PCCN practice Questions with Correct Answers
1. A 49-year-old male was recently admitted with an inferior wall
MI resulting from 100% occlusion of the right coronary artery
(RCA). The 12-Lead ECG reveals ST elevation in leads II, Ill, and avF.
You would expect to see reciprocal changes in which...
Patients taking angiotensin converting enzyme inhibitors may experience hyperkalemia. ACE
inhibitors block angiotensin II, which may lead to decreased aldosterone. Aldosterone is
responsible forexcreting potassium from the kidneys. Therefore, ACE inhibitors can cause
potassium retension and potassium levels should be monitored closely. In addition, renal labs
such as BUN and creatinine should be monitored. If the patient develops more than a 20%
increase in the creatinine, the medication should be discontinued.
A 57-year-old man was admitted with an acute myocardial infarction and is rapidly
deteriorating. He has a BP of 86/42
(57), heart rate of 110, weak, thready pulses, and mottled skin-especially at the knees. He has
had minimal urine output the past 8 hours. A Rapid Response is activated. Which of the
following medications would be the best option to increase the patient's cardiac output?
A Dobutamine
B Norepinephrine
C Amiodarone
D Phenylephrine - Answer✔✔-A Dobutamine. Dobutamine is a positive inotropic medication
used to improve myocardial dysfunction on patients with a low cardiac index and elevated
afterload. It will improve contractility and reduce afterload. Milrinone, which is a
phosphodiesterase inhibitor could also be used as an alternative to dobutamine, in the setting
of decompensated heart failure. It is used cautiously in patients experiencing cardiogiogenic
shock as one of the main side effects of Milrinone is hypotension. The half life of Milrinone is
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