PCCN practice questions, built for nurses.

BiPAP (non-invasive positive-pressure ventilation) reduces the work of breathing and helps clear CO2 in a COPD exacerbation (pH 7.31, PaCO2 58), and can prevent intubation.

Deep sedation depresses the respiratory drive the patient needs. Immediate chest physiotherapy doesn't address the acute hypercapnia. Pushing oxygen to a 100% saturation risks blunting the hypoxic drive and worsening CO2 retention.

Stable atrial fibrillation with a rapid ventricular response is managed with rate control and monitoring — give the ordered rate-controlling agent and watch the patient.

Immediate synchronized cardioversion is reserved for hemodynamically unstable patients. Chest compressions are for a pulseless patient, but this patient has a stable blood pressure. Withholding all cardiac medications leaves the rapid rate untreated.

Refractory hypoxemia with diffuse bilateral infiltrates and no cardiac cause suggests acute respiratory distress syndrome; the nurse recognizes that oxygen alone is failing and escalates for a higher level of care.

This pattern is a clinical deterioration, not a device error, an expected resuscitation response, or a stable finding to monitor passively.

Alteplase eligibility hinges on the symptom-onset or last-known-well time, since the drug is given only within a defined window from onset.

Dietary sodium, sleep position, and vitamin use have no bearing on thrombolytic timing decisions.

Retained bladder volume behind an enlarged prostate blocks urine drainage, the defining postrenal mechanism, and relieving the obstruction restores output.

Low blood volume and nephron toxins act before and within the kidney, and a long-standing process would not present with this sudden retention.