Prophecy PACU RN A v1
1. 0.25 mililiters: Meperidine (Demerol) 12.5mg every 15 minutes, IV prn is ordered
for shivering in the PACU. Meperidine is available in 50mg/1ml. How many mililiters
should be given?
2. A) Position the patient on their side
B) Place the patient in a prone position
C) Check the epidural line for kinks
***D) Contact the anesthesia provider: Upon inspecting a patient's epidural inser-
tion site, you notice swelling around the catheter. What should you do?
3. A) Has received discharge instructions, pain level 9 out 10, shortness of
breath
B) Drowsy, blood pressure returned to preoperative levels, on 6 liters oxygen
via face mask
***C) Drowsy, oxygen saturation of 96%, able to cough, and move all extremi-
ties
D) Fully alert, shallow breathing, on 3 liters via T-piece, can move 2 extremities-
: What set of findings indicates a patient is likely to be ready for phase 1 discharge?
4. A) 1.5 miligrams
***B) 25 micrograms
C) 100 micrograms
D 25 miligrams: What do you consider to be a safe dose of intravenous fentanyl for
an adult who does not have tolerance to opioids?
5. A) 10 mg hydralazine IV push
***B) 50 mcg fentanyl IV push
C) 2 mg lorazepam IV push
D) 5 mg metoprolol IV push: 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?
6. ***A) Wait until the family returns
B) Leave the discharge education on voicemail and discharge patient
C) Discharge patient with non-emergency transport
D) Take patient home yourself: You are about to discharge a day surgery patient
with aphasia and you discover the family members are not available for the discharge
instructions and are not responding to your phone calls. Business hours are over
and the PACU is about to close. How will you handle the situation?
7. A) Wake up the patient to sign the consent
B) Ask a friend to sign the consent
***C) Obtain the consent from medical POA
D) Proceed with the procedure: You received a patient from OR post hip replace-
, Prophecy PACU RN A v1
ment surgery. The anesthesiologist is planning a nerve block in PACU, but the patient
did not sign the consent for the nerve block. How will you proceed?
8. A) Prone
B) Trendelenburg
C) Semi-fowlers
***D) Flat to supine: What position would help alleviate headaches after spinal
anesthesia?
9. A) Decreased consciousness
B) Decreased pupillary light reflex
C) Decreased respiratory effort
***WRONG***D) Decreased sensation of pain: ***WRONG***
What is a physical manifestation of neuromuscular blockade (Roc, succinylcholine)?
10. A) Administer the medication with diphenhydramine
B) Ask the patient to describe their reaction to penicillin
C) Contact the pharmacist to clarify the order
***D) Contact the provider to question the order: The surgeon has ordered
ampicillin (Ancef) for a patient. When you check their chart, you see an allergy to
penicillin. What is the BEST action?
11. A) JP drain sutured in place near the lateral calf
B) Several small incisions in calf groin covered with gauze
***C) Clear dressing applied to the right groin
D) 3 in incision on the right upper thigh with bulky dressing: You are receiving
report for a patient who had a percutaneous transluminal angioplasty for right lower
extremity peripheral vascular disease and is now recovering in the PACU. What type
of surgical dressing do you expect to find for this patient?
12. ***A) Report the incident to your charge nurse
B) Refuse to take the patient
C) Take the report as she gave it to you
D) Figure out the clarifications from computer: You are receiving a report on
a post op patients from the OR nurse and during the report when you asked for
clarifications, the OR nurse became angry, belligerent, and rude. She ended up not
answering your question. How will you proceed?
13. A) IV acetaminophen (maybe??? bc super expensive???)
B) PO acetaminophen
C) PO ketorolac (maybe???? bc shows increased risk of bleeding than tylenol,
and is oral, which maybe they're trying to avoid PO after surgery)
***WRONG***D) IV ketorolac: ***WRONG***You are reviewing your orders for you
8 year-old patient that recently arrive in PACU. Which PRN pain order would you
question?
1. 0.25 mililiters: Meperidine (Demerol) 12.5mg every 15 minutes, IV prn is ordered
for shivering in the PACU. Meperidine is available in 50mg/1ml. How many mililiters
should be given?
2. A) Position the patient on their side
B) Place the patient in a prone position
C) Check the epidural line for kinks
***D) Contact the anesthesia provider: Upon inspecting a patient's epidural inser-
tion site, you notice swelling around the catheter. What should you do?
3. A) Has received discharge instructions, pain level 9 out 10, shortness of
breath
B) Drowsy, blood pressure returned to preoperative levels, on 6 liters oxygen
via face mask
***C) Drowsy, oxygen saturation of 96%, able to cough, and move all extremi-
ties
D) Fully alert, shallow breathing, on 3 liters via T-piece, can move 2 extremities-
: What set of findings indicates a patient is likely to be ready for phase 1 discharge?
4. A) 1.5 miligrams
***B) 25 micrograms
C) 100 micrograms
D 25 miligrams: What do you consider to be a safe dose of intravenous fentanyl for
an adult who does not have tolerance to opioids?
5. A) 10 mg hydralazine IV push
***B) 50 mcg fentanyl IV push
C) 2 mg lorazepam IV push
D) 5 mg metoprolol IV push: 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?
6. ***A) Wait until the family returns
B) Leave the discharge education on voicemail and discharge patient
C) Discharge patient with non-emergency transport
D) Take patient home yourself: You are about to discharge a day surgery patient
with aphasia and you discover the family members are not available for the discharge
instructions and are not responding to your phone calls. Business hours are over
and the PACU is about to close. How will you handle the situation?
7. A) Wake up the patient to sign the consent
B) Ask a friend to sign the consent
***C) Obtain the consent from medical POA
D) Proceed with the procedure: You received a patient from OR post hip replace-
, Prophecy PACU RN A v1
ment surgery. The anesthesiologist is planning a nerve block in PACU, but the patient
did not sign the consent for the nerve block. How will you proceed?
8. A) Prone
B) Trendelenburg
C) Semi-fowlers
***D) Flat to supine: What position would help alleviate headaches after spinal
anesthesia?
9. A) Decreased consciousness
B) Decreased pupillary light reflex
C) Decreased respiratory effort
***WRONG***D) Decreased sensation of pain: ***WRONG***
What is a physical manifestation of neuromuscular blockade (Roc, succinylcholine)?
10. A) Administer the medication with diphenhydramine
B) Ask the patient to describe their reaction to penicillin
C) Contact the pharmacist to clarify the order
***D) Contact the provider to question the order: The surgeon has ordered
ampicillin (Ancef) for a patient. When you check their chart, you see an allergy to
penicillin. What is the BEST action?
11. A) JP drain sutured in place near the lateral calf
B) Several small incisions in calf groin covered with gauze
***C) Clear dressing applied to the right groin
D) 3 in incision on the right upper thigh with bulky dressing: You are receiving
report for a patient who had a percutaneous transluminal angioplasty for right lower
extremity peripheral vascular disease and is now recovering in the PACU. What type
of surgical dressing do you expect to find for this patient?
12. ***A) Report the incident to your charge nurse
B) Refuse to take the patient
C) Take the report as she gave it to you
D) Figure out the clarifications from computer: You are receiving a report on
a post op patients from the OR nurse and during the report when you asked for
clarifications, the OR nurse became angry, belligerent, and rude. She ended up not
answering your question. How will you proceed?
13. A) IV acetaminophen (maybe??? bc super expensive???)
B) PO acetaminophen
C) PO ketorolac (maybe???? bc shows increased risk of bleeding than tylenol,
and is oral, which maybe they're trying to avoid PO after surgery)
***WRONG***D) IV ketorolac: ***WRONG***You are reviewing your orders for you
8 year-old patient that recently arrive in PACU. Which PRN pain order would you
question?
