CAPA Respiratory Assessment & Management 2

Question 1

A patient in the PACU after laparoscopic cholecystectomy has an SpO2 of 91% on 2L nasal cannula. The FIRST nursing intervention should be:

Accepted Answer

Stimulate the patient and encourage deep breathing

Answer

Stimulating the patient and encouraging deep breathing addresses the most common cause of hypoxemia in PACU — residual anesthetic-induced hypoventilation.

Question 2

Which clinical finding BEST indicates upper airway obstruction in a post-anesthesia patient?

Accepted Answer

Stridor with paradoxical chest-abdominal movement

Answer

Stridor combined with paradoxical (seesaw) chest-abdominal movement is the hallmark of upper airway obstruction, where the diaphragm descends but the airway blockage prevents chest rise.

Question 3

A patient who received a cervical nerve block for shoulder surgery develops dyspnea 30 minutes postoperatively. The MOST likely complication is:

Accepted Answer

Ipsilateral phrenic nerve palsy causing hemidiaphragm paresis

Answer

Interscalene brachial plexus blocks reliably cause ipsilateral phrenic nerve palsy, resulting in hemidiaphragm paresis and reduced respiratory capacity.

Question 4

When assessing breath sounds in a PACU patient, the nurse auscultates absent sounds over the left lung base with dullness to percussion. This finding is MOST consistent with:

Accepted Answer

Pleural effusion or hemothorax

Answer

Absent breath sounds with dullness to percussion indicate fluid in the pleural space, consistent with pleural effusion or hemothorax, not pneumothorax (which causes hyperresonance).

Question 5

A 58-year-old patient with a 40-pack-year smoking history is post-op day 0 after abdominal surgery. Which incentive spirometry instruction is MOST appropriate?

Accepted Answer

Take a slow, sustained maximal inhalation and hold for 5-10 seconds

Answer

A slow, sustained maximal inhalation held for 5-10 seconds maximally expands alveoli and prevents atelectasis, which is the therapeutic goal of incentive spirometry.

(CAPA) Certified Ambulatory Perianesthesia Nurse Practice Test

(CAPA) Certified Ambulatory Perianesthesia Nurse Practice Test

CAPA Respiratory Assessment & Management 2