CAPA Nausea & Vomiting Prevention 3

Question 1

A patient undergoing gynecologic laparoscopy begins vomiting in Phase I PACU. She received ondansetron and dexamethasone intraoperatively. Which rescue agent acts via a different mechanism than both prophylactic drugs?

Accepted Answer

Prochlorperazine 10 mg IV

Answer

Prochlorperazine is a phenothiazine/dopamine antagonist, offering a different mechanism from the serotonin antagonist and corticosteroid already used.

Question 2

Which factor most predisposes ambulatory surgical patients to PONV compared to inpatients?

Accepted Answer

Earlier ambulation and oral intake post-procedure

Answer

Early mandatory discharge in ambulatory settings means patients ambulate, eat, and drink sooner, all of which can trigger or worsen PONV.

Question 3

Which statement about nitrous oxide and PONV is accurate?

Accepted Answer

Nitrous oxide increases PONV risk by distending the bowel and stimulating the middle ear

Answer

Nitrous oxide increases PONV through bowel distension, middle ear pressure changes, and direct stimulation of the chemoreceptor trigger zone.

Question 4

An ambulatory patient is being discharged after knee arthroscopy. She reports mild nausea but no vomiting. What is the appropriate nursing intervention?

Accepted Answer

Provide an oral antiemetic for home use and reinforce discharge instructions

Answer

Mild nausea without vomiting in a patient who meets other discharge criteria can be managed with an oral antiemetic prescription and thorough patient education.

Question 5

Acupressure at the P6 (Neiguan) point has been studied for PONV prevention. Where is this point located?

Accepted Answer

Three finger-breadths proximal to the wrist crease on the inner forearm

Answer

The P6 (pericardium 6) point is located three finger-breadths proximal to the wrist crease between the palmaris longus and flexor carpi radialis tendons.

(CAPA) Certified Ambulatory Perianesthesia Nurse Practice Test

(CAPA) Certified Ambulatory Perianesthesia Nurse Practice Test

CAPA Nausea & Vomiting Prevention 3