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Type of Exam: Computer-based test (CBT)
Number of Questions: 165 multiple-choice questions
- 150 scored questions
- 15 unscored (pretest) questions (used for future exam development)
Exam Duration: 3 hours (180 minutes)
A scaled score of 75 or higher is required to pass the exam (on a scale of 0–100).

1. Preoperative Assessment and Preparation
- Patient History and Physical Assessment:
- Comprehensive evaluation of the patients medical
- surgical
- anesthesia history
- Diagnostic Tests:
- Interpretation of preoperative lab results
- imaging studies
- other diagnostic tests
- Risk Assessment: Identification of risk factors for anesthesia and surgery, including ASA (American Society of Anesthesiologists) classification.
- Patient Education: Preoperative instructions, informed consent, and patient/family education regarding the procedure and anesthesia.
- Medication Management: Review of current medications, including anticoagulants, and preoperative medication adjustments.

2. Anesthesia Care
- Types of Anesthesia: Understanding of general, regional, local, and monitored anesthesia care (MAC).
- Anesthetic Agents: Knowledge of commonly used anesthetic agents, their mechanisms of action, and side effects.
- Airway Management: Techniques for airway exam, management, and emergency interventions.
- Monitoring: Intraoperative monitoring standards, including hemodynamic, respiratory, and neurological monitoring.
- Complications: Recognition and management of anesthesia-related complications such as malignant hyperthermia, anaphylaxis, and respiratory depression.

3. Intraoperative Care
- Surgical Environment: Understanding the roles and responsibilities within the surgical team.
- Positioning: Proper patient positioning to prevent complications such as pressure ulcers and nerve damage.
- Infection Control: Sterile techniques, surgical site preparation, and prevention of surgical site infections (SSIs).
- Hemostasis: Techniques for controlling bleeding during surgery.
- Documentation: Accurate and timely documentation of intraoperative events and interventions.

4. Postoperative Care
- PACU (Post-Anesthesia Care Unit) Management: Immediate postoperative exam and monitoring, including airway, breathing, circulation, and neurological status.
- Pain Management: Assessment and management of postoperative pain, including pharmacological and non-pharmacological interventions.
- Nausea and Vomiting: Prevention and treatment of postoperative nausea and vomiting (PONV).
- Fluid and Electrolyte Balance: Management of intravenous fluids and recognition of electrolyte imbalances.
- Complications: Identification and management of postoperative complications such as hemorrhage, infection, and respiratory distress.

5. Discharge Criteria and Education
- Discharge Readiness: Criteria for safe discharge from the PACU, including Aldrete Score or Modified Aldrete Score.
- Patient Education: Postoperative instructions, including wound care, activity restrictions, and signs of complications.
- Follow-Up Care: Coordination of follow-up appointments and communication with primary care providers.
- Documentation: Accurate documentation of discharge instructions and patient status at discharge.

6. Professional Practice
- Ethical and Legal Issues: Understanding of ethical principles, legal responsibilities, and patient rights.
- Scope of Practice: Adherence to the scope of practice for perianesthesia nurses.
- Quality Improvement: Participation in quality improvement initiatives and evidence-based practice.
- Patient Advocacy: Advocacy for patient safety, informed consent, and patient-centered care.
- Interdisciplinary Collaboration: Effective communication and collaboration with other healthcare professionals.

7. Special Considerations
- Pediatric Patients: Unique considerations for the care of pediatric patients, including developmental stages and family-centered care.
- Geriatric Patients: Special considerations for elderly patients, including polypharmacy and age-related physiological changes.
- Bariatric Patients: Care considerations for obese patients, including equipment needs and anesthesia risks.
- Patients with Comorbidities: Management of patients with chronic conditions such as diabetes, cardiovascular disease, and respiratory disorders.

8. Emergency Situations
- Cardiac Arrest: Recognition and management of cardiac arrest, including Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS) protocols.
- Respiratory Emergencies: Management of acute respiratory distress, including airway obstruction and pulmonary embolism.
- Anaphylaxis: Recognition and treatment of anaphylactic reactions.
- Malignant Hyperthermia: Early recognition and management of malignant hyperthermia, including the use of dantrolene.

9. Pharmacology
- Anesthetic Agents: Knowledge of the pharmacology of anesthetic agents, including induction agents, inhalational agents, and neuromuscular blocking agents.
- Analgesics: Understanding of opioid and non-opioid analgesics, including their indications, dosages, and side effects.
- Sedatives and Hypnotics: Use of sedatives and hypnotics in the perianesthesia setting.
- Reversal Agents: Knowledge of reversal agents such as naloxone and flumazenil.
- Antiemetics: Use of antiemetic medications to prevent and treat PONV.

10. Infection Control and Safety
- Standard Precautions: Adherence to standard precautions to prevent the transmission of infections.
- Surgical Asepsis: Techniques for maintaining a sterile field and preventing surgical site infections.
- Environmental Safety: Ensuring a safe environment for patients and staff, including proper handling of hazardous materials.
- Emergency Preparedness: Knowledge of emergency preparedness protocols, including fire safety and disaster response.

11. Patient and Family Education
- Preoperative Education: Providing information about the surgical procedure, anesthesia, and preoperative preparations.
- Postoperative Instructions: Educating patients and families about postoperative care, including pain management, activity restrictions, and signs of complications.
- Emotional Support: Providing emotional support and addressing the psychological needs of patients and families.

12. Documentation and Communication
- Medical Records: Accurate and timely documentation of patient care, including exams, interventions, and outcomes.
- Handoff Communication: Effective communication during handoff reports, including SBAR (Situation, Background, Assessment, Recommendation) technique.
- Interdisciplinary Communication: Collaboration and communication with other healthcare team members to ensure continuity of care.

13. Research and Evidence-Based Practice
- Evidence-Based Practice: Application of current research and evidence-based guidelines in perianesthesia nursing practice.
- Quality Improvement: Participation in quality improvement projects to enhance patient outcomes and safety.
- Professional Development: Commitment to ongoing education and professional development in perianesthesia nursing.

14. Cultural Competence
- Cultural Sensitivity: Providing culturally competent care that respects the beliefs, values, and practices of diverse patient populations.
- Health Disparities: Understanding and addressing health disparities in perianesthesia care.
- Patient-Centered Care: Tailoring care to meet the individual needs and preferences of patients and families.

15. Legal and Ethical Issues
- Informed Consent: Ensuring that patients have a clear understanding of the risks, benefits, and alternatives to the procedure and anesthesia.
- Confidentiality: Protecting patient privacy and confidentiality in accordance with HIPAA regulations.
- Ethical Dilemmas: Navigating ethical dilemmas in perianesthesia practice, including end-of-life care and patient autonomy.

16. Technology and Equipment
- Monitoring Equipment: Familiarity with the use and interpretation of monitoring equipment, including ECG, pulse oximetry, and capnography.
- Anesthesia Machines: Understanding the components and function of anesthesia delivery systems.
- Emergency Equipment: Knowledge of the location and use of emergency equipment, including defibrillators and airway management tools.

17. Patient Safety
- Error Prevention: Strategies to prevent medical errors, including medication errors and wrong-site surgery.
- Patient Identification: Ensuring accurate patient identification using at least two patient identifiers.
- Time-Out Procedures: Participation in time-out procedures to verify the correct patient, procedure, and site.

18. Pain Management
- Pain Assessment: Use of pain exam tools and scales to evaluate patient pain levels.
- Pharmacological Interventions: Administration of analgesics, including opioids, non-opioids, and adjuvant medications.
- Non-Pharmacological Interventions: Use of non-pharmacological pain management techniques, such as relaxation, distraction, and positioning.

19. Complications and Emergencies
- Recognition and Response: Early recognition and response to complications such as bleeding, infection, and respiratory distress.
- Emergency Protocols: Familiarity with emergency protocols for cardiac arrest, anaphylaxis, and malignant hyperthermia.
- Crisis Management: Effective management of crisis situations, including communication and teamwork.

20. Professional Role and Responsibilities
- Scope of Practice: Understanding the scope of practice for perianesthesia nurses and adhering to professional standards.
- Continuing Education: Commitment to ongoing education and professional development.
- Leadership and Advocacy: Leadership in promoting patient safety, quality care, and advocacy for patients and families.

- Aldrete Score
- ASA Classification
- MAC (Monitored Anesthesia Care)
- PONV (Postoperative Nausea and Vomiting)
- Malignant Hyperthermia
- SBAR (Situation, Background, Assessment, Recommendation)
- HIPAA (Health Insurance Portability and Accountability Act)
- BLS (Basic Life Support)
- ACLS (Advanced Cardiac Life Support)