PCCN EXAMINATION TIPS AND STUDY GUIDE
2026 100% CORRECT QUESTIONS
⫸ Laboratory studies from a 22-year-old male client with Type I
diabetes mellitus are evaluated during an admission for severe
pneumonia. Which of the following laboratory results should the
nurse report to the physician?
A. Glycosylated hemoglobin (HbA1c), 9.8%
B. Low-density lipoprotein (LDL),
C. 94 mg/dLHematocrit (Hct), 53%
D. Urine specific gravity, 1.250 Answer: A. Glycosylated hemoglobin
(HbA1c), 9.8%
Feedback
Glycosylated hemoglobin measures the average blood sugar levels
over a 2 to 3 month time period. Clients with previously diagnosed
diabetes mellitus should aim to keep their HbA1c levels below
7%.CONTENT AREA: Clinical Judgement:
Endocrine/Hematology/Neurology/GI/Renal
⫸ The nurse is assessing a 68 year old female patient with a history
of chronic obstructive pulmonary disease (COPD). The patient
presents with complaints of recent confusion, increased fatigue, and
syncopal episodes when walking. The nurse assesses S3 and S4
sounds on auscultation, jugular vein distention, and +3 pitting edema
of the ankles and feet. Which of the following complications of
COPD does the nurse suspect the patient is most likely experiencing?
,A. Acute respiratory distress syndrome (ARDS)
B. Bronchiectasis
C. Heart failure
D. Cor pulmonale Answer: D. Cor pulmonale
Feedback
The nurse should recognize that a history of COPD together with the
signs and symptoms listed here are suggestive of cor pulmonale. The
patient requires further workup to confirm this diagnosis.
⫸ A 42-year-old male with Marfan syndrome and complaint of
dizziness is admitted to the telemetry unit for monitoring. Which of
the following accompanying symptoms may indicate the need for
immediate surgical attention?
A. Cough with vocal hoarseness
B. Limited rotation of the left shoulder
C.Headache that resolved after breakfast, but has returned
D. Sudden stabbing pain in the right elbow Answer: A. Cough with
vocal hoarseness
Feedback
Patients diagnosed with Marfan syndrome are at higher risk for aortic
aneurysms. Changes in vocal quality accompanied by a cough or
dysphagia (difficulty swallowing) may indicate that a thoracic aortic
aneurysm is becoming more enlarged.
⫸ The nurse is assessing a 74 year old female patient who has
presented with the following symptoms: cool, clammy skin; faint,
irregular peripheral pulses, and +3 pitting edema in her bilateral lower
,extremities. Her partner tells the nurse the patient has a history of
heart failure with a recent LVEF of 20%, as well as type 2 diabetes.
The patient's HR is 132, BP is 79/48, and blood glucose is 349. Which
of the following conditions does the nurse suspect?
A. Cardiogenic shock
B. Diabetic ketoacidosis
C. Fluid overload
D. Obstructive shock Answer: A. Cardiogenic shock
Feedback
The nurse should identify that cardiogenic shock is an emergency that
has extremely high mortality rates without timely intervention. The
patient's history of heart failure together with her acute symptoms of
weak pulses, edema, and hypotension all point to cardiogenic shock.
⫸ The nurse is caring for a patient with stage 5 chronic kidney
disease who normally receives hemodialysis three times a week on
Monday, Wednesday, and Friday. It is now Sunday and the patient
states they have missed their last two dialysis sessions. The patient is
complaining of shortness of breath and fatigue, and their labs show a
creatinine of 3.9 and potassium of 6.8. What is the BEST treatment
for this patient ?
A. 80 mg IV push furosemide followed by rechecking the potassium
level, with more IV furosemide as needed
B. 15 g kayexalate PO twice daily
C. Intravenous calcium infusion
D. Urgent hemodialysis Answer: D. Urgent hemodialysis
Feedback
, The nurse should recognize that dialysis is the best option for this
patient since they are already a regular dialysis patient and are a likely
candidate to receive urgent dialysis due to their missed dialysis
sessions, shortness of breath, and critical potassium level.
⫸ A 17-year-old male client is recovering from idiopathic infective
endocarditis. The nurse should include which of the following
teaching points in the discharge care plan for this client?
A. Taking prophylactic antibiotics before dental procedures
B. Drinking no more than 1 liter of fluid per day
C. Strictly avoiding caffeine or other stimulants
D. Encouraging a healthy low-fat diet that includes at least 2 grams of
sodium intake per day Answer: A. Taking prophylactic antibiotics
before dental procedures
Feedback
Client with a history of infective endocarditis should take
prophylactic antibiotics before dental procedures and some surgical
procedures.
⫸ The nurse is caring for a 21 year old female who is being treated
with IV magnesium for pre-eclampsia. Upon assessment, the nurse
notes that the patient's skin is flushed, her blood pressure is 88/56, and
her respiratory rate is 12. The nurse checks the patient's magnesium
level and finds that it is 7.2 mg/dL. Which of the following actions
does the nurse anticipate taking next?
A. Administering intravenous calcium gluconate
B. Increasing the rate of the magnesium infusion
2026 100% CORRECT QUESTIONS
⫸ Laboratory studies from a 22-year-old male client with Type I
diabetes mellitus are evaluated during an admission for severe
pneumonia. Which of the following laboratory results should the
nurse report to the physician?
A. Glycosylated hemoglobin (HbA1c), 9.8%
B. Low-density lipoprotein (LDL),
C. 94 mg/dLHematocrit (Hct), 53%
D. Urine specific gravity, 1.250 Answer: A. Glycosylated hemoglobin
(HbA1c), 9.8%
Feedback
Glycosylated hemoglobin measures the average blood sugar levels
over a 2 to 3 month time period. Clients with previously diagnosed
diabetes mellitus should aim to keep their HbA1c levels below
7%.CONTENT AREA: Clinical Judgement:
Endocrine/Hematology/Neurology/GI/Renal
⫸ The nurse is assessing a 68 year old female patient with a history
of chronic obstructive pulmonary disease (COPD). The patient
presents with complaints of recent confusion, increased fatigue, and
syncopal episodes when walking. The nurse assesses S3 and S4
sounds on auscultation, jugular vein distention, and +3 pitting edema
of the ankles and feet. Which of the following complications of
COPD does the nurse suspect the patient is most likely experiencing?
,A. Acute respiratory distress syndrome (ARDS)
B. Bronchiectasis
C. Heart failure
D. Cor pulmonale Answer: D. Cor pulmonale
Feedback
The nurse should recognize that a history of COPD together with the
signs and symptoms listed here are suggestive of cor pulmonale. The
patient requires further workup to confirm this diagnosis.
⫸ A 42-year-old male with Marfan syndrome and complaint of
dizziness is admitted to the telemetry unit for monitoring. Which of
the following accompanying symptoms may indicate the need for
immediate surgical attention?
A. Cough with vocal hoarseness
B. Limited rotation of the left shoulder
C.Headache that resolved after breakfast, but has returned
D. Sudden stabbing pain in the right elbow Answer: A. Cough with
vocal hoarseness
Feedback
Patients diagnosed with Marfan syndrome are at higher risk for aortic
aneurysms. Changes in vocal quality accompanied by a cough or
dysphagia (difficulty swallowing) may indicate that a thoracic aortic
aneurysm is becoming more enlarged.
⫸ The nurse is assessing a 74 year old female patient who has
presented with the following symptoms: cool, clammy skin; faint,
irregular peripheral pulses, and +3 pitting edema in her bilateral lower
,extremities. Her partner tells the nurse the patient has a history of
heart failure with a recent LVEF of 20%, as well as type 2 diabetes.
The patient's HR is 132, BP is 79/48, and blood glucose is 349. Which
of the following conditions does the nurse suspect?
A. Cardiogenic shock
B. Diabetic ketoacidosis
C. Fluid overload
D. Obstructive shock Answer: A. Cardiogenic shock
Feedback
The nurse should identify that cardiogenic shock is an emergency that
has extremely high mortality rates without timely intervention. The
patient's history of heart failure together with her acute symptoms of
weak pulses, edema, and hypotension all point to cardiogenic shock.
⫸ The nurse is caring for a patient with stage 5 chronic kidney
disease who normally receives hemodialysis three times a week on
Monday, Wednesday, and Friday. It is now Sunday and the patient
states they have missed their last two dialysis sessions. The patient is
complaining of shortness of breath and fatigue, and their labs show a
creatinine of 3.9 and potassium of 6.8. What is the BEST treatment
for this patient ?
A. 80 mg IV push furosemide followed by rechecking the potassium
level, with more IV furosemide as needed
B. 15 g kayexalate PO twice daily
C. Intravenous calcium infusion
D. Urgent hemodialysis Answer: D. Urgent hemodialysis
Feedback
, The nurse should recognize that dialysis is the best option for this
patient since they are already a regular dialysis patient and are a likely
candidate to receive urgent dialysis due to their missed dialysis
sessions, shortness of breath, and critical potassium level.
⫸ A 17-year-old male client is recovering from idiopathic infective
endocarditis. The nurse should include which of the following
teaching points in the discharge care plan for this client?
A. Taking prophylactic antibiotics before dental procedures
B. Drinking no more than 1 liter of fluid per day
C. Strictly avoiding caffeine or other stimulants
D. Encouraging a healthy low-fat diet that includes at least 2 grams of
sodium intake per day Answer: A. Taking prophylactic antibiotics
before dental procedures
Feedback
Client with a history of infective endocarditis should take
prophylactic antibiotics before dental procedures and some surgical
procedures.
⫸ The nurse is caring for a 21 year old female who is being treated
with IV magnesium for pre-eclampsia. Upon assessment, the nurse
notes that the patient's skin is flushed, her blood pressure is 88/56, and
her respiratory rate is 12. The nurse checks the patient's magnesium
level and finds that it is 7.2 mg/dL. Which of the following actions
does the nurse anticipate taking next?
A. Administering intravenous calcium gluconate
B. Increasing the rate of the magnesium infusion
