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PCCN Actual 2024 Questions with Verified Answers, 100% Guarantee Pass Score (2024 / 2025)
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PCCN Actual 2024 Questions with Verified Answers, 100% Guarantee Pass Score (2024 / 2025)
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PCCN questions.pdf file:///C:/Users/HP/Desktop/New%20fl/PCCN%20questionsPCCN Exam Questions & Answers
1. Coronary artery perfusion is dependent upon
A. diastolic pressure
B. systolic pressure
C. afterload
D. systemic vascular resistance (SVR)
Answer A. diastolic pressure
Diastolic pressure in the aortic root is higher than left ventricular end-diastolic pres- sure
(LVEDP), the pressure exerted on the ventricular muscle at the end of diastole when the ventricle
is full. This enables blood to flow from a higher pressure through open arteries to a lower
pressure, a pressure gradient known as coronary artery prefusion pressure. As diastolic
pressure drops, there is a decrease in coronary artery blood flow. Coronary artery perfusion is
not affected by systolic pressure, afterload or SVR, but they all increase the demand of oxygen in
the heart.
2. A post-STEMI (ST elevation myocardial infarction) patient is started on an
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angiotensin-converting enzyme (ACE) inhibitor during his hospital stay.Which of the
following is the most common serious side effect that may occur?
A. a nonproductive cough
B. pedal edema
C. swelling of the tongue and face
D. rhinorrhea
Answer C. swelling of the tongue and face
Although all of the answers may occur, swelling og the tongue and face is the most serious and
may require intervention. Patients should be instructed to seek medical attention immediately
for any signs of swelling in the tongue or throat.
3. Which of the following best describes the fourth heart sound (S4)
A. It occurs after ventricular contraction
B. It is best heard with the diaphragm of the stethoscope
C. It is a normal finding in children
D. It occurs during late diastole when the atria contracts
Answer D. It occurs during late diastole when the atria contracts
The presence of the extra heart sound S4 signifies a poorly compliant (stiff) left ventricle. An S4
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is also called an atrial heart sound since it occurs at the end of diastolic filling when the atria
contracts and fully fills the left ventricle.Known as "atrial kick", this filling is important to cardiac
output. The increased end-diastolic volume in the ventricle improves cardiac output. When the
left ventricle is stiff (decreased compliance with long term hypertension, aortic stenosis or with
acute STEMI), the atrium has to pump harder to move blood from the atrium to the ventricle,
causing a turbulent blood flow and extra heart sound.This heart sound is always pathologic. It
occurs before ventricular contraction, is best heard with the bell of the stethoscope and is never
a normal heart sound, even in children.
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4. Which pathologic changes found on the 12-lead ECG indicate myocardial ischemia?
A. ST-segment elevation
B. ST-segment depression and T-wave elevation
C. Q-wave formation
D. ST-segment depression andT-wave inversion
Answer D. ST segment depression and T wave inversion
Myocardial ischemia changes the repolarization of the ventricular muscle. That change is seen
on the 12 lead ECG as ST-segment depression and T wave inver- sion, which demonstrate
subendocardial ischemia -- the innermost layer of muscle in the myocardium. ST-segment
elevation indicates acute injury or infarction, ST segment depression and T wave elevation may
indicate an electrolyte abnormality, while Q wave formation indicates total infarction.
5. Positive inotropic agents are used to
A. improve cardiac output and tissue perfusion
B. decrease water loss through the kidneys
C. increase heart rate
D. vasodilate vessels
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