PCCN practice exam questions with correct
answers
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 answersC
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 answersC.
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 answersB.
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 answersB.
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
answers
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 answersC
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 answersC.
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 answersB.
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 answersB.
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
