Relias PACU RN A V1 -with 100% verified solutions-2024-2025.docx | Exams Nursing | Docsity (2024)

Download Relias PACU RN A V1 -with 100% verified solutions-2024-2025.docx and more Exams Nursing in PDF only on Docsity! Relias PACU RN A V1 -with 100% verified solutions- 2024-2025 What set of findings indicates a patient is likely to be ready for phase 1 discharge? ***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? 0.25 mililiters Upon inspecting a patient's epidural insertion site, you notice swelling around the catheter. What should you do? ***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? ***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? ***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? ***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? ***C) Obtain the consent from medical POA What is a physical manifestation of neuromuscular blockade (Roc, succinylcholine)? C) Decreased respiratory effort What position would help alleviate headaches after spinal anesthesia? ***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? ***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? ***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? ***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? C) PO ketorolac What is a physiologic effect related to unrelieved pain? ***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) 20 mg You are caring for a postoperative thyroidectomy patient in the PACU. What is the least likely finding for this patient? ***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? C) Inspect their lower back What is a result of shivering? ***B) Increased oxygen demand What combination of medications is an example of multi-modal pain management? 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? ***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? ***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? 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? Hold the PCA infusion Which factor puts a patient MOST at risk for confusion upon awakening from general anesthesia? 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? 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? 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? 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? Ask the patient to explain their wishes about resuscitation A patient's DNR order was revoked during surgery. When can it be reinstated? 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? 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? 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? 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? 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? ***C) 0.2 mg In PACU, upon reviewing the order for a PCA, you have a question about it. Who should you contact? D) Surgeon What information is important to include when providing patient education about the use of a PCA? 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? B) Call anesthesia provider What safety measure should you take when applying a fentanyl transdermal patch? 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? B) Stop the infusion pump