PCCN PRACTICE EXAM QUESTIONS AND
VERIFIED ACTUAL ANSWERS GRADED A+
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).
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 -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.
VERIFIED ACTUAL ANSWERS GRADED A+
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).
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 -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.
