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ALL PCCN ACTUAL EXAM NEWEST VERSION ACTUAL QUESTION AND CORRECT DETAILED ANSWERS RATED A GRADE.
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ALL PCCN ACTUAL EXAM NEWEST VERSION ACTUAL QUESTION AND CORRECT DETAILED ANSWERS RATED A GRADE.
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ALL PCCN ACTUAL EXAM NEWEST VERSION 2024-2025ACTUAL QUESTION AND CORRECT DETAILED ANSWERS
RATED A GRADE.
Your pt was admitted for malaise, severe dyspnea and had a syncopal
episode at work. He states he has a midline burning sensation in his
chest that worsens when he is supine. You suspect? ✔✔CORRECT
ANSWER✔✔MYOCARDITIS
It can also present as inspiratory pain. The pain when supine is a
cardinal sign of myocarditis. Other findings may include respiratory
infection and an S3, S4, and pericardial friction rub.
A definitive diagnosis of myocarditis can be made via? ✔✔CORRECT
ANSWER✔✔ENDOMYOCARDIAL BIOPSY
A biopsy is the ONLY definitive way to diagnose myocarditis.
The volume of fluid required to cause a pericardial tamponade is?
✔✔CORRECT ANSWER✔✔50-75 ml of blood
,Although 50-75 mls is a small amount, the pressure in the
intrapericardial space may equal or exceed atrial and vertricular
pressures causing an acute tamponade.
Beck's triad is a combination of symptoms useful in diagnosing cardiac
tamponade. They are? ✔✔CORRECT ANSWER✔✔Distended neck veins
Muffled heart sounds
Hypotension
Tachycardia is an early sign of tamponade. A narrowed pulse pressure
occurs, and fluid cannot be ejected from the heart. The muffled heart
sounds occur because the fluid in the sac minimized the transmission of
sound waves.
Which of the following hemodynamic changes will occur with cardiac
tamponade?
• Increased cardiac output
• Stroke volume decrease
• Contractility increases
• Decreased heart rate ✔✔CORRECT ANSWER✔✔STROKE VOLUME
DECREASE
Because the heart cannot adequately fill or eject its contents, stroke
volume (SV) decreases and causes a decreased cardiac output (CO).
,Contractility decreases because the muscles cannot stretch and,
therefore, cannot contract effectively.
If your pt had a cardiac tamponade, what you expect to see on a CXR?
✔✔CORRECT ANSWER✔✔A DILATED SUPERIOR VENA CAVA
The vena cava is dilated because blood couldn't flow into the right
atrium.
JVD would not be visible on a CXR.
The mediastinum would be widened.
Delineation of the pericardium or epicardium would not be visible on a
CXR.
Your pt was admitted for severe dyspnea, dysphagia, palpitations and
an intractable cough. On auscultation, you hear a loud S1 and a right
sided S3 and S4. This pt probably has? ✔✔CORRECT
ANSWER✔✔MITRAL STENOSIS
These symptoms could be caused by mitral stenosis, an ischemic left
ventricle, or failure of a left ventricle. The S3 and S4 sounds suggest
both a fluid problem and a pressure problem.
Quincke's sign is usually seen in what condition? ✔✔CORRECT
ANSWER✔✔AORTIC INSUFFICIENCY
, Quincke's sign is elicited by pressing down on he finger top; a visible
pulsation is seen in the nail bed. The sign results from a pulse with a
rapid, initial hard pulsation, followed by a sudden collapse as blood
flows back through the incompetent valve.
In pts with aortic insufficiency, the popliteal BP is often higher than the
brachial BP by at least 40 mm HG. This discrepancy between the
measurements is known as? ✔✔CORRECT ANSWER✔✔HILL'S SIGN
Hills's sign reflects the rapid rise in pulsation.
DeMusset's sign is also found in aortic insufficiency; it consists of the
bobbing of the head in time with the forceful pulse.
Holmes' and Rochelle's signs are not diagnostic signs.
In stable angina, which of the following is true about CK-MB isoenzymes
and troponins? ✔✔CORRECT ANSWER✔✔CK-MB ISOENZYMES AND
TROPONINS WILL NOT INCREASE
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: ✔✔CORRECT ANSWER✔✔fluid volume overload.
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