PCCN FINAL EXAM AND PRACTICE EXAM

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PCCN FINAL EXAM AND PRACTICE EXAM

NEWEST 2024 ACTUAL EXAM COMPLETE

230 QUESTIONS AND CORRECT ANSWERS

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PCCN FINAL EXAM

A myocardial infarction usually causes damage to the myocardium, progressing from the endocardium to the

epicardium. The first stage in myocardial damage is:

• Formation of zone of ischemia
• Formation of zone of necrosis
• Formation of zone of injury
• Decreased perfusion from hypotension - CORRECT

ANSWER-A:

Rationale: An MI causes damage to the myocardium in stages

beginning when ischemia develops, creating a zone of ischemia with viable cells. Cellular injury then occurs to those cells surrounding the infarcted area in the zone of injury. Infarction with necrosis of tissue comprises the zone of infarction, where cells are destroyed and eventually replaced with scar tissue. 1 / 4

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People may exhibit either hypertension or hypotension during an MI.

A patient presents with pulmonary edema characterized by tachypnea, tachycardia, hypertension, cough, fever, and cough with frothy sanguineous sputum. What initial treatments are most common?

• Oxygen, nitroglycerine, loop diuretics (furosemide), and

morphine

• Oxygen, thiazide diuretics, and ACE inhibitors
• Oxygen and thiazide diuretics
• Oxygen, morphine, and calcium channel blockers -

CORRECT ANSWER -A:

Rationale: The most common initial treatment of acute

pulmonary edema is oxygen to relieve dyspnea, nitroglycerine to reduce preload, loop diuretics, usually furosemide, to promote diuresis and venodilation, and morphine to reduce associated anxiety (although some doctors avoid morphine because of side effects). ACE inhibitors are also sometimes used to reduce afterload, but thiazide diuretics are not used to treat acute pulmonary edema. Calcium channel blockers may induce acute pulmonary edema if used with tocolytics.

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Acquired immunodeficiency syndrome (AIDS) is diagnosed

when the following criteria are met:

• HIV infection and AIDS-defining condition, such as

cytomegalovirus.

• HIV infection and CD4 count 400 cells/mm.
• HIV infection, CD4 count <100 cells/mm, and AIDS-defining

condition.

• HIV infection, CD4 count <200 cells/mm, and AIDS-defining

condition. - CORRECT ANSWER-D:

Rationale: AIDS is diagnosed with HIV infection, CD4 count

<200 cells/mm, and AIDS-defining condition, such as opportunistic infections (cytomegalovirus, tuberculosis), wasting syndrome, neoplasms (Kaposi's sarcoma) or AIDS dementia complex. Patients with AIDS may present with many types of symptoms, depending on the AIDS-defining condition, but more than half exhibit fever, lymphadenopathy, pharyngitis, rash, and myalgia/arthralgia.

Upon physical examination a 23-year-old female complains of chest pain and faintness upon exertion, fatigue, and loss of appetite. She has tachycardia with a weak pulse. Auscultation identifies an ejection click, a brief high-pitched sound occurring immediately after SI. Which of the following cardiac disorders is the most likely diagnosis?

• Coronary artery disease 3 / 4

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• Mitral valve stenosis
• Pericarditis

d. Aortic valve stenosis - CORRECT ANSWER -D:

Rationale: These symptoms, including the abnormal heart sound

(ejection click), are common to aortic valve stenosis. The aortic valve controlling the flow of blood from the left ventricle narrows, causing the left ventricular wall to thicken. Aortic stenosis may result from a birth defect or from damage caused by childhood rheumatic fever. Coronary artery disease is not directly associated with abnormal heart sounds although gallop rhythms can occur with related ventricular hypertrophy. Mitral valve stenosis may cause an opening snap, while pericarditis causes a friction rub.

Which of the following rhythm disturbances is most common after cardiac surgery?

• Ventricular fibrillation
• Ventricular tachycardia
• Premature ventricular contractions (PVCs)
• Atrial fibrillation, flutter, and tachycardia - CORRECT

ANSWER-D:

Rationale: Atrial arrhythmias, including fibrillation, flutter, and

tachycardia, are very common after cardiac surgery, occurring in more than half of patients with valvular surgery. Arrhythmias occur usually in the first 2-3 postoperative days and are often

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