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PCCN Exam 1 Practice Questions And 100% Correct Answers
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PCCN Exam 1 Practice Questions And 100%Correct Answers
1. A 49-year-old male was recently admitted with an inferior wall
MI resulting from 100% occlusion of the right coronary artery
(RCA). The 12-Lead ECG reveals ST elevation in leads II, Ill, and avF.
You would expect to see reciprocal changes in which leads?
A. I, aVR
B. V, V2
C. V, VA
D I, aVL - Answer 1. D. I, aVI. The RCA perfuses the inferior wall, and a mirror image or
reciprocal change will be seen in the high latera wall, reflected in leads I, and aVL, on
the 12-Lead ECG. Leads V1 and V2 correlate with the septal area; leads V3 and V4
correlate with the anterior area of the heart. The diagnostic value of the aVR lead is
limited as all the energy is depolarizing away from this lead.
You are called to the room of a 30-year-old female who is experiencing sustained
tonicclonic convulsions while seated in a chair. A family member relates: "She was just
talking to us and suddenly she let out a shriek and started flopping like a fish out of
water." What is your first priority of care?
A. Call for help and gently move the patient to the floor
B. Call for help and administer a prescribed antiepileptic
C. Call for help and administer a prescribed benzodiazepine
D. Call for help and monitor the course of the seizure - Answer A. Call for help and safely
guide the patient to the floor
Patient Safety is priority
The patient is a 46-year-old who has been diagnosed with pneumonia and is in sepsis.
,He was treated with 4 days of antibiotics and IV fluids. He is increasingly short of breath
and is now on 100% FiO, via non-re-breather mask. You obtain an ABG with the following
results: pH 7.20 / PaCO, 68/ PaO, 102/ HCO, 28. A chest x-ray reveals bilateral
pulmonary infiltrates. The patient is likely developing:
A. Worsening pneumonia
B. Acute Respiratory Distress Syndrome
C. Pulmonary embolus
D. Atelectasis - Answer B. Acute Respiratory Distress Syndrome
A 56-year-old male is brought into the PCU in a state of hypertensive crisis. The patient
has a blood pressure of 205/125 mm Hg and is complaining of a headache with nausea.
He states he ran out of blood pressure medication three days ago, but also appears to
be confused to the date and situation. What is the most appropriate treatment
approach?
A. Systolic pressure is rapidly reduced to 100 mm Hg with IV antihypertensive
medications and subsequently the diastolic pressure to 85 mm Hg with oral
antihypertensive medications
B. Gradually reduce systolic pressure to 120 mm Hg by using IV antihypertensive
medications, then maintain it with oral medications
C. Acutely decrease the diastolic pressure to 100 mm Hg with IV antihypertensive
agents, followed by gradual further reduction of the diastolic pressure to 85 mm Hg
using oral antihypertensive agents
D. Gradually decrease the diastolic pressure to 85 mm - Answer C. Rapidly decrease the
diastolic pressure to 100 mm Hg with IV antihypertensive medications, then continue to
gradually decrease the diastolic pressure to 85 mm Hg with oral antihypertensive
medication
5. When the nurse is administering Lisinopril to a patient diagnosed with systolic heart
failure, which of the following labs should be closely monitored?
A. Sodium
,B. Phosphate
C. Magnesium
D Potassium - Answer D. Potassium
The patients on angiotensin converting enzyme inhibitors can develop hyperkalemia.
ACE inhibitors block angiotensin II, which may cause decreased aldosterone.
Aldosterone is responsible for excreting potassium from the kidneys. Therefore, ACE
inhibitors can cause potassium retention and potassium levels should be watched very
closely. In addition to this, renal labs such as BUN and creatinine should be watched. If
there is more than a 20% increase in the creatinine, this medication should be stopped.
A 57-year-old male is admitted with an acute myocardial infarction and is rapidly
declining. He has a BP of 86/42
(57), tachycardic with a heart rate of 110, weak, thready pulses, and mottled
skin-especially at the knees. He has had minimal urine output the past 8 hours. A Rapid
Response is activated. Which of the following medications would be the best choice to
increase the patient's cardiac output?
A Dobutamine
B Norepinephrine
C Amiodarone
D Phenylephrine - Response A Dobutamine. Dobutamine is a positive inotropic agent
given to augment myocardial dysfunction in patients with low cardiac index and high
afterload. It will increase the contractility and reduce the afterload. Milrinone, as a
phosphodiesterase inhibitor, is an option instead of dobutamine in the situation of
decompensated heart failure. It is used cautiously in patients in cardiogiogenic shock as
one of the major side effects of Milrinone is hypotension. The half-life of Milrinone is
approximately 6 hours. Norepinephrine and Phenylephrine cause vasoconstriction,
which would increase the SVR and may compromise cardiac output.
You are caring for a patient post gastric bypass. Which of the following parameters
should you closely monitor post-operatively?
A* HR, RR, temperature, WBC & MAP
A* Protein levels and vitamin B12
C* Albumin and pre-albumin levels
D* Signs of dumping syndrome - Answer A* HR, RR, temperature, WBC & MAP
, You are caring for a patient who was admitted after a ground level fall. The patient has a
decreased level of consciousness. On admission, the patient is ordered to be a full
code. The family arrives with advanced directives stating the patient wishes not to have
CPR performed or life-sustaining treatment continued. The nurse approaches the
provider about this discrepancy, and the provider states, "I am aware of the advanced
directive, but the daughter wants everything done."
What is the best subsequent action by the nurse?
A* Ask the daughter why she wants everything done
B* Work with the provider and social worker to arrange a family conference
C* Inform the physician we must respect the desires of the patient
* Consult the situation with the nurse manager - Answer B* Work with the provider and
social worker to arrange a family conference
Which is the most effective measure to ensure the safety of the client undergoing
hemodialysis?
A* Direct view of the connection of machine and access device
B* Close monitoring of intake and output
C* Close bedrest
D* Evaluation of electrolytes q 4 hrs - Answer A* Direct view of the connection of
machine and access device
The nurse must always be able to visualize the junction of the central venous access and
the dialysis unit. Disconnection results in exsanguination within minutes.
Four hours after the initiation of an infusion of insulin for a patient admitted with diabetic
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