Certified Ambulatory Perianesthesia Nurse (CAPA) Practice Exam

In the initial care for a supine patient with laryngeal mask airway (LMA) in place, what is the primary action of the perianesthesia nurse?

1. Monitors for return of the swallowing reflex

2. Deflates the cuff

3. Suctions the oropharynx frequently

4. Removes the oral airway

The correct answer is: Monitors for return of the swallowing reflex

The primary action of the perianesthesia nurse in the initial care for a supine patient with a laryngeal mask airway (LMA) in place is to monitor for the return of the swallowing reflex. This is a critical focus for ensuring the patient's airway is protected and that they can maintain adequate ventilation. The swallowing reflex is an important indicator of a patient’s ability to manage their own airway; it shows that protective airway reflexes are returning and establishes readiness for extubation if necessary. Monitoring this reflex helps assess the patient's level of consciousness and responsiveness, which are pivotal in determining the safe transition from mechanical ventilation or airway devices to natural breathing. It directly informs the nurse about the appropriate timing for potential removal of the LMA and the readiness to implement further steps in patient recovery. While the other options may involve important considerations, they do not represent the primary focus at this stage of care. The cuff of the LMA should remain inflated until the patient demonstrates adequate protective reflexes, suctioning may be needed depending on the patient's condition but should not be a frequent intervention unless indicated by secretions, and removal of the oral airway is only considered when the patient can adequately maintain their own airway and demonstrates proper recovery.