CAPA Pharmacology & Pain Management 4

Question 1

A patient undergoing outpatient hernia repair receives a TAP (transversus abdominis plane) block. Which nerve fibers are primarily targeted by this regional technique?

Accepted Answer

Thoracolumbar spinal nerves T6-L1 supplying anterior abdominal wall

Answer

TAP blocks deposit local anesthetic between the internal oblique and transversus abdominis muscles, targeting thoracolumbar nerves T6-L1 innervating the anterior abdominal wall.

Question 2

Ketamine is administered as a subanesthetic infusion (0.1-0.5 mg/kg/hr) for postoperative pain. What is its PRIMARY analgesic mechanism?

Accepted Answer

NMDA receptor antagonism blocking central sensitization

Answer

Subanesthetic ketamine blocks NMDA receptors, preventing glutamate-mediated central sensitization and wind-up that amplify acute pain signals.

Question 3

A patient's discharge is delayed due to uncontrolled pain rating 8/10. She received her maximum IV opioid dose. Which non-opioid intervention should the nurse prioritize NEXT?

Accepted Answer

Administer oral oxycodone/acetaminophen per discharge orders

Answer

Transitioning to oral analgesics per discharge orders is the appropriate next step once IV opioid limits are reached, facilitating the transition for home pain management.

Question 4

A patient reports she took her prescribed oxycodone 5 mg and 'two extra Tylenol' at home. The nurse calculates her total acetaminophen intake. What is the maximum safe daily dose of acetaminophen for a healthy adult?

Accepted Answer

4,000 mg/day

Answer

The FDA-recommended maximum acetaminophen dose for healthy adults is 4,000 mg per day, though many guidelines recommend ≤3,000 mg/day for chronic use or liver risk.

Question 5

During phone follow-up after ambulatory surgery, a patient reports she has been using her opioid prescription around the clock 'just in case' rather than for actual pain. What is the MOST appropriate nursing response?

Accepted Answer

Educate her to take opioids only when pain occurs and at the lowest effective dose

Answer

Opioids should be used for actual pain at the lowest effective dose; routine prophylactic dosing increases dependence risk and side effects unnecessarily.

(CAPA) Certified Ambulatory Perianesthesia Nurse Practice Test

(CAPA) Certified Ambulatory Perianesthesia Nurse Practice Test

CAPA Pharmacology & Pain Management 4