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Exam (elaborations)

PCCN REVIEW PULMONARY EXAM QUESTIONS AND VERIFIED ANSWERS

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PCCN REVIEW PULMONARY EXAM QUESTIONS AND VERIFIED ANSWERS

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Uploaded on
December 18, 2025
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Written in
2025/2026
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The oxyhemoglobin dissociation curve may be shifted to the right by:


-Alkalosis, hyperthemia, hypercapnia
-Acidosis, hypercarbia, hyperthermia
-Acidosis, hypocarbia, hypothermia
-Alkalosis, hypothermia, hypercapnia


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Acidosis, hypercarbia, hyperthermia


These will all lead to a right shift in the oxyhemoglobin dissociation curve.
Hemoglobin has a decreased affinity for oxygen and enhances tissue
uptake of oxygen.




Carbon monoxide has an affinity for hemoglobin throught to be 200-300 times
greater than that of oxygen. Elimination of carbon monoxide occurs via the:

,-Kidneys
-Liver
-Spleen
-Lungs


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Lungs

In cases of severe carbon monoxide poisoning, hyperbaric therapy must
be utilized to force the molecure off the hemoglobin. The CO is then
eliminated by the lungs.




Your patient's blood gas results indicate uncompensated metabolic acidosis. A
probable cause for this would be:


-Anxiety
-Nasogastric suction
-Neuromuscular disorder
-Diabetic ketoacidosis


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Diabetic ketoacidosis

A build up of ketones results from imparied glucose utilization.

Additional causes of metabolic acidosis include diarrhea, renal failure,
methanol poisoning, aspirin overdose, and lactic acidosis.

Nasogastric suction removes chloride and causes metabolic alkalosis.




The cardianal sign of respiratory failure includes all of the following except:

,-Tachypnea
-Diaphoresis
-Restlessness
-Headache


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Headache

Headaches may be caused by multiple factors, but are not a cardinal sign
of respiratory failure. Patients will exhibit tachypnea, diaphoresis, and
restlessness as the body attempts to compensate for the respiratory
distress and then exhibit signs of oxygen deprivation and starvation.




Your patient has been diagnosed with pulmonary HTN. Which of the following
compensatory mechanisms would be expected if the patient suffered from chronic
hypoxia?


-Polycythemia
-Hypoplasia of the pulmonary vasculature
-Thinning of blood vessels in the lungs
-Cor pulmonale


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, Polycythemia

Effects of acute hypoxia are reversible.
Chronic hypoxia causes permanent changes in the lungs and pulmonary
vasculature (hyperplasia and hypertrophy). This will cause thickening of the
blood vessels and will narrow the lumen.
Polycythemia develops and the blood viscosity increases. The increased
number of cells will be available to carry O2 but the increased viscosity will
increase pressure in the pulmonary vasculature and force the right ventricle
to pump harder to maintain the CO level. The right venticle will
hypertrophy and eventually weaken, and the patient will develop right
heart failure (cor pulmonale).




Bernard lost his home to a fire this morning. He was burned on the chest and neck
while trying to put out the fire. He is dyspneic and has soot on his face, and his
eyebrows and nares are singed. The priority during treatment is to:


-Maintain cardiac output
-Maintain airway patency
-Treat burned areas
-Obtain ABGs and a carboxyhemoglobin level


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Maintain airway patency

Airway patency is always a priority. Bernard probably inhaled superheated
air and toxins. Most of the products found in a home will give off carbon
monoxide when burned. These toxins, plus the CO may cause edema of the
air passages




Ben was just transferred to the PCU. He had been in ICU for 2 weeks. Ben was
intubated for a time because of his ARDs. On arrival to your unit, you note that he is
tachycardic and restless. Ben is finally released from the hospital. He plans to visit his

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