RELIAS PACU RN A V1 EXAM QUESTIONS AND CORRECT ANSWERS VERIFIED LATEST 2024-2025 GRADE A, Exams of Nursing

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RELIAS PACU RN A V1 EXAM QUESTIONS

AND CORRECT ANSWERS VERIFIED

LATEST 2024 - 2025 GRADE A +

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 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 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 What is a result of shivering? - CORRECT ANSWER>>>***B) Increased oxygen demand

What combination of medications is an example of multi-modal pain management? - CORRECT ANSWER>>>C) IV hydromorphone and IV acetaminophen You are caring for a patient with a brachial plexus block after surgery. The patient begins to report chest discomfort on the side where the block was placed. A 12 lead EKG was normal. What order do you expect to be completed NEXT for this patient? - CORRECT ANSWER>>>D) Chest X-ray You need to obtain consent from a sedated patient post hip replacement surgery for a regional block. Two women showed up at bedside as next of kin. One has a child with patient and the other is the patient's girlfriend. How will you obtain the consent? - CORRECT ANSWER>>>B) Look for patient's parents or immediate family members What instructions for care should you include when educating a patient about their Penrose drain? - CORRECT ANSWER>>>B) Change your dressing 2 times a day or when it becomes wet

You are caring for a patient with a continuous basal rate PCA infusion when the patient becomes difficult to awaken. What should you do FIRST? - CORRECT ANSWER>>>Hold the PCA infusion Which factor puts a patient MOST at risk for confusion upon awakening from general anesthesia? - CORRECT ANSWER>>>B) Advanced Age You are providing care for a diabetic patient in the PACU. What care should you provide to decrease their risk of surgical site infections? - CORRECT ANSWER>>>B) Maintain blood glucose levels per protocol and hand hygiene What department approves and reviews medical aspects of care in the PACU including policies and procedures? - CORRECT ANSWER>>>Department of Anesthesia When providing care to a patient in the PACU who is receiving placement of a new permanent vascular access graft, what finding should you report immediately to the surgeon? - CORRECT ANSWER>>>Inability to palpate a thrill

While helping to prepare a patient for surgery, you notice that their medical record indicates DNR. What should you do? - CORRECT ANSWER>>>Ask the patient to explain their wishes about resuscitation A patient's DNR order was revoked during surgery. When can it be reinstated? - CORRECT ANSWER>>>Per institutional policy A patient who received general anesthesia tells you that their throat is sore and you notice their voice is hoarse. What should you do? - CORRECT ANSWER>>>provide ice chips and sips of water There are 4 patients in PACU: a patient who received surgery to repair their maxilla bone fracture, a patient recovering from esophageal resection for squamous cell cancer, a patient who is recovering from surgical placement of a tracheostomy, and a patient who is recovering from Roux-en Y gastric bypass surgery. For which of the patient is the insertion of a nasopharyngeal airway contraindicated? - CORRECT ANSWER>>>C) Maxilla bone fracture

You are caring for a patient when suddenly their ECG monitor shows coarse ventricular fibrillation. They become unable to rouse and pulseless. What is the PRIORITY intervention for this patient? - CORRECT ANSWER>>>C) Chest compressions You're about to discharge a patient who speaks a Vietnamese dialect. The patient has a friend who speaks that same dialect but this friend is at home. What will you do in order to give patient appropriate discharge instructions? - CORRECT ANSWER>>>Use your organization's designated translating system What do you consider to be the SAFEST initial dose of IV hydromorphone for a 70 year-old without renal impairment? - CORRECT ANSWER>>>***C) 0.2 mg In PACU, upon reviewing the order for a PCA, you have a question about it. Who should you contact? - CORRECT ANSWER>>>D) Surgeon What information is important to include when providing patient education about the use of a PCA? - CORRECT

ANSWER>>>Only you should press the button to receive pain medicine You observe a small amount of blood in the tubing of a continuous regional nerve block. What should you do FIRST? - CORRECT ANSWER>>>B) Call anesthesia provider What safety measure should you take when applying a fentanyl transdermal patch? - CORRECT ANSWER>>>Wear gloves You are caring for a patient in the PACU who is receiving an interscalene block for an upper extremity operation. When assessing the patient, you discover bilateral numbness of the chest and neck. What should you do NEXT? - CORRECT ANSWER>>>B) Stop the infusion pump To whom might you ask to apply a BiPAP? - CORRECT ANSWER>>>Respiratory Therapy A patient in phase 2 recovery has yet to urinate after surgery. You take the patient to the bathroom, and they are still unable to void. What should you do FIRST? - CORRECT ANSWER>>>B) Perform a bladder scan

What sign or symptom should you closely monitor for in a patient after they have neck surgery? - CORRECT ANSWER>>>B) Tracheal Deviation A patient had malignant hyperthermia during surgery. What kind of monitoring should they receive? - CORRECT ANSWER>>>Intensive care unit monitoring for 24 hours Threshold for hypothermia in PACU? - CORRECT ANSWER>>>Less than 36 degrees Celsius You receive a patient who has just arrived from surgery and is in Phase 1 PACU. The patient is unresponsive to name, has a respiratory rate of 12, is receiving 6 L with a face mask, and is making a gurgling sound with each exhalation. What action is MOST appropriate? - CORRECT ANSWER>>>C) Insert oral airway After day surgery, a patient is drowsy, nauseated, reporting 7 out of 10 pain, and requiring 4 liters oxygen to maintain sat greater than 92%. What level of care should this patient receive? - CORRECT ANSWER>>>Phase 1

What condition increases a patient's risk of respiratory depression when using a PCA pump? - CORRECT ANSWER>>>Sleep apnea What assessment finding indicates that a patient is ready to tolerate ice chips? - CORRECT ANSWER>>>Patient is able to cough After day surgery, the patient is awake, reports 2 out of 10 pain, denies nausea, has voided, has stable vital signs, but has yet to receive discharge instructions. What level of care should this patient receive? - CORRECT ANSWER>>>Phase 2 Reversal of Midazolam - CORRECT ANSWER>>>Flumazenil A sedated patient has just arrived to the PACU from the operating room with the anesthesia provider and a member of the surgical team. What should you do next? - CORRECT ANSWER>>>Assess their airway and oxygenation What drug is MOST effective in upper airway emergencies? - CORRECT ANSWER>>>D) Racemic epinephrine

You are caring for a patient in the PACU who was intubated and received general anesthesia during surgery. Now extubated, the patient reports feeling pain in their front tooth. Upon inspection, the tooth appears loose. What should you do? - CORRECT ANSWER>>>A) Contact the anesthesia provider and ask them to inspect the oral cavity What would delay discharge home when caring for a patient who received spinal anesthesia? - CORRECT ANSWER>>>Inability to void