PCCN QUESTIONS WITH DETAILED VERIFIED
ANSWERS; ALREADY GRADED A; 2026
A 45-year old woman is admitted with type 1 diabetic mellitus.
She is hyperventilating, has signs of dehydration (increased urine
output and increased thirst), and is tachycardic. Initial treatment
would include:
A. Diazoxide (Hyperstat) to inhibit the release of insulin
B. glucose for hypoglycemia
C. insulin therapy for ketoacidosis, fluid and electrolyte
replacement
D. intravenous fluids for dehydration and glucose for
hypoglycemia - correct answer- C. insulin therapy for
ketoacidosis, fluid and electrolyte replacement
The patient is exhibiting the signs and symptoms of diabetic
ketoacidosis (DKA). Signs of dehydration, such as polydipsia and
polyphagia, are due to large urine output, increased thirst is
secondary to dehydration and tachycardia is due to sympathetic
nervous system stimulation from an increased glucose level and
ketosis. Initial treatment would include insulin therapy, re-
hydration with fluids and electrolyte replacement. Diazoxide
would not be used since it inhibits insulin release (this patient
requires insulin to lower glucose). The patient is not
hypoglycemia. Signs and symptoms of hypoglycemia are similar;
,tachycardia, change in behavior (irritability) or level of
consciousness, sweating and shaking.
A 45-year-old female with history of bipolar disorder is one-day
postoperative following abdominal surgery. The patient slept
only one or two hours during the night and is speaking rapidly,
throwing her belongings at the nurses and insists she is going to
leave the hospital. The nurse should:
A. Notify the mental health crisis team
B. Notify social services
C. Notify the nursing supervisor
D. Notify the patient's husband - correct answer- A. Notify
the mental health crisis team
In many hospitals, this can be the rapid response team. Not all
hospitals have access to mental health professionals so the rapid
response team answers these calls. The mental health crisis
team is comprised of mental health professionals who can
assess the mental status of the patients as well as the medical-
surgical assessment. After the complete assessment is made, the
decision of how to treat this possible exacerbation of her bipolar
disorder may be made. The patient is at risk for hurting herself
and others and may need continuing assessment of mental and
surgical status beyond the rapid response team. Decisions will
be made with the attending physician. Social services may help
with placement, but not during an acute situation. The nursing
,supervisor may be notified as the rapid response team is
notified; this is a great strategy; however, the supervisor may
not have the ability to assess this complex patient. The
supervisor is more able to delegate care and request more help
to the area if needed. The patient's husband will need to be
called after the immediate assessment is made.
A 55 year old male postoperative patient is demonstrating signs
of pain; tachycardia, hypertension, abdominal guarding and
increased respiratory rate. The patient refuses pain medication
because he believes he will become addicted to the narcotics.
What is the nurse's best response?
A. Acknowledge that the patient is entitled to refuse pain
medications
B. Tell the patient that opioids have a low addiction rate when
used for postoperative pain while in the hospital
C. Admire the patient's stoicism
D. Acknowledge opioid addiction potential, and offer a back rub
- correct answer- B. Tell the patient that opioids have a low
addiction rate when used for postoperative pain while in the
hospital
Many people are concerned about addiction rates of narcotics;
however, the use of narcotics for postoperative pain while in the
hospital has a very low addiction rate. The risk for abuse
increases when patients go home with narcotics. Explaining to
, the patient that limited use in the hospital will increase his
recovery and reduce inflammation is the correct response. Any
patient may refuse medications after an explanation of the facts
are given. A back rub or alternative care is a way to treat the
patient if they absolutely refuse medications; however, the best
answer is to correct the patient's misinformation about the use
of narcotics during the immediate postoperative period.
A 55-year old male is admitted from the ICU after an acute Type
III aortic dissection. Treatment plan includes blood pressure
control. What medications would the nurse anticipate in this
patient?
A. digoxin (Lanoxin) and furosemide (Lasix)
B. metoprolol (Lopressor) and lisinopril (Prinivil)
C. furosemide and spironolactone (Aldactone)
D. bumetanide (Bumex) and amlodipine (Norvasc) - correct
answer- B. metoprolol (Lopressor) and lisinopril (Prinivil)
The blood pressure control of this patient is the most important
treatment in his care. The two most common drugs for the
treatment of an aortic dissection are a beta blocker and ACE
inhibitor. Diuretics may be added for more control of blood
pressure, but are not first-line drugs. Digoxin is not required for
this patient.
ANSWERS; ALREADY GRADED A; 2026
A 45-year old woman is admitted with type 1 diabetic mellitus.
She is hyperventilating, has signs of dehydration (increased urine
output and increased thirst), and is tachycardic. Initial treatment
would include:
A. Diazoxide (Hyperstat) to inhibit the release of insulin
B. glucose for hypoglycemia
C. insulin therapy for ketoacidosis, fluid and electrolyte
replacement
D. intravenous fluids for dehydration and glucose for
hypoglycemia - correct answer- C. insulin therapy for
ketoacidosis, fluid and electrolyte replacement
The patient is exhibiting the signs and symptoms of diabetic
ketoacidosis (DKA). Signs of dehydration, such as polydipsia and
polyphagia, are due to large urine output, increased thirst is
secondary to dehydration and tachycardia is due to sympathetic
nervous system stimulation from an increased glucose level and
ketosis. Initial treatment would include insulin therapy, re-
hydration with fluids and electrolyte replacement. Diazoxide
would not be used since it inhibits insulin release (this patient
requires insulin to lower glucose). The patient is not
hypoglycemia. Signs and symptoms of hypoglycemia are similar;
,tachycardia, change in behavior (irritability) or level of
consciousness, sweating and shaking.
A 45-year-old female with history of bipolar disorder is one-day
postoperative following abdominal surgery. The patient slept
only one or two hours during the night and is speaking rapidly,
throwing her belongings at the nurses and insists she is going to
leave the hospital. The nurse should:
A. Notify the mental health crisis team
B. Notify social services
C. Notify the nursing supervisor
D. Notify the patient's husband - correct answer- A. Notify
the mental health crisis team
In many hospitals, this can be the rapid response team. Not all
hospitals have access to mental health professionals so the rapid
response team answers these calls. The mental health crisis
team is comprised of mental health professionals who can
assess the mental status of the patients as well as the medical-
surgical assessment. After the complete assessment is made, the
decision of how to treat this possible exacerbation of her bipolar
disorder may be made. The patient is at risk for hurting herself
and others and may need continuing assessment of mental and
surgical status beyond the rapid response team. Decisions will
be made with the attending physician. Social services may help
with placement, but not during an acute situation. The nursing
,supervisor may be notified as the rapid response team is
notified; this is a great strategy; however, the supervisor may
not have the ability to assess this complex patient. The
supervisor is more able to delegate care and request more help
to the area if needed. The patient's husband will need to be
called after the immediate assessment is made.
A 55 year old male postoperative patient is demonstrating signs
of pain; tachycardia, hypertension, abdominal guarding and
increased respiratory rate. The patient refuses pain medication
because he believes he will become addicted to the narcotics.
What is the nurse's best response?
A. Acknowledge that the patient is entitled to refuse pain
medications
B. Tell the patient that opioids have a low addiction rate when
used for postoperative pain while in the hospital
C. Admire the patient's stoicism
D. Acknowledge opioid addiction potential, and offer a back rub
- correct answer- B. Tell the patient that opioids have a low
addiction rate when used for postoperative pain while in the
hospital
Many people are concerned about addiction rates of narcotics;
however, the use of narcotics for postoperative pain while in the
hospital has a very low addiction rate. The risk for abuse
increases when patients go home with narcotics. Explaining to
, the patient that limited use in the hospital will increase his
recovery and reduce inflammation is the correct response. Any
patient may refuse medications after an explanation of the facts
are given. A back rub or alternative care is a way to treat the
patient if they absolutely refuse medications; however, the best
answer is to correct the patient's misinformation about the use
of narcotics during the immediate postoperative period.
A 55-year old male is admitted from the ICU after an acute Type
III aortic dissection. Treatment plan includes blood pressure
control. What medications would the nurse anticipate in this
patient?
A. digoxin (Lanoxin) and furosemide (Lasix)
B. metoprolol (Lopressor) and lisinopril (Prinivil)
C. furosemide and spironolactone (Aldactone)
D. bumetanide (Bumex) and amlodipine (Norvasc) - correct
answer- B. metoprolol (Lopressor) and lisinopril (Prinivil)
The blood pressure control of this patient is the most important
treatment in his care. The two most common drugs for the
treatment of an aortic dissection are a beta blocker and ACE
inhibitor. Diuretics may be added for more control of blood
pressure, but are not first-line drugs. Digoxin is not required for
this patient.
