PCCN (Progressive Care Certified Nurse) EXAM QUESTIONS WITH CORRECT DETAILED ANSWERS || ALREADY GRADED A+ <LATEST VERSION>
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Course
PCCN
Institution
PCCN
PCCN (Progressive Care Certified Nurse)
EXAM QUESTIONS WITH
CORRECT DETAILED ANSWERS || ALREADY
GRADED A+ <LATEST VERSION>
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...
PCCN (Progressive Care Certified Nurse)
2025-2026 EXAM QUESTIONS WITH
CORRECT DETAILED ANSWERS || ALREADY
GRADED A+ <LATEST VERSION>
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.
What is the recommended starting dose for entresto? What is the target
maintenance dose and when would that be transitioned to? - ANSWER ✔
49mg/51mg PO BID
97mg/103mg PO BID after 2-4 weeks as tolerated
What are the long term heart failure options? - ANSWER ✔ biventricular pacing
for BBB patients
VAD devices
cardiac transplant
dobutamine or milrinone (+ inotropes) - can be used in palliative
What is the purpose of LVAD, RVAD, and BiVAD devices? - ANSWER ✔ short
term: bridge to transplant
long term: (LVAD) destination therapy
You have a patient with a history of cardiac transplant who presents with a HR of
35, what would you expect to do for treatment? - ANSWER ✔ pace! atropine does
not work on transplant patients!
What nerve is severed during cardiac transplant? - ANSWER ✔ vagus
A biventricular pacemaker is indicated for HFrEF patients with? - ANSWER ✔
BBB, EF <35% with a QRS >0.12
What are the diagnostics used for heart failure? - ANSWER ✔ EKG (ischemia,
BBB)
CXR (fluid overload, heart englargement)
,Echo/TEE (heart function, wall motion, presence of thrombus)
angiogram if ischemic
What heart disease presents as a STEMI, but results in a clean cardiac cath? -
ANSWER ✔ Takotsubo Cardiomyopathy
Murmurs of stenosis are auscultated with the valves are? - ANSWER ✔ open
Murmers of insufficiency/regurgitation are auscultated when valves are? -
ANSWER ✔ closed
Which valves are open during systole? - ANSWER ✔ pulmonary and aortic
Which valves are closed during systole? - ANSWER ✔ tricuspid and mitral
When are diastolic murmurs auscultated? - ANSWER ✔ after s2 heart sound
What murmurs would you hear when listening to the 5th intercostal space and the
midclavicular line? - ANSWER ✔ mitral/tricuspid stenosis (s1 - s2 - murmur)
mitral/tricuspid regurgitation (s1 - murmur- s2)
What murmurs would you hear when listening to the 2nd intercostal space, RSB? -
ANSWER ✔ aortic/pulmonic stenosis (s1-murmur - s2)
aortic/pulmonic regurgitation (s1 - s2 - murmur)
, What are causes of mitral regurgitation? - ANSWER ✔ MI
Ruptured chordina tendinae
severe L heart failure
L ventricular hypertrophy
cardiomyopathy
mitral valve prolapse
rheumatic heart disease
myxomatous degeneration
endocarditis
What are symptoms of mitral regurgitation? - ANSWER ✔ orthopnea/dyspnea
fatigue
angina
increase left atrial pressure
R heart failure
L heart failure
prone to afib d/t L atrial enlargement
What are the treatments for mitral regurgitation? - ANSWER ✔ medical
management to reduce preload & afterload
mitral valve clip
mitral valve replacement
What are the symptoms of mitral stenosis? - ANSWER ✔ pinkish cheeks
pulmonary edema
prone to afib
increased R heart pressures
pulmonary HTN
What are the treatments for mitral stenosis? - ANSWER ✔ medical management
to decrease preload and afterload
surgical replacement
balloon valvuloplasty (increase diameter of valve)
valve repair (commissurotomy)
Patients with mitral valve dysfunction are prone to what heart rhythm? -
ANSWER ✔ afib
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