CAPA Regional Anesthesia Recovery Care 3

Question 1

A patient with a thoracic paravertebral block develops hypotension and bradycardia in the PACU. Which mechanism BEST explains these findings?

Accepted Answer

Epidural spread of local anesthetic affecting cardiac accelerator fibers

Answer

Paravertebral blocks can spread epidurally, blocking cardiac accelerator fibers (T1-T4), causing bradycardia and hypotension.

Question 2

Which finding would indicate INADEQUATE regional anesthesia recovery before safe discharge in a patient who received a spinal anesthetic?

Accepted Answer

Return of perianal sensation (S4-S5 dermatome)

Answer

Return of sacral sensation (S4-S5), including perianal sensation, is the last indicator of complete spinal regression and is required before discharge.

Question 3

A patient recovering from a TAP (transversus abdominis plane) block reports sudden onset of nausea and lightheadedness. The nurse notes the patient is pale and diaphoretic. What should the nurse suspect FIRST?

Accepted Answer

Local anesthetic systemic toxicity from the TAP block

Answer

Sudden onset of systemic symptoms following a TAP block—a high-volume technique—should prompt suspicion of LAST, especially with CNS and cardiovascular signs.

Question 4

The nurse is caring for a patient with a continuous adductor canal catheter. Which catheter-related complication requires IMMEDIATE intervention?

Accepted Answer

Fever of 38.9°C with catheter site purulence

Answer

Fever with purulence at a nerve catheter site indicates infection and requires immediate catheter removal and antibiotic management.

Question 5

During recovery from a caudal epidural block in an adult patient, the nurse should PRIORITIZE monitoring for which complication?

Accepted Answer

Inadvertent intravascular injection causing cardiac arrhythmia

Answer

The caudal space is highly vascular; inadvertent intravascular injection of local anesthetic can cause rapid systemic toxicity including cardiac arrhythmia.

(CAPA) Certified Ambulatory Perianesthesia Nurse Practice Test

(CAPA) Certified Ambulatory Perianesthesia Nurse Practice Test

CAPA Regional Anesthesia Recovery Care 3