PCCN EXAM MASTER QUESTIONS AND ACTUAL ANSWERS ALL APPROVED 2024

PCCN EXAM MASTER QUESTIONS AND
ACTUAL ANSWERS ALL APPROVED 2024
1. -Cardiac -- -CORRECT -ANSWER-1. -Cardiac



Pt's -EKG -shows -ST -elevation -in -leads -II, -III, -and -aVF. -Where -is -the -MI? -- -CORRECT -ANSWER-
Inferior -wall -MI, -Right -coronary -artery



"Reciprocal -changes -are -often -seen -ini -leads -I -and -aVL"



Pt's -EKG -shows -ST -elevation -in -leads -V1 -and -V2. -Where -is -the -MI? -- -CORRECT -ANSWER-Septal
-area, -Left -Anterior -Descending -Artery



Pt's -EKG -shows -ST -elevation -in -leads -V3 -and -V4. -Where -is -the -MI? -- -CORRECT -ANSWER-
Anterior -area



Pt -has -ST -elevation -in -leads -V1-V4. -Which -coronary -artery -is -occluded? -- -CORRECT -ANSWER-
Left -Anterior -Descending -Artery



EKG -shows: -ST -segment -ELEVATION. -

What -does -this -indicate? -- -CORRECT -ANSWER-MI -or -INFARCTION



EKG -shows: -ST -segment -DEPRESSION. -

What -does -this -indicate? -- -CORRECT -ANSWER-Myocardial -ISCHEMIA



A -sign -of -necrosis -on -an -EKG -would -include: -- -CORRECT -ANSWER-Acute -ST -elevation. -abnormal
-Q -wave.



Along -with -acute -ST -elevation, -another -indicator -of -necrosis -would -be -an -abnormal -Q -wave. -If
-the -Q -wave -appears -within -about -6 -hours -of -a -transmural -MI, -it -is -an -ominous -sign. -If -the -

,Q -wave -is -more -than -0.04 -seconds -long, -it -is -a -sign -of -necrosis. -In -an -inferior -MI, -the -Q -
wave -should -not -exceed -0.03 -seconds -or -it -is -indicative -of -necrosis.



EKG -shows: -Tall -peaked -T -waves -and -wide -QRS -

What -does -this -indicate? -- -CORRECT -ANSWER-hyperkalemia



EKG -shows: -Prominent -U -wave -and -flat -T -wave -

What -does -this -indicate? -- -CORRECT -ANSWER-hypokalemia



EKG -shows: -PR -interval ->.2

What -does -this -indicate? -- -CORRECT -ANSWER-1st -degree -AV -block



EKG -shows: -Progressive -prolongation -of -PR -interval -until -QRS -complex -is -dropped

What -does -this -indicate? -- -CORRECT -ANSWER-Second -degree -AV -block -type -1 -or -Mobitz -(type -
I)



Difference -between -2nd -degree -AV -block -type -I -vs -II -- -CORRECT -ANSWER-2nd -degree -AV -block
-type -I: -PR -interval -progressively -lengthens -

Mnemonic: -(couple -is -progressively -ignoring -each -other)



2nd -degree -AV -block -type -II: -PR -interval -remains -constant -but -there -is -a -drop -QRS -complex -
here -and -there



Mnemonic: -(couple -acts -fine -then -one -day, -one -partner -doesn't -come -home)



EKG -shows: -No -association -with -P -wave -and -QRS -complexes

What -does -this -indicate? -- -CORRECT -ANSWER-3rd -degree -AV -block -aka -complete -heart -block

MEDICAL -EMERGENCY



Mnemonic: -(couple -is -divorced, -not -talking -to -each -other)

,Pt -with -2nd -degree -AV -block -type -II -with -5s -pauses -will -need... -- -CORRECT -ANSWER-emergent
-pacing -bc -these -long -pauses -can -cause -inadequate -perfusion -and -may -lead -to -cardiac -arrest.



How -do -you -tx -atrial -fibrillation? -- -CORRECT -ANSWER-3 -principles:



1. -Rate -control -(B-blockers -/ -non -DHP -Ca2+ -CB

2. -Rhythm -control -(anti -arrhythmic)

3. -Stroke -prevention -(Warfarin)



**If -patient -is -hemodynamically -unstable ---> -direct -cardioversion -with -100 -joules



Which -arrhythmia -is -commonly -associated -with -left-sided -heart -failure? -- -CORRECT -ANSWER-
Atrial -Fibrillation -bc -blood -is -not -moving -d/t -left -ventricular -hypertrophy



Sometimes -certain -medications -prolong -the -QT -interval, -potentially -causing -polymorphic -
ventricular -tachycardia. -The -drug -of -choice -to -treat -this -rhythm -is? -- -CORRECT -ANSWER-
MAGNESIUM



Magnesium -acts -on -the -processes -by -which -calcium -is -transferred -both -across -the -cell -
membrane -and -within -the -cell -itself. -If -high -doses -of -Magnesium -are -given, -it -may -slow -AV -
conduction



The -QT -interval -may -be -prolonged -by -use -of -tricyclic -antidepressants, -erythromycin -(ABX), -
quinidine -(antiarrhythmic) -or -terfenidine -(antihistamine).



Preload -vs -Afterload -- -CORRECT -ANSWER-Preload: -is -pressure -at -end -of -diastole -aka -filling -of -
heart



Afterload: -the -resistance -needed -to -pump -blood -out -of -heart -aka -systole



What -does -an -S3 -sound -indicate? -

, S4?

Split -S1 -- -CORRECT -ANSWER-S3 -indicates -volume -overload -aka -heart -failure



S4 -indicates -ventricular -hypertrophy -aka -decreased -compliance. -When -ventricles -thicken, -it -is -
harder -to -fill -adequately, -the -atria -eject -more -forcefully -causing -an -S4 -sound. -



Split -S1 -indicates -a -BBB -(bundle -branch -block) -or -PVCs



Where -is -murmur -heard -in -pt -with:

Aortic -stenosis

Mitral -Stenosis

Aortic -Regurgitation -

Mitral -Regurgitation -- -CORRECT -ANSWER-Aortic -stenosis: -Systole

Mitral -Stenosis: -Diastole

Aortic -Regurgitation: -Diastole

Mitral -Regurgitation: -Systole



Mneminic: -A -for -Systolic -(bc -first)

"Regurgitations" -are -opposite -of -stenosis



When -pt -has -acute -mitral -valve -regurgitation, -they -will -have -increased -pressure -in -what -area -
of -the -heart? -- -CORRECT -ANSWER-Increased -in -left -atrial -diastolic -pressure -bc -blood -is -flowing
-back -from -the -valve.



How -does -chronic -aortic -stenosis -lead -to -left -ventricular -hypertrophy? -- -CORRECT -ANSWER-
Chronic -aortic -stenosis -leads -to -left -ventricular -hypertrophy -bc -of -increased -workload -of -
pumping -blood -through -a -narrow -opening. -The -left -atrium -can -also -enlarge -but -mainly -causes -
left -ventricular -hypertrophy. -The -right -ventricle -will -remain -normal -for -a -period -of -time. -That's
-why -LHF -happens -first -then -leads -to -RHF.



Chronic -mitral -stenosis -will -cause -enlargement -in -which -area? -- -CORRECT -ANSWER-Left -atria -
hypertrophy. -