2025 RELIAS PACU RN ACTUAL EXAM EVALUATION
QUESTIONS WITH ANSWERS 2025/2026 GRADED A+
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? - C) Maxilla bone fracture
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? - C) Chest compressions
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? - Use 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? - ***C) 0.2 mg
In PACU, upon reviewing the order for a PCA, you have a question about it. Who should
you contact? - D) Surgeon
What information is important to include when providing patient education about the use
of a PCA? - Only you should press the button to receive pain medicine
You observe a small amount of blood in the tubing of a continuous regional nerve block.
What should you do FIRST? - B) Call anesthesia provider
What safety measure should you take when applying a fentanyl transdermal patch? -
Wear gloves
You are caring for a patient in the PACU who is receiving an interscalene block for an
upper extremity operation. When assessing the patient, you discover bilateral
numbness of the chest and neck. What should you do NEXT? - B) Stop the infusion
pump
To whom might you ask to apply a BiPAP? - Respiratory Therapy
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? - B)
Perform a bladder scan
What sign or symptom should you closely monitor for in a patient after they have neck
surgery? - B) Tracheal Deviation
, A patient had malignant hyperthermia during surgery. What kind of monitoring should
they receive? - Intensive care unit monitoring for 24 hours
Threshold for hypothermia in PACU? - Less than 36 degrees Celsius
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? - C) Insert oral airway
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? - Phase 1
What condition increases a patient's risk of respiratory depression when using a PCA
pump? - Sleep apnea
What assessment finding indicates that a patient is ready to tolerate ice chips? - Patient
is able to cough
After day surgery, the patient is awake, reports 2 out of 10 pain, denies nausea, has
voided, has stable vital signs, but has yet to receive discharge instructions. What level
of care should this patient receive? - Phase 2
Reversal of Midazolam - Flumazenil
A sedated patient has just arrived to the PACU from the operating room with the
anesthesia provider and a member of the surgical team. What should you do next? -
Assess their airway and oxygenation
What drug is MOST effective in upper airway emergencies? - D) Racemic epinephrine
You are caring for a patient in the PACU who was intubated and received general
anesthesia during surgery. Now extubated, the patient reports feeling pain in their front
tooth. Upon inspection, the tooth appears loose. What should you do? - A) Contact the
anesthesia provider and ask them to inspect the oral cavity
What would delay discharge home when caring for a patient who received spinal
anesthesia? - Inability to void
What is a physiologic effect related to unrelieved pain? - ***D) Decreased healing
QUESTIONS WITH ANSWERS 2025/2026 GRADED A+
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? - C) Maxilla bone fracture
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? - C) Chest compressions
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? - Use 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? - ***C) 0.2 mg
In PACU, upon reviewing the order for a PCA, you have a question about it. Who should
you contact? - D) Surgeon
What information is important to include when providing patient education about the use
of a PCA? - Only you should press the button to receive pain medicine
You observe a small amount of blood in the tubing of a continuous regional nerve block.
What should you do FIRST? - B) Call anesthesia provider
What safety measure should you take when applying a fentanyl transdermal patch? -
Wear gloves
You are caring for a patient in the PACU who is receiving an interscalene block for an
upper extremity operation. When assessing the patient, you discover bilateral
numbness of the chest and neck. What should you do NEXT? - B) Stop the infusion
pump
To whom might you ask to apply a BiPAP? - Respiratory Therapy
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? - B)
Perform a bladder scan
What sign or symptom should you closely monitor for in a patient after they have neck
surgery? - B) Tracheal Deviation
, A patient had malignant hyperthermia during surgery. What kind of monitoring should
they receive? - Intensive care unit monitoring for 24 hours
Threshold for hypothermia in PACU? - Less than 36 degrees Celsius
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? - C) Insert oral airway
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? - Phase 1
What condition increases a patient's risk of respiratory depression when using a PCA
pump? - Sleep apnea
What assessment finding indicates that a patient is ready to tolerate ice chips? - Patient
is able to cough
After day surgery, the patient is awake, reports 2 out of 10 pain, denies nausea, has
voided, has stable vital signs, but has yet to receive discharge instructions. What level
of care should this patient receive? - Phase 2
Reversal of Midazolam - Flumazenil
A sedated patient has just arrived to the PACU from the operating room with the
anesthesia provider and a member of the surgical team. What should you do next? -
Assess their airway and oxygenation
What drug is MOST effective in upper airway emergencies? - D) Racemic epinephrine
You are caring for a patient in the PACU who was intubated and received general
anesthesia during surgery. Now extubated, the patient reports feeling pain in their front
tooth. Upon inspection, the tooth appears loose. What should you do? - A) Contact the
anesthesia provider and ask them to inspect the oral cavity
What would delay discharge home when caring for a patient who received spinal
anesthesia? - Inability to void
What is a physiologic effect related to unrelieved pain? - ***D) Decreased healing
