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pccn practice Questions with answers
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pccn practice Questions with answersA nurse in the emergency department assesses a patient with a hand laceration and notices that the
patient smells strongly of alcohol. The patient is diabetic, irritable, and pale and reports headache. The
nurse is waiting for laboratory results. What serum glucose level might the nurse expect to find?
a. 50 to 60 mg/dL
b. <50 mg/dL
c. >1000 mg/dL
d. 80 to 110 mg/dL - Answer - b. <50mg/dL
Following a chest infection, a patient with type 1 diabetes reports fatigue and nausea. Assessment
reveals a blood glucose level of 450 mg/dL. Which of the following pharmacologic interventions are
priorities for patient care?
a. Administer intravenous (IV) fluids at the prescribed rate to correct sodium levels.
b. Administer intravenous (IV) fluids based on corrected sodium levels.
c. Administer prescribed insulin via IV bolus, then continuous drip.
d. "Administer intravenous (IV) fluids based on corrected sodium levels" and "Administer prescribed
insulin via IV bolus, then continuous drip". - Answer - d. "Administer intravenous (IV) fluids based on
corrected sodium levels" and "Administer prescribed insulin via IV bolus, then continuous drip".
Which of the following are possible complications from diabetic ketoacidosis?
a. Hyponitremia
b. Metabolic acidosis
c. Hyperkalemia
d. Metabolic alkalosis - Answer - b. Metabolic acidosis
MA- caused by ketosis resulting from insulin deficiency and stress hormone excess. Hyperkalemia is
caused by higher than normal levels of potassium, usually through impaired renal function.
Hyponatremia is a low level of nitrogen in the blood associated with protein malnutrition or
overhydration. Metabolic alkalosis is an acid-base imbalance, like metabolic acidosis, but is caused by an
increase in serum bicarbonate (HCO3) concentration.
An unconscious patient with hypoglycemia is being treated with IV glucose (50 mL of 50% dextrose IV
bolus) to correct serum glucose levels of 40 mg/dL. Which of the following is a possible complication of
administering hypertonic dextrose?
, pccn practice Questions with answers
a. Myocardial infarction
b. Cardiac arrest
c. Hypokalemia
d. Phlebitis - Answer - c. phlebitis
Hypoglycemia resulting from insulin excess or other causes in adults and children is typically treated
with 20 to 50 mL of 50% dextrose injection administered slowly (eg, 3 mL/minute) IV. Hypertonic
dextrose commonly causes phlebitis if a peripheral vein is used and should therefore be administered
slowly
A 27-year-old patient with rheumatoid arthritis is admitted with anemia. During administration of 200
mL packed red blood cells (PRBCs) over 1 hour, the patient becomes restless. Her pulse is bounding, and
her blood pressure is elevated. The most likely explanation is:
a. The transfusion was administered too quickly
b. The PRBCs are contaminated with gram-negative organisms
c. Allergic response to the transfusion
d. Hemolytic reaction to the transfusion - Answer - a. administered too quickly
Circulatory overload can happen any time during a transfusion and is likely when it is administered too
quickly. It causes hypertension, bounding pulse, and restlessness. Treatment involves slowing the
transfusion and monitoring the patient's progress. Hemolytic, bacterial, and allergic reactions typically
occur soon after transfusion is initiated; hemolytic and bacterial reactions are accompanied by
tachycardia, and allergic reaction is accompanied by hypotension
Complications associated with long-term transfusions for sickle cell anemia patients include:
a. Renal dysfunction
b. Alloimmunization
c. Stroke
d. Acute chest syndrome - Answer - b. Alloimmunization-
occurs when the patient develops antibodies against a range of antigens following repeated blood
product transfusions. The transfused cells are destroyed and the transfusion fails to correct the patient's
blood counts. The other answer choices are all complications of sickle cell anemia
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