PCCN: Practice Exam 2 Study Guide
Questions and Actual Answers.
What can worsen patient's outcome following an ischemic stroke? - Answer Fever,
Hyperglycemia, and low sodium can worsen a patient's outcome following an ischemic stroke.
What is the adverse effect of ACE inhibitors? - Answer Dry, Hacking Cough.
Stop the medication and do not administer.
What is happening in severe sepsis? - Answer Decreased preload due to blood vessels
vasodilate capillary leaks and volume depletion.
Volume resuscitation is a priority in severe sepsis and septic shock.
What are the signs of anxiety? - Answer Nausea, diarrhea, and shortness of breath.
What treatment options prevent atelectasis or new breath sound changes after abdominal
surgery? - Answer Chest X-ray and Pulmonary Hygiene.
What might cause a change of level of consciousness with a closed head injury? - Answer If
the patient's neuro assessment has changed from their typical baseline, it is due to an increased
intracranial pressure.
The difference between right axis, extreme right axis, and left axis deviation of the heart's
electrical triangle system - Answer Left axis deviation: Positive deflection QRS in Lead I.
Negative deflection QRS in lead aVF.
Extreme Right axis deviation: Negative deflection QRS in Lead I. Negative deflection QRS in lead
aVF.
Right axis deviation: Negative deflection QRS in lead I. Positive deflection in lead aVF.
Normal Axis deviation: Both positive deflection in lead I and aVF.
Patient with pancreatitis is showing Chvostek's sign. What lab finding may be affected? - Answer
Calcium serum level below 8.5
How does the S4 heart sound occur with ventricular hypertrophy? - Answer The ventricles
are too thick, and it is difficult to adequately fill the ventricles. The atria make a forceful
contraction. The sound and vibration of the ejection make the S4 heart sound.
, Exclusion criteria for rTPA (recombinant tissue plasminogen activator) - Answer -active
internal bleeding (an example is GI BLEED)
-acute bleeding
-surgeries within the past 3 months.
Early signs versus late signs of increased intracranial pressure - Answer Early signs: Change of
mental status, ↓ LOC
Late signs: Slurred speech, nystagmus, pupil inequality is a sign of impending herniation.
What is the ominous sign of acute asthma exacerbation going in to acute respiratory failure? -
Answer Hypercapnia or elevated PaCO2.
Clinical manifestations of cardiogenic shock - Answer ↓Stroke volume will activate RASS →
vasoconstriction → increase SVR (↑afterload).
↑LEDV → increase left atrial ↑preload.
signs are crackles and congestion.
pulmonary edema causes impaired gas exchange and impaired tissue perfusion → cool, pale,
and moist skin.
Unit practice council duties - Answer -Dissemination of new practice
-Review best practices
-Standards of practice
When is PCI completed for STEMI vs NSTEMI? - Answer 90 minutes for STEMI. 24 hours for
NSTMI.
Aortic Stenosis, Aortic Regurgitation, Mitral stenosis, and Mitral regurgitation murmur sounds -
Answer Aortic Stenosis: Systolic Murmur, Rales
Aortic regurgitation: Diastolic murmur, high-pitched decrescendo murmur.
Mitral stenosis: Diastolic murmur.
Mitral regurgitation: Holosystolic murmur, Split S2.
What is petechiae? - Answer Superficial bleeding under the skin that appears reddish-purple
and pinpoint-sized spots of hemorrhages on the skin.
How come heparin and coumadin is used for a stable Pulmonary embolism? - Answer
Heparin will prevent the clot from further growth, allowing the body to break it down normally.
coumadin is used for long-term anticoagulation.
Questions and Actual Answers.
What can worsen patient's outcome following an ischemic stroke? - Answer Fever,
Hyperglycemia, and low sodium can worsen a patient's outcome following an ischemic stroke.
What is the adverse effect of ACE inhibitors? - Answer Dry, Hacking Cough.
Stop the medication and do not administer.
What is happening in severe sepsis? - Answer Decreased preload due to blood vessels
vasodilate capillary leaks and volume depletion.
Volume resuscitation is a priority in severe sepsis and septic shock.
What are the signs of anxiety? - Answer Nausea, diarrhea, and shortness of breath.
What treatment options prevent atelectasis or new breath sound changes after abdominal
surgery? - Answer Chest X-ray and Pulmonary Hygiene.
What might cause a change of level of consciousness with a closed head injury? - Answer If
the patient's neuro assessment has changed from their typical baseline, it is due to an increased
intracranial pressure.
The difference between right axis, extreme right axis, and left axis deviation of the heart's
electrical triangle system - Answer Left axis deviation: Positive deflection QRS in Lead I.
Negative deflection QRS in lead aVF.
Extreme Right axis deviation: Negative deflection QRS in Lead I. Negative deflection QRS in lead
aVF.
Right axis deviation: Negative deflection QRS in lead I. Positive deflection in lead aVF.
Normal Axis deviation: Both positive deflection in lead I and aVF.
Patient with pancreatitis is showing Chvostek's sign. What lab finding may be affected? - Answer
Calcium serum level below 8.5
How does the S4 heart sound occur with ventricular hypertrophy? - Answer The ventricles
are too thick, and it is difficult to adequately fill the ventricles. The atria make a forceful
contraction. The sound and vibration of the ejection make the S4 heart sound.
, Exclusion criteria for rTPA (recombinant tissue plasminogen activator) - Answer -active
internal bleeding (an example is GI BLEED)
-acute bleeding
-surgeries within the past 3 months.
Early signs versus late signs of increased intracranial pressure - Answer Early signs: Change of
mental status, ↓ LOC
Late signs: Slurred speech, nystagmus, pupil inequality is a sign of impending herniation.
What is the ominous sign of acute asthma exacerbation going in to acute respiratory failure? -
Answer Hypercapnia or elevated PaCO2.
Clinical manifestations of cardiogenic shock - Answer ↓Stroke volume will activate RASS →
vasoconstriction → increase SVR (↑afterload).
↑LEDV → increase left atrial ↑preload.
signs are crackles and congestion.
pulmonary edema causes impaired gas exchange and impaired tissue perfusion → cool, pale,
and moist skin.
Unit practice council duties - Answer -Dissemination of new practice
-Review best practices
-Standards of practice
When is PCI completed for STEMI vs NSTEMI? - Answer 90 minutes for STEMI. 24 hours for
NSTMI.
Aortic Stenosis, Aortic Regurgitation, Mitral stenosis, and Mitral regurgitation murmur sounds -
Answer Aortic Stenosis: Systolic Murmur, Rales
Aortic regurgitation: Diastolic murmur, high-pitched decrescendo murmur.
Mitral stenosis: Diastolic murmur.
Mitral regurgitation: Holosystolic murmur, Split S2.
What is petechiae? - Answer Superficial bleeding under the skin that appears reddish-purple
and pinpoint-sized spots of hemorrhages on the skin.
How come heparin and coumadin is used for a stable Pulmonary embolism? - Answer
Heparin will prevent the clot from further growth, allowing the body to break it down normally.
coumadin is used for long-term anticoagulation.
