PCCN PRACTICE EXAM WITH VERIFIED QUESTIONS AND ANSWERS| LATEST UPLOAD|
GRADED A+
Pt on Vach, HR 135, RR 32, BP 90/48, conscious but c/o dizziness, recent K+ level is 3.4.
What action would you do first?
a. emergent defib
b. Amio 300mg IVP
c. emergent cardioversion
d. hang 10 me KCL/50mL D5W - correct answer-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. Torsade’s de pointes because the QTc is wide
D. Third-degree heart block because the PR interval is narrow - correct answer-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 torsade’s 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 - correct answer-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 - correct answer-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 - correct answer-D.
Older patients are at increased risk for delirium during acute hospitalization. Interventions
to manage acute delirium include removing or camouflaging tubes, removing unnecessary
equipment, frequently reorienting the patient, and ensuring that the call bell is consistently
within reach, assessing and treating pain effectively, and encouraging mobility and
involvement in activities of daily living. Restraining the patient is contraindicated in the care
of patients with delirium.
A patient shows a new slight facial droop and the patient's right arm is weaker than the left.
A priority intervention would be to
A. Obtain a serum glucose level
B. Obtain a full set of vital signs
C. Initiate the stroke protocol
D. Initiate the code response team - correct answer-C.
GRADED A+
Pt on Vach, HR 135, RR 32, BP 90/48, conscious but c/o dizziness, recent K+ level is 3.4.
What action would you do first?
a. emergent defib
b. Amio 300mg IVP
c. emergent cardioversion
d. hang 10 me KCL/50mL D5W - correct answer-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. Torsade’s de pointes because the QTc is wide
D. Third-degree heart block because the PR interval is narrow - correct answer-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 torsade’s 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 - correct answer-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 - correct answer-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 - correct answer-D.
Older patients are at increased risk for delirium during acute hospitalization. Interventions
to manage acute delirium include removing or camouflaging tubes, removing unnecessary
equipment, frequently reorienting the patient, and ensuring that the call bell is consistently
within reach, assessing and treating pain effectively, and encouraging mobility and
involvement in activities of daily living. Restraining the patient is contraindicated in the care
of patients with delirium.
A patient shows a new slight facial droop and the patient's right arm is weaker than the left.
A priority intervention would be to
A. Obtain a serum glucose level
B. Obtain a full set of vital signs
C. Initiate the stroke protocol
D. Initiate the code response team - correct answer-C.
