CPAN, CAPA Cert questions

A 12 year old with known sickle cell disease and autism has undergone an inguinal hernia repair. The perianesthesia nurse is aware that the MAIN surgical risk to this patient is: 1. hypoxia from anesthesia. 2. end-organ damage. 3. renal insufficiency. 4. toxicity from heavy metal. - answer-1. hypoxia from anesthesia. Domain: Physiological Needs Content Area: Stability of Respiratory System Reference: Hockenberry, M., Wilson, D. Wong's Nursing Care of Infants and Children. 10th Ed. CV. Mosby, 2015. pg 1348. A patient arrives in Phase I PACU receiving oxygen by nasal cannula at 2 liters per minute. The wave forms on pulse oximetry are initially normal with an oxygen saturation of 100%. Ten minutes after arrival to Phase I the alarm is sounded and the nurse notes that the monitor has stopped tracking the pulse. The perianesthesia nurse should FIRST: 1. increase the oxygen flow rate to the nasal cannula. 2. move the probe from the finger to the earlobe. 3. encourage patient to cough and deep breathe. 4. evaluate the patient for adverse physiological changes. - answer-4. evaluate the patient for adverse physiological changes. Domain: Physiological Needs Content Area: Stability of respiratory system Reference: Odom-Forren, J. Drain's PeriAnesthesia Nursing: A Critical Care Approach. 6th Ed. Elsevier Saunders, 2013. pg 357. A patient in the PACU who received general anesthesia is awake and alert with stable vital signs. When the perianesthesia nurse removes the patient's oxygen the O2 saturation periodically drops to 88%. The perianestheisa nurse's next best action is to: 1. notify the anesthesia provider 2. administer albuterol nebulizer 3. begin the stir-up regimen 4. perform chin lift - answer-3. begin the stir-up regimen Domain: Physiological Needs Content Area: Stability of respiratory system Reference: Urden, L., et al. Thelan's Critical Care Nursing, Diagnosis and Management, 7th Ed. Elsevier, 2014. pg 1103. A patient with type 2 diabetes mellitus is admitted the day of surgery with a glucose of 610 mg/dl. The perianesthesia nurse is aware that the patient may be at risk for: 1. diabetic ketoacidosis. 2. hypercalcemia. 3. diabetes insipidus. 4. hyperkalemia. - answer-1. DKA Domain: Physiological Needs Content Area: Stability of Endocrine System Reference: Fleisher, L. and Roizen, M. Essence of Anesthesia Practice, 3rd Ed. Elsevier Health Sciences, December, 2011. Pg 122. A week before a patient's surgery, it was noted in the history and physical assessment that the patient has acute bronchitis. The perianesthesia nurse's BEST action is to: 1. proceed with surgery. 2. get an order for an antibiotic. 3. notify the surgeon. 4. postpone the surgery. - answer-3. notify the surgeon. Domain: Physiological Needs Content Area: Stability of respiratory system Reference: American Society of PeriAnesthesia Nurses. Perianesthesia Nursing Standards, Practice Recommendations, and Interpretive Statements . ASPAN, Cherry Hill, NJ, 2015. pg 34 During a pre-op assessment, a patient reports taking his morning dose of medical marijuana. The perianesthesia nurse understands that: 1. recent use may impair ability to give consent. 2. no action is needed due to home medication regimen. 3. it is acceptable if there are no physical signs of marijuana intoxication 4. recent use will decrease post-op agitation - answer-1. recent use may impair ability to give consent Domain: Safety Needs Content Area: Deliver, document, and communicate care based on accepted national standards of perianesthesia nursing practice and applicable laws, guidelines, and regulations Reference: Fleisher, L. and Roizen, M. Essence of Anesthesia Practice, 3rd Ed. Elsevier Health Sciences, December, 2011. pg 616-617. Dur