PROPHECY PACU RN V1, 2024 100+ QUESTIONS WITH CORRECT ANSWERS
Meperidine (Demerol) 12.5mg every 15 minutes, IV prn is ordered for shivering in the PACU.
... [Show More] Meperidine is available in 50mg/1ml. How many mililiters should be given?
0.25 mililiters
Upon inspecting a patient's epidural insertion site, you notice swelling around the catheter. What should you do?
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?
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?
A) 1.5 miligrams
***B) 25 micrograms
C) 100 micrograms
D 25 miligrams
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?
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?
***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 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?
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
What position would help alleviate headaches after spinal anesthesia?
A) Prone
B) Trendelenburg
C) Semi-fowlers
***D) Flat to 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 [Show Less]