______________________________________
RELIAS PACU RN A V1
EXAM
RELIAS RN A V1: POST-ANESTHESIA
CARE UNIT REGISTERED NURSE
PRACTICE EXAM-STYLE QUESTIONS
& ANSWERS REVIEW
EXAM NAME: Relias PACU RN A V1 Exam
PROGRAM: Relias Healthcare Education Program
COURSE NAME: Post-Anesthesia Care Unit (PACU) Registered
Nurse Course – Version A
POST-ANESTHESIA CARE
UNIT (PACU) REGISTERED
NURSE COURSE – VERSION A
,RELIAS PACU RN A V1 EXAM
(Multiple Choice Format with Detailed Rationales)
1. What set of findings indicates a patient is likely ready for Phase 1
discharge?
A. Awake, vomiting, oxygen saturation 88%, unable to cough
B. Sleeping deeply, BP unstable, unable to move extremities
C. Drowsy, oxygen saturation of 96%, able to cough, and move all
extremities
D. Alert, severe pain, respiratory rate 8
Correct Answer: C
Rationale:
Phase 1 PACU discharge criteria focus primarily on airway stability, respiratory
adequacy, circulation, neurologic status, and oxygenation. A patient who can
maintain oxygen saturation, cough effectively, and move extremities
demonstrates recovery from anesthesia and neuromuscular blockade. Mild
drowsiness is expected after anesthesia and does not necessarily delay transfer.
Stable physiologic parameters indicate readiness for transition to Phase 2
recovery or inpatient care.
2. What is a physiologic result of postoperative shivering?
,A. Reduced cardiac workload
B. Increased oxygen demand
C. Lower metabolic rate
D. Decreased carbon dioxide production
Correct Answer: B
Rationale:
Shivering significantly increases metabolic activity and oxygen consumption. This
increased oxygen demand can place stress on the cardiovascular and respiratory
systems, particularly in elderly patients or those with cardiac disease.
Postoperative shivering may also increase pain and discomfort. Prompt treatment
helps reduce complications and improves patient comfort.
3. Which combination of medications is an example of multimodal pain
management?
A. IV morphine and oral oxycodone
B. IV fentanyl and IV hydromorphone
C. IV hydromorphone and IV acetaminophen
D. Oral hydrocodone and oral codeine
Correct Answer: C
Rationale:
Multimodal pain management uses medications from different drug classes and
mechanisms to improve pain control while minimizing opioid requirements.
Combining an opioid such as hydromorphone with a non-opioid like
acetaminophen provides synergistic pain relief. This approach reduces opioid side
, effects such as respiratory depression, nausea, and sedation. Multimodal
strategies are considered best practice in postoperative care.
4. A patient with a brachial plexus block develops chest discomfort on the
same side as the block placement. The ECG is normal. Which order do you
expect next?
A. CT scan of the abdomen
B. Echocardiogram
C. Cardiac enzyme testing
D. Chest X-ray
Correct Answer: D
Rationale:
A brachial plexus block may accidentally affect the phrenic nerve or cause
pneumothorax, particularly with interscalene approaches. Chest discomfort after a
regional block raises concern for respiratory complications. A chest X-ray is the
fastest and most appropriate diagnostic study to assess lung expansion and
diaphragm movement. Early identification prevents progression of respiratory
compromise.
5. A sedated patient requires consent for a regional block after hip
replacement surgery. Two women arrive claiming next-of-kin status: one
has a child with the patient and the other is the girlfriend. What should you
do?
RELIAS PACU RN A V1
EXAM
RELIAS RN A V1: POST-ANESTHESIA
CARE UNIT REGISTERED NURSE
PRACTICE EXAM-STYLE QUESTIONS
& ANSWERS REVIEW
EXAM NAME: Relias PACU RN A V1 Exam
PROGRAM: Relias Healthcare Education Program
COURSE NAME: Post-Anesthesia Care Unit (PACU) Registered
Nurse Course – Version A
POST-ANESTHESIA CARE
UNIT (PACU) REGISTERED
NURSE COURSE – VERSION A
,RELIAS PACU RN A V1 EXAM
(Multiple Choice Format with Detailed Rationales)
1. What set of findings indicates a patient is likely ready for Phase 1
discharge?
A. Awake, vomiting, oxygen saturation 88%, unable to cough
B. Sleeping deeply, BP unstable, unable to move extremities
C. Drowsy, oxygen saturation of 96%, able to cough, and move all
extremities
D. Alert, severe pain, respiratory rate 8
Correct Answer: C
Rationale:
Phase 1 PACU discharge criteria focus primarily on airway stability, respiratory
adequacy, circulation, neurologic status, and oxygenation. A patient who can
maintain oxygen saturation, cough effectively, and move extremities
demonstrates recovery from anesthesia and neuromuscular blockade. Mild
drowsiness is expected after anesthesia and does not necessarily delay transfer.
Stable physiologic parameters indicate readiness for transition to Phase 2
recovery or inpatient care.
2. What is a physiologic result of postoperative shivering?
,A. Reduced cardiac workload
B. Increased oxygen demand
C. Lower metabolic rate
D. Decreased carbon dioxide production
Correct Answer: B
Rationale:
Shivering significantly increases metabolic activity and oxygen consumption. This
increased oxygen demand can place stress on the cardiovascular and respiratory
systems, particularly in elderly patients or those with cardiac disease.
Postoperative shivering may also increase pain and discomfort. Prompt treatment
helps reduce complications and improves patient comfort.
3. Which combination of medications is an example of multimodal pain
management?
A. IV morphine and oral oxycodone
B. IV fentanyl and IV hydromorphone
C. IV hydromorphone and IV acetaminophen
D. Oral hydrocodone and oral codeine
Correct Answer: C
Rationale:
Multimodal pain management uses medications from different drug classes and
mechanisms to improve pain control while minimizing opioid requirements.
Combining an opioid such as hydromorphone with a non-opioid like
acetaminophen provides synergistic pain relief. This approach reduces opioid side
, effects such as respiratory depression, nausea, and sedation. Multimodal
strategies are considered best practice in postoperative care.
4. A patient with a brachial plexus block develops chest discomfort on the
same side as the block placement. The ECG is normal. Which order do you
expect next?
A. CT scan of the abdomen
B. Echocardiogram
C. Cardiac enzyme testing
D. Chest X-ray
Correct Answer: D
Rationale:
A brachial plexus block may accidentally affect the phrenic nerve or cause
pneumothorax, particularly with interscalene approaches. Chest discomfort after a
regional block raises concern for respiratory complications. A chest X-ray is the
fastest and most appropriate diagnostic study to assess lung expansion and
diaphragm movement. Early identification prevents progression of respiratory
compromise.
5. A sedated patient requires consent for a regional block after hip
replacement surgery. Two women arrive claiming next-of-kin status: one
has a child with the patient and the other is the girlfriend. What should you
do?
