Certified Postanesthesia Nurse CPANExams Forms 1-4, Answered_2022

Certifiead Postanesthesia Nurse CPAN Exams Forms 1- 4, Answered_2022 Certifiead Postanesthesia Nurse CPAN ExamsForms 1-4, Answered_2022. A 60-year-old female is admitted to the PACU following a diagnostic dilation and curettage with general anesthesia. Chart review reveals normal preoperative EKG-hemoglobin-hematocrit- and electrolyte values. Past medical history is remarkable for rheumatic fever during childhood. Thirty minutes later the patient develops the following EKG pattern --- A-fib--- The perianesthesia nurse interprets the rhythm strip as indicating A. Occasional premature atrial contractions B. First-degree heart block C. Atrial flutter D. Atrial fibrillation - A. Occasional premature atrial contractions B. First-degree heart block C. Atrial flutter D. Atrial fibrillation A 60-year-old female is admitted to the PACU following a diagnostic dilation and curettage with general anesthesia. Chart review reveals normal preoperative EKG-hemoglobin-hematocrit- and electrolyte values. Past medical history is remarkable for rheumatic fever during childhood. Thirty minutes later the patient develops the following EKG pattern --- A-fib--- If the defibrillator is not set on the synchronized mode during a cardioversion- which life threatening arrhythmia could occur? A. Ventricular fibrillations B. Wenckebach's phenomenon C. Premature ventricular contractions D. Ventricular tachycardia - Ventricular fibrillations Wenckebach's phenomenon Premature ventricular contractions Ventricular tachycardia A 60-year-old female is admitted to the PACU following a diagnostic dilation and curettage with general anesthesia. Chart review reveals normal preoperative EKG-hemoglobin-hematocrit- and electrolyte values. Past medical history is remarkable for rheumatic fever during childhood. Thirty minutes later the patient develops the following EKG pattern --- A-fib--- The patient is transferred to a surgical nursing unit following successful cardioversion because the ICU and monitored units are full. The PACU nurse should emphasize assessment for A. Atrioventricular dissociation B. Thermal incident C. Sinus bradycardia D. Emboli - A. Atrioventricular dissociation B. Thermal incident C. Sinus bradycardia D. Emboli The perianesthesia nurse has given the patient instructions regarding taking medications on the day of surgery. Which statement indicates that the patient understands the pre-op teaching A. "I will only have small amounts of water with the medications I take on the morning of surgery" B. "Since I have atrial fibrillation, 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 every day" - A. "I will only have small amounts of water with the medications I take on the morning of surgery" B. "Since I have atrial fibrillation, 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 every day" A patient in Phase II is complaining of nausea and refusing any medication. Which essential oil may be inhaled to treat post-operative nausea and vomiting? A. Rose B. Sandalwood C. Lemongrass D. Peppermint - A. Rose B. Sandalwood C. Lemongrass D. Peppermint Which one of the following positions would be indicated for a left lower lobectomy? A. Flat bed rest B. Turned to operative side only C. Turned to nonoperative side only D. Semi-Fowler's position with turning to either side - A. Flat bed rest B. Turned to operative side only C. Turned to nonoperative side only D. Semi-Fowler's position with turning to either side A patient with an implantable cardioverter 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 patient on the care of the magnet D. Adjust the placement of the magnet - A. Remove the magnet so the ICD is activated B. Remove the magnet so the ICD is deactivated C. Educate the patient on the care of the magnet D. Adjust the placement of the magnet A patient with a subarachnoid hemorrhage is lethargic but arousable. The patient is taken to surgery for an aneurysm clipping. ABG shows pH= 7.50 pCO2= 45 mm HG and HCO3-= 30 mEq/L. The perianesthesia nurse interprets this as: A. Respiratory alkalosis B. Respiratory acidosis C. Metabolic acidosis D. Metabolic alkalosis - A. Respiratory alkalosis B. Respiratory acidosis C. Metabolic acidosis D. Metabolic alkalosis While caring for a patient after lumbar posterior nerve root rhizotomy the perianesthesia nurse notes the patient has no movement or sensation to the lower extremities. The priority nursing action is to notify the: A. Anesthesiologist of muscle paralysis B. Operating room of the complications C. Surgeon of the absence of sensation D. Surgeon of lack of motor ability - A. Anesthesiologist of muscle paralysis B. Operating room of the complications C. Surgeon of the absence of sensation D. Surgeon of lack of motor ability While assisting an anesthesiologist performing a block for reflex sympathetic dystrophy the perianesthesia nurse observes that the affected arm becomes warm to the touch and flushed. The patient reports a sensation of heaviness in the arm. This indicates which of the following? A. Ineffective regional block B. Severe allergic reaction C. Successful therapeutic block D. Extravasation of the medication - A. Ineffective regional block B. Severe allergic reaction C. Successful therapeutic block D. Extravasation of the medication The perianesthesia nurse receives a patient post total parathyroidectomy. The patient is awake and oriented with a patent airway but complains of tingling around the mouth- slight hoarsenessand is mildly apprehensive. The perianesthesia nurse suspects: A. Vocal cord irritation B. Hypocalcemia C. Hypercalcemia D. Compromised airway - A. Vocal cord irritation B. Hypocalcemia C. Hypercalcemia D. Compromised airway The perianesthesia nurse receives a patient post total parathyroidectomy. The patient is awake and oriented with a patent airway but complains of tingling around the mouth- slight hoarsenessand is mildly apprehensive. The perianesthesia nurse's next action is to: A. Instruct the patient to remain silent to rest the vocal cords B. Have patient say "e" to check for nerve damage C. Call surgeon and anticipate an order for a calcium level D. Administer pain medication and look for signs of hemorrhage - A. Instruct the patient to remain silent to rest the vocal cords B. Have patient say "e" to check for nerve damage C. Call surgeon and anticipate an order for a calcium level D. Administer pain medication and look for signs of hemorrhage A 3-year-old patient arrives in the PACU following general anesthesia. The patient 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 nebulized racemic epinephrine B. Assisting the patient's breathing with BMV C. Maintaining the patient's head in the sniff position D. Suctioning the patient's oropharynx - A. Administration of nebulized racemic epinephrine B. Assisting the patient's breathing with BMV C. Maintaining the patient's head in the sniff position D. Suctioning the patient's oropharynx A postoperative pediatric tympanoplasty patient is asked to wrinkle the forehead- pucker lipssmile- and squeeze eyelids together. The PACU nurse is assessing the function of cranial nerve: A. V B. VII C. IX D. XII - A. V B. VII C. IX D. XII Evaluation calls made to an ambulatory patient during the 24-hour period after discharge can provide effective post-operative follow-up. This nursing action is most important to : A. Transfer aftercare to a public health nurse B. Give the patient a chance to ask questions and identify problems in the care given C. Advertise the institution's ambulatory surgery program D. Facilitate readmission in the event of complications - A. Transfer aftercare to a public health nurse B. Give the patient a chance to ask questions and identify problems in the care given C. Advertise the institution's ambulatory surgery program D. Facilitate readmission in the event of complications Following stabilization of femur and pelvic fractures a patient becomes anxious and oxygen saturations decrease to 86%. The patient continues to become confused and agitated. Upon further assessment the perianesthesia nurse notes petechiae on the patient's trunk. The perianesthesia nurse suspects: A. Fat embolism B. Tension pneumothorax C. Compartment syndrome D. Neurogenic bladder- A. Fat embolism B. Tension pneumothorax C. Compartment syndrome D. Neurogenic bladder In a young healthy post-operative patient hypoventilation may be reversed by: A. Restriction of fluids B. Administration of oxygen C. Stimulation of the patient D. Administration of pain medication- A. Restriction of fluids B. Administration of oxygen C. Stimulation of the patient D. Administration of pain medication A patient with type I diabetes is admitted the day of surgery with a glucose of 400 mg/dL. The nurse is aware that the patient may be at risk for: A. Hyperglycemic hyperosmolar syndrome B. Anuria C. Diabetic ketoacidosis D. Diabetes insipidus- A. Hyperglycemic hyperosmolar syndrome B. Anuria C. Diabetic ketoacidosis D. Diabetes insipidus During the interview of a 55-year-old patient before elective surgery the patient reports using no routine prescription medications- just some natural herbs. The perianesthesia nurse is aware thataccording to the ASA- teaching should include which of the following? A. Continue all herbal supplements that are taken in the evening B. Discontinue all herbal supplements 2 weeks prior to surgery C. Herbal supplements have no contraindications for surgery D. Continue all herbal supplements until 2 days prior to surgery- A. Continue all herbal supplements that are taken in the evening B. Discontinue all herbal supplements 2 weeks prior to surgery C. Herbal supplements have no contraindications for surgery D. Continue all herbal supplements until 2 days prior to surgery The occurrence of post-dural puncture headache is most frequently attributed to: A. A history of migraine headaches B. Poor positioning C. A slow loss of cerebrospinal fluid at puncture site D. Caffeine deprivation- A. A history of migraine headaches B. Poor positioning C. A slow loss of cerebrospinal fluid at puncture site D. Caffeine deprivation Asking the patient to position the tongue in midline following a carotid endarterectomy helps the perianesthesia nurse to assess the: A. Acoustic nerve B. Hypoglossal nerve C. Glossopharyngeal nerve D. Facial nerve- A. Acoustic nerve B. Hypoglossal nerve C. Glossopharyngeal nerve D. Facial nerve Which of the following symptoms in a postoperative tonsillectomy patient would be of particular concern to the perianesthesia nurse? A. Discomfort in the ear B. Hoarseness C. Frequent swallowing D. Throat discomfort- A. Discomfort in the ear B. Hoarseness C. Frequent swallowing D. Throat discomfort In postoperative patients with a history of end-stage renal disease the administration of IV glucose and regular insulin is used to correct the complication of: A. Hyponatremia B. Hypokalemia C. Hypernatremia D. Hyperkalemia- A. Hyponatremia B. Hypokalemia C. Hypernatremia D. Hyperkalemia The perianesthesia nurse caring for a 60 kg patient who is NPO should maintain IV fluid hourly maintenance rate at: A. 45 ml/kg/hr B. 55 ml/kg/hr C. 65 ml/kg/hr D. 100 ml/kg/hr- A. 45 ml/kg/hr B. 55 ml/kg/hr C. 65 ml/kg/hr D. 100 ml/kg/hr Which electrolyte abnormality will produce a widened QRS segment- peaked T waves- and impaired atrioventricular conduction? A. Hypokalemia B. Hyperkalemia C. Hypercalcemia D. Hypocalcemia- A. Hypokalemia B. Hyperkalemia C. Hypercalcemia D. Hypocalcemia After receiving cefazolin 1g- a patient experiences cardiac arrest. CPR is hampered by edema of the face- neck- and upper airway. The first drug prepared by the PACU nurse is: A. Epinephrine B. Ephedrine C. Dexamethasone D. Diphenhydramine- A. Epinephrine B. Ephedrine C. Dexamethasone D. Diphenhydramine The most common dysrhythmia in the pediatric patient in cardiac arrest is: A. Pulseless electrical activity B. Ventricular fibrillation C. Ventricular tachycardia D. Asystole- A. Pulseless electrical activity B. Ventricular fibrillation C. Ventricular tachycardia D. Asystole Following inhalational anesthesia a patient should be monitored for hypothermia. The PACU nurse is aware that the regulation of temperature is: 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- 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 During spinal and epidural anesthesia- the patient's body temperature control mechanisms are: A. Not affected 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- A. Not affected 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 The psychic disturbances attributed to ketamine anesthesia can be modified by the administration of: A. Diazepam B. Etomidate C. Butorphanol D. Nalbuphine- A. Diazepam B. Etomidate C. Butorphanol D. Nalbuphine The anesthetist indicates in the postoperative report that the patient was reversed with edrophonium and atropine. The reason for administering atropine is to: A. Decreases the likelihood of vomiting B. Promote acetylcholine release C. Enhance the onset of neuromuscular reversal D. Minimize muscarinic stimulation- A. Decreases the likelihood of vomiting B. Promote acetylcholine release C. Enhance the onset of neuromuscular reversal D. Minimize muscarinic stimulation The most common triggering agents of a malignant hyperthermia crisis are: A. Nitrous oxide and thiopental B. Halothane and succinylcholine C. Fentanyl and succinylcholine D. Isoflurane and thiopental- A. Nitrous oxide and thiopental B. Halothane and succinylcholine C. Fentanyl and succinylcholine D. Isoflurane and thiopental A surgical patient has been taking feverfew for migraine headache prevention. Medication reconciliation reveals the patient also take aspirin. The perianesthesia nurse informs the patient that the risks of using feverfew in combination with aspirin includes: A. An increased risk of bleeding B. An increased absorption of iron C. No effect on platelet aggregation D. Safe use during pregnancy- A. An increased risk of bleeding B. An increased absorption of iron C. No effect on platelet aggregation D. Safe use during pregnancy A 9-year-old child post appendectomy is dozing in the PACU after receiving morphine for patient- reported pain of 3 on a 0-to-10 scale. A short time later the nurse observes that the child is listless and sees the mother activating the patient-controlled analgesia (PCA). The nurse should first: A. Call the physician for a change of medication B. Tell the parent that this is an appropriate intervention C. Explain that only the patient is to operate the pump D. Discontinue the PCA- A. Call the physician for a change of medication B. Tell the parent that this is an appropriate intervention C. Explain that only the patient is to operate the pump D. Discontinue the PCA A patient arrives in the Phase I PACU with epidural infusion of fentanyl and bupivacaine. Vital signs are stable. The patient requests that the head of the bed be elevated. The perianesthesia nurse explains that the head elevation could result in: A. Hyperventilation B. Hypoventilation C. Hypertension D. Hypotension- A. Hyperventilation B. Hypoventilation C. Hypertension D. Hypotension It is important for a perianesthesia nurse to understand that a child's ability to classify and estimate pain normally develops around the age of: A. 4 or 5 years B. 7 or 8 years C. 10 or 11 years D. 13 or 14 years- A. 4 or 5 years B. 7 or 8 years C. 10 or 11 years D. 13 or 14 years The perianesthesia nurse assesses that a patient understands the impact of opioid use postoperatively when the patient verbalizes that opioids can cause: A. Diarrhea B. Nausea and vomiting C. Hypotension D. Insomnia- A. Diarrhea B. Nausea and vomiting C. Hypotension D. Insomnia During anesthesia handoff the provider reports using rapid sequence induction for intubation. The PACU nurse realizes the patient must have a history of: A. Gastroesophageal reflux B. Brain stem ataxia C. Anaphylaxis with sepsis D. Liver dysfunction- A. Gastroesophageal reflux B. Brain stem ataxia C. Anaphylaxis with sepsis D. Liver dysfunction The perianesthesia nurse demonstrates best practices in discharge teaching by: A. Assessing individual learning needs B. Giving all patients the same amount of information C. Completing written documentation in a timely manner D. Demonstrating psychomotor skills- A. Assessing individual learning needs B. Giving all patients the same amount of information C. Completing written documentation in a timely manner D. Demonstrating psychomotor skills According to ASPAN Perianesthesia Nursing Standards Practice recommendations and Interpretative Statements- the scope of care provided in post anesthesia Phase I includes: A. Preparation of patient and family for home care B. Preparation of patient for extended care C. Transition of the patient from an anesthetized state to Phase II or an inpatient setting D. Transition of the patient from the preoperative to the intraoperative phase- A. Preparation of patient and family for home care B. Preparation of patient for extended care C. Transition of the patient from an anesthetized state to Phase II or an inpatient setting D. Transition of the patient from the preoperative to the intraoperative phase A patient status post appendectomy is complaining of myalgia. The nurse reassures the patient this is a normal side effect of: A. Sevoflurane B. Fentanyl C. Midazolam D. Succinylcholine- A. Sevoflurane B. Fentanyl C. Midazolam D. Succinylcholine An Rh negative patient status post dilation and curettage for a missed abortion is instructed that before discharge she will receive: A. Vitamin B-12 B. Pitocin C. RhoGam D. Terbutaline- A. Vitamin B-12 B. Pitocin C. RhoGam D. Terbutaline In transcultural patient teaching- the perianesthesia nurse plans to: A. Learn how listening is communicated in the patient's culture B. Assume meaning is interpreted without distortion C. View the patient's culture through the nurse's life experience D. Avoid using gestures to help patient understand- A. Learn how listening is communicated in the patient's culture B. Assume meaning is interpreted without distortion C. View the patient's culture through the nurse's life experience D. Avoid using gestures to help patient understand A patient status post knee arthroscopy has a history of coronary artery disease and hypertension and did not take his metoprolol yesterday. The perianesthesia nurse is aware that the discharge instructions need to include the importance of taking this medication because the patient is at increased risk of: A. Hyperlipidemia B. Plaque rupture C. Hyperglycemia D. Myocardial ischemia- A. Hyperlipidemia B. Plaque rupture C. Hyperglycemia D. Myocardial ischemia Crutch training instruction after arthroscopic right knee surgery should include: A. Leading with the unaffected leg B. Applying dominant weight to axillary pads C. Taking large- steady steps D. Standing erect and looking downward when walking- A. Leading with the unaffected leg B. Applying dominant weight to axillary pads C. Taking large- steady steps D. Standing erect and looking downward when walking The patient displays 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- 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 In evaluating the care of a patient with vancomycin-resistant enterococci (VRE) the PACU nurse will consider which of the following? A. VRE can live for weeks on surfaces such as bed rails B. The patient should be placed in a negative-pressure room C. Transmission-based droplet precautions should be utilized D. Gloves are a sufficient barrier device- A. VRE can live for weeks on surfaces such as bed rails B. The patient should be placed in a negative-pressure room C. Transmission-based droplet precautions should be utilized D. Gloves are a sufficient barrier device In the care of a conscious patient who has been admitted to the PACU following a thyroidectomy- the position of choice is: A. Supine with one pillow B. Lying on one side with the head hyperextended C. Sim's position D. Semi-Fowler's position- A. Supine with one pillow B. Lying on one side with the head hyperextended C. Sim's position D. Semi-Fowler's position Postoperative discharge teaching for a patient who received an interscalene block with Ropivacaine should include instructions for the patient to: A. Notify surgeon for sudden pain or tingling of the arm B. Perform full range of motion exercises every 2 hours C. Contact surgeon if patient's hand is still numb 3 hours after surgery D. Protect elbow to avoid damage to ulnar nerve until block resolves- A. Notify surgeon for sudden pain or tingling of the arm B. Perform full range of motion exercises every 2 hours C. Contact surgeon if patient's hand is still numb 3 hours after surgery D. Protect elbow to avoid damage to ulnar nerve until block resolves The presence of the family visitation in the PACU will: A. Increase patient satisfaction B. Extended PACU length of stay C. Increase the infection rate D. Decrease nursing interaction- A. Increase patient satisfaction B. Extended PACU length of stay C. Increase the infection rate D. Decrease nursing interaction A patient who underwent a craniotomy for tumor removal is admitted to the PACU awake and alert. 30 minutes later the patient's level of consciousness decreases heart rate decreases to less than 60 and hypertension occurs. The PACU nurse notifies the neurosurgeon and anticipates the need for: A. Phenytoin and mannitol B. Atropine and furosemide C. Analgesics and midazolam D. Nitroprusside and labetolol- A. Phenytoin and mannitol B. Atropine and furosemide C. Analgesics and midazolam D. Nitroprusside and labetolol While drawing-up Versed into a syringe to use during a bedside procedure the perianesthesia nurse must make certain the label identifies the: A. Patient's full name the drug name and the expiration date B. Patient's full name the hospital identifiers and expiration date C. Medication name the solution strength and the hospital identifier D. Medication name, the quantity, and the solution strength of the medication- A. Patient's full name the drug name and the expiration date B. Patient's full name the hospital identifiers and expiration date C. Medication name the solution strength and the hospital identifier D. Medication name, the quantity, and the solution strength of the medication When conducting a discharge phone call on a patient following a partial thyroidectomy which of the following complaints should prompt the nurse to recommend immediate medical follow-up? A. Tetany B. Nausea C. Headache D. tinnitus- A. Tetany B. Nausea C. Headache D. tinnitus According to the Safe Medical Device Act the perianesthesia nurse must report any serious event that involves: A. Oral medications B. Restraint application C. Computer programs D. Family interactions- A. Oral medications B. Restraint application C. Computer programs D. Family interactions A perianesthesia nurse in Phase I PACU may care for which of the following patients? A. One unconscious adult stable with artificial airway and one conscious adult stable free of complications B. One unconscious patient hemodynamically stable with a stable airway over the age of 8 and one conscious patient stable free of complications C. Two unconscious stable patients 5 and 8 years of age D. One patient on mechanical life support and one stable patient- A. One unconscious adult stable with artificial airway and one conscious adult stable free of complications B. One unconscious patient hemodynamically stable with a stable airway over the age of 8 and one conscious patient stable free of complications C. Two unconscious stable patients 5 and 8 years of age D. One patient on mechanical life support and one stable patient The ASPAN recommended staffing ratio for a patient in isolation upon arrival to PACU is: A. One RN to one patient B. Two RNs to one patient C. One RN to two patients D. One RN to three patients- A. One RN to one patient B. Two RNs to one patient C. One RN to two patients D. One RN to three patients According to the ASPAN Perianesthesia Nursing Standards Practice Recommendations and Interpretive Statements the perianesthesia nurse administering moderate sedation to a patient makes sure that an emergency cart with a defibrillator is: A. Immediately available during the administrations B. Available on the next floor, near the elevator C. Unnecessary for a patient whose ASA score is 2 or less D. Unnecessary for moderate sedation- A. Immediately available during the administrations B. Available on the next floor, near the elevator C. Unnecessary for a patient whose ASA score is 2 or less D. Unnecessary for moderate sedation According to the American Society of Perianesthesia Nursing guidelines staffing of Phase I and Phase II PACUs is based on which of the following? A. A ratio of one registered nurse to two patients B. Vacation schedules and bed availability C. Patient acuity and physical facility D. The number of staff with ACLS and PALS- A. A ratio of one registered nurse to two patients B. Vacation schedules and bed availability C. Patient acuity and physical facility D. The number of staff with ACLS and PALS The most common allegation for medical malpractice claims occurring in the PACU is failure to: A. Obtain adequate orders B. Provide discharge teaching C. Monitor the patient's physiologic status D. Document appropriately- A. Obtain adequate orders B. Provide discharge teaching C. Monitor the patient's physiologic status D. Document appropriately A patient has been given ketamine as part of the anesthesia regimen. T