NEWEST PCCN EXAM / 2024 PCCN ACTUAL EXAM WITH
REAL QUESTIONS AND WELL ELABORATED ANSWERS
(100% CORRECT VERIFIED ANSWERS) A NEW UPDATED
VERSION |GUARANTEED SUCCESS
ScvO2 - ANSWER: saturation of central venous O2
blood sample from a central line
goal >70%
inferior MI 12 lead ekg changes - ANSWER: ST elevation in leads II, III, aVF
reciprocal ST depression changes in I and aVL
RCA affected in 65%, L circumflex in others
right ventricular infarction 12 lead ekg changes - ANSWER: V1, V2R-V4R
proximal RCA and inferior wall MI
R vent infarction s and s/ tx - ANSWER: tachycardia
hypotension
JVD
R sided echo will show blood backing up in the R side of the heart, poor forward flow
to the L side of the heart
tx: fluids ( preload dependent), + inotrope- dobutamine, avoid meds that lower
preload- nitrates, morphine, beta blockers, diurectics
R side of the heart is stunned with poor wall movement
inferior wall MI s and s/ tx - ANSWER: bradycardia- if symptomatic us atropine
high grade AV heart block (maybe temp perm)
Second dree type 1
hypotension
n/v
diaphoresis
monitor for s and s of R vent infarction
septal wall Mi ekg changes - ANSWER: ST elevation change in V1-V2
reciprocal ST depression changes in leads II,III,aVF
LAD affected
anterior wall MI ekg changes - ANSWER: ST elevation in lead V2-V4
st depression in leads II, III, aVF
artery affected: LAD/ L main
Anterior and septal wall MI s and s - ANSWER: L vent failure: s3 and s4 heart sounds
shock
2nd degree type 2, third degree
prepare to pace!
,bundle branch block
new loud murmur= suspect ventricular septal rupture or papillary musc rupture= get
an echo!
lateral wall Mi ekg changes - ANSWER: ST elevation in leads I, aVL, V5-V6
no reciprocal changes
L circumflex and LAD affected
can be associates with other MI locations (inferior and anterior)
posterior wall MI ekg changes - ANSWER: St elevation in posterior leads V7-V9
St depression in leads V1-V2
RCA affected in 90%, L circumflex 10%
Tall upright R waves in V1-V2
associated with inferior or lateral wall MI
LAD perfuses - ANSWER: septum and L anterior wall
RCA perfuses - ANSWER: the inferior wall, r vent, r atrium
posterior wall in 90% of ppl
L circumflex perfuses - ANSWER: the posterior wall in 10% of people, L lateral wall of
the L vent
normal ph levels - ANSWER: 7.35-7.45
norm PaO2 - ANSWER: 80-100
norm PaCO2 - ANSWER: 35-45
norm HCO3 - ANSWER: 22-26
norm base deficit - ANSWER: -2 to +2
SaO2 - ANSWER: 95-100%
normal urine specific gravity - ANSWER: 1.010-1.02
normal urine osmolarity - ANSWER: 500-850 mOsm/ kg
normal urine Na - ANSWER: 40-100
normal BUN/Cr ratio - ANSWER: 10:1-15:1
norm mg - ANSWER: 1.5-2.5
norm K - ANSWER: 3.5-5
, norm Na - ANSWER: 135-145
hypernatremia causes - ANSWER: Dehydration
Excess administration of NaCl or NaHCO3
Hypertonic enteral feedings
hypernatremia s and s - ANSWER: Thirst
Tachycardia
Hypotension
Restlessness
Irritable
Lethargy
Muscle weakness
Flushed skin
Oliguria (with dehydration)
May also see increased hematocrit (hemo-concentrated)
Increased chloride
Often >106 increased serum osmolarity
Increase urine specific gravity d/t concentrated urine in dehydration
Often > 1.025
Decreased urine Na
May also see inc in absence of dehydration
hypernatrmia tx - ANSWER: Fluid hydrations
Free H20
Diuretics
To remove sodium if appropriate for cause
Do not use if dehydrated!!!
hyponatremia causes - ANSWER: Excess h20 or Na depletion
Water retention dehydration
NG tube suction
SIADH
Dilutional hyponatremia
Intestinal surgery
DKA
hyponatremia s and s - ANSWER: Neuro changes
Headache
Confusion
Coma
Death
Anxiety
Weakness
Abdominal cramping
Seizures
Hypotension
REAL QUESTIONS AND WELL ELABORATED ANSWERS
(100% CORRECT VERIFIED ANSWERS) A NEW UPDATED
VERSION |GUARANTEED SUCCESS
ScvO2 - ANSWER: saturation of central venous O2
blood sample from a central line
goal >70%
inferior MI 12 lead ekg changes - ANSWER: ST elevation in leads II, III, aVF
reciprocal ST depression changes in I and aVL
RCA affected in 65%, L circumflex in others
right ventricular infarction 12 lead ekg changes - ANSWER: V1, V2R-V4R
proximal RCA and inferior wall MI
R vent infarction s and s/ tx - ANSWER: tachycardia
hypotension
JVD
R sided echo will show blood backing up in the R side of the heart, poor forward flow
to the L side of the heart
tx: fluids ( preload dependent), + inotrope- dobutamine, avoid meds that lower
preload- nitrates, morphine, beta blockers, diurectics
R side of the heart is stunned with poor wall movement
inferior wall MI s and s/ tx - ANSWER: bradycardia- if symptomatic us atropine
high grade AV heart block (maybe temp perm)
Second dree type 1
hypotension
n/v
diaphoresis
monitor for s and s of R vent infarction
septal wall Mi ekg changes - ANSWER: ST elevation change in V1-V2
reciprocal ST depression changes in leads II,III,aVF
LAD affected
anterior wall MI ekg changes - ANSWER: ST elevation in lead V2-V4
st depression in leads II, III, aVF
artery affected: LAD/ L main
Anterior and septal wall MI s and s - ANSWER: L vent failure: s3 and s4 heart sounds
shock
2nd degree type 2, third degree
prepare to pace!
,bundle branch block
new loud murmur= suspect ventricular septal rupture or papillary musc rupture= get
an echo!
lateral wall Mi ekg changes - ANSWER: ST elevation in leads I, aVL, V5-V6
no reciprocal changes
L circumflex and LAD affected
can be associates with other MI locations (inferior and anterior)
posterior wall MI ekg changes - ANSWER: St elevation in posterior leads V7-V9
St depression in leads V1-V2
RCA affected in 90%, L circumflex 10%
Tall upright R waves in V1-V2
associated with inferior or lateral wall MI
LAD perfuses - ANSWER: septum and L anterior wall
RCA perfuses - ANSWER: the inferior wall, r vent, r atrium
posterior wall in 90% of ppl
L circumflex perfuses - ANSWER: the posterior wall in 10% of people, L lateral wall of
the L vent
normal ph levels - ANSWER: 7.35-7.45
norm PaO2 - ANSWER: 80-100
norm PaCO2 - ANSWER: 35-45
norm HCO3 - ANSWER: 22-26
norm base deficit - ANSWER: -2 to +2
SaO2 - ANSWER: 95-100%
normal urine specific gravity - ANSWER: 1.010-1.02
normal urine osmolarity - ANSWER: 500-850 mOsm/ kg
normal urine Na - ANSWER: 40-100
normal BUN/Cr ratio - ANSWER: 10:1-15:1
norm mg - ANSWER: 1.5-2.5
norm K - ANSWER: 3.5-5
, norm Na - ANSWER: 135-145
hypernatremia causes - ANSWER: Dehydration
Excess administration of NaCl or NaHCO3
Hypertonic enteral feedings
hypernatremia s and s - ANSWER: Thirst
Tachycardia
Hypotension
Restlessness
Irritable
Lethargy
Muscle weakness
Flushed skin
Oliguria (with dehydration)
May also see increased hematocrit (hemo-concentrated)
Increased chloride
Often >106 increased serum osmolarity
Increase urine specific gravity d/t concentrated urine in dehydration
Often > 1.025
Decreased urine Na
May also see inc in absence of dehydration
hypernatrmia tx - ANSWER: Fluid hydrations
Free H20
Diuretics
To remove sodium if appropriate for cause
Do not use if dehydrated!!!
hyponatremia causes - ANSWER: Excess h20 or Na depletion
Water retention dehydration
NG tube suction
SIADH
Dilutional hyponatremia
Intestinal surgery
DKA
hyponatremia s and s - ANSWER: Neuro changes
Headache
Confusion
Coma
Death
Anxiety
Weakness
Abdominal cramping
Seizures
Hypotension
