ALL THE PCCN EXAM QUESTIONS WITH CORRECT ANSWERS

ALL THE PCCN EXAM QUESTIONS WITH
CORRECT ANSWERS

All the PCCN Exam - ans-Exam Coverage
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Exam coverage for the AACN PCCN Exam includes the comprehensive clinical knowledge
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and professional competencies required for progressive care nursing. It focuses on cardiov
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ascular, pulmonary, neurological, endocrine, renal, gastrointestinal, hematologic, and mult
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isystem disorders, emphasizing the care of acutely ill adult patients. The exam evaluates u
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nderstanding of hemodynamic monitoring, dysrhythmia interpretation, pharmacology, and xc xc xc xc xc xc xc xc




evidence-
based interventions for complex patient conditions. It also covers professional caring and e
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thical practice, including advocacy, collaboration, systems thinking, and clinical inquiry. Em
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phasis is placed on clinical judgment, patient safety, early recognition of complications, and
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the application of advanced nursing skills in progressive and step-down care settings.
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what is normal Pulmonary artery occlusion pressure (PAOP)? - ans-5-12 mmHg
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The nurse observes that the patient's jugular veins distend in the semi-
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upright position to more than 5 cm above the sternal angle. This is an indication of: - ans-
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fluid volume overload.
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The resistance against which the left ventricle must pump to eject its volume is: - ans-
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systemic vascular resistance. xc xc




When the tricuspid valve is open, central venous pressure reflects the filling pressure in the:
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- ans-right ventricle.
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Tachycardia is dangerous for the patient with ischemic heart disease because of: - ans-xc xc xc xc xc xc xc xc xc xc xc xc xc




compromised cardiac output. xc xc




During initial examination of a critical care patient, the nurse observes wide and convex nail
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s and bulbous fingertips. This is evidence of: - ans-central cyanosis.
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Priorities for palpation of the patient with cardiovascular disease include: - ans-
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estimating edema. xc




checking capillary refill xc xc




checking for DVT xc xc




arterial pulses xc




By blocking the conversion of angiotensin I to angiotensin II, angiotensin-
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converting enzyme inhibitors produce: - ans-b. vasodilation. xc xc xc xc xc xc

,The nurse has read that the cardiologist recommends the use of class IV drugs to depress s
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inus and atrioventricular node conduction and terminate supraventricular tachycardias in th
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e patient at this time. The nurse will anticipate orders for which medications? - ans-
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a. Verapamil, diltiazem, or amlodipine
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The nurse has administered a drug that stimulates β1-
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adrenergic sites. Following administration of the drug, the nurse will assess for: - ans-
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a. increased heart rate.
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The nurse is observing the patient's electrocardiographic monitor after insertion of a tempo
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rary pacemaker. Seeing a P-wave after the pacing artifact, the nurse knows that the: - ans-
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c. atrium is being paced.
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The possibility of microshock when handling a temporary pacemaker can be minimized by:
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- ans-
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b. insulating the ends of the wires. and wearing gloves when handling the pacing wires
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In the postoperative cardiovascular patient, the most frequent cause of a decreased cardia
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c output is: - ans-a. reduced preload.
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A patient is being monitored by continuous electrocardiogram (ECG) after placement of a tr
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ansvenous pacemaker. "Loss of capture" is seen on the ECG. Which nursing intervention xc xc xc xc xc xc xc xc xc xc xc xc xc




may correct this situation? - ans-
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a. Position the patient on the left side. or reposition the leads
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In analyzing the ECG strip, the nurse notices a spike before each QRS complex. The patien
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t's heart rate is 70 beats/min. This phenomenon is reflective of - ans-
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b. pacing artifact; the pacemaker is sensing and capturing.
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Calculate the cerebral perfusion pressure (CPP) for a patient with a mean arterial pressure
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(MAP) = 95 mm Hg and an intracranial pressure (ICP) = 15 mm Hg. - ans-b. 80 mm Hg
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What procedure secures an arteriovenous malformation when a pt's condition is too unstab
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le for surgery? - ans-
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embolization that can be done to secure the lesion without surgery. When the condition is m xc xc xc xc xc xc xc xc xc xc xc xc xc xc xc




ore stable, an operation might be considered if needed.
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Knowing that a patient has hypoxemia and ischemia in his brain, the nurse anticipates whic
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h of the following? - ans-a. Cerebrovascular dilation
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The nurse's priority in eye care for the patient in a coma will be: - ans-
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c. keeping the eyes moist to prevent corneal ulceration.
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The patient has markedly deep, rapid respirations with a fruity breath odor. Based on the pa
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tient's history, the nurse will: - ans-perform a blood glucose measurement.
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,The patient with the syndrome of inappropriate antidiuretic hormone (SIADH) secretion will
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need to have the imbalance of which electrolyte corrected as soon as possible? - ans-
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Sodium

Which of the following conditions occurs when the renal tubules are unable to reabsorb exc
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ess glucose? - ans-Glycosuria
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The patient has a waist measurement of 52 inches. His triglyceride level is 175 mg/
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dL, his high-density lipoprotein (HDL) cholesterol level is 32 mg/
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dL, and his fasting plasma glucose level is 224 mg/
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dL. His blood pressure readings are usually approximately 140/90 mm Hg. The nurse recog
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nizes the characteristics of: - ans-metabolic syndrome.
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To reverse the hyperglycemic hyperosmolar state, the nurse will first prepare to administer:
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- ans-fluids
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The nurse is caring for a patient with central diabetes insipidus (DI). The nurse should antici
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pate orders for the administration of: - ans-vasopressin
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In the syndrome of inappropriate antidiuretic hormone (SIADH), the physiological effect is: -
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ans-dilutional hyponatremia, reducing sodium concentration to critically low levels.
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Which assessment findings would indicate fluid volume excess? - ans-
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edema, auscultation of a third heart sound, crackles in lungs, bounding pulses, AMS, olguri
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a, HTN xc




The report of a renal patient's laboratory results shows that the blood urea nitrogen (BUN) l
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evel is less than 25 mg/ xc xc xc xc xc




dL. To fully understand the patient's renal status, the nurse must consider this value along
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with: - ans-c. creatinine level. xc xc xc xc




To determine whether edema in a patient's hands is due to circulatory compromise or anoth
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er cause, the nurse might: - ans-
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elevate the patient's extremities for 1 hour and observe the degree of edema still present.
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Hypovolemia causes tachycardia and : - ans-hypotension. xc xc xc xc xc xc




To avoid the complications that can result from administering furosemide (Lasix) to stimulat
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e urinary output, the nurse will carefully monitor: - ans-
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levels of electrolytes, especially potassium.
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Which dialysis method would be most appropriate for the hemodynamically stable patient i
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n the anuric phase of acute kidney injury (AKI)? - ans-Intermittent hemodialysis
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What are complications of continuous renal replacement therapy (CRRT)? - ans-
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Air embolism, decreased inflow pressure, electrolyte imbalance
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, Which electrolytes pose the most potential hazard if not within normal limits for the person
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with acute kidney failure? - ans-Potassium and calcium
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peaked T-waves and a widening of the QRS interval in a pt with AKI are indicative of: - ans-
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d. hyperkalemia.
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A patient presents with the following: HR, 120 beats/
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min; BP, 80/44 mm Hg; urine output averaging 20 mL/
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hr over the last 4 hours; afebrile; moist rales in the lungs bilaterally; BUN, 84 mg/
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dL; creatinine, 3.4 mg/
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dL. What is the probable cause of this patient's acute kidney injury (AKI)? - ans-
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Left ventricular failure causing prerenal AKI
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An elderly patient is in a motor vehicle accident and incurs a significant internal hemorrhage
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. He is at greatest risk for which category of acute kidney injury (AKI)? - ans-Prerenal
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A patient is admitted to the unit with the following laboratory values: urine specific gravity, 1.
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010; urine osmolality, 210 mOsm/kg; BUN/Cr ratio 10:1; urine sodium, 96 mEq/
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L. The urine output has been 60 mL since admission 2 hours ago. These values are most co
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nsistent with which of the following types of acute kidney injury (AKI)? - ans-Intrarenal
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Percussing the patient's stomach produces a tympanic sound is a sign that: - ans- xc xc xc xc xc xc xc xc xc xc xc xc xc




the patient's stomach is empty.
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The nurse is unable to hear bowel sounds in any of the four quadrants of the patient's abdo
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men. This may indicate the presence of: - ans-ban ileus.
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Auscultation of the abdomen reveals a bruit over the left renal artery. This is an indication of xc xc xc xc xc xc xc xc xc xc xc xc xc xc xc xc




: - ans-renal hypertension.
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The nurse observes that striae on the patient's abdomen are pink and purple. This may be a
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sign of: - ans-Cushing's syndrome.
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During auscultation of the patient's abdomen, the nurse hears frequent high-
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pitched, tinkling sounds. This is probably evidence of: - ans-normal bowel sounds.
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The nurse has been unable to hear any bowel sounds during examination of the patient's a
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bdomen. The minimum interval for listening before concluding that bowel sounds are abse
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nt is ____ minute(s). - ans-5
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During palpation of the patient's abdomen, rebound tenderness indicates: - ans-
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inflammation of the peritoneum, such as with appenticitis and Chrohn's dz xc xc xc xc xc xc xc xc xc xc




Elevated alkaline phosphatase level and increasing nausea and abdominal pain indicate: -
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ans-gallbladder disease.
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