CPAN Review 1

Physiologic Needs

100

Which of the following nursing interventions is most effective for a patient with a history of postoperative nausea and vomiting?

1. Providing ice chips
2. Administering ranitidine
3. Prevention
4. Avoiding administration of analgesics

3. Prevention

200

The perianesthesia nurse instructs a patient who received a brachial plexus nerve block to:

1. immediately report numbness and burning sensation.
2. be aware all blocks last only for 8 hours.
3. not apply a brace on the affected arm.
4. be proactive with pain medication to avoid uncontrollable discomfort.

4. Be proactive with pain medication to avoid uncontrollable discomfort

300

In caring for a patient receiving a blood transfusion, the perianesthesia nurse is aware that the most likely cause of a nonhemolytic febrile transfusion is:

1. WBC or platelet antibodies.
2. anti-E–anti-C interaction.
3. blood type incompatibility.
4. nonpyrogenic bacteria.

1. WBC or platelet antibodies

400

A patient is admitted to the PACU following a small-bowel resection. The patient is extremely lethargic, confused, and has the following vital signs: BP = 100/50, R = 8 and shallow, T = 34.8°C (94.6°F). Myxedema coma is diagnosed. Initially, the nurse prepares to:

1. provide fluid challenge.
2. administer calcium chloride IV.
3. rapidly rewarm the patient.
4. administer levothyroxine IV.

4. Administer levothyroxine IV

500

A potential negative side effect of positive end-expiratory pressure (PEEP) is:

1. alveolar collapse.
2. decreased intrapulmonary shunting.
3. increased cardiac output.
4. hypertension.

2. Decreased intrapulmonary shunting

Safety

100

The most common type of reaction to latex-containing products is a/an:

1. desensitizing allergic reaction.
2. Type IV reaction.
3. Type I reaction.
4. irritating nonallergic reaction.

4. Irritating nonallergic reaction

200

A geriatric patient's advanced age puts them at an increased risk for post-operative:

1. anorexia.
2. hypothermia.
3. nausea.
4. pain.

2. Hypothermia

300

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:

1. ensure that the patient follows commands.
2. prevent the complication of venous stasis.
3. accelerate emergence from anesthesia.
4. assess if patient is ready for discharge.

2. Prevent the complication of Venous Stasis

400

In the event that a pharmacologically paralyzed patient is inadvertently extubated, the first priority of the PACU nurse is to:

1. administer a muscarinic anticholinergic drug immediately.
2. establish and maintain the airway and ventilation.
3. administer an anticholinesterase drug immediately.
4. assess for muscle recovery before reintubating.

2. Establish and maintain the airway and ventilation

500

Surgery is scheduled for 0830. 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:

1. continues with the preoperative check-in process.
2. medicates the patient for nausea.
3. informs the patient that the case may be cancelled.
4. notifies the surgeon.

1. Continues with the preoperative check in process

Post Op

100

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

1. hyponatremia.
2. hypothermia.
3. tachycardia.
4. bradycardia.

3. Tachycardia

200

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

1. pituitary gland.
2. thyroid gland.
3. parathyroid gland.
4. adrenal glands.

3. Parathyroid gland

300

After extubation of a patient, which of the following would be considered most serious?

1. Sore throat
2. Impaired swallowing ability
3. Inspiratory stridor
4. Hoarseness

3. Inspiratory stridor

400

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:

1. prepare for the insertion of a chest tube.
2. obtain an order for analgesic.
3. apply a positive-pressure airway ventilator.
4. prepare for immediate removal of the central line.

1. Prepare for the insertion of a chest tube

500

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:

1. peroneal nerve.
2. femoral artery.
3. Achilles tendon.
4. sciatic nerve.

1. Peroneal Nerve

Professional Practice

100

A PACU education/research committee should have three commitments, which must include all of the following except:

1. development of innovative thinking.
2. freedom of inquiry.
3. individual progress of each nurse.
4. excellence in practice.

3. Individual progress of each nurse

200

A standard of practice for post anesthesia nursing is established by which acceptable levels of nursing action?

1. Promoting independent nursing judgment
2. Specifying the nursing goal while defining appropriate nursing measures
3. Identifying the nursing actions that meet JCAHO criteria
4. Prescribing the nursing intervention relative to standing orders

2. Specifying the nursing goal while defining appropriate nursing measures

300

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 staff with an in-service on infection control.
3. apprising the infectious disease service of the occurrences.
4. notifying the OR clinical specialist.

2. Presenting the staff with an in-service on infection control

400

In providing preoperative teaching to a patient requesting spinal anesthesia, the perianesthesia nurse is aware that an absolute contraindication for spinal anesthesia is:

1. patient refusal.
2. chronic back pain.
3. multiple sclerosis.
4. sickle cell anemia.

1. Patient refusal

500

A patient with streptococcal group A pharyngitis arrives in Phase I PACU. The perianesthesia nurse plans that the nurse to patient ratio should be:

1. two nurses to one patient.
2. one nurse to two patients.
3. one nurse to one patient.
4. one nurse to three patients.

3. One nurse to one patient

Potpourri

100

A pathological process that can interfere with accurate measurements of SpO2 when using a pulse oximeter is:

1. Cushing's disease.
2. hypoparathyroidism.
3. Raynaud's disease.
4. hyperthyroidism.

3. Raynaud's disease

200

The dissociative state attributed to ketamine anesthesia can be modified by the administration of a/an:

1. antiarrhythmic.
2. benzodiazepine.
3. narcotic.
4. anticonvulsant.

2. Benzodiazepine

300

A perianesthesia nurse is providing discharge instructions to a patient who asks questions about the phenazopyridine prescription. The nurse explains that it:

1. needs to be taken on an empty stomach.
2. provides relief from urgency and burning sensation.
3. helps minimize bleeding and formation of blood clots.
4. treats bacteria present in the urinary tract.

2. Provides relief from urgency and burning sensation

400

A patient in mild respiratory distress is in Phase I PACU. Another patient is a 6-year- old child whose parents have left to eat. A third patient has just arrived from the operating room. There are two patients waiting for discharge to Phase II, and one who is ready for discharge but waiting to void. According to the ASPAN Standards there should be at least:

1. two nurses.
2. three nurses.
3. four nurses.
4. five nurses.

3. four nurses

500

n 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.

1. Competing for the receptor sites