PCCN Exam 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
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.
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
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
Which electrolytes pose the most potential hazard if not within normal limits for the
person with acute kidney failure? - ANS-Potassium and calcium
peaked T-waves and a widening of the QRS interval in a pt with AKI are indicative of: -
ANS-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)? - ANS-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)? -
ANS-Prerenal
A patient is admitted to the unit with the following laboratory values: urine specific
gravity, 1.010; urine osmolality, 210 mOsm/kg; BUN/Cr ratio 10:1; urine sodium, 96
mEq/L. The urine output has been 60 mL since admission 2 hours ago. These values
are most consistent with which of the following types of acute kidney injury (AKI)? -
ANS-Intrarenal
Percussing the patient's stomach produces a tympanic sound is a sign that: - ANS-the
patient's stomach is empty.
The nurse is unable to hear bowel sounds in any of the four quadrants of the patient's
abdomen. This may indicate the presence of: - ANS-ban ileus.
Auscultation of the abdomen reveals a bruit over the left renal artery. This is an
indication of: - ANS-renal hypertension.
The nurse observes that striae on the patient's abdomen are pink and purple. This may
be a sign of: - ANS-Cushing's syndrome.
During auscultation of the patient's abdomen, the nurse hears frequent high-pitched,
tinkling sounds. This is probably evidence of: - ANS-normal bowel sounds.
The nurse has been unable to hear any bowel sounds during examination of the
patient's abdomen. The minimum interval for listening before concluding that bowel
sounds are absent is ____ minute(s). - ANS-5
During palpation of the patient's abdomen, rebound tenderness indicates: - ANS-
inflammation of the peritoneum, such as with appenticitis and Chrohn's dz
Elevated alkaline phosphatase level and increasing nausea and abdominal pain
indicate: - ANS-gallbladder disease.
The patient's serum transferrin level is higher than 300 mcg/dL. The nurse will review
other laboratory results to evaluate for the possible presence of: - ANS-iron deficiency
anemia.
The patient's alpha fetoprotein level is 200 ng/mL. This can indicate the presence of
____ cancer. - ANS-liver
Knowing that the patient has advanced liver disease, the nurse expects his partial
thromboplastin time (PTT) to be in the range of ____ seconds. - ANS-50 to 75
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
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.
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
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
Which electrolytes pose the most potential hazard if not within normal limits for the
person with acute kidney failure? - ANS-Potassium and calcium
peaked T-waves and a widening of the QRS interval in a pt with AKI are indicative of: -
ANS-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)? - ANS-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)? -
ANS-Prerenal
A patient is admitted to the unit with the following laboratory values: urine specific
gravity, 1.010; urine osmolality, 210 mOsm/kg; BUN/Cr ratio 10:1; urine sodium, 96
mEq/L. The urine output has been 60 mL since admission 2 hours ago. These values
are most consistent with which of the following types of acute kidney injury (AKI)? -
ANS-Intrarenal
Percussing the patient's stomach produces a tympanic sound is a sign that: - ANS-the
patient's stomach is empty.
The nurse is unable to hear bowel sounds in any of the four quadrants of the patient's
abdomen. This may indicate the presence of: - ANS-ban ileus.
Auscultation of the abdomen reveals a bruit over the left renal artery. This is an
indication of: - ANS-renal hypertension.
The nurse observes that striae on the patient's abdomen are pink and purple. This may
be a sign of: - ANS-Cushing's syndrome.
During auscultation of the patient's abdomen, the nurse hears frequent high-pitched,
tinkling sounds. This is probably evidence of: - ANS-normal bowel sounds.
The nurse has been unable to hear any bowel sounds during examination of the
patient's abdomen. The minimum interval for listening before concluding that bowel
sounds are absent is ____ minute(s). - ANS-5
During palpation of the patient's abdomen, rebound tenderness indicates: - ANS-
inflammation of the peritoneum, such as with appenticitis and Chrohn's dz
Elevated alkaline phosphatase level and increasing nausea and abdominal pain
indicate: - ANS-gallbladder disease.
The patient's serum transferrin level is higher than 300 mcg/dL. The nurse will review
other laboratory results to evaluate for the possible presence of: - ANS-iron deficiency
anemia.
The patient's alpha fetoprotein level is 200 ng/mL. This can indicate the presence of
____ cancer. - ANS-liver
Knowing that the patient has advanced liver disease, the nurse expects his partial
thromboplastin time (PTT) to be in the range of ____ seconds. - ANS-50 to 75
