PCCN CARDIAC EXAM - COMPLETE QUESTIONS AND DETAILED SOLUTIONS LATEST UPDATE
THIS YEAR JUST RELEASED
Question 1: Your patient just underwent a percutaneous
intervention for stent placement, after which he was returned to
your tele unit. You note a rash over the patient's trunk and arms.
This is probably due to _____.
A. An allergic reaction to contrast dye
B. Petechiae from a fat emolism
C. A reaction to the indwelling stent
D. A rash secondary to a Candida infection
Answer:
An allergic reaction to contrast dye.
Rationale: Iodine dye is used and will cause a rash, itching, swelling and
can also lead to laryngospasm and anaphylaxis in some patients. It is
imperative to determine whether the patient is allergic to iodine, shellfish,
or horses prior to initiating the procedure.
Question 2: A sign of necrosis on an EKG would include:
A. Acute ST elevation
B. A Right BBB
C. A Left BBB
D. A Q wave in lead III
Answer:
Acute ST elevation.
Rationale: Along with acute ST elevation, another indicator of necrosis
would be an abnormal Q wave. If the Q wave appears within about 6
hours of a transmural MI, it is an ominous sign. If the Q wave is more
than 0.04 seconds long, it is a sign of necrosis. In an inferior MI, the Q
,wave should not exceed 0.03 seconds or it is indicative of necrosis.
Question 3: Holly recieved 4 mg Morphine IV. She is now
unresponsive and her RR and depth are diminished. The antidote
for morphine is:
A. Regitine
B. Bicarbonate
C. Naloxone
D. Atropine
Answer:
Naloxone
Rationale: The antagonist for morphine and other opiods is Narcan
(naloxone). Generally, the naloxone dose is 0.4 mg IV. This dose can be
repeated about every 3 to 4 minutes for a total of 3 times. When you give
Narcan, you must always be alert for the patient to relapse once the
dose wears off. Administering multiple follow-up doses is not
uncommon.
Question 4: Complications associated with ventricular assist
devices (VADs) include:
A. Thromboembolism
B. Thrombocytopenia
C. Dissection of the aorta
D. Septicemia
Answer:
Thromboembolism
Rationale: Additional complications that are commonly seen with VADs
are infection and bleeding.
,Question 5: Thrombocytopenia, aortic dissection and septicemia
are complications of an intra-aortic balloon pump (IAPB).
Indications for use of a VAD include:
A. Dysrhythmias
B. As destination therapy
C. Prolonged cardiac arrest
D. Extensive organ damage
Answer:
As destination therapy
Rationale: Other indications for use of VAD include use as a bridge to
transplant, treatment of cardiogenic shock, and inability to wean from
cardiopulmonary bypass. Always be aware of the possibility of device
failure.
Question 6: Prolonged cardiac arrest, especially with neuroligical
damage is a contraindication for use of a VAD. Extensive organ
damage is another contraindication. Dysrhythmias are not
indications for use. The most common infection in patients with
VADs is:
A. Septicemia
B. Pericarditis
C. Pneumonia
D. Pericardial effusion
Answer:
Pneumonia
Rationale: PNA secondary to immobility is the primary reason for
infection with VADs. There may also exist a need for some type of
ventilatory support. Jst the fact that tubes are placed into the body is a
potential source of infection, but this is usually minimized by good hand
, washing and aseptic technique.
Question 7: The most common type of VAD is the
A. RVAD
B. VAD
C. BIVAD
D. LVAD
Answer:
LVAD
Rationale: The left ventricular assist device is the most commonly used
because left heart failure is more common and usually precedes right
venticular failure.
Question 8: The most common major impediment to family
education regarding placement of a ventricular assist device is:
A. Language
B. Technology
C. Time
D. Physician availability
Answer:
Time
Rationale: Quite often, the patient develops cardiogenic shock and
requires emergent placement of a VAD. If the nurse is able to at least
explain the function of the device, it can be a great relief to the family.
Question 9: The physician has just informed your patient that she
needs an LVAD. The patient is crying and says, "I just know I'm
going to die. What's the point? It must be my time." The patient is
obviously stressed. The priority for th nurse at this time is to:
THIS YEAR JUST RELEASED
Question 1: Your patient just underwent a percutaneous
intervention for stent placement, after which he was returned to
your tele unit. You note a rash over the patient's trunk and arms.
This is probably due to _____.
A. An allergic reaction to contrast dye
B. Petechiae from a fat emolism
C. A reaction to the indwelling stent
D. A rash secondary to a Candida infection
Answer:
An allergic reaction to contrast dye.
Rationale: Iodine dye is used and will cause a rash, itching, swelling and
can also lead to laryngospasm and anaphylaxis in some patients. It is
imperative to determine whether the patient is allergic to iodine, shellfish,
or horses prior to initiating the procedure.
Question 2: A sign of necrosis on an EKG would include:
A. Acute ST elevation
B. A Right BBB
C. A Left BBB
D. A Q wave in lead III
Answer:
Acute ST elevation.
Rationale: Along with acute ST elevation, another indicator of necrosis
would be an abnormal Q wave. If the Q wave appears within about 6
hours of a transmural MI, it is an ominous sign. If the Q wave is more
than 0.04 seconds long, it is a sign of necrosis. In an inferior MI, the Q
,wave should not exceed 0.03 seconds or it is indicative of necrosis.
Question 3: Holly recieved 4 mg Morphine IV. She is now
unresponsive and her RR and depth are diminished. The antidote
for morphine is:
A. Regitine
B. Bicarbonate
C. Naloxone
D. Atropine
Answer:
Naloxone
Rationale: The antagonist for morphine and other opiods is Narcan
(naloxone). Generally, the naloxone dose is 0.4 mg IV. This dose can be
repeated about every 3 to 4 minutes for a total of 3 times. When you give
Narcan, you must always be alert for the patient to relapse once the
dose wears off. Administering multiple follow-up doses is not
uncommon.
Question 4: Complications associated with ventricular assist
devices (VADs) include:
A. Thromboembolism
B. Thrombocytopenia
C. Dissection of the aorta
D. Septicemia
Answer:
Thromboembolism
Rationale: Additional complications that are commonly seen with VADs
are infection and bleeding.
,Question 5: Thrombocytopenia, aortic dissection and septicemia
are complications of an intra-aortic balloon pump (IAPB).
Indications for use of a VAD include:
A. Dysrhythmias
B. As destination therapy
C. Prolonged cardiac arrest
D. Extensive organ damage
Answer:
As destination therapy
Rationale: Other indications for use of VAD include use as a bridge to
transplant, treatment of cardiogenic shock, and inability to wean from
cardiopulmonary bypass. Always be aware of the possibility of device
failure.
Question 6: Prolonged cardiac arrest, especially with neuroligical
damage is a contraindication for use of a VAD. Extensive organ
damage is another contraindication. Dysrhythmias are not
indications for use. The most common infection in patients with
VADs is:
A. Septicemia
B. Pericarditis
C. Pneumonia
D. Pericardial effusion
Answer:
Pneumonia
Rationale: PNA secondary to immobility is the primary reason for
infection with VADs. There may also exist a need for some type of
ventilatory support. Jst the fact that tubes are placed into the body is a
potential source of infection, but this is usually minimized by good hand
, washing and aseptic technique.
Question 7: The most common type of VAD is the
A. RVAD
B. VAD
C. BIVAD
D. LVAD
Answer:
LVAD
Rationale: The left ventricular assist device is the most commonly used
because left heart failure is more common and usually precedes right
venticular failure.
Question 8: The most common major impediment to family
education regarding placement of a ventricular assist device is:
A. Language
B. Technology
C. Time
D. Physician availability
Answer:
Time
Rationale: Quite often, the patient develops cardiogenic shock and
requires emergent placement of a VAD. If the nurse is able to at least
explain the function of the device, it can be a great relief to the family.
Question 9: The physician has just informed your patient that she
needs an LVAD. The patient is crying and says, "I just know I'm
going to die. What's the point? It must be my time." The patient is
obviously stressed. The priority for th nurse at this time is to:
