CPAN Pharmacology Practice Exam With Answers (302 Solved Questions)

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CPAN questions with verified answersIn providing preoperative teaching to a patient requesting spinal anesthesia, theperianesthesia nurse is aware that an absolute contraindication for spinal anesthesia is:1. patient refusal.2. chronic back pain.3. multiple sclerosis.4. sickle cell anemia. - 1In administering flumazenil, the perianesthesia nurse is aware that it inhibits the centraleffects of benzodiazepines by:1. competing for the receptor sites.2. stimulating the cerebral cortex.3. occupying the mu receptor sites.4. metabolizing the medications. - 1A pathological process that can interfere with accurate measurements of SpO2 when usinga pulse oximeter is:1. Cushing's disease.2. hypoparathyroidism.3. Raynaud's disease.4. hyperthyroidism. - 3In the event that a pharmacologically paralyzed patient is inadvertently extubated, the firstpriority of the PACU nurse is to:1. administer a muscarinic anticholinergic drug immediately.2. establish and maintain the airway and ventilation.3. administer an anticholinesterase drug immediately.4. assess for muscle recovery before reintubating. - 2

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A PACU nurse identifies an increased number of postoperative infections and utilizes aquality improvement tool to collect more data. When deficiencies are noted in the Phase Iarea, the nurse next considers:1. developing a poster board on commonly used antibiotics.2. presenting staff with an in-service on infection control.3. apprising the infectious disease service of the occurrences.4. notifying the OR clinical specialist. - 2A staff nurse denied a merit increase expresses vigorous support for management and itspolicies instead of showing anger. The nurse's behavior is characterized as:1. identification.2. reaction formation.3. sublimation.4. rationalization. - 2When educating the patient on what to expect during the administration of spinal anesthesia,the perianesthesia nurse understands that the progression of blockage occurs in thefollowing order:1. sensory, motor, autonomic2. motor, sensory, autonomic3. autonomic, sensory, motor4. motor, autonomic, sensory - 3After extubation of a patient, which of the following would be considered most serious?1. Sore throat2. Impaired swallowing ability3. Inspiratory stridor4. Hoarseness - 3

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Which of the following interventions would be used first to maintain adequate perfusion andoxygen supply to cardiac muscles following hepatic surgery in a patient with a history ofcoronary artery disease:1. Ensure a hemoglobin concentration ≥ 10 g.2. Treat tachydysrhythmias and hypotension.3. Monitor oxygen saturation via pulse oximetry.4. Administer appropriate medications. - 1The use of the pulse oximeter has become a routine part of PACU care. The post anesthesianurse may decide that oximetry monitoring is indicated when the patient:1. has had minor surgery.2. has normal vital signs.3. has had regional anesthesia.4. is severely hypothermic. - 4The perianesthesia nurse is aware that a dramatic decrease in the calcium may be cause byremoval of the:1. pituitary gland.2. thyroid gland.3. parathyroid gland.4. adrenal glands. - 3Tidal volume is most precisely defined as the amount of:1. air exchange in one minute.2. gas passing into or out of the lungs in each respiratory cycle.3. gas remaining within the chest after maximal expiration.4. air exchange with full inspiration and expiration. - 2In caring for a preschool-aged child, the perianesthesia nurse is aware that the child'sprimary cause of anxiety prior to surgery is:

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1. fear of the medical equipment.2. striving for approval.3. loss of privacy.4. separation from parents. - 4One of the most frequent side effects of ketamine anesthesia is:1. hallucination.2. respiratory depression.3. hypotension.4. bradycardia. - 1A standard of practice for post anesthesia nursing is established by which acceptable levelsof nursing action?1. Promoting independent nursing judgment2. Specifying the nursing goal while defining appropriate nursing measures3. Identifying the nursing actions that meet JCAHO criteria4. Prescribing the nursing intervention relative to standing orders - 2A PACU education/research committee should have three commitments, which must includeall of the following except:1. development of innovative thinking.2. freedom of inquiry.3. individual progress of each nurse.4. excellence in practice. - 3The dissociative state attributed to ketamine anesthesia can be modified by theadministration of a/an:1. antiarrhythmic.2. benzodiazepine.

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3. narcotic.4. anticonvulsant. - 2Following a hernia repair, a 3-month-old is admitted to the PACU positioned on his side witha pacifier in his mouth. The airway becomes obstructed by the tongue. The obstruction canbe alleviated by:1. removing the pacifier.2. pinching the cheeks.3. turning him on his back.4. jaw thrust or chin lift - 4A post-op patient awaiting transport to a surgical floor is awake and responds appropriatelyto commands. The perioperative nurse instructs the patient to flex and extend his/ herlower extremities; the purpose of this is to:1. ensure that the patient follows commands.2. prevent the complication of venous stasis.3. accelerate emergence from anesthesia.4. assess if patient is ready for discharge. - 2A geriatric patient's advanced age puts them at an increased risk for post-operative:1. anorexia.2. hypothermia.3. nausea.4. pain. - 2During emergence from general anesthesia, a patient exhibits rapidly increasing symptomsof asthma. Vital signs are: BP = 190/100, HR = 144, R = 36, and SaO2 = 86%. Theperianesthesia nurse anticipates giving which of the following medications initially?1. Dexamethasone2. Nebulized epinephrine

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3. Nebulized albuterol4. Isoproterenol - 3A patient with streptococcal group A pharyngitis arrives in Phase I PACU. The perianesthesianurse plans that the nurse to patient ratio should be:1. two nurses to one patient.2. one nurse to two patients.3. one nurse to one patient.4. one nurse to three patients. - 3A 35-year-old patient arrives in the Phase I PACU crying and repeatedly asks, "Can't mymother come in here with me?" The perianesthesia nurse:1. informs the patient that visitation is prohibited in the PACU.2. reassures the patient and administers an analgesic.3. allows a brief visit at a time appropriate for patient, visitors, and staff.4. sedates the patient secondary to postanesthetic confusion. - 3In a patient status post thyroidectomy, the perianesthesia nurse would anticipatepostoperative signs of thyrotoxic crisis to include:1. hyponatremia.2. hypothermia.3. tachycardia.4. bradycardia. - 3Which of the following nursing interventions is most effective for a patient with a history ofpostoperative nausea and vomiting?1. Providing ice chips2. Administering ranitidine3. Prevention4. Avoiding administration of analgesics - 3

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A perianesthesia nurse is providing discharge instructions to a patient who asks questionsabout the phenazopyridine prescription. The nurse explains that it:1. needs to be taken on an empty stomach.2. provides relief from urgency and burning sensation.3. helps minimize bleeding and formation of blood clots.4. treats bacteria present in the urinary tract. - 2A patient in the PACU following hip arthroplasty complains of numbness to toes of affectedextremity. The patient has most likely sustained an injury to the:1. peroneal nerve.2. femoral artery.3. Achilles tendon.4. sciatic nerve. - 1Surgery is scheduled for 0830. The patient reports drinking 6 ounces of water at 0600 withmedications. Following American Society of Anesthesiologists (ASA) minimum fastingguidelines for n.p.o., the perianesthesia nurse:1. continues with the preoperative check-in process.2. medicates the patient for nausea.3. informs the patient that the case may be cancelled.4. notifies the surgeon. - 1A patient who speaks limited English is preparing for gallbladder surgery. The perianesthesianurse is aware that the appropriate interpreter to utilize for this patient is:1. an interpreter who is married to the patient's sister.2. an interpreter who has a contract with the facility.3. the patient's English-speaking husband.4. the patient's bilingual significant other. - 2

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A potential negative side effect of positive end-expiratory pressure (PEEP) is:1. alveolar collapse.2. decreased intrapulmonary shunting.3. increased cardiac output.4. hypertension. - 2A patient complains of dyspnea and chest pain after the insertion of a central-line catheter.The patient's breath sounds are diminished. After physician notification, the priority nursingaction is to:1. prepare for the insertion of a chest tube.2. obtain an order for analgesic.3. apply a positive-pressure airway ventilator.4. prepare for immediate removal of the central line. - 1The dissociative state attributed to ketamine anesthesia can be modified by theadministration of a/an:1. antiarrhythmic.2. benzodiazepine.3. antagonist.4. anticonvulsant. - 2Care for a patient who receives a skin graft to the forearm includes:1. maintain dependent position of the extremity.2. changing the bandages if necessary.3. elevation of the affected extremity.4. ROM exercises for the affected extremity. - 3The perianesthesia nurse learns that the patient takes MAO inhibitor routinely. Thisinformation is documented because of the potential lethal interaction with:

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1. meperidine.2. midazolam.3. succinylcholine.4. morphine. - 1Use of meperidine with an MAOI can lead to hypertension, convulsions, and coma.Prochlorperazine acts to treat postoperative nausea by affecting the:1. process of gastric emptying.2. chemoreceptor trigger zone.3. production of gastric acid.4. vestibular pathways. - 2In a 3-year-old patient, postintubation croup is least likely to develop when the patient has:1. remained in a supine position for a 1-hour procedure.2. been in a supine position for 15 minutes, then in a lateral position for 45 minutes.3. coughed actively and strained prior to extubation.4. required two attempts prior to successful intubation. - 1Following a hernia repair, a 3-month-old is admitted to the PACU positioned on his side witha pacifier in his mouth. The airway becomes obstructed by the tongue. The obstruction canbe alleviated by:1. removing the pacifier.2. pinching the cheeks.3. turning him on his back.4. hyperextending the jaw. - 2The perianesthesia nurse should question the accuracy of the SpO2 measurement whencaring for a patient with which of the underlying condition?1. Cushing's disease.

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2. hypothyroidism.3. Raynaud's disease.4. hyperthyroidism. - 3Signs and symptoms of Raynaud's disease include:Cold fingers or toes.Color changes in your skin in response to cold or stress.Numb, prickly feeling or stinging pain upon warming or stress relief.A patient 7 months pregnant is admitted for repair of a lacerated Achilles tendon. Duringassessment, contractions of her abdomen are noted. Which of the following positions shouldthis patient be placed?1. Right lateral tilt position2. Left lateral tilt position3. Supine4. Trendelenburg - 2Because your liver is on the right side of your abdomen, lying on your left side helps keepthe uterus off that large organ. Sleeping on the left side also improves circulation to theheart and allows for the best blood flow to the fetus, uterus, and kidneys.When preparing a patient for a brachial plexus nerve block for upper extremity surgery, theperianesthesia nurse is aware that the safest and easiest approach is:1. subclavicular.2. supraclavicular.3. interscalene.4. axillary. - 4The axillary approach to the brachial plexus is considered the safest of the four approachesbecause of reduced risk to surrounding structures such as the risk of phrenic nerveblockade and/or pneumothorax, but the general risks of accidental intravascular andintraneural injection still exists.

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To decrease nausea, the perianesthesia nurse instructs the patient to:1. take deep breaths.2. take several quick breaths.3. turn their head to the side.4. utilize Reiki or imagery. - 1The perianesthesia nurse would expect a patient with COPD to have received which of thefollowing anesthetic agents?1. Isoflurane2. Nitrous oxide3. Enflurane4. Halothane - 4.Halothane also has excellent bronchodilatory properties and remains an acceptablealternative for inductionIsoflurane - Isoflurane is a good bronchodilator, but it is not ideal for induction of anesthesiasince it is more pungent than sevoflurane and halothane and has a slower onset thansevoflurane.Sevoflurane - We prefer sevoflurane for inhalation induction since it has the mostpronounced bronchodilatory properties of the available agents.Desflurane - We avoid desflurane during induction of anesthesia in patients with COPD.Because of its extreme pungency, desflurane may increase secretions and cause coughing,laryngospasm, and/or bronchospasm during induction, particularly in current smokers, andit may increase airway resistance.In a preoperative visit, information to be collected by the perianesthesia nurse includes:

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1. type of surgery to be performed, previous surgical history and verification of paymentsource.2. cardiac status, vaccination status, respiratory status, and location of patient's familypostoperatively.3. surgical procedure, whether the patient has signed the consent form, and type ofanesthesia to be used.4. preexisting diseases, laboratory values, neurological status, current medications, andallergies. - 4A patient calls the preoperative center asking whether to continue taking his daily dose ofclonidine. The perianesthesia nurse is aware that clonidine should be:1. taken only if the surgeon deems it necessary.2. stopped at least 3 days preoperatively.3. stopped at least 5 days preoperatively.4. taken daily as prescribed. - 4Six hours postoperatively, a patient has not voided and his bladder is palpably distended. Thepatient refuses catheterization. If the nurse catheterizes the patient against his wishes, thisis considered:1. tort.2. assault.3. malpractice.4. battery. - 4A preoperative patient is admitted to the holding area prior to joint surgery. The patient askswhat the facility is doing to prevent postoperative surgical site infections. Theperianesthesia nurse is aware that according to the surgical care improvement project(SCIP), preop antibiotics should be administered:1. within 60 minutes of incision time.2. prior to induction.3. prior to leaving the holding area.

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4. upon arrival to the facility. - 1The perianesthesia nurse is aware that a dramatic decrease in the serum calcium level maybe caused by removal of the:1. parathyroid glands.2. pineal gland.3. adrenal glands.4. pituitary gland. - 1The perianesthesia nurse recognizes that upon a patient's arrival to the PACU, a side effectof ketamine anesthesia is:1. decreased muscle tone.2. hypotension.3. marked salivation.4. nausea and vomiting. - 3increased salivation due to stimulation of muscarinic receptors (can be contolled using anantimuscarinic)Other Side Effects:catatoniaamnesiadeficits in working and episodic memory (associated with frequent use)analgesiaelevated heart rate, cardiac output & blood pressurepost-op disorientationsensory & perceptual illusionsvivid dreamsulcerative cystitis (associated with chronic drug use)Contraindications:

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By asking a tympanoplasty patient to wrinkle the forehead, pucker lips, smile, and squeezeeyelids together, the PACU nurse is assessing the function of cranial nerve:1. V.2. VII.3. IX.4. XII. - 2The Faces Pain Rating Scale measurement tool is most appropriate for:1. a 2-year-old toddler.2. an 8-year-old child.3. a 15 year-old child.4. an infant. - 2A patient receives an intraoperative prophylactic dose of droperidol. The PACU nurse isaware that this drug has a potentiating action when administered:1. with narcotics and barbiturates.2. with nonsteroidal anti-inflammatory drugs.3. to a patient with increased ICP.4. to a hypertensive patient. - 1The perianesthesia nurse should utilize which of the following screening tools to identifypatients at risk for obstructive sleep apnea?1. STOP-Bang Questionnaire2. Aldrete Scoring Tool3. Ramsey Sedation Scale4. Pasero Opioid Induced Sedation Scale - 1YES/NO questions to the following:

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Snoring ?Do you Snore Loudly (loud enough to be heard through closed doors or your bed-partner elbows you for snoring at night)?Tired ?Do you often feel Tired, Fatigued, or Sleepy during the daytime (such as falling asleepduring driving or talking to someone)?Observed ?Has anyone Observed you Stop Breathing or Choking/Gasping during your sleep?Pressure ?Do you have or are being treated for High Blood Pressure ?Body Mass Index more than 35 kg/m2?Age older than 50 ?Neck size large ? (Measured around Adams apple)Is your shirt collar 16 inches / 40cm orlarger?Gender = Male ?The perianesthesia nurse receives a call inquiring about a patient who is in surgery. Theperianesthesia nurse's initial action is to:1. transfer the call to the O.R. desk.2. advise to call back later.3. provide the information.4. inform the family of the call. - 4During a preoperative telephone interview, a 52-year-old patient states that he has beenhospitalized twice in the past year for management of insulin-dependent diabetes mellitus.The ASA status of this patient is:1. Class I.2. Class II.

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