PCCN EXAM 200 Questions Actual (Latest 2026 /
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Terms in this set (200)
Coronary artery perfusion is A. diastolic pressure
dependent upon: Diastolic pressure in the aortic root is higher than
A. diastolic pressure left ventricular end-diastolic pressure (LVEDP), the
B. systolic pressure pressure exerted on the ventricular muscle at the
C. afterload end of diastole when the ventricle is full. This
D. systemic vascular resistance (SVR) enables blood to flow from a higher pressure
through open arteries to a lower pressure, a
pressure gradient known as coronary artery
prefusion pressure. As diastolic pressure drops,
there is a decrease in coronary artery blood flow.
Coronary artery perfusion is not affected by systolic
pressure, afterload or SVR, but they all increase the
demand of oxygen in the heart.
,A post-STEMI (ST elevation C. swelling of the tongue and face
myocardial infarction) patient is Although all of the answers may occur, swelling og
started on an angiotensin-converting the tongue and face is the most serious and may
enzyme (ACE) inhibitor during his require intervention. Patients should be instructed to
hospital stay. Which of the following seek medical attention immediately for any signs of
is the most common serious side swelling in the tongue or throat.
effect that may occur?
A. a nonproductive cough
B. pedal edema
C. swelling of the tongue and face
D. rhinorrhea
Which of the following best describes D. It occurs during late diastole when the atria
the fourth heart sound (S4): contracts
A. It occurs after ventricular The presence of the extra heart sound S4 signifies a
contraction poorly compliant (stiff) left ventricle. An S4 is also
B. It is best heard with the diaphragm called an atrial heart sound since it occurs at the
of the stethoscope end of diastolic filling when the atria contracts and
C. It is a normal finding in children fully fills the left ventricle. Known as "atrial kick", this
D. It occurs during late diastole when filling is important to cardiac output. The increased
the atria contracts end-diastolic volume in the ventricle improves
cardiac output. When the left ventricle is stiff
(decreased compliance with long term
hypertension, aortic stenosis or with acute STEMI),
the atrium has to pump harder to move blood from
the atrium to the ventricle, causing a turbulent
blood flow and extra heart sound. This heart sound
is always pathologic. It occurs before ventricular
contraction, is best heard with the bell of the
stethoscope and is never a normal heart sound,
even in children.
,Which pathologic changes found on D. ST segment depression and T wave inversion
the 12-lead ECG indicate myocardial Myocardial ischemia changes the repolarization of
ischemia? the ventricular muscle. That change is seen on the 12
A. ST-segment elevation lead ECG as ST-segment depression and T wave
B. ST-segment depression and T-wave inversion, which demonstrate subendocardial
elevation ischemia -- the innermost layer of muscle in the
C. Q-wave formation myocardium. ST-segment elevation indicates acute
D. ST-segment depression and T- injury or infarction, ST segment depression and T
wave inversion wave elevation may indicate an electrolyte
abnormality, while Q wave formation indicates total
infarction.
Positive inotropic agents are used to: A. improve cardiac output and tissue perfusion
A. improve cardiac output and tissue The term "inotropic" refers to affecting the force of
perfusion myocardial contraction. Improvement of cardiac
B. decrease water loss through the muscle contraction leads to improved cardiac
kidneys output and tissue perfusion.
C. increase heart rate
D. vasodilate vessels
A patient in the ED is now being A. current antibiotic use
admitted to telemetry bwith Use of antibiotics is not a contraindication for the
complaint of chest pain and has been use of alteplase. All the other answers -- recent
judged to be a possible candidate for abdominal surgery, recent gastrointestinal bleeding
therapy with alteplase (Activase). and a recent intracranial bleed -- are
Which of the following is not contraindications for the use of any fibrinolytic.
considered a contraindication for the
use of this medication?
A. current antibiotic use
B. recent abdominal surgery
C. recent gastrointestinal bleed
D. recent intracranial bleed
, The two major components that A. SVR (afterload) and cardiac output
determine blood pressure are: The equation for BP is: BP = SVR x cardiac output.
A. systemic vascular resistance (SVR) BP is determined by resistance of the arterial bed
(afterload) and cardiac output and the cardiac output. If the SVR (afterload) is high
B. contractility and SVR (afterload) and the cardiac output low, the patient may still
C. preload and SVR (afterload) have a normal BP. the pulse pressure will be lower,
D. contractility and SVR (afterload) but this is a compensatory response by the heart to
maintain BP. If the SVR (afterload) is low (as in early
septic shock), the cardiac output is very high,
thereby trying to support BP.
The layer of the arterial vessel wall A. media
responsible for changes in the The media layer of the arterial wall contains vascular
diameter of the artery is the: smooth muscle cells and is responsible for arterial
A. media tone. Vasoactive substances released in response to
B. intima the sympathetic nervous system and/or the renin-
C. externa angiotensin system determine arterial tone. Intima,
D. adventitia externa and adventitia are incorrect.
A patient presents in acute distress D. pulmonary congestion, low perfusion
with rales halfway up bilaterally; cool Rales indicate fluid in the alveolar sacs, possibly
and clammy extremities; elevated secondary to pulmonary edema, causing pulmonary
jugular venous distention (JVD); congestion. Pneumonia can also cause fluid in the
oxygen saturations at 95%, down from alveolar sacs. The patient is complaining of
99%; and complaints of shortness of shortness of breath, and the oxygen saturations are
breath. Which of the following lowering, also indicating that the patient has
findings correspond to the patient's pulmonary congestion. The patient's skin is cool and
cardiac status? clammy, indicating that the skin is poorly perfused.
A. no pulmonary congestion, normal Skin does not require oxygen and shunts blood
perfusion away in decreased cardiac function; therefore, this
B. no pulmonary congestion, low patient has pulmonary congestion and low
perfusion perfusion state. The other answers are incorrect.
C. pulmonary congestion, normal
perfusion
D. pulmonary congestion, low
perfusion
2027 Update) Questions & Accurate Correct
Answers (100% Correct Verified Answers) Already
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Terms in this set (200)
Coronary artery perfusion is A. diastolic pressure
dependent upon: Diastolic pressure in the aortic root is higher than
A. diastolic pressure left ventricular end-diastolic pressure (LVEDP), the
B. systolic pressure pressure exerted on the ventricular muscle at the
C. afterload end of diastole when the ventricle is full. This
D. systemic vascular resistance (SVR) enables blood to flow from a higher pressure
through open arteries to a lower pressure, a
pressure gradient known as coronary artery
prefusion pressure. As diastolic pressure drops,
there is a decrease in coronary artery blood flow.
Coronary artery perfusion is not affected by systolic
pressure, afterload or SVR, but they all increase the
demand of oxygen in the heart.
,A post-STEMI (ST elevation C. swelling of the tongue and face
myocardial infarction) patient is Although all of the answers may occur, swelling og
started on an angiotensin-converting the tongue and face is the most serious and may
enzyme (ACE) inhibitor during his require intervention. Patients should be instructed to
hospital stay. Which of the following seek medical attention immediately for any signs of
is the most common serious side swelling in the tongue or throat.
effect that may occur?
A. a nonproductive cough
B. pedal edema
C. swelling of the tongue and face
D. rhinorrhea
Which of the following best describes D. It occurs during late diastole when the atria
the fourth heart sound (S4): contracts
A. It occurs after ventricular The presence of the extra heart sound S4 signifies a
contraction poorly compliant (stiff) left ventricle. An S4 is also
B. It is best heard with the diaphragm called an atrial heart sound since it occurs at the
of the stethoscope end of diastolic filling when the atria contracts and
C. It is a normal finding in children fully fills the left ventricle. Known as "atrial kick", this
D. It occurs during late diastole when filling is important to cardiac output. The increased
the atria contracts end-diastolic volume in the ventricle improves
cardiac output. When the left ventricle is stiff
(decreased compliance with long term
hypertension, aortic stenosis or with acute STEMI),
the atrium has to pump harder to move blood from
the atrium to the ventricle, causing a turbulent
blood flow and extra heart sound. This heart sound
is always pathologic. It occurs before ventricular
contraction, is best heard with the bell of the
stethoscope and is never a normal heart sound,
even in children.
,Which pathologic changes found on D. ST segment depression and T wave inversion
the 12-lead ECG indicate myocardial Myocardial ischemia changes the repolarization of
ischemia? the ventricular muscle. That change is seen on the 12
A. ST-segment elevation lead ECG as ST-segment depression and T wave
B. ST-segment depression and T-wave inversion, which demonstrate subendocardial
elevation ischemia -- the innermost layer of muscle in the
C. Q-wave formation myocardium. ST-segment elevation indicates acute
D. ST-segment depression and T- injury or infarction, ST segment depression and T
wave inversion wave elevation may indicate an electrolyte
abnormality, while Q wave formation indicates total
infarction.
Positive inotropic agents are used to: A. improve cardiac output and tissue perfusion
A. improve cardiac output and tissue The term "inotropic" refers to affecting the force of
perfusion myocardial contraction. Improvement of cardiac
B. decrease water loss through the muscle contraction leads to improved cardiac
kidneys output and tissue perfusion.
C. increase heart rate
D. vasodilate vessels
A patient in the ED is now being A. current antibiotic use
admitted to telemetry bwith Use of antibiotics is not a contraindication for the
complaint of chest pain and has been use of alteplase. All the other answers -- recent
judged to be a possible candidate for abdominal surgery, recent gastrointestinal bleeding
therapy with alteplase (Activase). and a recent intracranial bleed -- are
Which of the following is not contraindications for the use of any fibrinolytic.
considered a contraindication for the
use of this medication?
A. current antibiotic use
B. recent abdominal surgery
C. recent gastrointestinal bleed
D. recent intracranial bleed
, The two major components that A. SVR (afterload) and cardiac output
determine blood pressure are: The equation for BP is: BP = SVR x cardiac output.
A. systemic vascular resistance (SVR) BP is determined by resistance of the arterial bed
(afterload) and cardiac output and the cardiac output. If the SVR (afterload) is high
B. contractility and SVR (afterload) and the cardiac output low, the patient may still
C. preload and SVR (afterload) have a normal BP. the pulse pressure will be lower,
D. contractility and SVR (afterload) but this is a compensatory response by the heart to
maintain BP. If the SVR (afterload) is low (as in early
septic shock), the cardiac output is very high,
thereby trying to support BP.
The layer of the arterial vessel wall A. media
responsible for changes in the The media layer of the arterial wall contains vascular
diameter of the artery is the: smooth muscle cells and is responsible for arterial
A. media tone. Vasoactive substances released in response to
B. intima the sympathetic nervous system and/or the renin-
C. externa angiotensin system determine arterial tone. Intima,
D. adventitia externa and adventitia are incorrect.
A patient presents in acute distress D. pulmonary congestion, low perfusion
with rales halfway up bilaterally; cool Rales indicate fluid in the alveolar sacs, possibly
and clammy extremities; elevated secondary to pulmonary edema, causing pulmonary
jugular venous distention (JVD); congestion. Pneumonia can also cause fluid in the
oxygen saturations at 95%, down from alveolar sacs. The patient is complaining of
99%; and complaints of shortness of shortness of breath, and the oxygen saturations are
breath. Which of the following lowering, also indicating that the patient has
findings correspond to the patient's pulmonary congestion. The patient's skin is cool and
cardiac status? clammy, indicating that the skin is poorly perfused.
A. no pulmonary congestion, normal Skin does not require oxygen and shunts blood
perfusion away in decreased cardiac function; therefore, this
B. no pulmonary congestion, low patient has pulmonary congestion and low
perfusion perfusion state. The other answers are incorrect.
C. pulmonary congestion, normal
perfusion
D. pulmonary congestion, low
perfusion
