2024 CPAN EXAM QUESTIONS
WITH CORRECT ANSWERS
After extubation of a patient, which of the following would be considered
most serious?
1. Sore throat
2. Impaired swallowing ability
3. Inspiratory stridor
4. Hoarseness - CORRECT-ANSWERS3
When a patient requires a muscle flap to repair a congenital or acquired
tissue defect, the phase I PACU nurse will monitor all of the following
EXCEPT:
1. Hypocalcemia
2. Hypovolemia
3. Hypotension
4. Hypothermia - CORRECT-ANSWERS1
Hypocalcemia does not have an effect on the flap site. Hypothermia,
hypotension, and hypovolemia could result in vasoconstriction and arterial
flow compromised for the viability of the graft.
When educating the patient on what to expect during the administration of
spinal anesthesia, the perianesthesia nurse understands that the progression
of blockage occurs in the following order:
1. sensory, motor, autonomic
2. motor, sensory, autonomic
3. autonomic, sensory, motor
4. motor, autonomic, sensory - CORRECT-ANSWERS3
A phase I PACU nurse receives a patient with basal cell carcinoma on the left
side of the nose. The patient underwent Mohs procedure and forehead flap.
The initial assessment findings of the flap's condition would be:
1. Normal color immediately postoperative; the flap will be bluish in color
2. The flap would be cool to touch
3. The flap will be white or gray in color
4. Capillary refill blanching is 4 seconds - CORRECT-ANSWERS3
,the normal color is white or gray immediately postoperatively. When the flap
is cool to touch., there may be reduced blood flow. Bluish color indicates
venous congestion, and delayed blanching indicates arterial insufficiency. All
of these could cause flap failure.
During the handoff report after an ENT procedure, the certified nurse
anesthetist mentions that the patient has a history of von Willebrand's
disease. The phase I PACU nurse creates a postoperative plan of care. The
plan includes frequent assessments for:
1. Patient complaint of palpitations and SOB
2. Speech difficulty and peripheral numbness
3. Dyspnea and hypotension
4. Muscosal bleeding and mild bruising - CORRECT-ANSWERSD
von Willebrand's disease is a common hematologic disorder that predisposes
patients to muscosal bleeding, epitaxy should, and mild bruising. Not all
patients with von Willebrand's disease require treatments however, patients
scheduled for surgery should be given coagulation factors to supplement
essential clotting factors. Desmopressin acetate given IV in the preop area is
a synthetic replacement for vasopressin and for homologous factors in the
blood to help minimize bleeding.
An otherwise healthy patient reports recent diagnosis of localized shingles.
The preoperative nurse is aware that herpes zoster is caused by reactivating
of the varicella zoster virus. When considering precautions to implement
during care of the patient, the perianesthesia nurse considers that the virus
spreads via:
1. Airborne transmission
2. Direct contact with a dry, crust lesion
3. Direct contact with a clear vehicle rash
4. Droplet transmission - CORRECT-ANSWERS3
The virus spread when a person has direct contact with the active herpes
zoster lesions. The lesions are infectious until they dry and crust over.
Standard precautions should be followed carefully, and any lesions should be
completely covered.
A patient with a body mass index BMI of 52 faces a number of potential
postop complications, including:
1. An increased risk of wound dehiscence and decreased risk of infection
2. An increased risk of wound dehiscence and increased risk of infection
3. A decreased risk of wound dehiscence and decreased risk of infection
,4. A decreased risk of wound dehiscence and increased risk of infection -
CORRECT-ANSWERS2
Obesity, defined as weight greater than 20% ideal body weight, presents an
increased incidence of wound dehiscence and infection. In addition, obese
patients generally have poorly vascularized adipose, which increases the risk
of ischemia.
A 42 year old construction worker experienced a traumatic injury while at
work. He is presenting to the hospital now for surgery to treat third-degree
burns sustained on his left lower extremity. A third degree burn involves:
1. Red, dry, nonblistered skin with allodynia
2. Superficial, oozing, and painful blisters
3. Moist, painful skin that blanches
4. Leathery, dry wound with little or no pain - CORRECT-ANSWERS4
Full-thickness/3rd degree burns cause severe injury or destruction to the
deepest layer of the skin, tissues, hair follicles, and sweat glands. Full
thickness burns are often the least painful because nerve endings have been
destroyed, causing absence of sensation.
Superficial, or 1st degree, burns damage only the outer layer of skin
(epidermis).
Partial-thickness/2nd degree burns injure the outer layer and layer
underneath.
a 4th degree burn involves bone, muscle, and often organs
The nurse is caring for a patient after a kidney transplant. Vital signs are
stable, and the urine output is clear yellow and greater than 30mL on
evaluation. The patient is receiving medication via patient-controlled
analgesia PCA pump and reports good control of postoperative pain. At the
next check of vital signs, the nurse see that the end-tidal CO2 reading is
52mmHg and recognizes this is a result of:
1. Hypoperfusion
2. Hypoventilation
3. Hypovolemia
4. Hypocarbia - CORRECT-ANSWERS2
hypoventilation as a result of residual anesthetic along with the introduction
of the PCA has Cause the patient to become sedated. IF there are no
perfusion issues, the mismatch perfusion ventilation will result in the
increased CO2 reading.
, Creatinine is an important indicator of glomerular filtration ability because:
1. It is a large molecule that should not fit through the glomeruli
2. Creatinine is the only filtered substance not reabsorbed
3. Creatinine is reabsorbed in limited quantities along with urea and
phosphate
4. It helps play a role in the secretion of hydrogen and potassium ions -
CORRECT-ANSWERS2
Creatinine is the only filtered substance not reabsorbed. It is entirely
secreted, Which allows creatinine to serve as an indicator of glomerular
filtration ability and kidney function.
This medication should be avoided in the patient with impaired renal
function:
1. Furosemide
2. Morphine
3. Acetaminophen
4. Ketorolac - CORRECT-ANSWERS4
Ketorolac should be avoided because it can be nephrotoxic. It is not
recommended for use in patients with impaired renal function
In patients with multiple skin folds and redundant skin, the nurse is aware
that a thorough inspection of the skin is necessary to determine if there are
any excoriation or rashes. Problem areas tend to be found in the groin,
perineum, a Lila, and large skin folds, and:
1. Between the toes
2. Behind the knees
3. Under the chin folds
4. Beneath the breasts - CORRECT-ANSWERS4
The bariatric patient with multiple skin folds experiences issuers related to
impaired hygiene due to the difficulty the patient has with reaching and
properly cleaning and drying skin. The larger skin folds as well as tissue
around the groin, perineum, breasts, and axilla are susceptible to
breakdown.
When assessing a bariatric patient preoperatively, the pre-op nurse knows
that - CORRECT-ANSWERS