PCCN Final Exam Review Questions & Answers,

PCCN Final Exam Review Questions & Answers,
A nurse is caring for a 71-year-old female patient with end-stage chronic obstructive
pulmonary disease (COPD) who is experiencing cardiac ischemia with increased
shortness of breath. The MOST appropriate goal of oxygen therapy for this patient would
be to:
A. Limit supplemental oxygen to lower the risk of reducing respiratory drive
B. Maintain oxygen saturations between 86% and 89%
C. Administer oxygen until oxygen saturations are greater than 95% in order to relieve
ischemia
D. Maintain oxygen saturations between 90% and 92% - D. Maintain oxygen saturations
between 90% and 92%
Feedback
Maintaining oxygen saturations between 90% and 92% will serve the purpose of
providing enough oxygen to relieve cardiac ischemia while reducing the risk of
respiratory depression in a patient with COPD.
Laboratory studies from a 22-year-old male client with Type I diabetes mellitus are
evaluated during an admission for severe pneumonia. Which of the following laboratory
results should the nurse report to the physician?
A. Glycosylated hemoglobin (HbA1c), 9.8%
B. Low-density lipoprotein (LDL),
C. 94 mg/dLHematocrit (Hct), 53%
D. Urine specific gravity, 1.250 - A. Glycosylated hemoglobin (HbA1c), 9.8%
Feedback
Glycosylated hemoglobin measures the average blood sugar levels over a 2 to 3 month
time period. Clients with previously diagnosed diabetes mellitus should aim to keep their
HbA1c levels below 7%.CONTENT AREA: Clinical Judgement:
Endocrine/Hematology/Neurology/GI/Renal
The nurse is assessing a 68 year old female patient with a history of chronic obstructive
pulmonary disease (COPD). The patient presents with complaints of recent confusion,
increased fatigue, and syncopal episodes when walking. The nurse assesses S3 and S4
sounds on auscultation, jugular vein distention, and +3 pitting edema of the ankles and
feet. Which of the following complications of COPD does the nurse suspect the patient is
most likely experiencing?
A. Acute respiratory distress syndrome (ARDS)
B. Bronchiectasis
C. Heart failure
D. Cor pulmonale - D. Cor pulmonale
Feedback
The nurse should recognize that a history of COPD together with the signs and symptoms
listed here are suggestive of cor pulmonale. The patient requires further workup to
confirm this diagnosis. 

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