CPAN (Certified Post Anesthesia Nurse) Practice Exam:
100 Multiple-Choice Questions with Verified Answers
and Detailed Rationales | Latest Update for ASPAN &
Perianesthesia Certification
Questions 1–100 with Correct Answers and Rationales
1. When should report to the PACU nurse occur?
a. Immediately on patient arrival to the PACU
b. Once an assessment has been done
c. Once the anesthesiologist is finished charting
d. Once the patient is deemed stable
Correct Answer: d. Once the patient is deemed stable
Rationale: AORN's guidance statement for patient transfer recommends that the
PACU nurse receive report once the patient has been deemed stable.
2. A patient with diabetes, mild hypertension, and a pacemaker will likely be
assigned what ASA level?
a. ASA I
b. ASA II
c. ASA III
d. ASA IV
Correct Answer: c. ASA III
Rationale: ASA III refers to a patient with a non-incapacitating severe systemic
disease. If this patient only had mild controlled diabetes and hypertension, their
classification is ASA II. If the patient's severe systemic illness caused a constant
threat to life, then they would be classified as ASA IV.
3. The nurse is teaching the patient methods for at-home pain control. When is
the best time to take opioid pain medication?
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,a. When the pain level is at 3
b. When the pain level is at 6
c. Exactly every 4 hours in the first 24 hours post operatively
d. As soon as the pain starts to increase
Correct Answer: d. As soon as the pain starts to increase
Rationale: The nurse should instruct the patient to take pain medication when the
pain begins to increase. Taking opioid medication as needed and as prescribed
will help prevent the patient from becoming addicted to it.
4. The patient is received from the OR after undergoing a vaginal sling procedure.
The report is as follows: The patient received metoclopramide preoperatively.
General anesthesia delivered without complication. Induction by propofol
followed by sevoflurane. IV ondansetron, fentanyl, and neostigmine delivered
prior to PACU arrival. Extubation without event. The patient is put on O2 at 2 LPM
via NC. BP = 136/84, P = 42, RR = 14, Oxygen saturation = 95%. The nurse knows
that the bradycardia is most likely related to which medications?
a. Sevoflurane and neostigmine interaction
b. Sevoflurane, propofol, and fentanyl interaction
c. Metoclopramide and neostigmine interaction
d. Metoclopramide, sevoflurane, and neostigmine reaction
Correct Answer: a. Sevoflurane and neostigmine interaction
Rationale: Neostigmine is used for muscle relaxant reversal in the OR setting. As a
side effect it slows the heart rate by interfering with the breakdown of
acetylcholine. Combined with volatile anesthetics, it can cause junctional
bradycardia. Treatment includes atropine and transcutaneous pacing if indicated.
5. The nurse is evaluating the patient who underwent coronary artery bypass
graft (CABG) surgery for early extubation. The patient currently has a PO2 of 85
mmHg, FIO2 of 30%, PCO2 of 43 mmHg, pH 7.39, SaO2 of 97%, maximum
inspiratory pressure –20, and minute volume 7 L/min. Which statement is true
about the patient's readiness for extubation?
a. The patient is not ready to extubate.
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,b. The patient is ready to extubate.
c. The patient is ready to move to on demand ventilation
d. The patient should be taken off the ventilator but not extubated.
Correct Answer: b. The patient is ready to extubate.
Rationale: The patient is ready to be extubated when: PO2 greater than 80 mm
Hg, FIO2 is 0.40 or less, PCO2 is less than 45 mm Hg, pH is between 7.35–7.45,
SaO2 is greater than 92%, maximum inspiratory pressure less than –20, and
minute volume is greater than 5 L/min. Early extubation after CABG surgery can
improve outcomes.
6. Which of the following medications/anesthetic gases has no effect on uterine
tone?
a. Ketamine
b. Nitrous oxide
c. Desflurane
d. Methohexital
Correct Answer: b. Nitrous oxide
Rationale: Nitrous oxide does not have known effects on uterine tone, which is
why it is used as an anesthetic adjunct in some labor and delivery units.
7. A patient must achieve at least which number on the Aldrete score before
being discharged?
a. 4
b. 6
c. 8
d. 10
Correct Answer: c. 8
Rationale: Although facility policies may vary, most patients should achieve at
least an 8 or higher on the Aldrete score before discharge should occur.
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, 8. Which of the following best describes the nursing roles for the nurse caring for
patients in Postanesthesia Phase II?
a. Focus on basic life-sustaining needs with constant vigilance required during this
phase.
b. Focus on preparation for care in the home or an extended care environment.
c. Focus on providing care when extended observation/intervention after
discharge is required.
d. Focus on preparing the patient for their surgical procedure.
Correct Answer: b. Focus on preparation for care in the home or an extended care
environment.
Rationale: The ASPAN definition of Postanesthesia Phase II care is a focus on
preparation for care in the home or an extended care environment. The greatest
level of vigilance is required in the Phase I PACU area.
9. The post-operative patient has undergone spinal anesthesia. They voice a
significant headache that improves when lying down. What is the most
appropriate nursing intervention?
a. Administer additional IV fluids.
b. Administer pain-relieving medications.
c. Encourage the patient to sit up as much as possible.
d. Provide the patient with decaffeinated instead of caffeinated coffee.
Correct Answer: a. Administer additional IV fluids.
Rationale: The patient is voicing post-dural puncture headache symptoms.
Appropriate nursing interventions include hydration, caffeine, and bed rest
(particularly in the lying down position).
10. According to the Pediatric Advanced Life Support (PALS) algorithm, what is the
initial intravenous epinephrine dose in milligrams for a pediatric patient weighing
20 kilograms?
a. 0.1 milligrams
b. 0.2 milligrams
4|Page
100 Multiple-Choice Questions with Verified Answers
and Detailed Rationales | Latest Update for ASPAN &
Perianesthesia Certification
Questions 1–100 with Correct Answers and Rationales
1. When should report to the PACU nurse occur?
a. Immediately on patient arrival to the PACU
b. Once an assessment has been done
c. Once the anesthesiologist is finished charting
d. Once the patient is deemed stable
Correct Answer: d. Once the patient is deemed stable
Rationale: AORN's guidance statement for patient transfer recommends that the
PACU nurse receive report once the patient has been deemed stable.
2. A patient with diabetes, mild hypertension, and a pacemaker will likely be
assigned what ASA level?
a. ASA I
b. ASA II
c. ASA III
d. ASA IV
Correct Answer: c. ASA III
Rationale: ASA III refers to a patient with a non-incapacitating severe systemic
disease. If this patient only had mild controlled diabetes and hypertension, their
classification is ASA II. If the patient's severe systemic illness caused a constant
threat to life, then they would be classified as ASA IV.
3. The nurse is teaching the patient methods for at-home pain control. When is
the best time to take opioid pain medication?
1|Page
,a. When the pain level is at 3
b. When the pain level is at 6
c. Exactly every 4 hours in the first 24 hours post operatively
d. As soon as the pain starts to increase
Correct Answer: d. As soon as the pain starts to increase
Rationale: The nurse should instruct the patient to take pain medication when the
pain begins to increase. Taking opioid medication as needed and as prescribed
will help prevent the patient from becoming addicted to it.
4. The patient is received from the OR after undergoing a vaginal sling procedure.
The report is as follows: The patient received metoclopramide preoperatively.
General anesthesia delivered without complication. Induction by propofol
followed by sevoflurane. IV ondansetron, fentanyl, and neostigmine delivered
prior to PACU arrival. Extubation without event. The patient is put on O2 at 2 LPM
via NC. BP = 136/84, P = 42, RR = 14, Oxygen saturation = 95%. The nurse knows
that the bradycardia is most likely related to which medications?
a. Sevoflurane and neostigmine interaction
b. Sevoflurane, propofol, and fentanyl interaction
c. Metoclopramide and neostigmine interaction
d. Metoclopramide, sevoflurane, and neostigmine reaction
Correct Answer: a. Sevoflurane and neostigmine interaction
Rationale: Neostigmine is used for muscle relaxant reversal in the OR setting. As a
side effect it slows the heart rate by interfering with the breakdown of
acetylcholine. Combined with volatile anesthetics, it can cause junctional
bradycardia. Treatment includes atropine and transcutaneous pacing if indicated.
5. The nurse is evaluating the patient who underwent coronary artery bypass
graft (CABG) surgery for early extubation. The patient currently has a PO2 of 85
mmHg, FIO2 of 30%, PCO2 of 43 mmHg, pH 7.39, SaO2 of 97%, maximum
inspiratory pressure –20, and minute volume 7 L/min. Which statement is true
about the patient's readiness for extubation?
a. The patient is not ready to extubate.
2|Page
,b. The patient is ready to extubate.
c. The patient is ready to move to on demand ventilation
d. The patient should be taken off the ventilator but not extubated.
Correct Answer: b. The patient is ready to extubate.
Rationale: The patient is ready to be extubated when: PO2 greater than 80 mm
Hg, FIO2 is 0.40 or less, PCO2 is less than 45 mm Hg, pH is between 7.35–7.45,
SaO2 is greater than 92%, maximum inspiratory pressure less than –20, and
minute volume is greater than 5 L/min. Early extubation after CABG surgery can
improve outcomes.
6. Which of the following medications/anesthetic gases has no effect on uterine
tone?
a. Ketamine
b. Nitrous oxide
c. Desflurane
d. Methohexital
Correct Answer: b. Nitrous oxide
Rationale: Nitrous oxide does not have known effects on uterine tone, which is
why it is used as an anesthetic adjunct in some labor and delivery units.
7. A patient must achieve at least which number on the Aldrete score before
being discharged?
a. 4
b. 6
c. 8
d. 10
Correct Answer: c. 8
Rationale: Although facility policies may vary, most patients should achieve at
least an 8 or higher on the Aldrete score before discharge should occur.
3|Page
, 8. Which of the following best describes the nursing roles for the nurse caring for
patients in Postanesthesia Phase II?
a. Focus on basic life-sustaining needs with constant vigilance required during this
phase.
b. Focus on preparation for care in the home or an extended care environment.
c. Focus on providing care when extended observation/intervention after
discharge is required.
d. Focus on preparing the patient for their surgical procedure.
Correct Answer: b. Focus on preparation for care in the home or an extended care
environment.
Rationale: The ASPAN definition of Postanesthesia Phase II care is a focus on
preparation for care in the home or an extended care environment. The greatest
level of vigilance is required in the Phase I PACU area.
9. The post-operative patient has undergone spinal anesthesia. They voice a
significant headache that improves when lying down. What is the most
appropriate nursing intervention?
a. Administer additional IV fluids.
b. Administer pain-relieving medications.
c. Encourage the patient to sit up as much as possible.
d. Provide the patient with decaffeinated instead of caffeinated coffee.
Correct Answer: a. Administer additional IV fluids.
Rationale: The patient is voicing post-dural puncture headache symptoms.
Appropriate nursing interventions include hydration, caffeine, and bed rest
(particularly in the lying down position).
10. According to the Pediatric Advanced Life Support (PALS) algorithm, what is the
initial intravenous epinephrine dose in milligrams for a pediatric patient weighing
20 kilograms?
a. 0.1 milligrams
b. 0.2 milligrams
4|Page
