HESI, The Post-Anesthesia Care Unit
(PACU), Mrs. Paul UPDATED ACTUAL
Exam Questions and CORRECT Answers
Physiological changes associated with the aging process may affect Mrs. Paul's response to
surgery. These will need to be considered as you provide care. Changes associated with aging
include:
- calcification of coronary arteries
- decreased reactivity of protective airway reflexes
- decreased ability to cope with temperature changes
- increase in subcutaneous fat
- decreased tolerance of changes in fluid volume
- decreased liver function - CORRECT ANSWER - A. calcification of coronary arteries
B. decreased reactivity of protective airway reflexes
C. decreased ability to cope with temperature changes
E. decreased tolerance of changes in fluid volume
F. decreased liver function
Mrs. Paul does not have any positioning restrictions as a result of her surgery. However, given
her low BP, you correctly decide to position her:
- supine, with one pillow
- semi-Fowler's
- Fowler's - CORRECT ANSWER - A. supine, with one pillow
Mrs. Paul remains prone to hypotension due to the effects of spinal anesthesia. The supine
position will best provide for perfusion of vital organs. For comfort, the head of the bed may be
elevated slightly and one pillow can be used.
Patient position after anesthesia is not related to the development of headache. Which of the
following can be associated with postdural puncture headache after regional anesthesia?
, - Younger age
- Male gender
- Pregnancy - CORRECT ANSWER - A. Younger age
Postdural puncture headache (PDPH) can be a complication of regional anesthesia (spinal or
epidural puncture). Younger people are at greater risk for postdural puncture headache than older
persons. Postdural puncture headache is most common in persons under 40 years of age, with the
highest frequency in those ages 18-30 years.
C. Pregnancy
Postdural puncture headache (PDPH) can be a complication of regional anesthesia (spinal or
epidural puncture). Postdural puncture headache occurs most frequently in pregnant women as a
consequence of epidural anesthesia administered during labor. If the dura is torn, the effects of
labor may increase cerebrospinal fluid (CSF) leakage. Use of smaller spinal needles makes tears
and leaks less likely.
Mrs. Paul is at high risk for venous thromboembolism (VTE). Which of the following is the
priority evidenced-based perianesthesia nursing intervention for VTE prophylaxis with Mrs.
Paul?
- Continue use of intermittent pneumatic compression (IPC) sleeves
- Encourage leg and ankle exercises
- Encourage early ambulation
- Provide early oral hydration - CORRECT ANSWER - A. Continue use of intermittent
pneumatic compression (IPC) sleeves
For patients at high risk for venous thromboembolism (VTE), pharmacologic prophylaxis with
low-dose unfractionated heparin (LDUH) or low-molecular weight heparin (LMWH) is indicated
and should be prescribed. Also indicated for high risk patients is mechanical prophylaxis with
properly fitted graduated compression stockings or intermittent pneumatic compression (IPC)
sleeves. In PACU, to help avoid VTE, it is most important that the nurse insure continued use of
pneumatic compression sleeves with Mrs. Paul.
You also assess Mrs. Paul's dorsalis pedis pulses. This is indicated because:
- it is common practice in PACU to check all pulse points
(PACU), Mrs. Paul UPDATED ACTUAL
Exam Questions and CORRECT Answers
Physiological changes associated with the aging process may affect Mrs. Paul's response to
surgery. These will need to be considered as you provide care. Changes associated with aging
include:
- calcification of coronary arteries
- decreased reactivity of protective airway reflexes
- decreased ability to cope with temperature changes
- increase in subcutaneous fat
- decreased tolerance of changes in fluid volume
- decreased liver function - CORRECT ANSWER - A. calcification of coronary arteries
B. decreased reactivity of protective airway reflexes
C. decreased ability to cope with temperature changes
E. decreased tolerance of changes in fluid volume
F. decreased liver function
Mrs. Paul does not have any positioning restrictions as a result of her surgery. However, given
her low BP, you correctly decide to position her:
- supine, with one pillow
- semi-Fowler's
- Fowler's - CORRECT ANSWER - A. supine, with one pillow
Mrs. Paul remains prone to hypotension due to the effects of spinal anesthesia. The supine
position will best provide for perfusion of vital organs. For comfort, the head of the bed may be
elevated slightly and one pillow can be used.
Patient position after anesthesia is not related to the development of headache. Which of the
following can be associated with postdural puncture headache after regional anesthesia?
, - Younger age
- Male gender
- Pregnancy - CORRECT ANSWER - A. Younger age
Postdural puncture headache (PDPH) can be a complication of regional anesthesia (spinal or
epidural puncture). Younger people are at greater risk for postdural puncture headache than older
persons. Postdural puncture headache is most common in persons under 40 years of age, with the
highest frequency in those ages 18-30 years.
C. Pregnancy
Postdural puncture headache (PDPH) can be a complication of regional anesthesia (spinal or
epidural puncture). Postdural puncture headache occurs most frequently in pregnant women as a
consequence of epidural anesthesia administered during labor. If the dura is torn, the effects of
labor may increase cerebrospinal fluid (CSF) leakage. Use of smaller spinal needles makes tears
and leaks less likely.
Mrs. Paul is at high risk for venous thromboembolism (VTE). Which of the following is the
priority evidenced-based perianesthesia nursing intervention for VTE prophylaxis with Mrs.
Paul?
- Continue use of intermittent pneumatic compression (IPC) sleeves
- Encourage leg and ankle exercises
- Encourage early ambulation
- Provide early oral hydration - CORRECT ANSWER - A. Continue use of intermittent
pneumatic compression (IPC) sleeves
For patients at high risk for venous thromboembolism (VTE), pharmacologic prophylaxis with
low-dose unfractionated heparin (LDUH) or low-molecular weight heparin (LMWH) is indicated
and should be prescribed. Also indicated for high risk patients is mechanical prophylaxis with
properly fitted graduated compression stockings or intermittent pneumatic compression (IPC)
sleeves. In PACU, to help avoid VTE, it is most important that the nurse insure continued use of
pneumatic compression sleeves with Mrs. Paul.
You also assess Mrs. Paul's dorsalis pedis pulses. This is indicated because:
- it is common practice in PACU to check all pulse points
