ALL THE PCCN EXAM QUESTIONS WITH ACCURATE
ANSWERS
_________ is the amount of pressure the left ventricle must work against to
pump blood into the circulation. correct answer Afterload; The greater this
resistance, the more the heart works to pump out blood.
____________is the stretching of muscle fibers in the ventricles and is
determined by the pressure and amount of blood remaining in the left ventricle at
the end of diastole. correct answer Preload
This stretching results from blood volume in the ventricles at end-diastole.
According to Starling's Law, the more the heart muscles stretch during diastole,
the more forcefully they contract during diastole.
15 little blocks = __ seconds correct answer 3
A common cause of restrictive cardiomyopathy is? correct answer Glycogen
storage disease and Amyloidosis. The myocardium, especially the left ventricle,
becomes rigid from fibrosis, which results in inadequate left ventricular filling and
increased atrial dilation. Left ventricular diastolic dysfunction occurs, but systolic
function remains normal in this type of cafrdiomyopathy. Fluid backs up into the
lungs and the patients looks as if he has CHF. There is no cure for restrictive
cardiomyopathy; instead symptoms are treated as they occur.
A definitive diagnosis of myocarditis can be made via? correct answer
ENDOMYOCARDIAL BIOPSY
A biopsy is the ONLY definitive way to diagnose myocarditis.
,A diastolic murmur will occur as a result of regurgitant blood flow over which of
the following valves? correct answer Pulmonic and aortic
During ventricular diastole, both the aortic and pulmonic valves close. If a valve is
incompetent, the blood will flow backwards through the valve, creating turbulent
blood flow-- that is, a murmur.
A drug that can cause a significant rise in the INR is? correct answer
AMIODARONE
These cause a SIGNIFICANT rise in INR:
ASA
sulfonamides (ABXs)
cimetidine (Tagamet, an H2 antogonist receptor), fluoroquinolones (ABXs)
macrolide antibiotics
Those below all cause a MODERATE rise in INR:
Ethacrinic acid (loop diuretic, antihypertensive) PCN (ABX)
Statins (anticholesterol medications)
A drug that will significantly decrease the INR would be? correct answer VITAMIN
K
Vitamin K is considered the antidote for warfarin, but can actually lower the INR
too much and increase warfarin resistance, so careful monitoring is needed.
,These cause SIGNIFICANT decrease in INR:
Rifampin (ABX)
Phenobarbital (barbiturate anticonvulsant)
Glutethimide (hypnotic sedative)
Those below cause a MODERATE decrease in INR:
Naficillin (narrow spectrum ABX)
High dose Vitamin C (cancer tx)
Cyclosporin (immunosuppressant)
A heart murmur associated with acute valvular regurg would be? correct answer
S4
S1 and S2 are normal heart sounds
S3 is associated with fluid status
S4 is associated with compliance.
a larger than normal Q wave is a sign of ___ correct answer infarction
A layer of connective tissue which surrounds the heart and acts as a tough,
protective sac. It consists of fibrous pericardium and serous pericardium. correct
answer Pericardium
a loss of 1 L of a fluid that is _____ would result in the greatest decrease in the
effective circulating volume correct answer isotonic
, A normal value for an EF would be? correct answer The EF should be more than
50%. It represents the amount of blood ejected from the left ventricle compared
to the total amount available, expressed as a %. An EF of 35% or less indicates a
problem with contractility, outflow or filling.
EXA: If the ventricle contains 90ml of blood and 50mls are ejected, the amount
would be expressed as a %, in this case 55%.
A patient is admitted to the unit with the following laboratory values: urine
specific gravity, 1.010; urine osmolality, 210 mOsm/kg; BUN/Cr ratio 10:1; urine
sodium, 96 mEq/L. The urine output has been 60 mL since admission 2 hours ago.
These values are most consistent with which of the following types of acute
kidney injury (AKI)? correct answer Intrarenal
A patient is being monitored by continuous electrocardiogram (ECG) after
placement of a transvenous pacemaker. "Loss of capture" is seen on the ECG.
Which nursing intervention may correct this situation? correct answer a. Position
the patient on the left side. or reposition the leads
A patient on mechanical ventilation is receiving total parenteral nutrition (TPN).
Why is appropriate caloric intake important? correct answer Excessive calorie
intake can cause an increase in PaCO2.
A patient presents with the following: HR, 120 beats/min; BP, 80/44 mm Hg; urine
output averaging 20 mL/hr over the last 4 hours; afebrile; moist rales in the lungs
bilaterally; BUN, 84 mg/dL; creatinine, 3.4 mg/dL. What is the probable cause of
this patient's acute kidney injury (AKI)? correct answer Left ventricular failure
causing prerenal AKI
ANSWERS
_________ is the amount of pressure the left ventricle must work against to
pump blood into the circulation. correct answer Afterload; The greater this
resistance, the more the heart works to pump out blood.
____________is the stretching of muscle fibers in the ventricles and is
determined by the pressure and amount of blood remaining in the left ventricle at
the end of diastole. correct answer Preload
This stretching results from blood volume in the ventricles at end-diastole.
According to Starling's Law, the more the heart muscles stretch during diastole,
the more forcefully they contract during diastole.
15 little blocks = __ seconds correct answer 3
A common cause of restrictive cardiomyopathy is? correct answer Glycogen
storage disease and Amyloidosis. The myocardium, especially the left ventricle,
becomes rigid from fibrosis, which results in inadequate left ventricular filling and
increased atrial dilation. Left ventricular diastolic dysfunction occurs, but systolic
function remains normal in this type of cafrdiomyopathy. Fluid backs up into the
lungs and the patients looks as if he has CHF. There is no cure for restrictive
cardiomyopathy; instead symptoms are treated as they occur.
A definitive diagnosis of myocarditis can be made via? correct answer
ENDOMYOCARDIAL BIOPSY
A biopsy is the ONLY definitive way to diagnose myocarditis.
,A diastolic murmur will occur as a result of regurgitant blood flow over which of
the following valves? correct answer Pulmonic and aortic
During ventricular diastole, both the aortic and pulmonic valves close. If a valve is
incompetent, the blood will flow backwards through the valve, creating turbulent
blood flow-- that is, a murmur.
A drug that can cause a significant rise in the INR is? correct answer
AMIODARONE
These cause a SIGNIFICANT rise in INR:
ASA
sulfonamides (ABXs)
cimetidine (Tagamet, an H2 antogonist receptor), fluoroquinolones (ABXs)
macrolide antibiotics
Those below all cause a MODERATE rise in INR:
Ethacrinic acid (loop diuretic, antihypertensive) PCN (ABX)
Statins (anticholesterol medications)
A drug that will significantly decrease the INR would be? correct answer VITAMIN
K
Vitamin K is considered the antidote for warfarin, but can actually lower the INR
too much and increase warfarin resistance, so careful monitoring is needed.
,These cause SIGNIFICANT decrease in INR:
Rifampin (ABX)
Phenobarbital (barbiturate anticonvulsant)
Glutethimide (hypnotic sedative)
Those below cause a MODERATE decrease in INR:
Naficillin (narrow spectrum ABX)
High dose Vitamin C (cancer tx)
Cyclosporin (immunosuppressant)
A heart murmur associated with acute valvular regurg would be? correct answer
S4
S1 and S2 are normal heart sounds
S3 is associated with fluid status
S4 is associated with compliance.
a larger than normal Q wave is a sign of ___ correct answer infarction
A layer of connective tissue which surrounds the heart and acts as a tough,
protective sac. It consists of fibrous pericardium and serous pericardium. correct
answer Pericardium
a loss of 1 L of a fluid that is _____ would result in the greatest decrease in the
effective circulating volume correct answer isotonic
, A normal value for an EF would be? correct answer The EF should be more than
50%. It represents the amount of blood ejected from the left ventricle compared
to the total amount available, expressed as a %. An EF of 35% or less indicates a
problem with contractility, outflow or filling.
EXA: If the ventricle contains 90ml of blood and 50mls are ejected, the amount
would be expressed as a %, in this case 55%.
A patient is admitted to the unit with the following laboratory values: urine
specific gravity, 1.010; urine osmolality, 210 mOsm/kg; BUN/Cr ratio 10:1; urine
sodium, 96 mEq/L. The urine output has been 60 mL since admission 2 hours ago.
These values are most consistent with which of the following types of acute
kidney injury (AKI)? correct answer Intrarenal
A patient is being monitored by continuous electrocardiogram (ECG) after
placement of a transvenous pacemaker. "Loss of capture" is seen on the ECG.
Which nursing intervention may correct this situation? correct answer a. Position
the patient on the left side. or reposition the leads
A patient on mechanical ventilation is receiving total parenteral nutrition (TPN).
Why is appropriate caloric intake important? correct answer Excessive calorie
intake can cause an increase in PaCO2.
A patient presents with the following: HR, 120 beats/min; BP, 80/44 mm Hg; urine
output averaging 20 mL/hr over the last 4 hours; afebrile; moist rales in the lungs
bilaterally; BUN, 84 mg/dL; creatinine, 3.4 mg/dL. What is the probable cause of
this patient's acute kidney injury (AKI)? correct answer Left ventricular failure
causing prerenal AKI
