Certified Post Anesthesia Nurse (CPAN) Exam Test
Bank– Complete Guide with Actual Exam Questions,
Correct Answers and Rationales | Latest Updated
Version 2026/2027 | 100% Verified Study Guide
Question 1
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:
A. Sensory, motor, autonomic
B. Motor, sensory, autonomic
C. Autonomic, sensory, motor
D. Motor, autonomic, sensory
Answer: C
Rationale: Spinal anesthesia blocks autonomic fibers first, then sensory, then motor
fibers.
Question 2
After extubation of a patient, which of the following would be considered most serious?
A. Sore throat
B. Impaired swallowing ability
C. Inspiratory stridor
D. Hoarseness
Answer: C
Rationale: Inspiratory stridor indicates upper airway obstruction and is a medical
emergency requiring immediate intervention.
Question 3
Which intervention 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?
A. Ensure a hemoglobin concentration ≥ 10 g
B. Treat tachyarrhythmias and hypotension
C. Monitor oxygen saturation via pulse oximetry
D. Administer appropriate medications
Answer: A
Rationale: Adequate hemoglobin concentration is essential for oxygen delivery to
cardiac muscles.
pg. 1
,Question 4
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:
A. Has had minor surgery
B. Has normal vital signs
C. Has had regional anesthesia
D. Is severely hypothermic
Answer: D
Rationale: Severe hypothermia can cause peripheral vasoconstriction, affecting SpO2
accuracy.
Question 5
The perianesthesia nurse is aware that a dramatic decrease in the serum calcium may be
caused by removal of the:
A. Pituitary gland
B. Thyroid gland
C. Parathyroid gland
D. Adrenal glands
Answer: C
Rationale: Parathyroid glands regulate calcium levels. Removal causes hypocalcemia.
Question 6
Tidal volume is most precisely defined as the amount of:
A. Air exchange in one minute
B. Gas passing into or out of the lungs in each respiratory cycle
C. Gas remaining within the chest after maximal expiration
D. Air exchange with full inspiration and expiration
Answer: B
Rationale: Tidal volume is the volume of gas inhaled or exhaled in each respiratory
cycle.
Question 7
In caring for a preschool-aged child, the perianesthesia nurse is aware that the child's
primary cause of anxiety prior to surgery is:
A. Fear of the medical equipment
B. Striving for approval
C. Loss of privacy
D. Separation from parents
Answer: D
Rationale: Preschool-aged children experience separation anxiety, making parental
separation their primary fear.
pg. 2
,Question 8
One of the most frequent side effects of ketamine anesthesia is:
A. Hallucination
B. Respiratory depression
C. Hypotension
D. Bradycardia
Answer: A
Rationale: Ketamine causes emergence reactions including hallucinations, vivid
dreams, and disorientation.
Question 9
In providing preoperative teaching to a patient requesting spinal anesthesia, the
perianesthesia nurse is aware that an absolute contraindication for spinal anesthesia is:
A. Patient refusal
B. Chronic back pain
C. Multiple sclerosis
D. Sickle cell anemia
Answer: A
Rationale: Patient refusal is an absolute contraindication for any procedure.
Question 10
In administering flumazenil, the perianesthesia nurse is aware that it inhibits the central
effects of benzodiazepines by:
A. Competing for the receptor sites
B. Stimulating the cerebral cortex
C. Occupying the mu receptor sites
D. Metabolizing the medications
Answer: A
Rationale: Flumazenil is a competitive antagonist at benzodiazepine receptor sites.
Question 11
A pathological process that can interfere with accurate measurements of SpO2 when
using a pulse oximeter is:
A. Cushing's disease
B. Hypoparathyroidism
C. Raynaud's disease
D. Hyperthyroidism
Answer: C
Rationale: Raynaud's disease causes peripheral vasoconstriction, reducing blood flow
and affecting SpO2 readings.
pg. 3
, Question 12
In the event that a pharmacologically paralyzed patient is inadvertently extubated, the
first priority of the PACU nurse is to:
A. Administer a muscarinic anticholinergic drug immediately
B. Establish and maintain the airway and ventilation
C. Administer an anticholinesterase drug immediately
D. Assess for muscle recovery before reintubating
Answer: B
Rationale: Airway and ventilation are always the first priority in any emergency.
Question 13
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:
A. Developing a poster board on commonly used antibiotics
B. Presenting staff with an in-service on infection control
C. Apprising the infectious disease service of the occurrences
D. Notifying the OR clinical specialist
Answer: B
Rationale: Education through in-service addresses practice deficiencies and improves
outcomes.
Question 14
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:
A. Identification
B. Reaction formation
C. Sublimation
D. Rationalization
Answer: B
Rationale: Reaction formation is expressing the opposite of one's true feelings.
Question 15
A standard of practice for post anesthesia nursing is established by which acceptable
levels of nursing action?
A. Promoting independent nursing judgment
B. Specifying the nursing goal while defining appropriate nursing measures
C. Identifying the nursing actions that meet JCAHO criteria
D. Prescribing the nursing intervention relative to standing orders
Answer: B
pg. 4
Bank– Complete Guide with Actual Exam Questions,
Correct Answers and Rationales | Latest Updated
Version 2026/2027 | 100% Verified Study Guide
Question 1
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:
A. Sensory, motor, autonomic
B. Motor, sensory, autonomic
C. Autonomic, sensory, motor
D. Motor, autonomic, sensory
Answer: C
Rationale: Spinal anesthesia blocks autonomic fibers first, then sensory, then motor
fibers.
Question 2
After extubation of a patient, which of the following would be considered most serious?
A. Sore throat
B. Impaired swallowing ability
C. Inspiratory stridor
D. Hoarseness
Answer: C
Rationale: Inspiratory stridor indicates upper airway obstruction and is a medical
emergency requiring immediate intervention.
Question 3
Which intervention 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?
A. Ensure a hemoglobin concentration ≥ 10 g
B. Treat tachyarrhythmias and hypotension
C. Monitor oxygen saturation via pulse oximetry
D. Administer appropriate medications
Answer: A
Rationale: Adequate hemoglobin concentration is essential for oxygen delivery to
cardiac muscles.
pg. 1
,Question 4
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:
A. Has had minor surgery
B. Has normal vital signs
C. Has had regional anesthesia
D. Is severely hypothermic
Answer: D
Rationale: Severe hypothermia can cause peripheral vasoconstriction, affecting SpO2
accuracy.
Question 5
The perianesthesia nurse is aware that a dramatic decrease in the serum calcium may be
caused by removal of the:
A. Pituitary gland
B. Thyroid gland
C. Parathyroid gland
D. Adrenal glands
Answer: C
Rationale: Parathyroid glands regulate calcium levels. Removal causes hypocalcemia.
Question 6
Tidal volume is most precisely defined as the amount of:
A. Air exchange in one minute
B. Gas passing into or out of the lungs in each respiratory cycle
C. Gas remaining within the chest after maximal expiration
D. Air exchange with full inspiration and expiration
Answer: B
Rationale: Tidal volume is the volume of gas inhaled or exhaled in each respiratory
cycle.
Question 7
In caring for a preschool-aged child, the perianesthesia nurse is aware that the child's
primary cause of anxiety prior to surgery is:
A. Fear of the medical equipment
B. Striving for approval
C. Loss of privacy
D. Separation from parents
Answer: D
Rationale: Preschool-aged children experience separation anxiety, making parental
separation their primary fear.
pg. 2
,Question 8
One of the most frequent side effects of ketamine anesthesia is:
A. Hallucination
B. Respiratory depression
C. Hypotension
D. Bradycardia
Answer: A
Rationale: Ketamine causes emergence reactions including hallucinations, vivid
dreams, and disorientation.
Question 9
In providing preoperative teaching to a patient requesting spinal anesthesia, the
perianesthesia nurse is aware that an absolute contraindication for spinal anesthesia is:
A. Patient refusal
B. Chronic back pain
C. Multiple sclerosis
D. Sickle cell anemia
Answer: A
Rationale: Patient refusal is an absolute contraindication for any procedure.
Question 10
In administering flumazenil, the perianesthesia nurse is aware that it inhibits the central
effects of benzodiazepines by:
A. Competing for the receptor sites
B. Stimulating the cerebral cortex
C. Occupying the mu receptor sites
D. Metabolizing the medications
Answer: A
Rationale: Flumazenil is a competitive antagonist at benzodiazepine receptor sites.
Question 11
A pathological process that can interfere with accurate measurements of SpO2 when
using a pulse oximeter is:
A. Cushing's disease
B. Hypoparathyroidism
C. Raynaud's disease
D. Hyperthyroidism
Answer: C
Rationale: Raynaud's disease causes peripheral vasoconstriction, reducing blood flow
and affecting SpO2 readings.
pg. 3
, Question 12
In the event that a pharmacologically paralyzed patient is inadvertently extubated, the
first priority of the PACU nurse is to:
A. Administer a muscarinic anticholinergic drug immediately
B. Establish and maintain the airway and ventilation
C. Administer an anticholinesterase drug immediately
D. Assess for muscle recovery before reintubating
Answer: B
Rationale: Airway and ventilation are always the first priority in any emergency.
Question 13
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:
A. Developing a poster board on commonly used antibiotics
B. Presenting staff with an in-service on infection control
C. Apprising the infectious disease service of the occurrences
D. Notifying the OR clinical specialist
Answer: B
Rationale: Education through in-service addresses practice deficiencies and improves
outcomes.
Question 14
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:
A. Identification
B. Reaction formation
C. Sublimation
D. Rationalization
Answer: B
Rationale: Reaction formation is expressing the opposite of one's true feelings.
Question 15
A standard of practice for post anesthesia nursing is established by which acceptable
levels of nursing action?
A. Promoting independent nursing judgment
B. Specifying the nursing goal while defining appropriate nursing measures
C. Identifying the nursing actions that meet JCAHO criteria
D. Prescribing the nursing intervention relative to standing orders
Answer: B
pg. 4
