CAPA Pediatric Perianesthesia Nursing 5 ā Questions and Answers
Question 1: Which condition is a contraindication to same-day discharge after ambulatory surgery in a former premature infant?
- Postconceptual age less than 60 weeks (Correct answer)
- Weight less than 10 kg at the time of surgery
- History of neonatal jaundice
- Presence of a parent or caregiver at home
Correct answer: Postconceptual age less than 60 weeks
Former premature infants with postconceptual age under 60 weeks are at high risk for post-anesthetic apnea and require overnight monitoring, making same-day discharge unsafe.
Question 2: A 7-year-old child is in Phase II recovery and reports nausea. The nurse notes no vomiting has occurred. What is the most appropriate initial intervention?
- Administer ondansetron IV and encourage slow deep breathing (Correct answer)
- Hold all oral intake and reassess in 1 hour
- Discharge the child immediately before vomiting occurs
- Administer metoclopramide IM as first-line antiemetic
Correct answer: Administer ondansetron IV and encourage slow deep breathing
Ondansetron is the first-line antiemetic in pediatric patients, and non-pharmacologic measures like deep breathing can also reduce nausea in the ambulatory setting.
Question 3: When performing a pain assessment in a 5-year-old, which scale is most age-appropriate?
- Faces Pain ScaleāRevised (FPS-R) (Correct answer)
- Numeric Rating Scale 0ā10
- CPOT (Critical-Care Pain Observation Tool)
- Visual Analog Scale (VAS)
Correct answer: Faces Pain ScaleāRevised (FPS-R)
The Faces Pain ScaleāRevised (FPS-R) is validated for children aged 4 and older and uses facial expressions that children can reliably self-report.
Question 4: A child is brought to the PACU after hypospadias repair. Which assessment finding should the perianesthesia nurse prioritize?
- Urine output and catheter patency (Correct answer)
- Blood glucose level
- Temperature greater than 38Ā°C
- Level of parental anxiety
Correct answer: Urine output and catheter patency
After hypospadias repair, ensuring catheter patency and adequate urine output is the priority as catheter obstruction can cause urinary retention and bladder distension.
Question 5: Which statement about pediatric IV fluid tonicity in the perianesthesia period is correct?
- Hypotonic fluids are avoided due to risk of hyponatremia and cerebral edema (Correct answer)
- Normal saline (0.9% NaCl) is contraindicated in children under 2 years
- Hypotonic fluids such as 0.2% NaCl/D5W are the preferred maintenance solution
- Dextrose-containing fluids should always be used in all pediatric cases
Correct answer: Hypotonic fluids are avoided due to risk of hyponatremia and cerebral edema
Current guidelines recommend isotonic or near-isotonic fluids for pediatric perioperative maintenance due to the serious risk of hyponatremia-induced cerebral edema from hypotonic solutions.
Question 6: A 12-year-old girl is scheduled for laparoscopic appendectomy under general anesthesia. Which PONV risk factor is specific to her demographic?
- Female sex after puberty substantially increases PONV risk (Correct answer)
- Age under 13 years is protective against PONV
- Laparoscopic procedures have lower PONV risk than open surgery
- Her weight is the primary determinant of PONV risk
Correct answer: Female sex after puberty substantially increases PONV risk
Female sex is a major adult PONV risk factor that becomes significant after puberty, and post-pubertal adolescent girls carry adult-level PONV risk.
Question 7: A 4-year-old in the PACU has a temperature of 38.9Ā°C after adenotonsillectomy. The nurse should first:
- Assess for signs of malignant hyperthermia including muscle rigidity and rising CO2 (Correct answer)
- Administer acetaminophen PR and apply cool cloths
- Notify the surgeon of a likely wound infection
- Obtain a blood culture and initiate antibiotic therapy
Correct answer: Assess for signs of malignant hyperthermia including muscle rigidity and rising CO2
Any unexplained fever and temperature elevation after volatile anesthesia must first be assessed for malignant hyperthermia, which is a life-threatening emergency requiring immediate intervention.
CAPA Pediatric Perianesthesia Nursing 5
Which condition is a contraindication to same-day discharge after ambulatory surgery in a former premature infant?