LATEST PCCN PRACTICE EXAM NOTES (2021)
QUESTIONS WITH VERIFIED SOLUTIONS
Pt on Vtach, HR 135, RR 32, BP 90/48, conscious but c/o dizziness, recent K+ lvl is 3.4.
What action would you do first?
a. emergent defib
b. amio 300mg IVP
c. emergent cardioversion
d. hang 10 mEq KCL/50mL D5W - CORRECT ANSWER C
The nurse notes the following when analyzing a patient's telemetry strip: HR, 65/min
and regular; PR interval, 0.22 seconds; QRS complex, 0.10 seconds; QTc, 0.52 seconds.
Which of the following dysrhythmias is the patient at risk for?
A. Atrial fibrillation because the PR interval is wide
B. Sinus arrhythmia because the QRS complex is narrow
C. Torsades de pointes because the QTc is wide
D. Third-degree heart block because the PR interval is narrow - CORRECT ANSWER
C.
QT measurements reflect the duration of ventricular repolarization. Lengthening of QT
interval is associated with arrhythmias, adverse cardiac events, and increased mortality
because a longer QT duration places the vulnerable ventricular repolarization phase
close to the next depolarization, increasing the likelihood of R-on-T. The most common
arrhythmia that occurs with prolonged QTc is torsades de pointes. Atrial fibrillation, sinus
bradycardia, and third-degree heart block are not typically associated with prolonged
ventricular repolarization (QTc >0.50 seconds).
,LATEST PCCN PRACTICE EXAM NOTES (2021)
QUESTIONS WITH VERIFIED SOLUTIONS
A patient with chronic obstructive pulmonary disease (COPD) is admitted for worsening
dyspnea and possible pneumonia. The current ABG results are pH, 7.19; PaO2, 52 mm
Hg; PaCO2, 68 mm Hg; HCO3 - , 32 mmol/L. The nurse would interpret these results as
A. Metabolic acidosis with hypoxemia
B. Respiratory acidosis with hypoxemia
C. Respiratory alkalosis with typical oxygenation for a COPD patient
D. Metabolic alkalosis with typical oxygenation for a COPD patient - CORRECT ANSWER
B.
Based on the ABG analysis, the patient is experiencing a respiratory acidosis with
hypoxemia most likely due to the pneumonia. A pH of 7.19 indicates acidosis; a PaCO2
of 68 mm Hg is elevated and a cause of acidosis; an HCO3 - of 32 mmol/L indicates
renal compensation; a PaO2 of 52 mm Hg indicates hypoxemia
76-year-old patient is receiving gentamicin and linezolid for an infection. Which of the
following potential complications is the most important for the nurse to monitor this
patient for?
A. Acute delirium
B. Acute kidney injury
C. Acute hepatic failure
D. Sepsis - CORRECT ANSWER B.
Gentamicin is a nephrotoxic agent that places patients at risk for acute kidney injury,
and this risk is increased in older patients. Acute delirium (A), liver failure (C), and
, LATEST PCCN PRACTICE EXAM NOTES (2021)
QUESTIONS WITH VERIFIED SOLUTIONS
sepsis (D) are all complications that could occur in an older adult with an infection but
would not be caused by the administration of an antibiotic.
An older patient is experiencing delirium 24 hours following hip replacement. Which
intervention might worsen the patient's condition?
A. Removing any unnecessary tubes and equipment from the room
B. Assessing and treating the patient's pain every 2 hours
C. Ensuring that the patient has the means to call for help
D. Loosely applying soft restraints - CORRECT ANSWER D.
Older patients are at increased risk for delirium during acute hospitalization.
Interventions to manage acute delirium include removing or camouflaging tubes,
removing unnecessary equipment, frequently reorienting the patient, and ensuring that
the call bell is consistently within reach, assessing and treating pain effectively, and
encouraging mobility and involvement in activities of daily living. Restraining the patient
is contraindicated in the care of patients with delirium.
A patient shows a new slight facial droop and the patient's right arm is weaker than the
left. A priority intervention would be to
A. Obtain a serum glucose level
B. Obtain a full set of vital signs
C. Initiate the stroke protocol
D. Initiate the code response team - CORRECT ANSWER C.
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