CAPA Phase I & Phase II Recovery Care 2 — Questions and Answers
Question 1: A patient in Phase I PACU has a SpO2 of 88% on 2L nasal cannula. What is the most appropriate immediate intervention?
- Increase oxygen flow rate and reposition the airway (Correct answer)
- Administer naloxone 0.4mg IV
- Call the anesthesiologist immediately
- Apply a non-rebreather mask at 15L/min
Correct answer: Increase oxygen flow rate and reposition the airway
Initial management of hypoxemia includes increasing supplemental oxygen and optimizing airway positioning before escalating to pharmacologic reversal.
Question 2: Which Aldrete score component specifically assesses a patient's ability to breathe deeply and cough freely?
- Activity
- Respiration (Correct answer)
- Circulation
- Consciousness
Correct answer: Respiration
The Respiration component of the Aldrete score evaluates the patient's ability to breathe deeply and cough effectively.
Question 3: A patient emerges from general anesthesia with a temperature of 35.1°C (95.2°F). Which intervention is the priority?
- Administer meperidine for shivering prophylaxis
- Apply active warming measures such as forced-air warming blankets (Correct answer)
- Increase IV fluid rate to warm the patient internally
- Notify the surgeon immediately
Correct answer: Apply active warming measures such as forced-air warming blankets
Active external warming with forced-air warming blankets is the most effective and immediate intervention for postoperative hypothermia.
Question 4: During Phase II recovery, a patient reports persistent nausea after two doses of ondansetron. What is the most appropriate next step?
- Administer a third dose of ondansetron
- Switch to an antiemetic from a different drug class such as promethazine or droperidol (Correct answer)
- Delay discharge until nausea resolves spontaneously
- Administer IV metoclopramide and reassess in 15 minutes
Correct answer: Switch to an antiemetic from a different drug class such as promethazine or droperidol
When a single antiemetic class fails, using an agent from a different class targets different receptor pathways for better PONV control.
Question 5: What is the minimum urine output considered acceptable before discharging a patient home from Phase II PACU?
- Voiding is not a universal discharge requirement for all patients (Correct answer)
- At least 30 mL since arrival
- At least 100 mL total output
- At least 0.5 mL/kg/hr for two consecutive hours
Correct answer: Voiding is not a universal discharge requirement for all patients
Current evidence-based guidelines do not mandate voiding as a universal discharge criterion unless the patient had spinal anesthesia or a procedure with high urinary retention risk.
Question 6: A patient in Phase I PACU is exhibiting emergence delirium with thrashing and attempts to pull out the IV. What is the safest immediate intervention?
- Restrain all four extremities immediately
- Administer propofol 40mg IV to re-sedate the patient
- Reorient the patient verbally, ensure safety, and consider a small dose of midazolam or propofol (Correct answer)
- Call a code and prepare for rapid sequence intubation
Correct answer: Reorient the patient verbally, ensure safety, and consider a small dose of midazolam or propofol
Emergence delirium management prioritizes patient safety, calm reorientation, and judicious use of small sedative doses when needed.
Question 7: Which of the following is a Phase II PACU discharge criterion using the Post-Anesthetic Discharge Scoring System (PADSS)?
- Aldrete score ≥ 9
- Pain controlled with oral analgesics and rated ≤ 4/10 (Correct answer)
- SpO2 > 98% on room air for 30 minutes
- Ability to perform a straight leg raise
Correct answer: Pain controlled with oral analgesics and rated ≤ 4/10
PADSS evaluates vital signs, ambulation, nausea/vomiting, pain, and surgical bleeding; pain controlled with oral analgesics rated acceptable by the patient is a scored criterion.
CAPA Phase I & Phase II Recovery Care 2
A patient in Phase I PACU has a SpO2 of 88% on 2L nasal cannula.
What is the most appropriate immediate intervention?