Certified Post Anesthesia Nurse (CPAN) Practice Exam

What combination of risk factors indicates a patient may have a decreased chance of postoperative nausea and vomiting (PONV)?

1. Use of opioids, length of procedure

2. Female, non-smoker, use of opioids

3. Male smoker, history of motion sickness

4. Female hypertension, history of PONV

The correct answer is: Female, non-smoker, use of opioids

The combination of risk factors that suggests a patient may have a decreased chance of postoperative nausea and vomiting (PONV) includes being male, a smoker, and having a history of motion sickness. This option suggests characteristics that are generally associated with a lower incidence of PONV. Males typically have a lower risk for PONV compared to females, and smoking is linked to reduced nausea and vomiting in the postoperative setting. This is due to the physiological effects of nicotine, which can have a protective effect against nausea. Additionally, a history of motion sickness can indicate that an individual has a lower susceptibility to the systemic effects leading to PONV, as they often develop coping mechanisms or adaptations. In contrast, the other combinations presented include factors that are widely recognized to increase the risk of PONV. For instance, the use of opioids is strongly associated with a higher incidence of nausea and vomiting, and long surgical procedures also enhance this risk. Female gender has been consistently found as a risk factor for PONV, along with those who have a history of hypertension or previous episodes of PONV, which are factors that indicate increased susceptibility rather than resilience to postoperative nausea and vomiting. Therefore, recognizing the combination of male gender, smoking