CAPA Postanesthesia Care 2 — Questions and Answers
Question 1: A patient in Phase I PACU after general anesthesia has a respiratory rate of 8 breaths/min and SpO2 of 90% on 4L nasal cannula. What is the priority intervention?
- Increase oxygen flow to 6L
- Apply jaw thrust and stimulate the patient (Correct answer)
- Administer naloxone 0.4 mg IV
- Notify the surgeon immediately
Correct answer: Apply jaw thrust and stimulate the patient
Stimulation and airway positioning are the first steps for opioid-related respiratory depression before pharmacologic reversal.
Question 2: Which assessment finding is most concerning in a patient 30 minutes post-spinal anesthesia in the ambulatory setting?
- Blood pressure 110/70 mmHg
- Heart rate 58 bpm
- Inability to move lower extremities (Correct answer)
- Pruritus on the face and chest
Correct answer: Inability to move lower extremities
Persistent motor blockade beyond expected duration may indicate a high spinal or epidural hematoma requiring urgent evaluation.
Question 3: A patient exhibits confusion, tachycardia, and hypertension 1 hour after receiving scopolamine patch preoperatively. Which condition is most likely?
- Emergence delirium
- Anticholinergic toxidrome (Correct answer)
- Malignant hyperthermia
- Serotonin syndrome
Correct answer: Anticholinergic toxidrome
Scopolamine, an anticholinergic, can cause confusion, tachycardia, dry skin, and urinary retention — classic anticholinergic toxidrome.
Question 4: When using the Modified Aldrete Score for Phase I PACU discharge, which criterion is scored from 0 to 2?
- Pain level
- Activity level (Correct answer)
- Nausea severity
- Temperature
Correct answer: Activity level
The Modified Aldrete Score evaluates activity, respiration, circulation, consciousness, and oxygen saturation, each scored 0–2.
Question 5: A patient in Phase II recovery reports dizziness when standing. SpO2 is 98%, BP is 95/60 mmHg supine and 75/50 mmHg standing. What is the most appropriate action?
- Administer ephedrine 5 mg IV
- Return the patient to supine, give IV fluid bolus, and reassess (Correct answer)
- Discharge with a responsible adult driver
- Apply compression stockings and ambulate slowly
Correct answer: Return the patient to supine, give IV fluid bolus, and reassess
Orthostatic hypotension requires the patient to return to supine position and receive volume resuscitation before reattempting ambulation.
Question 6: Which PACU finding after laparoscopic cholecystectomy warrants immediate physician notification?
- Right shoulder pain rated 3/10
- Urinary output of 35 mL/hr
- Abdominal distension with absent bowel sounds and hypotension (Correct answer)
- Nausea without vomiting
Correct answer: Abdominal distension with absent bowel sounds and hypotension
Abdominal distension with hypotension suggests intra-abdominal bleeding or bowel perforation requiring emergent surgical evaluation.
Question 7: A nurse is caring for a patient with obstructive sleep apnea (OSA) post-procedure. Which positioning strategy is most appropriate during Phase I recovery?
- Supine with head of bed flat
- Lateral decubitus or head-of-bed elevated 30–45 degrees (Correct answer)
- Prone position
- Trendelenburg position
Correct answer: Lateral decubitus or head-of-bed elevated 30–45 degrees
Semi-upright or lateral positioning reduces upper airway collapse and improves oxygenation in OSA patients in the PACU.
CAPA Postanesthesia Care 2
A patient in Phase I PACU after general anesthesia has a respiratory rate of 8 breaths/min and SpO2 of 90% on 4L nasal cannula.
What is the priority intervention?