PCCN questions with Explained Answers

Two days following a near-drowning ac- cident, a pt is dyspneic, using accessory muscles, expectorating large amounts of secretions and reporting feeling of im- pending death. Changes to the assess- ment data include RR- 24 TO 36 CXR clear to bilateral diffuse infiltrates ABG 40% face mask or 100% non-re- breather mask pO2 120 mm Hg to 56 mm Hg pCO2 33 mmHg to 56 mmHg pH 7.42 to 7.35 HCO3 24 meq/L to 27 mEq/L Which of the ff do these changes most likely represent A. aspiration pneumonia B. pulmonary embolism C. interstitial pneumonitis D.ARDS A pt reports chest pain that is sharp, con- stant, worse when lying down and allevi- ated with sitting up and leaning forward. The most likely cause of these findings is A. ACS B. pericarditis C. PE D.AAA A pt tells a nurse, "I don't know how I'm going to pay for this hospitalization." The nurse should A. arrange a meeting with hospital social services staff B. Notify the business office so a pay- ment plan can be designed C.redirect the pt toward meeting psycho￾D.The onset of symptoms occured within 48 hours of the incident. THe bilateral diffuse infiltrates and ABG results indi- cating hypoxemia and CO2 retention are all consistent with ARDS. Aspiration pneumonia should include hypoxxemia, respiratory alkalosis. The CXR results would reveal an area of opacity with aspiration pneumonia rather than diffuse infiltrates. Interstitial lung disease invlolves an in￾flammation of supportive tissue between the air sacs rather than inflammation in the air sacs themselves. Symptoms would be SOB and a dry cough. B Pericarditis is inflammation of the peri- cardial sac. The damaged epicardium becomes rough and inflamed and irri￾tates the pericardium lying adjacent to it, precipitating pericarditis.Pain is the most common symptom of pericarditis. THe pain is sharp, constant and is alleviated when sitting up and leaning forward. A. Collaboration with a social worker is indicated in this case the social worker can assist the pt in identifying ways to address the financial implications of this hospitalization and help identify methods of payments. PCCN questions 2 / 40 logic needs D. give the pt applications for public as- sistance medical coverage