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PCCN Exam Prep-Comprehensive
Practice Questions And Correct
Answers
Which is the best intervention to promote safety of the patient receiving
hemodialysis?
A* Direct visualization of the connection between the machine and the access
device
B* Strict intake and output monitoring
C* Strict bedrest
D* Electrolyte assessment q 4 hours - correct-answer - A* Direct visualization of
the connection between the machine and the access device
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The nurse must be able to visualize the junction of the central venous access and
the dialysis unit at all times. Disconnection can result in exsanguination within
minutes.
Four hours after starting an insulin infusion in a patient admitted with diabetic
ketoacidosis, the patient's blood glucose is 235 mg/dL. Which of the following
fluids should be administered at this point?
A Hypertonic solution to hydrate the cell
B D5.45 or D NS with a glucose source
C Isotonic saline bolus to maintain extracellular hydration
D Hypotonic saline to provide cellular hydration - correct-answer - B D5.45 or D
NS with a glucose source
Dextrose should be included in IV fluids since the glucose has dropped below 250.
This is done to prevent hypoglycycemia.
11. A 45-year-old male is admitted to 1500m With Severe sepsis.
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You are administering lactated ringers 500 ml IV boluses. A central line has been
placed. Which of the findings below indicate the fluid boluses are having its
intended effect?
A* MAP of 55 mm Hg
B* ScvO, of 52%
C* Initial lactate level 4.2 mmol/L, now 1.8 mmol/L
D* Urine output of 15 ml/hour - correct-answer - C* Initial lactate level 4.2
mmol/L, now 1.8 mmol/L
Early goal directed therapy for sepsis include early fluid resuscitation at 30 mL/kg
to maintain the MAP greater than 65 mm Hg, ScvO2 greater that 70%, and urine
output greater than 0.5 mL/kg/hr. The goal is always to normalize the lactate
level. The lactate clearance (lactate decreasing to 1.8 mmol/L) is a trend in the
right direction and an indirect sign of increased perfusion.
12. A 72-year-old male patient has been in the PCU for 6 days for treatment of a
COPD exacerbation. He has been receiving VTE prophylaxis with subcutaneous
Heparin since admission. Today, his platelet count decreased significantly to
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43,000 and he was found to have a new DVT on his right upper extremity. What
do you suspect is the most likely cause of these new findings?
A DIC
B* ITP
C* HIT
D* TRALI - correct-answer - C HIT
The hallmark sign of Heparin Induced Thrombocytopenia (HIT) is a significant
decrease in platelet count over a 24 hour period (>50% within 5-10 days of
administering Heparin. The other hallmark sign is a new development of a DVT
despite being on VTE prophylaxis. DIC and ITP can decrease platelet counts but
with the specific scenario of a new DVT and precipitous drop in platelets the best
answer is HIT. Transfusion related acute lung injury (TRALI) is a complication from
a blood transfusion reaction, which causes acute lung injury typically within 6
hours of a blood transfusion.
20. Which laboratory values are consistent in a patient with acute pancreatitis?
A. Elevated lipase, elevated amylase, hypocalcemia & hyperglycemia
B• Elevated lipase, elevated amylase, hypercalcemia & hyperkalemia
PCCN Exam Prep-Comprehensive
Practice Questions And Correct
Answers
Which is the best intervention to promote safety of the patient receiving
hemodialysis?
A* Direct visualization of the connection between the machine and the access
device
B* Strict intake and output monitoring
C* Strict bedrest
D* Electrolyte assessment q 4 hours - correct-answer - A* Direct visualization of
the connection between the machine and the access device
,2|Page
The nurse must be able to visualize the junction of the central venous access and
the dialysis unit at all times. Disconnection can result in exsanguination within
minutes.
Four hours after starting an insulin infusion in a patient admitted with diabetic
ketoacidosis, the patient's blood glucose is 235 mg/dL. Which of the following
fluids should be administered at this point?
A Hypertonic solution to hydrate the cell
B D5.45 or D NS with a glucose source
C Isotonic saline bolus to maintain extracellular hydration
D Hypotonic saline to provide cellular hydration - correct-answer - B D5.45 or D
NS with a glucose source
Dextrose should be included in IV fluids since the glucose has dropped below 250.
This is done to prevent hypoglycycemia.
11. A 45-year-old male is admitted to 1500m With Severe sepsis.
,3|Page
You are administering lactated ringers 500 ml IV boluses. A central line has been
placed. Which of the findings below indicate the fluid boluses are having its
intended effect?
A* MAP of 55 mm Hg
B* ScvO, of 52%
C* Initial lactate level 4.2 mmol/L, now 1.8 mmol/L
D* Urine output of 15 ml/hour - correct-answer - C* Initial lactate level 4.2
mmol/L, now 1.8 mmol/L
Early goal directed therapy for sepsis include early fluid resuscitation at 30 mL/kg
to maintain the MAP greater than 65 mm Hg, ScvO2 greater that 70%, and urine
output greater than 0.5 mL/kg/hr. The goal is always to normalize the lactate
level. The lactate clearance (lactate decreasing to 1.8 mmol/L) is a trend in the
right direction and an indirect sign of increased perfusion.
12. A 72-year-old male patient has been in the PCU for 6 days for treatment of a
COPD exacerbation. He has been receiving VTE prophylaxis with subcutaneous
Heparin since admission. Today, his platelet count decreased significantly to
, 4|Page
43,000 and he was found to have a new DVT on his right upper extremity. What
do you suspect is the most likely cause of these new findings?
A DIC
B* ITP
C* HIT
D* TRALI - correct-answer - C HIT
The hallmark sign of Heparin Induced Thrombocytopenia (HIT) is a significant
decrease in platelet count over a 24 hour period (>50% within 5-10 days of
administering Heparin. The other hallmark sign is a new development of a DVT
despite being on VTE prophylaxis. DIC and ITP can decrease platelet counts but
with the specific scenario of a new DVT and precipitous drop in platelets the best
answer is HIT. Transfusion related acute lung injury (TRALI) is a complication from
a blood transfusion reaction, which causes acute lung injury typically within 6
hours of a blood transfusion.
20. Which laboratory values are consistent in a patient with acute pancreatitis?
A. Elevated lipase, elevated amylase, hypocalcemia & hyperglycemia
B• Elevated lipase, elevated amylase, hypercalcemia & hyperkalemia
