Certified Post anesthesia Nurse CPAN Exam Form 1-4,
Questions & Answers
A 60-year-old female is admitted to the PACU following a diagnostic dilation and curettage with general
anesthesia. Chart review reveals normal preoperative EKG-hemoglobin-hematocrit- and electrolyte
values. Past medical history is remarkable for rheumatic fever during childhood. Thirty minutes later
the patient develops the following EKG pattern --- A-fib---
The perianesthesia nurse interprets the rhythm strip as indicating
A. Occasional premature atrial contractions
B. First-degree heart block
C. Atrial flutter
D. Atrial fibrillation - Ans-A. Occasional premature atrial contractions
B. First-degree heart block
C. Atrial flutter
*D. Atrial fibrillation*
A 60-year-old female is admitted to the PACU following a diagnostic dilation and curettage with general
anesthesia. Chart review reveals normal preoperative EKG-hemoglobin-hematocrit- and electrolyte
values. Past medical history is remarkable for rheumatic fever during childhood. Thirty minutes later
the patient develops the following EKG pattern --- A-fib---
If the defibrillator is not set on the synchronized mode during a cardioversion- which life
threatening arrhythmia could occur?
A. Ventricular fibrillations
B. Wenckebach's phenomenon
C. Premature ventricular contractions
D. Ventricular tachycardia -Ans-*Ventricular fibrillations*
Wenckebach's phenomenon
Premature ventricular contractions
Ventricular tachycardia
,A 60-year-old female is admitted to the PACU following a diagnostic dilation and curettage with general
anesthesia. Chart review reveals normal preoperative EKG-hemoglobin-hematocrit- and electrolyte
values. Past medical history is remarkable for rheumatic fever during childhood. Thirty minutes later
the patient develops the following EKG pattern --- A-fib---
The patient is transferred to a surgical nursing unit following successful cardioversion because the
ICU and monitored units are full. The PACU nurse should emphasize assessment for
A. Atrioventricular dissociation
B. Thermal incident
C. Sinus bradycardia
D. Emboli - Ans-A. Atrioventricular dissociation
B. Thermal incident
C. Sinus bradycardia
D. * Emboli*
The perianesthesia nurse has given the patient instructions regarding taking medications on the day of
surgery. Which statement indicates that the patient understands the pre-op teaching
A. "I will only have small amounts of water with the medications I take on the morning of surgery"
B. "Since I have atrial fibrillation, I need to take my warfarin on the morning of surgery"
C. "I will take my vitamins and herbal supplements on the morning of surgery"
D. "Since I am diabetic, I need to take my insulin and eat breakfast every day" - Ans-A. *"I will only have
small amounts of water with the medications I take on the morning of surgery"*
B. "Since I have atrial fibrillation, I need to take my warfarin on the morning of surgery"
C. "I will take my vitamins and herbal supplements on the morning of surgery"
D. "Since I am diabetic, I need to take my insulin and eat breakfast every day"
A patient in Phase II is complaining of nausea and refusing any medication. Which essential oil may be
inhaled to treat post-operative nausea and vomiting?
,A. Rose
B. Sandalwood
C. Lemongrass
D. Peppermint - Ans-A. Rose
B. Sandalwood
C. Lemongrass
D. *Peppermint*
Which one of the following positions would be indicated for a left lower lobectomy?
A. Flat bed rest
B. Turned to operative side only
C. Turned to nonoperative side only
D. Semi-Fowler's position with turning to either side - Ans-A. Flat bed rest
B. Turned to operative side only
C. Turned to nonoperative side only
D. *Semi-Fowler's position with turning to either side*
A patient with an implantable cardioverter defibrillator (ICD) arrives in the PACU with a magnet over
the generator. The perianesthesia nurse should:
A. Remove the magnet so the ICD is activated
B. Remove the magnet so the ICD is deactivated
C. Educate the patient on the care of the magnet
D. Adjust the placement of the magnet - Ans-A. *Remove the magnet so the ICD is activated*
B. Remove the magnet so the ICD is deactivated
C. Educate the patient on the care of the magnet
D. Adjust the placement of the magnet
A patient with a subarachnoid hemorrhage is lethargic but arousable. The patient is taken to surgery for
an aneurysm clipping. ABG shows pH= 7.50 pCO2= 45 mm HG and HCO3-= 30 mEq/L. The
perianesthesia nurse interprets this as:
, A. Respiratory alkalosis
B. Respiratory acidosis
C. Metabolic acidosis
D. Metabolic alkalosis - Ans-A. Respiratory alkalosis
B. Respiratory acidosis
C. Metabolic acidosis
D. *Metabolic alkalosis*
While caring for a patient after lumbar posterior nerve root rhizotomy the perianesthesia nurse
notes the patient has no movement or sensation to the lower extremities. The priority nursing action
is to notify the:
A. Anesthesiologist of muscle paralysis
B. Operating room of the complications
C. Surgeon of the absence of sensation
D. Surgeon of lack of motor ability - Ans-A. Anesthesiologist of muscle paralysis
B. Operating room of the complications
C. Surgeon of the absence of sensation
D. *Surgeon of lack of motor ability*
While assisting an anesthesiologist performing a block for reflex sympathetic dystrophy the
perianesthesia nurse observes that the affected arm becomes warm to the touch and flushed.
The patient reports a sensation of heaviness in the arm. This indicates which of the following?
A. Ineffective regional block
B. Severe allergic reaction
C. Successful therapeutic block
D. Extravasation of the medication - Ans-A. Ineffective regional block
B. Severe allergic reaction
C. *Successful therapeutic block*
D. Extravasation of the medication
Questions & Answers
A 60-year-old female is admitted to the PACU following a diagnostic dilation and curettage with general
anesthesia. Chart review reveals normal preoperative EKG-hemoglobin-hematocrit- and electrolyte
values. Past medical history is remarkable for rheumatic fever during childhood. Thirty minutes later
the patient develops the following EKG pattern --- A-fib---
The perianesthesia nurse interprets the rhythm strip as indicating
A. Occasional premature atrial contractions
B. First-degree heart block
C. Atrial flutter
D. Atrial fibrillation - Ans-A. Occasional premature atrial contractions
B. First-degree heart block
C. Atrial flutter
*D. Atrial fibrillation*
A 60-year-old female is admitted to the PACU following a diagnostic dilation and curettage with general
anesthesia. Chart review reveals normal preoperative EKG-hemoglobin-hematocrit- and electrolyte
values. Past medical history is remarkable for rheumatic fever during childhood. Thirty minutes later
the patient develops the following EKG pattern --- A-fib---
If the defibrillator is not set on the synchronized mode during a cardioversion- which life
threatening arrhythmia could occur?
A. Ventricular fibrillations
B. Wenckebach's phenomenon
C. Premature ventricular contractions
D. Ventricular tachycardia -Ans-*Ventricular fibrillations*
Wenckebach's phenomenon
Premature ventricular contractions
Ventricular tachycardia
,A 60-year-old female is admitted to the PACU following a diagnostic dilation and curettage with general
anesthesia. Chart review reveals normal preoperative EKG-hemoglobin-hematocrit- and electrolyte
values. Past medical history is remarkable for rheumatic fever during childhood. Thirty minutes later
the patient develops the following EKG pattern --- A-fib---
The patient is transferred to a surgical nursing unit following successful cardioversion because the
ICU and monitored units are full. The PACU nurse should emphasize assessment for
A. Atrioventricular dissociation
B. Thermal incident
C. Sinus bradycardia
D. Emboli - Ans-A. Atrioventricular dissociation
B. Thermal incident
C. Sinus bradycardia
D. * Emboli*
The perianesthesia nurse has given the patient instructions regarding taking medications on the day of
surgery. Which statement indicates that the patient understands the pre-op teaching
A. "I will only have small amounts of water with the medications I take on the morning of surgery"
B. "Since I have atrial fibrillation, I need to take my warfarin on the morning of surgery"
C. "I will take my vitamins and herbal supplements on the morning of surgery"
D. "Since I am diabetic, I need to take my insulin and eat breakfast every day" - Ans-A. *"I will only have
small amounts of water with the medications I take on the morning of surgery"*
B. "Since I have atrial fibrillation, I need to take my warfarin on the morning of surgery"
C. "I will take my vitamins and herbal supplements on the morning of surgery"
D. "Since I am diabetic, I need to take my insulin and eat breakfast every day"
A patient in Phase II is complaining of nausea and refusing any medication. Which essential oil may be
inhaled to treat post-operative nausea and vomiting?
,A. Rose
B. Sandalwood
C. Lemongrass
D. Peppermint - Ans-A. Rose
B. Sandalwood
C. Lemongrass
D. *Peppermint*
Which one of the following positions would be indicated for a left lower lobectomy?
A. Flat bed rest
B. Turned to operative side only
C. Turned to nonoperative side only
D. Semi-Fowler's position with turning to either side - Ans-A. Flat bed rest
B. Turned to operative side only
C. Turned to nonoperative side only
D. *Semi-Fowler's position with turning to either side*
A patient with an implantable cardioverter defibrillator (ICD) arrives in the PACU with a magnet over
the generator. The perianesthesia nurse should:
A. Remove the magnet so the ICD is activated
B. Remove the magnet so the ICD is deactivated
C. Educate the patient on the care of the magnet
D. Adjust the placement of the magnet - Ans-A. *Remove the magnet so the ICD is activated*
B. Remove the magnet so the ICD is deactivated
C. Educate the patient on the care of the magnet
D. Adjust the placement of the magnet
A patient with a subarachnoid hemorrhage is lethargic but arousable. The patient is taken to surgery for
an aneurysm clipping. ABG shows pH= 7.50 pCO2= 45 mm HG and HCO3-= 30 mEq/L. The
perianesthesia nurse interprets this as:
, A. Respiratory alkalosis
B. Respiratory acidosis
C. Metabolic acidosis
D. Metabolic alkalosis - Ans-A. Respiratory alkalosis
B. Respiratory acidosis
C. Metabolic acidosis
D. *Metabolic alkalosis*
While caring for a patient after lumbar posterior nerve root rhizotomy the perianesthesia nurse
notes the patient has no movement or sensation to the lower extremities. The priority nursing action
is to notify the:
A. Anesthesiologist of muscle paralysis
B. Operating room of the complications
C. Surgeon of the absence of sensation
D. Surgeon of lack of motor ability - Ans-A. Anesthesiologist of muscle paralysis
B. Operating room of the complications
C. Surgeon of the absence of sensation
D. *Surgeon of lack of motor ability*
While assisting an anesthesiologist performing a block for reflex sympathetic dystrophy the
perianesthesia nurse observes that the affected arm becomes warm to the touch and flushed.
The patient reports a sensation of heaviness in the arm. This indicates which of the following?
A. Ineffective regional block
B. Severe allergic reaction
C. Successful therapeutic block
D. Extravasation of the medication - Ans-A. Ineffective regional block
B. Severe allergic reaction
C. *Successful therapeutic block*
D. Extravasation of the medication
