Prophecy PACU RN A v1- complete solution guide; 2022
1. Meperidine (Demerol) 12.5mg every 15 minutes, IV prn is ordered for shiv- ering
in the PACU. Meperidine is available in 50mg/1ml. How many mililiters should be
given?: 0.25 mililiters
2. Upon inspecting a patient's epidural insertion site, you notice swelling around
the catheter. What should you do?: A) 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
3. What set of findings indicates a patient is likely to be ready for phase 1
discharge?: A) 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
4. What do you consider to be a safe dose of intravenous fentanyl for an adult who
does not have tolerance to opioids?: A) 1.5 miligrams
***B) 25 micrograms
C) 100 micrograms
D 25 miligrams
5. 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?: A) 10 mg hydralazine IV push
***B) 50 mcg fentanyl IV push
,C) 2 mg lorazepam IV push
D) 5 mg metoprolol IV push
6. 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?: ***A) Wait until the family returns
B) Leave the discharge education on voicemail and discharge patient
C) Discharge patient with non-emergency transport
D) Take patient home yourself
7. You received a patient from OR post hip replacement surgery. The anes-
thesiologist is planning a nerve block in PACU, but the patient did not sign
, the consent for the nerve block. How will you proceed?: A) Wake up the patient to sign
the consent
B) Ask a friend to sign the consent
***C) Obtain the consent from medical POA D) Proceed with the procedure
8. What position would help alleviate headaches after spinal anesthesia?: A) Prone
B) Trendelenburg
C) Semi-fowlers
***D) Flat to supine
9. ***WRONG***
What is a physical manifestation of neuromuscular blockade (Roc, succinyl-
choline)?: A) Decreased consciousness
B) Decreased pupillary light reflex
C) Decreased respiratory effort
***WRONG***D) Decreased sensation of pain
10. 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?: A) 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
11. You are receiving report for a patient who had a percutaneous translumi- nal
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?: A) 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
1. Meperidine (Demerol) 12.5mg every 15 minutes, IV prn is ordered for shiv- ering
in the PACU. Meperidine is available in 50mg/1ml. How many mililiters should be
given?: 0.25 mililiters
2. Upon inspecting a patient's epidural insertion site, you notice swelling around
the catheter. What should you do?: A) 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
3. What set of findings indicates a patient is likely to be ready for phase 1
discharge?: A) 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
4. What do you consider to be a safe dose of intravenous fentanyl for an adult who
does not have tolerance to opioids?: A) 1.5 miligrams
***B) 25 micrograms
C) 100 micrograms
D 25 miligrams
5. 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?: A) 10 mg hydralazine IV push
***B) 50 mcg fentanyl IV push
,C) 2 mg lorazepam IV push
D) 5 mg metoprolol IV push
6. 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?: ***A) Wait until the family returns
B) Leave the discharge education on voicemail and discharge patient
C) Discharge patient with non-emergency transport
D) Take patient home yourself
7. You received a patient from OR post hip replacement surgery. The anes-
thesiologist is planning a nerve block in PACU, but the patient did not sign
, the consent for the nerve block. How will you proceed?: A) Wake up the patient to sign
the consent
B) Ask a friend to sign the consent
***C) Obtain the consent from medical POA D) Proceed with the procedure
8. What position would help alleviate headaches after spinal anesthesia?: A) Prone
B) Trendelenburg
C) Semi-fowlers
***D) Flat to supine
9. ***WRONG***
What is a physical manifestation of neuromuscular blockade (Roc, succinyl-
choline)?: A) Decreased consciousness
B) Decreased pupillary light reflex
C) Decreased respiratory effort
***WRONG***D) Decreased sensation of pain
10. 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?: A) 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
11. You are receiving report for a patient who had a percutaneous translumi- nal
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?: A) 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
