PCCN Exam Questions
and Answers
what are first clues of ARDS? - Answer-tachypnea, progressive hypoxemia, acute onset
what do you see on CXR with ARDS? - Answer-ground glass opacities, WHITE OUT
treatment for ARDS: - Answer-intubate, use low tidal volumes, permissive with high
CO2, use PEEP to pop alveoli open and pushes fluid out of alveoli back into interstitium
three types of non-small cell lung cancer: - Answer-adenocarcinoma
large cell carcinoma
squamous cell carcinoma
what is a pneumonectomy? - Answer-removal of entire lung
what is a vital nursing intervention after thoracic surgery? - Answer-pain control so
patient can take deep breaths
encourage IS
where does lung CA mets to? - Answer-brain
where does breast CA mets to? - Answer-bone, lungs
where does sarcoma mets to? - Answer-lungs
where does colorectal CA mets to? - Answer-liver, lung
where does testicular CA mets to? - Answer-liver, lung
where does prostate CA mets to? - Answer-bone, lung, liver
s/s of R heart failure - Answer-BLE edema, JVD, engorgement of liver, ascites
s/s of L heart failure - Answer-crackles in bases of lungs, dyspnea, hypoxia, orthopnea,
pink/frothy sputum
right sided AV valve - Answer-tricuspid
left sided AV valve - Answer-mitral
right sided semilunar valve - Answer-pulmonic valve
,left sided semilunar valve - Answer-aortic valve
what prevents AV valve prolapse? - Answer-chordae tendinae
what does stenosis mean? - Answer-stiff valves, wont open well
what does insufficiency mean? - Answer-floppy valves, dont close well, regurgitation,
prolapse
types of diastolic murmors - Answer-tricuspid and mitral stenosis, pulmonic and aortic
insufficiency
types of systolic murmors - Answer-tricuspid and mitral insufficiency, pulmonic and
aortic stenosis
what is normal CO? - Answer-4-8L/min
what are negative chronatropes? - Answer-drugs that slow down the HR
-beta blockers
-CCB (verapamil and diltiazem)
what type of drug is digoxin and how does it slow down the HR? - Answer-Dig is a
cardiac glycoside and slows down HR by acting on AV node
atropine ACLS guidelines - Answer-give for symptomatic bradycardia
0.05 mg, can repeat x1
what does sympathetic nervous system release? - Answer-catecholamines -
epinephrine and norepinephrine
what is pressor of choice for neurogenic shock? - Answer-dopamine
what is special rule for Right sided infarcts? - Answer-give fluid to increase filling
pressures
we dont use pressors until.... - Answer-the tank is full
why do we use pressors? - Answer-to increase coronary artery perfusion pressures to
meet o2 demands of heart muscle
what is number one pressor of choice for septic shock or trauma? - Answer-levophed
what does alpha stimulating mean? - Answer-pressor clamps down periphery to shunt
blood to core
, what does beta stimulating mean? - Answer-pressor works on the heart, either increase
HR or squeeze of heart muscle
patients with poor LV function can have a high afterload with... - Answer-a normal or low
BP
what do ACE inhibitors do? - Answer-decrease pressure heart has to push against to
move blood forward by preventing production of angiotensin II which is potent
vasoconstrictor - allows patient to vasodilate
also diureses the patient
increase SV and CO by decreasing afterload
what is the number one drug of priority in HF? - Answer-ACE inhibitors (prils)
common side effects of ace inhibitors? - Answer-dry non productive cough and
angioedema
how to Angiotensin Receptor Blockers (ARBS) work? - Answer-antagonize angiotensin
II to allow vasodilation to happen and get many of same benefits as ACE inhibitors
SARTANS
how do calcium channel blockers work? - Answer-the way they decrease afterload is
reduce it by lowering intracellular calcium levels which keeps vascular smooth muscle
from being able to constrict so allows for vasodilation
cardizem drip dosing - Answer-bolus of 0.25 mg/kg (second dose of 0.35 mg/kg may be
given)
then drip at 5-10 mg/hr and canbe increased in 5 mg increments to 15 mg/hr PRN
what are positive inotropes? - Answer-increase contractility of the heart
what is most common complication of dopamine? - Answer-tachycardia
what are the three drugs with dose range of 1-20 mcg? - Answer-levophed, dobutamine,
dopamine
what can you expect to see when giving dobutamine? - Answer-PVCs (ectopy - it is
irritating to heart muscle)
what is normal range for digoxin levels? - Answer-0.8-2
what are s/s of dig toxicity? - Answer-YELLOW GREEN HALOS, heart blocks, ectopy
what is the antidote for dig toxicity? - Answer-digibind or mag IV if patient unstable
what increases the risk of dig toxicity? - Answer-hypokalemia or renal insufficiency
and Answers
what are first clues of ARDS? - Answer-tachypnea, progressive hypoxemia, acute onset
what do you see on CXR with ARDS? - Answer-ground glass opacities, WHITE OUT
treatment for ARDS: - Answer-intubate, use low tidal volumes, permissive with high
CO2, use PEEP to pop alveoli open and pushes fluid out of alveoli back into interstitium
three types of non-small cell lung cancer: - Answer-adenocarcinoma
large cell carcinoma
squamous cell carcinoma
what is a pneumonectomy? - Answer-removal of entire lung
what is a vital nursing intervention after thoracic surgery? - Answer-pain control so
patient can take deep breaths
encourage IS
where does lung CA mets to? - Answer-brain
where does breast CA mets to? - Answer-bone, lungs
where does sarcoma mets to? - Answer-lungs
where does colorectal CA mets to? - Answer-liver, lung
where does testicular CA mets to? - Answer-liver, lung
where does prostate CA mets to? - Answer-bone, lung, liver
s/s of R heart failure - Answer-BLE edema, JVD, engorgement of liver, ascites
s/s of L heart failure - Answer-crackles in bases of lungs, dyspnea, hypoxia, orthopnea,
pink/frothy sputum
right sided AV valve - Answer-tricuspid
left sided AV valve - Answer-mitral
right sided semilunar valve - Answer-pulmonic valve
,left sided semilunar valve - Answer-aortic valve
what prevents AV valve prolapse? - Answer-chordae tendinae
what does stenosis mean? - Answer-stiff valves, wont open well
what does insufficiency mean? - Answer-floppy valves, dont close well, regurgitation,
prolapse
types of diastolic murmors - Answer-tricuspid and mitral stenosis, pulmonic and aortic
insufficiency
types of systolic murmors - Answer-tricuspid and mitral insufficiency, pulmonic and
aortic stenosis
what is normal CO? - Answer-4-8L/min
what are negative chronatropes? - Answer-drugs that slow down the HR
-beta blockers
-CCB (verapamil and diltiazem)
what type of drug is digoxin and how does it slow down the HR? - Answer-Dig is a
cardiac glycoside and slows down HR by acting on AV node
atropine ACLS guidelines - Answer-give for symptomatic bradycardia
0.05 mg, can repeat x1
what does sympathetic nervous system release? - Answer-catecholamines -
epinephrine and norepinephrine
what is pressor of choice for neurogenic shock? - Answer-dopamine
what is special rule for Right sided infarcts? - Answer-give fluid to increase filling
pressures
we dont use pressors until.... - Answer-the tank is full
why do we use pressors? - Answer-to increase coronary artery perfusion pressures to
meet o2 demands of heart muscle
what is number one pressor of choice for septic shock or trauma? - Answer-levophed
what does alpha stimulating mean? - Answer-pressor clamps down periphery to shunt
blood to core
, what does beta stimulating mean? - Answer-pressor works on the heart, either increase
HR or squeeze of heart muscle
patients with poor LV function can have a high afterload with... - Answer-a normal or low
BP
what do ACE inhibitors do? - Answer-decrease pressure heart has to push against to
move blood forward by preventing production of angiotensin II which is potent
vasoconstrictor - allows patient to vasodilate
also diureses the patient
increase SV and CO by decreasing afterload
what is the number one drug of priority in HF? - Answer-ACE inhibitors (prils)
common side effects of ace inhibitors? - Answer-dry non productive cough and
angioedema
how to Angiotensin Receptor Blockers (ARBS) work? - Answer-antagonize angiotensin
II to allow vasodilation to happen and get many of same benefits as ACE inhibitors
SARTANS
how do calcium channel blockers work? - Answer-the way they decrease afterload is
reduce it by lowering intracellular calcium levels which keeps vascular smooth muscle
from being able to constrict so allows for vasodilation
cardizem drip dosing - Answer-bolus of 0.25 mg/kg (second dose of 0.35 mg/kg may be
given)
then drip at 5-10 mg/hr and canbe increased in 5 mg increments to 15 mg/hr PRN
what are positive inotropes? - Answer-increase contractility of the heart
what is most common complication of dopamine? - Answer-tachycardia
what are the three drugs with dose range of 1-20 mcg? - Answer-levophed, dobutamine,
dopamine
what can you expect to see when giving dobutamine? - Answer-PVCs (ectopy - it is
irritating to heart muscle)
what is normal range for digoxin levels? - Answer-0.8-2
what are s/s of dig toxicity? - Answer-YELLOW GREEN HALOS, heart blocks, ectopy
what is the antidote for dig toxicity? - Answer-digibind or mag IV if patient unstable
what increases the risk of dig toxicity? - Answer-hypokalemia or renal insufficiency
