PCCN CERTIFICATION PAPER 2026 FULL
SOLUTION GRADED A+
● One day following posterior spinal fusion surgery a 35 year old female
suddenly exhibits restlessness, labored breathing and acute chest pain.
Her heart rate is 122/min., she is afebrile, and exhibits slightly
diminished breath sounds on the right side.
Which of the following will most likely confirm the patient's diagnosis?
A. Pulmonary radioisotope scan
B. Echocardiogram
C. Cardiac enzyme studies
D. Chest x-ray and arterial blood gases. Answer: A. Pulmonary
radioisotope scan
● The nursing staff does not wish to be assigned a difficult patient who
continues to demonstrate disorderly behavior. Which of the following is
an acceptable solution?
A. Request the family control the patient's behavior.
B. Transfer the patient
C. The patient assignment should be decided by the Charge Nurse.
,D. Alternate the patient assignment among the nursing staff.. Answer: D.
Alternate the patient assignment among the nursing staff.
● A patient who is 72 hours postoperative repair of a bowel obstruction
suddenly demonstrates shortness of breath and his respiratory rate
increases from 22 to 45/min. His SpO2 went from 95% to 88% acutely.
An arterial blood gas sample obtained while the patient is receiving
oxygen via a nasal cannula at 6L/min reveals the following results:
pH 7.40
pCO2 27
pO2 50
A chest x-ray is obtained and a "ground-glass-like appearance" is
reported. Auscultation of the lungs reveals diffuse crackles that were not
present previously.
The findings described above should lead the nurse to believe that the
patient has:
A. Acute respiratory distress syndrome
B. A pulmonary embolus
C. A spontaneous pneumothorax
D. Aspiration pneumonia. Answer: A. Acute respiratory distress
syndrome
, ● A patient who is 72 hours postoperative repair of a bowel obstruction
suddenly demonstrates shortness of breath and his respiratory rate
increases from 22 to 45/min. His SpO2 went from 95% to 88% acutely.
An arterial blood gas sample obtained while the patient is receiving
oxygen via a nasal cannula at 6L/min reveals the following results:
pH 7.40
pCO2 27
pO2 50
A chest x-ray is obtained and a "ground-glass-like appearance" is
reported. Auscultation of the lungs reveals diffuse crackles that were not
present previously.
On admission, your patient's arterial blood gas on room air is: pH 7.23,
PaCO2 55, PaO2 90, HCO3 30. The correct arterial blood gas
interpretation is:
A. Uncompensated metabolic acidosis
B. Uncompensated respiratory alkalosis
C. Uncompensated respiratory acidosis
D. Uncompensated metabolic alkalosis. Answer: C. Uncompensated
respiratory acidosis
● A patient who is 72 hours postoperative repair of a bowel obstruction
suddenly demonstrates shortness of breath and his respiratory rate
increases from 22 to 45/min. His SpO2 went from 95% to 88% acutely.
SOLUTION GRADED A+
● One day following posterior spinal fusion surgery a 35 year old female
suddenly exhibits restlessness, labored breathing and acute chest pain.
Her heart rate is 122/min., she is afebrile, and exhibits slightly
diminished breath sounds on the right side.
Which of the following will most likely confirm the patient's diagnosis?
A. Pulmonary radioisotope scan
B. Echocardiogram
C. Cardiac enzyme studies
D. Chest x-ray and arterial blood gases. Answer: A. Pulmonary
radioisotope scan
● The nursing staff does not wish to be assigned a difficult patient who
continues to demonstrate disorderly behavior. Which of the following is
an acceptable solution?
A. Request the family control the patient's behavior.
B. Transfer the patient
C. The patient assignment should be decided by the Charge Nurse.
,D. Alternate the patient assignment among the nursing staff.. Answer: D.
Alternate the patient assignment among the nursing staff.
● A patient who is 72 hours postoperative repair of a bowel obstruction
suddenly demonstrates shortness of breath and his respiratory rate
increases from 22 to 45/min. His SpO2 went from 95% to 88% acutely.
An arterial blood gas sample obtained while the patient is receiving
oxygen via a nasal cannula at 6L/min reveals the following results:
pH 7.40
pCO2 27
pO2 50
A chest x-ray is obtained and a "ground-glass-like appearance" is
reported. Auscultation of the lungs reveals diffuse crackles that were not
present previously.
The findings described above should lead the nurse to believe that the
patient has:
A. Acute respiratory distress syndrome
B. A pulmonary embolus
C. A spontaneous pneumothorax
D. Aspiration pneumonia. Answer: A. Acute respiratory distress
syndrome
, ● A patient who is 72 hours postoperative repair of a bowel obstruction
suddenly demonstrates shortness of breath and his respiratory rate
increases from 22 to 45/min. His SpO2 went from 95% to 88% acutely.
An arterial blood gas sample obtained while the patient is receiving
oxygen via a nasal cannula at 6L/min reveals the following results:
pH 7.40
pCO2 27
pO2 50
A chest x-ray is obtained and a "ground-glass-like appearance" is
reported. Auscultation of the lungs reveals diffuse crackles that were not
present previously.
On admission, your patient's arterial blood gas on room air is: pH 7.23,
PaCO2 55, PaO2 90, HCO3 30. The correct arterial blood gas
interpretation is:
A. Uncompensated metabolic acidosis
B. Uncompensated respiratory alkalosis
C. Uncompensated respiratory acidosis
D. Uncompensated metabolic alkalosis. Answer: C. Uncompensated
respiratory acidosis
● A patient who is 72 hours postoperative repair of a bowel obstruction
suddenly demonstrates shortness of breath and his respiratory rate
increases from 22 to 45/min. His SpO2 went from 95% to 88% acutely.
