PCCN ACTUAL Exam 2025 Questions and
Answers
The nurse observes that the patient's jugular veins distend in the semi-upright position to more
than 5 cm above the sternal angle. This is an indication of: - ANS fluid volume overload.
what is normal Pulmonary artery occlusion pressure (PAOP)? - ANS 5-12 mmHg
The resistance against which the left ventricle must pump to eject its volume is: -
ANS systemic vascular resistance.
When the tricuspid valve is open, central venous pressure reflects the filling pressure in the: -
ANS right ventricle.
Tachycardia is dangerous for the patient with ischemic heart disease because of: -
ANS compromised cardiac output.
During initial examination of a critical care patient, the nurse observes wide and convex nails
and bulbous fingertips. This is evidence of: - ANS central cyanosis.
Priorities for palpation of the patient with cardiovascular disease include: - ANS estimating
edema.
checking capillary refill
checking for DVT
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,arterial pulses
By blocking the conversion of angiotensin I to angiotensin II, angiotensin-converting enzyme
inhibitors produce: - ANS b. vasodilation.
The nurse has read that the cardiologist recommends the use of class IV drugs to depress sinus
and atrioventricular node conduction and terminate supraventricular tachycardias in the
patient at this time. The nurse will anticipate orders for which medications? - ANS a.
Verapamil, diltiazem, or amlodipine
The nurse has administered a drug that stimulates β1-adrenergic sites. Following administration
of the drug, the nurse will assess for: - ANS a. increased heart rate.
The nurse is observing the patient's electrocardiographic monitor after insertion of a temporary
pacemaker. Seeing a P-wave after the pacing artifact, the nurse knows that the: - ANS c.
atrium is being paced.
The possibility of microshock when handling a temporary pacemaker can be minimized by: -
ANS b. insulating the ends of the wires. and wearing gloves when handling the pacing wires
In the postoperative cardiovascular patient, the most frequent cause of a decreased cardiac
output is: - ANS a. reduced preload.
A patient is being monitored by continuous electrocardiogram (ECG) after placement of a
transvenous pacemaker. "Loss of capture" is seen on the ECG. Which nursing intervention may
correct this situation? - ANS a. Position the patient on the left side. or reposition the leads
In analyzing the ECG strip, the nurse notices a spike before each QRS complex. The patient's
heart rate is 70 beats/min. This phenomenon is reflective of - ANS 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
(MAP) = 95 mm Hg and an intracranial pressure (ICP) = 15 mm Hg. - ANS b. 80 mm Hg
What procedure secures an arteriovenous malformation when a pt's condition is too unstable
for surgery? - ANS embolization that can be done to secure the lesion without surgery. When
the condition is more stable, an operation might be considered if needed.
Knowing that a patient has hypoxemia and ischemia in his brain, the nurse anticipates which of
the following? - ANS a. Cerebrovascular dilation
The nurse's priority in eye care for the patient in a coma will be: - ANS c. keeping the eyes
moist to prevent corneal ulceration.
The patient has markedly deep, rapid respirations with a fruity breath odor. Based on the
patient's history, the nurse will: - ANS perform a blood glucose measurement.
The patient with the syndrome of inappropriate antidiuretic hormone (SIADH) secretion will
need to have the imbalance of which electrolyte corrected as soon as possible? -
ANS Sodium
Which of the following conditions occurs when the renal tubules are unable to reabsorb excess
glucose? - ANS Glycosuria
The patient has a waist measurement of 52 inches. His triglyceride level is 175 mg/dL, his high-
density lipoprotein (HDL) cholesterol level is 32 mg/dL, and his fasting plasma glucose level is
224 mg/dL. His blood pressure readings are usually approximately 140/90 mm Hg. The nurse
recognizes the characteristics of: - ANS metabolic syndrome.
To reverse the hyperglycemic hyperosmolar state, the nurse will first prepare to administer: -
ANS fluids
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, The nurse is caring for a patient with central diabetes insipidus (DI). The nurse should anticipate
orders for the administration of: - ANS vasopressin
In the syndrome of inappropriate antidiuretic hormone (SIADH), the physiological effect is: -
ANS dilutional hyponatremia, reducing sodium concentration to critically low levels.
Which assessment findings would indicate fluid volume excess? - ANS edema, auscultation of
a third heart sound, crackles in lungs, bounding pulses, AMS, olguria, HTN
The report of a renal patient's laboratory results shows that the blood urea nitrogen (BUN) level
is less than 25 mg/dL. To fully understand the patient's renal status, the nurse must consider
this value along with: - ANS c. creatinine level.
To determine whether edema in a patient's hands is due to circulatory compromise or another
cause, the nurse might: - ANS elevate the patient's extremities for 1 hour and observe the
degree of edema still present.
Hypovolemia causes tachycardia and : - ANS hypotension.
To avoid the complications that can result from administering furosemide (Lasix) to stimulate
urinary output, the nurse will carefully monitor: - ANS levels of electrolytes, especially
potassium.
Which dialysis method would be most appropriate for the hemodynamically stable patient in
the anuric phase of acute kidney injury (AKI)? - ANS Intermittent hemodialysis
What are complications of continuous renal replacement therapy (CRRT)? - ANS Air
embolism, decreased inflow pressure, electrolyte imbalance
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Answers
The nurse observes that the patient's jugular veins distend in the semi-upright position to more
than 5 cm above the sternal angle. This is an indication of: - ANS fluid volume overload.
what is normal Pulmonary artery occlusion pressure (PAOP)? - ANS 5-12 mmHg
The resistance against which the left ventricle must pump to eject its volume is: -
ANS systemic vascular resistance.
When the tricuspid valve is open, central venous pressure reflects the filling pressure in the: -
ANS right ventricle.
Tachycardia is dangerous for the patient with ischemic heart disease because of: -
ANS compromised cardiac output.
During initial examination of a critical care patient, the nurse observes wide and convex nails
and bulbous fingertips. This is evidence of: - ANS central cyanosis.
Priorities for palpation of the patient with cardiovascular disease include: - ANS estimating
edema.
checking capillary refill
checking for DVT
Pg. 1 Copyright © 2025 Jasonmcconell. ALL RIGHTS RESERVED.
,arterial pulses
By blocking the conversion of angiotensin I to angiotensin II, angiotensin-converting enzyme
inhibitors produce: - ANS b. vasodilation.
The nurse has read that the cardiologist recommends the use of class IV drugs to depress sinus
and atrioventricular node conduction and terminate supraventricular tachycardias in the
patient at this time. The nurse will anticipate orders for which medications? - ANS a.
Verapamil, diltiazem, or amlodipine
The nurse has administered a drug that stimulates β1-adrenergic sites. Following administration
of the drug, the nurse will assess for: - ANS a. increased heart rate.
The nurse is observing the patient's electrocardiographic monitor after insertion of a temporary
pacemaker. Seeing a P-wave after the pacing artifact, the nurse knows that the: - ANS c.
atrium is being paced.
The possibility of microshock when handling a temporary pacemaker can be minimized by: -
ANS b. insulating the ends of the wires. and wearing gloves when handling the pacing wires
In the postoperative cardiovascular patient, the most frequent cause of a decreased cardiac
output is: - ANS a. reduced preload.
A patient is being monitored by continuous electrocardiogram (ECG) after placement of a
transvenous pacemaker. "Loss of capture" is seen on the ECG. Which nursing intervention may
correct this situation? - ANS a. Position the patient on the left side. or reposition the leads
In analyzing the ECG strip, the nurse notices a spike before each QRS complex. The patient's
heart rate is 70 beats/min. This phenomenon is reflective of - ANS b. pacing artifact; the
pacemaker is sensing and capturing.
Pg. 2 Copyright © 2025 Jasonmcconell. ALL RIGHTS RESERVED.
,Calculate the cerebral perfusion pressure (CPP) for a patient with a mean arterial pressure
(MAP) = 95 mm Hg and an intracranial pressure (ICP) = 15 mm Hg. - ANS b. 80 mm Hg
What procedure secures an arteriovenous malformation when a pt's condition is too unstable
for surgery? - ANS embolization that can be done to secure the lesion without surgery. When
the condition is more stable, an operation might be considered if needed.
Knowing that a patient has hypoxemia and ischemia in his brain, the nurse anticipates which of
the following? - ANS a. Cerebrovascular dilation
The nurse's priority in eye care for the patient in a coma will be: - ANS c. keeping the eyes
moist to prevent corneal ulceration.
The patient has markedly deep, rapid respirations with a fruity breath odor. Based on the
patient's history, the nurse will: - ANS perform a blood glucose measurement.
The patient with the syndrome of inappropriate antidiuretic hormone (SIADH) secretion will
need to have the imbalance of which electrolyte corrected as soon as possible? -
ANS Sodium
Which of the following conditions occurs when the renal tubules are unable to reabsorb excess
glucose? - ANS Glycosuria
The patient has a waist measurement of 52 inches. His triglyceride level is 175 mg/dL, his high-
density lipoprotein (HDL) cholesterol level is 32 mg/dL, and his fasting plasma glucose level is
224 mg/dL. His blood pressure readings are usually approximately 140/90 mm Hg. The nurse
recognizes the characteristics of: - ANS metabolic syndrome.
To reverse the hyperglycemic hyperosmolar state, the nurse will first prepare to administer: -
ANS fluids
Pg. 3 Copyright © 2025 Jasonmcconell. ALL RIGHTS RESERVED.
, The nurse is caring for a patient with central diabetes insipidus (DI). The nurse should anticipate
orders for the administration of: - ANS vasopressin
In the syndrome of inappropriate antidiuretic hormone (SIADH), the physiological effect is: -
ANS dilutional hyponatremia, reducing sodium concentration to critically low levels.
Which assessment findings would indicate fluid volume excess? - ANS edema, auscultation of
a third heart sound, crackles in lungs, bounding pulses, AMS, olguria, HTN
The report of a renal patient's laboratory results shows that the blood urea nitrogen (BUN) level
is less than 25 mg/dL. To fully understand the patient's renal status, the nurse must consider
this value along with: - ANS c. creatinine level.
To determine whether edema in a patient's hands is due to circulatory compromise or another
cause, the nurse might: - ANS elevate the patient's extremities for 1 hour and observe the
degree of edema still present.
Hypovolemia causes tachycardia and : - ANS hypotension.
To avoid the complications that can result from administering furosemide (Lasix) to stimulate
urinary output, the nurse will carefully monitor: - ANS levels of electrolytes, especially
potassium.
Which dialysis method would be most appropriate for the hemodynamically stable patient in
the anuric phase of acute kidney injury (AKI)? - ANS Intermittent hemodialysis
What are complications of continuous renal replacement therapy (CRRT)? - ANS Air
embolism, decreased inflow pressure, electrolyte imbalance
Pg. 4 Copyright © 2025 Jasonmcconell. ALL RIGHTS RESERVED.
