CPAN Exam Prep | Certified Post Anesthesia
Nurse Study Guide & Perianesthesia Practice
Questions with Complete Solutions (Already
Passed A+) 2026/2027
• ventricular tachycardia treatment -✓✓magnesium, lidocaine, or isoproterenol
infusion to shorten QT interval
• causes of local anesthestic systemic toxicity -✓✓inadvertant vascular injection of
drug from nerve blocks and occasional result from continuous infusion and
accumulation of drug for days
• Second degree AV block Type 1 (Wenckebach) -✓✓PR interval gets
progressively longer until the ventricular beat is dropped
- irregular rhythm
• Stable tachycardia treatment -✓✓Adenosine 6mg IV push followed by fluid bolus
- 12mg dose may be administered twice after initial 6mg dose
• Unstable tachycardia treatment -✓✓sedation if conscious and synchronized
cardioversion followed by ACLS strategies
• atrial fibrillation/ atrial flutter -✓✓no organized atrial activities therefore no P
waves
• afib/a flutter treatment -✓✓anticoagulants
cardizem or amiodarone to control rate
if unstable: cardioversion
• dantrolene dosing for maligent hyperthermia -✓✓2.5mg/kg IV bolus repeated
every 5-10 minutes until symptoms improve
- dosing as high as 10mg/kg may be needed
• 2 different concentrations of dantrolene -✓✓- Dantrium/Revonto [20mg/vial]
reconstituted with 60 mL sterile water for injection
- Ryanodex [250 mg/vial] reconstituted with 5 mL sterile water for injection
,• CPR quality -✓✓- push hard (at least 2 inches) and fast (at least 100)
- allow full chest recoil
- minimize interruptions
- avoid excessive ventilation
- if no advanced airway 30:2
• shock energy for defibrillation -✓✓give 1 shock: biphasic 120-200J
second and subsequent shocks should be equivalent
• ACLS epinephrine dose -✓✓1mg every 3-5 minutes
• ACLS amiodarone dose -✓✓first dose: 300mg bolus
second dose: 150mg
• ACLS lidocaine dose -✓✓first dose: 1-1.5mg/kg
second dose: 0.5-0.75mg/kg
• reversible causes (H's) -✓✓hypovolemia
hypoxia
hydrogen ion (acidosis)
hyperkalemia
hypothemia
• reversible causes (T's) -✓✓tension pneumothorax
tamponade cardiac
toxins
thrombosis pulmonary
thrombosis coronary
• respiration rate for continuous CPR in infant/child with advanced airway -✓✓1
breath every 2-3 seconds (20-30/minute)
• lipid emulsion therapy rescue for LAST -✓✓initial bolus of 20% lipid emulsion:
dose 1.5mL/kg rapidly over 1 minute, followed by continuous infusion at
0.25mL/kg/min
- continue lipid emulsion infusion for at least 10 minutes after patient is stabilized
,• what medications should be avoided for patients with LAST -✓✓vasopressin
calcium channel blockers
beta blockers
propofol
high doses of epi
addition local anesthetic
• how does local anesthetic absorption work -✓✓to slow or prevent cell membrane
depolarization which leads to the complete loss of information across the length of
the neuron resulting in patient percieved "numbness"
- the higher the fat solubility, the faster the absorption
• S&S of malignant hyperthermia -✓✓muscle rigidity
hypercapnia
rhabdomyolysis
hypeerthermia
tachycardia
tachypnea
metabolic acidosis
respiratory acidosis
hyperkalemia
myobloinuria
increased creatinine
dysrhymthias
cyanosis
rigidity
sweating
• 2nd degree AV block type 2 (mobitz) -✓✓some P waves are not conducted to the
ventricule and therefore not followed by the QRS complex
• 2nd degree AV block type 2 (mobitz) treatment -✓✓avoid atropine
transcutaneous or temporary transvenous pacing if placed perioperatively
permanent pacer required to support heart rhythm
• 3rd degree AV block -✓✓total loss of electrical conduction between atria and
ventricles
• 3rd degree AV block treatment -✓✓transcutaneous pacing
, insertion of permanent pacer required
• triggering pharmacological agents for malignent hyperthermia -✓✓Isoflurane,
sevoflurane, desflurane, halothane, enflurane, ether, and the depolarizing muscle
relaxant succinylcholine
• cincinnati prehopsital neurologic screening tool to identify stroke -✓✓facial
drooping
arm drift
abnormal speech
• symptomatic bradycardia treatment -✓✓atropine: 1mg IV bolus repeat every 3-5
minutes to maximum of 3mg IV
transcutaneous pacing
dopamine: 5-20mcg/kg/min
epinephrine: 2-10 mcg/min
• hemorrhagic stroke treatment -✓✓consult neurology - begin hemorrhage pathway
• ischemic stroke treatment -✓✓consider fibrolytic therapy (rTPA)
- no anticoagulants or antiplatelet treatment for 24 hours
- if not canidate for fibrolytic therapyL administer aspirin
• S&S of LAST -✓✓agitation
blurred vision
numbness
tinnitus
metallic taste
twitching
unconsciousness
seizures
cardiac and respiratory arrest
• Vtach treatment -✓✓if awake: amiodarone IV bolus followed by amiodarone
infusion or synchronized cardioversion
if unstable: CPR, defibrillate, ACLS protocol
Nurse Study Guide & Perianesthesia Practice
Questions with Complete Solutions (Already
Passed A+) 2026/2027
• ventricular tachycardia treatment -✓✓magnesium, lidocaine, or isoproterenol
infusion to shorten QT interval
• causes of local anesthestic systemic toxicity -✓✓inadvertant vascular injection of
drug from nerve blocks and occasional result from continuous infusion and
accumulation of drug for days
• Second degree AV block Type 1 (Wenckebach) -✓✓PR interval gets
progressively longer until the ventricular beat is dropped
- irregular rhythm
• Stable tachycardia treatment -✓✓Adenosine 6mg IV push followed by fluid bolus
- 12mg dose may be administered twice after initial 6mg dose
• Unstable tachycardia treatment -✓✓sedation if conscious and synchronized
cardioversion followed by ACLS strategies
• atrial fibrillation/ atrial flutter -✓✓no organized atrial activities therefore no P
waves
• afib/a flutter treatment -✓✓anticoagulants
cardizem or amiodarone to control rate
if unstable: cardioversion
• dantrolene dosing for maligent hyperthermia -✓✓2.5mg/kg IV bolus repeated
every 5-10 minutes until symptoms improve
- dosing as high as 10mg/kg may be needed
• 2 different concentrations of dantrolene -✓✓- Dantrium/Revonto [20mg/vial]
reconstituted with 60 mL sterile water for injection
- Ryanodex [250 mg/vial] reconstituted with 5 mL sterile water for injection
,• CPR quality -✓✓- push hard (at least 2 inches) and fast (at least 100)
- allow full chest recoil
- minimize interruptions
- avoid excessive ventilation
- if no advanced airway 30:2
• shock energy for defibrillation -✓✓give 1 shock: biphasic 120-200J
second and subsequent shocks should be equivalent
• ACLS epinephrine dose -✓✓1mg every 3-5 minutes
• ACLS amiodarone dose -✓✓first dose: 300mg bolus
second dose: 150mg
• ACLS lidocaine dose -✓✓first dose: 1-1.5mg/kg
second dose: 0.5-0.75mg/kg
• reversible causes (H's) -✓✓hypovolemia
hypoxia
hydrogen ion (acidosis)
hyperkalemia
hypothemia
• reversible causes (T's) -✓✓tension pneumothorax
tamponade cardiac
toxins
thrombosis pulmonary
thrombosis coronary
• respiration rate for continuous CPR in infant/child with advanced airway -✓✓1
breath every 2-3 seconds (20-30/minute)
• lipid emulsion therapy rescue for LAST -✓✓initial bolus of 20% lipid emulsion:
dose 1.5mL/kg rapidly over 1 minute, followed by continuous infusion at
0.25mL/kg/min
- continue lipid emulsion infusion for at least 10 minutes after patient is stabilized
,• what medications should be avoided for patients with LAST -✓✓vasopressin
calcium channel blockers
beta blockers
propofol
high doses of epi
addition local anesthetic
• how does local anesthetic absorption work -✓✓to slow or prevent cell membrane
depolarization which leads to the complete loss of information across the length of
the neuron resulting in patient percieved "numbness"
- the higher the fat solubility, the faster the absorption
• S&S of malignant hyperthermia -✓✓muscle rigidity
hypercapnia
rhabdomyolysis
hypeerthermia
tachycardia
tachypnea
metabolic acidosis
respiratory acidosis
hyperkalemia
myobloinuria
increased creatinine
dysrhymthias
cyanosis
rigidity
sweating
• 2nd degree AV block type 2 (mobitz) -✓✓some P waves are not conducted to the
ventricule and therefore not followed by the QRS complex
• 2nd degree AV block type 2 (mobitz) treatment -✓✓avoid atropine
transcutaneous or temporary transvenous pacing if placed perioperatively
permanent pacer required to support heart rhythm
• 3rd degree AV block -✓✓total loss of electrical conduction between atria and
ventricles
• 3rd degree AV block treatment -✓✓transcutaneous pacing
, insertion of permanent pacer required
• triggering pharmacological agents for malignent hyperthermia -✓✓Isoflurane,
sevoflurane, desflurane, halothane, enflurane, ether, and the depolarizing muscle
relaxant succinylcholine
• cincinnati prehopsital neurologic screening tool to identify stroke -✓✓facial
drooping
arm drift
abnormal speech
• symptomatic bradycardia treatment -✓✓atropine: 1mg IV bolus repeat every 3-5
minutes to maximum of 3mg IV
transcutaneous pacing
dopamine: 5-20mcg/kg/min
epinephrine: 2-10 mcg/min
• hemorrhagic stroke treatment -✓✓consult neurology - begin hemorrhage pathway
• ischemic stroke treatment -✓✓consider fibrolytic therapy (rTPA)
- no anticoagulants or antiplatelet treatment for 24 hours
- if not canidate for fibrolytic therapyL administer aspirin
• S&S of LAST -✓✓agitation
blurred vision
numbness
tinnitus
metallic taste
twitching
unconsciousness
seizures
cardiac and respiratory arrest
• Vtach treatment -✓✓if awake: amiodarone IV bolus followed by amiodarone
infusion or synchronized cardioversion
if unstable: CPR, defibrillate, ACLS protocol
