Prophecy PACU RN A V1 Exam Questions and
Answers with Detailed Rationales | Post-Anesthesia
Care Unit Nursing Assessment | Complete Solutions |
Latest Update 2026/2027 | Graded A+
THIS EXAM INCLUDES:
✔ Complete Prophecy PACU RN A V1 Study Guide
✔ Verified Questions and Correct Answers
✔ Detailed Rationales for Every Question
✔ Scenario-Based Practice Questions
✔ Competency Assessment Preparation
✔ Latest Updated 2026/2027 Content
,Prophecy PACU RN A V1 Exam Questions and Answers with Detailed Rationales
| Post-Anesthesia Care Unit Nursing Assessment | Complete Solutions | Latest
Update 2026/2027 | Graded A+
1. Meperidine (Demerol) 12.5mg every 15 minutes, IV prn is
ordered for shivering in the PACU. Meperidine is available
in 50mg/1ml. How many milliliters should be given?
Correct Answer: 0.25 milliliters
Rationale: To calculate the correct dose: (12.5 mg ÷ 50 mg) × 1 mL = 0.25 mL.
Meperidine is an opioid analgesic that is particularly effective for treating post-
anesthetic shivering, which increases oxygen consumption and metabolic demand. The
small IV dose is administered slowly to avoid respiratory depression.
Distractor Rationales:
• 0.5 mL would be 25 mg, double the ordered dose
• 2.5 mL would be 125 mg, a dangerously high dose
• 0.025 mL would be 1.25 mg, an insufficient dose
2. Upon inspecting a patient's epidural insertion site, you
notice swelling around the catheter. What should you do?
Correct Answer: D) Contact the anesthesia provider
Rationale: Swelling at an epidural insertion site can indicate several serious
complications including hematoma formation, infection, or fluid leakage. The anesthesia
provider must be notified immediately to assess for potential epidural hematoma (which
can cause permanent neurologic damage if not addressed promptly), infection, or
catheter migration. This is a safety-critical finding requiring immediate provider
evaluation.
,Distractor Rationales:
• A) Positioning alone will not address the underlying cause of swelling
• B) Prone position may increase pressure on the site and is not therapeutic
• C) Checking for kinks addresses mechanical issues but not the swelling itself\
3. What set of findings indicates a patient is likely to be
ready for phase 1 discharge?
Correct Answer: C) Drowsy, oxygen saturation of 96%, able to cough, and move all
extremities
Rationale: Phase 1 discharge criteria (often assessed using the Aldrete Score or similar
tool) require: stable vital signs (including SpO2 > 90-92% on room air or baseline),
ability to maintain airway (cough/gag reflex), ability to move extremities (motor function
returning), and appropriate level of consciousness. Drowsiness is acceptable in Phase 1
as long as the patient is arousable and maintaining their airway.
Distractor Rationales:
• A) Pain level 9/10 and shortness of breath indicate inadequate pain control and
respiratory compromise
• B) Requiring 6L oxygen and being drowsy without indicating arousability is
concerning
• D) Shallow breathing indicates respiratory depression; ability to move only 2
extremities suggests incomplete neurologic recovery
4. What do you consider to be a safe dose of intravenous
fentanyl for an adult who does not have tolerance to
opioids?
, Correct Answer: B) 25 micrograms
Rationale: For an opioid-naïve adult, the standard initial IV fentanyl dose is 25-50 mcg
(0.025-0.05 mg). Fentanyl is 100 times more potent than morphine, so careful dosing is
essential. The medication should be titrated to effect, typically given in small increments
every 5-15 minutes to avoid respiratory depression.
Distractor Rationales:
• A) 1.5 mg (1500 mcg) is a massive overdose that would cause severe respiratory
depression and cardiac arrest
• C) 100 mcg is typically the maximum single dose for an opioid-naïve patient and
should only be given with caution
• D) 25 mg (25,000 mcg) is an extreme overdose that would be fatal
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?
Correct Answer: B) 50 mcg fentanyl IV push
Rationale: The patient is exhibiting clear signs of severe pain (grimacing, restlessness,
moaning, tachycardia, hypertension, tachypnea). Pain is the most likely cause of the
elevated vital signs and should be treated FIRST. Adequate pain control often reduces
blood pressure and heart rate without additional antihypertensives. Fentanyl provides
rapid onset (1-2 minutes) and can be safely titrated.
Distractor Rationales:
• A) Hydralazine treats hypertension but does not address the underlying pain; it
could cause hypotension after pain is relieved
Answers with Detailed Rationales | Post-Anesthesia
Care Unit Nursing Assessment | Complete Solutions |
Latest Update 2026/2027 | Graded A+
THIS EXAM INCLUDES:
✔ Complete Prophecy PACU RN A V1 Study Guide
✔ Verified Questions and Correct Answers
✔ Detailed Rationales for Every Question
✔ Scenario-Based Practice Questions
✔ Competency Assessment Preparation
✔ Latest Updated 2026/2027 Content
,Prophecy PACU RN A V1 Exam Questions and Answers with Detailed Rationales
| Post-Anesthesia Care Unit Nursing Assessment | Complete Solutions | Latest
Update 2026/2027 | Graded A+
1. Meperidine (Demerol) 12.5mg every 15 minutes, IV prn is
ordered for shivering in the PACU. Meperidine is available
in 50mg/1ml. How many milliliters should be given?
Correct Answer: 0.25 milliliters
Rationale: To calculate the correct dose: (12.5 mg ÷ 50 mg) × 1 mL = 0.25 mL.
Meperidine is an opioid analgesic that is particularly effective for treating post-
anesthetic shivering, which increases oxygen consumption and metabolic demand. The
small IV dose is administered slowly to avoid respiratory depression.
Distractor Rationales:
• 0.5 mL would be 25 mg, double the ordered dose
• 2.5 mL would be 125 mg, a dangerously high dose
• 0.025 mL would be 1.25 mg, an insufficient dose
2. Upon inspecting a patient's epidural insertion site, you
notice swelling around the catheter. What should you do?
Correct Answer: D) Contact the anesthesia provider
Rationale: Swelling at an epidural insertion site can indicate several serious
complications including hematoma formation, infection, or fluid leakage. The anesthesia
provider must be notified immediately to assess for potential epidural hematoma (which
can cause permanent neurologic damage if not addressed promptly), infection, or
catheter migration. This is a safety-critical finding requiring immediate provider
evaluation.
,Distractor Rationales:
• A) Positioning alone will not address the underlying cause of swelling
• B) Prone position may increase pressure on the site and is not therapeutic
• C) Checking for kinks addresses mechanical issues but not the swelling itself\
3. What set of findings indicates a patient is likely to be
ready for phase 1 discharge?
Correct Answer: C) Drowsy, oxygen saturation of 96%, able to cough, and move all
extremities
Rationale: Phase 1 discharge criteria (often assessed using the Aldrete Score or similar
tool) require: stable vital signs (including SpO2 > 90-92% on room air or baseline),
ability to maintain airway (cough/gag reflex), ability to move extremities (motor function
returning), and appropriate level of consciousness. Drowsiness is acceptable in Phase 1
as long as the patient is arousable and maintaining their airway.
Distractor Rationales:
• A) Pain level 9/10 and shortness of breath indicate inadequate pain control and
respiratory compromise
• B) Requiring 6L oxygen and being drowsy without indicating arousability is
concerning
• D) Shallow breathing indicates respiratory depression; ability to move only 2
extremities suggests incomplete neurologic recovery
4. What do you consider to be a safe dose of intravenous
fentanyl for an adult who does not have tolerance to
opioids?
, Correct Answer: B) 25 micrograms
Rationale: For an opioid-naïve adult, the standard initial IV fentanyl dose is 25-50 mcg
(0.025-0.05 mg). Fentanyl is 100 times more potent than morphine, so careful dosing is
essential. The medication should be titrated to effect, typically given in small increments
every 5-15 minutes to avoid respiratory depression.
Distractor Rationales:
• A) 1.5 mg (1500 mcg) is a massive overdose that would cause severe respiratory
depression and cardiac arrest
• C) 100 mcg is typically the maximum single dose for an opioid-naïve patient and
should only be given with caution
• D) 25 mg (25,000 mcg) is an extreme overdose that would be fatal
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?
Correct Answer: B) 50 mcg fentanyl IV push
Rationale: The patient is exhibiting clear signs of severe pain (grimacing, restlessness,
moaning, tachycardia, hypertension, tachypnea). Pain is the most likely cause of the
elevated vital signs and should be treated FIRST. Adequate pain control often reduces
blood pressure and heart rate without additional antihypertensives. Fentanyl provides
rapid onset (1-2 minutes) and can be safely titrated.
Distractor Rationales:
• A) Hydralazine treats hypertension but does not address the underlying pain; it
could cause hypotension after pain is relieved
