PCCN practice exam notes (2024/2025) Already Passed

PCCN practice exam notes (2024/2025) Already Passed Pt on Vtach, HR 135, RR 32, BP 90/48, conscious but c/o dizziness, recent K+ lvl is 3.4. What action would you do first? a. emergent defib b. amio 300mg IVP c. emergent cardioversion d. hang 10 mEq KCL/50mL D5W C The nurse notes the following when analyzing a patient's telemetry strip: HR, 65/min and regular; PR interval, 0.22 seconds; QRS complex, 0.10 seconds; QTc, 0.52 seconds. Which of the following dysrhythmias is the patient at risk for? A. Atrial fibrillation because the PR interval is wide B. Sinus arrhythmia because the QRS complex is narrow C. Torsades de pointes because the QTc is wide D. Third-degree heart block because the PR interval is narrow C. QT measurements reflect the duration of ventricular repolarization. Lengthening of QT interval is associated with arrhythmias, adverse cardiac events, and increased mortality because a longer QT duration places the vulnerable ventricular repolarization phase close to the next depolarization, increasing the likelihood of R-on-T. The most common arrhythmia that occurs with prolonged QTc is torsades de pointes. Atrial fibrillation, sinus bradycardia, and third-degree heart block are not typically associated with prolonged ventricular repolarization (QTc 0.50 seconds). A patient with chronic obstructive pulmonary disease (COPD) is admitted for worsening dyspnea and possible pneumonia. The current ABG results are pH, 7.19; PaO2, 52 mm Hg; PaCO2, 68 mm Hg; HCO3 - , 32 mmol/L. The nurse would interpret these results as A. Metabolic acidosis with hypoxemia B. Respiratory acidosis with hypoxemia C. Respiratory alkalosis with typical oxygenation for a COPD patient D. Metabolic alkalosis with typical oxygenation for a COPD patient B. Based on the ABG analysis, the patient is experiencing a respiratory acidosis with hypoxemia most likely due to the pneumonia. A pH of 7.19 indicates acidosis; a PaCO2 of 68 mm Hg is elevated and a cause of acidosis; an HCO3 - of 32 mmol/L indicates renal compensation; a PaO2 of 52 mm Hg indicates hypoxemia 76-year-old patient is receiving gentamicin and linezolid for an infection. Which of the following potential complications is the most important for the nurse to monitor this patient for? A. Acute delirium B. Acute kidney injury C. Acute hepatic failure D. Sepsis B. Gentamicin is a nephrotoxic agent that places patients at risk for acute kidney injury, and this risk is increased in older patients. Acute delirium (A), liver failure (C), and sepsis (D) are all complications that could occur in an older adult with an infection but would not be caused by the administration of an antibiotic. An older patient is experiencing delirium 24 hours following hip replacement. Which intervention might worsen the patient's condition? A. Removing any unnecessary tubes and equipment from the room B. Assessing and treating the patient's pain every 2 hours C. Ensuring that the patient has the means to call for help D. Loosely applying soft restraints