Exam
Exam Solution zm
PCCN 2026 A+ GRADE ASSURED COMPLETE SOLUTION
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S AND VERIFIED ANSWERS (1535E)
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QUESTION 1 zm
1. A 49-year-
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old male was recently admitted with an inferior wall MI resulting from 100% occlusio
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n of the right coronary artery (RCA). The 12-
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lead ECG reveals ST elevation in leads II, III, and a VF. You would expect to see recipr
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ocal changes in which leads?
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A. I, a VR
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B. V1, V2
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C. V3, V4
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D. I, a VL
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ANSWER
D. I, aVL. The RCA perfuses the inferior wall and the mirror image or reciprocal change will be seen
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in the high lateral wall, which is reflected in leads I, and aVL on the 12-
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Lead ECG. Leads V1 and V2 correlate with the septal area, leads V3 and V4 correlate with the anteri
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or area of the heart. The aVR lead does not provide much diagnostic value as all energy is depolariz
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ing away from this lead.
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QUESTION 2 zm
5. Which of the following labs must be closely monitored when administering Lisinopr
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il to a patient with systolic heart failure?
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A. Sodium
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B. Phosphate
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C. Magnesium
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D. Potassium
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ANSWER
D. Potassium. Patients taking angiotensin converting enzyme inhibitors may experience hyperkalemia
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. ACE inhibitors block angiotensin II, which may lead to decreased aldosterone. Aldosterone is respo
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nsible for excreting potassium from the kidneys. Therefore, ACE inhibitors can cause potassium rete
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ntion and potassium levels should be monitored closely. In addition, renal labs such as BUN and cre
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, atinine should be monitored. If the patient develops more than a 20% increase in the creatinine, the
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medication should be discontinued.
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QUESTION 3 zm
7. You are caring for a patient post gastric bypass. Which of the following parameters
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should you closely monitor after surgery?
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A. HR, RR, temperature, WBC & MAP
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B. Protein levels and vitamin B12
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C. Albumin and pre-albumin levels
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D. Signs of dumping syndrome
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ANSWER
A. HR, RR, temperature, WBC & MAP. Gastric bypass carries similar risks to any intestinal surgery, i
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ncluding the risk of an anastomotic leak. Often the first and only signs of the leak will be subtle cha
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nges in vitals or an increase in WBC. Other potential complications include bleeding, although it is r
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are.
QUESTION 4 zm
9. Which is the best intervention to promote safety of the patient receiving hemodialy
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sis?
A. Direct visualization of the connection between the machine and the access device
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B. Strict intake and output monitoring
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C. Strict bedrest
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D. Electrolyte assessment q 4 hours
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ANSWER
A. Direct visualization of the connection between the machine and the access device. The nurse must
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be able to visualize the junction of the central venous access and the dialysis unit at all times. Disc
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onnection can result in exsanguination within minutes.
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QUESTION 5 zm
11. A 45 year old male is admitted to the PCU with severe sepsis. You are administeri
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ng lactated ringers 500 ml IV boluses. A central line has been placed. Which of the fin
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dings below indicate the fluid boluses are having its intended effect?
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A. MAP of 55 mm Hg
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B. ScuO2 of 52%
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C. Initial lactate level 4.2 mmol/L now 1.8 mmol/L
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D. Urine output of 15 ml/hour.
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ANSWER
C. Initial lactate level 4.2 mmol/L, now 1.8 mmol/L. Early goal directed therapy for sepsis includes e
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arly fluid resuscitation at 30 mL/kg to maintain the MAP greater than 65 mm Hg, ScvO2 greater tha
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Exam Solution zm
PCCN 2026 A+ GRADE ASSURED COMPLETE SOLUTION
zm zm zm zm zm zm
S AND VERIFIED ANSWERS (1535E)
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QUESTION 1 zm
1. A 49-year-
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old male was recently admitted with an inferior wall MI resulting from 100% occlusio
zm zm zm zm zm zm zm zm zm zm zm zm zm
n of the right coronary artery (RCA). The 12-
zm zm zm zm zm zm zm zm
lead ECG reveals ST elevation in leads II, III, and a VF. You would expect to see recipr
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
ocal changes in which leads?
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A. I, a VR
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B. V1, V2
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C. V3, V4
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D. I, a VL
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ANSWER
D. I, aVL. The RCA perfuses the inferior wall and the mirror image or reciprocal change will be seen
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
in the high lateral wall, which is reflected in leads I, and aVL on the 12-
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
Lead ECG. Leads V1 and V2 correlate with the septal area, leads V3 and V4 correlate with the anteri
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
or area of the heart. The aVR lead does not provide much diagnostic value as all energy is depolariz
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ing away from this lead.
zm zm zm zm
QUESTION 2 zm
5. Which of the following labs must be closely monitored when administering Lisinopr
zm zm zm zm zm zm zm zm zm zm zm zm
il to a patient with systolic heart failure?
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A. Sodium
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B. Phosphate
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C. Magnesium
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D. Potassium
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ANSWER
D. Potassium. Patients taking angiotensin converting enzyme inhibitors may experience hyperkalemia
zm zm zm zm zm zm zm zm zm zm
. ACE inhibitors block angiotensin II, which may lead to decreased aldosterone. Aldosterone is respo
zm zm zm zm zm zm zm zm zm zm zm zm zm zm
nsible for excreting potassium from the kidneys. Therefore, ACE inhibitors can cause potassium rete
zm zm zm zm zm zm zm zm zm zm zm zm zm
ntion and potassium levels should be monitored closely. In addition, renal labs such as BUN and cre
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
, atinine should be monitored. If the patient develops more than a 20% increase in the creatinine, the
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medication should be discontinued.
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QUESTION 3 zm
7. You are caring for a patient post gastric bypass. Which of the following parameters
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should you closely monitor after surgery?
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A. HR, RR, temperature, WBC & MAP
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B. Protein levels and vitamin B12
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C. Albumin and pre-albumin levels
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D. Signs of dumping syndrome
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ANSWER
A. HR, RR, temperature, WBC & MAP. Gastric bypass carries similar risks to any intestinal surgery, i
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
ncluding the risk of an anastomotic leak. Often the first and only signs of the leak will be subtle cha
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
nges in vitals or an increase in WBC. Other potential complications include bleeding, although it is r
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
are.
QUESTION 4 zm
9. Which is the best intervention to promote safety of the patient receiving hemodialy
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sis?
A. Direct visualization of the connection between the machine and the access device
zm zm zm zm zm zm zm zm zm zm zm zm
B. Strict intake and output monitoring
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C. Strict bedrest
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D. Electrolyte assessment q 4 hours
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ANSWER
A. Direct visualization of the connection between the machine and the access device. The nurse must
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
be able to visualize the junction of the central venous access and the dialysis unit at all times. Disc
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
onnection can result in exsanguination within minutes.
zm zm zm zm zm zm
QUESTION 5 zm
11. A 45 year old male is admitted to the PCU with severe sepsis. You are administeri
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
ng lactated ringers 500 ml IV boluses. A central line has been placed. Which of the fin
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
dings below indicate the fluid boluses are having its intended effect?
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A. MAP of 55 mm Hg
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B. ScuO2 of 52%
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C. Initial lactate level 4.2 mmol/L now 1.8 mmol/L
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D. Urine output of 15 ml/hour.
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ANSWER
C. Initial lactate level 4.2 mmol/L, now 1.8 mmol/L. Early goal directed therapy for sepsis includes e
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
arly fluid resuscitation at 30 mL/kg to maintain the MAP greater than 65 mm Hg, ScvO2 greater tha
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