PCCN REVIEW 2026 ACTUAL TEST WITH
ACCURATE ILLUSTRATIONS; NEWLY UPDATED
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 answer- A. 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 answer-
C. 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 answer- Central 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 answer- C. 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 answer-
Widening 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 answer- D. 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.
ACCURATE ILLUSTRATIONS; NEWLY UPDATED
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 answer- A. 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 answer-
C. 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 answer- Central 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 answer- C. 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 answer-
Widening 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 answer- D. 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.
