PCCN Questions and Answers 2025 Latest

PCCN Questions and Answers 2025 Latest
CoronaryAarteryAperfusionAisAdependentAupon:
A.AdiastolicApressure
B.AsystolicApressure
C.Aafterload
D.AsystemicAvascularAresistanceA(SVR)A-ACORRECTAANSWERS-A.AdiastolicApressure
DiastolicApressureAinAtheAaorticArootAisAhigherAthanAleftAventricularAend-
diastolicApressureA(LVEDP),AtheApressureAexertedAonAtheAventricularAmuscleAatAtheAendAof
AdiastoleAwhenAtheAventricleAisAfull.AThisAenablesAbloodAtoAflowAfromAaAhigherApressureA

throughAopenAarteriesAtoAaAlowerApressure,AaApressureAgradientAknownAasAcoronaryAartery
AprefusionApressure.AAsAdiastolicApressureAdrops,AthereAisAaAdecreaseAinAcoronaryAarteryA

bloodAflow.ACoronaryAarteryAperfusionAisAnotAaffectedAbyAsystolicApressure,AafterloadAorA
SVR,AbutAtheyAallAincreaseAtheAdemandAofAoxygenAinAtheAheart.
AApost-STEMIA(STAelevationAmyocardialAinfarction)ApatientAisAstartedAonAanAangiotensin-
convertingAenzymeA(ACE)AinhibitorAduringAhisAhospitalAstay.AWhichAofAtheAfollowingAisAtheA
mostAcommonAseriousAsideAeffectAthatAmayAoccur?
A.AaAnonproductiveAcough
B.ApedalAedema
C.AswellingAofAtheAtongueAandAface
D.ArhinorrheaA-ACORRECTAANSWERS-C.AswellingAofAtheAtongueAandAface
AlthoughAallAofAtheAanswersAmayAoccur,AswellingAogAtheAtongueAandAfaceAisAtheAmostAseri
ousAandAmayArequireAintervention.APatientsAshouldAbeAinstructedAtoAseekAmedicalAattentio
nAimmediatelyAforAanyAsignsAofAswellingAinAtheAtongueAorAthroat.
WhichAofAtheAfollowingAbestAdescribesAtheAfourthAheartAsoundA(S4):
A.AItAoccursAafterAventricularAcontraction
B.AItAisAbestAheardAwithAtheAdiaphragmAofAtheAstethoscope
C.AItAisAaAnormalAfindingAinAchildren
D.AItAoccursAduringAlateAdiastoleAwhenAtheAatriaAcontractsA-ACORRECTAANSWERS-
D.AItAoccursAduringAlateAdiastoleAwhenAtheAatriaAcontracts
TheApresenceAofAtheAextraAheartAsoundAS4AsignifiesAaApoorlyAcompliantA(stiff)AleftAventricle
.AAnAS4AisAalsoAcalledAanAatrialAheartAsoundAsinceAitAoccursAatAtheAendAofAdiastolicAfillingAw
henAtheAatriaAcontractsAandAfullyAfillsAtheAleftAventricle.AKnownAasA"atrialAkick",AthisAfillingAisA
importantAtoAcardiacAoutput.ATheAincreasedAend-
diastolicAvolumeAinAtheAventricleAimprovesAcardiacAoutput.AWhenAtheAleftAventricleAisAstiffA(
decreasedAcomplianceAwithAlongAtermAhypertension,AaorticAstenosisAorAwithAacuteASTEMI
),AtheAatriumAhasAtoApumpAharderAtoAmoveAbloodAfromAtheAatriumAtoAtheAventricle,AcausingA
aAturbulentAbloodAflowAandAextraAheartAsound.AThisAheartAsoundAisAalwaysApathologic.AItAo
ccursAbeforeAventricularAcontraction,AisAbestAheardAwithAtheAbellAofAtheAstethoscopeAandAis
AneverAaAnormalAheartAsound,AevenAinAchildren.

WhichApathologicAchangesAfoundAonAtheA12-leadAECGAindicateAmyocardialAischemia?
A.AST-segmentAelevation
B.AST-segmentAdepressionAandAT-waveAelevation
C.AQ-waveAformation

,D.AST-segmentAdepressionAandAT-waveAinversionA-ACORRECTAANSWERS-
D.ASTAsegmentAdepressionAandATAwaveAinversion
MyocardialAischemiaAchangesAtheArepolarizationAofAtheAventricularAmuscle.AThatAchangeAi
sAseenAonAtheA12AleadAECGAasAST-
segmentAdepressionAandATAwaveAinversion,AwhichAdemonstrateAsubendocardialAischemia
A--AtheAinnermostAlayerAofAmuscleAinAtheAmyocardium.AST-

segmentAelevationAindicatesAacuteAinjuryAorAinfarction,ASTAsegmentAdepressionAandATAwa
veAelevationAmayAindicateAanAelectrolyteAabnormality,AwhileAQAwaveAformationAindicatesAt
otalAinfarction.
PositiveAinotropicAagentsAareAusedAto:
A.AimproveAcardiacAoutputAandAtissueAperfusion
B.AdecreaseAwaterAlossAthroughAtheAkidneys
C.AincreaseAheartArate
D.AvasodilateAvesselsA-ACORRECTAANSWERS-
A.AimproveAcardiacAoutputAandAtissueAperfusion
TheAtermA"inotropic"ArefersAtoAaffectingAtheAforceAofAmyocardialAcontraction.AImprovement
AofAcardiacAmuscleAcontractionAleadsAtoAimprovedAcardiacAoutputAandAtissueAperfusion.

AApatientAinAtheAEDAisAnowAbeingAadmittedAtoAtelemetryAbwithAcomplaintAofAchestApainAand
AhasAbeenAjudgedAtoAbeAaApossibleAcandidateAforAtherapyAwithAalteplaseA(Activase).AWhic

hAofAtheAfollowingAisAnotAconsideredAaAcontraindicationAforAtheAuseAofAthisAmedication?
A.AcurrentAantibioticAuse
B.ArecentAabdominalAsurgery
C.ArecentAgastrointestinalAbleed
D.ArecentAintracranialAbleedA-ACORRECTAANSWERS-A.AcurrentAantibioticAuse
UseAofAantibioticsAisAnotAaAcontraindicationAforAtheAuseAofAalteplase.AAllAtheAotherAanswersA
--
ArecentAabdominalAsurgery,ArecentAgastrointestinalAbleedingAandAaArecentAintracranialAble

edA--AareAcontraindicationsAforAtheAuseAofAanyAfibrinolytic.
TheAtwoAmajorAcomponentsAthatAdetermineAbloodApressureAare:
A.AsystemicAvascularAresistanceA(SVR)A(afterload)AandAcardiacAoutput
B.AcontractilityAandASVRA(afterload)
C.ApreloadAandASVRA(afterload)
D.AcontractilityAandASVRA(afterload)A-ACORRECTAANSWERS-
A.ASVRA(afterload)AandAcardiacAoutput
TheAequationAforABPAis:ABPA=ASVRAxAcardiacAoutput.
BPAisAdeterminedAbyAresistanceAofAtheAarterialAbedAandAtheAcardiacAoutput.AIfAtheASVRA(aft
erload)AisAhighAandAtheAcardiacAoutputAlow,AtheApatientAmayAstillAhaveAaAnormalABP.AtheApu
lseApressureAwillAbeAlower,AbutAthisAisAaAcompensatoryAresponseAbyAtheAheartAtoAmaintainA
BP.AIfAtheASVRA(afterload)AisAlowA(asAinAearlyAsepticAshock),AtheAcardiacAoutputAisAveryAhig
h,AtherebyAtryingAtoAsupportABP.
TheAlayerAofAtheAarterialAvesselAwallAresponsibleAforAchangesAinAtheAdiameterAofAtheAartery
AisAthe:

A.Amedia
B.Aintima
C.Aexterna
D.AadventitiaA-ACORRECTAANSWERS-A.Amedia

,TheAmediaAlayerAofAtheAarterialAwallAcontainsAvascularAsmoothAmuscleAcellsAandAisArespon
sibleAforAarterialAtone.AVasoactiveAsubstancesAreleasedAinAresponseAtoAtheAsympatheticAn
ervousAsystemAand/orAtheArenin-
angiotensinAsystemAdetermineAarterialAtone.AIntima,AexternaAandAadventitiaAareAincorrect.
AApatientApresentsAinAacuteAdistressAwithAralesAhalfwayAupAbilaterally;AcoolAandAclammyAe
xtremities;AelevatedAjugularAvenousAdistentionA(JVD);AoxygenAsaturationsAatA95%,AdownAfr
omA99%;AandAcomplaintsAofAshortnessAofAbreath.AWhichAofAtheAfollowingAfindingsAcorresp
ondAtoAtheApatient'sAcardiacAstatus?
A.AnoApulmonaryAcongestion,AnormalAperfusion
B.AnoApulmonaryAcongestion,AlowAperfusion
C.ApulmonaryAcongestion,AnormalAperfusion
D.ApulmonaryAcongestion,AlowAperfusionA-ACORRECTAANSWERS-
D.ApulmonaryAcongestion,AlowAperfusion
RalesAindicateAfluidAinAtheAalveolarAsacs,ApossiblyAsecondaryAtoApulmonaryAedema,Acausi
ngApulmonaryAcongestion.APneumoniaAcanAalsoAcauseAfluidAinAtheAalveolarAsacs.ATheApati
entAisAcomplainingAofAshortnessAofAbreath,AandAtheAoxygenAsaturationsAareAlowering,AalsoA
indicatingAthatAtheApatientAhasApulmonaryAcongestion.ATheApatient'sAskinAisAcoolAandAclam
my,AindicatingAthatAtheAskinAisApoorlyAperfused.ASkinAdoesAnotArequireAoxygenAandAshuntsA
bloodAawayAinAdecreasedAcardiacAfunction;Atherefore,AthisApatientAhasApulmonaryAcongest
ionAandAlowAperfusionAstate.ATheAotherAanswersAareAincorrect.
WhenAlisteningAtoAheartAsounds,AS1AsignifiesAwhichAofAtheAfollowing?
A.AtheAbeginningAofAventricularAsystole
B.AtheAbeginningAofAventricularAdiastole
C.AtheApropulsionAofAbloodAintoAaAnon-compliantAventricle
D.AtheAbloodAgoingAinAtheAwrongAdirectionA-ACORRECTAANSWERS-
A.AtheAbeginningAofAventricularAsystole
TheAheartAsoundAofAS1AindicatesAtheAopeningAofAtheAaorticAandApulmonicAvalvesAandAmark
sAtheAbeginningAofAventricularAsystoleAorAejection.ATheAbeginningAofAdiastoleAisAafterAS2,Ap
ropulsionAofAbloodAintoAaAnoncompliantAchamberAisAS4,AandAbloodAgoingAinAtheAwrongAdire
ctionAwillAcauseAaAmurmur.
AApatientAwithApulmonaryAedemaAhasAimpairedAdiffusionAdueAto:
A.AincreasedAthicknessAofAtheAalveolarAcapillaryAmembrane
B.AretainingACO2
C.AanAelevatedAbodyAtemperatureAassociatedAwithApulmonaryAedema
D.AlowAbarometricApressureA-ACORRECTAANSWERS-
A.AincreasedAthicknessAofAtheAalveolarAcapillaryAmembrane
WithAincreasingAleftAventricularApressures,AbloodAmovesAbackAintoAtheAleftAatrium,AthenAtoA
theApulmonaryAveins.AWhenAtheApressureAinAtheApulmonaryAveinsAincreases,AcapillaryAfun
ctionAdecreases,AandAfluidAthenAshiftsAtoAtheAinterstitialAspace,AcausingAinterstitialAedema,A
thereby,AincreasingAtheAthicknessAofAtheAspaceAoxygenAmustAtravel.AWhenAleftAventricularA
pressuresAincrease,AtheAfluidAthenAshiftsAtoAtheAalveolarAspace,AcausingApulmonaryAedem
a.AThisAfluidAactsAasAaAdeterrentAtoAoxygenAdiffusion.ARetentionAofACO2AdoesAnotAimpairAdi
ffusion.AAnAelevatedAbodyAtemperatureAassociatedAwithApulmonaryAedemaAisAnotAcausingA
aAdiffusionAabnormality;AincreasedAtemperatureAshiftsAtheAoxyhemoglobinAcurveAtoAtheArig
ht,AmoreAquicklyAreleasingAoxygenAtoAtheAtissues.ALowAbarometricApressureAhasAnoAeffectA
onAdiffusionAofAgasesAinAtheAlung.

, AApatientAwithAanAanterior-
wallASTEMIAisAinAcardiogenicAshock.AWhatAwouldAbeAtheAhemodynamicAprofileAassessme
nt?
A.AdecreasedAcardiacAindex,AincreasedApreload,AincreasedAafterload
B.AdecreasedAcardiacAindex,AdecreasedApreload,AincreasedAafterload
C.AdecreasedAcardiacAindex,AdecreasedApreload,AdecreasedAafterload
D.AincreasedAcardiacAindex,AdecreasedApreload,AdecreasedAafterloadA-
ACORRECTAANSWERS-

A.AdecreasedAcardiacAindex,AincreasedApreload,AincreasedAafterload
InAaApatientAwithAcardiogenicAshock,AbothApreloadAandAafterloadAareAincreasedAdueAtoAsev
ereAvasoconstrictionAonAbothAtheAvenousAandAarterialAside.AArterialAvasoconstrictionAincre
asesAafterloadAandAthereforeAlowersAcardiacAindex.ABecauseAtheAventricleAisAfailingAandAc
ontractilityAisAalsoAlow,AtheAleftAventricularApressuresAincreaseAandAcauseAbloodAtoAincreas
eAinAtheApulmonaryAbed,AresultingAinAincreasedArightAventricularApressuresAandApreload.AIn
AheartAfailure,AthereAisAanAincreaseAinApreloadAandAafterloadAwithAaAdecreaseAinAcardiacAin

dexAandAcontractility.ATheAotherAanswersAareAincorrect.
AApatientAisAdischargedAwithAtheAdiagnosisAofAsevereAperipheralAvascularAdiseaseA(PVD).A
InAadditionAtoAmedicationAandAaAwalkingAregime,AifAapplicable,AwhichAofAtheAfollowingAisAes
sentialAeducationAatAtimeAofAdischarge?
A.AnutritionalAcounseling
B.AsmokingAcessationAcounseling
C.AsocialAworkAconsult
D.AspeechAtherapyAconsultA-ACORRECTAANSWERS-B.AsmokingAcessationAcounseling
CessationAofAtobaccoAuseAisAtheAmostAimportantAnon-
pharmacologicalAinterventionAthatAcanAbeAdoneAtoAimproveAsignsAandAsymptomsAofAperiph
eralAbvascularAdisease.ASocialAworkAconsultAandAspeechAtherapyAmayAnotAbeAindicatedAinA
thisApatient.AAllApatientsAmayAbenefitAfromAnutritionAcounseling;Ahowever,AthisAisAnotAaApri
maryAconcernAforAthisApatient.
AAmedicationAthatAdilatesAbothAtheAvenousAandAarterialAbedsAwillAcauseAwhichAofAtheAfollo
wingAresults?
A.AincreasedApreload,AdecreasedAafterload
B.AincreasedApreload,AincreasedAafterload
C.AdecreasedApreload,AdecreasedAafterload
D.AdecreasedApreload,AincreasedAafterloadA-ACORRECTAANSWERS-
C.AdecreasedApreload,AdecreasedAafterload
WhenAbothAtheAvenousAandAarterialAbedsAareAdilated,AthereAwillAbeAlessAvenousAreturn,Aca
usingAaAdecreasedApreloadA(ex.Anitroglycerin).AWithAarterialAvasodilation,AtheAafterloadAwill
AdecreaseA(exAnitroprusside,AACE-I).AAfterloadAinAthisAcaseAisAresistantAtoALVApumping.

StableAanginaAisAbestAdefinedAas:
A.ApainAthatAincreasesAinAseverity
B.ApainAthatAisAnew
C.ApainAthatAoccursAatArest
D.ApainAthatAhasAaApredictableApatternAoverAtimeA-ACORRECTAANSWERS-
D.ApainAthatAhasAaApredictableApatternAoverAtime
StableAanginaAisApredictableA--
AtheApatientAcanAdescribeAtheApainAandAhowAitAisAinitiatedAaccuratelyAeachAtimeA--