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Relias PACU RN A v1 Relias EXAM TEST
QUESTIONS AND ANSWERS (202 5 /202 6 )
(VERIFIED ANSWERS)
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>>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 What set of findings indicates a patient is likely to be ready for phase 1 discharge? - CORRECT ANSWER>>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 extremities D) Fully alert, shallow breathing, on 3 liters via T-piece, can move 2 extremities
What do you consider to be a safe dose of intravenous fentanyl for an adult who does not have tolerance to opioids? - CORRECT ANSWER>>A) 1.5 miligrams ***B) 25 micrograms C) 100 micrograms D 25 miligrams Your patient in the PACU has a blood pressure of 171/ 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>>A) 10 mg hydralazine IV push B) 50 mcg fentanyl IV push C) 2 mg lorazepam IV push D) 5 mg metoprolol 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 B) Leave the discharge education on voicemail and discharge patient C) Discharge patient with non-emergency transport D) Take patient home yourself
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>>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 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>>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 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 B) Refuse to take the patient C) Take the report as she gave it to you D) Figure out the clarifications from computer
WRONGYou are reviewing your orders for you 8 year- old patient that recently arrive in PACU. Which PRN pain order would you question? - CORRECT ANSWER>>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) WRONGD) IV ketorolac What is a physiologic effect related to unrelieved pain? - CORRECT ANSWER>>A) Hypoglycemia B) Bradycardia C) Decreased metabolism 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 B) The tube passes from the esophagus into the jejunum This tube is inserted into the stomach D) The tube is inserted directly into the colon
WRONGAfter surgery, a sleepy yet responsive patient with an intact gag reflex has a large amount of salivary secretions. What should you do? - CORRECT ANSWER>>WRONGA) Turn the patient on their side B) Provide oral suctioning C) Contact the anesthesia provider 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 B) Fourth intercostal level at the midclavicular line C) Fifth intercostal level at the midaxillary line D) Fifth intercostal level at the midclavicular line A carotid endarterectomy patient arrives to you in the PACU. What initial assessment is MOST important? - CORRECT ANSWER>>A) pupil checks B) pain scale C) capillary refill D) blood glucose WRONGThere 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 postanesthesia care? - CORRECT ANSWER>>A) The patient who has partial return of sensation after spinal block B) The patient who is alert but disoriented to time C) The patient who is drowsy but awakens to touch WRONGD) The patient who reports dizziness upon sitting upright 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>>A) Sickle cell anemia ***B) End Stage Renal Disease C) Gastroesophageal reflux D) Diabetes Mellitus 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>>A) Brisk capillary refill at the access site B) No numbness or tingling of the hand C) Clean, dry, and intact dressing ***D) A palpable thrill and audible bruit
hypertension. What should you do? - CORRECT ANSWER>>A) Evaluate the patient's pain level (probs correct) WRONGB) Administer 20mg furosemide orally C) Transfer the patient to the unit 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>>A) Cardiac rhythm, heart rate, blood pressure *B) Pupil response, facial and extremity movement C) Bowel sounds, urinary output, and oral cavity D) RR, BP, Temp Which patient is MOST at risk for developing postoperative cardiogenic shock? - CORRECT ANSWER>>A) A 78 year old male adult with CKD B) Pt with recent MI C) Female pt with ES liver disease D) Pediatric patient with metastatic lymphadenopathy WRONG 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>>WRONGA) 5 mg B) 20 mg (probs correct)
C) 3 mg D) 40 mg You are caring for a postoperative thyroidectomy patient in the PACU. What is the least likely finding for this patient? - CORRECT ANSWER>>A) Paresthesia of the fingers and toes B) Low Hgb C) Muscle Cramps D) Tingling in hands and feet WRONG 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>>WRONG**A) Help them to a new position B) Administer pain medication C) Inspect their lower back (probs correct, pt might be bleeding into back) D) Check their hematocrit What is a result of shivering? - CORRECT ANSWER>>A) Decreased oxygen consumption ***B) Increased oxygen demand C) Peripheral vasoconstriction D) Elevated end tidal CO WRONG
What instructions for care should you include when educating a patient about their Penrose drain? - CORRECT ANSWER>>WORNGA) You will have bright red drainage from the tube for several days B) Change your dressing 2 times a day or when it becomes wet (very probs correct) C) This drainage tube helps prevent accumulation of bile D) Remove the safety pin at the end of the tube when you get home 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>>***A) Hold the PCA infusion B) Elevate the head of bed 45 degrees C) Stay with patient D) Contact anesthesia provider 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 WRONG 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
B) 1 mg C) 0.2 mg D) 0.5 mcg WRONG In PACU, upon reviewing the order for a PCA, you have a question about it. Who should you contact? - CORRECT ANSWER>>WRONG***A) Hospitalist B) Anesthesiologist C) Critical Care Intensivist 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 WRONG You observe a small amount of blood in the tubing of a continuous regional nerve block. What should you do FIRST? - CORRECT ANSWER>>A) Look for signs of anesthesia toxicity B) Call anesthesia provider WRONGC) Asses patient's vital signs D) Apply ice pack to insertion site What safety measure should you take when applying a fentanyl transdermal patch? - CORRECT ANSWER>>Wear gloves
WRONG (very confused) 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>>A) Clamp the infusion tubing B) Stop the infusion pump WRONGC) Double check the pump settings D) Provide supplemental oxygen To whom might you ask to apply a BiPAP? - CORRECT ANSWER>>Respiratory Therapy WRONG 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>>WRONGA) Offer the patient a cup of water B) Perform a bladder scan (probs correct) C) Document unable to void D) Obtain an order for a catheter WRONG What sign or symptom should you closely monitor for in a patient after they have neck surgery? - CORRECT ANSWER>>WRONGA) Severe Headache
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 WRONG (no idea what CORRECT ANSWER is) What drug is MOST effective in upper airway emergencies? - CORRECT ANSWER>>A) Terbutaline B) Nebulized albuterol WRONGC) Humidified oxygen D) Racemic epinephrine
WRONG
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 (probs correct) WRONGB) Review the preoperative documentation about the patient's dentition C) Secure the tooth by packing folded or rolled gauze around it D) Contact the surgical team and ask them to inspect the patient's throat What would delay discharge home when caring for a patient who received spinal anesthesia? - CORRECT ANSWER>>Inability to void
