AACN PCCN Exam Review Multisystem
Questions & Answers
Normal inflammatory response - ANSWERSvasodilatation, increased microvascular permeability,
cellular activation and release of mediators, and coagulation
Define sepsis - ANSWERSsystemic response to infection, manifested by two or more conditions
resulting from infection (temp >38C, HR >90 bpm, RR >20 bpm, PaCO2 <32 mmHg, WBC >12,
<4)
Define septic shock - ANSWERSsepsis with hypotension, despite adequate fluid resuscitation,
along with presence of perfusion abnormalities including lactic acidosis, oliguria, acute AMS
Risk factors for sepsis - ANSWERSmalnutrition, immunosuppression, prolonged antibiotic use,
invasive devices
Define MODS - ANSWERSmultiple organ dysfunction, worsening progression of systemic
inflammatory response (SIRS) involving signs of organ dysfunction
Management of sepsis - ANSWERStreat cause (antibiotics), maximize oxygen, maximize CO
(difficult bc pathological problem of SIRS is increased permeability of capillary bed - liberal fluid
admin), decrease oxygen demand (reduce tachycardia, tachypnea, hyperthermia, pain, prevent
shivering, comfort measures)
What is NOT an accurate measurement of adequate perfusion - ANSWERSBLOOD PRESSURE,
adequate pressure does not always equal adequate perfusion
, Symptoms of alcohol withdrawal - ANSWERSinsomnia, tremors, anxiety, GI upset, HA, sweating,
palpitations, hallucinations, seizures, fever, agitation
How is isopropyl alcohol intoxication distinguished from other types of alcohol intoxication -
ANSWERSpresence of ketoacids in urine and serum
Which imbalance is seen in methanol intoxication and relieved by hyperventilation -
ANSWERSmetabolic acidosis (decreased bicarbonate level)
Which alcohol intoxication affects renal tubular degeneration - ANSWERSethylene glycol
intoxication
Which vitamins are most important in alcohol withdrawal - ANSWERSthiamine, folate (banana
bag of B vitamins)
Signs and symptoms applicable to majority of drug overdose - ANSWERSdecreased LOC,
behavioral changes, respiratory depression
Antidote for acetaminophen - ANSWERSN-acetylcysteine
Antidote for opiates - ANSWERSnaloxone
Antidote for benzodiazepines - ANSWERSflumazenil (avoid if potential for seizure)
Antidote for digoxin - ANSWERSdigiband
Antidote for cyanide - ANSWERSkelocyanor
Questions & Answers
Normal inflammatory response - ANSWERSvasodilatation, increased microvascular permeability,
cellular activation and release of mediators, and coagulation
Define sepsis - ANSWERSsystemic response to infection, manifested by two or more conditions
resulting from infection (temp >38C, HR >90 bpm, RR >20 bpm, PaCO2 <32 mmHg, WBC >12,
<4)
Define septic shock - ANSWERSsepsis with hypotension, despite adequate fluid resuscitation,
along with presence of perfusion abnormalities including lactic acidosis, oliguria, acute AMS
Risk factors for sepsis - ANSWERSmalnutrition, immunosuppression, prolonged antibiotic use,
invasive devices
Define MODS - ANSWERSmultiple organ dysfunction, worsening progression of systemic
inflammatory response (SIRS) involving signs of organ dysfunction
Management of sepsis - ANSWERStreat cause (antibiotics), maximize oxygen, maximize CO
(difficult bc pathological problem of SIRS is increased permeability of capillary bed - liberal fluid
admin), decrease oxygen demand (reduce tachycardia, tachypnea, hyperthermia, pain, prevent
shivering, comfort measures)
What is NOT an accurate measurement of adequate perfusion - ANSWERSBLOOD PRESSURE,
adequate pressure does not always equal adequate perfusion
, Symptoms of alcohol withdrawal - ANSWERSinsomnia, tremors, anxiety, GI upset, HA, sweating,
palpitations, hallucinations, seizures, fever, agitation
How is isopropyl alcohol intoxication distinguished from other types of alcohol intoxication -
ANSWERSpresence of ketoacids in urine and serum
Which imbalance is seen in methanol intoxication and relieved by hyperventilation -
ANSWERSmetabolic acidosis (decreased bicarbonate level)
Which alcohol intoxication affects renal tubular degeneration - ANSWERSethylene glycol
intoxication
Which vitamins are most important in alcohol withdrawal - ANSWERSthiamine, folate (banana
bag of B vitamins)
Signs and symptoms applicable to majority of drug overdose - ANSWERSdecreased LOC,
behavioral changes, respiratory depression
Antidote for acetaminophen - ANSWERSN-acetylcysteine
Antidote for opiates - ANSWERSnaloxone
Antidote for benzodiazepines - ANSWERSflumazenil (avoid if potential for seizure)
Antidote for digoxin - ANSWERSdigiband
Antidote for cyanide - ANSWERSkelocyanor
