primary drugs used to reverse sedation and analgesia in moderate sedation are: - CORRECT ANSWER>>>naloxene and flumazenil patients receiving medication to achieve moderate sedation/analgesia must have venous access maintained until discharge criteria are met: - CORRECT ANSWER>>>true the highest priority of assessment is: - CORRECT ANSWER>>>oxygenation the stage of anesthesia during which the patient is at most risk to harm themselves is: - CORRECT
ANSWER>>>stage II: delirium recovery and emergency are dependent upon: - CORRECT ANSWER>>>- duration of anesthesia
- use of additional medications
- physical status of the patient postoperative shivering due to intraoperative vasodilation is a consideration with: - CORRECT ANSWER>>>halothane seizure activity may be enhanced by the administration of:
- CORRECT ANSWER>>>enflurane succinylcholine is: - CORRECT ANSWER>>>metabolized by plasma cholinesterase factors that may contribute to a prolonged neuromuscular blockade are: - CORRECT ANSWER>>>- hypothermia
- acidosis
- renal or hepatic disease blockade of nerve fibers by local anesthetic agents occurs in the following order: - CORRECT ANSWER>>>false in outpatient surgery, a patient has had a reversal agent in Phase I PACU. 20min later, the patient is transferred to
Phase II PACU. Suddenly, the patient is exhibiting the following signs and symptoms: drowsy and unarousable, respirations are 8 and shallow, blood pressure is 90/60, and the heart rate is 58. the initial nursing management of this patient is the following: - CORRECT ANSWER>>>bag-valve-mask at 15L/min the total body water in the normal adult is: - CORRECT ANSWER>>>70% the perianesthesia nurse should discontinue the use of intravenous opioids when there is/are: - CORRECT ANSWER>>>signs of an allergic reaction when caring for the patient who has just had a lumbar epidural catheter placed, all of the following are true except: - CORRECT ANSWER>>>continuous administration of the medication is appropriate with a dermatome level of T it is safe and effective to use IV PCA administration in children older than 8 years of age provided they: - CORRECT ANSWER>>> factors influencing nausea and vomiting are either
peripheral or central in origin. which of the following are peripheral factors? - CORRECT ANSWER>>>major intraabdominal surgery and premature oral intake of fluids the best position for the prevention of aspiration is: - CORRECT ANSWER>>>head down and left lateral malignant hyperthermia may be triggered by which agent - CORRECT ANSWER>>>succinylcholine which of the following can mimic MH? - CORRECT ANSWER>>>- thyroid storm
- cocaine / ecstasy overdose
- sepsis if a patient undergoing a major abdominal surgery is more likely to become hypothermic than another patient having a ventral hernia repair and both surgeries take approximately two hours, what would be the minimum ambient room temperature? - CORRECT ANSWER>>> deg farenheit a true core temperature can be measured by all of the methods except: - CORRECT ANSWER>>>an infrared tympanic temperature
you have just admitted a frail 92 yearold female to the PACU after her hip fracture repair. on assessment, you note several large flat bruised areas on her hands and arms. you: - CORRECT ANSWER>>>- continue your assessment by reviewing the chart
- continue your assessment by receiving report from the anesthesiologist bradycardia may be life threatening in the infant/small child and requires immediate attention: - CORRECT ANSWER>>>true for perianesthesia teaching to be effective it must: - CORRECT ANSWER>>>- be tailored to the patient's identified needs
- be presented in a manner in which the patient can understand
- be modified to overcome sensory and language barriers
- use simple phrases, repetition, and return demonstration documentation of all teaching, both preoperative and postoperative serves as a: - CORRECT ANSWER>>>- reference for the patient to review - checklist for the nurse to refer to
- legal and chart auditing purposes
discharge criteria are established: - CORRECT ANSWER>>>- in collaboration with nursing, the department of anesthesiology, and medical staff
- use specific assessment parameters
- must be approved by the department of anesthesiology and medical staff when preparing the phase II patient for discharge, the perianesthesia nurse completes the following except: - CORRECT ANSWER>>>discharges the patient 60min after admission to phase II identify three ways to limit exposure to radiation - CORRECT ANSWER>>>- decrease the time of exposure
- increase the distance from the radiation source
- place an absorbent shield between staff and the radiation source name three major complications of cardiac catheterization
- CORRECT ANSWER>>>- death
- stroke
- cardiac perforation absolute contraindications for the use of MRI technology include: - CORRECT ANSWER>>>- pacemakers
- implanted defibrilators
- implanted drug infusers
a 30 y/o male 90 kg is scheduled for a knee arthroscopy. NPO at midnight. surgery start time is 0800. OR length is 1 hr. total fluids require: - CORRECT ANSWER>>> 3 - CORRECT ANSWER>>>When educating the patient on what to expect during the administration of spinal anesthesia, the perianesthesia nurse understands that the progression of blockage occurs in the following order:
- sensory, motor, autonomic
- motor, sensory, autonomic 3. autonomic, sensory, motor
- motor, autonomic, sensory 3 - CORRECT ANSWER>>>After extubation of a patient, which of the following would be considered most serious?
- Sore throat
- Impaired swallowing ability
- Inspiratory stridor
- Hoarseness 1 - CORRECT ANSWER>>>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. 4 - CORRECT ANSWER>>>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. 3 - CORRECT ANSWER>>>The perianesthesia nurse is aware that a dramatic decrease in the calcium may be cause by removal of the:
- pituitary gland.
- thyroid gland.
- parathyroid gland.
- adrenal glands. 2 - CORRECT ANSWER>>>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. 4 - CORRECT ANSWER>>>In caring for a preschoolaged child, the perianesthesia nurse is aware that the child's primary cause of anxiety prior to surgery is:
- fear of the medical equipment.
- striving for approval.
- loss of privacy.
- separation from parents. 1 - CORRECT ANSWER>>>One of the most frequent side effects of ketamine anesthesia is:
- hallucination.
- respiratory depression.
- hypotension.
- bradycardia. 1 - CORRECT ANSWER>>>In providing preoperative teaching to a patient requesting spinal anesthesia, the perianesthesia nurse is aware that an absolute contraindication for spinal anesthesia is:
- patient refusal.
- chronic back pain.
- multiple sclerosis.
- sickle cell anemia. 1 - CORRECT ANSWER>>>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. 3 - CORRECT ANSWER>>>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. 2 - CORRECT ANSWER>>>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. 2 - CORRECT ANSWER>>>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:
- developing a poster board on commonly used antibiotics.
- presenting staff with an in-service on infection control.
- apprising the infectious disease service of the occurrences.
- notifying the OR clinical specialist. 2 - CORRECT ANSWER>>>A staff nurse denied a merit increase expresses vigorous support for management and its policies instead of showing anger. The nurse's behavior is characterized as:
- identification.
- reaction formation.
- sublimation.
- rationalization. 2 - CORRECT ANSWER>>>A standard of practice for post anesthesia nursing is established by which acceptable levels of nursing action?
- Promoting independent nursing judgment
- Specifying the nursing goal while defining appropriate nursing measures
- Identifying the nursing actions that meet JCAHO criteria
- Prescribing the nursing intervention relative to standing orders 3 - CORRECT ANSWER>>>A PACU education/research committee should have three commitments, which must include all of the following except:
- development of innovative thinking.
- freedom of inquiry.
- individual progress of each nurse.
- excellence in practice. 2 - CORRECT ANSWER>>>The dissociative state attributed to ketamine anesthesia can be modified by the administration of a/an:
- antiarrhythmic.
- benzodiazepine.
- narcotic.
- anticonvulsant. 4 - CORRECT ANSWER>>>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 2 - CORRECT ANSWER>>>A post-op patient awaiting transport to a surgical floor is awake and responds appropriately to commands. The perioperative nurse instructs the patient to flex and extend his/ her lower extremities; the purpose of this is to:
- ensure that the patient follows commands.
- prevent the complication of venous stasis.
- accelerate emergence from anesthesia.
- assess if patient is ready for discharge.
2 - CORRECT ANSWER>>>A geriatric patient's advanced age puts them at an increased risk for postoperative:
- anorexia.
- hypothermia.
- nausea.
- pain. 3 - CORRECT ANSWER>>>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 3 - CORRECT ANSWER>>>A patient with streptococcal group A pharyngitis arrives in Phase I PACU. The perianesthesia nurse plans that the nurse to patient ratio should be:
- two nurses to one patient.
- one nurse to two patients.
- one nurse to one patient.
- one nurse to three patients. 3 - CORRECT ANSWER>>>A 35-year-old patient arrives in the Phase I PACU crying and repeatedly asks, "Can't my mother come in here with me?" The perianesthesia nurse:
- informs the patient that visitation is prohibited in the PACU.
- reassures the patient and administers an analgesic. 3. allows a brief visit at a time appropriate for patient, visitors, and staff.
- sedates the patient secondary to postanesthetic confusion. 3 - CORRECT ANSWER>>>In a patient status post thyroidectomy, the perianesthesia nurse would anticipate postoperative signs of thyrotoxic crisis to include:
- hyponatremia.
- hypothermia.
- tachycardia.
- bradycardia. 3 - CORRECT ANSWER>>>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 2 - CORRECT ANSWER>>>A perianesthesia nurse is providing discharge instructions to a patient who asks questions about the phenazopyridine prescription. The nurse explains that it:
- needs to be taken on an empty stomach.
- provides relief from urgency and burning sensation.
- helps minimize bleeding and formation of blood clots.
- treats bacteria present in the urinary tract. 1 - CORRECT ANSWER>>>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.
1 - CORRECT ANSWER>>>Surgery is scheduled for
- The patient 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:
- continues with the preoperative check-in process.
- medicates the patient for nausea.
- informs the patient that the case may be cancelled.
- notifies the surgeon. 2 - CORRECT ANSWER>>>A patient who speaks limited English is preparing for gallbladder surgery. The perianesthesia nurse is aware that the appropriate interpreter to utilize for this patient is:
- an interpreter who is married to the patient's sister.
- an interpreter who has a contract with the facility.
- the patient's English-speaking husband.
- the patient's bilingual significant other. 2 - CORRECT ANSWER>>>A potential negative side effect of positive end-expiratory pressure (PEEP) is:
- alveolar collapse.
- decreased intrapulmonary shunting.
- increased cardiac output.
- hypertension. 1 - CORRECT ANSWER>>>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. 2 - CORRECT ANSWER>>>The dissociative state attributed to ketamine anesthesia can be modified by the administration of a/an:
- antiarrhythmic.
- benzodiazepine.
- antagonist.
- anticonvulsant. 3 - CORRECT ANSWER>>>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. 1 Use of meperidine with an MAOI can lead to hypertension, convulsions, and coma. - CORRECT ANSWER>>>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. 2 - CORRECT ANSWER>>>Prochlorperazine acts to treat postoperative nausea by affecting the:
- process of gastric emptying.
- chemoreceptor trigger zone.
- production of gastric acid.
- vestibular pathways. 1 - CORRECT ANSWER>>>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. 2. 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. 2 - CORRECT ANSWER>>>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. 4. hyperextending the jaw. 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. - CORRECT ANSWER>>>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. 2 Because your liver is on the right side of your abdomen, lying on your left side helps keep the uterus off 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. - CORRECT ANSWER>>>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 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. - CORRECT ANSWER>>>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. 1 - CORRECT ANSWER>>>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.
Halothane also has excellent bronchodilatory properties and remains an acceptable alternative for induction