2026 RELIAS PACU RN A V1 FINAL EXAM
PRACTICE TEST QUESTIONS WITH
ANSWERS 2025/2026 GRADED A+
1. What set of findings indicates a patient is likely to be ready for phase 1
discharge?
Correct ,,,answer,,,: Drowsy, oxygen saturation of 96%, able to cough, and move
all extremities
Rationale: Phase 1 discharge criteria require the patient to maintain a patent
airway, demonstrate adequate oxygenation (SpO2 >90%), have protective reflexes
(cough/gag), and show motor function. Drowsiness is acceptable as long as the
patient is easily arousable .
2. 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
Rationale: Using the formula (Desired dose / Available dose) × Volume = (12.5
mg / 50 mg) × 1 mL = 0.25 mL. Meperidine is effective for post-anesthesia
shivering, which increases oxygen demand and metabolic consumption .
3. Upon inspecting a patient's epidural insertion site, you notice swelling
around the catheter. What should you do?
Correct ,,,answer,,,: Contact the anesthesia provider
Rationale: Swelling at an epidural insertion site may indicate fluid collection,
hematoma, or infection. This requires immediate anesthesia provider evaluation to
prevent complications such as nerve compression or epidural abscess .
,4. What do you consider to be a safe dose of intravenous fentanyl for an adult
who does not have tolerance to opioids?
Correct ,,,answer,,,: 25 micrograms
Rationale: For opioid-naïve adults, a safe initial fentanyl dose is 25-50 mcg IV.
Starting with 25 mcg allows for assessment of response and minimizes risk of
respiratory depression .
5. 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,,,: 50 mcg fentanyl IV push
Rationale: This presentation indicates severe pain (tachycardia, hypertension,
restlessness, moaning). Fentanyl is a rapid-acting opioid that provides quick pain
relief and will lower sympathetic response. Pain should be addressed before
treating hypertension in this context .
6. 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,,,: Wait until the family returns
Rationale: A patient with aphasia cannot safely receive or comprehend discharge
instructions independently. Discharging without ensuring the caregiver
understands instructions would compromise patient safety .
7. 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,,,: Obtain the consent from medical POA
Rationale: If the patient is sedated or unable to consent, the medical Power of
Attorney (POA) or legal surrogate must provide informed consent for the nerve
block procedure .
, 8. What is a physical manifestation of neuromuscular blockade (Roc,
succinylcholine)?
Correct ,,,answer,,,: Decreased respiratory effort
Rationale: Neuromuscular blocking agents (NMBAs) like rocuronium and
succinylcholine cause skeletal muscle paralysis, including the diaphragm and
intercostal muscles, leading to decreased or absent respiratory effort .
9. What position would help alleviate headaches after spinal anesthesia?
Correct ,,,answer,,,: Flat to supine
Rationale: Post-dural puncture headache (PDPH) results from cerebrospinal fluid
leakage. The flat supine position reduces CSF pressure and alleviates headache
symptoms. Hydration and caffeine may also help .
10. 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,,,: Contact the provider to question the order
Rationale: Cross-reactivity between penicillins and cephalosporins (including
ampicillin/Ancef) occurs in approximately 10% of patients with penicillin allergy.
The order should be verified with the provider before administration .
11. 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,,,: Clear dressing applied to the right groin
Rationale: Percutaneous transluminal angioplasty (PTA) accesses the femoral
artery via the groin. A clear dressing allows visualization of the access site for
bleeding or hematoma formation .
12. You are receiving a report on 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 ,,,answer,,,ing your question.
PRACTICE TEST QUESTIONS WITH
ANSWERS 2025/2026 GRADED A+
1. What set of findings indicates a patient is likely to be ready for phase 1
discharge?
Correct ,,,answer,,,: Drowsy, oxygen saturation of 96%, able to cough, and move
all extremities
Rationale: Phase 1 discharge criteria require the patient to maintain a patent
airway, demonstrate adequate oxygenation (SpO2 >90%), have protective reflexes
(cough/gag), and show motor function. Drowsiness is acceptable as long as the
patient is easily arousable .
2. 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
Rationale: Using the formula (Desired dose / Available dose) × Volume = (12.5
mg / 50 mg) × 1 mL = 0.25 mL. Meperidine is effective for post-anesthesia
shivering, which increases oxygen demand and metabolic consumption .
3. Upon inspecting a patient's epidural insertion site, you notice swelling
around the catheter. What should you do?
Correct ,,,answer,,,: Contact the anesthesia provider
Rationale: Swelling at an epidural insertion site may indicate fluid collection,
hematoma, or infection. This requires immediate anesthesia provider evaluation to
prevent complications such as nerve compression or epidural abscess .
,4. What do you consider to be a safe dose of intravenous fentanyl for an adult
who does not have tolerance to opioids?
Correct ,,,answer,,,: 25 micrograms
Rationale: For opioid-naïve adults, a safe initial fentanyl dose is 25-50 mcg IV.
Starting with 25 mcg allows for assessment of response and minimizes risk of
respiratory depression .
5. 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,,,: 50 mcg fentanyl IV push
Rationale: This presentation indicates severe pain (tachycardia, hypertension,
restlessness, moaning). Fentanyl is a rapid-acting opioid that provides quick pain
relief and will lower sympathetic response. Pain should be addressed before
treating hypertension in this context .
6. 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,,,: Wait until the family returns
Rationale: A patient with aphasia cannot safely receive or comprehend discharge
instructions independently. Discharging without ensuring the caregiver
understands instructions would compromise patient safety .
7. 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,,,: Obtain the consent from medical POA
Rationale: If the patient is sedated or unable to consent, the medical Power of
Attorney (POA) or legal surrogate must provide informed consent for the nerve
block procedure .
, 8. What is a physical manifestation of neuromuscular blockade (Roc,
succinylcholine)?
Correct ,,,answer,,,: Decreased respiratory effort
Rationale: Neuromuscular blocking agents (NMBAs) like rocuronium and
succinylcholine cause skeletal muscle paralysis, including the diaphragm and
intercostal muscles, leading to decreased or absent respiratory effort .
9. What position would help alleviate headaches after spinal anesthesia?
Correct ,,,answer,,,: Flat to supine
Rationale: Post-dural puncture headache (PDPH) results from cerebrospinal fluid
leakage. The flat supine position reduces CSF pressure and alleviates headache
symptoms. Hydration and caffeine may also help .
10. 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,,,: Contact the provider to question the order
Rationale: Cross-reactivity between penicillins and cephalosporins (including
ampicillin/Ancef) occurs in approximately 10% of patients with penicillin allergy.
The order should be verified with the provider before administration .
11. 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,,,: Clear dressing applied to the right groin
Rationale: Percutaneous transluminal angioplasty (PTA) accesses the femoral
artery via the groin. A clear dressing allows visualization of the access site for
bleeding or hematoma formation .
12. You are receiving a report on 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 ,,,answer,,,ing your question.
