PCCN PCCN Multisystem Conditions and Shock 1

Question 1

A patient in septic shock has a MAP of 58 mmHg despite 2 liters of IV fluid. Which vasopressor is the first-line agent per Surviving Sepsis guidelines?

Accepted Answer

Norepinephrine

Answer

Norepinephrine is the first-line vasopressor for septic shock per Surviving Sepsis Campaign guidelines due to its alpha-adrenergic effects.

Question 2

Which hemodynamic profile is characteristic of early distributive (septic) shock?

Accepted Answer

Low SVR, high CO, low PCWP

Answer

Septic shock causes vasodilation (low SVR), compensatory high cardiac output, and low filling pressures (low PCWP) in early stages.

Question 3

A trauma patient develops hypotension, distended neck veins, and absent breath sounds on the left. The nurse should prepare for:

Accepted Answer

Needle decompression of the left chest

Answer

Absent breath sounds with hypotension and JVD after trauma indicates tension pneumothorax requiring emergency needle decompression.

Question 4

Which finding best differentiates cardiogenic shock from hypovolemic shock?

Accepted Answer

Elevated PCWP and reduced cardiac output

Answer

Cardiogenic shock is characterized by elevated PCWP (fluid backing up) and reduced cardiac output, unlike hypovolemic shock which has low PCWP.

Question 5

A patient with anaphylactic shock after contrast dye administration. Which medication is administered first?

Accepted Answer

Epinephrine 1:1000 IM

Answer

Epinephrine IM is the first-line and life-saving treatment for anaphylaxis, reversing bronchospasm and vasodilation immediately.

PCCN Exam Practice Test

PCCN Exam Practice Test

PCCN PCCN Multisystem Conditions and Shock 1