CAPA Evidence-Based Practice in PACU 4 — Questions and Answers
Question 1: A PACU nurse uses the PICO format to develop a clinical question. What does the 'C' stand for?
- Complication
- Comparison intervention (Correct answer)
- Clinical context
- Cost-effectiveness
Correct answer: Comparison intervention
In the PICO framework, 'C' stands for Comparison, the alternative intervention against which the primary intervention is measured.
Question 2: Evidence-based nursing practice supports which approach to postoperative shivering management in the PACU?
- Active warming blankets as first-line treatment over pharmacologic agents (Correct answer)
- Meperidine administered immediately without assessing cause
- Cold IV fluids to rapidly reduce core temperature
- Withholding treatment until temperature drops below 35°C
Correct answer: Active warming blankets as first-line treatment over pharmacologic agents
Active warming with forced-air blankets is the first-line evidence-based intervention for postoperative shivering related to hypothermia.
Question 3: Which nursing action best demonstrates integration of EBP into daily PACU care?
- Applying interventions based on personal clinical experience only
- Using a validated pain scale consistently and documenting response to analgesics (Correct answer)
- Administering analgesics based on physician preference rather than patient report
- Avoiding protocol changes to maintain consistency
Correct answer: Using a validated pain scale consistently and documenting response to analgesics
Consistently using validated tools and documenting outcomes reflects evidence-based, systematic nursing practice.
Question 4: An evidence-based postoperative nausea protocol includes risk stratification. Which tool is validated for predicting PONV risk in adults?
- Ramsay Sedation Scale
- Apfel Simplified Risk Score (Correct answer)
- Mallampati Classification
- ASA Physical Status Classification
Correct answer: Apfel Simplified Risk Score
The Apfel Simplified Risk Score uses four factors (female sex, non-smoking, PONV history, opioid use) to predict adult PONV risk.
Question 5: A perianesthesia nurse critically appraises a systematic review on regional anesthesia benefits. What is the primary advantage of a systematic review over a single RCT?
- It uses a larger patient sample from pooled studies to increase statistical power (Correct answer)
- It is faster to conduct than a single trial
- It eliminates the need for randomization
- It relies on expert consensus rather than data
Correct answer: It uses a larger patient sample from pooled studies to increase statistical power
Systematic reviews pool data from multiple studies, increasing sample size and statistical power to detect true effects.
Question 6: Which postoperative cognitive monitoring tool is validated by evidence for detecting early delirium in the PACU?
- Glasgow Coma Scale (GCS)
- Confusion Assessment Method for the ICU (CAM-ICU) (Correct answer)
- Mini-Mental State Examination (MMSE)
- Bispectral Index (BIS) monitoring
Correct answer: Confusion Assessment Method for the ICU (CAM-ICU)
CAM-ICU is a validated, widely used tool for detecting delirium in postoperative and ICU settings.
Question 7: According to evidence-based practice, how should a PACU nurse respond when a patient's pain score does not improve after a second opioid dose?
- Administer a third opioid dose at double the original amount
- Reassess for alternative pain sources and consider non-opioid adjuncts (Correct answer)
- Document and wait for the surgeon to re-evaluate
- Apply ice to the surgical site only
Correct answer: Reassess for alternative pain sources and consider non-opioid adjuncts
Evidence-based pain management requires reassessment and multimodal approaches when opioids alone are ineffective.
CAPA Evidence-Based Practice in PACU 4
A PACU nurse uses the PICO format to develop a clinical question.
What does the 'C' stand for?