PCCN ACTUAL Exam 2025 Questions and
6. During initial examination of a critical care patient, the nurse observes
Answers wide and convex nails and bulbous fingertips. This is evidence of
(Answer) centralcyanosis.
(Verified Answers)
7. Priorities for palpation of the patient with cardiovascular disease include:-
1. The nurse observes that the patient's jugular veins distend in the semi-up- : estimating edema.
right position to more than 5 cm above the sternal angle. This is an indication checking capillary refill
of (Answer) fluid volume overload. checking for DVT
arterial pulses
2. what is normal Pulmonary artery occlusion pressure (PAOP) (Answer) 5-
12 mmHg 8. By blocking the conversion of angiotensin I to angiotensin II, an-
giotensin-converting enzyme inhibitors produce (Answer) b.
vasodilation.
3. The resistance against which the left ventricle must pump to eject its
volume is (Answer) systemic vascular resistance. 9. The nurse has read that the cardiologist recommends the use of class IV
drugs to depress sinus and atrioventricular node conduction and terminate
4. When the tricuspid valve is open, central venous pressure reflects the supraventricular tachycardias in the patient at this time. The nurse will antic-
filling pressure in the (Answer) right ventricle. ipate orders for which medications (Answer) a. Verapamil, diltiazem, or
amlodipine
5. Tachycardia is dangerous for the patient with ischemic heart disease
because of (Answer) compromised cardiac output. 10. The nurse has administered a drug that stimulates ²1-adrenergic sites.
,Following administration of the drug, the nurse will assess for (Answer) a. 14. A patient is being monitored by continuous electrocardiogram (ECG)
increasedheart rate. after placement of a transvenous pacemaker. "Loss of capture" is seen on
11. The nurse is observing the patient's electrocardiographic monitor after the ECG. Which nursing intervention may correct this situation (Answer) a.
insertion of a temporary pacemaker. Seeing a P-wave after the pacing arti- Positionthe patient on the left side. or reposition the leads
fact, the nurse knows that the (Answer) c. atrium is being paced.
15. In analyzing the ECG strip, the nurse notices a spike before each QRS
12. The possibility of microshock when handling a temporary pacemaker can complex. The patient's heart rate is 70 beats/min. This phenomenon is reflec-
be minimized by (Answer) b. insulating the ends of the wires. and wearing tive of: b. pacing artifact; the pacemaker is sensing and capturing.
gloves when handling the pacing wires
16. Calculate the cerebral perfusion pressure (CPP) for a patient with a mean
13. In the postoperative cardiovascular patient, the most frequent cause of a arterial pressure (MAP) = 95 mm Hg and an intracranial pressure (ICP) = 15
decreased cardiac output is (Answer) a. reduced preload. mm Hg.: b. 80 mm Hg
17. What procedure secures an arteriovenous malformation when a pt's
condition is too unstable for surgery (Answer) embolization that can be done
to securethe lesion without surgery. When the condition is more stable, an
operation mightbe considered if needed.
18. Knowing that a patient has hypoxemia and ischemia in his brain, the
nurse anticipates which of the following (Answer) a. Cerebrovascular
dilation
,19. The nurse's priority in eye care for the patient in a coma will be (Answer) 24. To reverse the hyperglycemic hyperosmolar state, the nurse will first
c. keeping the eyes moist to prevent corneal ulceration. prepare to administer (Answer) fluids
25. The nurse is caring for a patient with central diabetes insipidus (DI). The
20. The patient has markedly deep, rapid respirations with a fruity breath nurse should anticipate orders for the administration of (Answer)
odor. Based on the patient's history, the nurse will (Answer) perform a vasopressin
blood glucosemeasurement.
21. The patient with the syndrome of inappropriate antidiuretic hormone
(SIADH) secretion will need to have the imbalance of which electrolyte
corrected as soon as possible (Answer) Sodium
22. Which of the following conditions occurs when the renal tubules are
unable to reabsorb excess glucose (Answer) Glycosuria
23. The patient has a waist measurement of 52 inches. His triglyceride level is
175 mg/dL, his high-density lipoprotein (HDL) cholesterol level is 32 mg/dL,
and his fasting plasma glucose level is 224 mg/dL. His blood pressure
readings are usually approximately 140/90 mm Hg. The nurse recognizes the
characteristics of (Answer) metabolic syndrome.
, 26. In the syndrome of inappropriate antidiuretic hormone (SIADH), the phys- 32. Which dialysis method would be most appropriate for the hemodynam-
iological effect is (Answer) dilutional hyponatremia, reducing sodium ically stable patient in the anuric phase of acute kidney injury (AKI)
concentration to critically low levels. (Answer) Inter-mittent hemodialysis
33. What are complications of continuous renal replacement therapy
27. Which assessment findings would indicate fluid volume excess (Answer) (CRRT) (Answer) Air embolism, decreased inflow pressure, electrolyte
edema,auscultation of a third heart sound, crackles in lungs, bounding pulses, imbalance
AMS, olguria, HTN 34. Which electrolytes pose the most potential hazard if not within normal
limits for the person with acute kidney failure (Answer) Potassium and
calcium
28. The report of a renal patient's laboratory results shows that the blood 35. peaked T-waves and a widening of the QRS interval in a pt with AKI are
urea nitrogen (BUN) level is less than 25 mg/dL. To fully understand the indicative of (Answer) d. hyperkalemia.
patient's renal status, the nurse must consider this value along with 36. A patient presents with the following: HR, 120 beats/min; BP, 80/44 mm
(Answer) c. creatinine level. Hg; urine output averaging 20 mL/hr over the last 4 hours; afebrile; moist
rales in the lungs bilaterally; BUN, 84 mg/dL; creatinine, 3.4 mg/dL. What is
29. To determine whether edema in a patient's hands is due to circulatory the probable cause of this patient's acute kidney injury (AKI) (Answer) Left
compromise or another cause, the nurse might (Answer) elevate the patient's ventricularfailure causing prerenal AKI
extremi-ties for 1 hour and observe the degree of edema still present. 37. An elderly patient is in a motor vehicle accident and incurs a significant
internal hemorrhage. He is at greatest risk for which category of acute kidney
injury (AKI) (Answer) Prerenal
30. Hypovolemia causes tachycardia and (Answer) hypotension.
31. To avoid the complications that can result from administering furosemide
(Lasix) to stimulate urinary output, the nurse will carefully monitor (Answer)
levels ofelectrolytes, especially potassium.
6. During initial examination of a critical care patient, the nurse observes
Answers wide and convex nails and bulbous fingertips. This is evidence of
(Answer) centralcyanosis.
(Verified Answers)
7. Priorities for palpation of the patient with cardiovascular disease include:-
1. The nurse observes that the patient's jugular veins distend in the semi-up- : estimating edema.
right position to more than 5 cm above the sternal angle. This is an indication checking capillary refill
of (Answer) fluid volume overload. checking for DVT
arterial pulses
2. what is normal Pulmonary artery occlusion pressure (PAOP) (Answer) 5-
12 mmHg 8. By blocking the conversion of angiotensin I to angiotensin II, an-
giotensin-converting enzyme inhibitors produce (Answer) b.
vasodilation.
3. The resistance against which the left ventricle must pump to eject its
volume is (Answer) systemic vascular resistance. 9. The nurse has read that the cardiologist recommends the use of class IV
drugs to depress sinus and atrioventricular node conduction and terminate
4. When the tricuspid valve is open, central venous pressure reflects the supraventricular tachycardias in the patient at this time. The nurse will antic-
filling pressure in the (Answer) right ventricle. ipate orders for which medications (Answer) a. Verapamil, diltiazem, or
amlodipine
5. Tachycardia is dangerous for the patient with ischemic heart disease
because of (Answer) compromised cardiac output. 10. The nurse has administered a drug that stimulates ²1-adrenergic sites.
,Following administration of the drug, the nurse will assess for (Answer) a. 14. A patient is being monitored by continuous electrocardiogram (ECG)
increasedheart rate. after placement of a transvenous pacemaker. "Loss of capture" is seen on
11. The nurse is observing the patient's electrocardiographic monitor after the ECG. Which nursing intervention may correct this situation (Answer) a.
insertion of a temporary pacemaker. Seeing a P-wave after the pacing arti- Positionthe patient on the left side. or reposition the leads
fact, the nurse knows that the (Answer) c. atrium is being paced.
15. In analyzing the ECG strip, the nurse notices a spike before each QRS
12. The possibility of microshock when handling a temporary pacemaker can complex. The patient's heart rate is 70 beats/min. This phenomenon is reflec-
be minimized by (Answer) b. insulating the ends of the wires. and wearing tive of: b. pacing artifact; the pacemaker is sensing and capturing.
gloves when handling the pacing wires
16. Calculate the cerebral perfusion pressure (CPP) for a patient with a mean
13. In the postoperative cardiovascular patient, the most frequent cause of a arterial pressure (MAP) = 95 mm Hg and an intracranial pressure (ICP) = 15
decreased cardiac output is (Answer) a. reduced preload. mm Hg.: b. 80 mm Hg
17. What procedure secures an arteriovenous malformation when a pt's
condition is too unstable for surgery (Answer) embolization that can be done
to securethe lesion without surgery. When the condition is more stable, an
operation mightbe considered if needed.
18. Knowing that a patient has hypoxemia and ischemia in his brain, the
nurse anticipates which of the following (Answer) a. Cerebrovascular
dilation
,19. The nurse's priority in eye care for the patient in a coma will be (Answer) 24. To reverse the hyperglycemic hyperosmolar state, the nurse will first
c. keeping the eyes moist to prevent corneal ulceration. prepare to administer (Answer) fluids
25. The nurse is caring for a patient with central diabetes insipidus (DI). The
20. The patient has markedly deep, rapid respirations with a fruity breath nurse should anticipate orders for the administration of (Answer)
odor. Based on the patient's history, the nurse will (Answer) perform a vasopressin
blood glucosemeasurement.
21. The patient with the syndrome of inappropriate antidiuretic hormone
(SIADH) secretion will need to have the imbalance of which electrolyte
corrected as soon as possible (Answer) Sodium
22. Which of the following conditions occurs when the renal tubules are
unable to reabsorb excess glucose (Answer) Glycosuria
23. The patient has a waist measurement of 52 inches. His triglyceride level is
175 mg/dL, his high-density lipoprotein (HDL) cholesterol level is 32 mg/dL,
and his fasting plasma glucose level is 224 mg/dL. His blood pressure
readings are usually approximately 140/90 mm Hg. The nurse recognizes the
characteristics of (Answer) metabolic syndrome.
, 26. In the syndrome of inappropriate antidiuretic hormone (SIADH), the phys- 32. Which dialysis method would be most appropriate for the hemodynam-
iological effect is (Answer) dilutional hyponatremia, reducing sodium ically stable patient in the anuric phase of acute kidney injury (AKI)
concentration to critically low levels. (Answer) Inter-mittent hemodialysis
33. What are complications of continuous renal replacement therapy
27. Which assessment findings would indicate fluid volume excess (Answer) (CRRT) (Answer) Air embolism, decreased inflow pressure, electrolyte
edema,auscultation of a third heart sound, crackles in lungs, bounding pulses, imbalance
AMS, olguria, HTN 34. Which electrolytes pose the most potential hazard if not within normal
limits for the person with acute kidney failure (Answer) Potassium and
calcium
28. The report of a renal patient's laboratory results shows that the blood 35. peaked T-waves and a widening of the QRS interval in a pt with AKI are
urea nitrogen (BUN) level is less than 25 mg/dL. To fully understand the indicative of (Answer) d. hyperkalemia.
patient's renal status, the nurse must consider this value along with 36. A patient presents with the following: HR, 120 beats/min; BP, 80/44 mm
(Answer) c. creatinine level. Hg; urine output averaging 20 mL/hr over the last 4 hours; afebrile; moist
rales in the lungs bilaterally; BUN, 84 mg/dL; creatinine, 3.4 mg/dL. What is
29. To determine whether edema in a patient's hands is due to circulatory the probable cause of this patient's acute kidney injury (AKI) (Answer) Left
compromise or another cause, the nurse might (Answer) elevate the patient's ventricularfailure causing prerenal AKI
extremi-ties for 1 hour and observe the degree of edema still present. 37. An elderly patient is in a motor vehicle accident and incurs a significant
internal hemorrhage. He is at greatest risk for which category of acute kidney
injury (AKI) (Answer) Prerenal
30. Hypovolemia causes tachycardia and (Answer) hypotension.
31. To avoid the complications that can result from administering furosemide
(Lasix) to stimulate urinary output, the nurse will carefully monitor (Answer)
levels ofelectrolytes, especially potassium.
