CAPA Phase I & Phase II Recovery Care 3

Question 1

A Phase I PACU patient who received spinal anesthesia can move both legs but reports inability to void despite feeling the urge. What is the most likely cause?

Accepted Answer

Residual sympathetic blockade inhibiting bladder contraction

Answer

Spinal anesthesia blocks sacral nerve roots S2-S4, impairing detrusor muscle contraction and causing urinary retention even as motor block resolves.

Question 2

Which parameter is the most sensitive early indicator of internal hemorrhage in the immediate postoperative period?

Accepted Answer

Increase in heart rate

Answer

Tachycardia is typically the earliest compensatory response to hypovolemia and hemorrhage before blood pressure drops significantly.

Question 3

A patient in Phase II PACU rates pain at 7/10 but has already received the maximum dose of IV ketorolac. What is the most appropriate next step?

Accepted Answer

Offer an oral opioid analgesic if the patient can tolerate oral intake

Answer

Transitioning to oral multimodal analgesia, including oral opioids when appropriate, is standard Phase II pain management when IV NSAID maximum doses are reached.

Question 4

Laryngospasm in the immediate postoperative period is BEST managed initially by:

Accepted Answer

Applying continuous positive airway pressure (CPAP) with 100% oxygen and jaw thrust

Answer

Initial laryngospasm management uses positive pressure ventilation with 100% oxygen and jaw thrust to break the spasm before resorting to pharmacologic paralysis.

Question 5

A perianesthesia nurse notes that a patient's train-of-four (TOF) ratio is 0.7 after reversal with neostigmine. What does this indicate?

Accepted Answer

Residual neuromuscular blockade; the patient may have impaired airway protection

Answer

A TOF ratio below 0.9 indicates residual neuromuscular blockade, which can impair airway reflexes and increase aspiration risk.

(CAPA) Certified Ambulatory Perianesthesia Nurse Practice Test

(CAPA) Certified Ambulatory Perianesthesia Nurse Practice Test

CAPA Phase I & Phase II Recovery Care 3