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Cheat sheet

CAPA Cheat Sheet

Practice QuestionsStudy Guide

Anesthesia

20%of exam

TechniquesAgentsReversalSedation DepthSpecial Populations

Physiology

16%of exam

SystemsComorbiditiesTemperatureFluidsGlucose

Monitoring + Intervention

30%of exam

AirwayPainPONVEmergenciesIntervention Picker

Care Considerations

25%of exam

ContinuumHandoffDischargeTeachingDischarge Picker

Professional Practice

9%of exam

StandardsConsentPrivacyDocumentationEscalation

Quick Facts

Exam
CAPA
Credential
Ambulatory Perianesthesia Nurse
Questions
185 MCQ
Scored
140 scored + 45 pretest
Time
3 hours
Pass
450/800 scaled
Eligibility
RN + 1,200 hours
Windows
Mar-May; Sep-Nov

MAC vs General

MAC

  • Anesthesia service
  • Depth can vary
  • Assess patient

General

  • Unconscious patient
  • Airway often supported
  • Reflexes impaired

Label never guarantees depth

Techniques

General
Unconscious; airway risk
Regional
Block region
Local
Site anesthesia
Moderate
Purposeful response
Deep
Airway help possible
MAC
Provider-managed sedation
TIVA
IV maintenance
Spinal
Sympathetic block

Agents + Reversal

Propofol
Fast; no analgesia
Midazolam
Amnesia; sedation
Fentanyl
Analgesia; hypoventilation
Ketamine
Analgesic dissociation
Dexmedetomidine
Bradycardia; sedation
Naloxone
Opioid reversal
Flumazenil
Benzo reversal
Dantrolene
MH treatment
Sugammadex
Rocuronium reversal

Systems

Respiratory
Oxygenation first
Cardiac
Perfusion + rhythm
Neuro
Awake; baseline
Endocrine
Glucose swings
Renal
Retention; clearance
GI
PONV; aspiration
Integumentary
Wounds; pressure
Hematologic
Bleeding risk

Comorbidities

OSA
Opioid sensitivity
Obesity
Rapid desaturation
Diabetes
Glucose; wounds
CKD
Drug clearance
Pregnancy
Aspiration; positioning
Geriatric
Delayed clearance
Pediatrics
Airway reserve
Anticoagulants
Bleeding risk

Priority Ladder

Airway, breathing, circulation before discharge decisions.

AirwayBreathingCirculationDischarge

MH vs LAST

MH

  • Volatile trigger
  • Rising CO2
  • Dantrolene

LAST

  • Local anesthetic
  • Neuro symptoms
  • Lipid emulsion

Trigger identifies treatment

Intervention Picker

  1. Snoring respirations→Open airway(Position first)
  2. Apnea or RR6→Assist ventilation(Call anesthesia)
  3. Opioid oversedation→Naloxone(Monitor rebound)
  4. Benzo oversedation→Flumazenil(Seizure risk)
  5. Rigidity + hypercarbia→MH protocol(Dantrolene)
  6. Metallic taste→LAST protocol(Lipid ready)
  7. Hives + hypotension→Epinephrine(Airway priority)
  8. Wheezing recovery→Oxygen + bronchodilator(Escalate)
  9. Saturated dressing→Assess bleeding(Notify surgeon)

Airway

Obstruction
Position; open airway
Hypoventilation
Assist ventilation
Laryngospasm
No air movement
Bronchospasm
Wheeze; beta agonist
Aspiration
Protect airway
OSA
Room-air stability
Opioids
Monitor sedation
CPAP
Use if prescribed

Emergencies

MH
Dantrolene; cooling
LAST
Lipid emulsion
Anaphylaxis
Epinephrine; airway
Bleeding
Quantify; escalate
Shock
Perfusion support
Fire
Stop gases
Stroke
Neuro change
Chest pain
ABC; notify

Pain + PONV

Pain score
Trend + function
IV opioid
Recheck 15-30 min
Oral meds
Recheck 45-60 min
Multimodal
Opioid sparing
Regional block
Protect numb limb
PONV
Aspiration delay
Hydration
Nausea support
Shivering
Oxygen demand

Home Teaching

Meds, wound, warning signs, escort, resources.

MedsWoundWarningsEscortResources

CAPA vs CPAN

CAPA

  • Preanesthesia focus
  • Phase II recovery
  • Discharge central

CPAN

  • Phase I focus
  • Immediate emergence
  • Stabilization central

Match practice phase

Discharge Picker

  1. Unstable airway→Continue monitoring(No discharge)
  2. OSA desaturates→Room-air trial(Escalate)
  3. Motor block persists→Fall precautions(Delay ambulation)
  4. PONV uncontrolled→Treat nausea(Delay discharge)
  5. No escort→Hold discharge(Responsible adult)
  6. Teaching unclear→Teach-back(Use interpreter)
  7. New chest pain→Emergency response(No discharge)
  8. Home equipment missing→Case management(Resource gap)

Continuum

Preadmission
Screen risks
Day-of
Verify readiness
Phase II
Functional recovery
Extended care
Ongoing observation
Transport
Stable transfer
Escort
Responsible adult
Teaching
Patient + caregiver
Home resources
Equipment; support

Stable vs Ready

Stable

  • Vitals acceptable
  • Moment assessment
  • May still risk

Ready

  • Criteria met
  • Escort prepared
  • Instructions understood

Discharge needs function

Professional Filter

Scope, standards, consent, privacy, documentation.

ScopeStandardsConsentPrivacyDocument

Exam Facts

Owner
ABPANC
Delivery
PSI computer exam
Total
185 questions
Scored
140 questions
Pretest
45 unscored
Limit
3 hours
Passing
450 scaled
Scale
200-800

Blueprint Weights

Monitoring
30%
Care
25%
Anesthesia
20%
Physiology
16%
Practice
9%
Big two
55% combined

Standards

ASPAN
Specialty standards
ASA
Anesthesia guidance
ACLS
Adult resuscitation
PALS
Pediatric resuscitation
MHAUS
MH readiness
HIPAA
Privacy rule
Consent
Verify; clarify
Scope
Competency limits

Common Traps

MAC

Not fixed sedation ≠ Assess current depth

Pretest Items

Not labeled ≠ Treat all scored

Scaled Score

Not raw percent ≠ 450 always passes

Room Air

Oxygen masks risk ≠ Stability proves readiness

Nerve Block

Comfort not readiness ≠ Motor function matters

Consent

Nurse does not obtain ≠ Nurse verifies process

Last Minute

  1. 1.CAPA focus: ambulatory phases
  2. 2.Monitoring plus care equals 55%
  3. 3.185 questions in 3 hours
  4. 4.450 scaled score passes
  5. 5.Airway first, discharge later
  6. 6.MAC depth can change
  7. 7.LAST needs lipid readiness
  8. 8.MH needs dantrolene
  9. 9.No escort means no discharge
  10. 10.Verify consent before procedure

CAPA

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The Certified Ambulatory Perianesthesia Nurse CAPA Study Guide

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