Prophecy PACU RN A V1 Exam Questions & Answers 2024

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? - 0.25 mililiters 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 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 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 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 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 Prophecy PACU RN A V1 Exam Questions & Answers 2024 D) Take patient home yourself You received a patient from OR post hip replacement surgery. The anesthesiologist 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 What position would help alleviate headaches after spinal anesthesia? - A) Prone B) Trendelenburg C) Semi-fowlers ***D) Flat to supine ***WRONG*** What is a physical manifestation of neuromuscular blockade (Roc, succinylcholine)? - A) Decreased consciousness B) Decreased pupillary light reflex C) Decreased respiratory effort ***WRONG***D) 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? - 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 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? - 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 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? - ***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 ***WRONG***You are reviewing your orders for you 8 year-old patient that recently arrive in PACU. Which PRN pain order would you question? - A) 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) ***WRONG***D) IV ketorolac What is a physiologic effect related to unrelieved pain? - A) Hypoglycemia B) Bradycardia C) Decreased metabolism ***D) Decreased healing You are caring for a patient after placement of a percutaneous J tube. A student nurse asks you, " Where does this tube go in the patient?" How should you answer? - ***A) The tube is placed into the Jejunum B) The tube passes from the esophagus into the jejunum This tube is inserted into the stomach D) The tube is inserted directly into the colon ***WRONG***When caring for a patient who is recovering from placement of a new arteriovenous fistula in their right arm, you observe the presence of mild edema at the site. What should you do? - A) Hold pressure on the anastomosis graft B) Elevate the right arm above the heart ***WRONG***C) Apply an ice pack to the arm D) Contact the surgical team You are caring for patient who is intubated, receiving ventilatory support, and is sedated with a propofol infusion. Over the last 5 minutes you have decreased the propofol infusion in preparation for extubation. The patient is now opening their eyes to voice and following commands. What should you do NEXT to prepare the patient for immediate extubation? - A) Place a manual, resuscitator device at the bedside B) Insert an oral airway ***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? - A) 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 ***WRONG***After surgery, a sleepy yet responsive patient with an intact gag reflex has a large amount of salivary secretions. What should you do? - ***WRONG***A) 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? - ***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? - ***A) pupil checks B) pain scale C) capillary refill D) blood glucose ***WRONG***There 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? - A) 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 ***WRONG***D) The patient who reports dizziness upon sitting upright Your patient arrives to PACU with lactated ringer's ordered at 100ml/hr. Which pre-existing condition would make you question this order? - A) Sickle cell anemia ***B) End Stage Renal Disease C) Gastroesophageal reflux D) Diabetes Mellitus While assessing your post-op patient with a new dialysis graft, what should the PACU nurse monitor to evaluate the functionality of the graft? - A) Brisk capillary refill at the access site B) No numbness or tingling of the hand C) Clean, dry, and intact dressing ***D) A palpable thrill and audible bruit You are taking care of a 300lb male status post abdominal surgery, and he requests to be repositioned. He is currently on a hover mat. What is the BEST way to achieve this? - A) Inflate the hover mat yourself and move the patient to his desired position B) Ask patient to move himself up in the bed ***C) Wait for additional assistance before moving the patient D) Tell your patient it is unsafe to move at this time What is an example of Phase 1 discharge criteria? - A) 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? - D) 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? - A) Evaluate the patient's pain level (probs correct) **WRONG**B) Administer 20mg furosemide orally C) Transfer the patient to the unit D) Contact the anesthesia provider