RELIAS PACU RN A V1 QUESTIONS
AND ANSWERS
What0set0of0findings0indicates0a0patient0is0likely0to0be0ready0for0phase010discharge?0-
0ans✔***C)0Drowsy,0oxygen0saturation0of096%,0able0to0cough,0and0move0all0extremiti
es
Meperidine0(Demerol)012.5mg0every0150minutes,0IV0prn0is0ordered0for0shivering0in0the
0PACU.0Meperidine0is0available0in050mg/1ml.0How0many0mililiters0should0be0given?0-
0ans✔0.250mililiters
Upon0inspecting0a0patient's0epidural0insertion0site,0you0notice0swelling0around0the0cat
heter.0What0should0you0do?0-0ans✔***D)0Contact0the0anesthesia0provider
What0do0you0consider0to0be0a0safe0dose0of0intravenous0fentanyl0for0an0adult0who0doe
s0not0have0tolerance0to0opioids?0-0ans✔***B)0250micrograms
Your0patient0in0the0PACU0has0a0blood0pressure0of0171/920mmHg,0a0heart0rate0of0120,
0respiratory0rate0of024,0is0grimacing,0restless,0and0moaning0in0bed.0What0medication0s
hould0you0prepare0to0give0FIRST?0-0ans✔***B)0500mcg0fentanyl0IV0push
You0are0about0to0discharge0a0day0surgery0patient0with0aphasia0and0you0discover0the0f
amily0members0are0not0available0for0the0discharge0instructions0and0are0not0respondin
g0to0your0phone0calls.0Business0hours0are0over0and0the0PACU0is0about0to0close.0How
0will0you0handle0the0situation?0-0ans✔***A)0Wait0until0the0family0returns
You0received0a0patient0from0OR0post0hip0replacement0surgery.0The0anesthesiologist0i
s0planning0a0nerve0block0in0PACU,0but0the0patient0did0not0sign0the0consent0for0the0ne
rve0block.0How0will0you0proceed?0-0ans✔***C)0Obtain0the0consent0from0medical0POA
What0is0a0physical0manifestation0of0neuromuscular0blockade0(Roc,0succinylcholine)?0-
0ans✔C)0Decreased0respiratory0effort
What0position0would0help0alleviate0headaches0after0spinal0anesthesia?0-
0ans✔***D)0Flat0to0supine
, The0surgeon0has0ordered0ampicillin0(Ancef)0for0a0patient.0When0you0check0their0chart,
0you0see0an0allergy0to0penicillin.0What0is0the0BEST0action?0-
0ans✔***D)0Contact0the0provider0to0question0the0order
You0are0receiving0report0for0a0patient0who0had0a0percutaneous0transluminal0angioplas
ty0for0right0lower0extremity0peripheral0vascular0disease0and0is0now0recovering0in0the0P
ACU.0What0type0of0surgical0dressing0do0you0expect0to0find0for0this0patient?0-
0ans✔***C)0Clear0dressing0applied0to0the0right0groin
You0are0receiving0a0report0on0a0post0op0patients0from0the0OR0nurse0and0during0the0r
eport0when0you0asked0for0clarifications,0the0OR0nurse0became0angry,0belligerent,0and
0rude.0She0ended0up0not0answering0your0question.0How0will0you0proceed?0-
0ans✔***A)0Report0the0incident0to0your0charge0nurse
You0are0reviewing0your0orders0for0you080year-
old0patient0that0recently0arrive0in0PACU.0Which0PRN0pain0order0would0you0question?
0-0ans✔C)0PO0ketorolac
What0is0a0physiologic0effect0related0to0unrelieved0pain?0-
0ans✔***D)0Decreased0healing
You0are0caring0for0a0patient0after0placement0of0a0percutaneous0J0tube.0A0student0nurs
e0asks0you,0"0Where0does0this0tube0go0in0the0patient?"0How0should0you0answer?0-
0ans✔***A)0The0tube0is0placed0into0the0Jejunum
When0caring0for0a0patient0who0is0recovering0from0placement0of0a0new0arteriovenous0fi
stula0in0their0right0arm,0you0observe0the0presence0of0mild0edema0at0the0site.0What0sh
ould0you0do?0-0ans✔B)0Elevate0the0right0arm0above0the0heart
You0are0caring0for0patient0who0is0intubated,0receiving0ventilatory0support,0and0is0sedat
ed0with0a0propofol0infusion.0Over0the0last050minutes0you0have0decreased0the0propofol0
infusion0in0preparation0for0extubation.0The0patient0is0now0opening0their0eyes0to0voice0
and0following0commands.0What0should0you0do0NEXT0to0prepare0the0patient0for0imme
diate0extubation?0-0ans✔***C)0Stop0the0propofol0infusion
When0caring0for0a0patient0who0is0receiving0outpatient0surgery,0what0is0the0BEST0way0
to0know0that0a0patient's0post-
operative0blood0pressure0is0sufficient0for0discharge0to0home?0-0ans✔***B)0It0is0+/-
020%0of0baseline0pre-operative0levels
After0surgery,0a0sleepy0yet0responsive0patient0with0an0intact0gag0reflex0has0a0large0a
mount0of0salivary0secretions.0What0should0you0do?0-0ans✔D)0Insert0an0oral0airway
Where0is0the0phlebostatic0axis0for0leveling0the0transducer0of0an0arterial0line?0-
0ans✔***A)0Fourth0intercostal0level0at0the0midaxillary0line
AND ANSWERS
What0set0of0findings0indicates0a0patient0is0likely0to0be0ready0for0phase010discharge?0-
0ans✔***C)0Drowsy,0oxygen0saturation0of096%,0able0to0cough,0and0move0all0extremiti
es
Meperidine0(Demerol)012.5mg0every0150minutes,0IV0prn0is0ordered0for0shivering0in0the
0PACU.0Meperidine0is0available0in050mg/1ml.0How0many0mililiters0should0be0given?0-
0ans✔0.250mililiters
Upon0inspecting0a0patient's0epidural0insertion0site,0you0notice0swelling0around0the0cat
heter.0What0should0you0do?0-0ans✔***D)0Contact0the0anesthesia0provider
What0do0you0consider0to0be0a0safe0dose0of0intravenous0fentanyl0for0an0adult0who0doe
s0not0have0tolerance0to0opioids?0-0ans✔***B)0250micrograms
Your0patient0in0the0PACU0has0a0blood0pressure0of0171/920mmHg,0a0heart0rate0of0120,
0respiratory0rate0of024,0is0grimacing,0restless,0and0moaning0in0bed.0What0medication0s
hould0you0prepare0to0give0FIRST?0-0ans✔***B)0500mcg0fentanyl0IV0push
You0are0about0to0discharge0a0day0surgery0patient0with0aphasia0and0you0discover0the0f
amily0members0are0not0available0for0the0discharge0instructions0and0are0not0respondin
g0to0your0phone0calls.0Business0hours0are0over0and0the0PACU0is0about0to0close.0How
0will0you0handle0the0situation?0-0ans✔***A)0Wait0until0the0family0returns
You0received0a0patient0from0OR0post0hip0replacement0surgery.0The0anesthesiologist0i
s0planning0a0nerve0block0in0PACU,0but0the0patient0did0not0sign0the0consent0for0the0ne
rve0block.0How0will0you0proceed?0-0ans✔***C)0Obtain0the0consent0from0medical0POA
What0is0a0physical0manifestation0of0neuromuscular0blockade0(Roc,0succinylcholine)?0-
0ans✔C)0Decreased0respiratory0effort
What0position0would0help0alleviate0headaches0after0spinal0anesthesia?0-
0ans✔***D)0Flat0to0supine
, The0surgeon0has0ordered0ampicillin0(Ancef)0for0a0patient.0When0you0check0their0chart,
0you0see0an0allergy0to0penicillin.0What0is0the0BEST0action?0-
0ans✔***D)0Contact0the0provider0to0question0the0order
You0are0receiving0report0for0a0patient0who0had0a0percutaneous0transluminal0angioplas
ty0for0right0lower0extremity0peripheral0vascular0disease0and0is0now0recovering0in0the0P
ACU.0What0type0of0surgical0dressing0do0you0expect0to0find0for0this0patient?0-
0ans✔***C)0Clear0dressing0applied0to0the0right0groin
You0are0receiving0a0report0on0a0post0op0patients0from0the0OR0nurse0and0during0the0r
eport0when0you0asked0for0clarifications,0the0OR0nurse0became0angry,0belligerent,0and
0rude.0She0ended0up0not0answering0your0question.0How0will0you0proceed?0-
0ans✔***A)0Report0the0incident0to0your0charge0nurse
You0are0reviewing0your0orders0for0you080year-
old0patient0that0recently0arrive0in0PACU.0Which0PRN0pain0order0would0you0question?
0-0ans✔C)0PO0ketorolac
What0is0a0physiologic0effect0related0to0unrelieved0pain?0-
0ans✔***D)0Decreased0healing
You0are0caring0for0a0patient0after0placement0of0a0percutaneous0J0tube.0A0student0nurs
e0asks0you,0"0Where0does0this0tube0go0in0the0patient?"0How0should0you0answer?0-
0ans✔***A)0The0tube0is0placed0into0the0Jejunum
When0caring0for0a0patient0who0is0recovering0from0placement0of0a0new0arteriovenous0fi
stula0in0their0right0arm,0you0observe0the0presence0of0mild0edema0at0the0site.0What0sh
ould0you0do?0-0ans✔B)0Elevate0the0right0arm0above0the0heart
You0are0caring0for0patient0who0is0intubated,0receiving0ventilatory0support,0and0is0sedat
ed0with0a0propofol0infusion.0Over0the0last050minutes0you0have0decreased0the0propofol0
infusion0in0preparation0for0extubation.0The0patient0is0now0opening0their0eyes0to0voice0
and0following0commands.0What0should0you0do0NEXT0to0prepare0the0patient0for0imme
diate0extubation?0-0ans✔***C)0Stop0the0propofol0infusion
When0caring0for0a0patient0who0is0receiving0outpatient0surgery,0what0is0the0BEST0way0
to0know0that0a0patient's0post-
operative0blood0pressure0is0sufficient0for0discharge0to0home?0-0ans✔***B)0It0is0+/-
020%0of0baseline0pre-operative0levels
After0surgery,0a0sleepy0yet0responsive0patient0with0an0intact0gag0reflex0has0a0large0a
mount0of0salivary0secretions.0What0should0you0do?0-0ans✔D)0Insert0an0oral0airway
Where0is0the0phlebostatic0axis0for0leveling0the0transducer0of0an0arterial0line?0-
0ans✔***A)0Fourth0intercostal0level0at0the0midaxillary0line
