Certified Post Anesthesia Nurse CPAN Exam
2025| Actual 185 Questions and Correct Answers
with Explanations for Guaranteed Success
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:
Sensory, motor, autonomic
Motor, sensory, autonomic
Autonomic, sensory, motor
Motor, autonomic, sensory
Correct Answer: 3. Autonomic, sensory, motor
Explanation: Spinal anesthesia blocks nerve conduction in the order of autonomic fibers first
(affecting blood pressure and other autonomic functions), followed by sensory fibers (loss of
sensation), and then motor fibers (loss of movement). This sequence is due to the varying
sensitivity of nerve fiber types to local anesthetics.
Question 2: After extubation of a patient, which of the following would be considered most
serious?
Sore throat
Impaired swallowing ability
Inspiratory stridor
Hoarseness
Correct Answer: 3. Inspiratory stridor
,Explanation: Inspiratory stridor indicates potential airway obstruction, which is a critical and
potentially life-threatening condition requiring immediate intervention. Sore throat, impaired
swallowing, and hoarseness are less severe and typically resolve without urgent intervention.
Question 3: 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.
Correct Answer: 2. Treat tachydysrhythmias and hypotension.
Explanation: Addressing tachydysrhythmias and hypotension is the priority to restore
adequate cardiac perfusion and oxygen delivery, as these directly impact coronary artery blood
flow. Monitoring and maintaining hemoglobin are important but secondary to stabilizing acute
hemodynamic instability.
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:
Has had minor surgery.
Has normal vital signs.
Has had regional anesthesia.
Is severely hypothermic.
Correct Answer: 4. Is severely hypothermic.
Explanation: Severe hypothermia can impair oxygen delivery and increase the risk of
hypoxemia, making pulse oximetry monitoring critical. Patients with minor surgery, normal vital
signs, or regional anesthesia may not require continuous monitoring unless other risk factors are
present.
,Question 5: The perianesthesia nurse is aware that a dramatic decrease in calcium may be caused
by removal of the:
Pituitary gland.
Thyroid gland.
Parathyroid gland.
Adrenal glands.
Correct Answer: 3. Parathyroid gland.
Explanation: The parathyroid glands regulate calcium levels through parathyroid hormone
(PTH). Removal or damage during surgery (e.g., thyroidectomy) can lead to hypocalcemia due
to decreased PTH production.
Question 6: 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.
Correct Answer: 2. Gas passing into or out of the lungs in each respiratory cycle.
Explanation: Tidal volume is the volume of air moved into or out of the lungs during a single
normal breath (respiratory cycle). It does not refer to minute ventilation, residual volume, or total
inspiratory/expiratory exchange.
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:
Fear of the medical equipment.
, Striving for approval.
Loss of privacy.
Separation from parents.
Correct Answer: 4. Separation from parents.
Explanation: Preschool-aged children primarily experience anxiety due to separation from
parents, as they rely heavily on parental presence for security and comfort in unfamiliar settings
like a hospital.
Question 8: One of the most frequent side effects of ketamine anesthesia is:
Hallucination.
Respiratory depression.
Hypotension.
Bradycardia.
Correct Answer: 1. Hallucination.
Explanation: Ketamine is known for causing dissociative effects, including hallucinations,
particularly during emergence. It typically preserves respiratory drive and cardiovascular
stability, making respiratory depression, hypotension, and bradycardia less common.
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:
Patient refusal.
Chronic back pain.
Multiple sclerosis.
Sickle cell anemia.
2025| Actual 185 Questions and Correct Answers
with Explanations for Guaranteed Success
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:
Sensory, motor, autonomic
Motor, sensory, autonomic
Autonomic, sensory, motor
Motor, autonomic, sensory
Correct Answer: 3. Autonomic, sensory, motor
Explanation: Spinal anesthesia blocks nerve conduction in the order of autonomic fibers first
(affecting blood pressure and other autonomic functions), followed by sensory fibers (loss of
sensation), and then motor fibers (loss of movement). This sequence is due to the varying
sensitivity of nerve fiber types to local anesthetics.
Question 2: After extubation of a patient, which of the following would be considered most
serious?
Sore throat
Impaired swallowing ability
Inspiratory stridor
Hoarseness
Correct Answer: 3. Inspiratory stridor
,Explanation: Inspiratory stridor indicates potential airway obstruction, which is a critical and
potentially life-threatening condition requiring immediate intervention. Sore throat, impaired
swallowing, and hoarseness are less severe and typically resolve without urgent intervention.
Question 3: 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.
Correct Answer: 2. Treat tachydysrhythmias and hypotension.
Explanation: Addressing tachydysrhythmias and hypotension is the priority to restore
adequate cardiac perfusion and oxygen delivery, as these directly impact coronary artery blood
flow. Monitoring and maintaining hemoglobin are important but secondary to stabilizing acute
hemodynamic instability.
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:
Has had minor surgery.
Has normal vital signs.
Has had regional anesthesia.
Is severely hypothermic.
Correct Answer: 4. Is severely hypothermic.
Explanation: Severe hypothermia can impair oxygen delivery and increase the risk of
hypoxemia, making pulse oximetry monitoring critical. Patients with minor surgery, normal vital
signs, or regional anesthesia may not require continuous monitoring unless other risk factors are
present.
,Question 5: The perianesthesia nurse is aware that a dramatic decrease in calcium may be caused
by removal of the:
Pituitary gland.
Thyroid gland.
Parathyroid gland.
Adrenal glands.
Correct Answer: 3. Parathyroid gland.
Explanation: The parathyroid glands regulate calcium levels through parathyroid hormone
(PTH). Removal or damage during surgery (e.g., thyroidectomy) can lead to hypocalcemia due
to decreased PTH production.
Question 6: 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.
Correct Answer: 2. Gas passing into or out of the lungs in each respiratory cycle.
Explanation: Tidal volume is the volume of air moved into or out of the lungs during a single
normal breath (respiratory cycle). It does not refer to minute ventilation, residual volume, or total
inspiratory/expiratory exchange.
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:
Fear of the medical equipment.
, Striving for approval.
Loss of privacy.
Separation from parents.
Correct Answer: 4. Separation from parents.
Explanation: Preschool-aged children primarily experience anxiety due to separation from
parents, as they rely heavily on parental presence for security and comfort in unfamiliar settings
like a hospital.
Question 8: One of the most frequent side effects of ketamine anesthesia is:
Hallucination.
Respiratory depression.
Hypotension.
Bradycardia.
Correct Answer: 1. Hallucination.
Explanation: Ketamine is known for causing dissociative effects, including hallucinations,
particularly during emergence. It typically preserves respiratory drive and cardiovascular
stability, making respiratory depression, hypotension, and bradycardia less common.
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:
Patient refusal.
Chronic back pain.
Multiple sclerosis.
Sickle cell anemia.
