Complications and emergencies: PONV risk score: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Complications and emergencies: PONV risk score

Sample item

Which patient has the highest risk of postoperative nausea and vomiting based on the Apfel score?

AA 65-year-old male smoker with no prior historyBA 70-year-old male smoker with a history of motion sicknessCA non-smoking woman with a history of motion sickness receiving postoperative opioidsDA 40-year-old man on a regional technique

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. A non-smoking woman with a history of motion sickness receiving postoperative opioids

The Apfel score counts female sex, non-smoking status, previous PONV or motion sickness and postoperative opioids, with each worth a point. A woman who is a non-smoker, has motion sickness and needs opioids scores 4 and has a risk of about 80%.

Option by option

A. A 65-year-old male smoker with no prior history
A male smoker with no history has few or no risk factors.
B. A 70-year-old male smoker with a history of motion sickness
A male smoker has only one risk factor.
C. A non-smoking woman with a history of motion sickness receiving postoperative opioids (correct)
Correct. She has all four Apfel risk factors.
D. A 40-year-old man on a regional technique
A man under regional anaesthesia without opioids scores the lowest.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is C, A non-smoking woman with a history of motion sickness receiving postoperative opioids. The Apfel score counts female sex, non-smoking status, previous PONV or motion sickness and postoperative opioids, with each worth a point.

Why is "A 65-year-old male smoker with no prior history" not the answer?

A male smoker with no history has few or no risk factors.

Why is "A 70-year-old male smoker with a history of motion sickness" not the answer?

A male smoker has only one risk factor.

Why is "A 40-year-old man on a regional technique" not the answer?

A man under regional anaesthesia without opioids scores the lowest.

What concept does this question test?

It tests Complications and emergencies: PONV risk score in Anaesthesia. A woman who is a non-smoker, has motion sickness and needs opioids scores 4 and has a risk of about 80%.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Complications and emergencies: PONV risk score?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.