PACU Pre and Post Testing: Questions from Boards Prep Books
Dr. Joyce Hairston and Dr. Suma Ramzan
1. Which of the following are potential complications of postoperative hypothermia?
1. Hypertension
2. Patient discomfort
3. Delayed emergence
4. Increased cardiac irritability
A. Choices 1,2 and 3 are correct.
B. Choices 1 and 3 are correct.
C. Choices 2 and 4 are correct.
D. Only choice 4 is correct.
E. All choices are correct.
2. What is NOT measured in the Modified Aldrete Score?
A. Consciousness
B. Saturation
C. Ability to tolerate oral fluids
D. Activity level
3. An appropriate initial dose for flumazenil is:
A. 0.2-0.5 mg
B. 0.5-1 mg
C. 1-2 mg
D. 2-3 mg
4. Regarding intraoperative use of low-dose Ketamine and its effects in the PACU, which are true?
1. It may decrease postoperative pain
2. It may decrease PONV
3. It may adversely affect mood
4. It may shorten PACU stay
A. Choices 1,2 and 3 are correct.
B. Choices 1 and 3 are correct.
C. Choices 2 and 4 are correct.
D. Only choice 4 is correct.
E. All choices are correct.
5: Risk factors for corneal abrasions include:
1. Pediatric patients
2. Head or neck surgery
3. Supine positioning
4. Long surgical time
A. Choices 1,2 and 3 are correct.
B. Choices 1 and 3 are correct.
C. Choices 2 and 4 are correct.
D. Only choice 4 is correct.
E. All choices are correct.
6: Which of these is required (recommended) prior to discharge from the PACU?
A.
B.
C.
D.
Patients drink clear fluids without vomiting
Patients urinate before discharge
Patients have adult supervision to accompany them home
Patients stay in the PACU for a specified minimum amount of time before discharge
7. Postoperative patient triage should be based on :
A.
B.
C.
D.
E.
Ambulatory vs inpatient status
Potential for postoperative complications
Age
American Society of Anesthesiologists (ASA) classification
Respiratory therapy
8: Disadvantages of IM opioid administration include all of the following EXCEPT:
A.
Unpredictable uptake
B.
C.
D.
E.
Larger dose requirements
Shortened onset
Pain on administration
Risk of hematoma formation
9: Which of the following statements regarding epidural opioid analgesia is FALSE?
A.
B.
C.
D.
E.
Serotonin antagonists may be used to treat side effects
It may improved outcome after urologic procedures
The addition of clonidine enhances analgesia
It is a useful technique for controlling pain after gastroplasty surgery.
Delayed respiratory depression results from vascular uptake.
10: All of the following are causes of hypotension in the PACU EXCEPT:
A.
B.
C.
D.
E.
Myocardial ischemia
Blood pressure cuff with a narrow width
Rewarming of a hypothermic patient
Addisonian crisis
Furosemide therapy
11: Which of the following is not an example of relative hypovolemia?
A.
B.
C.
D.
E.
Vasovagal stimulation
Epidural analgesia
Pregnancy
Positive pressure ventilation
Hemorrhage
12: Which of the following statements concerning postoperative bradycardia is TRUE:
A.
B.
C.
D.
E.
Most bradycardias are benign and are secondary to autonomic imbalance
Nodal rhythm is common and is best treated with an alpha-adrenergic agonist.
Idioventricular rhythms are usually benign
Idioventricular rhythms usually respond well to atropine
Cardiac pacing is rarely effective for bradyarrhythmia.
13: Which of the following statements concerning the postoperative appearance of atrial premature contractions is
TRUE?
A. The cause is most frequently a structural injury to the mitral valve
B. The P wave is usually normal
C. Usually, there is a compensatory pause
D. There can be wide QRS complexes; however they resemble normal QRS complexes in general shape.
E. Generally, they result in hemodynamic compromise requiring urgent treatment.
14: Choose the true statement regarding perioperative carbon monoxide poisoning:
A.
B.
C.
D.
E.
Cyanosis is the most reliable sign
PaO2 is usually low
The risk is greatest for patients anesthetized outside the operating room
Symptoms of nausea, vomiting, and headache in the PACU are specific for CO poisoning.
CO irreversibly binds to hemoglobin
15: Choose the TRUE statement regarding hypoxemia in the PACU.
A.
B.
C.
D.
E.
Hypoxemia rarely occurs after regional anesthesia
Children with adenotonsillar hypertrophy are at risk of hypoxemia
The incidence of hypoxemia in postoperative patients breathing room air in the PACU is low.
The cost of providing supplemental oxygen is prohibitive
Use of oxygen prevents hypoxemia
16: Which of the following induction agents has the lowest incidence of perioperative nausea and vomiting?
A.
B.
C.
D.
E.
Thiopental
Methohexital
Etomidate
Propofol
Ketamine
17: Which of the following agents administered intravenously is not an appropriate treatment for nausea and vomiting?
A.
B.
C.
D.
E.
Metoclopramide
Scopolamine
Ondansetron
Ephedrine
Propofol
18: Choose the correct statement regarding adjuncts used for postoperative analgesia.
A.
B.
C.
D.
Rofecoxib administration provides a secondary cardioprotective benefit
Ketorolac administration may decrease cardiac ischemic events.
Ibuprofen and acetaminophen are ineffective when they are administered orally before surgery
Agonist-antagonist analgesics are the best adjuncts to supplement analgesia.
E. The use of clonidine is limited by bradycardia.
19: Postoperative hypertension should be treated if :
1. the patient develops angina
2. the patient is having large amounts of postoperative bleeding
3. the patient had a cerebral aneurysm clipping
4. the diastolic blood pressure is 10% above baseline
A. Choices 1, 2 and 3 are correct.
B. Choices 1 and 3 are correct.
C. Choices 2 and 4 are correct.
D. Only choice 4 is correct.
E. All choices are correct.
20: Increased CO2 production in the PACU can be caused by :
1. shivering
2. infection
3. malignant hyperthermia
4. hyperalimentation
A. Choices 1, 2 and 3 are correct.
B. Choices 1 and 3 are correct.
C. Choices 2 and 4 are correct.
D. Only choice 4 is correct.
E. All choices are correct.