PCCN Exam Questions With Valid Solutions.
The nurse observes that the patient's jugular veins distend in the semi-upright
position to more than 5 cm above the sternal angle. This is an indication of: -
accurate answers-fluid volume overload.
what is normal Pulmonary artery occlusion pressure (PAOP)? - accurate
answers-5-12 mmHg
The resistance against which the left ventricle must pump to eject its volume
is: - accurate answers-systemic vascular resistance.
When the tricuspid valve is open, central venous pressure reflects the filling
pressure in the: - accurate answers-right ventricle.
Tachycardia is dangerous for the patient with ischemic heart disease because
of: - accurate answers-compromised cardiac output.
During initial examination of a critical care patient, the nurse observes wide
and convex nails and bulbous fingertips. This is evidence of: - accurate
answers-central cyanosis.
Priorities for palpation of the patient with cardiovascular disease include: -
accurate answers-estimating edema.
checking capillary refill
checking for DVT
arterial pulses
By blocking the conversion of angiotensin I to angiotensin II, angiotensin-
converting enzyme inhibitors produce: - accurate answers-b. vasodilation.
The nurse has read that the cardiologist recommends the use of class IV drugs
to depress sinus and atrioventricular node conduction and terminate
supraventricular tachycardias in the patient at this time. The nurse will
anticipate orders for which medications? - accurate answers-a. Verapamil,
diltiazem, or amlodipine
,The nurse has administered a drug that stimulates β1-adrenergic sites.
Following administration of the drug, the nurse will assess for: - accurate
answers-a. increased heart rate.
The nurse is observing the patient's electrocardiographic monitor after
insertion of a temporary pacemaker. Seeing a P-wave after the pacing artifact,
the nurse knows that the: - accurate answers-c. atrium is being paced.
The possibility of microshock when handling a temporary pacemaker can be
minimized by: - accurate answers-b. insulating the ends of the wires. and
wearing gloves when handling the pacing wires
In the postoperative cardiovascular patient, the most frequent cause of a
decreased cardiac output is: - accurate answers-a. reduced preload.
A patient is being monitored by continuous electrocardiogram (ECG) after
placement of a transvenous pacemaker. "Loss of capture" is seen on the ECG.
Which nursing intervention may correct this situation? - accurate answers-a.
Position the patient on the left side. or reposition the leads
In analyzing the ECG strip, the nurse notices a spike before each QRS complex.
The patient's heart rate is 70 beats/min. This phenomenon is reflective of -
accurate answers-b. pacing artifact; the pacemaker is sensing and capturing.
Calculate the cerebral perfusion pressure (CPP) for a patient with a mean
arterial pressure (MAP) = 95 mm Hg and an intracranial pressure (ICP) = 15
mm Hg. - accurate answers-b. 80 mm Hg
What procedure secures an arteriovenous malformation when a pt's condition
is too unstable for surgery? - accurate answers-embolization that can be done
to secure the lesion without surgery. When the condition is more stable, an
operation might be considered if needed.
Knowing that a patient has hypoxemia and ischemia in his brain, the nurse
anticipates which of the following? - accurate answers-a. Cerebrovascular
dilation
The nurse's priority in eye care for the patient in a coma will be: - accurate
answers-c. keeping the eyes moist to prevent corneal ulceration.
,The patient has markedly deep, rapid respirations with a fruity breath odor.
Based on the patient's history, the nurse will: - accurate answers-perform a
blood glucose measurement.
The patient with the syndrome of inappropriate antidiuretic hormone
(SIADH) secretion will need to have the imbalance of which electrolyte
corrected as soon as possible? - accurate answers-Sodium
Which of the following conditions occurs when the renal tubules are unable to
reabsorb excess glucose? - accurate answers-Glycosuria
The patient has a waist measurement of 52 inches. His triglyceride level is 175
mg/dL, his high-density lipoprotein (HDL) cholesterol level is 32 mg/dL, and
his fasting plasma glucose level is 224 mg/dL. His blood pressure readings are
usually approximately 140/90 mm Hg. The nurse recognizes the
characteristics of: - accurate answers-metabolic syndrome.
To reverse the hyperglycemic hyperosmolar state, the nurse will first prepare
to administer: - accurate answers-fluids
The nurse is caring for a patient with central diabetes insipidus (DI). The
nurse should anticipate orders for the administration of: - accurate answers-
vasopressin
In the syndrome of inappropriate antidiuretic hormone (SIADH), the
physiological effect is: - accurate answers-dilutional hyponatremia, reducing
sodium concentration to critically low levels.
Which assessment findings would indicate fluid volume excess? - accurate
answers-edema, auscultation of a third heart sound, crackles in lungs,
bounding pulses, AMS, olguria, HTN
The report of a renal patient's laboratory results shows that the blood urea
nitrogen (BUN) level is less than 25 mg/dL. To fully understand the patient's
renal status, the nurse must consider this value along with: - accurate
answers-c. creatinine level.
, To determine whether edema in a patient's hands is due to circulatory
compromise or another cause, the nurse might: - accurate answers-elevate the
patient's extremities for 1 hour and observe the degree of edema still present.
Hypovolemia causes tachycardia and : - accurate answers-hypotension.
To avoid the complications that can result from administering furosemide
(Lasix) to stimulate urinary output, the nurse will carefully monitor: -
accurate answers-levels of electrolytes, especially potassium.
Which dialysis method would be most appropriate for the hemodynamically
stable patient in the anuric phase of acute kidney injury (AKI)? - accurate
answers-Intermittent hemodialysis
What are complications of continuous renal replacement therapy (CRRT)? -
accurate answers-Air embolism, decreased inflow pressure, electrolyte
imbalance
Which electrolytes pose the most potential hazard if not within normal limits
for the person with acute kidney failure? - accurate answers-Potassium and
calcium
peaked T-waves and a widening of the QRS interval in a pt with AKI are
indicative of: - accurate answers-d. hyperkalemia.
A patient presents with the following: HR, 120 beats/min; BP, 80/44 mm Hg;
urine output averaging 20 mL/hr over the last 4 hours; afebrile; moist rales in
the lungs bilaterally; BUN, 84 mg/dL; creatinine, 3.4 mg/dL. What is the
probable cause of this patient's acute kidney injury (AKI)? - accurate answers-
Left ventricular failure causing prerenal AKI
An elderly patient is in a motor vehicle accident and incurs a significant
internal hemorrhage. He is at greatest risk for which category of acute kidney
injury (AKI)? - accurate answers-Prerenal
A patient is admitted to the unit with the following laboratory values: urine
specific gravity, 1.010; urine osmolality, 210 mOsm/kg; BUN/Cr ratio 10:1;
urine sodium, 96 mEq/L. The urine output has been 60 mL since admission 2
The nurse observes that the patient's jugular veins distend in the semi-upright
position to more than 5 cm above the sternal angle. This is an indication of: -
accurate answers-fluid volume overload.
what is normal Pulmonary artery occlusion pressure (PAOP)? - accurate
answers-5-12 mmHg
The resistance against which the left ventricle must pump to eject its volume
is: - accurate answers-systemic vascular resistance.
When the tricuspid valve is open, central venous pressure reflects the filling
pressure in the: - accurate answers-right ventricle.
Tachycardia is dangerous for the patient with ischemic heart disease because
of: - accurate answers-compromised cardiac output.
During initial examination of a critical care patient, the nurse observes wide
and convex nails and bulbous fingertips. This is evidence of: - accurate
answers-central cyanosis.
Priorities for palpation of the patient with cardiovascular disease include: -
accurate answers-estimating edema.
checking capillary refill
checking for DVT
arterial pulses
By blocking the conversion of angiotensin I to angiotensin II, angiotensin-
converting enzyme inhibitors produce: - accurate answers-b. vasodilation.
The nurse has read that the cardiologist recommends the use of class IV drugs
to depress sinus and atrioventricular node conduction and terminate
supraventricular tachycardias in the patient at this time. The nurse will
anticipate orders for which medications? - accurate answers-a. Verapamil,
diltiazem, or amlodipine
,The nurse has administered a drug that stimulates β1-adrenergic sites.
Following administration of the drug, the nurse will assess for: - accurate
answers-a. increased heart rate.
The nurse is observing the patient's electrocardiographic monitor after
insertion of a temporary pacemaker. Seeing a P-wave after the pacing artifact,
the nurse knows that the: - accurate answers-c. atrium is being paced.
The possibility of microshock when handling a temporary pacemaker can be
minimized by: - accurate answers-b. insulating the ends of the wires. and
wearing gloves when handling the pacing wires
In the postoperative cardiovascular patient, the most frequent cause of a
decreased cardiac output is: - accurate answers-a. reduced preload.
A patient is being monitored by continuous electrocardiogram (ECG) after
placement of a transvenous pacemaker. "Loss of capture" is seen on the ECG.
Which nursing intervention may correct this situation? - accurate answers-a.
Position the patient on the left side. or reposition the leads
In analyzing the ECG strip, the nurse notices a spike before each QRS complex.
The patient's heart rate is 70 beats/min. This phenomenon is reflective of -
accurate answers-b. pacing artifact; the pacemaker is sensing and capturing.
Calculate the cerebral perfusion pressure (CPP) for a patient with a mean
arterial pressure (MAP) = 95 mm Hg and an intracranial pressure (ICP) = 15
mm Hg. - accurate answers-b. 80 mm Hg
What procedure secures an arteriovenous malformation when a pt's condition
is too unstable for surgery? - accurate answers-embolization that can be done
to secure the lesion without surgery. When the condition is more stable, an
operation might be considered if needed.
Knowing that a patient has hypoxemia and ischemia in his brain, the nurse
anticipates which of the following? - accurate answers-a. Cerebrovascular
dilation
The nurse's priority in eye care for the patient in a coma will be: - accurate
answers-c. keeping the eyes moist to prevent corneal ulceration.
,The patient has markedly deep, rapid respirations with a fruity breath odor.
Based on the patient's history, the nurse will: - accurate answers-perform a
blood glucose measurement.
The patient with the syndrome of inappropriate antidiuretic hormone
(SIADH) secretion will need to have the imbalance of which electrolyte
corrected as soon as possible? - accurate answers-Sodium
Which of the following conditions occurs when the renal tubules are unable to
reabsorb excess glucose? - accurate answers-Glycosuria
The patient has a waist measurement of 52 inches. His triglyceride level is 175
mg/dL, his high-density lipoprotein (HDL) cholesterol level is 32 mg/dL, and
his fasting plasma glucose level is 224 mg/dL. His blood pressure readings are
usually approximately 140/90 mm Hg. The nurse recognizes the
characteristics of: - accurate answers-metabolic syndrome.
To reverse the hyperglycemic hyperosmolar state, the nurse will first prepare
to administer: - accurate answers-fluids
The nurse is caring for a patient with central diabetes insipidus (DI). The
nurse should anticipate orders for the administration of: - accurate answers-
vasopressin
In the syndrome of inappropriate antidiuretic hormone (SIADH), the
physiological effect is: - accurate answers-dilutional hyponatremia, reducing
sodium concentration to critically low levels.
Which assessment findings would indicate fluid volume excess? - accurate
answers-edema, auscultation of a third heart sound, crackles in lungs,
bounding pulses, AMS, olguria, HTN
The report of a renal patient's laboratory results shows that the blood urea
nitrogen (BUN) level is less than 25 mg/dL. To fully understand the patient's
renal status, the nurse must consider this value along with: - accurate
answers-c. creatinine level.
, To determine whether edema in a patient's hands is due to circulatory
compromise or another cause, the nurse might: - accurate answers-elevate the
patient's extremities for 1 hour and observe the degree of edema still present.
Hypovolemia causes tachycardia and : - accurate answers-hypotension.
To avoid the complications that can result from administering furosemide
(Lasix) to stimulate urinary output, the nurse will carefully monitor: -
accurate answers-levels of electrolytes, especially potassium.
Which dialysis method would be most appropriate for the hemodynamically
stable patient in the anuric phase of acute kidney injury (AKI)? - accurate
answers-Intermittent hemodialysis
What are complications of continuous renal replacement therapy (CRRT)? -
accurate answers-Air embolism, decreased inflow pressure, electrolyte
imbalance
Which electrolytes pose the most potential hazard if not within normal limits
for the person with acute kidney failure? - accurate answers-Potassium and
calcium
peaked T-waves and a widening of the QRS interval in a pt with AKI are
indicative of: - accurate answers-d. hyperkalemia.
A patient presents with the following: HR, 120 beats/min; BP, 80/44 mm Hg;
urine output averaging 20 mL/hr over the last 4 hours; afebrile; moist rales in
the lungs bilaterally; BUN, 84 mg/dL; creatinine, 3.4 mg/dL. What is the
probable cause of this patient's acute kidney injury (AKI)? - accurate answers-
Left ventricular failure causing prerenal AKI
An elderly patient is in a motor vehicle accident and incurs a significant
internal hemorrhage. He is at greatest risk for which category of acute kidney
injury (AKI)? - accurate answers-Prerenal
A patient is admitted to the unit with the following laboratory values: urine
specific gravity, 1.010; urine osmolality, 210 mOsm/kg; BUN/Cr ratio 10:1;
urine sodium, 96 mEq/L. The urine output has been 60 mL since admission 2
