CAPA Patient Safety & Monitoring 3

Question 1

A PACU nurse notes that a patient's arterial line waveform shows pulsus paradoxus. Which condition is MOST concerning?

Accepted Answer

Cardiac tamponade

Answer

Pulsus paradoxus — an exaggerated drop in systolic BP during inspiration — is a hallmark of cardiac tamponade caused by pericardial compression of the heart.

Question 2

A patient undergoing ambulatory knee arthroscopy reports sudden pleuritic chest pain and tachycardia at 30 minutes post-op. Which diagnosis should the nurse consider FIRST?

Accepted Answer

Pulmonary embolism

Answer

Acute onset pleuritic chest pain with tachycardia in the postoperative period is a classic presentation of pulmonary embolism and requires urgent evaluation.

Question 3

Which urine output value per hour should prompt the PACU nurse to notify the physician for a 70 kg adult patient?

Accepted Answer

20 mL/hr

Answer

Adequate urine output is 0.5 mL/kg/hr; for a 70 kg patient this is 35 mL/hr, so 20 mL/hr indicates oliguria warranting physician notification.

Question 4

A patient in Phase II recovery begins shivering uncontrollably. Which intervention is MOST effective for perianesthesia shivering?

Accepted Answer

Administer IV meperidine 12.5–25 mg

Answer

Low-dose IV meperidine is the most effective pharmacologic treatment for post-anesthesia shivering by acting on kappa-opioid receptors and thermoregulatory centers.

Question 5

When using a Bispectral Index (BIS) monitor in the PACU, which BIS value range indicates an adequately sedated but arousable patient?

Accepted Answer

60–80

Answer

A BIS value of 60–80 corresponds to moderate sedation — the patient is responsive to stimulation but has depressed consciousness.

(CAPA) Certified Ambulatory Perianesthesia Nurse Practice Test

(CAPA) Certified Ambulatory Perianesthesia Nurse Practice Test

CAPA Patient Safety & Monitoring 3