PCCN Exam prep practice Questions
BEST STUDY GUIDE RATED A+
1. A 49-year-old male was recently admitted with an inferior wall
MI resulting from 100% occlusion of the right coronary artery
(RCA). The 12-Lead ECG reveals ST elevation in leads II, Ill, and avF.
You would expect to see reciprocal changes in which leads?
A. I, aVR
B. V, V2
✅
C. V, VA
D I, aVL - correct answer 1. D. I, aVI. The RCA perfuses the inferior wall and the
mirror image or reciprocal change will be seen in the high latera wall, which is
reflected in leads I, and aVL, on the 12-Lead ECG. Leads V1 and V2 correlate with
the septal area, leads V3 and V4 correlate With the anterior area of the heart. The
aVR lead does not provide much diagnostic value as all energy is depolarizing
away from this lead.
You are summoned to the room of a 30-year-old female who is experiencing
sustained tonic-clonic convulsions while sitting in a chair. A family member states:
"She was just talking to us and suddenly she let out a shriek and started flopping
like a fish out of water." What is your initial priority of care?
A. Call for help and safely guide the patient to the floor
B. Call for help and administer a prescribed antiepileptic
✅
C. Call for help and administer a prescribed benzodiazepine
D. Call for help and monitor the course of the seizure - correct answer A. Call
for help and safely guide the patient to the floor
Patient Safety is priority
A 46-year-old patient presents with pneumonia and sepsis.
,PCCN Exam prep practice Questions
BEST STUDY GUIDE RATED A+
He was treated with 4 days of antibiotics and IV fluids. He is increasingly short of
breath and is now on 100% FiO, via non-re-breather mask. You obtain an ABG with
the following results: pH 7.20 / PaCO, 68/ PaO, 102/ HCO, 28. A chest x-ray reveals
bilateral pulmonary infiltrates. The patient is likely developing:
A. Worsening pneumonia
B. Acute Respiratory Distress Syndrome
✅
C. Pulmonary embolus
D. Atelectasis - correct answer B. Acute Respiratory Distress Syndrome
A 56-year-old male is admitted to the PCU with a hypertensive crisis. His blood
pressure is now 205/125 mm Hg and he is complaining of a headache with
nausea. He reports he ran out of blood pressure medication three days ago, but
also appears to be confused to the date and situation. What is the most
appropriate treatment approach?
A. Rapidly lower the systolic pressure to 100 mm Hg with IV antihypertensive
medication, then gradually reduce the diastolic pressure to 85 mm Hg with oral
antihypertensive medications
B. Slowly lower the systolic pressure to 120 mm Hg with IV antihypertensive
medications, then switch to oral antihypertensive medications for maintenance
C. Rapidly lower the diastolic pressure to 100 mm Hg with IV antihypertensive
medications, then continue to gradually reduce the diastolic pressure to 85 mm
Hg with oral antihypertensive medications
D. Slowly lower the diastolic pressure to 85 mm - correct answer ✅C. Rapidly
lower the diastolic pressure to 100 mm Hg with IV antihypertensive medications,
,PCCN Exam prep practice Questions
BEST STUDY GUIDE RATED A+
then continue to gradually reduce the diastolic pressure to 85 mm Hg with oral
antihypertensive medication
5. Which of the following labs must be closely monitored when administering
Lisinopril to a patient with systolic heart failure?
A. Sodium
B. Phosphate
✅
C. Magnesium
D Potassium - correct answer D. Potassium
Patients taking angiotensin converting enzyme inhibitors may experience
hyperkalemia. ACE inhibitors block angiotensin II, which may lead to decreased
aldosterone. Aldosterone is responsible forexcreting potassium from the kidneys.
Therefore, ACE inhibitors can cause potassium retension and potassium levels
should be monitored closely. In addition, renal labs such as BUN and creatinine
should be monitored. If the patient develops more than a 20% increase in the
creatinine, the medication should be discontinued.
A 57-year-old man was admitted with an acute myocardial infarction and is rapidly
deteriorating. He has a BP of 86/42
(57), heart rate of 110, weak, thready pulses, and mottled skin-especially at the
knees. He has had minimal urine output the past 8 hours. A Rapid Response is
activated. Which of the following medications would be the best option to
increase the patient's cardiac output?
A Dobutamine
B Norepinephrine
C Amiodarone
, PCCN Exam prep practice Questions
BEST STUDY GUIDE RATED A+
D Phenylephrine - correct answer ✅ A Dobutamine. Dobutamine is a positive
inotropic medication used to improve myocardial dysfunction on patients with a
low cardiac index and elevated afterload. It will improve contractility and reduce
afterload. Milrinone, which is a phosphodiesterase inhibitor could also be used as
an alternative to dobutamine, in the setting of decompensated heart failure. It is
used cautiously in patients experiencing cardiogiogenic shock as one of the main
side effects of Milrinone is hypotension. The half life of Milrinone is about 6 hours.
Norepinephrine and Phenylephrine cause vasoconstriction, which would increase
the SVR and may compromise cardiac output.
You are caring for a patient post gastric bypass. Which of the following parameters
should you closely monitor after surgery?
A* HR, RR, temperature, WBC & MAP
B* Protein levels and vitamin B12
✅
C* Albumin and pre-albumin levels
D* Signs of dumping syndrome - correct answer A* HR, RR, temperature, WBC
& MAP
You are caring for a patient admitted after a ground level fall. The patient has
decreased level of consciousness. On admission the patient is ordered to be a full
code. The family arrives with advanced directives stating the patient wishes not to
have CPR performed or life sustaining treatment continued. The nurse approaches
the provider about this discrepancy and the provider states "I am aware of the
advanced directive, but the daughter wants everything done."
What is the appropriate next step by the nurse?
A* Ask the daughter why she wants everything done
B* Collaborate with the provider and social worker to schedule a family meeting
BEST STUDY GUIDE RATED A+
1. A 49-year-old male was recently admitted with an inferior wall
MI resulting from 100% occlusion of the right coronary artery
(RCA). The 12-Lead ECG reveals ST elevation in leads II, Ill, and avF.
You would expect to see reciprocal changes in which leads?
A. I, aVR
B. V, V2
✅
C. V, VA
D I, aVL - correct answer 1. D. I, aVI. The RCA perfuses the inferior wall and the
mirror image or reciprocal change will be seen in the high latera wall, which is
reflected in leads I, and aVL, on the 12-Lead ECG. Leads V1 and V2 correlate with
the septal area, leads V3 and V4 correlate With the anterior area of the heart. The
aVR lead does not provide much diagnostic value as all energy is depolarizing
away from this lead.
You are summoned to the room of a 30-year-old female who is experiencing
sustained tonic-clonic convulsions while sitting in a chair. A family member states:
"She was just talking to us and suddenly she let out a shriek and started flopping
like a fish out of water." What is your initial priority of care?
A. Call for help and safely guide the patient to the floor
B. Call for help and administer a prescribed antiepileptic
✅
C. Call for help and administer a prescribed benzodiazepine
D. Call for help and monitor the course of the seizure - correct answer A. Call
for help and safely guide the patient to the floor
Patient Safety is priority
A 46-year-old patient presents with pneumonia and sepsis.
,PCCN Exam prep practice Questions
BEST STUDY GUIDE RATED A+
He was treated with 4 days of antibiotics and IV fluids. He is increasingly short of
breath and is now on 100% FiO, via non-re-breather mask. You obtain an ABG with
the following results: pH 7.20 / PaCO, 68/ PaO, 102/ HCO, 28. A chest x-ray reveals
bilateral pulmonary infiltrates. The patient is likely developing:
A. Worsening pneumonia
B. Acute Respiratory Distress Syndrome
✅
C. Pulmonary embolus
D. Atelectasis - correct answer B. Acute Respiratory Distress Syndrome
A 56-year-old male is admitted to the PCU with a hypertensive crisis. His blood
pressure is now 205/125 mm Hg and he is complaining of a headache with
nausea. He reports he ran out of blood pressure medication three days ago, but
also appears to be confused to the date and situation. What is the most
appropriate treatment approach?
A. Rapidly lower the systolic pressure to 100 mm Hg with IV antihypertensive
medication, then gradually reduce the diastolic pressure to 85 mm Hg with oral
antihypertensive medications
B. Slowly lower the systolic pressure to 120 mm Hg with IV antihypertensive
medications, then switch to oral antihypertensive medications for maintenance
C. Rapidly lower the diastolic pressure to 100 mm Hg with IV antihypertensive
medications, then continue to gradually reduce the diastolic pressure to 85 mm
Hg with oral antihypertensive medications
D. Slowly lower the diastolic pressure to 85 mm - correct answer ✅C. Rapidly
lower the diastolic pressure to 100 mm Hg with IV antihypertensive medications,
,PCCN Exam prep practice Questions
BEST STUDY GUIDE RATED A+
then continue to gradually reduce the diastolic pressure to 85 mm Hg with oral
antihypertensive medication
5. Which of the following labs must be closely monitored when administering
Lisinopril to a patient with systolic heart failure?
A. Sodium
B. Phosphate
✅
C. Magnesium
D Potassium - correct answer D. Potassium
Patients taking angiotensin converting enzyme inhibitors may experience
hyperkalemia. ACE inhibitors block angiotensin II, which may lead to decreased
aldosterone. Aldosterone is responsible forexcreting potassium from the kidneys.
Therefore, ACE inhibitors can cause potassium retension and potassium levels
should be monitored closely. In addition, renal labs such as BUN and creatinine
should be monitored. If the patient develops more than a 20% increase in the
creatinine, the medication should be discontinued.
A 57-year-old man was admitted with an acute myocardial infarction and is rapidly
deteriorating. He has a BP of 86/42
(57), heart rate of 110, weak, thready pulses, and mottled skin-especially at the
knees. He has had minimal urine output the past 8 hours. A Rapid Response is
activated. Which of the following medications would be the best option to
increase the patient's cardiac output?
A Dobutamine
B Norepinephrine
C Amiodarone
, PCCN Exam prep practice Questions
BEST STUDY GUIDE RATED A+
D Phenylephrine - correct answer ✅ A Dobutamine. Dobutamine is a positive
inotropic medication used to improve myocardial dysfunction on patients with a
low cardiac index and elevated afterload. It will improve contractility and reduce
afterload. Milrinone, which is a phosphodiesterase inhibitor could also be used as
an alternative to dobutamine, in the setting of decompensated heart failure. It is
used cautiously in patients experiencing cardiogiogenic shock as one of the main
side effects of Milrinone is hypotension. The half life of Milrinone is about 6 hours.
Norepinephrine and Phenylephrine cause vasoconstriction, which would increase
the SVR and may compromise cardiac output.
You are caring for a patient post gastric bypass. Which of the following parameters
should you closely monitor after surgery?
A* HR, RR, temperature, WBC & MAP
B* Protein levels and vitamin B12
✅
C* Albumin and pre-albumin levels
D* Signs of dumping syndrome - correct answer A* HR, RR, temperature, WBC
& MAP
You are caring for a patient admitted after a ground level fall. The patient has
decreased level of consciousness. On admission the patient is ordered to be a full
code. The family arrives with advanced directives stating the patient wishes not to
have CPR performed or life sustaining treatment continued. The nurse approaches
the provider about this discrepancy and the provider states "I am aware of the
advanced directive, but the daughter wants everything done."
What is the appropriate next step by the nurse?
A* Ask the daughter why she wants everything done
B* Collaborate with the provider and social worker to schedule a family meeting
