CAPA Evidence-Based Practice in PACU 2 — Questions and Answers
Question 1: According to evidence-based guidelines, which intervention most effectively reduces postoperative nausea and vomiting (PONV) in high-risk ambulatory patients?
- Single-agent antiemetic prophylaxis only
- Multimodal prophylaxis combining two or more antiemetic agents (Correct answer)
- Restricting oral fluids until discharge
- Routine nasogastric tube placement
Correct answer: Multimodal prophylaxis combining two or more antiemetic agents
Evidence supports multimodal PONV prophylaxis using two or more agents from different classes for high-risk patients.
Question 2: When appraising a research study for PACU practice change, which study design provides the highest level of evidence?
- Expert opinion consensus statement
- Case-control study
- Randomized controlled trial (Correct answer)
- Retrospective cohort study
Correct answer: Randomized controlled trial
Randomized controlled trials are considered the gold standard for evidence quality in clinical research hierarchies.
Question 3: An evidence-based practice protocol recommends early ambulation post-PACU discharge. Which outcome does this primarily target?
- Reduction of surgical site infection
- Prevention of deep vein thrombosis and pulmonary embolism (Correct answer)
- Improvement of anesthetic elimination
- Reduction of incisional pain
Correct answer: Prevention of deep vein thrombosis and pulmonary embolism
Early ambulation is evidence-based for reducing venous stasis and the risk of DVT and PE in postoperative patients.
Question 4: The ASPAN evidence-based practice model recommends that nurses grade evidence before implementing a practice change. What does a Grade A recommendation signify?
- Expert opinion with limited clinical data
- Evidence from at least one well-designed RCT or systematic review (Correct answer)
- Animal study data extrapolated to humans
- Observational data from a single institution
Correct answer: Evidence from at least one well-designed RCT or systematic review
Grade A recommendations are supported by strong evidence from randomized controlled trials or systematic reviews.
Question 5: Which outcome measure is most appropriate for evaluating evidence-based pain management effectiveness in the PACU?
- Time to first analgesic request only
- Patient-reported pain scores combined with functional assessments (Correct answer)
- Nurse assessment of behavioral cues alone
- Total opioid dose administered during surgery
Correct answer: Patient-reported pain scores combined with functional assessments
Combining patient-reported pain scores with functional status provides a more comprehensive, evidence-based measure of pain management.
Question 6: A CAPA nurse wants to implement evidence-based temperature monitoring. According to best practice, what is the threshold for defining postoperative hypothermia?
- Core temperature below 37°C
- Core temperature below 36°C (Correct answer)
- Core temperature below 35°C
- Core temperature below 34°C
Correct answer: Core temperature below 36°C
Clinical evidence and guidelines define postoperative hypothermia as a core temperature below 36°C.
Question 7: In evidence-based PACU practice, which strategy best supports early discharge readiness in ambulatory surgical patients?
- Requiring all patients to void before discharge regardless of procedure
- Using validated discharge scoring tools such as the Modified Aldrete or PADSS (Correct answer)
- Keeping patients until the effects of all reversal agents are verified
- Delaying discharge until oral intake equals preoperative baseline
Correct answer: Using validated discharge scoring tools such as the Modified Aldrete or PADSS
Validated discharge scoring tools like the Modified Aldrete or PADSS provide objective, evidence-based criteria for safe discharge.
CAPA Evidence-Based Practice in PACU 2
According to evidence-based guidelines, which intervention most effectively reduces postoperative nausea and vomiting (PONV) in high-risk ambulatory patients?