CAPA Pharmacology & Pain Management 3

Question 1

A PACU patient develops nausea and vomiting 30 minutes after receiving IV morphine. Which antiemetic mechanism is MOST directly targeting opioid-induced nausea?

Accepted Answer

D2 receptor antagonism at the chemoreceptor trigger zone

Answer

Opioids stimulate dopamine D2 receptors in the chemoreceptor trigger zone; dopamine antagonists like prochlorperazine or droperidol most directly counter this mechanism.

Question 2

A patient in Phase I recovery has respiratory rate of 8/min and SpO2 of 88% after receiving fentanyl and midazolam. After administering naloxone, the nurse should anticipate which complication?

Accepted Answer

Acute pulmonary edema and hypertensive crisis

Answer

Naloxone reversal of opioids can cause sudden catecholamine surge leading to acute pulmonary edema, severe hypertension, and cardiac arrhythmias.

Question 3

Dexmedetomidine is used as an adjunct sedative-analgesic in some ambulatory procedures. Its PRIMARY analgesic and sedative mechanism involves which receptor?

Accepted Answer

Alpha-2 adrenergic receptor agonism

Answer

Dexmedetomidine is a highly selective alpha-2 adrenergic agonist that produces sedation via the locus coeruleus and analgesia via spinal cord alpha-2 receptors.

Question 4

A patient with a history of chronic opioid use requires higher-than-expected opioid doses postoperatively to achieve adequate pain control. This phenomenon is BEST described as:

Accepted Answer

Opioid tolerance

Answer

Opioid tolerance is a pharmacological phenomenon where repeated exposure reduces the drug's effect, requiring higher doses to achieve the same analgesic response.

Question 5

Liposomal bupivacaine (Exparel) is used for postoperative analgesia. What distinguishes it from standard bupivacaine regarding its pharmacokinetics?

Accepted Answer

Extended release providing analgesia up to 72 hours

Answer

Liposomal bupivacaine uses DepoFoam technology for sustained release, extending analgesia to 72 hours compared to standard bupivacaine's 8-12 hours.

(CAPA) Certified Ambulatory Perianesthesia Nurse Practice Test

(CAPA) Certified Ambulatory Perianesthesia Nurse Practice Test

CAPA Pharmacology & Pain Management 3