Certified Post Anesthesia Nurse (CPAN) Exam
Verified Questions, Correct Answers, and
Detailed Explanations for Students||Already
Graded A+
1. Which of the following is the most common cause of
postoperative hypoxemia?
A. Pulmonary embolism
B. Atelectasis
C. Pneumothorax
D. Aspiration
Answer: B. Atelectasis
Rationale: Atelectasis, or alveolar collapse, is the most frequent
cause of hypoxemia after surgery due to shallow breathing, pain, and
anesthesia effects.
2. What is the recommended oxygen saturation target for most
post-anesthesia patients?
A. >85%
B. >90%
C. >92%
D. >95%
Answer: C. >92%
Rationale: Maintaining SpO₂ above 92% ensures adequate
oxygenation while avoiding hyperoxia in most post-anesthesia
patients.
3. A patient in the PACU develops sudden hypotension,
tachycardia, and cool, clammy skin. The first nursing action should
be:
,A. Administer IV fluids
B. Notify the surgeon
C. Assess airway, breathing, and circulation
D. Apply oxygen via mask
Answer: C. Assess airway, breathing, and circulation
Rationale: ABC assessment is the priority to identify life-threatening
conditions and stabilize the patient before other interventions.
4. Which of the following medications is commonly used to reverse
opioid-induced respiratory depression?
A. Flumazenil
B. Naloxone
C. Atropine
D. Protamine
Answer: B. Naloxone
Rationale: Naloxone is an opioid antagonist that rapidly reverses
opioid-induced respiratory depression and sedation.
5. Postoperative nausea and vomiting (PONV) is most commonly
associated with:
A. Regional anesthesia
B. Short surgical procedures
C. Female gender, non-smoker, history of motion sickness
D. Elderly patients
Answer: C. Female gender, non-smoker, history of motion sickness
Rationale: These factors are well-established risk factors for PONV;
awareness allows for prophylaxis and monitoring.
6. A patient who has received spinal anesthesia complains of a
severe headache when sitting upright. The nurse should suspect:
,A. Migraine
B. Post-dural puncture headache
C. Tension headache
D. Sinus headache
Answer: B. Post-dural puncture headache
Rationale: Post-dural puncture headache occurs due to CSF leakage
after spinal anesthesia and typically worsens when the patient is
upright.
7. Which of the following is the earliest sign of malignant
hyperthermia in the PACU?
A. Hyperthermia
B. Tachycardia
C. Muscle rigidity
D. Acidosis
Answer: C. Muscle rigidity
Rationale: Early signs include generalized or jaw rigidity;
hyperthermia often develops later as the crisis progresses.
8. The primary nursing goal when managing a patient with a
nasogastric tube postoperatively is to:
A. Administer medications
B. Monitor tube placement and drainage
C. Promote early feeding
D. Prevent skin breakdown
Answer: B. Monitor tube placement and drainage
Rationale: Proper tube function prevents complications such as
aspiration and ensures adequate gastric decompression.
, 9. Which intervention is most effective in preventing postoperative
atelectasis?
A. Early ambulation
B. Administering opioids
C. Limiting fluid intake
D. Keeping the patient NPO
Answer: A. Early ambulation
Rationale: Ambulation and deep-breathing exercises enhance lung
expansion and reduce atelectasis risk.
10. What is the primary purpose of the Aldrete scoring system in
the PACU?
A. Predict postoperative complications
B. Assess readiness for discharge from PACU
C. Evaluate pain management effectiveness
D. Monitor fluid balance
Answer: B. Assess readiness for discharge from PACU
Rationale: The Aldrete score evaluates activity, respiration,
circulation, consciousness, and oxygen saturation to determine safe
discharge.
11. Which electrolyte imbalance is commonly observed after
prolonged surgery with large fluid shifts?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hypermagnesemia
Answer: B. Hypokalemia
Rationale: Large fluid shifts and diuretics can lead to potassium
depletion, increasing risk for arrhythmias.
Verified Questions, Correct Answers, and
Detailed Explanations for Students||Already
Graded A+
1. Which of the following is the most common cause of
postoperative hypoxemia?
A. Pulmonary embolism
B. Atelectasis
C. Pneumothorax
D. Aspiration
Answer: B. Atelectasis
Rationale: Atelectasis, or alveolar collapse, is the most frequent
cause of hypoxemia after surgery due to shallow breathing, pain, and
anesthesia effects.
2. What is the recommended oxygen saturation target for most
post-anesthesia patients?
A. >85%
B. >90%
C. >92%
D. >95%
Answer: C. >92%
Rationale: Maintaining SpO₂ above 92% ensures adequate
oxygenation while avoiding hyperoxia in most post-anesthesia
patients.
3. A patient in the PACU develops sudden hypotension,
tachycardia, and cool, clammy skin. The first nursing action should
be:
,A. Administer IV fluids
B. Notify the surgeon
C. Assess airway, breathing, and circulation
D. Apply oxygen via mask
Answer: C. Assess airway, breathing, and circulation
Rationale: ABC assessment is the priority to identify life-threatening
conditions and stabilize the patient before other interventions.
4. Which of the following medications is commonly used to reverse
opioid-induced respiratory depression?
A. Flumazenil
B. Naloxone
C. Atropine
D. Protamine
Answer: B. Naloxone
Rationale: Naloxone is an opioid antagonist that rapidly reverses
opioid-induced respiratory depression and sedation.
5. Postoperative nausea and vomiting (PONV) is most commonly
associated with:
A. Regional anesthesia
B. Short surgical procedures
C. Female gender, non-smoker, history of motion sickness
D. Elderly patients
Answer: C. Female gender, non-smoker, history of motion sickness
Rationale: These factors are well-established risk factors for PONV;
awareness allows for prophylaxis and monitoring.
6. A patient who has received spinal anesthesia complains of a
severe headache when sitting upright. The nurse should suspect:
,A. Migraine
B. Post-dural puncture headache
C. Tension headache
D. Sinus headache
Answer: B. Post-dural puncture headache
Rationale: Post-dural puncture headache occurs due to CSF leakage
after spinal anesthesia and typically worsens when the patient is
upright.
7. Which of the following is the earliest sign of malignant
hyperthermia in the PACU?
A. Hyperthermia
B. Tachycardia
C. Muscle rigidity
D. Acidosis
Answer: C. Muscle rigidity
Rationale: Early signs include generalized or jaw rigidity;
hyperthermia often develops later as the crisis progresses.
8. The primary nursing goal when managing a patient with a
nasogastric tube postoperatively is to:
A. Administer medications
B. Monitor tube placement and drainage
C. Promote early feeding
D. Prevent skin breakdown
Answer: B. Monitor tube placement and drainage
Rationale: Proper tube function prevents complications such as
aspiration and ensures adequate gastric decompression.
, 9. Which intervention is most effective in preventing postoperative
atelectasis?
A. Early ambulation
B. Administering opioids
C. Limiting fluid intake
D. Keeping the patient NPO
Answer: A. Early ambulation
Rationale: Ambulation and deep-breathing exercises enhance lung
expansion and reduce atelectasis risk.
10. What is the primary purpose of the Aldrete scoring system in
the PACU?
A. Predict postoperative complications
B. Assess readiness for discharge from PACU
C. Evaluate pain management effectiveness
D. Monitor fluid balance
Answer: B. Assess readiness for discharge from PACU
Rationale: The Aldrete score evaluates activity, respiration,
circulation, consciousness, and oxygen saturation to determine safe
discharge.
11. Which electrolyte imbalance is commonly observed after
prolonged surgery with large fluid shifts?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hypermagnesemia
Answer: B. Hypokalemia
Rationale: Large fluid shifts and diuretics can lead to potassium
depletion, increasing risk for arrhythmias.
