CAPA Respiratory Assessment & Management 4

Question 1

A patient received IV morphine 4mg in PACU and now has a respiratory rate of 8 breaths/min with pinpoint pupils. The nurse administers naloxone 0.4mg IV. Which outcome requires repeat naloxone dosing?

Accepted Answer

Respiratory rate of 8 persists after 2-3 minutes

Answer

If respiratory depression persists after 2-3 minutes, repeat naloxone dosing (0.1-0.2mg increments) is indicated, as the initial dose was insufficient to reverse opioid effect.

Question 2

Which of the following is a contraindication to nasopharyngeal airway insertion in a PACU patient?

Accepted Answer

Suspected basilar skull fracture

Answer

Suspected basilar skull fracture is an absolute contraindication to nasopharyngeal airway insertion, as the tube could enter the cranial vault through a cribriform plate fracture.

Question 3

A patient post-thyroidectomy develops inspiratory stridor, dysphagia, and neck swelling 2 hours after surgery. The PRIORITY intervention is:

Accepted Answer

Prepare for reintubation or surgical airway

Answer

Progressive neck hematoma after thyroidectomy can cause complete airway obstruction; securing the airway via reintubation or surgical airway is the immediate priority before the airway is lost.

Question 4

When applying a nasal cannula, the nurse should position the prongs so that:

Accepted Answer

The prongs curve downward following the natural curvature of the nares

Answer

Nasal cannula prongs should curve downward to follow the natural anatomy of the nares, optimizing flow toward the pharynx and improving patient comfort and oxygen delivery.

Question 5

A post-anesthesia patient has a PaO2 of 70 mmHg on 4L nasal cannula (estimated FiO2 ~0.36). What is the approximate P/F ratio, and what does it indicate?

Accepted Answer

P/F = 194, indicating mild ARDS

Answer

P/F ratio = PaO2 ÷ FiO2 = 70 ÷ 0.36 ≈ 194, which falls in the mild ARDS range (200-300) and indicates impaired oxygenation requiring close monitoring.

(CAPA) Certified Ambulatory Perianesthesia Nurse Practice Test

(CAPA) Certified Ambulatory Perianesthesia Nurse Practice Test

CAPA Respiratory Assessment & Management 4