CAPA Discharge Criteria & Planning 2 — Questions and Answers
Question 1: A patient scores 9 on the Modified Aldrete Score after ambulatory surgery. Which single criterion is most likely keeping the score below 10?
- Oxygen saturation of 94% on room air (Correct answer)
- Blood pressure within 20% of baseline
- Able to move all four extremities
- Fully awake and oriented
Correct answer: Oxygen saturation of 94% on room air
An SpO2 of 94% on room air scores 1 instead of 2, commonly preventing a perfect Modified Aldrete Score.
Question 2: Which of the following is the MOST appropriate pain criterion for ambulatory discharge readiness?
- Complete absence of pain
- Pain controlled with oral analgesics and rated ≤4/10 (Correct answer)
- Pain rated ≤7/10 regardless of medication
- IV opioids required but patient is comfortable
Correct answer: Pain controlled with oral analgesics and rated ≤4/10
Discharge pain criteria require pain manageable with oral analgesics and rated at or below a moderate level (≤4/10).
Question 3: A patient who received spinal anesthesia is ready for discharge when which of the following criteria is met?
- Absence of any sensory block in the lower extremities
- Return of perianal sensation, plantar flexion, and proprioception (Correct answer)
- Patient able to bear weight for 30 seconds
- Motor block resolved but sensory block may persist
Correct answer: Return of perianal sensation, plantar flexion, and proprioception
Return of perianal (S4-S5) sensation, plantar flexion, and proprioception confirms adequate regression of spinal block for safe discharge.
Question 4: Which instruction is MOST critical to include when discharging an ambulatory surgery patient who received general anesthesia?
- Avoid alcohol for 24 hours and do not drive or make legal decisions (Correct answer)
- Resume a normal diet immediately to regain strength
- Return to work the following morning if feeling well
- Resume all prescription medications at the usual time tonight
Correct answer: Avoid alcohol for 24 hours and do not drive or make legal decisions
Residual anesthetic effects impair judgment and psychomotor function for 24 hours, making driving and legal decisions unsafe.
Question 5: A Phase I PACU nurse is evaluating a patient for fast-tracking directly to Phase II. Which finding would EXCLUDE fast-tracking?
- Modified Aldrete Score of 12
- Nausea controlled with antiemetics
- PONV requiring IV antiemetics every 15 minutes (Correct answer)
- Mild incisional discomfort rated 3/10
Correct answer: PONV requiring IV antiemetics every 15 minutes
Persistent PONV requiring frequent IV antiemetics indicates the patient is not stable enough to bypass Phase I monitoring.
Question 6: Before discharging a patient following ambulatory knee arthroscopy, which assessment BEST confirms readiness for ambulation at home?
- Patient verbalizes understanding of crutch use
- Patient successfully ambulates with assistive device under nursing supervision (Correct answer)
- Surgeon has documented weight-bearing orders
- Physical therapy has been consulted
Correct answer: Patient successfully ambulates with assistive device under nursing supervision
Actual supervised ambulation assessment confirms the patient can safely mobilize at home before discharge.
Question 7: A 68-year-old patient is ready for discharge but lives alone. Which action is MOST appropriate?
- Discharge the patient with a written phone number for the unit
- Delay discharge until a responsible adult escort is arranged (Correct answer)
- Call a taxi and provide the driver with discharge instructions
- Discharge and schedule a same-day phone follow-up
Correct answer: Delay discharge until a responsible adult escort is arranged
A responsible adult escort and caregiver are mandatory for ambulatory surgery discharge; living alone without one contraindicates immediate discharge.
CAPA Discharge Criteria & Planning 2
A patient scores 9 on the Modified Aldrete Score after ambulatory surgery.
Which single criterion is most likely keeping the score below 10?