PCCN EXAM QUESTIONS WITH WELL
QUALIFIED ANSWERS GRADED A+
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: -- -CORRECT -ANSWER-fluid -
volume -overload.
what -is -normal -Pulmonary -artery -occlusion -pressure -(PAOP)? -- -CORRECT -ANSWER-5-12 -mmHg
The -resistance -against -which -the -left -ventricle -must -pump -to -eject -its -volume -is: -- -CORRECT -
ANSWER-systemic -vascular -resistance.
When -the -tricuspid -valve -is -open, -central -venous -pressure -reflects -the -filling -pressure -in -the: --
-CORRECT -ANSWER-right -ventricle.
Tachycardia -is -dangerous -for -the -patient -with -ischemic -heart -disease -because -of: -- -CORRECT -
ANSWER-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: -- -CORRECT -ANSWER-central -cyanosis.
Priorities -for -palpation -of -the -patient -with -cardiovascular -disease -include: -- -CORRECT -ANSWER-
estimating -edema.
checking -capillary -refill
checking -for -DVT
arterial -pulses
By -blocking -the -conversion -of -angiotensin -I -to -angiotensin -II, -angiotensin-converting -enzyme -
inhibitors -produce: -- -CORRECT -ANSWER-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? -- -CORRECT -
ANSWER-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: -- -CORRECT -ANSWER-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: -- -CORRECT -
ANSWER-c. -atrium -is -being -paced.
The -possibility -of -microshock -when -handling -a -temporary -pacemaker -can -be -minimized -by: -- -
CORRECT -ANSWER-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: -- -CORRECT -ANSWER-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? -- -CORRECT -ANSWER-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 -- -CORRECT -ANSWER-b. -pacing -
artifact; -the -pacemaker -is -sensing -and -capturing.
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. -- -CORRECT -ANSWER-b. -
80 -mm -Hg
What -procedure -secures -an -arteriovenous -malformation -when -a -pt's -condition -is -too -unstable -
for -surgery? -- -CORRECT -ANSWER-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? -- -CORRECT -ANSWER-a. -Cerebrovascular -dilation
The -nurse's -priority -in -eye -care -for -the -patient -in -a -coma -will -be: -- -CORRECT -ANSWER-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: -- -CORRECT -ANSWER-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? -- -CORRECT -
ANSWER-Sodium
Which -of -the -following -conditions -occurs -when -the -renal -tubules -are -unable -to -reabsorb -
excess -glucose? -- -CORRECT -ANSWER-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: -- -CORRECT -ANSWER-metabolic -syndrome.
To -reverse -the -hyperglycemic -hyperosmolar -state, -the -nurse -will -first -prepare -to -administer: -- -
CORRECT -ANSWER-fluids
The -nurse -is -caring -for -a -patient -with -central -diabetes -insipidus -(DI). -The -nurse -should -
anticipate -orders -for -the -administration -of: -- -CORRECT -ANSWER-vasopressin
In -the -syndrome -of -inappropriate -antidiuretic -hormone -(SIADH), -the -physiological -effect -is: -- -
CORRECT -ANSWER-dilutional -hyponatremia, -reducing -sodium -concentration -to -critically -low -
levels.
Which -assessment -findings -would -indicate -fluid -volume -excess? -- -CORRECT -ANSWER-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: -- -CORRECT -ANSWER-c. -creatinine -level.
To -determine -whether -edema -in -a -patient's -hands -is -due -to -circulatory -compromise -or -another
-cause, -the -nurse -might: -- -CORRECT -ANSWER-elevate -the -patient's -extremities -for -1 -hour -and -
observe -the -degree -of -edema -still -present.
Hypovolemia -causes -tachycardia -and -: -- -CORRECT -ANSWER-hypotension.
To -avoid -the -complications -that -can -result -from -administering -furosemide -(Lasix) -to -stimulate -
urinary -output, -the -nurse -will -carefully -monitor: -- -CORRECT -ANSWER-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)? -- -CORRECT -ANSWER-Intermittent -hemodialysis
What -are -complications -of -continuous -renal -replacement -therapy -(CRRT)? -- -CORRECT -ANSWER-
Air -embolism, -decreased -inflow -pressure, -electrolyte -imbalance
Which -electrolytes -pose -the -most -potential -hazard -if -not -within -normal -limits -for -the -person -
with -acute -kidney -failure? -- -CORRECT -ANSWER-Potassium -and -calcium
peaked -T-waves -and -a -widening -of -the -QRS -interval -in -a -pt -with -AKI -are -indicative -of: -- -
CORRECT -ANSWER-d. -hyperkalemia.
A -patient -presents -with -the -following: -HR, -120 -beats/min; -BP, -80/44 -mm -Hg; -urine -output -
averaging -20 -mL/hr -over -the -last -4 -hours; -afebrile; -moist -rales -in -the -lungs -bilaterally; -BUN, -
84 -mg/dL; -creatinine, -3.4 -mg/dL. -What -is -the -probable -cause -of -this -patient's -acute -kidney -
injury -(AKI)? -- -CORRECT -ANSWER-Left -ventricular -failure -causing -prerenal -AKI
An -elderly -patient -is -in -a -motor -vehicle -accident -and -incurs -a -significant -internal -hemorrhage. -
He -is -at -greatest -risk -for -which -category -of -acute -kidney -injury -(AKI)? -- -CORRECT -ANSWER-
Prerenal
QUALIFIED ANSWERS GRADED A+
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: -- -CORRECT -ANSWER-fluid -
volume -overload.
what -is -normal -Pulmonary -artery -occlusion -pressure -(PAOP)? -- -CORRECT -ANSWER-5-12 -mmHg
The -resistance -against -which -the -left -ventricle -must -pump -to -eject -its -volume -is: -- -CORRECT -
ANSWER-systemic -vascular -resistance.
When -the -tricuspid -valve -is -open, -central -venous -pressure -reflects -the -filling -pressure -in -the: --
-CORRECT -ANSWER-right -ventricle.
Tachycardia -is -dangerous -for -the -patient -with -ischemic -heart -disease -because -of: -- -CORRECT -
ANSWER-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: -- -CORRECT -ANSWER-central -cyanosis.
Priorities -for -palpation -of -the -patient -with -cardiovascular -disease -include: -- -CORRECT -ANSWER-
estimating -edema.
checking -capillary -refill
checking -for -DVT
arterial -pulses
By -blocking -the -conversion -of -angiotensin -I -to -angiotensin -II, -angiotensin-converting -enzyme -
inhibitors -produce: -- -CORRECT -ANSWER-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? -- -CORRECT -
ANSWER-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: -- -CORRECT -ANSWER-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: -- -CORRECT -
ANSWER-c. -atrium -is -being -paced.
The -possibility -of -microshock -when -handling -a -temporary -pacemaker -can -be -minimized -by: -- -
CORRECT -ANSWER-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: -- -CORRECT -ANSWER-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? -- -CORRECT -ANSWER-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 -- -CORRECT -ANSWER-b. -pacing -
artifact; -the -pacemaker -is -sensing -and -capturing.
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. -- -CORRECT -ANSWER-b. -
80 -mm -Hg
What -procedure -secures -an -arteriovenous -malformation -when -a -pt's -condition -is -too -unstable -
for -surgery? -- -CORRECT -ANSWER-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? -- -CORRECT -ANSWER-a. -Cerebrovascular -dilation
The -nurse's -priority -in -eye -care -for -the -patient -in -a -coma -will -be: -- -CORRECT -ANSWER-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: -- -CORRECT -ANSWER-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? -- -CORRECT -
ANSWER-Sodium
Which -of -the -following -conditions -occurs -when -the -renal -tubules -are -unable -to -reabsorb -
excess -glucose? -- -CORRECT -ANSWER-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: -- -CORRECT -ANSWER-metabolic -syndrome.
To -reverse -the -hyperglycemic -hyperosmolar -state, -the -nurse -will -first -prepare -to -administer: -- -
CORRECT -ANSWER-fluids
The -nurse -is -caring -for -a -patient -with -central -diabetes -insipidus -(DI). -The -nurse -should -
anticipate -orders -for -the -administration -of: -- -CORRECT -ANSWER-vasopressin
In -the -syndrome -of -inappropriate -antidiuretic -hormone -(SIADH), -the -physiological -effect -is: -- -
CORRECT -ANSWER-dilutional -hyponatremia, -reducing -sodium -concentration -to -critically -low -
levels.
Which -assessment -findings -would -indicate -fluid -volume -excess? -- -CORRECT -ANSWER-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: -- -CORRECT -ANSWER-c. -creatinine -level.
To -determine -whether -edema -in -a -patient's -hands -is -due -to -circulatory -compromise -or -another
-cause, -the -nurse -might: -- -CORRECT -ANSWER-elevate -the -patient's -extremities -for -1 -hour -and -
observe -the -degree -of -edema -still -present.
Hypovolemia -causes -tachycardia -and -: -- -CORRECT -ANSWER-hypotension.
To -avoid -the -complications -that -can -result -from -administering -furosemide -(Lasix) -to -stimulate -
urinary -output, -the -nurse -will -carefully -monitor: -- -CORRECT -ANSWER-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)? -- -CORRECT -ANSWER-Intermittent -hemodialysis
What -are -complications -of -continuous -renal -replacement -therapy -(CRRT)? -- -CORRECT -ANSWER-
Air -embolism, -decreased -inflow -pressure, -electrolyte -imbalance
Which -electrolytes -pose -the -most -potential -hazard -if -not -within -normal -limits -for -the -person -
with -acute -kidney -failure? -- -CORRECT -ANSWER-Potassium -and -calcium
peaked -T-waves -and -a -widening -of -the -QRS -interval -in -a -pt -with -AKI -are -indicative -of: -- -
CORRECT -ANSWER-d. -hyperkalemia.
A -patient -presents -with -the -following: -HR, -120 -beats/min; -BP, -80/44 -mm -Hg; -urine -output -
averaging -20 -mL/hr -over -the -last -4 -hours; -afebrile; -moist -rales -in -the -lungs -bilaterally; -BUN, -
84 -mg/dL; -creatinine, -3.4 -mg/dL. -What -is -the -probable -cause -of -this -patient's -acute -kidney -
injury -(AKI)? -- -CORRECT -ANSWER-Left -ventricular -failure -causing -prerenal -AKI
An -elderly -patient -is -in -a -motor -vehicle -accident -and -incurs -a -significant -internal -hemorrhage. -
He -is -at -greatest -risk -for -which -category -of -acute -kidney -injury -(AKI)? -- -CORRECT -ANSWER-
Prerenal
