PCCN PULMONARY EXAM |ACTUAL QUESTIONS
AND VERIFIED ANSWERS 2026-2027 UPDATED
EDITION|GRADED A+
Question 1
Your patient had an exacerbation of COPD. The rapid response team was called and is
currently intubating the patient and preparing him for transfer to ICU. When the family
visits, they are shocked to see the people working with the patient. No one had told them
the patient had deteriorated and required intubation. After the patient is intubated and is
being wheeled past them, family members try to communicate verbally with the patient,
but he does not respond except to gesture. The nurse should tell the family members:
-They must leave the area because they are exciting the patient.
-The tube used for breathing prevents the patient from speaking
-They must speak with the doctor, who will explain why the patient cannot speak
-The patient is very ill and may die.
CORRECT ANSWER
The tube used for breathing prevents the patient from speaking
This is a case where communication is clearly the problem. The family should have been
informed by someone that the patient needed assistance with breathing and that they
should expect a transfer. It should also have been mentioned how the patient might look in
the ICU. In addition, it could have been communicated about the patient's inability to
speak.
The other answers are all non-theraputic responses. The family is clearly distressed, so a
simple explaination in best.
Question 2
1
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,Ben was just transferred to the PCU. He had been in ICU for 2 weeks. Ben was intubated
for a time because of his ARDs. On arrival to your unit, you note that he is tachycardic and
restless. Ben states, "I can't be here now. What if something like this happens to me
again?" The nurse's best response would be:
-The nurses in our unit can take care of you
-We are not very far away at the nurses' station
-Your insurance will not cover another day there
-You sound concerned about leaving the ICU
CORRECT ANSWER
You sound concerned about leaving the ICU
Theraputic communication occurs when the patient's feelings are validated. This response
allows for the patient to express the concerns he has about the transfer. The other answers
are closed and judgmental and do not allow for any expression of feeling from the patient.
Question 3
Ben was just transferred to the PCU. He had been in ICU for 2 weeks. Ben was intubated
for a time because of his ARDs. On arrival to your unit, you note that he is tachycardic and
restless. A set of blood gases drawn just prior to his transfer show:
pH 7.52, PaCO2 31, HCO3 22, PaO2 87.
These results would indicate:
-Respiratory acidosis
-Respiratory alkalosis
-Metabloic acidosis
-Metabolic alkalosis
2
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,CORRECT ANSWER
Respiratory alkalosis
Ben was quite anxious and tachycardic. His RR probably was increased because of both
anxiety and his condition.
He would blow off CO2.
His pH is below normal, so it is uncompensated.
The HCO3 is low, indicating alkalosis
The interpretation would be:
Uncompensated Respiratory Alkolosis
Question 4
Ben was just transferred to the PCU. He had been in ICU for 2 weeks. Ben was intubated
for a time because of his ARDs. On arrival to your unit, you note that he is tachycardic and
restless. Ben is finally released from the hospital. He plans to visit his family in Denver.
Part of the patient teaching for Ben should include information on the effects of high
altitude on his ability to oxygenate effectively. Which of the following changes would be
expected on his blood gas results?
-The pH would decrease
-No effect
-The O2 saturation would decrease
-The PaO2 would increase
CORRECT ANSWER
The O2 saturation would decrease
At higher altitudes, there is decreased atmospheric pressure to force oxygen into the lungs.
To compensate for the lower pressure, the person must breathe faster. The percentage of
3
@https://www.stuvia.com/user/thestudyvault
, oxygen remains the same, but the partial pressure of the oxygen decreases. Aterial PaO2
decreases, as does O2 saturation. The rapid breathing will result in hyperventillation,
raising the pH and lowering the PaCO2 level.
Question 5
SaO2 values account for what % of O2 carreid within the bloodstream?
-2-3%
-10-24%
-97-98%
-100%
CORRECT ANSWER
97-98%
The % of total oxygen carried within the bloodstream attributed to the SaO2 is 97-98%.
SaO2 is the arterial saturation of hemoglobin. The % corresponds to the % of hemoglobin
on the red blood cells that carries O2. Typically this % is documented as normal when
within 93-99%.
PaO2 is the % of O2 within the bloodstream that is free or dissolved in the plasma. This
value is documented in mmHg and is considered normal when within the range of 80-100
mmHg.
Question 6
Hypoxemia is best defined as:
-A decrease in O2 at the cellular level
-A decrease in O2 levels in arterial blood
4
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AND VERIFIED ANSWERS 2026-2027 UPDATED
EDITION|GRADED A+
Question 1
Your patient had an exacerbation of COPD. The rapid response team was called and is
currently intubating the patient and preparing him for transfer to ICU. When the family
visits, they are shocked to see the people working with the patient. No one had told them
the patient had deteriorated and required intubation. After the patient is intubated and is
being wheeled past them, family members try to communicate verbally with the patient,
but he does not respond except to gesture. The nurse should tell the family members:
-They must leave the area because they are exciting the patient.
-The tube used for breathing prevents the patient from speaking
-They must speak with the doctor, who will explain why the patient cannot speak
-The patient is very ill and may die.
CORRECT ANSWER
The tube used for breathing prevents the patient from speaking
This is a case where communication is clearly the problem. The family should have been
informed by someone that the patient needed assistance with breathing and that they
should expect a transfer. It should also have been mentioned how the patient might look in
the ICU. In addition, it could have been communicated about the patient's inability to
speak.
The other answers are all non-theraputic responses. The family is clearly distressed, so a
simple explaination in best.
Question 2
1
@https://www.stuvia.com/user/thestudyvault
,Ben was just transferred to the PCU. He had been in ICU for 2 weeks. Ben was intubated
for a time because of his ARDs. On arrival to your unit, you note that he is tachycardic and
restless. Ben states, "I can't be here now. What if something like this happens to me
again?" The nurse's best response would be:
-The nurses in our unit can take care of you
-We are not very far away at the nurses' station
-Your insurance will not cover another day there
-You sound concerned about leaving the ICU
CORRECT ANSWER
You sound concerned about leaving the ICU
Theraputic communication occurs when the patient's feelings are validated. This response
allows for the patient to express the concerns he has about the transfer. The other answers
are closed and judgmental and do not allow for any expression of feeling from the patient.
Question 3
Ben was just transferred to the PCU. He had been in ICU for 2 weeks. Ben was intubated
for a time because of his ARDs. On arrival to your unit, you note that he is tachycardic and
restless. A set of blood gases drawn just prior to his transfer show:
pH 7.52, PaCO2 31, HCO3 22, PaO2 87.
These results would indicate:
-Respiratory acidosis
-Respiratory alkalosis
-Metabloic acidosis
-Metabolic alkalosis
2
@https://www.stuvia.com/user/thestudyvault
,CORRECT ANSWER
Respiratory alkalosis
Ben was quite anxious and tachycardic. His RR probably was increased because of both
anxiety and his condition.
He would blow off CO2.
His pH is below normal, so it is uncompensated.
The HCO3 is low, indicating alkalosis
The interpretation would be:
Uncompensated Respiratory Alkolosis
Question 4
Ben was just transferred to the PCU. He had been in ICU for 2 weeks. Ben was intubated
for a time because of his ARDs. On arrival to your unit, you note that he is tachycardic and
restless. Ben is finally released from the hospital. He plans to visit his family in Denver.
Part of the patient teaching for Ben should include information on the effects of high
altitude on his ability to oxygenate effectively. Which of the following changes would be
expected on his blood gas results?
-The pH would decrease
-No effect
-The O2 saturation would decrease
-The PaO2 would increase
CORRECT ANSWER
The O2 saturation would decrease
At higher altitudes, there is decreased atmospheric pressure to force oxygen into the lungs.
To compensate for the lower pressure, the person must breathe faster. The percentage of
3
@https://www.stuvia.com/user/thestudyvault
, oxygen remains the same, but the partial pressure of the oxygen decreases. Aterial PaO2
decreases, as does O2 saturation. The rapid breathing will result in hyperventillation,
raising the pH and lowering the PaCO2 level.
Question 5
SaO2 values account for what % of O2 carreid within the bloodstream?
-2-3%
-10-24%
-97-98%
-100%
CORRECT ANSWER
97-98%
The % of total oxygen carried within the bloodstream attributed to the SaO2 is 97-98%.
SaO2 is the arterial saturation of hemoglobin. The % corresponds to the % of hemoglobin
on the red blood cells that carries O2. Typically this % is documented as normal when
within 93-99%.
PaO2 is the % of O2 within the bloodstream that is free or dissolved in the plasma. This
value is documented in mmHg and is considered normal when within the range of 80-100
mmHg.
Question 6
Hypoxemia is best defined as:
-A decrease in O2 at the cellular level
-A decrease in O2 levels in arterial blood
4
@https://www.stuvia.com/user/thestudyvault
