PCCN EXAM QUESTIONS AND ANSWERS WITH SOLUTIONS 2024

PCCN EXAM QUESTIONS AND
ANSWERS WITH SOLUTIONS 2024
TheRnurseRobservesRthatRtheRpatient'sRjugularRveinsRdistendRinRtheRsemi-
uprightRpositionRtoRmoreRthanR5RcmRaboveRtheRsternalRangle.RThisRisRanRindicationRof:R-
RANSWERRfluidRvolumeRoverload.




whatRisRnormalRPulmonaryRarteryRocclusionRpressureR(PAOP)?R-RANSWERR5-12RmmHg



TheRresistanceRagainstRwhichRtheRleftRventricleRmustRpumpRtoRejectRitsRvolumeRis:R-
RANSWERRsystemicRvascularRresistance.




WhenRtheRtricuspidRvalveRisRopen,RcentralRvenousRpressureRreflectsRtheRfillingRpressureRinRthe:R-
RANSWERRrightRventricle.




TachycardiaRisRdangerousRforRtheRpatientRwithRischemicRheartRdiseaseRbecauseRof:R-
RANSWERRcompromisedRcardiacRoutput.




DuringRinitialRexaminationRofRaRcriticalRcareRpatient,RtheRnurseRobservesRwideRandRconvexRnailsRandRbulbo
usRfingertips.RThisRisRevidenceRof:R-RANSWERRcentralRcyanosis.



PrioritiesRforRpalpationRofRtheRpatientRwithRcardiovascularRdiseaseRinclude:R-RANSWERRestimatingRedema.

checkingRcapillaryRrefill

checkingRforRDVT

arterialRpulses



ByRblockingRtheRconversionRofRangiotensinRIRtoRangiotensinRII,Rangiotensin-
convertingRenzymeRinhibitorsRproduce:R-RANSWERRb.Rvasodilation.



TheRnurseRhasRreadRthatRtheRcardiologistRrecommendsRtheRuseRofRclassRIVRdrugsRtoRdepressRsinusRandRatri
oventricularRnodeRconductionRandRterminateRsupraventricularRtachycardiasRinRtheRpatientRatRthisRtime.RTh
eRnurseRwillRanticipateRordersRforRwhichRmedications?R-RANSWERRa.RVerapamil,Rdiltiazem,RorRamlodipine

,TheRnurseRhasRadministeredRaRdrugRthatRstimulatesRβ1-
adrenergicRsites.RFollowingRadministrationRofRtheRdrug,RtheRnurseRwillRassessRfor:R-
RANSWERRa.RincreasedRheartRrate.




TheRnurseRisRobservingRtheRpatient'sRelectrocardiographicRmonitorRafterRinsertionRofRaRtemporaryRpacema
ker.RSeeingRaRP-waveRafterRtheRpacingRartifact,RtheRnurseRknowsRthatRthe:R-
RANSWERRc.RatriumRisRbeingRpaced.




TheRpossibilityRofRmicroshockRwhenRhandlingRaRtemporaryRpacemakerRcanRbeRminimizedRby:R-
RANSWERRb.RinsulatingRtheRendsRofRtheRwires.RandRwearingRglovesRwhenRhandlingRtheRpacingRwires




InRtheRpostoperativeRcardiovascularRpatient,RtheRmostRfrequentRcauseRofRaRdecreasedRcardiacRoutputRis:R-
RANSWERRa.RreducedRpreload.




ARpatientRisRbeingRmonitoredRbyRcontinuousRelectrocardiogramR(ECG)RafterRplacementRofRaRtransvenousRp
acemaker.R"LossRofRcapture"RisRseenRonRtheRECG.RWhichRnursingRinterventionRmayRcorrectRthisRsituation?R-
RANSWERRa.RPositionRtheRpatientRonRtheRleftRside.RorRrepositionRtheRleads




InRanalyzingRtheRECGRstrip,RtheRnurseRnoticesRaRspikeRbeforeReachRQRSRcomplex.RTheRpatient'sRheartRrateRis
R70Rbeats/min.RThisRphenomenonRisRreflectiveRofR-

RANSWERRb.RpacingRartifact;RtheRpacemakerRisRsensingRandRcapturing.




CalculateRtheRcerebralRperfusionRpressureR(CPP)RforRaRpatientRwithRaRmeanRarterialRpressureR(MAP)R=R95R
mmRHgRandRanRintracranialRpressureR(ICP)R=R15RmmRHg.R-RANSWERRb.R80RmmRHg



WhatRprocedureRsecuresRanRarteriovenousRmalformationRwhenRaRpt'sRconditionRisRtooRunstableRforRsurger
y?R-
RANSWERRembolizationRthatRcanRbeRdoneRtoRsecureRtheRlesionRwithoutRsurgery.RWhenRtheRconditionRisRmo

reRstable,RanRoperationRmightRbeRconsideredRifRneeded.



KnowingRthatRaRpatientRhasRhypoxemiaRandRischemiaRinRhisRbrain,RtheRnurseRanticipatesRwhichRofRtheRfollo
wing?R-RANSWERRa.RCerebrovascularRdilation

,TheRnurse'sRpriorityRinReyeRcareRforRtheRpatientRinRaRcomaRwillRbe:R-
RANSWERRc.RkeepingRtheReyesRmoistRtoRpreventRcornealRulceration.




TheRpatientRhasRmarkedlyRdeep,RrapidRrespirationsRwithRaRfruityRbreathRodor.RBasedRonRtheRpatient'sRhisto
ry,RtheRnurseRwill:R-RANSWERRperformRaRbloodRglucoseRmeasurement.



TheRpatientRwithRtheRsyndromeRofRinappropriateRantidiureticRhormoneR(SIADH)RsecretionRwillRneedRtoRhav
eRtheRimbalanceRofRwhichRelectrolyteRcorrectedRasRsoonRasRpossible?R-RANSWERRSodium



WhichRofRtheRfollowingRconditionsRoccursRwhenRtheRrenalRtubulesRareRunableRtoRreabsorbRexcessRglucose?
R-RANSWERRGlycosuria




TheRpatientRhasRaRwaistRmeasurementRofR52Rinches.RHisRtriglycerideRlevelRisR175Rmg/dL,RhisRhigh-
densityRlipoproteinR(HDL)RcholesterolRlevelRisR32Rmg/dL,RandRhisRfastingRplasmaRglucoseRlevelRisR224Rmg/d
L.RHisRbloodRpressureRreadingsRareRusuallyRapproximatelyR140/90RmmRHg.RTheRnurseRrecognizesRtheRchara
cteristicsRof:R-RANSWERRmetabolicRsyndrome.



ToRreverseRtheRhyperglycemicRhyperosmolarRstate,RtheRnurseRwillRfirstRprepareRtoRadminister:R-
RANSWERRfluids




TheRnurseRisRcaringRforRaRpatientRwithRcentralRdiabetesRinsipidusR(DI).RTheRnurseRshouldRanticipateRordersRf
orRtheRadministrationRof:R-RANSWERRvasopressin



InRtheRsyndromeRofRinappropriateRantidiureticRhormoneR(SIADH),RtheRphysiologicalReffectRis:R-
RANSWERRdilutionalRhyponatremia,RreducingRsodiumRconcentrationRtoRcriticallyRlowRlevels.




WhichRassessmentRfindingsRwouldRindicateRfluidRvolumeRexcess?R-
RANSWERRedema,RauscultationRofRaRthirdRheartRsound,RcracklesRinRlungs,RboundingRpulses,RAMS,Rolguria,R

HTN



TheRreportRofRaRrenalRpatient'sRlaboratoryRresultsRshowsRthatRtheRbloodRureaRnitrogenR(BUN)RlevelRisRlessRt
hanR25Rmg/dL.RToRfullyRunderstandRtheRpatient'sRrenalRstatus,RtheRnurseRmustRconsiderRthisRvalueRalongRwi
th:R-RANSWERRc.RcreatinineRlevel.

, ToRdetermineRwhetherRedemaRinRaRpatient'sRhandsRisRdueRtoRcirculatoryRcompromiseRorRanotherRcause,Rth
eRnurseRmight:R-
RANSWERRelevateRtheRpatient'sRextremitiesRforR1RhourRandRobserveRtheRdegreeRofRedemaRstillRpresent.




HypovolemiaRcausesRtachycardiaRandR:R-RANSWERRhypotension.



ToRavoidRtheRcomplicationsRthatRcanRresultRfromRadministeringRfurosemideR(Lasix)RtoRstimulateRurinaryRou
tput,RtheRnurseRwillRcarefullyRmonitor:R-RANSWERRlevelsRofRelectrolytes,RespeciallyRpotassium.



WhichRdialysisRmethodRwouldRbeRmostRappropriateRforRtheRhemodynamicallyRstableRpatientRinRtheRanuricR
phaseRofRacuteRkidneyRinjuryR(AKI)?R-RANSWERRIntermittentRhemodialysis



WhatRareRcomplicationsRofRcontinuousRrenalRreplacementRtherapyR(CRRT)?R-
RANSWERRAirRembolism,RdecreasedRinflowRpressure,RelectrolyteRimbalance




WhichRelectrolytesRposeRtheRmostRpotentialRhazardRifRnotRwithinRnormalRlimitsRforRtheRpersonRwithRacuteR
kidneyRfailure?R-RANSWERRPotassiumRandRcalcium



peakedRT-wavesRandRaRwideningRofRtheRQRSRintervalRinRaRptRwithRAKIRareRindicativeRof:R-
RANSWERRd.Rhyperkalemia.




ARpatientRpresentsRwithRtheRfollowing:RHR,R120Rbeats/min;RBP,R80/44RmmRHg;RurineRoutputRaveragingR20R
mL/hrRoverRtheRlastR4Rhours;Rafebrile;RmoistRralesRinRtheRlungsRbilaterally;RBUN,R84Rmg/dL;Rcreatinine,R3.4R
mg/dL.RWhatRisRtheRprobableRcauseRofRthisRpatient'sRacuteRkidneyRinjuryR(AKI)?R-
RANSWERRLeftRventricularRfailureRcausingRprerenalRAKI




AnRelderlyRpatientRisRinRaRmotorRvehicleRaccidentRandRincursRaRsignificantRinternalRhemorrhage.RHeRisRatRgr
eatestRriskRforRwhichRcategoryRofRacuteRkidneyRinjuryR(AKI)?R-RANSWERRPrerenal



ARpatientRisRadmittedRtoRtheRunitRwithRtheRfollowingRlaboratoryRvalues:RurineRspecificRgravity,R1.010;RurineR
osmolality,R210RmOsm/kg;RBUN/CrRratioR10:1;RurineRsodium,R96RmEq/L.RTheRurineRoutputRhasRbeenR60RmL
RsinceRadmissionR2RhoursRago.RTheseRvaluesRareRmostRconsistentRwithRwhichRofRtheRfollowingRtypesRofRacut

eRkidneyRinjuryR(AKI)?R-RANSWERRIntrarenal