Prophecy general ICU RN A V1 Questions & Answers, Distinction Level Assignment

Prophecy ICU RN A v1 Exam. 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 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