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Neurology ICU prophecy2022

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Prophecy PACU RN A v1



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? - 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

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