CAPA Perianesthesia Complications & Emergency Response 2

Question 1

A patient develops urticaria, hypotension, and wheezing minutes after receiving IV antibiotics in the PACU. What is the FIRST-LINE treatment?

Accepted Answer

Epinephrine 0.3 mg IM into the anterolateral thigh

Answer

Diphenhydramine 50 mg IV

Answer

Methylprednisolone 125 mg IV

Answer

Albuterol via nebulizer

Question 2

Local anesthetic systemic toxicity (LAST) most characteristically presents initially with which symptom cluster?

Accepted Answer

CNS excitation: perioral numbness, tinnitus, and metallic taste

Answer

Cardiovascular collapse and pulseless VT

Answer

Respiratory arrest without warning

Answer

Severe hypotension and bradycardia

Question 3

What is the definitive treatment for refractory cardiac arrest caused by local anesthetic systemic toxicity (LAST)?

Accepted Answer

20% lipid emulsion (intralipid) IV bolus

Answer

High-dose epinephrine bolus (>1 mg IV)

Answer

Calcium chloride 1 g IV

Answer

Sodium bicarbonate 1 mEq/kg IV

Question 4

What is the correct initial bolus dose of 20% lipid emulsion (intralipid) for LAST per ASRA guidelines?

Accepted Answer

1.5 mL/kg IV over 2-3 minutes

Answer

0.5 mL/kg IV over 2-3 minutes

Answer

1 mL/kg IV over 2-3 minutes

Answer

2 mL/kg IV over 2-3 minutes

Question 5

Which patient factor MOST significantly increases the risk of pulmonary aspiration in the perianesthesia period?

Accepted Answer

History of GERD combined with inadequate preoperative fasting

Answer

Age greater than 65 years

Answer

Use of regional anesthesia technique

Answer

Female sex and obesity combined

Question 6

After administering epinephrine for anaphylaxis, what is the NEXT priority intervention?

Accepted Answer

Establish large-bore IV access and begin aggressive fluid resuscitation

Answer

Administer diphenhydramine 50 mg IV

Answer

Obtain a 12-lead ECG immediately

Answer

Apply high-flow oxygen via non-rebreather mask only

Question 7

A PACU patient who received a bupivacaine femoral nerve block develops sudden seizures and progressive QRS widening on the monitor. The nurse should FIRST:

Accepted Answer

Activate the LAST protocol and prepare 20% lipid emulsion

Answer

Administer phenytoin IV for seizure control

Answer

Call for the MH cart and begin cooling measures

Answer

Administer amiodarone IV for the wide-complex rhythm