PCCN Exam prep practice Questions
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1. 1. A 49-year-old male was recently admitted 1. D. I, aVI. The RCA perfuses the inferior
with an inferior wall wall and the mirror image or reciprocal
MI resulting from 100% occlusion of the change will be seen in the high latera
right coronary artery wall, which is reflected in leads I, and aVL,
(RCA). The 12-Lead ECG reveals ST elevation on the 12-Lead ECG. Leads V1 and V2
in leads II, Ill, and avF. correlate with the septal area, leads V3
You would expect to see reciprocal changes and V4 correlate With the anterior area of
in which leads? the heart. The aVR lead does not provide
A. I, aVR much diagnostic value as all energy is
B. V, V2 depolarizing away from this lead.
C. V, VA
D I, aVL
2. You are summoned to the room of a A. Call for help and safely guide the pa-
30-year-old female who is experiencing sus- tient to the floor
tained tonic-clonic convulsions while sitting Patient Safety is priority
in a chair. A family member states: "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 initial priority of care?
A. Call for help and safely guide 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
3. A 46-year-old patient presents with pneumo- B. Acute Respiratory Distress Syndrome
nia and sepsis.
He was treated with 4 days of antibiotics and
, PCCN Exam prep practice Questions
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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
4. A 56-year-old male is admitted to the PCU C. Rapidly lower the diastolic pressure
with a hypertensive crisis. His blood pres- to 100 mm Hg with IV antihypertensive
sure is now 205/125 mm Hg and he is com- medications, then continue to gradually
plaining of a headache with nausea. He re- reduce the diastolic pressure to 85 mm
ports he ran out of blood pressure medica- Hg with oral antihypertensive medication
tion three days ago, but also appears to be
confused to the date and situation. What is
the most appropriate treatment approach?
A. Rapidly lower the systolic pressure to 100
mm Hg with IV antihypertensive medication,
then gradually reduce the diastolic pressure
to 85 mm Hg with oral antihypertensive
medications
B. Slowly lower the systolic pressure to 120
mm Hg with IV antihypertensive medica-
tions, then switch to oral antihypertensive
medications for maintenance
C. Rapidly lower the diastolic pressure to
100 mm Hg with IV antihypertensive med-
, PCCN Exam prep practice Questions
Study online at https://quizlet.com/_h1d7k0
ications, then continue to gradually reduce
the diastolic pressure to 85 mm Hg with oral
antihypertensive medications
D. Slowly lower the diastolic pressure to 85
mm
5. 5. Which of the following labs must be close- D. Potassium
ly monitored when administering Lisinopril Patients taking angiotensin converting
to a patient with systolic heart failure? enzyme inhibitors may experience hy-
A. Sodium perkalemia. ACE inhibitors block an-
B. Phosphate giotensin II, which may lead to de-
C. Magnesium creased aldosterone. Aldosterone is re-
D Potassium sponsible forexcreting potassium from
the kidneys. Therefore, ACE inhibitors
can cause potassium retension and
potassium levels should be monitored
closely. In addition, renal labs such as
BUN and creatinine should be moni-
tored. If the patient develops more than
a 20% increase in the creatinine, the
medication should be discontinued.
6. A 57-year-old man was admitted with an A Dobutamine. Dobutamine is a positive
acute myocardial infarction and is rapidly de- inotropic medication used to improve
teriorating. He has a BP of 86/42 myocardial dysfunction on patients with
(57), heart rate of 110, weak, thready puls- a low cardiac index and elevated af-
es, and mottled skin-especially at the knees. terload. It will improve contractility and
He has had minimal urine output the past 8 reduce afterload. Milrinone, which is a
hours. A Rapid Response is activated. Which phosphodiesterase inhibitor could also
of the following medications would be the be used as an alternative to dobuta-
best option to increase the patient's cardiac mine, in the setting of decompensat-
, PCCN Exam prep practice Questions
Study online at https://quizlet.com/_h1d7k0
output? ed heart failure. It is used cautiously
A Dobutamine in patients experiencing cardiogiogenic
B Norepinephrine shock as one of the main side effects of
C Amiodarone Milrinone is hypotension. The half life of
D Phenylephrine Milrinone is about 6 hours. Norepineph-
rine and Phenylephrine cause vasocon-
striction, which would increase the SVR
and may compromise cardiac output.
7. You are caring for a patient post gastric A* HR, RR, temperature, WBC & MAP
bypass. Which of the following parameters
should you closely monitor after surgery?
A* HR, RR, temperature, WBC & MAP
B* Protein levels and vitamin B12
C* Albumin and pre-albumin levels
D* Signs of dumping syndrome
8. You are caring for a patient admitted after a B* Collaborate with the provider and so-
ground level fall. The patient has decreased cial worker to schedule a family meeting
level of consciousness. On admission the pa-
tient 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 appropriate next step by the
nurse?
A* Ask the daughter why she wants every-
thing done
Study online at https://quizlet.com/_h1d7k0
1. 1. A 49-year-old male was recently admitted 1. D. I, aVI. The RCA perfuses the inferior
with an inferior wall wall and the mirror image or reciprocal
MI resulting from 100% occlusion of the change will be seen in the high latera
right coronary artery wall, which is reflected in leads I, and aVL,
(RCA). The 12-Lead ECG reveals ST elevation on the 12-Lead ECG. Leads V1 and V2
in leads II, Ill, and avF. correlate with the septal area, leads V3
You would expect to see reciprocal changes and V4 correlate With the anterior area of
in which leads? the heart. The aVR lead does not provide
A. I, aVR much diagnostic value as all energy is
B. V, V2 depolarizing away from this lead.
C. V, VA
D I, aVL
2. You are summoned to the room of a A. Call for help and safely guide the pa-
30-year-old female who is experiencing sus- tient to the floor
tained tonic-clonic convulsions while sitting Patient Safety is priority
in a chair. A family member states: "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 initial priority of care?
A. Call for help and safely guide 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
3. A 46-year-old patient presents with pneumo- B. Acute Respiratory Distress Syndrome
nia and sepsis.
He was treated with 4 days of antibiotics and
, PCCN Exam prep practice Questions
Study online at https://quizlet.com/_h1d7k0
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
4. A 56-year-old male is admitted to the PCU C. Rapidly lower the diastolic pressure
with a hypertensive crisis. His blood pres- to 100 mm Hg with IV antihypertensive
sure is now 205/125 mm Hg and he is com- medications, then continue to gradually
plaining of a headache with nausea. He re- reduce the diastolic pressure to 85 mm
ports he ran out of blood pressure medica- Hg with oral antihypertensive medication
tion three days ago, but also appears to be
confused to the date and situation. What is
the most appropriate treatment approach?
A. Rapidly lower the systolic pressure to 100
mm Hg with IV antihypertensive medication,
then gradually reduce the diastolic pressure
to 85 mm Hg with oral antihypertensive
medications
B. Slowly lower the systolic pressure to 120
mm Hg with IV antihypertensive medica-
tions, then switch to oral antihypertensive
medications for maintenance
C. Rapidly lower the diastolic pressure to
100 mm Hg with IV antihypertensive med-
, PCCN Exam prep practice Questions
Study online at https://quizlet.com/_h1d7k0
ications, then continue to gradually reduce
the diastolic pressure to 85 mm Hg with oral
antihypertensive medications
D. Slowly lower the diastolic pressure to 85
mm
5. 5. Which of the following labs must be close- D. Potassium
ly monitored when administering Lisinopril Patients taking angiotensin converting
to a patient with systolic heart failure? enzyme inhibitors may experience hy-
A. Sodium perkalemia. ACE inhibitors block an-
B. Phosphate giotensin II, which may lead to de-
C. Magnesium creased aldosterone. Aldosterone is re-
D Potassium sponsible forexcreting potassium from
the kidneys. Therefore, ACE inhibitors
can cause potassium retension and
potassium levels should be monitored
closely. In addition, renal labs such as
BUN and creatinine should be moni-
tored. If the patient develops more than
a 20% increase in the creatinine, the
medication should be discontinued.
6. A 57-year-old man was admitted with an A Dobutamine. Dobutamine is a positive
acute myocardial infarction and is rapidly de- inotropic medication used to improve
teriorating. He has a BP of 86/42 myocardial dysfunction on patients with
(57), heart rate of 110, weak, thready puls- a low cardiac index and elevated af-
es, and mottled skin-especially at the knees. terload. It will improve contractility and
He has had minimal urine output the past 8 reduce afterload. Milrinone, which is a
hours. A Rapid Response is activated. Which phosphodiesterase inhibitor could also
of the following medications would be the be used as an alternative to dobuta-
best option to increase the patient's cardiac mine, in the setting of decompensat-
, PCCN Exam prep practice Questions
Study online at https://quizlet.com/_h1d7k0
output? ed heart failure. It is used cautiously
A Dobutamine in patients experiencing cardiogiogenic
B Norepinephrine shock as one of the main side effects of
C Amiodarone Milrinone is hypotension. The half life of
D Phenylephrine Milrinone is about 6 hours. Norepineph-
rine and Phenylephrine cause vasocon-
striction, which would increase the SVR
and may compromise cardiac output.
7. You are caring for a patient post gastric A* HR, RR, temperature, WBC & MAP
bypass. Which of the following parameters
should you closely monitor after surgery?
A* HR, RR, temperature, WBC & MAP
B* Protein levels and vitamin B12
C* Albumin and pre-albumin levels
D* Signs of dumping syndrome
8. You are caring for a patient admitted after a B* Collaborate with the provider and so-
ground level fall. The patient has decreased cial worker to schedule a family meeting
level of consciousness. On admission the pa-
tient 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 appropriate next step by the
nurse?
A* Ask the daughter why she wants every-
thing done
