All PCCN Exam Questions and Answers From
2022/2023
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: -
ANSWER fluid volume overload.
what is normal Pulmonary artery occlusion pressure (PAOP)? - ANSWER 5-12
mmHg
The resistance against which the left ventricle must pump to eject its volume is: -
ANSWER systemic vascular resistance.
When the tricuspid valve is open, central venous pressure reflects the filling pressure
in the: - ANSWER right ventricle.
Tachycardia is dangerous for the patient with ischemic heart disease because of: -
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: - ANSWER central
cyanosis.
Priorities for palpation of the patient with cardiovascular disease include: - 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: - 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? - 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: - 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: - ANSWER c. atrium is being paced.
The possibility of microshock when handling a temporary pacemaker can be
minimized by: - 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: - 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? - 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 - 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. -
ANSWER b. 80 mm Hg
What procedure secures an arteriovenous malformation when a pt's condition is too
unstable for surgery? - 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? - ANSWER a. Cerebrovascular dilation
The nurse's priority in eye care for the patient in a coma will be: - 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: - 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? - ANSWER Sodium
Which of the following conditions occurs when the renal tubules are unable to
reabsorb excess glucose? - 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: -
ANSWER metabolic syndrome.
To reverse the hyperglycemic hyperosmolar state, the nurse will first prepare to
administer: - ANSWER fluids
The nurse is caring for a patient with central diabetes insipidus (DI). The nurse
should anticipate orders for the administration of: - ANSWER vasopressin
,In the syndrome of inappropriate antidiuretic hormone (SIADH), the physiological
effect is: - ANSWER dilutional hyponatremia, reducing sodium concentration to
critically low levels.
Which assessment findings would indicate fluid volume excess? - 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: - ANSWER c. creatinine level.
To determine whether edema in a patient's hands is due to circulatory compromise
or another cause, the nurse might: - ANSWER elevate the patient's extremities for 1
hour and observe the degree of edema still present.
Hypovolemia causes tachycardia and : - ANSWER hypotension.
To avoid the complications that can result from administering furosemide (Lasix) to
stimulate urinary output, the nurse will carefully monitor: - 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)? - ANSWER Intermittent
hemodialysis
What are complications of continuous renal replacement therapy (CRRT)? -
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? - ANSWER Potassium and calcium
peaked T-waves and a widening of the QRS interval in a pt with AKI are indicative of:
- 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)? - 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)? -
ANSWER 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)? - ANSWER Intrarenal
Percussing the patient's stomach produces a tympanic sound is a sign that: -
ANSWER 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: - ANSWER ban ileus.
Auscultation of the abdomen reveals a bruit over the left renal artery. This is an
indication of: - ANSWER renal hypertension.
The nurse observes that striae on the patient's abdomen are pink and purple. This
may be a sign of: - ANSWER Cushing's syndrome.
During auscultation of the patient's abdomen, the nurse hears frequent high-pitched,
tinkling sounds. This is probably evidence of: - ANSWER 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). - ANSWER 5
During palpation of the patient's abdomen, rebound tenderness indicates: -
ANSWER inflammation of the peritoneum, such as with appenticitis and Chrohn's
dz
Elevated alkaline phosphatase level and increasing nausea and abdominal pain
indicate: - ANSWER 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: - ANSWER iron
deficiency anemia.
The patient's alpha fetoprotein level is 200 ng/mL. This can indicate the presence of
____ cancer. - ANSWER liver
Knowing that the patient has advanced liver disease, the nurse expects his partial
thromboplastin time (PTT) to be in the range of ____ seconds. - ANSWER 50 to 75
The patient has advanced cirrhosis. Her serum albumin level is anticipated to be: -
ANSWER decreased.
A vasopressin drip for a patient with bleeding esophagogastric varices would be
contraindicated if the patient has a history of: - ANSWER coronary artery disease
What type of formula would be most appropriate for a patient with acute pancreatitis?
- ANSWER Low fat
A person with a body mass index (BMI) of 32 would be considered: - ANSWER
obese