Anesthesia
24%of exam
Physiology
18%of exam
Monitoring + Intervention
35%of exam
Care Considerations
14%of exam
HandoffTransferEducationPsychosocialDevelopmentDischarge
Professional Practice
9%of exam
StandardsSafetyEthicsDocumentationPrivacyCollaboration
Quick Facts
- Exam
- CPAN
- Sponsor
- ABPANC
- Focus
- Phase I PACU
- Questions
- 185 MCQ
- Scored
- 140 scored
- Pretest
- 45 unscored
- Time
- 3 hours
- Pass
- 450 scaled
- Scale
- 200-800
- Vendor
- PSI
- Eligibility
- RN + 1200 hours
MH Clues
EtCO2 climbs before temperature scares.
EtCO2RigidityAcidosisDantrolene
MH vs Fever
MH
- Rising EtCO2
- Rigidity
- Dantrolene now
Fever
- Slower onset
- Infection workup
- Antipyretics
EtCO2 drives urgency
Techniques
- General
- Unconscious airway support
- Regional
- Nerve distribution block
- Local
- Site-specific anesthesia
- Moderate sedation
- Purposeful response
- MAC
- Anesthesia-monitored sedation
- TIVA
- IV anesthesia only
- Neuraxial
- Spinal/epidural block
- Peripheral block
- Extremity analgesia
LAST Clues
Mouth rings, ears ring, seizures start.
PerioralTinnitusSeizureLipid
LAST vs Anaphylaxis
LAST
- After local
- Seizure/collapse
- Lipid therapy
Anaphylaxis
- Allergen exposure
- Bronchospasm/hypotension
- Epinephrine
Trigger identifies pathway
Agents + Reversal
- Volatiles
- MH triggers
- Succinylcholine
- MH trigger
- Propofol
- Rapid hypnotic
- Ketamine
- Dissociative analgesia
- Opioids
- Respiratory depression
- Benzodiazepines
- Sedation/amnesia
- Naloxone
- Opioid reversal
- Flumazenil
- Benzo reversal
- Sugammadex
- Rocuronium reversal
- Neostigmine
- Cholinesterase inhibition
Spinal vs Epidural
Spinal
- Single injection
- Rapid dense block
- Hypotension risk
Epidural
- Catheter possible
- Segmental dosing
- Hematoma watch
Speed vs titration
Block Complications
- Interscalene
- Phrenic palsy
- Supraclavicular
- Pneumothorax risk
- Cervical plexus
- Horner syndrome
- Neuraxial opioid
- Delayed depression
- High spinal
- Hypotension/apnea
- Epidural hematoma
- Neuro emergency
- LAST
- Seizures/collapse
- Tourniquet pain
- Regional breakthrough
Hypoxia vs Delirium
Hypoxia
- Check airway
- Assess SpO2
- Ventilate/oxygenate
Delirium
- After oxygenation
- Reorient calmly
- Find causes
Oxygen first
Respiratory
- Hypoventilation
- CO2 retention
- Obstruction
- Noisy effort
- Laryngospasm
- Closed glottis
- Bronchospasm
- Wheezing resistance
- Atelectasis
- Collapsed alveoli
- Aspiration
- Gastric contamination
- OSA
- Opioid sensitivity
- Pneumothorax
- Unilateral sounds
- NPPE
- Post-obstruction edema
Circulation
- Hypovolemia
- Tachycardia/hypotension
- Bleeding
- Trend drains
- Shock
- Poor perfusion
- MI
- ST changes
- Mobitz II
- Pacing risk
- Hypertension
- Pain/hypoxia/full bladder
- Embolism
- Sudden hypoxemia
- Aortocaval
- Left tilt
Neuro + Endocrine
- Delayed emergence
- Drugs/metabolic/neuro
- Delirium
- Hypoxia first
- Stroke
- Time-sensitive escalation
- ICP rise
- Midline/head up
- Hypoglycemia
- Altered mentation
- DKA
- Polyuria/acidosis
- Hypocalcemia
- Tetany signs
- Hyperkalemia
- Wide QRS
Temperature + Fluids
- Hypothermia
- Shivering/O2 demand
- Normothermia
- Active warming
- MH
- Hypermetabolic crisis
- Acidosis
- Ventilate/perfuse
- Citrate toxicity
- Low ionized calcium
- AKI
- Urine trend
- Fluid bolus
- Hypovolemia response
- Blood products
- Massive loss
PACU First Look
Airway, breathing, circulation before comfort.
AirwayBreathingCirculationPain
Pain vs Respiratory Depression
Pain
- Assess scale
- Multimodal options
- Reassess response
Resp depression
- Slow respirations
- Low EtCO2 alarm
- Ventilate/reverse
Breathing wins
Airway Picker
- Snoring obstruction→Jaw thrust(Open airway)
- Secretions present→Suction(Clear airway)
- Low SpO2→Oxygen(Assess ventilation)
- Hypoventilation→Ventilate(Bag-mask)
- Laryngospasm→Positive pressure(Call anesthesia)
- OSA patient→Extended monitoring(Limit opioids)
- Intubated transport→Monitor/O2/BVM(Emergency meds)
Airway Monitoring
- SpO2
- Oxygen saturation
- EtCO2
- Ventilation trend
- ABG
- Gas exchange
- Aldrete
- Phase I readiness
- Sedation score
- Arousal depth
- Extubation
- Protective reflexes
- LMA removal
- Awake preferred
- Suction
- Clear secretions
- Jaw thrust
- Obstruction relief
Emergency Picker
- Rising EtCO2→MH protocol(Dantrolene)
- Seizure after block→LAST protocol(Lipid)
- Absent sounds→Pneumothorax response(Escalate)
- Widened QRS→IV calcium(Hyperkalemia)
- Opioid apnea→Ventilate first(Naloxone)
- Anaphylaxis signs→Epinephrine(Airway/fluids)
- New neuro deficit→Stroke alert(Time matters)
Pain + PONV
- Multimodal
- Multiple mechanisms
- Opioid titration
- Pain vs breathing
- Regional analgesia
- Motor/sensory checks
- PCA
- Patient controlled
- FLACC
- Nonverbal child
- FACES
- Young verbal child
- PONV
- Hydrate/antiemetic
- P6
- Antiemetic acupressure
Pain PONV Picker
- Severe pain→Titrate analgesia(Reassess)
- Respiratory depression→Hold opioid(Ventilate)
- Regional numbness→Neurovascular check(Trend)
- Nonverbal child→FLACC(Behavior)
- Verbal young child→FACES(Self-report)
- Nausea/vomiting→Antiemetic(Hydrate)
- Complementary PONV→P6 acupressure(Adjunct)
Lines Drains Wounds
- Arterial line
- Waveform/limb perfusion
- Central line
- Never force flush
- PICC
- Check occlusion
- Chest tube
- Air leak/drainage
- JP drain
- Bulb suction
- Serosanguineous
- Expected early
- Bright red
- Active bleeding
- Milky drainage
- Chyle leak
- Wound dehiscence
- Cover/escalate
Emergencies
- MH signs
- EtCO2/rigidity/heat
- Dantrolene
- MH antidote
- LAST signs
- Neuro then cardiac
- Lipid emulsion
- LAST therapy
- Anaphylaxis
- Epinephrine/airway
- Tension pneumo
- Decompress now
- Hyperkalemia ECG
- Calcium first
- Opioid overdose
- Ventilate/naloxone
Transfer Ready
Stable trends beat one pretty number.
AirwayVitalsPainHandoff
CPAN vs CAPA
CPAN
- Phase I
- Immediate recovery
- PACU instability
CAPA
- Ambulatory phases
- Preop/Phase II
- Discharge flow
Match primary practice
Transfer Picker
- Unstable airway→Stay Phase I(Escalate)
- Stable vitals→Assess criteria(Aldrete)
- Drain change→Report trend(Before transfer)
- Discharge teaching→Written/verbal(Verify learning)
- Language barrier→Interpreter(No family)
- Cognitive impairment→Caregiver(Reorient)
- No ride→Delay discharge(Safety)
Care Transitions
- Phase I
- Immediate recovery
- Phase II
- Discharge readiness
- Handoff
- Structured transfer
- SBAR
- Situation/background/assessment/recommendation
- Transport
- Monitor/O2/airway meds
- Family presence
- Reorientation support
- Interpreter
- Language access
- Caregiver
- Home safety
- Readiness
- Vitals/airway/pain
Phase I vs Phase II
Phase I
- Airway focus
- Frequent vitals
- Unstable trends
Phase II
- Ambulation
- Oral intake
- Home readiness
Stability before discharge
Individualized Care
- Pediatric
- Developmental scales
- Geriatric
- Reserve/delirium risk
- Pregnant
- Left uterine displacement
- Autism
- Reduce stimulation
- PTSD
- Trauma-informed care
- Substance use
- Tolerance/withdrawal
- Obesity
- Airway/OSA risk
- Latex allergy
- Latex-free setup
- Cultural beliefs
- Negotiate care
Document Care
Assess, intervene, reassess, communicate.
AssessInterveneReassessCommunicate
Standards vs Policy
Standards
- External guidance
- Professional baseline
- Evidence informed
Policy
- Local process
- Facility specific
- Operational rules
Use both
Exam Blueprint
- Anesthesia
- 24%
- Physiology
- 18%
- Monitoring
- 35%
- Care considerations
- 14%
- Professional practice
- 9%
- Blueprint cycle
- 2023-2027 exams
- Scoring
- Equated scale
- Retest
- Next window
Standards + Safety
- ASPAN
- Perianesthesia standards
- ASA
- Postanesthesia standards
- ACLS
- Adult resuscitation
- PALS
- Pediatric resuscitation
- MHAUS
- MH protocol
- HIPAA
- Privacy rule
- Consent
- Clarify discrepancies
- DNR
- Required reconsideration
- Incident report
- Safety documentation
- Competency
- Observed validation
Common Traps
Pretest Items
Unlabeled ≠ Still answer all
Scaled Score
450 scale ≠ Not fixed percent
Agitation
Could be hypoxia ≠ Not just anxiety
Hypothermia
Raises oxygen demand ≠ Not benign shivering
Pulse Ox
Oxygenation estimate ≠ Not ventilation proof
Central Line
Gentle troubleshoot ≠ Never force flush
DNR Surgery
Reconsider required ≠ Not automatic suspension
Family Interpreter
Use professional ≠ Not convenience substitute
Aldrete Score
Supports decision ≠ Not sole judgment
Pain Report
Believe patient ≠ Balance sedation
Last Minute
- 1.185 questions, 3 hours
- 2.140 scored; 45 pretest
- 3.Pass is 450 scaled
- 4.Monitoring is 35%
- 5.Airway before pain control
- 6.EtCO2 detects ventilation
- 7.Volatiles and succinylcholine trigger MH
- 8.Dantrolene treats MH
- 9.LAST gets lipid emulsion
- 10.SpO2 is not ventilation
- 11.Never force central lines
- 12.Trend vitals before transfer
- 13.Use interpreter for teaching
- 14.Document assessment and reassessment
Buy on Amazon
Study guide on MometrixSame family resources
Explore More ABPANC Perianesthesia Nursing Certifications
Continue into nearby exams from the same family. Each card keeps practice questions, study guides, flashcards, videos, and articles in one place.
More From This Family
Videos and articles for deeper review.