CAPA Phase I & Phase II Recovery Care 5

Question 1

A patient in Phase I PACU begins to exhibit signs of local anesthetic systemic toxicity (LAST) including perioral numbness, tinnitus, and agitation. The FIRST drug to prepare is:

Accepted Answer

20% lipid emulsion (Intralipid) IV infusion

Answer

20% lipid emulsion is the primary antidote for LAST and should be immediately drawn up and administered at the first signs of systemic local anesthetic toxicity.

Question 2

Which of the following interventions BEST reduces the risk of postoperative nausea and vomiting (PONV) in a high-risk ambulatory surgery patient?

Accepted Answer

Multimodal prophylaxis combining a 5-HT3 antagonist with dexamethasone and TIVA technique

Answer

Multimodal PONV prophylaxis using agents from different classes combined with TIVA (avoiding volatile anesthetics) significantly reduces PONV incidence in high-risk patients.

Question 3

A patient arrives in Phase I PACU with pinpoint pupils, a respiratory rate of 6 breaths/min, and SpO2 of 82%. The most likely etiology and initial intervention are:

Accepted Answer

Opioid-induced respiratory depression; administer naloxone titrated in small doses with airway support

Answer

The classic triad of pinpoint pupils, bradypnea, and hypoxia indicates opioid overdose; titrated naloxone with airway support is the appropriate reversal strategy.

Question 4

When is it appropriate to use the 'fast-track' protocol that bypasses Phase I PACU and admits the patient directly to Phase II?

Accepted Answer

When the patient meets predetermined criteria including an Aldrete-equivalent score ≥ 12 immediately upon OR exit

Answer

Fast-tracking is appropriate only when patients meet validated scoring criteria demonstrating adequate recovery from anesthesia immediately post-procedure, not based on capacity or procedure type alone.

Question 5

A patient in Phase II PACU who underwent inguinal hernia repair under spinal anesthesia complains of a severe bilateral positional headache that worsens when sitting up. This presentation is most consistent with:

Accepted Answer

Post-dural puncture headache (PDPH) from cerebrospinal fluid leak

Answer

Postural bilateral headache worse in upright position following spinal anesthesia is the classic presentation of post-dural puncture headache caused by CSF leak.

(CAPA) Certified Ambulatory Perianesthesia Nurse Practice Test

(CAPA) Certified Ambulatory Perianesthesia Nurse Practice Test

CAPA Phase I & Phase II Recovery Care 5