Progressive Care Certified
Nurse Exam Review (PCCN)
Questions and Answers Exam
What happens to fluid in an acute stress response? - ANSWER>>body holds onto
fluid
What does Thromboxane A2 secretion do? - ANSWER>>Activates platelets and
makes them sticky
What class of anticoagulant is Aspirin? - ANSWER>>Antiplatelet
What class of anticoagulant is Integrilin? - ANSWER>>GP IIb/IIIa inhibitor
What class of anticoagulant is Activase? - ANSWER>>fibrinolytic agent
Name a direct thrombin agent - ANSWER>>arixtra
What happens within the spleen in sepsis? - ANSWER>>Platelets get eaten up
What causes DIC? - ANSWER>>(ALWAYS) secondary to overstimulation of clotting
factors leading to overall decrease in clotting factors and platelet malfunction
3 triggering factors for DIC - ANSWER>>tissue breakdown, sepsis (plt aggregation),
injury to vascular endothelium
Healthcare factors that could lead to DIC - ANSWER>>prolonged bypass, massive
blood transfusion, transplant rejection, transfusion reaction
,Clinical presentation for DIC - ANSWER>>signs of thrombus (petichiae), decreased
UO, chest pain, dyspnea, ST/T wave changes
Platelet count in DIC - ANSWER>>BELOW 100,000
Fibrinogen level in DIC - ANSWER>>LESS THAN 200mg/100mL
What 3 labs will be LOW in DIC - ANSWER>>platelets, fibrinogen, antithrombin III
What 3 labs will be INCREASED in DIC - ANSWER>>PTT, PT, D-Dimer (can also
sendout a FDP/FSP)
Treatment for DIC : 4 things - ANSWER>>always ABC, then treat : hypovolemia,
hypotension, hypoxia & acidosis
Indication for RBC - ANSWER>>significant decrease in Hgb & Hct
Indication for PLT - ANSWER>>Decreased plt count OR malfunctioning plt
Indications for FFP - ANSWER>>general coagulation deficiencies
What does FFP contain to help with clotting & what must be administered with it?
- ANSWER>>V & VII - must have ionized calcium to work
What coag factors are unique to CRYO - ANSWER>>fibrinogen and antithrombin 3
Indications for CRYO - ANSWER>>DIC*, von wildebrands
Adverse effects of blood transfusions (potassium, calcium, ammonia,
temperature) - ANSWER>>HYPERkalemia, HYPOcalcemia, ammonia intox,
HYPOthermia
Complications of DIC - ANSWER>>Hypovolemic shock, ARF, ARDS, stroke
, What is the leading risk factor for developing DVT & PE - ANSWER>>CANCER
What is Tumor Lysis syndrome similar to? - ANSWER>>Rhabdo
Which cancers can metastasize to pericardium? - ANSWER>>Endometrial &
Uterine
Symptoms of pericardial effusion - ANSWER>>Low BP, NARROW pulse pressure,
High HR
Most common cellulitis bacteria type - ANSWER>>gram positive (PO ABX)
What characterizes necrotizing fascitis? - ANSWER>>"flesh eating" releases air,
anaerobic bacteria that requires IV abx
Primary chemical mediator in anaphylaxis? - ANSWER>>histamine
What is an EARLY sign of DIC? - ANSWER>>signs of thrombus formation
Kidney main function (& 2 hormones) - ANSWER>>regulation of homeostasis /
production and release of hormones (ADH & erythropoetin)
Which renal lab value will be affected first - ANSWER>>GFR decrease first, then
creat later
What is a normal serum osmolality - ANSWER>>275-295 (glucose & electrolytes)
What is a normal BUN/creat ratio? - ANSWER>>10:1 -- WIDER ratio usually means
DRY
Hypovolemia signs (BUN & Creat) - ANSWER>>INCREASED BUN & NORMAL creat
Nurse Exam Review (PCCN)
Questions and Answers Exam
What happens to fluid in an acute stress response? - ANSWER>>body holds onto
fluid
What does Thromboxane A2 secretion do? - ANSWER>>Activates platelets and
makes them sticky
What class of anticoagulant is Aspirin? - ANSWER>>Antiplatelet
What class of anticoagulant is Integrilin? - ANSWER>>GP IIb/IIIa inhibitor
What class of anticoagulant is Activase? - ANSWER>>fibrinolytic agent
Name a direct thrombin agent - ANSWER>>arixtra
What happens within the spleen in sepsis? - ANSWER>>Platelets get eaten up
What causes DIC? - ANSWER>>(ALWAYS) secondary to overstimulation of clotting
factors leading to overall decrease in clotting factors and platelet malfunction
3 triggering factors for DIC - ANSWER>>tissue breakdown, sepsis (plt aggregation),
injury to vascular endothelium
Healthcare factors that could lead to DIC - ANSWER>>prolonged bypass, massive
blood transfusion, transplant rejection, transfusion reaction
,Clinical presentation for DIC - ANSWER>>signs of thrombus (petichiae), decreased
UO, chest pain, dyspnea, ST/T wave changes
Platelet count in DIC - ANSWER>>BELOW 100,000
Fibrinogen level in DIC - ANSWER>>LESS THAN 200mg/100mL
What 3 labs will be LOW in DIC - ANSWER>>platelets, fibrinogen, antithrombin III
What 3 labs will be INCREASED in DIC - ANSWER>>PTT, PT, D-Dimer (can also
sendout a FDP/FSP)
Treatment for DIC : 4 things - ANSWER>>always ABC, then treat : hypovolemia,
hypotension, hypoxia & acidosis
Indication for RBC - ANSWER>>significant decrease in Hgb & Hct
Indication for PLT - ANSWER>>Decreased plt count OR malfunctioning plt
Indications for FFP - ANSWER>>general coagulation deficiencies
What does FFP contain to help with clotting & what must be administered with it?
- ANSWER>>V & VII - must have ionized calcium to work
What coag factors are unique to CRYO - ANSWER>>fibrinogen and antithrombin 3
Indications for CRYO - ANSWER>>DIC*, von wildebrands
Adverse effects of blood transfusions (potassium, calcium, ammonia,
temperature) - ANSWER>>HYPERkalemia, HYPOcalcemia, ammonia intox,
HYPOthermia
Complications of DIC - ANSWER>>Hypovolemic shock, ARF, ARDS, stroke
, What is the leading risk factor for developing DVT & PE - ANSWER>>CANCER
What is Tumor Lysis syndrome similar to? - ANSWER>>Rhabdo
Which cancers can metastasize to pericardium? - ANSWER>>Endometrial &
Uterine
Symptoms of pericardial effusion - ANSWER>>Low BP, NARROW pulse pressure,
High HR
Most common cellulitis bacteria type - ANSWER>>gram positive (PO ABX)
What characterizes necrotizing fascitis? - ANSWER>>"flesh eating" releases air,
anaerobic bacteria that requires IV abx
Primary chemical mediator in anaphylaxis? - ANSWER>>histamine
What is an EARLY sign of DIC? - ANSWER>>signs of thrombus formation
Kidney main function (& 2 hormones) - ANSWER>>regulation of homeostasis /
production and release of hormones (ADH & erythropoetin)
Which renal lab value will be affected first - ANSWER>>GFR decrease first, then
creat later
What is a normal serum osmolality - ANSWER>>275-295 (glucose & electrolytes)
What is a normal BUN/creat ratio? - ANSWER>>10:1 -- WIDER ratio usually means
DRY
Hypovolemia signs (BUN & Creat) - ANSWER>>INCREASED BUN & NORMAL creat
