PCCN EXAM 2024/2025 WITH 100%
ACCURATE SOLUTIONS
Pt on Vtach, HR 135, RR 32, BP 90/48, conscious but c/o dizziness,
recent K+ lvl is 3.4. What action would you do first?
a. emergent defib
b. amio 300mg IVP
c. emergent cardioversion
d. hang 10 mEq KCL/50mL D5W - Precise Answer ✔✔C
The nurse notes the following when analyzing a patient's telemetry strip:
HR, 65/min and regular; PR interval, 0.22 seconds; QRS complex, 0.10
seconds; QTc, 0.52 seconds. Which of the following dysrhythmias is the
patient at risk for?
A. Atrial fibrillation because the PR interval is wide
B. Sinus arrhythmia because the QRS complex is narrow
C. Torsades de pointes because the QTc is wide
D. Third-degree heart block because the PR interval is narrow - Precise
Answer ✔✔C.
QT measurements reflect the duration of ventricular repolarization.
Lengthening of QT interval is associated with arrhythmias, adverse
cardiac events, and increased mortality because a longer QT duration
,places the vulnerable ventricular repolarization phase close to the next
depolarization, increasing the likelihood of R-on-T. The most common
arrhythmia that occurs with prolonged QTc is torsades de pointes. Atrial
fibrillation, sinus bradycardia, and third-degree heart block are not
typically associated with prolonged ventricular repolarization (QTc
>0.50 seconds).
A patient with chronic obstructive pulmonary disease (COPD) is
admitted for worsening dyspnea and possible pneumonia. The current
ABG results are pH, 7.19; PaO2, 52 mm Hg; PaCO2, 68 mm Hg; HCO3
- , 32 mmol/L. The nurse would interpret these results as
A. Metabolic acidosis with hypoxemia
B. Respiratory acidosis with hypoxemia
C. Respiratory alkalosis with typical oxygenation for a COPD patient
D. Metabolic alkalosis with typical oxygenation for a COPD patient -
Precise Answer ✔✔B.
Based on the ABG analysis, the patient is experiencing a respiratory
acidosis with hypoxemia most likely due to the pneumonia. A pH of
7.19 indicates acidosis; a PaCO2 of 68 mm Hg is elevated and a cause of
acidosis; an HCO3 - of 32 mmol/L indicates renal compensation; a PaO2
of 52 mm Hg indicates hypoxemia
76-year-old patient is receiving gentamicin and linezolid for an
infection. Which of the following potential complications is the most
important for the nurse to monitor this patient for?
A. Acute delirium
, B. Acute kidney injury
C. Acute hepatic failure
D. Sepsis - Precise Answer ✔✔B.
Gentamicin is a nephrotoxic agent that places patients at risk for acute
kidney injury, and this risk is increased in older patients. Acute delirium
(A), liver failure (C), and sepsis (D) are all complications that could
occur in an older adult with an infection but would not be caused by the
administration of an antibiotic.
An older patient is experiencing delirium 24 hours following hip
replacement. Which intervention might worsen the patient's condition?
A. Removing any unnecessary tubes and equipment from the room
B. Assessing and treating the patient's pain every 2 hours
C. Ensuring that the patient has the means to call for help
D. Loosely applying soft restraints - Precise Answer ✔✔D.
Older patients are at increased risk for delirium during acute
hospitalization. Interventions to manage acute delirium include
removing or camouflaging tubes, removing unnecessary equipment,
frequently reorienting the patient, and ensuring that the call bell is
consistently within reach, assessing and treating pain effectively, and
encouraging mobility and involvement in activities of daily living.
Restraining the patient is contraindicated in the care of patients with
delirium.
ACCURATE SOLUTIONS
Pt on Vtach, HR 135, RR 32, BP 90/48, conscious but c/o dizziness,
recent K+ lvl is 3.4. What action would you do first?
a. emergent defib
b. amio 300mg IVP
c. emergent cardioversion
d. hang 10 mEq KCL/50mL D5W - Precise Answer ✔✔C
The nurse notes the following when analyzing a patient's telemetry strip:
HR, 65/min and regular; PR interval, 0.22 seconds; QRS complex, 0.10
seconds; QTc, 0.52 seconds. Which of the following dysrhythmias is the
patient at risk for?
A. Atrial fibrillation because the PR interval is wide
B. Sinus arrhythmia because the QRS complex is narrow
C. Torsades de pointes because the QTc is wide
D. Third-degree heart block because the PR interval is narrow - Precise
Answer ✔✔C.
QT measurements reflect the duration of ventricular repolarization.
Lengthening of QT interval is associated with arrhythmias, adverse
cardiac events, and increased mortality because a longer QT duration
,places the vulnerable ventricular repolarization phase close to the next
depolarization, increasing the likelihood of R-on-T. The most common
arrhythmia that occurs with prolonged QTc is torsades de pointes. Atrial
fibrillation, sinus bradycardia, and third-degree heart block are not
typically associated with prolonged ventricular repolarization (QTc
>0.50 seconds).
A patient with chronic obstructive pulmonary disease (COPD) is
admitted for worsening dyspnea and possible pneumonia. The current
ABG results are pH, 7.19; PaO2, 52 mm Hg; PaCO2, 68 mm Hg; HCO3
- , 32 mmol/L. The nurse would interpret these results as
A. Metabolic acidosis with hypoxemia
B. Respiratory acidosis with hypoxemia
C. Respiratory alkalosis with typical oxygenation for a COPD patient
D. Metabolic alkalosis with typical oxygenation for a COPD patient -
Precise Answer ✔✔B.
Based on the ABG analysis, the patient is experiencing a respiratory
acidosis with hypoxemia most likely due to the pneumonia. A pH of
7.19 indicates acidosis; a PaCO2 of 68 mm Hg is elevated and a cause of
acidosis; an HCO3 - of 32 mmol/L indicates renal compensation; a PaO2
of 52 mm Hg indicates hypoxemia
76-year-old patient is receiving gentamicin and linezolid for an
infection. Which of the following potential complications is the most
important for the nurse to monitor this patient for?
A. Acute delirium
, B. Acute kidney injury
C. Acute hepatic failure
D. Sepsis - Precise Answer ✔✔B.
Gentamicin is a nephrotoxic agent that places patients at risk for acute
kidney injury, and this risk is increased in older patients. Acute delirium
(A), liver failure (C), and sepsis (D) are all complications that could
occur in an older adult with an infection but would not be caused by the
administration of an antibiotic.
An older patient is experiencing delirium 24 hours following hip
replacement. Which intervention might worsen the patient's condition?
A. Removing any unnecessary tubes and equipment from the room
B. Assessing and treating the patient's pain every 2 hours
C. Ensuring that the patient has the means to call for help
D. Loosely applying soft restraints - Precise Answer ✔✔D.
Older patients are at increased risk for delirium during acute
hospitalization. Interventions to manage acute delirium include
removing or camouflaging tubes, removing unnecessary equipment,
frequently reorienting the patient, and ensuring that the call bell is
consistently within reach, assessing and treating pain effectively, and
encouraging mobility and involvement in activities of daily living.
Restraining the patient is contraindicated in the care of patients with
delirium.
