CAPA Certification Exam ACTUAL EXAM
2026/2027 | Certified Ambulatory PeriAnesthesia
Nurse | 185 Questions | Verified Q&A | Pass
Guaranteed - A+ Graded
Exam Specifications:
Total Questions: 185
Time Limit: 4 hours (standard CAPA exam )
Passing Standard: 90% (105/185 correct)
SECTION 1: PHASE I & II PERIANESTHESIA NURSING CARE (60 Questions)
Q1: A 72-year-old patient arrives in Phase I recovery following general anesthesia for a laparoscopic
cholecystectomy. The patient's Aldrete score is 6 (activity: 2, respiration: 1, circulation: 2, consciousness:
1, SpO2: 0). Which action should the nurse take FIRST?
A. Transfer the patient to Phase II for continued observation.
B. Administer supplemental oxygen at 2L via nasal cannula.
C. Document the score and reassess in 15 minutes.
D. Notify the anesthesia provider immediately.
Correct Answer: B [CORRECT]
Rationale: The patient has an SpO2 subscore of 0 (SpO2 <90% on room air), indicating immediate
hypoxemia requiring oxygen administration per Phase I recovery standards; this is a nursing intervention
within scope that must precede further assessment or notification (Domain 1: Phase I & II Perianesthesia
Nursing Care). Option A is incorrect because an Aldrete score of 6 (specifically SpO2 of 0) does not meet
the minimum score of 9 required for Phase II transfer in ambulatory settings. Option C delays critical
respiratory intervention and violates the standard of immediate hypoxemia management. Option D is
premature because the nurse must first implement basic supportive measures (oxygen) and reassess
before escalating to the anesthesia provider unless the condition is immediately life-threatening.
,Q2: A 45-year-old patient in Phase II recovery 90 minutes post-colonoscopy with propofol sedation
requests discharge. The Aldrete score is 10, vitals are stable, but the patient states they "feel fine to
drive home." Which response demonstrates appropriate ambulatory perianesthesia nursing judgment?
A. Allow discharge since the Aldrete score meets criteria and the patient feels capable.
B. Explain that a responsible adult must transport the patient home and verify escort availability.
C. Extend observation for another 2 hours to ensure the patient cannot drive.
D. Administer a sedative to prevent the patient from attempting to drive.
Correct Answer: B [CORRECT]
Rationale: Ambulatory perianesthesia standards require a responsible adult escort for all patients
receiving sedation or anesthesia, regardless of Aldrete score or subjective feelings of wellness; cognitive
impairment from residual sedation can persist beyond apparent clinical recovery (Domain 1: Phase I & II
Perianesthesia Nursing Care; Domain 6: Discharge Planning). Option A violates discharge safety
standards and creates significant liability for the facility and nurse. Option C unnecessarily extends stay
without addressing the core requirement of escort verification. Option D is inappropriate and potentially
dangerous, adding additional sedation to an already recovering patient.
Q3: [SELECT ALL THAT APPLY] A 58-year-old patient arrives in Phase I following general anesthesia for
shoulder arthroscopy. Which assessments are the Phase I nurse's priority within the first 5 minutes?
(Select all that apply.)
A. Patency of airway and respiratory rate/depth
B. Level of consciousness and ability to follow commands
C. Presence of surgical dressing and incisional integrity
D. Pain score using a standardized scale
E. Aldrete score calculation
F. Verification of discharge transportation arrangements
Correct Answers: A, B, C, D [CORRECT]
Rationale: Immediate Phase I priorities follow the ABCs: airway patency and respiration (A), neurological
status including consciousness (B), surgical site integrity (C), and comfort assessment (D) are all critical
first assessments upon admission (Domain 1: Phase I & II Perianesthesia Nursing Care). Option E (Aldrete
score) is calculated after these initial assessments are stabilized and ongoing, not within the first 5
,minutes. Option F is a Phase II/discharge consideration, not an immediate post-anesthetic recovery
priority.
Q4: A 3-year-old child arrives in Phase I following tonsillectomy with general anesthesia. The child is
crying, has stridor on inspiration, and SpO2 is 92% on room air. Which intervention is the priority?
A. Administer IV morphine for pain control.
B. Position the child supine for airway alignment.
C. Apply blow-by oxygen and summon anesthesia provider immediately.
D. Offer oral fluids to soothe the throat.
Correct Answer: C [CORRECT]
Rationale: Post-tonsillectomy stridor with hypoxemia indicates potential airway obstruction from
edema, bleeding, or laryngospasm requiring immediate oxygenation and anesthesia provider presence
for potential airway intervention (Domain 1: Phase I & II Perianesthesia Nursing Care; Domain 2: Airway
& Physiologic Management). Option A is contraindicated because morphine can further depress
respiration and mask neurological deterioration in a potentially obstructed airway. Option B is
dangerous as supine positioning may worsen airway obstruction in a child with potential upper airway
edema; lateral or upright positioning is preferred. Option D is contraindicated because oral fluids are
prohibited until airway reflexes are fully intact and bleeding risk is assessed.
Q5: You are the Phase II nurse preparing a patient for discharge following breast biopsy with local
anesthesia and monitored anesthesia care (MAC). Which finding requires you to delay discharge?
A. Patient reports pain score of 3/10 controlled with oral acetaminophen.
B. Patient is unable to void 6 hours post-procedure with 300mL bladder scan.
C. Patient has stable vital signs and Aldrete score of 10.
D. Patient's responsible adult escort has arrived and signed instructions.
Correct Answer: B [CORRECT]
Rationale: Inability to void with significant urinary retention (300mL) following anesthesia requires
intervention before discharge to prevent complications; this meets criteria for bladder catheterization or
extended observation in ambulatory settings (Domain 1: Phase I & II Perianesthesia Nursing Care;
Domain 6: Discharge Planning). Option A represents acceptable pain control for discharge. Option C
, indicates full recovery readiness. Option D satisfies the escort requirement but does not override
medical discharge criteria.
Q6: A 68-year-old patient with a history of obstructive sleep apnea (OSA) is in Phase I recovery following
total knee replacement under spinal anesthesia. The patient is somnolent but arousable, respiratory
rate 10/min, SpO2 89% on 2L NC. Which action should the nurse take FIRST?
A. Increase oxygen to 4L and apply continuous capnography.
B. Transfer to Phase II since spinal anesthesia doesn't require full Aldrete recovery.
C. Administer naloxone assuming opioid overdose from spinal morphine.
D. Position patient prone to improve ventilation.
Correct Answer: A [CORRECT]
Rationale: The OSA patient with respiratory depression and hypoxemia requires immediate increased
oxygen support and capnography monitoring to detect hypoventilation and CO2 retention, which are
high-risk in this population (Domain 1: Phase I & II Perianesthesia Nursing Care; Domain 2: Airway &
Physiologic Management). Option B is incorrect because spinal anesthesia with sedation requires full
Phase I recovery, and OSA patients have heightened monitoring needs. Option C is premature without
evidence of opioid-induced respiratory depression; naloxone should be reserved for confirmed opioid
toxicity. Option D is contraindicated as prone positioning post-knee surgery is impractical and potentially
harmful; semi-Fowler's or lateral positioning is appropriate.
Q7: [ORDERED RESPONSE] Place the following Phase I admission activities in the correct priority order:
1. Assess airway patency and breathing pattern
2. Verify patient identity and surgical procedure
3. Check vital signs including SpO2
4. Review anesthesia record for intraoperative events
5. Assess level of consciousness
Correct Order: 2, 1, 3, 5, 4 [CORRECT]
Rationale: Safety protocols require identity/procedure verification first (2) to ensure correct patient;
then immediate ABCs with airway/breathing (1), followed by vital signs (3) and consciousness (5);
anesthesia record review (4) occurs after initial stabilization (Domain 1: Phase I & II Perianesthesia
2026/2027 | Certified Ambulatory PeriAnesthesia
Nurse | 185 Questions | Verified Q&A | Pass
Guaranteed - A+ Graded
Exam Specifications:
Total Questions: 185
Time Limit: 4 hours (standard CAPA exam )
Passing Standard: 90% (105/185 correct)
SECTION 1: PHASE I & II PERIANESTHESIA NURSING CARE (60 Questions)
Q1: A 72-year-old patient arrives in Phase I recovery following general anesthesia for a laparoscopic
cholecystectomy. The patient's Aldrete score is 6 (activity: 2, respiration: 1, circulation: 2, consciousness:
1, SpO2: 0). Which action should the nurse take FIRST?
A. Transfer the patient to Phase II for continued observation.
B. Administer supplemental oxygen at 2L via nasal cannula.
C. Document the score and reassess in 15 minutes.
D. Notify the anesthesia provider immediately.
Correct Answer: B [CORRECT]
Rationale: The patient has an SpO2 subscore of 0 (SpO2 <90% on room air), indicating immediate
hypoxemia requiring oxygen administration per Phase I recovery standards; this is a nursing intervention
within scope that must precede further assessment or notification (Domain 1: Phase I & II Perianesthesia
Nursing Care). Option A is incorrect because an Aldrete score of 6 (specifically SpO2 of 0) does not meet
the minimum score of 9 required for Phase II transfer in ambulatory settings. Option C delays critical
respiratory intervention and violates the standard of immediate hypoxemia management. Option D is
premature because the nurse must first implement basic supportive measures (oxygen) and reassess
before escalating to the anesthesia provider unless the condition is immediately life-threatening.
,Q2: A 45-year-old patient in Phase II recovery 90 minutes post-colonoscopy with propofol sedation
requests discharge. The Aldrete score is 10, vitals are stable, but the patient states they "feel fine to
drive home." Which response demonstrates appropriate ambulatory perianesthesia nursing judgment?
A. Allow discharge since the Aldrete score meets criteria and the patient feels capable.
B. Explain that a responsible adult must transport the patient home and verify escort availability.
C. Extend observation for another 2 hours to ensure the patient cannot drive.
D. Administer a sedative to prevent the patient from attempting to drive.
Correct Answer: B [CORRECT]
Rationale: Ambulatory perianesthesia standards require a responsible adult escort for all patients
receiving sedation or anesthesia, regardless of Aldrete score or subjective feelings of wellness; cognitive
impairment from residual sedation can persist beyond apparent clinical recovery (Domain 1: Phase I & II
Perianesthesia Nursing Care; Domain 6: Discharge Planning). Option A violates discharge safety
standards and creates significant liability for the facility and nurse. Option C unnecessarily extends stay
without addressing the core requirement of escort verification. Option D is inappropriate and potentially
dangerous, adding additional sedation to an already recovering patient.
Q3: [SELECT ALL THAT APPLY] A 58-year-old patient arrives in Phase I following general anesthesia for
shoulder arthroscopy. Which assessments are the Phase I nurse's priority within the first 5 minutes?
(Select all that apply.)
A. Patency of airway and respiratory rate/depth
B. Level of consciousness and ability to follow commands
C. Presence of surgical dressing and incisional integrity
D. Pain score using a standardized scale
E. Aldrete score calculation
F. Verification of discharge transportation arrangements
Correct Answers: A, B, C, D [CORRECT]
Rationale: Immediate Phase I priorities follow the ABCs: airway patency and respiration (A), neurological
status including consciousness (B), surgical site integrity (C), and comfort assessment (D) are all critical
first assessments upon admission (Domain 1: Phase I & II Perianesthesia Nursing Care). Option E (Aldrete
score) is calculated after these initial assessments are stabilized and ongoing, not within the first 5
,minutes. Option F is a Phase II/discharge consideration, not an immediate post-anesthetic recovery
priority.
Q4: A 3-year-old child arrives in Phase I following tonsillectomy with general anesthesia. The child is
crying, has stridor on inspiration, and SpO2 is 92% on room air. Which intervention is the priority?
A. Administer IV morphine for pain control.
B. Position the child supine for airway alignment.
C. Apply blow-by oxygen and summon anesthesia provider immediately.
D. Offer oral fluids to soothe the throat.
Correct Answer: C [CORRECT]
Rationale: Post-tonsillectomy stridor with hypoxemia indicates potential airway obstruction from
edema, bleeding, or laryngospasm requiring immediate oxygenation and anesthesia provider presence
for potential airway intervention (Domain 1: Phase I & II Perianesthesia Nursing Care; Domain 2: Airway
& Physiologic Management). Option A is contraindicated because morphine can further depress
respiration and mask neurological deterioration in a potentially obstructed airway. Option B is
dangerous as supine positioning may worsen airway obstruction in a child with potential upper airway
edema; lateral or upright positioning is preferred. Option D is contraindicated because oral fluids are
prohibited until airway reflexes are fully intact and bleeding risk is assessed.
Q5: You are the Phase II nurse preparing a patient for discharge following breast biopsy with local
anesthesia and monitored anesthesia care (MAC). Which finding requires you to delay discharge?
A. Patient reports pain score of 3/10 controlled with oral acetaminophen.
B. Patient is unable to void 6 hours post-procedure with 300mL bladder scan.
C. Patient has stable vital signs and Aldrete score of 10.
D. Patient's responsible adult escort has arrived and signed instructions.
Correct Answer: B [CORRECT]
Rationale: Inability to void with significant urinary retention (300mL) following anesthesia requires
intervention before discharge to prevent complications; this meets criteria for bladder catheterization or
extended observation in ambulatory settings (Domain 1: Phase I & II Perianesthesia Nursing Care;
Domain 6: Discharge Planning). Option A represents acceptable pain control for discharge. Option C
, indicates full recovery readiness. Option D satisfies the escort requirement but does not override
medical discharge criteria.
Q6: A 68-year-old patient with a history of obstructive sleep apnea (OSA) is in Phase I recovery following
total knee replacement under spinal anesthesia. The patient is somnolent but arousable, respiratory
rate 10/min, SpO2 89% on 2L NC. Which action should the nurse take FIRST?
A. Increase oxygen to 4L and apply continuous capnography.
B. Transfer to Phase II since spinal anesthesia doesn't require full Aldrete recovery.
C. Administer naloxone assuming opioid overdose from spinal morphine.
D. Position patient prone to improve ventilation.
Correct Answer: A [CORRECT]
Rationale: The OSA patient with respiratory depression and hypoxemia requires immediate increased
oxygen support and capnography monitoring to detect hypoventilation and CO2 retention, which are
high-risk in this population (Domain 1: Phase I & II Perianesthesia Nursing Care; Domain 2: Airway &
Physiologic Management). Option B is incorrect because spinal anesthesia with sedation requires full
Phase I recovery, and OSA patients have heightened monitoring needs. Option C is premature without
evidence of opioid-induced respiratory depression; naloxone should be reserved for confirmed opioid
toxicity. Option D is contraindicated as prone positioning post-knee surgery is impractical and potentially
harmful; semi-Fowler's or lateral positioning is appropriate.
Q7: [ORDERED RESPONSE] Place the following Phase I admission activities in the correct priority order:
1. Assess airway patency and breathing pattern
2. Verify patient identity and surgical procedure
3. Check vital signs including SpO2
4. Review anesthesia record for intraoperative events
5. Assess level of consciousness
Correct Order: 2, 1, 3, 5, 4 [CORRECT]
Rationale: Safety protocols require identity/procedure verification first (2) to ensure correct patient;
then immediate ABCs with airway/breathing (1), followed by vital signs (3) and consciousness (5);
anesthesia record review (4) occurs after initial stabilization (Domain 1: Phase I & II Perianesthesia
