AACN PCCN Practice Test Review-
Graded A
What are signs of dialysis disequilibrium syndrome - ANS-Headache
Nausea/vomiting
Restlessness
AMS
Agitation
Seizures
What causes disequilibrium syndrome? How can it be avoided? - ANS-This occurs
when plasma solutes (i.e. urea) are lowered too quickly.
Prevent by reducing dialysis time and increasing frequency.
What causes myocarditis? - ANS-Recent viral infections
Cocaine abuse
Autoimmune disease (i.e. SLE)
What is a key intervention to increase preload in the setting of cardiac tamponade while
waiting for a pericardiocentesis? - ANS-Placing the patient in Trendelenburg's (feet
above head).
Consider: IVF
D/C preload lowering agents: diuretics, nitrates, and morphine
Signs of middle cerebral artery stroke - ANS-* Contralateral hemiplegia
* Sensory involvement
* Aphasia (if dominant hemisphere involved)
* Neglect (if non-dominant hemisphere involved) (i.e. denial of weakness)
* Homonymous hemianopsia (loss of same visual field in both eyes)
Signs of anterior cerebral artery stroke - ANS-* Weakness or sensory loss of
contralateral leg and proximal arm
* Behavior disturbance (confusion, indecisiveness, memory loss, urinary incontinence)
Signs of posterior cerebral artery stroke - ANS-* Contralateral visual field loss
* Color blindness
* Impaired depth perception
* Memory loss
, * Sensory loss
* Nystagmus
* Pupillary abnormalities
* Ataxia
Signs of a vertebral artery stroke - ANS-* Ipsilateral numbness to face/nose/eye with
contralateral numbness to body
* Facial weakness
* Vertigo
* Ataxia
* Nystagmus
* Dysphagia
* Dysarthria
Hematochezia - ANS-Bright red blood per rectum
True/False: in a severe asthma attack, progression of PaCO2 to normal is a good sign. -
ANS-False.
Progression of PaCO2 to normal or increased level indicates impending respiratory
failure.
Fidelity - ANS-The duty to be faithful by keeping promises and fulfilling commitments.
Beneficence - ANS-* Preventing harm to others
*Promoting and acting for the good of others
*Eliminating harmful circumstances
Nonmaleficence - ANS-Do no harm
Veracity - ANS-Truthfulness
What is a common electrolyte abnormality in patients with cancer? - ANS-
Hypercalcemia.
It occurs in 33% of cancer patients. Caused by issue of calcium regulation (too much
entering ECF or inadequate excretion by the kidneys).
What is the definition of a STEMI? - ANS-ST elevation (> 1.5 mm) at the J point in >/= 2
contiguous leads
True/false: a drop in hemoglobin/hematocrit occurs early in the setting of a bleed. -
ANS-False.
H/H may not change significantly for SEVERAL HOURS.
Graded A
What are signs of dialysis disequilibrium syndrome - ANS-Headache
Nausea/vomiting
Restlessness
AMS
Agitation
Seizures
What causes disequilibrium syndrome? How can it be avoided? - ANS-This occurs
when plasma solutes (i.e. urea) are lowered too quickly.
Prevent by reducing dialysis time and increasing frequency.
What causes myocarditis? - ANS-Recent viral infections
Cocaine abuse
Autoimmune disease (i.e. SLE)
What is a key intervention to increase preload in the setting of cardiac tamponade while
waiting for a pericardiocentesis? - ANS-Placing the patient in Trendelenburg's (feet
above head).
Consider: IVF
D/C preload lowering agents: diuretics, nitrates, and morphine
Signs of middle cerebral artery stroke - ANS-* Contralateral hemiplegia
* Sensory involvement
* Aphasia (if dominant hemisphere involved)
* Neglect (if non-dominant hemisphere involved) (i.e. denial of weakness)
* Homonymous hemianopsia (loss of same visual field in both eyes)
Signs of anterior cerebral artery stroke - ANS-* Weakness or sensory loss of
contralateral leg and proximal arm
* Behavior disturbance (confusion, indecisiveness, memory loss, urinary incontinence)
Signs of posterior cerebral artery stroke - ANS-* Contralateral visual field loss
* Color blindness
* Impaired depth perception
* Memory loss
, * Sensory loss
* Nystagmus
* Pupillary abnormalities
* Ataxia
Signs of a vertebral artery stroke - ANS-* Ipsilateral numbness to face/nose/eye with
contralateral numbness to body
* Facial weakness
* Vertigo
* Ataxia
* Nystagmus
* Dysphagia
* Dysarthria
Hematochezia - ANS-Bright red blood per rectum
True/False: in a severe asthma attack, progression of PaCO2 to normal is a good sign. -
ANS-False.
Progression of PaCO2 to normal or increased level indicates impending respiratory
failure.
Fidelity - ANS-The duty to be faithful by keeping promises and fulfilling commitments.
Beneficence - ANS-* Preventing harm to others
*Promoting and acting for the good of others
*Eliminating harmful circumstances
Nonmaleficence - ANS-Do no harm
Veracity - ANS-Truthfulness
What is a common electrolyte abnormality in patients with cancer? - ANS-
Hypercalcemia.
It occurs in 33% of cancer patients. Caused by issue of calcium regulation (too much
entering ECF or inadequate excretion by the kidneys).
What is the definition of a STEMI? - ANS-ST elevation (> 1.5 mm) at the J point in >/= 2
contiguous leads
True/false: a drop in hemoglobin/hematocrit occurs early in the setting of a bleed. -
ANS-False.
H/H may not change significantly for SEVERAL HOURS.
