CAPA Nausea & Vomiting Prevention 4

Question 1

Droperidol carries an FDA black box warning related to which adverse effect?

Accepted Answer

QTc prolongation and risk of torsades de pointes

Answer

The FDA issued a black box warning for droperidol in 2001 due to its potential to prolong the QTc interval and cause potentially fatal torsades de pointes.

Question 2

A patient with prolonged QTc interval requires rescue antiemetic therapy. Which drug should be avoided?

Accepted Answer

Ondansetron

Answer

Ondansetron, like other 5-HT3 antagonists, can prolong the QTc interval and should be used with caution or avoided in patients with existing QTc prolongation.

Question 3

Which mechanism explains why propofol has antiemetic properties?

Accepted Answer

It reduces activity in the chemoreceptor trigger zone by modulating GABA and dopamine pathways

Answer

Propofol's antiemetic effect is thought to result from modulation of GABA-A receptors and reduction of dopaminergic activity in the chemoreceptor trigger zone.

Question 4

Postoperative opioids contribute to PONV through which primary mechanism?

Accepted Answer

Stimulation of mu-opioid receptors in the chemoreceptor trigger zone and delayed gastric emptying

Answer

Opioids activate mu-receptors in the chemoreceptor trigger zone and reduce gastrointestinal motility, both of which promote nausea and vomiting.

Question 5

A 28-year-old female non-smoker with a history of PONV is scheduled for thyroidectomy. She has an Apfel score of 3. Per ERAS guidelines, how many prophylactic antiemetic agents should she receive?

Accepted Answer

Three or more agents in a multimodal regimen

Answer

Current ERAS and SAMBA guidelines recommend triple or quadruple prophylaxis for patients with Apfel scores of 3-4, targeting multiple receptor pathways.

(CAPA) Certified Ambulatory Perianesthesia Nurse Practice Test

(CAPA) Certified Ambulatory Perianesthesia Nurse Practice Test

CAPA Nausea & Vomiting Prevention 4