CPAN Pharmacology Fundamentals 2

Question 1

A patient in the PACU receives neostigmine to reverse neuromuscular blockade. Which drug must be given concurrently to prevent bradycardia?

Accepted Answer

Atropine

Answer

Neostigmine inhibits acetylcholinesterase and increases muscarinic activity, requiring concurrent anticholinergic agents like atropine or glycopyrrolate to prevent bradycardia.

Question 2

Which opioid is considered safest in patients with renal failure due to its lack of active metabolites?

Accepted Answer

Fentanyl

Answer

Fentanyl is metabolized to inactive compounds and does not accumulate in renal failure, unlike morphine (morphine-6-glucuronide) or meperidine (normeperidine).

Question 3

A PACU patient develops laryngospasm. After jaw thrust fails, what drug is the first-line pharmacologic intervention?

Accepted Answer

Succinylcholine 0.1–0.2 mg/kg IV

Answer

A small 'laryngospasm dose' of succinylcholine (0.1–0.2 mg/kg IV) rapidly relaxes the spastic laryngeal muscles while minimizing full paralysis.

Question 4

Dexmedetomidine exerts its sedative and analgesic effects primarily through which receptor?

Accepted Answer

Alpha-2 adrenergic receptor

Answer

Dexmedetomidine is a highly selective alpha-2 adrenergic agonist that produces sedation, analgesia, and anxiolysis with minimal respiratory depression.

Question 5

A patient is receiving ketorolac (Toradol) in the PACU. Which condition is a contraindication to its use?

Accepted Answer

Peptic ulcer disease

Answer

Ketorolac is an NSAID that inhibits prostaglandins, increasing the risk of GI bleeding and ulceration, making active peptic ulcer disease a contraindication.

(CPAN) Certified Post Anesthesia Nurse Practice Test

(CPAN) Certified Post Anesthesia Nurse Practice Test

CPAN Pharmacology Fundamentals 2