PCCN Review 2025 questions with correct
answers,46
A 17-year-old male client is recovering from idiopathic infective endocarditis. The nurse
should include which of the following teaching points in the discharge care plan for this
client?
A. Taking prophylactic antibiotics before dental procedures
B. Drinking no more than 1 liter of fluid per day
C. Strictly avoiding caffeine or other stimulants
D. Encouraging a healthy low-fat diet that includes at least 2 grams of sodium intake per day -
correct answersA. Taking prophylactic antibiotics before dental procedures
Feedback
Client with a history of infective endocarditis should take prophylactic antibiotics before
dental procedures and some surgical procedures.
A 18-year-old male patient is receiving a series of albuterol treatments via oxygenated
nebulizer to treat an acute severe asthma attack. The BEST way to evaluate the effectiveness
of these treatments is to:
A. Monitor for absence of auscultated wheezing
B. Ask the patient if his breathing feels easier
C. Compare the patient's current peak flow reading with his baseline readings
D. Obtain a pulse oximetry reading of >90% - correct answersC. Compare the patient's current
peak flow reading with his baseline readings
Feedback
Comparing peak flow readings to baseline is a cost-effective, efficient, objective method to
determine effectiveness of asthma treatments. Absence of wheezing may indicate further
airflow restriction, so it is not a definitive method of determining effectiveness of treatments.
,A 19-year-old male patient admitted with fever, malaise, and headache exhibits positive
Brudzinski's and Kernig's signs. These signs indicate: - correct answersCentral nervous system
(CNS) infection
Feedback
Kernig's sign is the inability to straighten the leg when the hip is flexed 90 degrees.
Brudzinski's sign is the flexion of the hips and knees that occurs when the neck is flexed. Both
of these signs, when positive, indicate meningitis.
A 22-year-old male patient is admitted for observation following a linear temporal skull
fracture from a skiing accident. Upon admission at 2 pm, the patient was alert and oriented,
and reports that he "passed out for a second" immediately after his accident. At 4 pm, the
nurse notes that the patient's Glasgow Coma Scale (GCS) is 8. The nurse should:
A. Continue to monitor for changes
B. Place the patient in Trendelenburg position
C. Prepare the patient for burr hole placement with clot evacuation
D. Prepare to administer tissue plasminogen activator (tPA) to reverse occlusive stroke -
correct answersC. Prepare the patient for burr hole placement with clot evacuation
Feedback
This patient is exhibiting classic signs and symptoms of an epidural hematoma. Surgical
intervention to remove the hematoma and relieve pressure on the brain should be performed
as soon as possible.
A 24-year-old male patient sustained blunt chest trauma during an automobile crash, and is
admitted to the telemetry unit for monitoring. All of the following assessment details may
indicate the development of a hemothorax EXCEPT: - correct answersWidening pulse pressure
Feedback
Signs of a hemothorax may include hypotension, tachycardia, low oxygen saturations,
elevated carbon dioxide levels (hypercapnia), and tracheal deviation to the unaffected side.
Subcutaneous emphysema may also be present (even in the case of hemothorax) if the injury
to the lung allows air to seep out of the chest cavity. Pulse pressure narrows because of the
compression of the heart that occurs with both hemothoraces and pneumothoraces.
,A 25-year-old male client is admitted with a diagnosis of pericarditis. The nurse should
prepare to assist with a pericardiocentesis when the client exhibits which of the following
signs or symptoms?
A. Pericardial friction rub
B. Sharp chest pain over the sternal area
C. Elevated blood C-reactive protein level
D. Pulsus paradoxus - correct answersD. Pulsus paradoxus
Feedback
Pulsus paradoxus is defined as a drop of 10 mmHg or more in systolic blood pressure during
inspiration. Pulsus paradoxus is an indicator of cardiac tamponade, a life-threatening
complication of pericarditis. Other listed signs and symptoms may be exhibited by a client
with pericarditis with or without cardiac tamponade.
A 26-year-old female patient is admitted with a diagnosis of hyperglycemic hyperosmolar
syndrome (HHS). The patient's serum glucose level 30 minutes ago was 748 mg/dL. Which of
the following sets of laboratory results could the nurse anticipate?
A. Serum sodium 150 mEq/L, serum creatinine 2.1 mg/dL
B. Elevated serum osmolarity, BUN 6 mg/dL
C. Serum potassium 3.0 mEq/L, decreased serum osmolarity
D. Serum potassium 5.9 mEq/L, serum sodium 129 mEq/L - correct answersD. Serum
potassium 5.9 mEq/L, serum sodium 129 mEq/L
Feedback
Most patients with HHNK exhibit elevated serum potassium levels and decreased serum
sodium levels due to the significant fluid shifts that occur with this condition. If a patient
presents with a normal or low level of serum potassium, potassium replacement should
accompany standard interventions to correct HHNK, as these interventions lower serum
potassium and may precipitate cardiac complications if the electrolyte is not replaced.
, A 28-year-old male patient from Thailand is admitted to the telemetry unit with a history of
syncope. His electrocardiogram shows a right bundle branch block (RBBB) with ongoing ST
elevation in leads V1 through V3, but the patient does not report chest pain or shortness of
breath. The nurse anticipates that this patient may be diagnosed with which of the following
genetic cardiac diseases?
A. Marfan syndrome
B. Brugada syndrome
C. Velocardiofacial syndrome
D. Holt-Oram syndrome - correct answersBrugada syndrome
Feedback
Brugada syndrome is characterized by structural right ventricular pathology that exhibits as
asymptomatic ST elevation in leads V1-3 present all the time, or in response to the
administration of certain medications (e.g., sodium channel blockers). The genetic defect
alters sodium ion conduction. Other ECG abnormalities include the appearance of a right
bundle branch block and long PR intervals. Fever or elevation in temperature from exercise
will exacerbate the ST elevation.
A 32-year-old female patient admitted to a telemetry floor has been waiting three months for
a kidney transplant. Her husband angrily tells the nurse, "This is ridiculous! I feel so
hopeless!" Which of the following thought patterns should guide the nurse's response?
A. Frustration is a normal part of the grieving process and does not usually require nursing
intervention.
B. Expressions of hopelessness may be harmful to the patient, and should be made out of the
hearing of the patient.
C. Maintaining the integrity of the family system is crucial in the transplant process.
D. Discussion of negative emotions may disrupt the process of resolution and should be
avoided. - correct answersC. Maintaining the integrity of the family system is crucial in the
transplant process.
Feedback
Caring practices involves engaging family caregivers in order to create supportive and
therapeutic environments for comfort and healing. Discussing this husband's feelings more in
answers,46
A 17-year-old male client is recovering from idiopathic infective endocarditis. The nurse
should include which of the following teaching points in the discharge care plan for this
client?
A. Taking prophylactic antibiotics before dental procedures
B. Drinking no more than 1 liter of fluid per day
C. Strictly avoiding caffeine or other stimulants
D. Encouraging a healthy low-fat diet that includes at least 2 grams of sodium intake per day -
correct answersA. Taking prophylactic antibiotics before dental procedures
Feedback
Client with a history of infective endocarditis should take prophylactic antibiotics before
dental procedures and some surgical procedures.
A 18-year-old male patient is receiving a series of albuterol treatments via oxygenated
nebulizer to treat an acute severe asthma attack. The BEST way to evaluate the effectiveness
of these treatments is to:
A. Monitor for absence of auscultated wheezing
B. Ask the patient if his breathing feels easier
C. Compare the patient's current peak flow reading with his baseline readings
D. Obtain a pulse oximetry reading of >90% - correct answersC. Compare the patient's current
peak flow reading with his baseline readings
Feedback
Comparing peak flow readings to baseline is a cost-effective, efficient, objective method to
determine effectiveness of asthma treatments. Absence of wheezing may indicate further
airflow restriction, so it is not a definitive method of determining effectiveness of treatments.
,A 19-year-old male patient admitted with fever, malaise, and headache exhibits positive
Brudzinski's and Kernig's signs. These signs indicate: - correct answersCentral nervous system
(CNS) infection
Feedback
Kernig's sign is the inability to straighten the leg when the hip is flexed 90 degrees.
Brudzinski's sign is the flexion of the hips and knees that occurs when the neck is flexed. Both
of these signs, when positive, indicate meningitis.
A 22-year-old male patient is admitted for observation following a linear temporal skull
fracture from a skiing accident. Upon admission at 2 pm, the patient was alert and oriented,
and reports that he "passed out for a second" immediately after his accident. At 4 pm, the
nurse notes that the patient's Glasgow Coma Scale (GCS) is 8. The nurse should:
A. Continue to monitor for changes
B. Place the patient in Trendelenburg position
C. Prepare the patient for burr hole placement with clot evacuation
D. Prepare to administer tissue plasminogen activator (tPA) to reverse occlusive stroke -
correct answersC. Prepare the patient for burr hole placement with clot evacuation
Feedback
This patient is exhibiting classic signs and symptoms of an epidural hematoma. Surgical
intervention to remove the hematoma and relieve pressure on the brain should be performed
as soon as possible.
A 24-year-old male patient sustained blunt chest trauma during an automobile crash, and is
admitted to the telemetry unit for monitoring. All of the following assessment details may
indicate the development of a hemothorax EXCEPT: - correct answersWidening pulse pressure
Feedback
Signs of a hemothorax may include hypotension, tachycardia, low oxygen saturations,
elevated carbon dioxide levels (hypercapnia), and tracheal deviation to the unaffected side.
Subcutaneous emphysema may also be present (even in the case of hemothorax) if the injury
to the lung allows air to seep out of the chest cavity. Pulse pressure narrows because of the
compression of the heart that occurs with both hemothoraces and pneumothoraces.
,A 25-year-old male client is admitted with a diagnosis of pericarditis. The nurse should
prepare to assist with a pericardiocentesis when the client exhibits which of the following
signs or symptoms?
A. Pericardial friction rub
B. Sharp chest pain over the sternal area
C. Elevated blood C-reactive protein level
D. Pulsus paradoxus - correct answersD. Pulsus paradoxus
Feedback
Pulsus paradoxus is defined as a drop of 10 mmHg or more in systolic blood pressure during
inspiration. Pulsus paradoxus is an indicator of cardiac tamponade, a life-threatening
complication of pericarditis. Other listed signs and symptoms may be exhibited by a client
with pericarditis with or without cardiac tamponade.
A 26-year-old female patient is admitted with a diagnosis of hyperglycemic hyperosmolar
syndrome (HHS). The patient's serum glucose level 30 minutes ago was 748 mg/dL. Which of
the following sets of laboratory results could the nurse anticipate?
A. Serum sodium 150 mEq/L, serum creatinine 2.1 mg/dL
B. Elevated serum osmolarity, BUN 6 mg/dL
C. Serum potassium 3.0 mEq/L, decreased serum osmolarity
D. Serum potassium 5.9 mEq/L, serum sodium 129 mEq/L - correct answersD. Serum
potassium 5.9 mEq/L, serum sodium 129 mEq/L
Feedback
Most patients with HHNK exhibit elevated serum potassium levels and decreased serum
sodium levels due to the significant fluid shifts that occur with this condition. If a patient
presents with a normal or low level of serum potassium, potassium replacement should
accompany standard interventions to correct HHNK, as these interventions lower serum
potassium and may precipitate cardiac complications if the electrolyte is not replaced.
, A 28-year-old male patient from Thailand is admitted to the telemetry unit with a history of
syncope. His electrocardiogram shows a right bundle branch block (RBBB) with ongoing ST
elevation in leads V1 through V3, but the patient does not report chest pain or shortness of
breath. The nurse anticipates that this patient may be diagnosed with which of the following
genetic cardiac diseases?
A. Marfan syndrome
B. Brugada syndrome
C. Velocardiofacial syndrome
D. Holt-Oram syndrome - correct answersBrugada syndrome
Feedback
Brugada syndrome is characterized by structural right ventricular pathology that exhibits as
asymptomatic ST elevation in leads V1-3 present all the time, or in response to the
administration of certain medications (e.g., sodium channel blockers). The genetic defect
alters sodium ion conduction. Other ECG abnormalities include the appearance of a right
bundle branch block and long PR intervals. Fever or elevation in temperature from exercise
will exacerbate the ST elevation.
A 32-year-old female patient admitted to a telemetry floor has been waiting three months for
a kidney transplant. Her husband angrily tells the nurse, "This is ridiculous! I feel so
hopeless!" Which of the following thought patterns should guide the nurse's response?
A. Frustration is a normal part of the grieving process and does not usually require nursing
intervention.
B. Expressions of hopelessness may be harmful to the patient, and should be made out of the
hearing of the patient.
C. Maintaining the integrity of the family system is crucial in the transplant process.
D. Discussion of negative emotions may disrupt the process of resolution and should be
avoided. - correct answersC. Maintaining the integrity of the family system is crucial in the
transplant process.
Feedback
Caring practices involves engaging family caregivers in order to create supportive and
therapeutic environments for comfort and healing. Discussing this husband's feelings more in
