PROGRESSIVE CARE CERTIFIED NURSE (PCCN)
CERTIFICATION EXAM REVIEW/AACN LATEST
2022/2023
Pt on Vtach, HR 135, RR 32, BP 90/48, conscious but c/o dizziness, recent K+ lvl is 3.4. What action would
you do first?
a. emergent defib
b. amio 300mg IVP
c. emergent cardioversion
d. hang 10 mEq KCL/50mL D5W (correct answers)C
The nurse notes the following when analyzing a patient's telemetry strip: HR, 65/min and regular; PR
interval, 0.22 seconds; QRS complex, 0.10 seconds; QTc, 0.52 seconds. Which of the following
dysrhythmias is the patient at risk for?
A. Atrial fibrillation because the PR interval is wide
B. Sinus arrhythmia because the QRS complex is narrow
C. Torsades de pointes because the QTc is wide
D. Third-degree heart block because the PR interval is narrow (correct answers)C.
QT measurements reflect the duration of ventricular repolarization. Lengthening of QT interval is
associated with arrhythmias, adverse cardiac events, and increased mortality because a longer QT
duration places the vulnerable ventricular repolarization phase close to the next depolarization,
increasing the likelihood of R-on-T. The most common arrhythmia that occurs with prolonged QTc is
torsades de pointes. Atrial fibrillation, sinus bradycardia, and third-degree heart block are not typically
associated with prolonged ventricular repolarization (QTc >0.50 seconds).
,A patient with chronic obstructive pulmonary disease (COPD) is admitted for worsening dyspnea and
possible pneumonia. The current ABG results are pH, 7.19; PaO2, 52 mm Hg; PaCO2, 68 mm Hg; HCO3 - ,
32 mmol/L. The nurse would interpret these results as
A. Metabolic acidosis with hypoxemia
B. Respiratory acidosis with hypoxemia
C. Respiratory alkalosis with typical oxygenation for a COPD patient
D. Metabolic alkalosis with typical oxygenation for a COPD patient (correct answers)B.
Based on the ABG analysis, the patient is experiencing a respiratory acidosis with hypoxemia most likely
due to the pneumonia. A pH of 7.19 indicates acidosis; a PaCO2 of 68 mm Hg is elevated and a cause of
acidosis; an HCO3 - of 32 mmol/L indicates renal compensation; a PaO2 of 52 mm Hg indicates
hypoxemia
76-year-old patient is receiving gentamicin and linezolid for an infection. Which of the following
potential complications is the most important for the nurse to monitor this patient for?
A. Acute delirium
B. Acute kidney injury
C. Acute hepatic failure
D. Sepsis (correct answers)B.
Gentamicin is a nephrotoxic agent that places patients at risk for acute kidney injury, and this risk is
increased in older patients. Acute delirium (A), liver failure (C), and sepsis (D) are all complications that
could occur in an older adult with an infection but would not be caused by the administration of an
antibiotic.
An older patient is experiencing delirium 24 hours following hip replacement. Which intervention might
worsen the patient's condition?
, A. Removing any unnecessary tubes and equipment from the room
B. Assessing and treating the patient's pain every 2 hours
C. Ensuring that the patient has the means to call for help
D. Loosely applying soft restraints (correct answers)D.
Older patients are at increased risk for delirium during acute hospitalization. Interventions to manage
acute delirium include removing or camouflaging tubes, removing unnecessary equipment, frequently
reorienting the patient, and ensuring that the call bell is consistently within reach, assessing and treating
pain effectively, and encouraging mobility and involvement in activities of daily living. Restraining the
patient is contraindicated in the care of patients with delirium.
A patient shows a new slight facial droop and the patient's right arm is weaker than the left. A priority
intervention would be to
A. Obtain a serum glucose level
B. Obtain a full set of vital signs
C. Initiate the stroke protocol
D. Initiate the code response team (correct answers)C.
The stroke protocol should be activated as soon as signs of stroke are identified in a patient. Initial signs
of stroke include facial droop, arm down drift, and garbled speech. For best outcomes, the time elapsed
between initials signs of stroke and treatment must be as short as possible.
Which of the following lab results shows acute pancreatitis? (correct answers)elevated glucose, lipase,
amylase, BUN/Cr, triglycerides, and bilirubin (know your lab values)
low calcium, mag and potassium
CERTIFICATION EXAM REVIEW/AACN LATEST
2022/2023
Pt on Vtach, HR 135, RR 32, BP 90/48, conscious but c/o dizziness, recent K+ lvl is 3.4. What action would
you do first?
a. emergent defib
b. amio 300mg IVP
c. emergent cardioversion
d. hang 10 mEq KCL/50mL D5W (correct answers)C
The nurse notes the following when analyzing a patient's telemetry strip: HR, 65/min and regular; PR
interval, 0.22 seconds; QRS complex, 0.10 seconds; QTc, 0.52 seconds. Which of the following
dysrhythmias is the patient at risk for?
A. Atrial fibrillation because the PR interval is wide
B. Sinus arrhythmia because the QRS complex is narrow
C. Torsades de pointes because the QTc is wide
D. Third-degree heart block because the PR interval is narrow (correct answers)C.
QT measurements reflect the duration of ventricular repolarization. Lengthening of QT interval is
associated with arrhythmias, adverse cardiac events, and increased mortality because a longer QT
duration places the vulnerable ventricular repolarization phase close to the next depolarization,
increasing the likelihood of R-on-T. The most common arrhythmia that occurs with prolonged QTc is
torsades de pointes. Atrial fibrillation, sinus bradycardia, and third-degree heart block are not typically
associated with prolonged ventricular repolarization (QTc >0.50 seconds).
,A patient with chronic obstructive pulmonary disease (COPD) is admitted for worsening dyspnea and
possible pneumonia. The current ABG results are pH, 7.19; PaO2, 52 mm Hg; PaCO2, 68 mm Hg; HCO3 - ,
32 mmol/L. The nurse would interpret these results as
A. Metabolic acidosis with hypoxemia
B. Respiratory acidosis with hypoxemia
C. Respiratory alkalosis with typical oxygenation for a COPD patient
D. Metabolic alkalosis with typical oxygenation for a COPD patient (correct answers)B.
Based on the ABG analysis, the patient is experiencing a respiratory acidosis with hypoxemia most likely
due to the pneumonia. A pH of 7.19 indicates acidosis; a PaCO2 of 68 mm Hg is elevated and a cause of
acidosis; an HCO3 - of 32 mmol/L indicates renal compensation; a PaO2 of 52 mm Hg indicates
hypoxemia
76-year-old patient is receiving gentamicin and linezolid for an infection. Which of the following
potential complications is the most important for the nurse to monitor this patient for?
A. Acute delirium
B. Acute kidney injury
C. Acute hepatic failure
D. Sepsis (correct answers)B.
Gentamicin is a nephrotoxic agent that places patients at risk for acute kidney injury, and this risk is
increased in older patients. Acute delirium (A), liver failure (C), and sepsis (D) are all complications that
could occur in an older adult with an infection but would not be caused by the administration of an
antibiotic.
An older patient is experiencing delirium 24 hours following hip replacement. Which intervention might
worsen the patient's condition?
, A. Removing any unnecessary tubes and equipment from the room
B. Assessing and treating the patient's pain every 2 hours
C. Ensuring that the patient has the means to call for help
D. Loosely applying soft restraints (correct answers)D.
Older patients are at increased risk for delirium during acute hospitalization. Interventions to manage
acute delirium include removing or camouflaging tubes, removing unnecessary equipment, frequently
reorienting the patient, and ensuring that the call bell is consistently within reach, assessing and treating
pain effectively, and encouraging mobility and involvement in activities of daily living. Restraining the
patient is contraindicated in the care of patients with delirium.
A patient shows a new slight facial droop and the patient's right arm is weaker than the left. A priority
intervention would be to
A. Obtain a serum glucose level
B. Obtain a full set of vital signs
C. Initiate the stroke protocol
D. Initiate the code response team (correct answers)C.
The stroke protocol should be activated as soon as signs of stroke are identified in a patient. Initial signs
of stroke include facial droop, arm down drift, and garbled speech. For best outcomes, the time elapsed
between initials signs of stroke and treatment must be as short as possible.
Which of the following lab results shows acute pancreatitis? (correct answers)elevated glucose, lipase,
amylase, BUN/Cr, triglycerides, and bilirubin (know your lab values)
low calcium, mag and potassium
