CPAN CPAN Respiratory and Airway Management 2

Question 1

A PACU patient has shallow respirations and a tidal volume of 3 mL/kg after general anesthesia. What is the likely cause?

Accepted Answer

Residual neuromuscular blockade causing inadequate respiratory effort

Answer

Residual neuromuscular blockade from non-depolarizing muscle relaxants is a common cause of inadequate tidal volumes and respiratory weakness post-anesthesia.

Question 2

Which test best assesses for adequate reversal of neuromuscular blockade before extubation in the PACU?

Accepted Answer

Train-of-four (TOF) ratio ≥0.9 with qualitative or quantitative neuromuscular monitoring

Answer

A train-of-four ratio of 0.9 or greater using neuromuscular monitoring confirms adequate reversal of neuromuscular blockade and safe muscle function.

Question 3

A patient develops acute bronchospasm in the PACU after extubation. What is the first-line pharmacological treatment?

Accepted Answer

Inhaled short-acting beta-2 agonist (e.g., albuterol)

Answer

Inhaled short-acting beta-2 agonists such as albuterol are the first-line treatment for bronchospasm, providing rapid bronchodilation with minimal systemic effects.

Question 4

How does the PACU nurse differentiate between hypoxemia caused by hypoventilation versus ventilation-perfusion (V/Q) mismatch?

Accepted Answer

Hypoventilation improves with 100% oxygen alone; V/Q mismatch does not reliably correct with oxygen alone and is associated with elevated CO2

Answer

Hypoventilation causes hypoxemia with elevated CO2 that responds to increasing ventilation, while V/Q mismatch (e.g., atelectasis, PE) may not fully correct with oxygen alone.

Question 5

Which nursing intervention best prevents post-operative atelectasis in PACU patients?

Accepted Answer

Encouraging incentive spirometry and deep breathing exercises every 1-2 hours

Answer

Regular incentive spirometry and deep breathing promote alveolar recruitment and prevent atelectasis, which is common after general anesthesia due to reduced functional residual capacity.

(CPAN) Certified Post Anesthesia Nurse Practice Test

(CPAN) Certified Post Anesthesia Nurse Practice Test

CPAN CPAN Respiratory and Airway Management 2