Certified Ambulatory Perianesthesia Nurse (CAPA) Practice Exam

Which patient is most at risk for experiencing awareness under anesthesia?

1. A 5 year old undergoing a tonsillectomy

2. A 15 year old undergoing a scheduled arthroscopic knee procedure

3. A 30 year old undergoing an emergency surgery for a compound fracture

4. A 70 year old undergoing a colectomy for colon cancer

The correct answer is: A 30 year old undergoing an emergency surgery for a compound fracture

The patient undergoing an emergency surgery for a compound fracture is at the highest risk for experiencing awareness under anesthesia. This situation generally involves a rapid sequence of events where the patient may not receive the full preparatory anesthetic regimen often provided in elective surgeries. Emergency situations can lead to a rushed or less thorough anesthetic process, as clinicians may prioritize immediate surgical needs. In contrast, other patients undergoing more routine procedures, such as a tonsillectomy or an elective arthroscopic knee surgery, would likely be given a standard induction of anesthesia with carefully monitored dosing. Additionally, older patients, like the one undergoing a colectomy for colon cancer, tend to be more closely monitored and receive well-planned anesthetic care, reducing their chances of experiencing awareness. In summary, the immediate and urgent nature of the emergency surgery increases the likelihood of a less optimal anesthetic experience, making this patient the one most at risk for awareness under anesthesia.