CPAN Exam Certified Post Anesthesia Nurse Actual 2026/2027
with Detailed Rationales | Complete Exam-Style Questions |
Pass Guaranteed – A+ Graded
EXAM INFORMATION
Total Questions: 50
Recommended Time: 75 Minutes
Passing Threshold: 82%
Exam Format: Multiple Choice Questions (MCQs)
Question Style: Scenario-Based, Applied, and Clinical Decision-Making Questions
Difficulty Level: Advanced and Comprehensive
==============================
SECTION 1: Preoperative Assessment and Preparation
Question 1
A 68-year-old client is scheduled for elective total knee arthroplasty under general
anesthesia. During the preoperative assessment, the client reports taking warfarin 5 mg
daily for atrial fibrillation. The international normalized ratio is 2.8. Which action by the
perianesthesia nurse is most appropriate?
A. Proceed with surgery as scheduled because the INR is within therapeutic range
B. Notify the surgeon and anesthesiologist immediately to discuss postponement or
bridging therapy
C. Instruct the client to hold the warfarin dose on the morning of surgery only
D. Administer vitamin K 10 mg subcutaneously to reverse anticoagulation
,Correct Answer: B
Rationale: An INR of 2.8 exceeds the safe threshold for elective orthopedic surgery,
which typically requires an INR below 1.5. The perianesthesia nurse must communicate
this finding to the surgeon and anesthesiologist to determine if surgery should be
postponed or if bridging anticoagulation therapy is indicated. Proceeding with surgery
increases bleeding risk. Holding only the morning dose is insufficient for warfarin
reversal. Vitamin K reversal is reserved for emergency situations and would delay
surgery further due to unpredictable onset.
Question 2
A perianesthesia nurse is conducting a preoperative assessment on a client with a
history of obstructive sleep apnea who is scheduled for outpatient laparoscopic
cholecystectomy. The client uses continuous positive airway pressure at home. Which
preoperative instruction is most important for the nurse to provide?
A. Discontinue CPAP use 24 hours before surgery to prevent airway complications
B. Bring your CPAP machine to the facility for use during recovery
C. Take your prescribed sedative the night before surgery to ensure adequate rest
D. Sleep in the supine position the night before surgery to improve ventilation
Correct Answer: B
Rationale: Clients with obstructive sleep apnea are at increased risk for postoperative
airway obstruction and hypoventilation, particularly when sedated. Bringing the CPAP
,device ensures continuity of therapy during the recovery period. Discontinuing CPAP
before surgery is contraindicated. Sedatives should be used cautiously in clients with
OSA due to respiratory depression risk. Supine positioning worsens airway obstruction
in OSA.
Question 3
A client with type 1 diabetes mellitus is scheduled for morning surgery. The client
normally takes 20 units of glargine insulin at bedtime and 6 units of regular insulin
before meals. The perianesthesia nurse is providing preoperative instructions. Which
instruction regarding insulin management is most accurate?
A. Take the full dose of glargine insulin the night before surgery and hold the morning
regular insulin
B. Hold all insulin the night before and morning of surgery to prevent hypoglycemia
C. Reduce the glargine dose by 25% the night before and hold morning regular insulin
D. Take regular insulin with a small snack on the morning of surgery
Correct Answer: C
Rationale: For clients with type 1 diabetes undergoing surgery, basal insulin should
generally be continued but may be reduced by 20-25% the evening before surgery to
reduce hypoglycemia risk while maintaining basal coverage. Morning prandial insulin is
held due to NPO status. Holding all insulin can precipitate diabetic ketoacidosis. Taking
regular insulin with a snack violates NPO guidelines.
, Question 4
A perianesthesia nurse is assessing a client scheduled for outpatient surgery. The client
reports drinking clear liquids 3 hours before the scheduled arrival time. According to
current ASPAN and ASA fasting guidelines, which action should the nurse take?
A. Cancel the surgery because the client violated NPO guidelines
B. Proceed with the preoperative plan because clear liquids are acceptable up to 2 hours
before surgery
C. Notify the anesthesiologist to discuss possible delay of the procedure
D. Instruct the client to drink additional clear liquids to prevent dehydration
Correct Answer: B
Rationale: Current ASA fasting guidelines permit clear liquids up to 2 hours before
elective surgery requiring general anesthesia, regional anesthesia, or sedation. Since the
client drank clear liquids 3 hours prior, this is within acceptable guidelines. Cancellation
is unnecessary. Additional liquids would violate the 2-hour restriction. The nurse should
document the intake and proceed with the plan.
Question 5
A 55-year-old client with a history of gastroesophageal reflux disease is scheduled for
general anesthesia. The client reports taking omeprazole daily but did not take the
morning dose due to NPO status. Which complication is the client at increased risk for
during the perianesthesia period?
with Detailed Rationales | Complete Exam-Style Questions |
Pass Guaranteed – A+ Graded
EXAM INFORMATION
Total Questions: 50
Recommended Time: 75 Minutes
Passing Threshold: 82%
Exam Format: Multiple Choice Questions (MCQs)
Question Style: Scenario-Based, Applied, and Clinical Decision-Making Questions
Difficulty Level: Advanced and Comprehensive
==============================
SECTION 1: Preoperative Assessment and Preparation
Question 1
A 68-year-old client is scheduled for elective total knee arthroplasty under general
anesthesia. During the preoperative assessment, the client reports taking warfarin 5 mg
daily for atrial fibrillation. The international normalized ratio is 2.8. Which action by the
perianesthesia nurse is most appropriate?
A. Proceed with surgery as scheduled because the INR is within therapeutic range
B. Notify the surgeon and anesthesiologist immediately to discuss postponement or
bridging therapy
C. Instruct the client to hold the warfarin dose on the morning of surgery only
D. Administer vitamin K 10 mg subcutaneously to reverse anticoagulation
,Correct Answer: B
Rationale: An INR of 2.8 exceeds the safe threshold for elective orthopedic surgery,
which typically requires an INR below 1.5. The perianesthesia nurse must communicate
this finding to the surgeon and anesthesiologist to determine if surgery should be
postponed or if bridging anticoagulation therapy is indicated. Proceeding with surgery
increases bleeding risk. Holding only the morning dose is insufficient for warfarin
reversal. Vitamin K reversal is reserved for emergency situations and would delay
surgery further due to unpredictable onset.
Question 2
A perianesthesia nurse is conducting a preoperative assessment on a client with a
history of obstructive sleep apnea who is scheduled for outpatient laparoscopic
cholecystectomy. The client uses continuous positive airway pressure at home. Which
preoperative instruction is most important for the nurse to provide?
A. Discontinue CPAP use 24 hours before surgery to prevent airway complications
B. Bring your CPAP machine to the facility for use during recovery
C. Take your prescribed sedative the night before surgery to ensure adequate rest
D. Sleep in the supine position the night before surgery to improve ventilation
Correct Answer: B
Rationale: Clients with obstructive sleep apnea are at increased risk for postoperative
airway obstruction and hypoventilation, particularly when sedated. Bringing the CPAP
,device ensures continuity of therapy during the recovery period. Discontinuing CPAP
before surgery is contraindicated. Sedatives should be used cautiously in clients with
OSA due to respiratory depression risk. Supine positioning worsens airway obstruction
in OSA.
Question 3
A client with type 1 diabetes mellitus is scheduled for morning surgery. The client
normally takes 20 units of glargine insulin at bedtime and 6 units of regular insulin
before meals. The perianesthesia nurse is providing preoperative instructions. Which
instruction regarding insulin management is most accurate?
A. Take the full dose of glargine insulin the night before surgery and hold the morning
regular insulin
B. Hold all insulin the night before and morning of surgery to prevent hypoglycemia
C. Reduce the glargine dose by 25% the night before and hold morning regular insulin
D. Take regular insulin with a small snack on the morning of surgery
Correct Answer: C
Rationale: For clients with type 1 diabetes undergoing surgery, basal insulin should
generally be continued but may be reduced by 20-25% the evening before surgery to
reduce hypoglycemia risk while maintaining basal coverage. Morning prandial insulin is
held due to NPO status. Holding all insulin can precipitate diabetic ketoacidosis. Taking
regular insulin with a snack violates NPO guidelines.
, Question 4
A perianesthesia nurse is assessing a client scheduled for outpatient surgery. The client
reports drinking clear liquids 3 hours before the scheduled arrival time. According to
current ASPAN and ASA fasting guidelines, which action should the nurse take?
A. Cancel the surgery because the client violated NPO guidelines
B. Proceed with the preoperative plan because clear liquids are acceptable up to 2 hours
before surgery
C. Notify the anesthesiologist to discuss possible delay of the procedure
D. Instruct the client to drink additional clear liquids to prevent dehydration
Correct Answer: B
Rationale: Current ASA fasting guidelines permit clear liquids up to 2 hours before
elective surgery requiring general anesthesia, regional anesthesia, or sedation. Since the
client drank clear liquids 3 hours prior, this is within acceptable guidelines. Cancellation
is unnecessary. Additional liquids would violate the 2-hour restriction. The nurse should
document the intake and proceed with the plan.
Question 5
A 55-year-old client with a history of gastroesophageal reflux disease is scheduled for
general anesthesia. The client reports taking omeprazole daily but did not take the
morning dose due to NPO status. Which complication is the client at increased risk for
during the perianesthesia period?
