More PCCN Practice Qs with
Rationales Exam 2026/2027 Updated
Verified Questions and Solutions A+
Pass Guaranteed
A patient with hypertensive crisis has become increasingly confused and
pulls out the IV. In order to avoid the complication of hypertensive
encephalopathy, the nurse should expect to include monitoring for
A. decreasing pulse pressure MAP.
B. signs of HF.
C. bruising from restraints.
D. hyperglycemia.
- ANS - B. signs of HF.
Patients with hypertensive crisis should be monitored for signs of HF,
widening pulse pressure, and seizures which are all signs of hypertensive
encephalopathy. Restraints should be avoided as they increase
intracranial pressure and BP contributing to worsening hypertensive
crisis.
A patient with mitral stenosis is admitted. Which dysrhythmias should be
of GREATEST concern to the nurse?
A. Wolff-Parkinson-White syndrome
,B. afib
C. torsades de pointes
D. monomorphic vtach
- ANS - B. afib
Mitral stenosis is characterized by a narrowing of the valve orifice and
enlargement of the left atrium due to obstruction of flow into the left
ventricle. The left atrial hypertrophy causes changes in depolarization
and repolarization and increases the risk for atrial fibrillation. The most
common cause of monomorphic vtach (VT) is AMI, not mitral stenosis.
Other causes of monomorphic VT are hypomagnesemia, hypokalemia,
and dilated cardiomyopathy. Wolff-Parkinson-White (WPW) syndrome is
characterized by a short PR interval, delta wave and tachycardia greater
than 200 beats per minute. WPW syndrome is causes by early activation
of the ventricles via an accessory pathway and is not associated with
mitral stenosis. Torsades de pointes is a polymorphic ventricular
tachycardia associated with a long QT interval. It is pause-dependent and
commonly associated with drug-induced QT prolongation, not mitral
stenosis.
A patient with HF is on a diuretic and fluid restriction. The assessment
indicates atrial tachycardia with a rate of 130, presence of crackles in all
lung fields, an S3 at the left apex and BP of 90/40 (previously 130/60).
The patient reports feeling SOB. The nurse should anticipate the
administration of
A. a fluid bolus to enhance preload
B. dopamine (Inotropic) to support BP
C. dobutamine (Dobutrex) to augment CO
,D. adenosine (Adenocard) to reverse the tachcardia
- ANS - C. dobutamine (Dobutrex) to augment CO
In patients w/ decompensated HF, the use of IV inotropic agents such as
dobutamine may be indicated to support cardiac function and cardiac
output. Dobutamine has beta-2 effects (in addition to beta-1) which
results in mild vasodilation. It is especially useful for afterload reduction
in HF patients that cannot tolerate vasodilator therapy. The
administration of a fluid bolus will make the patient's condition worse.
Dopamine does not provide afterload reduction and may worsen the
patient's tachycardia. Adenosine is not indicated as the HR is less than
150 and the goal is to treat the underlying cause of the tachycardia.
A patient with a hx of HF and ACS is admitted following an episode of
syncope. Two hours later, the assessment reveals, shallow breaths and
bilateral clear lung sounds. Data are: BP 134/64 (supine); 90/60 standing;
RR 32; UO 30 mL over past 2 hours. The nurse should anticipate:
A. IV fluids
B. nesiritide (Natrecor)
C. dopamine
D. mannitol
- ANS - A. IV fluids
Although this pt has a hx of HF, data suggest orthostatic hypotension and
hypovolemia which should initially be treated with fluids. While HF may
be of concern, the patient's breath sounds are clear at present. Careful
monitoring of patient tolerance is needed during the administration of a
fluid challenge. Nesiritide is used for short-term tx of decompensated
, CHF. It vasodilates both veins and arteries and increases diuresis and
natriuresis which would worsen orthostasis. The use of an osmotic
diuretic is not indicated and may cause further hypovolemia. Dopamine
augments CO by improving contractility and tissue perfusion. It will
increase BP but the patient's underlying hypovolemia needs to be
corrected first.
A patient who was admitted with uncontrolled HTN is scheduled for
discharge. Which education is a PRIORITY for the nurse during discharge
instructions?
A. relaxation and stress management techniques
B. multidrug regimens and consequences if not followed
C. BP monitoring along with alcohol and caffeine changes
D. lifestyle modifications for cessation of vaping, dietary and exercise
adjustments
- ANS - B. multidrug regimens and consequences if not followed
Multidrug regimens with two or three medications of different drug
classes are almost always required to achieve recommended BP goals.
Insufficient time for patient engagement as well as multidrug burden,
prescription drug costs, and medication side effects are primary
contributors to medication noncompliance. The primary prevention of
hypertension requires large-scale societal changes, including further
efforts to influence the food industry to reduce salt in processed foods,
efforts to increase exercise, and availability of fresh fruits and
vegetables. After a person's BP rises to hypertensive or even pre-
hypertensive levels, lifestyle modification alone is almost never enough
to return it to normal, and recidivism is typical. Lifestyle modifications
Rationales Exam 2026/2027 Updated
Verified Questions and Solutions A+
Pass Guaranteed
A patient with hypertensive crisis has become increasingly confused and
pulls out the IV. In order to avoid the complication of hypertensive
encephalopathy, the nurse should expect to include monitoring for
A. decreasing pulse pressure MAP.
B. signs of HF.
C. bruising from restraints.
D. hyperglycemia.
- ANS - B. signs of HF.
Patients with hypertensive crisis should be monitored for signs of HF,
widening pulse pressure, and seizures which are all signs of hypertensive
encephalopathy. Restraints should be avoided as they increase
intracranial pressure and BP contributing to worsening hypertensive
crisis.
A patient with mitral stenosis is admitted. Which dysrhythmias should be
of GREATEST concern to the nurse?
A. Wolff-Parkinson-White syndrome
,B. afib
C. torsades de pointes
D. monomorphic vtach
- ANS - B. afib
Mitral stenosis is characterized by a narrowing of the valve orifice and
enlargement of the left atrium due to obstruction of flow into the left
ventricle. The left atrial hypertrophy causes changes in depolarization
and repolarization and increases the risk for atrial fibrillation. The most
common cause of monomorphic vtach (VT) is AMI, not mitral stenosis.
Other causes of monomorphic VT are hypomagnesemia, hypokalemia,
and dilated cardiomyopathy. Wolff-Parkinson-White (WPW) syndrome is
characterized by a short PR interval, delta wave and tachycardia greater
than 200 beats per minute. WPW syndrome is causes by early activation
of the ventricles via an accessory pathway and is not associated with
mitral stenosis. Torsades de pointes is a polymorphic ventricular
tachycardia associated with a long QT interval. It is pause-dependent and
commonly associated with drug-induced QT prolongation, not mitral
stenosis.
A patient with HF is on a diuretic and fluid restriction. The assessment
indicates atrial tachycardia with a rate of 130, presence of crackles in all
lung fields, an S3 at the left apex and BP of 90/40 (previously 130/60).
The patient reports feeling SOB. The nurse should anticipate the
administration of
A. a fluid bolus to enhance preload
B. dopamine (Inotropic) to support BP
C. dobutamine (Dobutrex) to augment CO
,D. adenosine (Adenocard) to reverse the tachcardia
- ANS - C. dobutamine (Dobutrex) to augment CO
In patients w/ decompensated HF, the use of IV inotropic agents such as
dobutamine may be indicated to support cardiac function and cardiac
output. Dobutamine has beta-2 effects (in addition to beta-1) which
results in mild vasodilation. It is especially useful for afterload reduction
in HF patients that cannot tolerate vasodilator therapy. The
administration of a fluid bolus will make the patient's condition worse.
Dopamine does not provide afterload reduction and may worsen the
patient's tachycardia. Adenosine is not indicated as the HR is less than
150 and the goal is to treat the underlying cause of the tachycardia.
A patient with a hx of HF and ACS is admitted following an episode of
syncope. Two hours later, the assessment reveals, shallow breaths and
bilateral clear lung sounds. Data are: BP 134/64 (supine); 90/60 standing;
RR 32; UO 30 mL over past 2 hours. The nurse should anticipate:
A. IV fluids
B. nesiritide (Natrecor)
C. dopamine
D. mannitol
- ANS - A. IV fluids
Although this pt has a hx of HF, data suggest orthostatic hypotension and
hypovolemia which should initially be treated with fluids. While HF may
be of concern, the patient's breath sounds are clear at present. Careful
monitoring of patient tolerance is needed during the administration of a
fluid challenge. Nesiritide is used for short-term tx of decompensated
, CHF. It vasodilates both veins and arteries and increases diuresis and
natriuresis which would worsen orthostasis. The use of an osmotic
diuretic is not indicated and may cause further hypovolemia. Dopamine
augments CO by improving contractility and tissue perfusion. It will
increase BP but the patient's underlying hypovolemia needs to be
corrected first.
A patient who was admitted with uncontrolled HTN is scheduled for
discharge. Which education is a PRIORITY for the nurse during discharge
instructions?
A. relaxation and stress management techniques
B. multidrug regimens and consequences if not followed
C. BP monitoring along with alcohol and caffeine changes
D. lifestyle modifications for cessation of vaping, dietary and exercise
adjustments
- ANS - B. multidrug regimens and consequences if not followed
Multidrug regimens with two or three medications of different drug
classes are almost always required to achieve recommended BP goals.
Insufficient time for patient engagement as well as multidrug burden,
prescription drug costs, and medication side effects are primary
contributors to medication noncompliance. The primary prevention of
hypertension requires large-scale societal changes, including further
efforts to influence the food industry to reduce salt in processed foods,
efforts to increase exercise, and availability of fresh fruits and
vegetables. After a person's BP rises to hypertensive or even pre-
hypertensive levels, lifestyle modification alone is almost never enough
to return it to normal, and recidivism is typical. Lifestyle modifications
