LATEST PCCN PRACTICE QUESTIONS
2024/2025 QUESTIONS WITH VERIFIED
SOLUTIONS
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 leads?
A. I, aVR
B. V, V2
C. V, VA
D I, aVL - CORRECT ANSWER 1. D. I, aVI. The RCA perfuses the inferior wall and
the mirror image or reciprocal change will be seen in the high latera wall, which is
reflected in leads I, and aVL, on the 12-Lead ECG. Leads V1 and V2 correlate with the
septal area, leads V3 and V4 correlate With the anterior area of the heart. The aVR lead
does not provide much diagnostic value as all energy is depolarizing away from this lead.
You are summoned to the room of a 30-year-old female who is experiencing sustained
tonic-clonic convulsions while sitting in a chair. A family member states: "She was just
talking to us and suddenly she let out a shriek and started flopping like a fish out of
water." What is your initial priority of care?
A. Call for help and safely guide the patient to the floor
B. Call for help and administer a prescribed antiepileptic
C. Call for help and administer a prescribed benzodiazepine
D. Call for help and monitor the course of the seizure - CORRECT ANSWER A. Call
for help and safely guide the patient to the floor
Patient Safety is priority
,LATEST PCCN PRACTICE QUESTIONS
2024/2025 QUESTIONS WITH VERIFIED
SOLUTIONS
A 46-year-old patient presents with pneumonia and sepsis.
He was treated with 4 days of antibiotics and IV fluids. He is increasingly short of breath
and is now on 100% FiO, via non-re-breather mask. You obtain an ABG with the
following results: pH 7.20 / PaCO, 68/ PaO, 102/ HCO, 28. A chest x-ray reveals bilateral
pulmonary infiltrates. The patient is likely developing:
A. Worsening pneumonia
B. Acute Respiratory Distress Syndrome
C. Pulmonary embolus
D. Atelectasis - CORRECT ANSWER B. Acute Respiratory Distress Syndrome
A 56-year-old male is admitted to the PCU with a hypertensive crisis. His blood pressure
is now 205/125 mm Hg and he is complaining of a headache with nausea. He reports he
ran out of blood pressure medication three days ago, but also appears to be confused to
the date and situation. What is the most appropriate treatment approach?
A. Rapidly lower the systolic pressure to 100 mm Hg with IV antihypertensive
medication, then gradually reduce the diastolic pressure to 85 mm Hg with oral
antihypertensive medications
B. Slowly lower the systolic pressure to 120 mm Hg with IV antihypertensive
medications, then switch to oral antihypertensive medications for maintenance
,LATEST PCCN PRACTICE QUESTIONS
2024/2025 QUESTIONS WITH VERIFIED
SOLUTIONS
C. Rapidly lower the diastolic pressure to 100 mm Hg with IV antihypertensive
medications, then continue to gradually reduce the diastolic pressure to 85 mm Hg with
oral antihypertensive medications
D. Slowly lower the diastolic pressure to 85 mm - CORRECT ANSWER C. Rapidly
lower the diastolic pressure to 100 mm Hg with IV antihypertensive medications, then
continue to gradually reduce the diastolic pressure to 85 mm Hg with oral
antihypertensive medication
5. Which of the following labs must be closely monitored when administering Lisinopril to
a patient with systolic heart failure?
A. Sodium
B. Phosphate
C. Magnesium
D Potassium - CORRECT ANSWER D. Potassium
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
, LATEST PCCN PRACTICE QUESTIONS
2024/2025 QUESTIONS WITH VERIFIED
SOLUTIONS
(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 - CORRECT 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 about 6 hours. Norepinephrine and
Phenylephrine cause vasoconstriction, which would increase the SVR and may
compromise cardiac output.
You are caring for a patient post gastric bypass. Which of the following parameters
should you closely monitor after surgery?
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