PCCN Practice Exam | 100+ Questions
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A pt with history of COPD and anterior wall MI that occurred 1 year ago is
now SOB and expectorating pink frothy sputum. The pt has a rapid,
irregular heart-beat with an O2 sat of 89%. The most likely cause of these
S/S is
A. pulmonary edema
B. cardiac tamponade
C. pneumococcal pneumonia
D. ARDS - Correct Answer - A (History and current symptoms are
consistent for pulmonary edema)
Which of the ff patients in the PCU should be further evaluated for
malnutrition? The pt with
A. a third episode of ARF and poor pulmonary function tests
B. hypoactive bowel sounds and normal albumin levels
C. sepsis who hasa 10 kg water weight gain and is receiving diuretics
D. elevated BMI and Hgb of 14.6 - Correct Answer - A (Malnutrition and
respiratory failure are closely lined. Critically ill pt with respiratory failure are
vulnerable to complication of underfeeding or overfeeding.)
,A pt with ESRD and HF is receiving HD through an AV graft. VS are BP
190/94, HR 104, RR 26. The pt has crackles bilaterally and is bleeding from
the graft site. The nurse should
A. asses for bruit and thrill every 30 min for 2 hours and reasses
B. notify the interventional radiologist
C. ask the nephrologist to insert a temp catheter into the contralateral arm
D. collaborate with the nephrologists regarding not using heparin during
dialysis treatment - Correct Answer - B (If the bleeding is not controlled
following application of direct pressure to the site, repair by an
interventional radiologist is indicated.)
A pt presents with a temperature of 105.6 F (40.9) and nuchal rigidity. A
nurse obtains blood culture and administers antibiotics. The patient
remains febrile, and the family questions the adequacy of the interventions.
The nurse's best response should be to
A. arrange a social service consult
B. assure the family that everything will be explained later.
C suggest that the family discuss their concerns with the physician
D. acknowledge the family's concerns while explaining rationales for the
interventions - Correct Answer - D (The nurse demonstrating high levels of
caring practices and facilitation of learning will acknowledge and address
the family's learning)
A pt who is newly admitted is hemodynamically stable, had sustained a
stroke and had been on mechanical ventilation via tracheostomy tube, a
continuous sedation infusion and enteral feedings in the ICU for several
days. The pt is now off sedation and receiving O2 via a trach collar. Gastric
,residual volumes of 250 ml every 6 hours over the past 3 days have been
noted. Upon collaborating with the nutritionist and physician, the nurse
should anticipate which of the ff
A. dilution of the enteral feeds by 50% with water
B. administration of a prokinetic agent
C. decreasing the rate of enteral feedings by 50%
D. initiation of pernteral nutrition - Correct Answer - B (In a studr of 206
critically ill pt, 2 or more GRVs of at least 200 mL and 1 or more GRVs of at
least 250 mL were found significantly more often in pt who experienced
frequent aspiration. Prokinetics have been advocated to improve gastric
emptying.)
Which of the ff electrolye abnormalities should the PCU nurse anticipate in
caring for a pt with chronic alcohol abuse
A. hypomagnesemia
B. hyperphosphatemia
C. hypercalcemia
D. hyponatremia - Correct Answer - A (Pt with chronic alcohol abuse are
at risk of reasons (1) their diet is typically low in magnesium, (2) alcohol
diuresis pulls magnesium out of the body, and (3) there is associated poor
GI absorption of dietary magnesium in chronic alcohol abuse.)
A pt develops SVT hypotension and chest pain. The goal of therapy will be
to
A. reduce HR to increase diastolic filling time
B. produce arteriolar constriction to increase perfusion pressure
C. dilate coronary arteries to increase myocardial O2 delivery
, D. promote venous constriction to increase preload - Correct Answer - A
(Rapid heart rates can lead to hemodynamic instability, because the fast
rate prevents adequate ventricular filling during diastole and increases
myocardial oxygen demand, while decreasing time available for coronary
artery filling)
Which of the following would be the most important immediate concern
when managing a pt with an acute ischemic stroke
A. preventing pressure ulcers from limited mobility related to hemiparesis
B. avoiding HTN while maintaining adequate cerebral perfusion
C. performing a CT scan to evaluate for bleeding form tPA infusion
D. intubation and mechanical ventilation for airway protection - Correct
Answer - B (The main goals for managing the pt with acute ischemic
stroke are twofold: (1) enhancement of cerebral blood flow and (2)
neuroprotection, with the aim to reduce the intrinsic vulnerability of brain
tissue to ischemia)
A pt with history of taking gentamicin (Garamycin) is admitted with oliguria,
confusion, lethargy, nausea and vomiting. Lab data are as follows
BUN 26
Cr 1.6
Na 130
K 4.9
Calcium 7.8
Which of the following should the nurse suspect
A. dehydration
B. acute tubular necrosis
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