CPAN/ Certified Postanesthesia Nurse, Exams Forms 1-
4, 2022
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
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
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
,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"
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
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
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
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
,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
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
The perianesthesia nurse receives a patient post total parathyroidectomy. The patient
is awake and oriented with a patent airway but complains of tingling around the
mouth- slight hoarseness- and is mildly apprehensive.
The perianesthesia nurse suspects:
A. Vocal cord irritation
B. Hypocalcemia
C. Hypercalcemia
D. Compromised airway
The perianesthesia nurse receives a patient post total parathyroidectomy. The patient
is awake and oriented with a patent airway but complains of tingling around the
mouth- slight hoarseness- and is mildly apprehensive.
The perianesthesia nurse's next action is to:
A. Instruct the patient to remain silent to rest the vocal cords
B. Have patient say "e" to check for nerve damage
C. Call surgeon and anticipate an order for a calcium level
D. Administer pain medication and look for signs of hemorrhage
A 3-year-old patient arrives in the PACU following general anesthesia. The patient
has a croupy cough- inspiratory stridor- and intercostal retractions are noted.
Humidified oxygen is being administered at 8L/min via blow by.
Initially the perianesthesia nurse anticipates:
A. Administration of nebulized racemic epinephrine
B. Assisting the patient's breathing with BMV
, C. Maintaining the patient's head in the sniff position
D. Suctioning the patient's oropharynx
A postoperative pediatric tympanoplasty patient is asked to wrinkle the forehead-
pucker lips- smile- and squeeze eyelids together. The PACU nurse is assessing the
function of cranial nerve:
A. V
B. VII
C. IX
D. XII
Evaluation calls made to an ambulatory patient during the 24-hour period after
discharge can provide effective post-operative follow-up. This nursing action is most
important to :
A. Transfer aftercare to a public health nurse
B. Give the patient a chance to ask questions and identify problems in the care given
C. Advertise the institution's ambulatory surgery program
D. Facilitate readmission in the event of complications - A. Transfer aftercare to a
public health nurse
B. *Give the patient a chance to ask questions and identify problems in the care
given*
C. Advertise the institution's ambulatory surgery program
D. Facilitate readmission in the event of complications
Following stabilization of femur and pelvic fractures a patient becomes anxious and
oxygen saturations decrease to 86%. The patient continues to become confused and
agitated. Upon further assessment the perianesthesia nurse notes petechiae on the
patient's trunk. The perianesthesia nurse suspects:
A. Fat embolism
B. Tension pneumothorax
C. Compartment syndrome
D. Neurogenic bladder - A. *Fat embolism*
B. Tension pneumothorax
C. Compartment syndrome
D. Neurogenic bladder
In a young healthy post-operative patient hypoventilation may be reversed by:
A. Restriction of fluids
B. Administration of oxygen
C. Stimulation of the patient
D. Administration of pain medication - A. Restriction of fluids
4, 2022
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
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
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
,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"
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
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
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
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
,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
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
The perianesthesia nurse receives a patient post total parathyroidectomy. The patient
is awake and oriented with a patent airway but complains of tingling around the
mouth- slight hoarseness- and is mildly apprehensive.
The perianesthesia nurse suspects:
A. Vocal cord irritation
B. Hypocalcemia
C. Hypercalcemia
D. Compromised airway
The perianesthesia nurse receives a patient post total parathyroidectomy. The patient
is awake and oriented with a patent airway but complains of tingling around the
mouth- slight hoarseness- and is mildly apprehensive.
The perianesthesia nurse's next action is to:
A. Instruct the patient to remain silent to rest the vocal cords
B. Have patient say "e" to check for nerve damage
C. Call surgeon and anticipate an order for a calcium level
D. Administer pain medication and look for signs of hemorrhage
A 3-year-old patient arrives in the PACU following general anesthesia. The patient
has a croupy cough- inspiratory stridor- and intercostal retractions are noted.
Humidified oxygen is being administered at 8L/min via blow by.
Initially the perianesthesia nurse anticipates:
A. Administration of nebulized racemic epinephrine
B. Assisting the patient's breathing with BMV
, C. Maintaining the patient's head in the sniff position
D. Suctioning the patient's oropharynx
A postoperative pediatric tympanoplasty patient is asked to wrinkle the forehead-
pucker lips- smile- and squeeze eyelids together. The PACU nurse is assessing the
function of cranial nerve:
A. V
B. VII
C. IX
D. XII
Evaluation calls made to an ambulatory patient during the 24-hour period after
discharge can provide effective post-operative follow-up. This nursing action is most
important to :
A. Transfer aftercare to a public health nurse
B. Give the patient a chance to ask questions and identify problems in the care given
C. Advertise the institution's ambulatory surgery program
D. Facilitate readmission in the event of complications - A. Transfer aftercare to a
public health nurse
B. *Give the patient a chance to ask questions and identify problems in the care
given*
C. Advertise the institution's ambulatory surgery program
D. Facilitate readmission in the event of complications
Following stabilization of femur and pelvic fractures a patient becomes anxious and
oxygen saturations decrease to 86%. The patient continues to become confused and
agitated. Upon further assessment the perianesthesia nurse notes petechiae on the
patient's trunk. The perianesthesia nurse suspects:
A. Fat embolism
B. Tension pneumothorax
C. Compartment syndrome
D. Neurogenic bladder - A. *Fat embolism*
B. Tension pneumothorax
C. Compartment syndrome
D. Neurogenic bladder
In a young healthy post-operative patient hypoventilation may be reversed by:
A. Restriction of fluids
B. Administration of oxygen
C. Stimulation of the patient
D. Administration of pain medication - A. Restriction of fluids
