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American Board of Perianesthesia Nursing
Certification: Certified Post Anesthesia
Nurse Practice Exam Questions And
Correct Answers (Verified Answers) Plus
Explanation 2026 Q&A | Instant
Download Pdf.
Q1. A patient in Phase I PACU has just arrived from the OR
following general anesthesia with endotracheal intubation.
Which assessment finding requires immediate intervention?
✅ B. Stridor on exhalation
Rationale: Stridor indicates upper airway obstruction, often from
laryngospasm or laryngeal edema. This is a critical airway
emergency requiring immediate intervention (jaw thrust, positive
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pressure, possibly succinylcholine). Snoring suggests partial
obstruction but is less emergent; oxygen saturation of 92% is low
but not immediately critical without stridor.
Q2. The most common cause of upper airway obstruction in
the immediate postoperative period is:
✅ C. Posterior displacement of the tongue
Rationale: In a supine, sedated patient, the tongue falls
backward against the posterior pharynx, causing obstruction. This
is the most common cause of post-extubation airway obstruction
and is typically relieved by head tilt, chin lift, or jaw thrust.
Q3. A patient who received succinylcholine during surgery
develops muscle weakness and difficulty weaning from the
ventilator 20 minutes after arrival in PACU. The most likely
cause is:
✅ D. Phase II neuromuscular blockade
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Rationale: Succinylcholine is a depolarizing neuromuscular
blocker. Phase I block (initial depolarization) lasts 5–10 minutes.
Phase II block (prolonged depolarization) can occur after large
doses or in patients with pseudocholinesterase deficiency,
manifesting as prolonged weakness and respiratory depression.
Q4. A patient’s oxygen saturation drops to 85% despite 6
L/min oxygen via face mask. The PACU nurse notes absent
breath sounds on the right side. This is most consistent with:
✅ B. Tension pneumothorax
Rationale: Tension pneumothorax presents with hypoxia, absent
breath sounds on the affected side, tracheal deviation (late sign),
and hypotension. Immediate needle decompression is required.
Atelectasis would not cause absent breath sounds.
Q5. Which medication is first-line for treating laryngospasm?
✅ C. Positive pressure ventilation with 100% oxygen
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Rationale: Initial management of laryngospasm is jaw thrust and
positive pressure ventilation with 100% oxygen. If this fails,
succinylcholine (0.1–0.5 mg/kg IV) is given. Racemic epinephrine
is for post-extubation stridor from edema, not acute
laryngospasm.
Q6. The PACU nurse is caring for a patient who received
neostigmine and glycopyrrolate at the end of surgery. The
patient now has wheezing and difficulty breathing. This is
most likely:
✅ A. Bronchospasm from neostigmine
Rationale: Neostigmine (anticholinesterase) can cause
bronchospasm in susceptible patients (e.g., asthmatics).
Glycopyrrolate (anticholinergic) is given to block muscarinic
effects (bradycardia, salivation), but it does not fully prevent
bronchospasm.
American Board of Perianesthesia Nursing
Certification: Certified Post Anesthesia
Nurse Practice Exam Questions And
Correct Answers (Verified Answers) Plus
Explanation 2026 Q&A | Instant
Download Pdf.
Q1. A patient in Phase I PACU has just arrived from the OR
following general anesthesia with endotracheal intubation.
Which assessment finding requires immediate intervention?
✅ B. Stridor on exhalation
Rationale: Stridor indicates upper airway obstruction, often from
laryngospasm or laryngeal edema. This is a critical airway
emergency requiring immediate intervention (jaw thrust, positive
,Page 2 of 114
pressure, possibly succinylcholine). Snoring suggests partial
obstruction but is less emergent; oxygen saturation of 92% is low
but not immediately critical without stridor.
Q2. The most common cause of upper airway obstruction in
the immediate postoperative period is:
✅ C. Posterior displacement of the tongue
Rationale: In a supine, sedated patient, the tongue falls
backward against the posterior pharynx, causing obstruction. This
is the most common cause of post-extubation airway obstruction
and is typically relieved by head tilt, chin lift, or jaw thrust.
Q3. A patient who received succinylcholine during surgery
develops muscle weakness and difficulty weaning from the
ventilator 20 minutes after arrival in PACU. The most likely
cause is:
✅ D. Phase II neuromuscular blockade
,Page 3 of 114
Rationale: Succinylcholine is a depolarizing neuromuscular
blocker. Phase I block (initial depolarization) lasts 5–10 minutes.
Phase II block (prolonged depolarization) can occur after large
doses or in patients with pseudocholinesterase deficiency,
manifesting as prolonged weakness and respiratory depression.
Q4. A patient’s oxygen saturation drops to 85% despite 6
L/min oxygen via face mask. The PACU nurse notes absent
breath sounds on the right side. This is most consistent with:
✅ B. Tension pneumothorax
Rationale: Tension pneumothorax presents with hypoxia, absent
breath sounds on the affected side, tracheal deviation (late sign),
and hypotension. Immediate needle decompression is required.
Atelectasis would not cause absent breath sounds.
Q5. Which medication is first-line for treating laryngospasm?
✅ C. Positive pressure ventilation with 100% oxygen
, Page 4 of 114
Rationale: Initial management of laryngospasm is jaw thrust and
positive pressure ventilation with 100% oxygen. If this fails,
succinylcholine (0.1–0.5 mg/kg IV) is given. Racemic epinephrine
is for post-extubation stridor from edema, not acute
laryngospasm.
Q6. The PACU nurse is caring for a patient who received
neostigmine and glycopyrrolate at the end of surgery. The
patient now has wheezing and difficulty breathing. This is
most likely:
✅ A. Bronchospasm from neostigmine
Rationale: Neostigmine (anticholinesterase) can cause
bronchospasm in susceptible patients (e.g., asthmatics).
Glycopyrrolate (anticholinergic) is given to block muscarinic
effects (bradycardia, salivation), but it does not fully prevent
bronchospasm.
