PCCN Review Comprehensive Exam 2026/2027:
PCCN Review- Critical Care & Key Nursing
Concepts | PCCN Review-Cardiovascular| PCCN
Review -Renal | PCCN Review- Dysrhythmias| A
Review of 1555 Questions From Past Exams with
Correct Accurate Answers and Clinical
Rationales | Guaranteed Pass
A nurse is caring for a 71-year-old female patient with end-stage chronic
obstructive pulmonary disease (copd) who is experiencing cardiac ischemia with
increased shortness of breath. The most appropriate goal of oxygen therapy for this
patient would be to: - Answer✔️-maintain oxygen saturations between 90% and
92%
Feedback
Maintaining oxygen saturations between 90% and 92% will serve the purpose of
providing enough oxygen to relieve cardiac ischemia while reducing the risk of
respiratory depression in a patient with copd.
Laboratory studies from a 22-year-old male client with type i diabetes mellitus are
evaluated during an admission for severe pneumonia. Which of the following
laboratory results should the nurse report to the physician? - Answer✔️-
glycosylated hemoglobin (hba1c), 9.8%
Feedback
Glycosylated hemoglobin measures the average blood sugar levels over a 2 to 3
month time period. Clients with previously diagnosed diabetes mellitus should aim
to keep their hba1c levels below 7%.content area: clinical judgement:
endocrine/hematology/neurology/gi/renal
The nurse is assessing a 68 year old female patient with a history of chronic
obstructive pulmonary disease (copd). The patient presents with complaints of
recent confusion, increased fatigue, and syncopal episodes when walking. The
nurse assesses s3 and s4 sounds on auscultation, jugular vein distention, and +3
pitting edema of the ankles and feet. Which of the following complications of copd
,does the nurse suspect the patient is most likely experiencing? - Answer✔️-cor
pulmonale
Feedback
The nurse should recognize that a history of copd together with the signs and
symptoms listed here are suggestive of cor pulmonale. The patient requires further
workup to confirm this diagnosis.
A 42-year-old male with Marfan syndrome and complaint of dizziness is admitted
to the telemetry unit for monitoring. Which of the following accompanying
symptoms may indicate the need for immediate surgical attention? - Answer✔️-a.
Cough with vocal hoarseness
Feedback
Patients diagnosed with Marfan syndrome are at higher risk for aortic aneurysms.
Changes in vocal quality accompanied by a cough or dysphagia (difficulty
swallowing) may indicate that a thoracic aortic aneurysm is becoming more
enlarged.
The nurse is assessing a 74 year old female patient who has presented with the
following symptoms: cool, clammy skin; faint, irregular peripheral pulses, and +3
pitting edema in her bilateral lower extremities. Her partner tells the nurse the
patient has a history of heart failure with a recent LVEF of 20%, as well as type 2
diabetes. The patient's hr is 132, bp is 79/48, and blood glucose is 349. Which of
the following conditions does the nurse suspect? - Answer✔️-cardiogenic shock
Feedback
The nurse should identify that cardiogenic shock is an emergency that has
extremely high mortality rates without timely intervention. The patient's history of
heart failure together with her acute symptoms of weak pulses, edema, and
hypotension all point to cardiogenic shock.
The nurse is caring for a patient with stage 5 chronic kidney disease who normally
receives hemodialysis three times a week on Monday, Wednesday, and Friday. It is
now Sunday and the patient states they have missed their last two dialysis sessions.
The patient is complaining of shortness of breath and fatigue, and their labs show a
creatinine of 3.9 and potassium of 6.8. What is the best treatment for this patient ? -
Answer✔️-urgent hemodialysis
Feedback
The nurse should recognize that dialysis is the best option for this patient since
they are already a regular dialysis patient and are a likely candidate to receive
,urgent dialysis due to their missed dialysis sessions, shortness of breath, and
critical potassium level.
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? - Answer✔️-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.
The nurse is caring for a 21 year old female who is being treated with iv
magnesium for pre-eclampsia. Upon assessment, the nurse notes that the patient's
skin is flushed, her blood pressure is 88/56, and her respiratory rate is 12. The
nurse checks the patient's magnesium level and finds that it is 7.2 mg/dl. Which of
the following actions does the nurse anticipate taking next? - Answer✔️-
administering intravenous calcium gluconate
Feedback
The nurse should identify that the signs and symptoms here are reflective of a
critically high magnesium level, reflected by the lab level of 7.2 mg/dl, and that the
correct treatment is an infusion of calcium gluconate.
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: - Answer✔️-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 71-year-old female patient is admitted after evaluation in the emergency
department (ed) for suspected coronary syndrome involving the inferior wall.
Which of the following changes would the nurse anticipate seeing on a 12-lead ecg
for an inferior wall myocardial infarction (mi)? - Answer✔️-st elevation, q waves,
and inverted t waves in leads ii, iii, and AVF
Feedback
, Acute coronary syndromes involving the inferior cardiac wall will most often
manifest as st elevation and inverted t waves in leads ii, iii, and avf. Q waves may
appear during the acute phases of the syndrome, or may appear as an infarction
heals (more common).
The nurse has a 32 year old female patient with a diagnosis of major depressive
disorder. The patient tells the nurse that she wishes every night that she could go to
sleep and never wake up. She also tells the nurse that she has been thinking that it
would be easy to take a whole bottle of Tylenol "to end my pain forever." what is
the most appropriate intervention for the nurse to take? - Answer✔️-ensure that the
patient's physical environment is safe and free of objects that could be used to
harm herself
Feedback
The nurse should identify that the most important thing when working with a
patient who is expressing suicidal ideology is patient safety; this begins with the
patient's physical environment and ensuring that there is nothing that the patient
can access that can be used to harm themselves.
A telemetry nurse is caring for a 59-year-old male patient who is being evaluated
for non-specific cardiac symptoms. Just after the nurse arrives in the patient's room
to administer the morning medications, the patient loses consciousness. The
cardiac monitor reveals third-degree av heart block with ventricular escape beats at
38 beats per minute (bpm). The nurse should: - Answer✔️-prepare to initiate
transcutaneous pacing
Feedback
Third-degree heart block with a slow ventricular escape rhythm that is not
sufficient to keep a patient alert should be immediately addressed by
transcutaneous pacing to provide adequate brain perfusion (and perfusion of other
organs). Medications should be administered per ACLS protocols or as directed by
a health care practitioner.
The nurse is educating a 24 year old patient who has been diagnosed with diabetic
gastroparesis. The nurse teaches the patient that which of the following lifestyle
modifications will be helpful and appropriate? - Answer✔️-ensure well-controlled
blood glucose levels
Feedback
The nurse should know that ensuring well-controlled blood glucose levels is one of
the most helpful strategies for diabetic gastroparesis. The other three strategies
listed are all contraindicated and can make the condition worse.
PCCN Review- Critical Care & Key Nursing
Concepts | PCCN Review-Cardiovascular| PCCN
Review -Renal | PCCN Review- Dysrhythmias| A
Review of 1555 Questions From Past Exams with
Correct Accurate Answers and Clinical
Rationales | Guaranteed Pass
A nurse is caring for a 71-year-old female patient with end-stage chronic
obstructive pulmonary disease (copd) who is experiencing cardiac ischemia with
increased shortness of breath. The most appropriate goal of oxygen therapy for this
patient would be to: - Answer✔️-maintain oxygen saturations between 90% and
92%
Feedback
Maintaining oxygen saturations between 90% and 92% will serve the purpose of
providing enough oxygen to relieve cardiac ischemia while reducing the risk of
respiratory depression in a patient with copd.
Laboratory studies from a 22-year-old male client with type i diabetes mellitus are
evaluated during an admission for severe pneumonia. Which of the following
laboratory results should the nurse report to the physician? - Answer✔️-
glycosylated hemoglobin (hba1c), 9.8%
Feedback
Glycosylated hemoglobin measures the average blood sugar levels over a 2 to 3
month time period. Clients with previously diagnosed diabetes mellitus should aim
to keep their hba1c levels below 7%.content area: clinical judgement:
endocrine/hematology/neurology/gi/renal
The nurse is assessing a 68 year old female patient with a history of chronic
obstructive pulmonary disease (copd). The patient presents with complaints of
recent confusion, increased fatigue, and syncopal episodes when walking. The
nurse assesses s3 and s4 sounds on auscultation, jugular vein distention, and +3
pitting edema of the ankles and feet. Which of the following complications of copd
,does the nurse suspect the patient is most likely experiencing? - Answer✔️-cor
pulmonale
Feedback
The nurse should recognize that a history of copd together with the signs and
symptoms listed here are suggestive of cor pulmonale. The patient requires further
workup to confirm this diagnosis.
A 42-year-old male with Marfan syndrome and complaint of dizziness is admitted
to the telemetry unit for monitoring. Which of the following accompanying
symptoms may indicate the need for immediate surgical attention? - Answer✔️-a.
Cough with vocal hoarseness
Feedback
Patients diagnosed with Marfan syndrome are at higher risk for aortic aneurysms.
Changes in vocal quality accompanied by a cough or dysphagia (difficulty
swallowing) may indicate that a thoracic aortic aneurysm is becoming more
enlarged.
The nurse is assessing a 74 year old female patient who has presented with the
following symptoms: cool, clammy skin; faint, irregular peripheral pulses, and +3
pitting edema in her bilateral lower extremities. Her partner tells the nurse the
patient has a history of heart failure with a recent LVEF of 20%, as well as type 2
diabetes. The patient's hr is 132, bp is 79/48, and blood glucose is 349. Which of
the following conditions does the nurse suspect? - Answer✔️-cardiogenic shock
Feedback
The nurse should identify that cardiogenic shock is an emergency that has
extremely high mortality rates without timely intervention. The patient's history of
heart failure together with her acute symptoms of weak pulses, edema, and
hypotension all point to cardiogenic shock.
The nurse is caring for a patient with stage 5 chronic kidney disease who normally
receives hemodialysis three times a week on Monday, Wednesday, and Friday. It is
now Sunday and the patient states they have missed their last two dialysis sessions.
The patient is complaining of shortness of breath and fatigue, and their labs show a
creatinine of 3.9 and potassium of 6.8. What is the best treatment for this patient ? -
Answer✔️-urgent hemodialysis
Feedback
The nurse should recognize that dialysis is the best option for this patient since
they are already a regular dialysis patient and are a likely candidate to receive
,urgent dialysis due to their missed dialysis sessions, shortness of breath, and
critical potassium level.
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? - Answer✔️-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.
The nurse is caring for a 21 year old female who is being treated with iv
magnesium for pre-eclampsia. Upon assessment, the nurse notes that the patient's
skin is flushed, her blood pressure is 88/56, and her respiratory rate is 12. The
nurse checks the patient's magnesium level and finds that it is 7.2 mg/dl. Which of
the following actions does the nurse anticipate taking next? - Answer✔️-
administering intravenous calcium gluconate
Feedback
The nurse should identify that the signs and symptoms here are reflective of a
critically high magnesium level, reflected by the lab level of 7.2 mg/dl, and that the
correct treatment is an infusion of calcium gluconate.
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: - Answer✔️-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 71-year-old female patient is admitted after evaluation in the emergency
department (ed) for suspected coronary syndrome involving the inferior wall.
Which of the following changes would the nurse anticipate seeing on a 12-lead ecg
for an inferior wall myocardial infarction (mi)? - Answer✔️-st elevation, q waves,
and inverted t waves in leads ii, iii, and AVF
Feedback
, Acute coronary syndromes involving the inferior cardiac wall will most often
manifest as st elevation and inverted t waves in leads ii, iii, and avf. Q waves may
appear during the acute phases of the syndrome, or may appear as an infarction
heals (more common).
The nurse has a 32 year old female patient with a diagnosis of major depressive
disorder. The patient tells the nurse that she wishes every night that she could go to
sleep and never wake up. She also tells the nurse that she has been thinking that it
would be easy to take a whole bottle of Tylenol "to end my pain forever." what is
the most appropriate intervention for the nurse to take? - Answer✔️-ensure that the
patient's physical environment is safe and free of objects that could be used to
harm herself
Feedback
The nurse should identify that the most important thing when working with a
patient who is expressing suicidal ideology is patient safety; this begins with the
patient's physical environment and ensuring that there is nothing that the patient
can access that can be used to harm themselves.
A telemetry nurse is caring for a 59-year-old male patient who is being evaluated
for non-specific cardiac symptoms. Just after the nurse arrives in the patient's room
to administer the morning medications, the patient loses consciousness. The
cardiac monitor reveals third-degree av heart block with ventricular escape beats at
38 beats per minute (bpm). The nurse should: - Answer✔️-prepare to initiate
transcutaneous pacing
Feedback
Third-degree heart block with a slow ventricular escape rhythm that is not
sufficient to keep a patient alert should be immediately addressed by
transcutaneous pacing to provide adequate brain perfusion (and perfusion of other
organs). Medications should be administered per ACLS protocols or as directed by
a health care practitioner.
The nurse is educating a 24 year old patient who has been diagnosed with diabetic
gastroparesis. The nurse teaches the patient that which of the following lifestyle
modifications will be helpful and appropriate? - Answer✔️-ensure well-controlled
blood glucose levels
Feedback
The nurse should know that ensuring well-controlled blood glucose levels is one of
the most helpful strategies for diabetic gastroparesis. The other three strategies
listed are all contraindicated and can make the condition worse.
