CPAN Clinical Procedures and Protocols 4

Question 1

A PACU patient receiving a remifentanil infusion intraoperatively now reports severe pain (9/10) within minutes of arrival. The most likely explanation is:

Accepted Answer

Opioid-induced hyperalgesia from remifentanil

Answer

Remifentanil is strongly associated with acute opioid-induced hyperalgesia upon cessation due to its ultra-short half-life and rapid offset, leading to heightened pain sensitivity.

Question 2

A patient in the PACU develops shivering with a core temperature of 35.2°C. Which intervention is MOST effective for treating post-anesthetic shivering?

Accepted Answer

Administer meperidine 12.5–25 mg IV

Answer

Meperidine in low doses (12.5–25 mg IV) is the most effective pharmacologic treatment for post-anesthetic shivering due to its action on kappa opioid receptors.

Question 3

A patient in the PACU has a urine output of 15 mL over the past hour following a 4-hour abdominal surgery. Blood pressure is 110/70 mmHg and HR is 88 bpm. The nurse should:

Accepted Answer

Assess for bladder distension and notify the provider if no improvement

Answer

Oliguria (<0.5 mL/kg/hr) in the PACU warrants assessment for bladder distension or urinary retention and prompt provider notification if not resolved.

Question 4

When caring for a patient with a regional nerve block in the PACU, the nurse's primary neurovascular assessment should include:

Accepted Answer

Capillary refill, pulses, sensation, and motor function distal to the block

Answer

Neurovascular checks distal to a nerve block assess for vascular compromise or compartment syndrome by evaluating the 5 Ps: pain, pallor, pulselessness, paresthesia, and paralysis.

Question 5

A patient with known obstructive sleep apnea arrives in the PACU after general anesthesia. Which positioning measure is MOST important?

Accepted Answer

Position the patient semi-upright (30–45 degrees) or lateral

Answer

Semi-upright or lateral positioning reduces upper airway collapse in OSA patients by decreasing the effect of gravity on oropharyngeal soft tissues.

(CPAN) Certified Post Anesthesia Nurse Practice Test

(CPAN) Certified Post Anesthesia Nurse Practice Test

CPAN Clinical Procedures and Protocols 4