CAPA CAPA Anxiety & Psychological Support 2 — Questions and Answers
Question 1: Which non-pharmacologic intervention has STRONG evidence for reducing preoperative anxiety in adults?
- Mandatory fasting for 12+ hours
- Music therapy and guided relaxation (Correct answer)
- Routine use of preoperative benzodiazepines
- Complete isolation before surgery
Correct answer: Music therapy and guided relaxation
Music therapy and guided relaxation have demonstrated effectiveness in reducing anxiety without pharmacologic side effects in the perioperative setting.
Question 2: A patient expresses extreme fear about waking up during surgery. The BEST nursing response is to:
- Dismiss the concern as statistically unlikely
- Validate the concern and explain intraoperative monitoring protocols (Correct answer)
- Refer the patient to psychiatry before proceeding
- Reassure without providing any details
Correct answer: Validate the concern and explain intraoperative monitoring protocols
Validating the patient's concern and providing factual information about anesthesia monitoring addresses fear with both empathy and education.
Question 3: Emergence delirium is MOST commonly seen in which patient population in the PACU?
- Elderly patients on beta-blockers
- Young children and older adults (Correct answer)
- Middle-aged adults with anxiety disorders
- Patients who received spinal anesthesia
Correct answer: Young children and older adults
Young children (especially ages 2-6) and elderly adults are most susceptible to emergence delirium due to developmental and neurological factors.
Question 4: Which assessment tool is MOST appropriate for screening for postoperative delirium in elderly patients?
- FLACC scale
- Confusion Assessment Method (CAM) (Correct answer)
- Richmond Agitation-Sedation Scale (RASS)
- Visual Analog Scale
Correct answer: Confusion Assessment Method (CAM)
The Confusion Assessment Method (CAM) is the gold standard tool for identifying delirium in non-ICU patients, including postoperative elderly adults.
Question 5: A patient recovering from ambulatory surgery is tearful and states they feel like something is wrong. The nurse should:
- Explain that these feelings are normal and will pass
- Thoroughly assess the patient for physiologic and psychological concerns (Correct answer)
- Administer an anti-anxiety medication per protocol
- Ask the family to provide comfort while the nurse attends other patients
Correct answer: Thoroughly assess the patient for physiologic and psychological concerns
Tearfulness or a sense of impending doom can be a symptom of both psychological distress and serious physiologic events and requires thorough assessment.
Question 6: Allowing family members to be present during PACU recovery has been shown to:
- Increase patient anxiety
- Decrease patient anxiety and improve satisfaction (Correct answer)
- Interfere with nursing assessments
- Increase length of PACU stay
Correct answer: Decrease patient anxiety and improve satisfaction
Research supports that family presence in the PACU reduces patient anxiety, promotes comfort, and improves overall satisfaction scores.
CAPA CAPA Anxiety & Psychological Support 2
Which non-pharmacologic intervention has STRONG evidence for reducing preoperative anxiety in adults?