Medical Terminology and Concepts, Exams of Advanced Education

Download Medical Terminology and Concepts and more Exams Advanced Education in PDF only on Docsity! PCCN Exam Questions With 100% Correct Answers 2023 epoetin alfa - Correct Answer-anemia related to chronic kidney disease should be treated with ______________________. folic acid, Vitamin B12 - Correct Answer-Name two treatments for megaloblastic anemia. infection - Correct Answer-Glucose control (via insulin drip) in the post-CABG patient decreases the risk of ___________________. acidosis - Correct Answer-In acute oliguric kidney injury, hyperkalemia leads to ____________________. right - Correct Answer-Obstructive-sleep apnea patients are at risk for ________-sided heart failure. hydration - Correct Answer-Acute pancreatitis patients need aggressive _________________________ as their first line treatment. right - Correct Answer-The best way to diagnose pulmonary hypertension and get heart pressure measurements is ________-sided heart catheterization. False (hypoglycemia can cause stroke-like signs and symptoms) - Correct Answer-True or False: hyperglycemia can cause stroke-like signs and symptoms. benzodiazepines - Correct Answer-The goal of alcohol withdrawal management is adequate sedation with _____________________. heparin - Correct Answer-If atrial fibrillation lasts more than 24 hours, the patient should get a ____________ drip at therapeutic levels beta blockers - Correct Answer-Rate control for atrial fibrillation can be achieved with a cardizem drip. _______________ are also an alternative for rate control. transesophageal echocardiogram - Correct Answer-A ___________________________________________ should be done before attempting to cardiovert a patient with atrial fibrillation. 15-20 - Correct Answer-The ischemic stroke patient should have their blood pressure lowered ____-____% within the first day. A too-low BP can result in neurological worsening. beta blockers - Correct Answer-Cardiac surgery patients can be on _______________ pre- and post-operatively to control atrial fibrillation. preload - Correct Answer-Nitroglycerin is contraindicated in right ventricular infarction because it decreases ____________________. seizures - Correct Answer-Both hypernatremia and hyponatremia can cause _____________________. Sepsis - Correct Answer-DIC is common in ____________ because coagulation is impaired. jaundice - Correct Answer-_________________ is common in DIC patients because stress and hypotension can cause hepatocellular injury. true - Correct Answer-True or False: Sputum cultures are not recommended for COPD exacerbation. False (Antibiotics are not recommended. Short-acting beta agonists are first line therapy.) - Correct Answer-True or False: Antibiotics are recommended for COPD exacerbation. False (afterload and preload are increased with cardiogenic shock; afterload needs to be decreased and vasoconstrictors are contraindicated) - Correct Answer-True or False: The goal of treatment for cardiogenic shock is to increase afterload with vasoconstrictors like norepinephrine (levophed). cardiogenic shock - Correct Answer-Vasosonstrictors (norepinephrine), beta-blockers, and low molecular weight heparin should be avoided for patients with this condition. Vasopressin (ADH) - Correct Answer-_______________________ can improve portal hypertension in upper GI bleed/liver cirrhosis patients. sepsis - Correct Answer-ARDS is most often part of a systemic inflammatory process, particularly systemic ____________. endocarditis - Correct Answer-A patient with a new systolic murmur should be evaluated for ____________________. true - Correct Answer-True or False: acute ischemic stroke patients need to be as flat as possible in bed for the first 24 hours. False - Correct Answer-True or False: A pulmonary embolism patient will have crackles in the lungs. polyurethane - Correct Answer-This type of foam is hydrophobic. It can be used on all wounds except if painful, has tunneling or sinus tracts, resulting from deep trauma, or needs controlled growth of granulation. morphine, oxygen, loop diuretics, nitroglycerin - Correct Answer-Main treatments of acute pulmonary edema. 10:1 - Correct Answer-Normal BUN:Creatinine ratio acute lung injury - Correct Answer-A problem characterized by crackling rales and wheezing, decreased pulmonary compliance, and cyanosis. Oxygen should be administered at 100% to keep sats above 90 because of the V/Q mismatch. complete coronary occlusion - Correct Answer-In Q-wave myocardial infarctions, 80- 90% of patients have ______________________________. metabolic syndrome - Correct Answer-a syndrome of insulin resistance that puts patients at risk of diabetes. Characterized by abdominal obesity, high triglycerides, low HDL, high blood pressure, high fasting glucose, high C-reactive protein (proinflammatory state) and high fibrinogen levels (prothrombic state) 24-44 - Correct Answer-Oxygen delivery with nasal cannula ranges from ____-____%. 95% - Correct Answer-The oximetry of the post-cardiac surgery patient should be maintained at or above _____. 90% - Correct Answer-The patient with acute lung injury receives oxygen to maintain SpO2 at _____. bleeding esophageal varices - Correct Answer-What is the most common complication of portal hypertension? decrease - Correct Answer-Diuresis and dehydration cause preload to ___________. cardiomyopathy - Correct Answer-In the normal heart, a decrease in heart rate causes an increase in stroke volume. However, in _______________, this compensation may not happen and a decrease heart rate will cause lower cardiac output. thromboembolism - Correct Answer-The nurse knows that the patient with dilated cardiomyopathy is at risk for sudden death from... cardiac tamponade - Correct Answer-The risk of removal of epicardial pacing wires is __________________________________. nimodipine - Correct Answer-cerebral vasospasm absolutely need _______________, even if hypotensive. A fluid bolus or vasopressor should be given for hypotension. calcium channel blockers - Correct Answer-Heart failure patients with reduced ejection fraction cannot have ____________________. hypertrophic cardiomyopathy - Correct Answer-Patients with this myopathy cannot be given inotropes like digoxin, dopamine, dobutamine, or milrinone. aortic stenosis - Correct Answer-The patient with a systolic ejection murmur, a split S2, and rales should be evaluated for pulmonary edema related to ______________. right - Correct Answer-pulmonic stenosis is related to ________ ventricular hypertrophy. left - Correct Answer-aortic stenosis is related to ____________ ventricular hypertrophy obstetric - Correct Answer-DIC is most commonly associated with trauma, sepsis and ____________________ emergencies. The patient will have profound bleeding problems, and guiac positive stool. anion gap - Correct Answer-the ____________________ is the calculated difference between the positively charged ions (potassium, sodium) and the negatively charged ions (chloride, bicarbonate) in the serum. A decreasing value is suggestive of progress of resolution of DKA. jejunal - Correct Answer-Utilization of _______________ feedings maintain gut integrity and minimize pancreatic stimulation for patients with acute necrotizing pancreatitis. antifibrinolytics - Correct Answer-Myopathy and tinnitus are associated with _____________________. sickle cell anemia - Correct Answer-Hydroxyureas are medications used to reduce the number of transfusions needed for _____________________ patients. Myelosuppression is a dangerous side effect. phlebitis - Correct Answer-A major complication of hypertonic dextrose is _____________________. occipital lobe - Correct Answer-The part of the brain that manages vision, visual recognition, reading comprehension cerebellum - Correct Answer-part of the brain that manages coordination, balance, and gait parietal lobe - Correct Answer-the part of the brain that manages object recognition by size, weight shape, and body part awareness hypocalcemia - Correct Answer-Chvostek sign is a facial twitch elicited by tapping over the facial nerve. It indicates ___________________. splenic injury - Correct Answer-Kehr's sign is referred pain to the left shoulder and is often seen in patients with _____________________ patients. subarachnoid hemorrhage - Correct Answer-Kerning's sign is seen in ____________________, meningitis, and conditions of meningeal irritation. It is positive if the thigh is flexed at the hip with the knee at 90 degrees, then extension in the knee is painful leading to resistance. aortic rupture - Correct Answer-Cullen's sign is periumbilical ecchymosis found in the setting of necrotizing pancreatitis, abdominal trauma and _____________________. True - Correct Answer-True or False: The atria cannot be paced when in atrial fibrillation. c (When the ventricles are thickened, as in hypertrophy, it is more difficult to fill them adequately. The atria eject more forcefully, and the vibration of this ejection causes the S4 heart sound. In the setting of pericarditis, a pericardial friction rub may be auscultated. A S3 heart sound (ventricular gallop) is auscultated in heart failure with fluid overload. A split S1 may be auscultated with a bundle branch block or frequent PVCs) - Correct Answer-A S4 heart sound is expected in which of the following? A. Pericarditis B. Left ventricular failure C. Ventricular hypertrophy D. Bundle branch block Alpha - Correct Answer-____________ cells in the pancreas produce glucagon. b (The profound dehydration will lead to an elevated serum osmolality in Diabetes Insipidus because of the water loss. In diabetes insipidus there is a lack of ADH. The sodium level may elevate while the urine specific gravity will drop due to dilutional effects.) - Correct Answer-A 56-year-old suffered a cardiopulmonary arrest & received 45 minutes of chest compressions. He has recovered, but has severe short term memory loss. On day 3 of his hospital stay, you notice his urine drainage bag is suddenly full. The urine is clear without color. He continues with UOP of 700-1000 mL per hour x 2 hours. Which of the following assessment findings would you expect? A. Serum sodium level of 126 B. Serum osmolality of 320 C. Urine specific gravity of 1.025 D. Serum potassium of 3.5 b - Correct Answer-Earliest signs of increased intracranial pressure (ICP) include: anastomotic - Correct Answer-Potential complications of bariatric surgery include infection and bleeding, and gastric bypass also carries the risk of _____________________ leak. Signs may be insidious such that elevated heart rate is the only indicator before sepsis begins. V2 - Correct Answer-Injury to the posterior heart wall manifests itself with ST- depression in the septal leads with a large R-wave in lead _____ which is a reciprocal change. The right coronary artery is of issue. nephrotoxicity - Correct Answer-Vancomycin has a high risk of _______________________ and an elevated serum creatinine is important to review with the providers to ensure the plan will be to continue to the planned medication treatment. bradycardia - Correct Answer-_______________________ is the best indicator that shock is from a neurogenic cause such as spinal shock. d - Correct Answer-An 18-year-old with Type 1 diabetes is admitted with a hyperglycemic emergency. Her initial glucose was 320 mg/dL with a potassium of 5.2. Your highest priority when caring for her is: A. Correcting her glucose levels B. Ensuring she eats dinner C. Restarting her home SQ insulin D. Correcting her fluid deficit b (Damage to the pancreas inhibits its endocrine function of insulin production. Without insulin, hyperglycemia ensues. Lipolysis from pancreatic enzyme causes increased free fatty acids in the vascular compartment that bind calcium. Thus, the patient may exhibit hypocalcemia. Hypokalemia can result from excessive vomiting.) - Correct Answer- Which set of lab values is commonly seen in acute pancreatitis? A. Hyperglycemia, hypercalcemia, hyperkalemia B. Hyperglycemia, hypocalcemia, hypokalemia C. Hypoglycemia, hypocalcemia, hypokalemia D. Hypoglycemia, hypercalcemia, hyperkalemia a (Serious side effects of Depakote include an increased risk for infection, liver failure, and pancreatitis. In general, patients in the PCU should be assessed daily for discontinuation of invasive lines, tubes and drains, but this patient is at a increased risk.) - Correct Answer-99. A patient admitted to the PCU with seizures refractory to his current home medications. He is started on Depakote (Valproic acid). The patient has a central line and urinary catheter in place. Which action by the nurse demonstrates an understanding of medication side effects? A. Collaborate daily with the medical team to evaluate the need of the central line and urinary catheter B. Order seizure pads from central supply C. Apply sequential compression devices upon arrival to the unit D. Advocate for daily bowel care protocol down - Correct Answer-Following pneumonectomy, or removal of the entire lung, the operative side is placed ___________ to allow for optimal expansion of the remaining lung. opposite - Correct Answer-Following lobectomy, patients are positioned on the ___________ side to maximize perfusion and gas exchange in the unaffected size. a (The bundle of His and right bundle branch are located primarily in the anterior wall, so both of these may be affected in an anterior MI. 2nd degree type II heart block occurs when conduction is blocked at the bundle of His or in one of the bundle branches. If the patient develops a 2nd degree Type 2 block, you should prepare to transcutaneous pace the patient and transfer to the ICU.) - Correct Answer-A patient with an anterior wall MI should be monitored for which of the following complications? A. Right BBB & 2nd degree Type 2 heart block B. 1st degree heart block C. Aberrantly conducted rhythms D. Supraventricular tachycardia b (Glucagon hydrochloride is the antidote for calcium-channel antagonists and beta- adrenergic receptor antagonists. Flumazenil is given to reverse benzodiazepine effects. Naltrexone hydrochloride is given to treat alcohol or opiate dependence. Deferoxamine is used to treat acute iron toxicity.) - Correct Answer-A patient with newly diagnosed dementia was admitted to the PCU after an accidental metoprolol overdose. The patient has a HR of 42. What medication would you expect the provider to order as an antidote? A. Flumazenil B. Glucagon hydrochloride C. Naltrexone hydrochloride D. Deferoxamine mesylate d (Side effects of dexamethasone include decreased potassium and calcium levels, hyperglycemia, and myopathy that results in proximal muscle weakness.) - Correct Answer-A patient is admitted with adrenal insufficiency. The provider orders Dexamethasone (Decadron). Which side effect should you anticipate? A. Increased potassium level B. Increased calcium level C. Hypoglycemia D. Proximal muscle weakness d (Left ventricular failure causes backup of blood into the pulmonary vasculature, leading to crackles, insufficient cardiac output and hypotension. The S3 heart sound is caused by decreased ventricular compliance, as the ventricle is so full of blood that it is unable to stretch further.) - Correct Answer-Clinical signs of cardiogenic shock secondary to acute left ventricular failure include: A. Hypotension, S4 heart sound, pericardial friction rub B. S3 heart sound, Hypotension, systolic murmur C. Diastolic murmur, S4 heart sound, Hypertension D. Crackles, S3 heart sound, hypotension d - Correct Answer-3. A patient is being treated for hypertensive crisis with labetalol (Normodyne) 10 mg IV every 2 hours PRN and Enalapril (Vasotec) 1.25 mg IV every 6 hours. The RN should hold the medications and notify the provider when lab findings show: A. ↓ Potassium B. ↑ Hematocrit C. ↓ Platelets D. ↑ Liver function tests Kupchik, Nicole . ACE the PCCN®! You Can Do It! Practice Review Questions (pp. 164- 165). Kindle Edition. a (Atrial fibrillation. Atrial fibrillation occurs due to distension of the atrial myocardial tissue as a result of reduced left ventricular emptying. The tissues around the pulmonary veins are typical sites for atrial ectopy. 2nd degree AV block type II and 3rd degree AV block are complications associated with occlusion of the left anterior descending artery during acute coronary syndrome. 2nd degree AV block type I is seen with conditions that produce ischemia to the AV node.) - Correct Answer-Which arrhythmia is commonly associated with left-sided heart failure? A. Atrial fibrillation B. 2nd degree AV block type I C. 2nd degree AV block type II D. 3rd degree AV block a (The best place to auscultate the mitral valve is the left mid-clavicular line, 5th ICS- directly over the anatomic location of the valve. The mitral valve is open during diastole, so altered flow due to stenosis is best heard then.) - Correct Answer-A murmur associated with mitral stenosis is best auscultated: A. At the left mid-clavicular line, during diastole B. At the left mid-clavicular line, during systole C. At the right sternal border, during diastole D. At the right sternal border, during b (When there is severe loss of gastric content as in the case of vomiting, there is also loss of hydrochloric acid (HCl). Whenever a hydrogen ion is lost, a bicarbonate ion is gained. In the setting of hypokalemia, alkalosis may be present due to intracellular shifting of bicarb ions. Other causes of metabolic alkalosis include diarrhea, excessive bicarbonate administration and excessive loop diuretic use.) - Correct Answer-A patient with severe vomiting may exhibit which of the following acid/base imbalances? A. Metabolic acidosis B. Metabolic alkalosis C. Anion gap acidosis