AACN PCCN EXAM: MULTISYSTEM WITH 100% CORRECT ANSWERS GRADE A CERTIFIED 2025/26

Normal inflammatory response - correct answervasodilatation, increased microvascular permeability, cellular activation and release of mediators, and coagulation Define sepsis - correct answersystemic response to infection, manifested by two or more conditions resulting from infection (temp 38C, HR 90 bpm, RR 20 bpm, PaCO2 32 mmHg, WBC 12, 4) Define septic shock - correct answersepsis with hypotension, despite adequate fluid resuscitation, along with presence of perfusion abnormalities including lactic acidosis, oliguria, acute AMS Risk factors for sepsis - correct answermalnutrition, immunosuppression, prolonged antibiotic use, invasive devices Define MODS - correct answermultiple organ dysfunction, worsening progression of systemic inflammatory response (SIRS) involving signs of organ dysfunction Management of sepsis - correct answertreat cause (antibiotics), maximize oxygen, maximize CO (difficult bc pathological problem of SIRS is increased permeability of capillary bed - liberal fluid admin), decrease oxygen demand (reduce tachycardia, tachypnea, hyperthermia, pain, prevent shivering, comfort measures) What is NOT an accurate measurement of adequate perfusion - correct answerBLOOD PRESSURE, adequate pressure does not always equal adequate perfusion Symptoms of alcohol withdrawal - correct answerinsomnia, tremors, anxiety, GI upset, HA, sweating, palpitations, hallucinations, seizures, fever, agitation How is isopropyl alcohol intoxication distinguished from other types of alcohol intoxication - correct answerpresence of ketoacids in urine and serum Which imbalance is seen in methanol intoxication and relieved by hyperventilation - correct answermetabolic acidosis (decreased bicarbonate level) Which alcohol intoxication affects renal tubular degeneration - correct answerethylene glycol intoxication Which vitamins are most important in alcohol withdrawal - correct answerthiamine, folate (banana bag of B vitamins) Signs and symptoms applicable to majority of drug overdose - correct answerdecreased LOC, behavioral changes, respiratory depression Antidote for acetaminophen - correct answerN-acetylcysteine Antidote for opiates - correct answernaloxone Antidote for benzodiazepines - correct answerflumazenil (avoid if potential for seizure) Antidote for digoxin - correct answerdigiband Antidote for cyanide - correct answerkelocyanor Antidote for tricyclic antidepressants - correct answersodium bicarbonate Antidote for beta blockers or calcium channel blockers - correct answerglucagon and calcium Antidote for methanol - correct answerfolinic acid Risk reduction for CLABSI - correct answerearly de-escalation of access when no longer needed, gloves when accessing line, hand hygiene, daily CHG bathing, removal of catheter if any signs of sepsis occur Risk reduction for hospital acquired PNA - correct answerHOB 30 degrees, assess residual volumes during enteral feeding, wash hands before/after contact with patient secretions or resp equipment Risk reduction for pressure injuries - correct answerreposition patient q2hrs, pressure reduction mattresses, elevate heals off bed using pillows, elbow pads, skin barriers for incontinent patients Nursing care for dying patient - correct answeruse advance directives, discuss values and beliefs pertaining to death and dying, be genuine in touch and presence, take cues from patient and family Define nonmaleficence - correct answerduty to do no harm Define beneficence - correct answerobligation to prevent harm and promote good by actively helping others advance and realize their interests