THE PCCN EXAM ACTUAL - QUESTIONS WIT

THE PCCN EXAM (ACTUAL - QUESTIONS WIT

ANSWERS

WhichHelectrolytesHposeHtheHmostHpotentialHhazardHifHnotHwithinH normalHlimitsHforHtheHpersonHwithHacuteHkidneyHfailure?-H<<>>PotassiumHandHcalcium

peakedHT- wavesHandHaHwideningHofHtheHQRS HintervalHinHaHptHwithHAKIHareHi

ndicativeHof:H-H<<>>d.Hhyperkalemia.

AHpatientHpresentsHwithHtheHfollowing:HHR,H120Hbeats/min;HBP,H8

0/44Hmm HHg;HurineHoutputHaveragingH20HmL/hrHoverHtheHlastH4Hhou rs;Hafebrile;HmoistHralesHinHtheHlungsHbilaterally;HBUN,H84Hmg/dL;H creatinine,H3.4Hmg/dL.HWhatHisHtheHprobableHcauseHofHthisHpatient' sHacuteHkidneyHinjuryH(AKI)?H- <<>>LeftHventricularHfailureHcausingHprerenalHAKI ToHdetermineHwhetherHedemaHinHaHpatient'sHhandsHisHdueHtoHcircul

atoryHcompromiseHorHanotherHcause,HtheHnurseHmight:H-

<<>>elevateHtheHpatient'sHextremitiesHforH1HhourHand HobserveHtheHdegreeHofHedemaHstillHpresent.

HypovolemiaHcausesHtachycardiaHandH:H-

<<>>hypotension.

ToHavoidHtheHcomplicationsHthatHcanHresultHfromHadministeringHfu rosemideH(Lasix)HtoHstimulateHurinaryHoutput,HtheHnurseHwillHcaref

ullyHmonitor:H-

H<<>>levelsHofHelectrolytes,HespeciallyHpotassium. 1 / 4

THE HPCCN HEXAM H(ACTUAL -

HQUESTIONS HWITH HANSWERS

WhichHdialysisHmethodHwouldHbeHmostHappropriateHforHtheHhemo dynamicallyHstableHpatientHinHtheHanuricHphaseHofHacuteHkidneyHinj uryH(AKI)?H-H<<>>IntermittentHhemodialysis

WhatHareHcomplicationsHofHcontinuousHrenalHreplacementHtherap yH(CRRT)?H- H<<>>AirHembolism,HdecreasedHinflowHpressure,Helec trolyteHimbalance

WhatHtypeHofHformulaHwouldHbeHmostHappropriateHforHaHpatientHwit hHacuteHpancreatitis?H-H<<>>Low Hfat

AHpersonHwithHaHbodyHmassHindexH(BMI)HofH32HwouldHbeHconsider

ed:H-H<<>>obese

DietHtherapyHforHaHhypertensiveHpersonH1HdayHafterHaHmyocardialH

infarctionHwouldHincludeHallHtheHfollowingHexcept:

-H<<>>aHfluid-restrictedHdiet.

KwashiorkorHmalnutritionHresultsHin:H-

H<<>>lowHlevelsHofHserumHproteins,HlowHlymphocyteH count,HandHhairHloss.

SignificantHlaboratoryHandHclinicalHfindingsHinHtheHnutritionalHass

essmentHofHpatientHwithHcardiovascularHdiseaseHinclude:H-

<<>>b.HelevatedHlow- densityHlipoproteinH(LDL)HcholesterolHandHdecreasedHsubcutaneo usHfat. 2 / 4

THE HPCCN HEXAM H(ACTUAL -

HQUESTIONS HWITH HANSWERS

SerumHproteinsHserveHtheHfunctionHof:H-

<<>>maintainingHosmoticHpressure.

AHpatientHonHmechanicalHventilationHisHreceivingHtotalHparenteral HnutritionH(TPN).HWhy HisHappropriateHcaloricHintakeHimportant?H- H<<>>ExcessiveHcalorieHintakeHcanHcauseHanHincreas eHinHPaCO2.HowHdoesHAKIHcauseHacidosis?H- H<<>>DecreasedHurineHoutputHimpairsHpotassiumHexc retion.HTheHresultingHhyperkalemiaHcausesHaHshiftHinHH+,HtheHaccu mulationHresultsHinHacidosis

AHpatientHwithHsevereHabdominalHpainHforHtheHlastHweekHpresentsH withHelevatedHamylase,Hlipase,HandHaHrigidHabdomen.HWhatHdoHyo uHsuspect?H-H<<>>pancreatitis

HowHisHacuteHpancreatitisHtreated?H- <<>>hydration,HelectrolyteHbalance,HnutritionHandHpa inHcontrol

WhatHprocedureHmeasuresHheartHpressureHandHdiagnosesHpulmon aryHhypertension?H-H<<>>right- sidedHheartHcatheterization;HprovidesHmeasurementsHofHrightHatriu m,HrightHventricle,HpulmonaryHartery,HandHpulmonaryHarteryHocclu siveHpressure 3 / 4

THE HPCCN HEXAM H(ACTUAL -

HQUESTIONS HWITH HANSWERS

Why HdoesHloweringHfeverHimproveHprognosisHinHstrokeHpts?H- <<>>IncreasedHmetabolicHdemands,HenhancedH neurotransmitterHrelease,HandHincreasedHfreeHradicalsHmayHi ncreaseHstrokeHmortality.

WhatHisHaHcontraindicationHtoHadministerHnitroglycerinHtoHaHptHwit hHaHrightHventricularHinfarction?H- <<>>nitroglycerinHreducesHpreload,HandHptsHwithHaHR VIHareHpreloadHdependent

WhatHareHsixHriskHfactorsHforHdelirium?H- <<>>cognitiveHimpairment,HsleepHdeprivation,Hdehy dration,Himmobility,HhearingHimpairment,HvisionHimpairment

WhatHdoesHaHpericardialHfrictionHrubHsoundHlike?H- <<>>gratingHsoundHwithHs1HandHs2HNor malHPRHintervalH-H<<>>0.12- 0.20HnormalHQRSH-H<<>>0.04-0.10 complicationsHofHanHintra-aorticHballoonHpumpH(IAPB).H- <<>>Thrombocytopenia,HaorticHdissectionHandHsepti cemia

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