CPAN Clinical Procedures and Protocols 5

Question 1

A patient in the PACU complains of severe headache, photophobia, and neck stiffness after spinal anesthesia. The nurse should first suspect:

Accepted Answer

Post-dural puncture headache

Answer

Post-dural puncture headache (PDPH) is the most common cause of these symptoms after spinal anesthesia due to CSF leakage through the dural puncture site.

Question 2

A PACU patient who received spinal anesthesia has a block level at T6 and develops bradycardia (HR 42 bpm) and hypotension. The nurse anticipates administering:

Accepted Answer

Atropine and IV fluid bolus

Answer

High spinal block can cause sympathectomy leading to bradycardia and hypotension, treated with atropine for the heart rate and IV fluids or vasopressors for blood pressure.

Question 3

A patient recovering from ambulatory surgery asks to be discharged. The nurse notes the patient cannot stand without dizziness. Using the PADSS criteria, this patient should receive a score of:

Accepted Answer

1 for the ambulation criterion

Answer

The Post-Anesthetic Discharge Scoring System (PADSS) scores ambulation as 1 when the patient has dizziness/giddiness but is able to ambulate with assistance.

Question 4

A Phase II PACU patient is being prepared for home discharge after outpatient laparoscopic surgery. Which discharge instruction is MOST critical for patient safety?

Accepted Answer

Do not drive or operate machinery for 24 hours after anesthesia

Answer

Residual anesthetic and sedative effects impair psychomotor function for up to 24 hours; driving prohibition is a mandatory patient safety instruction after general or sedation anesthesia.

Question 5

In the PACU, a patient receiving a heparin infusion after vascular surgery develops oozing from IV sites and hematuria. The nurse suspects heparin-induced coagulopathy and expects which laboratory finding?

Accepted Answer

Supratherapeutic aPTT greater than 120 seconds

Answer

Bleeding with heparin therapy most commonly results from a supratherapeutic aPTT; values >120 seconds significantly increase hemorrhagic risk and warrant dose adjustment or reversal with protamine.

(CPAN) Certified Post Anesthesia Nurse Practice Test

(CPAN) Certified Post Anesthesia Nurse Practice Test

CPAN Clinical Procedures and Protocols 5