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PCCN Review 2025 Questions and Answers

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PCCN Review 2025 Questions and Answers

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PCCN Review 2025 Questions and Answers
AAnurseAisAcaringAforAaA71-year-oldAfemaleApatientAwithAend-
stageAchronicAobstructiveApulmonaryAdiseaseA(COPD)AwhoAisAexperiencingAcardiacA
ischemiaAwithAincreasedAshortnessAofAbreath.ATheAMOSTAappropriateAgoalAofAoxygenAthe
rapyAforAthisApatientAwouldAbeAto:
A.ALimitAsupplementalAoxygenAtoAlowerAtheAriskAofAreducingArespiratoryAdrive
B.AMaintainAoxygenAsaturationsAbetweenA86%AandA89%
C.AAdministerAoxygenAuntilAoxygenAsaturationsAareAgreaterAthanA95%AinAorderAtoArelieveAis
chemiaA
D.AMaintainAoxygenAsaturationsAbetweenA90%AandA92%A-ACORRECTAANSWERS-
D.AMaintainAoxygenAsaturationsAbetweenA90%AandA92%

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MaintainingAoxygenAsaturationsAbetweenA90%AandA92%AwillAserveAtheApurposeAofAprovidi
ngAenoughAoxygenAtoArelieveAcardiacAischemiaAwhileAreducingAtheAriskAofArespiratoryAdepr
essionAinAaApatientAwithACOPD.
LaboratoryAstudiesAfromAaA22-year-
oldAmaleAclientAwithATypeAIAdiabetesAmellitusAareAevaluatedAduringAanAadmissionAforAsever
eApneumonia.AWhichAofAtheAfollowingAlaboratoryAresultsAshouldAtheAnurseAreportAtoAtheAph
ysician?A
A.AGlycosylatedAhemoglobinA(HbA1c),A9.8%A
B.ALow-densityAlipoproteinA(LDL),A
C.A94Amg/dLHematocritA(Hct),A53%A
D.AUrineAspecificAgravity,A1.250A-ACORRECTAANSWERS-
A.AGlycosylatedAhemoglobinA(HbA1c),A9.8%
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GlycosylatedAhemoglobinAmeasuresAtheAaverageAbloodAsugarAlevelsAoverAaA2AtoA3AmonthA
timeAperiod.AClientsAwithApreviouslyAdiagnosedAdiabetesAmellitusAshouldAaimAtoAkeepAtheir
AHbA1cAlevelsAbelowA7%.CONTENT AAREA:AClinicalAJudgement:AEndocrine/Hematology/

Neurology/GI/Renal
TheAnurseAisAassessingAaA68AyearAoldAfemaleApatientAwithAaAhistoryAofAchronicAobstructiveA
pulmonaryAdiseaseA(COPD).ATheApatientApresentsAwithAcomplaintsAofArecentAconfusion,Ai
ncreasedAfatigue,AandAsyncopalAepisodesAwhenAwalking.ATheAnurseAassessesAS3AandAS4
AsoundsAonAauscultation,AjugularAveinAdistention,AandA+3ApittingAedemaAof AtheAanklesAandA

feet.AWhichAofAtheAfollowingAcomplicationsAofACOPDAdoesAtheAnurseAsuspectAtheApatientAi
sAmostAlikelyAexperiencing?A
A.AAcuteArespiratoryAdistressAsyndromeA(ARDS)A
B.ABronchiectasisA
C.AHeartAfailureA
D.ACorApulmonaleA-ACORRECTAANSWERS-D.ACorApulmonale
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,TheAnurseAshouldArecognizeAthatAaAhistoryAofACOPDAtogetherAwithAtheAsignsAandAsympto
msAlistedAhereAareAsuggestiveAofAcorApulmonale.ATheApatientArequiresAfurtherAworkupAtoAc
onfirmAthisAdiagnosis.
AA42-year-
oldAmaleAwithAMarfanAsyndromeAandAcomplaintAofAdizzinessAisAadmittedAtoAtheAtelemetryA
unitAforAmonitoring.AWhichAofAtheAfollowingAaccompanyingAsymptomsAmayAindicateAtheAne
edAforAimmediateAsurgicalAattention?
A.ACoughAwithAvocalAhoarseness
B.ALimitedArotationAofAtheAleftAshoulder
C.HeadacheAthatAresolvedAafterAbreakfast,AbutAhasAreturned
D.ASuddenAstabbingApainAinAtheArightAelbowA-ACORRECTAANSWERS-
A.ACoughAwithAvocalAhoarseness
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PatientsAdiagnosedAwithAMarfanAsyndromeAareAatAhigherAriskAforAaorticAaneurysms.AChan
gesAinAvocalAqualityAaccompaniedAbyAaAcoughAorAdysphagiaA(difficultyAswallowing)AmayAin
dicateAthatAaAthoracicAaorticAaneurysmAisAbecomingAmoreAenlarged.
TheAnurseAisAassessingAaA74AyearAoldAfemaleApatientAwhoAhasApresentedAwithAtheAfollowin
gAsymptoms:Acool,AclammyAskin;Afaint,AirregularAperipheralApulses,AandA+3ApittingAedemaAi
nAherAbilateralAlowerAextremities.AHerApartnerAtellsAtheAnurseAtheApatientAhasAaAhistoryAofAh
eartAfailureAwithAaArecentALVEFAofA20%,AasAwellAasAtypeA2Adiabetes.ATheApatient'sAHRAisA1
32,ABPAisA79/48,AandAbloodAglucoseAisA349.AWhichAofAtheAfollowingAconditionsAdoesAtheAnu
rseAsuspect?
A.ACardiogenicAshock
B.ADiabeticAketoacidosis
C.AFluidAoverload
D.AObstructiveAshockA-ACORRECTAANSWERS-A.ACardiogenicAshock
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TheAnurseAshouldAidentifyAthatAcardiogenicAshockAisAanAemergencyAthatAhasAextremelyAhi
ghAmortalityAratesAwithoutAtimelyAintervention.ATheApatient'sAhistoryAofAheartAfailureAtogeth
erAwithAherAacuteAsymptomsAofAweakApulses,Aedema,AandAhypotensionAallApointAtoAcardio
genicAshock.
TheAnurseAisAcaringAforAaApatientAwithAstageA5AchronicAkidneyAdiseaseAwhoAnormallyArecei
vesAhemodialysisAthreeAtimesAaAweekAonAMonday,AWednesday,AandAFriday.AItAisAnowASun
dayAandAtheApatientAstatesAtheyAhaveAmissedAtheirAlastAtwoAdialysisAsessions.ATheApatientA
isAcomplainingAofAshortnessAofAbreathAandAfatigue,AandAtheirAlabsAshowAaAcreatinineAofA3.9
AandApotassiumAofA6.8.AWhatAisAtheABESTAtreatmentAforAthisApatientA?

A.A80AmgAIVApushAfurosemideAfollowedAbyArecheckingAtheApotassiumAlevel,AwithAmoreAIVAf
urosemideAasAneeded
B.A15AgAkayexalateAPOAtwiceAdaily
C.AIntravenousAcalciumAinfusion
D.AUrgentAhemodialysisA-ACORRECTAANSWERS-D.AUrgentAhemodialysis
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TheAnurseAshouldArecognizeAthatAdialysisAisAtheAbestAoptionAforAthisApatientAsinceAtheyAare
AalreadyAaAregularAdialysisApatientAandAareAaAlikelyAcandidateAtoAreceiveAurgentAdialysisAdu

eAtoAtheirAmissedAdialysisAsessions,AshortnessAofAbreath,AandAcriticalApotassiumAlevel.

,AA17-year-
oldAmaleAclientAisArecoveringAfromAidiopathicAinfectiveAendocarditis.ATheAnurseAshouldAincl
udeAwhichAofAtheAfollowingAteachingApointsAinAtheAdischargeAcareAplanAforAthisAclient?
A.ATakingAprophylacticAantibioticsAbeforeAdentalAprocedures
B.ADrinkingAnoAmoreAthanA1AliterAofAfluidAperAday
C.AStrictlyAavoidingAcaffeineAorAotherAstimulants
D.AEncouragingAaAhealthyAlow-
fatAdietAthatAincludesAatAleastA2AgramsAofAsodiumAintakeAperAdayA-ACORRECTAANSWERS-
A.ATakingAprophylacticAantibioticsAbeforeAdentalAprocedures
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ClientAwithAaAhistoryAofAinfectiveAendocarditisAshouldAtakeAprophylacticAantibioticsAbeforeA
dentalAproceduresAandAsomeAsurgicalAprocedures.
TheAnurseAisAcaringAforAaA21AyearAoldAfemaleAwhoAisAbeingAtreatedAwithAIVAmagnesiumAforA
pre-
eclampsia.AUponAassessment,AtheAnurseAnotesAthatAtheApatient'sAskinAisAflushed,AherAbloo
dApressureAisA88/56,AandAherArespiratoryArateAisA12.ATheAnurseAchecksAtheApatient'sAmagn
esiumAlevelAandAfindsAthatAitAisA7.2Amg/dL.AWhichAofAtheAfollowingAactionsAdoesAtheAnurseA
anticipateAtakingAnext?
A.AAdministeringAintravenousAcalciumAgluconate
B.AIncreasingAtheArateAofAtheAmagnesiumAinfusion
C.APlacingAtheApatientAinATrendelenburgAandAadministeringAaAbolusAofAIVAfluid
D.PreparingAtheApatientAforAaAbedsideAcardioversion.A-ACORRECTAANSWERS-
A.AAdministeringAintravenousAcalciumAgluconate
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TheAnurseAshouldAidentifyAthatAtheAsignsAandAsymptomsAhereAareAreflectiveAofAaAcriticallyA
highAmagnesiumAlevel,AreflectedAbyAtheAlabAlevelAofA7.2Amg/dL,AandAthatAtheAcorrectAtreat
mentAisAanAinfusionAofAcalciumAgluconate.
AA22-year-
oldAmaleApatientAisAadmittedAforAobservationAfollowingAaAlinearAtemporalAskullAfractureAfro
mAaAskiingAaccident.AUponAadmissionAatA2Apm,AtheApatientAwasAalertAandAoriented,AandAre
portsAthatAheA"passedAoutAforAaAsecond"AimmediatelyAafterAhisAaccident.AAtA4Apm,AtheAnurs
eAnotesAthatAtheApatient'sAGlasgowAComaAScaleA(GCS)AisA8.ATheAnurseAshould:
A.AContinueAtoAmonitorAforAchanges
B.APlaceAtheApatientAinATrendelenburgAposition
C.APrepareAtheApatientAforAburrAholeAplacementAwithAclotAevacuation
D.APrepareAtoAadministerAtissueAplasminogenAactivatorA(tPA)AtoAreverseAocclusiveAstrokeA
-ACORRECTAANSWERS-
C.APrepareAtheApatientAforAburrAholeAplacementAwithAclotAevacuation
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ThisApatientAisAexhibitingAclassicAsignsAandAsymptomsAofAanAepiduralAhematoma.ASurgical
AinterventionAtoAremoveAtheAhematomaAandArelieveApressureAonAtheAbrainAshouldAbeAperfo

rmedAasAsoonAasApossible.
AA71-year-
oldAfemaleApatientAisAadmittedAafterAevaluationAinAtheAemergencyAdepartmentA(ED)AforAsu
spectedAcoronaryAsyndromeAinvolvingAtheAinferiorAwall.AWhichAofAtheAfollowingAchangesAw

, ouldAtheAnurseAanticipateAseeingAonAaA12-
leadAECGAforAanAinferiorAwallAmyocardialAinfarctionA(MI)?
A.ASTAelevation,AQAwaves,AandAinvertedATAwavesAinAleadsAII,AIII,AandAaVF
B.ASTAelevation,AQAwaves,AandAinvertedATAwavesAinAleadsAIAandAaVL
C.ASTAdepression,AQAwaves,AandAspikedATAwavesAinAleadsAII,AIII,AandAaVF
D.ASTAelevationAandAinvertedATAwavesAinAallAprecordialAleadsA-ACORRECTAANSWERS-
A.ASTAelevation,AQAwaves,AandAinvertedATAwavesAinAleadsAII,AIII,AandAaVF
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AcuteAcoronaryAsyndromesAinvolvingAtheAinferiorAcardiacAwallAwillAmostAoftenAmanifestAasA
STAelevationAandAinvertedATAwavesAinAleadsAII,AIII,AandAaVF.AQAwavesAmayAappearAduringA
theAacuteAphasesAofAtheAsyndrome,AorAmayAappearAasAanAinfarctionAhealsA(moreAcommon
).
TheAnurseAhasAaA32AyearAoldAfemaleApatientAwithAaAdiagnosisAofAmajorAdepressiveAdisorde
r.ATheApatientAtellsAtheAnurseAthatAsheAwishesAeveryAnightAthatAsheAcouldAgoAtoAsleepAandA
neverAwakeAup.ASheAalsoAtellsAtheAnurseAthatAsheAhasAbeenAthinkingAthatAitAwouldAbeAeasy
AtoAtakeAaAwholeAbottleAofATylenolA"toAendAmyApainAforever."AWhatAisAtheAMOSTAappropriat

eAinterventionAforAtheAnurseAtoAtake?
A.AEncourageAtheApatientAtoAengageAinApsychotherapyAwhenAsheAisAreadyAtoAtalkAaboutAh
erAfeelings.
B.AEnsureAthatAtheApatient'sAphysicalAenvironmentAisAsafeAandAfreeAofAobjectsAthatAcouldAb
eAusedAtoAharmAherself
C.ARemindAtheApatientAtoAtakeAherAscheduledAmedications
D.ATellAtheApatientAtoAtakeAsomeAtimeAaloneAtoAprocessAherAthoughtsAandAfeelingsA-
ACORRECTAANSWERS-

B.AEnsureAthatAtheApatient'sAphysicalAenvironmentAisAsafeAandAfreeAofAobjectsAthatAcouldAb
eAusedAtoAharmAherself
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TheAnurseAshouldAidentifyAthatAtheAmostAimportantAthingAwhenAworkingAwithAaApatientAwho
AisAexpressingAsuicidalAideologyAisApatientAsafety;AthisAbeginsAwithAtheApatient'sAphysicalAe

nvironmentAandAensuringAthatAthereAisAnothingAthatAtheApatientAcanAaccessAthatAcanAbeAus
edAtoAharmAthemselves.
AAtelemetryAnurseAisAcaringAforAaA59-year-
oldAmaleApatientAwhoAisAbeingAevaluatedAforAnon-
specificAcardiacAsymptoms.AJustAafterAtheAnurseAarrivesAinAtheApatient'sAroomAtoAadministe
rAtheAmorningAmedications,AtheApatientAlosesAconsciousness.ATheAcardiacAmonitorAreveal
sAthird-
degreeAAVAheartAblockAwithAventricularAescapeAbeatsAatA38AbeatsAperAminuteA(bpm).ATheA
nurseAshould:
A.APrepareAtoAinitiateAtranscutaneousApacing
B.AAdministerAatropineA0.5AmgAIV
C.APrepareAtheApatientAforAcardioversion
D.AAdministerAadenosineA(Adenocard)A6AmgArapidAIVApushA-ACORRECTAANSWERS-
A.APrepareAtoAinitiateAtranscutaneousApacing
Feedback
Third-
degreeAheartAblockAwithAaAslowAventricularAescapeArhythmAthatAisAnotAsufficientAtoAkeepAaA

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