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Meperidine (Demerol) 12.5mg every 15 minutes, IV prn is ordered for shivering in the PACU. Meperidine is available in 50mg/1ml. How many mililiters should be given? โโ0.25 mililiters Upon inspecting a patient's epidural insertion site, you notice swelling around the catheter. What should you do? โโA) Position the patient on their side B) Place the patient in a prone position C) Check the epidural line for kinks ***D) Contact the anesthesia provider What set of findings indicates a patient is likely to be ready for phase 1 discharge? โโA) Has received discharge instructions, pain level 9 out 10, shortness of breath B) Drowsy, blood pressure returned to preoperative levels, on 6 liters oxygen via face mask ***C) Drowsy, oxygen saturation of 96%, able to cough, and move all extremities D) Fully alert, shallow breathing, on 3 liters via T-piece, can move 2 extremities
Prophecy PACU RN A v1 Questions and
Answers 2025 100% Pass
graded A+
What do you consider to be a safe dose of intravenous fentanyl for an adult who does not have tolerance to opioids? โโA) 1.5 miligrams ***B) 25 micrograms C) 100 micrograms D 25 miligrams Your patient in the PACU has a blood pressure of 171/92 mmHg, a heart rate of 120, respiratory rate of 24, is grimacing, restless, and moaning in bed. What medication should you prepare to give FIRST? โโA) 10 mg hydralazine IV push B) 50 mcg fentanyl IV push C) 2 mg lorazepam IV push D) 5 mg metoprolol IV push You are about to discharge a day surgery patient with aphasia and you discover the family members are not available for the discharge instructions and are not responding to your phone calls. Business hours are over and the PACU is about to close. How will you handle the situation? โโA) Wait until the family returns B) Leave the discharge education on voicemail and discharge patient C) Discharge patient with non-emergency transport
WRONGD) Decreased sensation of pain The surgeon has ordered ampicillin (Ancef) for a patient. When you check their chart, you see an allergy to penicillin. What is the BEST action? โโA) Administer the medication with diphenhydramine B) Ask the patient to describe their reaction to penicillin C) Contact the pharmacist to clarify the order ***D) Contact the provider to question the order You are receiving report for a patient who had a percutaneous transluminal angioplasty for right lower extremity peripheral vascular disease and is now recovering in the PACU. What type of surgical dressing do you expect to find for this patient? โโA) JP drain sutured in place near the lateral calf B) Several small incisions in calf groin covered with gauze ***C) Clear dressing applied to the right groin D) 3 in incision on the right upper thigh with bulky dressing You are receiving a report on a post op patients from the OR nurse and during the report when you asked for clarifications, the OR nurse became angry, belligerent, and rude. She ended up not
answering your question. How will you proceed? โโ***A) Report the incident to your charge nurse B) Refuse to take the patient C) Take the report as she gave it to you D) Figure out the clarifications from computer WRONGYou are reviewing your orders for you 8 year-old patient that recently arrive in PACU. Which PRN pain order would you question? โโA) IV acetaminophen (maybe??? bc super expensive???) B) PO acetaminophen C) PO ketorolac (maybe???? bc shows increased risk of bleeding than tylenol, and is oral, which maybe they're trying to avoid PO after surgery) WRONGD) IV ketorolac What is a physiologic effect related to unrelieved pain? โโA) Hypoglycemia B) Bradycardia C) Decreased metabolism ***D) Decreased healing
C) Stop the propofol infusion D) As the patient to cough When caring for a patient who is receiving outpatient surgery, what is the BEST way to know that a patient's post-operative blood pressure is sufficient for discharge to home? โโA) The pressure is greater than 100 mmHg SBP B) It is +/- 20% of baseline pre-operative levels C) Adhere to professional standards D) Follow the anesthesia order set WRONGAfter surgery, a sleepy yet responsive patient with an intact gag reflex has a large amount of salivary secretions. What should you do? โโWRONGA) Turn the patient on their side B) Provide oral suctioning C) Contact the anesthesia provider D) Insert an oral airway Where is the phlebostatic axis for leveling the transducer of an arterial line? โโ***A) Fourth intercostal level at the midaxillary line
B) Fourth intercostal level at the midclavicular line C) Fifth intercostal level at the midaxillary line D) Fifth intercostal level at the midclavicular line A carotid endarterectomy patient arrives to you in the PACU. What initial assessment is MOST important? โโ***A) pupil checks B) pain scale C) capillary refill D) blood glucose WRONGThere are 4 patients in PACU: A patient who is alert but disoriented to time, a patient who reports dizziness upon sitting upright, a patient who has partial return of sensation after spinal, and a patient who is drowsy but awakens to touch. Which patient is MOST ready to transfer to phase 2 post-anesthesia care? โโA) The patient who has partial return of sensation after spinal block B) The patient who is alert but disoriented to time C) The patient who is drowsy but awakens to touch WRONGD) The patient who reports dizziness upon sitting upright
What is an example of Phase 1 discharge criteria? โโA) The patient's family member has arrived to take them home B) The patient is ready and able to ambulate to the bathroom ***C) The patient can maintain their airway D) The patient's vital signs have been monitored for 60 minutes You were called in at 2am and did not leave the hospital until 4am. However, your regular shift starts at 7am, and you are extremely tired. What is the appropriate action? โโD) Call your manager and ask for the unit protocol WRONG You are caring for a patient in Phase 1 recovery and they appear ready to transfer except that their blood pressure continues to stay 50mmHg above their pre-anesthetic SBP. At home the patient takes a diuretic and beta-blocker for hypertension. What should you do? โโA) Evaluate the patient's pain level (probs correct) WRONGB) Administer 20mg furosemide orally C) Transfer the patient to the unit D) Contact the anesthesia provider
You receive a patient to Phase I recovery from IR status post cerebral aneurysm clipping. Which assessment is most important for you to perform? โโA) Cardiac rhythm, heart rate, blood pressure *B) Pupil response, facial and extremity movement C) Bowel sounds, urinary output, and oral cavity D) RR, BP, Temp Which patient is MOST at risk for developing postoperative cardiogenic shock? โโA) A 78 year old male adult with CKD B) Pt with recent MI C) Female pt with ES liver disease D) Pediatric patient with metastatic lymphadenopathy WRONG When setting up a morphine PCA pump for a 5'10'' female patient recovering from hip surgery who is 49 years old, 180 lb, and has no history of sleep apnea, what is an expected 4-hr dose limit? โโWRONGA) 5 mg B) 20 mg (probs correct) C) 3 mg
D) Elevated end tidal CO WRONG What combination of medications is an example of multi-modal pain management? โโA) IV PCA morphine with IV fentanyl WRONGB) Oral morphine ER and IV morphine C) IV hydromorphone and IV acetaminophen (probs correct, one is opioid, other is not) D) IV hydromorphone and IV morphine You are caring for a patient with a brachial plexus block after surgery. The patient begins to report chest discomfort on the side where the block was placed. A 12 lead EKG was normal. What order do you expect to be completed NEXT for this patient? โโA) Echo B) Cardiac biomarkers C) CMP ***D) Chest X-ray You need to obtain consent from a sedated patient post hip replacement surgery for a regional block. Two women showed up at bedside as next of kin. One has a child with patient and the
other is the patient's girlfriend. How will you obtain the consent? โโA) Proceed with patient signature B) Look for patient's parents or immediate family members C) Allow one of the women to sign D) Allow both women to sign WRONG What instructions for care should you include when educating a patient about their Penrose drain? โโWORNGA) You will have bright red drainage from the tube for several days B) Change your dressing 2 times a day or when it becomes wet (very probs correct) C) This drainage tube helps prevent accumulation of bile D) Remove the safety pin at the end of the tube when you get home You are caring for a patient with a continuous basal rate PCA infusion when the patient becomes difficult to awaken. What should you do FIRST? โโA) Hold the PCA infusion B) Elevate the head of bed 45 degrees C) Stay with patient D) Contact anesthesia provider
A patient who received general anesthesia tells you that their throat is sore and you notice their voice is hoarse. What should you do? โโprovide ice chips and sips of water WRONG There are 4 patients in PACU: a patient who received surgery to repair their maxilla bone fracture, a patient recovering from esophageal resection for squamous cell cancer, a patient who is recovering from surgical placement of a tracheostomy, and a patient who is recovering from Roux-en Y gastric bypass surgery. For which of the patient is the insertion of a nasopharyngeal airway contraindicated? โโC) Maxilla bone fracture (probs correct) WRONG D) Patient recovering from tracheostomy WRONG You are caring for a patient when suddenly their ECG monitor shows coarse ventricular fibrillation. They become unable to rouse and pulseless. What is the PRIORITY intervention for this patient? โโA) IV Epi B) IV Amio C) Chest compressions (probs correct) ****WRONG***D) Defib
You're about to discharge a patient who speaks a Vietnamese dialect. The patient has a friend who speaks that same dialect but this friend is at home. What will you do in order to give patient appropriate discharge instructions? โโUse your organization's designated translating system What do you consider to be the SAFEST initial dose of IV hydromorphone for a 70 year-old without renal impairment? โโA) 0.5 mg B) 1 mg C) 0.2 mg D) 0.5 mcg WRONG In PACU, upon reviewing the order for a PCA, you have a question about it. Who should you contact? โโWRONG***A) Hospitalist B) Anesthesiologist C) Critical Care Intensivist D) Surgeon What information is important to include when providing patient education about the use of a PCA? โโOnly you should press the button to receive pain medicine
To whom might you ask to apply a BiPAP? โโRespiratory Therapy WRONG A patient in phase 2 recovery has yet to urinate after surgery. You take the patient to the bathroom, and they are still unable to void. What should you do FIRST? โโWRONGA) Offer the patient a cup of water B) Perform a bladder scan (probs correct) C) Document unable to void D) Obtain an order for a catheter WRONG What sign or symptom should you closely monitor for in a patient after they have neck surgery? โโWRONGA) Severe Headache B) Tracheal Deviation C) Sudden disorientation D) Pain at incision site A patient had malignant hyperthermia during surgery. What kind of monitoring should they receive? โโIntensive care unit monitoring for 24 hours
Threshold for hypothermia in PACU? โโLess than 36 degrees Celsius WRONG You receive a patient who has just arrived from surgery and is in Phase 1 PACU. The patient is unresponsive to name, has a respiratory rate of 12, is receiving 6 L with a face mask, and is making a gurgling sound with each exhalation. What action is MOST appropriate? โโA) Ask the patient to state their name WRONGB) Turn patient on their side C) Insert oral airway (maybe???) D) Increase oxygen level After day surgery, a patient is drowsy, nauseated, reporting 7 out of 10 pain, and requiring 4 liters oxygen to maintain sat greater than 92%. What level of care should this patient receive? โโPhase 1 What condition increases a patient's risk of respiratory depression when using a PCA pump? โโSleep apnea
