PACU test UPDATED ACTUAL Exam
Questions and CORRECT Answers
Characteristics of minimal sedation - CORRECT ANSWER - Just for relaxing, little risk,
no change to respiratory/CV status. Ex: nitrous oxide
Characteristics of moderate sedation (conscious sedation) - CORRECT ANSWER - IV
only (no gas), benzos & opioids, pt is calm but can be aroused. Should not affect resp/CV status.
Provider must supervise but RN can administer (in WA). MAC is a type of moderate sedation
Characteristics of deep sedation - CORRECT ANSWER - Depressed consciousness.
Anesthesiologist administers. Amnesia. Loss of reflexes
Characteristics of general anesthesia - CORRECT ANSWER - Unconscious, amnesia, loss
of reflexes. Total loss of airway. Impaired CV. Anesthesiology practitioner only.
Pathophysiology of benzodiazepines - CORRECT ANSWER - Works at GABA-A
receptors
Affect GABA reception, increases effect of GABA into receptor, increases chloride ion passage.
Decreases possibility of neuron from firing.
Suppresses respiratory response to hypercarbia and suppresses seizure activity
Examples of benzodiazepine - CORRECT ANSWER - Midazolam (Versed), lorazepam
(Ativan), diazepam (Valium
Benzodiazepine reversal - CORRECT ANSWER - Flumazenil (Romazicon)
Meds: Barbituates (Example, MOA) - CORRECT ANSWER - Ex: Methohexital
MOA: Works on GABA receptors. Not reversible with flumazenil. Long effect. Incr HR, decr
BP. Not commonly used, only given for neuro cases
, Meds: Non-barbituate (example, MOA) - CORRECT ANSWER - Ex: propofol, etomidate.
MOA: works like a barbituate but not a barbituate
Propofol (Class, pros/cons) - CORRECT ANSWER - Class: Non-barbituate
Pros: Low PONV, no effect on ICP. Quick on/off
Cons: No analgesia. Potent vasodilator at high doses. No reversal but quick on/off. Apnea
common
Do not give with soy/egg allergy
Etomidate (Class, pros/cons) - CORRECT ANSWER - Class: Non-barbituate
Pros: Not as much of a vasodilator as propofol, better for pts not hemodynamically stable.
Common for cardiac procedures
Cons: High risk of PONV and hiccups/laryngospasm (fentanyl can help these last 2)
Ketamine (Class, pros/cons) - CORRECT ANSWER - Class: Dissosciative agent
Pros: Blocks pain conduction, very helpful with pts with OUD or high tolerance
Cons: Dissosciative, can cause emergence delirium. Wake slowly (no stimulation).. Incr HR and
CO/ICP. Can cause hallucinations (give with benzodiazepines)
Meperidine (Demerol) (Class, uses) - CORRECT ANSWER - Class: Opioid
Uses: Shivering
Caution with pts on MAOI inhibitors
Dosages for opioids (least strong - strongest) - CORRECT ANSWER - 1. Morphine: 1-
10mg
2. Hydromorphone: 0.1-1mg (6x stronger than morphine)
3. Fentanyl: 25-200 mcg (80-125x stronger than morphine)
4. Remifentanil: Same potency as fentanyl, only given by anesthesia
5. Sufentanil: (5-7X stronger than fentanyl)
Questions and CORRECT Answers
Characteristics of minimal sedation - CORRECT ANSWER - Just for relaxing, little risk,
no change to respiratory/CV status. Ex: nitrous oxide
Characteristics of moderate sedation (conscious sedation) - CORRECT ANSWER - IV
only (no gas), benzos & opioids, pt is calm but can be aroused. Should not affect resp/CV status.
Provider must supervise but RN can administer (in WA). MAC is a type of moderate sedation
Characteristics of deep sedation - CORRECT ANSWER - Depressed consciousness.
Anesthesiologist administers. Amnesia. Loss of reflexes
Characteristics of general anesthesia - CORRECT ANSWER - Unconscious, amnesia, loss
of reflexes. Total loss of airway. Impaired CV. Anesthesiology practitioner only.
Pathophysiology of benzodiazepines - CORRECT ANSWER - Works at GABA-A
receptors
Affect GABA reception, increases effect of GABA into receptor, increases chloride ion passage.
Decreases possibility of neuron from firing.
Suppresses respiratory response to hypercarbia and suppresses seizure activity
Examples of benzodiazepine - CORRECT ANSWER - Midazolam (Versed), lorazepam
(Ativan), diazepam (Valium
Benzodiazepine reversal - CORRECT ANSWER - Flumazenil (Romazicon)
Meds: Barbituates (Example, MOA) - CORRECT ANSWER - Ex: Methohexital
MOA: Works on GABA receptors. Not reversible with flumazenil. Long effect. Incr HR, decr
BP. Not commonly used, only given for neuro cases
, Meds: Non-barbituate (example, MOA) - CORRECT ANSWER - Ex: propofol, etomidate.
MOA: works like a barbituate but not a barbituate
Propofol (Class, pros/cons) - CORRECT ANSWER - Class: Non-barbituate
Pros: Low PONV, no effect on ICP. Quick on/off
Cons: No analgesia. Potent vasodilator at high doses. No reversal but quick on/off. Apnea
common
Do not give with soy/egg allergy
Etomidate (Class, pros/cons) - CORRECT ANSWER - Class: Non-barbituate
Pros: Not as much of a vasodilator as propofol, better for pts not hemodynamically stable.
Common for cardiac procedures
Cons: High risk of PONV and hiccups/laryngospasm (fentanyl can help these last 2)
Ketamine (Class, pros/cons) - CORRECT ANSWER - Class: Dissosciative agent
Pros: Blocks pain conduction, very helpful with pts with OUD or high tolerance
Cons: Dissosciative, can cause emergence delirium. Wake slowly (no stimulation).. Incr HR and
CO/ICP. Can cause hallucinations (give with benzodiazepines)
Meperidine (Demerol) (Class, uses) - CORRECT ANSWER - Class: Opioid
Uses: Shivering
Caution with pts on MAOI inhibitors
Dosages for opioids (least strong - strongest) - CORRECT ANSWER - 1. Morphine: 1-
10mg
2. Hydromorphone: 0.1-1mg (6x stronger than morphine)
3. Fentanyl: 25-200 mcg (80-125x stronger than morphine)
4. Remifentanil: Same potency as fentanyl, only given by anesthesia
5. Sufentanil: (5-7X stronger than fentanyl)
