PCCN questions ALL ANSWERS 100%
CORRECT SPRING FALL-2022/2023
SOLUTION GUARANTEED GRADE A+
Two days following a near-drowning accident, a pt is dyspneic, using accessory
muscles, expectorating large amounts of secretions and reporting feeling of impending
death. Changes to the assessment data include
RR- 24 TO 36
CXR clear to bilateral diffuse infiltrates
ABG 40?ce mask or 100% non-rebreather mask
pO2 120 mm Hg to 56 mm Hg
pCO2 33 mmHg to 56 mmHg
pH 7.42 to 7.35
HCO3 24 meq/L to 27 mEq/L
Which of the ff do these changes most likely represent
A. aspiration pneumonia
B. pulmonary embolism
C. interstitial pneumonitis
D. ARDS - D. The onset of symptoms occured within 48 hours of the incident. THe
bilateral diffuse infiltrates and ABG results indicating hypoxemia and CO2 retention are
all consistent with ARDS.
Aspiration pneumonia should include hypoxxemia, respiratory alkalosis. The CXR
results would reveal an area of opacity with aspiration pneumonia rather than diffuse
infiltrates.
Interstitial lung disease invlolves an inflammation of supportive tissue between the air
sacs rather than inflammation in the air sacs themselves. Symptoms would be SOB and
a dry cough.
A pt reports chest pain that is sharp, constant, worse when lying down and alleviated
with sitting up and leaning forward. The most likely cause of these findings is
A. ACS
B. pericarditis
C. PE
D. AAA - B Pericarditis is inflammation of the pericardial sac. The damaged epicardium
becomes rough and inflamed and irritates the pericardium lying adjacent to it,
precipitating pericarditis. Pain is the most common symptom of pericarditis. THe pain is
sharp, constant and is alleviated when sitting up and leaning forward.
A pt tells a nurse, "I don't know how I'm going to pay for this hospitalization." The nurse
should
A. arrange a meeting with hospital social services staff
B. Notify the business office so a payment plan can be designed
C. redirect the pt toward meeting psychologic needs
D. give the pt applications for public assistance medical coverage - A. Collaboration with
a social worker is indicated in this case the social worker can assist the pt in identifying
ways to address the financial implications of this hospitalization and help identify
methods of payments.
A cardiac pt with with DNR status is being managed medically. The nurse notes a new
cough, thick yellow sputum and a temperature of 101.4 (38.4) Coarse crackles are
present in the right upper field. The nurse should most immediately anticipate
A. blood and sputum cultures followed by a broad spectrum abx
B. mucolytics and judicious IV fluid administration
C. an antyipyretic and conservative management
D. NPO status and encouragement of frequent activity - A. This pt symptoms are
consistent with pneumonia. Management should include abx therapy, oxygen therapy
for hypoxemia, mechanical ventilation if acute respiratory failure develops, fluid
management for hydration, nutritional support, and treatment of associated medical
problems and complications