Certified Post Anesthesia Nurse (CPAN) Practice Exam

Which group is at a higher risk for postoperative nausea and vomiting (PONV)?

1. Non-smokers

2. Smokers

3. Individuals with high BMI

4. Long-term medication users

The correct answer is: Non-smokers

Individuals at a higher risk for postoperative nausea and vomiting (PONV) are indeed non-smokers. This is primarily because smoking is associated with reduced sensitivity of the antiemetic centers in the brain. Smokers tend to have a lower incidence of PONV likely due to physiological adaptations that affect drug metabolism and receptor responses. In addition to smoking status, risk factors for PONV also include female gender, history of motion sickness, and the use of certain anesthetic agents. Non-smokers, who lack these protective adaptations, are therefore more susceptible to experiencing nausea and vomiting following surgery. Other groups such as high BMI individuals and long-term medication users may have varying risks but are not as definitively linked to increased PONV risk as the distinction between smokers and non-smokers is. Smokers generally have a protective effect against PONV, while non-smokers do not, thus placing them at a higher risk.