CPAN Practice Questions (2026) — Free Sample Questions with Answers

Answer: B

Adequate recovery, since all four twitches are present: Having all four twitches does not mean recovery. A TOF ratio below 0.9 means meaningful residual weakness that endangers the airway.

Residual blockade, because the ratio is below 0.9: Correct. Adequate recovery requires a TOF ratio of 0.9 or more. At 0.6, the patient is at risk for airway obstruction, aspiration and hypoxemia; notify anesthesia about further reversal and support breathing.

Opioid sedation, since neuromuscular blockade wears off: These findings (weak grip, ptosis, a low TOF ratio) point to neuromuscular weakness. Opioid sedation does not lower the TOF ratio.

Normal emergence, since the patient is awake and talking: Being awake does not rule out residual paralysis. Patients can be conscious and still too weak to protect the airway.

Residual neuromuscular blockade: a TOF ratio below 0.9. Clinical signs such as head lift are less reliable than quantitative monitoring.

Answer: B

Transfusion of packed red cells for hemorrhagic shock: Blood loss is minimal and does not explain the hypotension that persists despite fluids. Transfusion would not fix the underlying problem.

IV hydrocortisone for acute adrenal insufficiency: Correct. Long-term steroid use suppresses the HPA axis. Major surgery can then trigger adrenal crisis: hypotension resistant to fluids and pressors, hypoglycemia and hyponatremia. IV hydrocortisone (for example 100 mg) treats it.

IV insulin infusion for stress hyperglycemia: This patient is hypoglycemic. Insulin would be dangerous.

IV furosemide to treat fluid overload: These findings show shock with too little circulating volume and cortisol, not fluid overload.

Suspect adrenal crisis in long-term steroid users with hypotension that does not respond to fluids and pressors, along with hypoglycemia and hyponatremia. Treat with IV hydrocortisone.

Answer: C

Aspiration pneumonitis from regurgitated stomach contents: Aspiration may cause hypoxemia and infiltrates, but it is not typically marked by pink frothy sputum right after obstruction was relieved.

Cardiogenic pulmonary edema from fluid overload: A healthy young patient who received only 900 mL of fluid and has no heart disease is very unlikely to have cardiogenic edema.

Negative-pressure pulmonary edema after the obstruction: Correct. Forceful breathing against a closed glottis creates very negative intrathoracic pressure that pulls fluid into the alveoli. It is classic in young, muscular patients. Treat with oxygen and CPAP or PEEP, with airway support as needed.

Acute pulmonary embolism from venous thrombosis: Pulmonary embolism rarely causes pink frothy sputum and bilateral crackles right after laryngospasm.

Hypoxemia, crackles and pink frothy sputum minutes after an upper airway obstruction (laryngospasm) suggest negative-pressure pulmonary edema. It is usually self-limited with supportive oxygen and PEEP.

Answer: C

Give a racemic epinephrine nebulizer for airway edema: Racemic epinephrine treats subglottic edema, which develops more gradually. It will not open vocal cords that are in spasm.

Place the patient in Trendelenburg to improve venous return: Trendelenburg does nothing to open a closed glottis and can impair ventilation.

Give 100% O₂ by mask with positive pressure and a jaw thrust: Correct. For laryngospasm, apply a jaw thrust (with pressure at the laryngospasm notch) and positive pressure with 100% oxygen. Prepare for a small dose of succinylcholine as ordered by anesthesia if it continues.

Have the patient cough hard to clear secretions from the cords: A patient in complete laryngospasm cannot move air to cough. Positive-pressure ventilation is needed.

Laryngospasm: call for help, jaw thrust, CPAP or positive pressure with 100% O₂, and succinylcholine if it persists. Watch afterward for negative-pressure pulmonary edema.

Answer: D

9: A 9 would need only one subscore of 1. This patient has 1 point for circulation, 1 for consciousness and 1 for oxygen saturation.

6: This undercounts activity or respiration, which both score 2 (moves four limbs; breathes deeply and coughs).

8: Eight misses one deduction. Circulation, consciousness and oxygen saturation each score 1, not 2.

7: Correct. Activity 2 + respiration 2 + circulation 1 (BP 20-49% from baseline) + consciousness 1 (arousable on calling) + oxygen saturation 1 (needs O₂ to stay above 90%) = 7. This is below the usual threshold of 9 or more for Phase I discharge.

Modified Aldrete scores activity, respiration, circulation, consciousness and SpO₂ at 0-2 each (maximum 10). A score of 9 or more is commonly used along with other ASPAN-based discharge criteria.

Answer: C

Give the surgical findings, since daughters count as next of kin: Being related does not automatically permit disclosure of clinical details. The patient's wishes and facility verification procedures apply.

Refuse all information and hang up, since HIPAA bans any disclosure: HIPAA allows limited sharing with family involved in care when the patient agrees or does not object, or when it is in the patient's best interest. A blanket refusal is not required.

Verify identity per policy; share only what the patient allowed: Correct. Follow facility procedures such as a passcode or the patient's designated contacts and share only the minimum information the patient has authorized. Surgical findings are usually left for the surgeon to discuss.

Ask the drowsy patient now whether it is fine to share every detail: A drowsy patient just out of anesthesia may not be able to make a reliable decision. Use documented preferences and policy instead.

HIPAA allows limited disclosure to involved family consistent with the patient's wishes. Verify identity, share the minimum necessary, and refer clinical findings to the surgeon.