What position would help alleviate headaches after spinal anesthesia?
- A) Prone
B) Trendelenburg
C) Semi-fowlers
***D) Flat to
... [Show More] supine
***WRONG***
What is a physical manifestation of neuromuscular blockade (Roc, succinylcholine)?
- A) Decreased consciousness
B) Decreased pupillary light reflex
C) Decreased respiratory effort
***WRONG***D) Decreased sensation of pain
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?
- 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?
- 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?
- ***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
***WRONG***You are reviewing your orders for you 8 year-old patient that recently
arrive in PACU. Which PRN pain order would you question? - 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
What is a physiologic effect related to unrelieved pain?
- 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?
- ***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
***WRONG***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?
- A) Hold pressure on the anastomosis graft
B) Elevate the right arm above the heart
***WRONG***C) Apply an ice pack to the arm
D) Contact the surgical team
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?
- A) Place a manual, resuscitator device at the bedside
B) Insert an oral airway
***C) Stop the propofol infusion
D) As the patient to cough
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? -
A) The pressure is greater than 100 mmHg SBP
***B) It is +/- 20% of baseline pre-operative levels
C) Adhere to professional standards
D) Follow the anesthesia order set
***WRONG***After surgery, a sleepy yet responsive patient with an intact gag reflex has
a large amount of salivary secretions. What should you do?
- ***WRONG***A) 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? - ***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? - ***A) pupil checks
B) pain scale
C) capillary refill
D) blood glucose
***WRONG***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? - 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
***WRONG***D) The patient who reports dizziness upon sitting upright
Your patient arrives to PACU with lactated ringer's ordered at 100ml/hr. Which preexisting condition would make you question this order? - 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? - 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
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?
- A) Inflate the hover mat yourself and move the patient to his desired position
B) Ask patient to move himself up in the bed
***C) Wait for additional assistance before moving the patient
D) Tell your patient it is unsafe to move at this time
What is an example of Phase 1 discharge criteria? - A) The patient's family member has
arrived to take them home
B) The patient is ready and able to ambulate to the bathroom
***C) The patient can maintain their airway
D) The patient's vital signs have been monitored for 60 minutes
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? -
D) Call your manager and ask for the unit protocol
**WRONG**
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? - A) Evaluate the patient's pain level (probs correct)
**WRONG**B) 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? - 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? - 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? - ***WRONG**A) 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? - 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? - ***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? - A) Decreased oxygen consumption
***B) Increased oxygen demand
C) Peripheral vasoconstriction
D) Elevated end tidal CO2
***WRONG***
What combination of medications is an example of multi-modal pain management? - A)
IV PCA morphine with IV fentanyl
***WRONG***B) Oral morphine ER and IV morphine
C) IV hydromorphone and IV acetaminophen (probs correct, one is opioid, other is not)
D) IV hydromorphone and IV morphine
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? - A)
Echo
B) Cardiac biomarkers
C) CMP
***D) Chest X-ray [Show Less]