Relias PACU RN A v1 Prep Exam Questions And Answers All Correct.

***C) Drowsy, oxygen saturation of 96%, able to cough, and move all extremities 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? - correct answer 0.25 mililiters 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 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 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 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? - correct answer ***A) Wait until the family returns You received a patient from OR post hip replacement 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? - correct answer ***C) Obtain the consent from medical POA What is a physical manifestation of neuromuscular blockade (Roc, succinylcholine)? - correct answer C) Decreased respiratory effort What position would help alleviate headaches after spinal anesthesia? - correct answer ***D) Flat to supine 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? - correct answer ***D) Contact the provider to question the order 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? - correct answer ***C) Clear dressing applied to the right groin 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? - correct answer ***A) Report the incident to your charge nurse You are reviewing your orders for you 8 year-old patient that recently arrive in PACU. Which PRN pain order would you question? - correct answer C) PO ketorolac What is a physiologic effect related to unrelieved pain? - correct answer ***D) Decreased healing You are caring for a patient after placement of a percutaneous J tube. A student nurse asks you, " Where does this tube go in the patient?" How should you answer? - correct answer ***A) The tube is placed into the Jejunum When caring for a patient who is recovering from placement of a new arteriovenous fistula in their right arm, you observe the presence of mild edema at the site. What should you do? - correct answer B) Elevate the right arm above the heart You are caring for patient who is intubated, receiving ventilatory support, and is sedated with a propofol infusion. Over the last 5 minutes you have decreased the propofol infusion in preparation for extubation. The patient is now opening their eyes to voice and following commands. What should you do NEXT to prepare the patient for immediate extubation? - correct answer ***C) Stop the propofol infusion When caring for a patient who is receiving outpatient surgery, what is the BEST way to know that a patient's post-operative blood pressure is sufficient for discharge to home? - correct answer ***B) It is +/- 20% of baseline pre-operative levels After surgery, a sleepy yet responsive patient with an intact gag reflex has a large amount of salivary secretions. What should you do? - correct answer D) Insert an oral airway Where is the phlebostatic axis for leveling the transducer of an arterial line? - correct answer ***A) Fourth intercostal level at the midaxillary line A carotid endarterectomy patient arrives to you in the PACU. What initial assessment is MOST important? - correct answer ***A) pupil checks There are 4 patients in PACU: A patient who is alert but disoriented to time, a patient who reports dizziness upon sitting upright, a patient who has partial return of sensation after spinal, and a patient who is drowsy but awakens to touch. Which patient is MOST ready to transfer to phase 2 post-anesthesia care? - correct answer B) The patient who is alert but disoriented to time Your patient arrives to PACU with lactated ringer's ordered at 100ml/hr. Which pre-existing condition would make you question this order? - correct answer ***B) End Stage Renal Disease While assessing your post-op patient with a new dialysis graft, what should the PACU nurse monitor to evaluate the functionality of the graft? - correct answer ***D) A palpable thrill and audible bruit You are taking care of a 300lb male status post abdominal surgery, and he requests to be repositioned. He is currently on a hover mat. What is the BEST way to achieve this? - correct answer ***C) Wait for additional assistance before moving the patient What is an example of Phase 1 discharge criteria? - correct answer ***C) The patient can maintain their airway You were called in at 2am and did not leave the hospital until 4am. However, your regular shift starts at 7am, and you are extremely tired. What is the appropriate action? - correct answer D) Call your manager and ask for the unit protocol You are caring for a patient in Phase 1 recovery and they appear ready to transfer except that their blood pressure continues to stay 50mmHg above their pre-anesthetic SBP. At home the patient takes a diuretic and beta-blocker for hypertension. What should you do? - correct answer D) Contact the anesthesia provider You receive a patient to Phase I recovery from IR status post cerebral aneurysm clipping. Which assessment is most important for you to perform? - correct answer ***B) Pupil response, facial and extremity movement Which patient is MOST at risk for developing postoperative cardiogenic shock? - correct answer ***B) Pt with recent MI When setting up a morphine PCA pump for a 5'10'' female patient recovering from hip surgery who is 49 years old, 180 lb, and has no history of sleep apnea, what is an expected 4-hr dose limit? - correct answer B) 20 mg You are caring for a postoperative thyroidectomy patient in the PACU. What is the least likely finding for this patient? - correct answer ***B) Low Hgb After a 6-hour abdominal surgery during which a patient was on their back, a patient reports persistent lower back pain. What should you do next? - correct answer C) Inspect their lower back