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PCCN PRACTICE QUESTIONS AND
ANSWERS LATEST REVIEW 2022/2023
what type of WBC increases with anaphylaxis
(correct answers)basophils
what type of WBC increases with allergic reaction or parasite?
(correct answers)eosinophils
what are mature neutrophils?
(correct answers)segs
what are immature neutrophils?
(correct answers)bands
what are types of granulocytes?
(correct answers)neutrophils, eosinophils, and basophils
what are types of agranulocytes?
(correct answers)monocytes, lymphocytes (T and B lymphocytes)
what type of WBC "starts the war" or triggers an immune response?
(correct answers)monocytes
,what is a shift to the left with neutrophils?
(correct answers)an increase in immature neutrophils (bands). if bands > 10% start thinking infection or
inflammation
what do basophils become when they leave the vessels and enter tissues for response?
(correct answers)mast cells
what are common stress responses?
(correct answers)PE, pneumonia, GI bleed
normal platelet count
(correct answers)150,000-400,000
what is reversal agent for heparin?
(correct answers)protamine sulfate
what is reversal agent for coumadin?
(correct answers)vitamin K or FFP
what are causes of DIC?
(correct answers)sepsis, blood or immuno disease, if greater than 4 units PRBCs received in 24 hours,
solid organ transplant, trauma
,what is DIC? (correct answers)unpredictable clotting, some progress to bleeding bc used up all of
clotting factors, always secondary diagnosis to something else
what are s/s of DIC? (correct answers)dusky fingers/toes (clotting in capillaries), bleeding (gums, oozing
of IV sites), unexplained petechiae/bruising
lab changes in DIC (correct answers)-decreased platelets < 100,000
-increased coags (PTT, INR, PT)
-decreased fibrinogen levels (protein precursor to fibrin which is essential to make the clot)
-increased FSPs (things that make the clot)
-increased D dimer
how to treat DIC (correct answers)treat clotting phase with heparin
treat bleeding phase with cyroprecipitate - blood product of choice for hemorrhage related to DIC - gives
pt back clotting factors AND fibrinogen
What is HIT? (correct answers)Heparin Induced Thrombocytopenia. platelets decrease 5-14 days after
receiving heparin. more likely to be caused by low molecular weight heparin (SQ). see unpredictable
clotting, more common in venous.
, what is HIT treatment? (correct answers)stop all heparin! including heparin flushes. stop coumadin!
don't want to give platelets because it will cause more clotting.
what is most common reason patients reject an organ/blood? (correct answers)they develop antibodies
what are s/s of hypoglycemia? (correct answers)pale, sweaty, cool/clammy, shaky, confusion, vision
changes (blurred or seeing spots)
what do cells start to break down when they dont have glucose for energy? what does this produce?
(correct answers)proteins and fats, ketones
what is DKA? (correct answers)more commonly in type one diabetics who produce little to no insulin. as
glucose in blood increases, it causes osmotic diuresis and patient excretes large volumes of urine.
patient may become hypovolemic. patient will develop ketoacidosis and lactic acidosis.
what s/s of DKA? (correct answers)blood sugar 250-800
sweet, fruity breath
postural hypotension
kusmol respirations (deep + labored) to decrease CO2 to attempt to normalize pH
nausea/vomiting
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