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AACN PCCN exam consists of 125 multiple-choice questions that cover a range of topics related to progressive care nursing. PCCN exam is divided into two parts: clinical judgment and professional caring and ethical practice. The clinical judgment section assesses the nurse’s ability to think critically and make sound clinical decisions based on patient data. The professional caring and ethical practice section assesses the nurse’s ability to provide compassionate care and maintain ethical and professional standards.
NEW QUESTION # 172
Red blood cell indices are useful in determining the etiology of:
- A. Anemia
- B. Infection
- C. Pain
- D. Edema
Answer: A
Explanation:
Correct answer: Anemia
Red blood cell indices are useful in determining the etiology of anemia.
RBC indices (mean corpuscular hemoglobin, RBC distribution width, mean corpuscular volume, and mean corpuscular hemoglobin concentration) are measurements of the weight, size, and hemoglobin concentration of the individual RBCs also known as erythrocytes.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 324.
NEW QUESTION # 173
A young boy has ingested 20 tylenol (acetaminophen). What do you expect he is likely to have due to this?
- A. Stroke
- B. Fulminant hepatic failure
- C. Renal failure
- D. Cardiac failure
Answer: B
Explanation:
Explanation: The boys is likely to have Fulminant hepatic failure that will happen due to acetaminophen intake. Fulminant hepatic failure (FHF) is usually defined as the severe impairment of hepatic functions in the absence of preexisting liver disease. However, unlike in adults, encephalopathy may be absent, late, or unrecognized in children.
NEW QUESTION # 174
A 50-year-old male chronic drinker, presented in medical OPD with intermittent fever, epistaxis, ankle edema, indigestion, abdominal pain and palmar erythema. What is he suffering from based on clinical findings?
- A. Compensated cirrhosis
- B. Acute fulminant hepatitis
- C. Decompensated cirrhosis
- D. Cholecystitis
Answer: A
Explanation:
Explanation: According to the symptoms presented, he is suffering from compensated cirrhosis because alcohol is the cause of cirrhosis. Other features of compensated cirrhosis are intermittent fever, epistaxis, ankle edema, palmar erythema.
NEW QUESTION # 175
Factors that may play a role in the development of gastritis include all of the following except:
- A. An increase in mucosal blood flow
- B. A decrease in bicarbonate secretion
- C. An increase in bile salts
- D. An increase in the production of pepsin
Answer: A
Explanation:
Correct answer: An increase in mucosal blood flow
A decrease in mucosal blood flow, caused by an increased production of gastric acid, increased bile salts, or other factors such as the use of alcohol, nonsteroidal anti-inflammatory drugs, and stress overwhelm the mucosal defense mechanisms and allow gastric acids to permeate the mucosal barrier.
An increased production of gastric acids can lead to the formation of gastric lesions. An increase in bile salts can lead to the formation of gastric lesions. Decreased bicarbonate secretion allows gastric acids to permeate the mucosal barrier.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 342.
NEW QUESTION # 176
Risk factors for meningitis include all of the following except:
- A. Immunocompromise
- B. Crowded living conditions
- C. Gender
- D. Trauma
Answer: C
Explanation:
Correct answer: Gender
Meningitis is an acute inflammation of the meninges of the brain and spinal cord. It can be caused by bacteria, viruses, fungi, or parasites. Risk factors include crowded living conditions, immunocompromise, trauma, surgery that disrupts the meninges, and trauma.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 318.
NEW QUESTION # 177
The surgical procedure that is defined as the removal of a bronchovascular segment of the lung lobe is:
- A. Wedge resection
- B. Lobectomy
- C. Pneumonectomy
- D. Segmental resection
Answer: D
Explanation:
Correct answer: Segmental resection
A segmental resection is the removal of a bronchovascular segment of the lung lobe.
A pneumonectomy is the removal of the entire lung. A lobectomy is the resection of one or more lobes of the lung. A wedge resection is the removal of a small wedge-shaped section of lung tissue.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 253.
NEW QUESTION # 178
Which of the following is the leading cause of acute liver failure in the United States?
- A. Hepatitis A
- B. Nonalcoholic fatty liver disease
- C. Acetaminophen overdose
- D. Hepatitis B
Answer: C
Explanation:
Correct answer: Acetaminophen overdose
Acute liver failure, also known as fulminant hepatic failure, results in massive cell necrosis which leads to multiorgan dysfunction. Its leading cause in Europe and the US is acetaminophen overdose. Other causes include viral hepatitis (A, B, and E), shock and thrombosis.
Nonalcoholic fatty liver disease is one of the most common causes of chronic liver disease in the Western world.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 349.
NEW QUESTION # 179
Which of the following refers to a technique that uses a combination of analgesics and sedatives to minimize discomfort during a procedure while assuring that the patient can maintain ventilation and communicate throughout the procedure?
- A. Critical sedation
- B. Conscious sedation
- C. Progressive sedation
- D. Presence sedation
Answer: B
Explanation:
Correct answer: Conscious sedation
Conscious sedation or moderate sedation is common in progressive, acute care and special procedure units. Amnesia is anticipated and often desired. The patient's ability to maintain a patent airway is central to the decision related to the use of conscious sedation.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 157.
NEW QUESTION # 180
Management of a basilar skull fracture may include all of the following except:
- A. Antibiotic therapy
- B. Lumbar puncture to drain cerebrospinal fluid that is compressing the healing dura
- C. Surgical repair of cerebrospinal fluid leaks
- D. Maintaining the head of the bed at less than 15 degrees elevation
Answer: D
Explanation:
Correct answer: Maintaining the head of the bed at less than 15 degrees elevation Management of cerebrospinal fluid leaks associated with basilar skull fractures may include:
* Elevating the head of the bed
* Antibiotic therapy
* Lumbar drainage of cerebrospinal fluid if needed to decrease pressure on the healing dura Although most cerebrospinal fluid leaks stop spontaneously, those that persist may require surgical repair.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 500.
NEW QUESTION # 181
Which of the following is a cardiac hormone that regulates cardiovascular homeostasis and fluid volume during states of volume and pressure overload?
- A. Octreotide
- B. Nitroprusside
- C. Nesiritide
- D. Hydralazine
Answer: C
Explanation:
Correct answer: Nesiritide
Nesiritide is a recombinant human b-type natriuretic peptide, which is a cardiac hormone that regulates cardiovascular homeostasis and fluid volume during states of volume and pressure overload.
Sodium nitroprusside is a vasodilator that affects both the venous and arterial systems; hydralazine is an arterial vasodilating agent; octreotide is the synthetic analog of somatostatin.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 171-172, 181.
NEW QUESTION # 182
A nurse is monitoring a client who was recently admitted to the unit after a cardiac catheterization.
Which of the following ordered assignments is the nurse's priority?
- A. Monitor the client's urinary output
- B. Assess pulses proximal to the insertion site
- C. Assess pulses distal to insertion site
- D. Assess the client's heart rate
Answer: C
Explanation:
Explanation: After the procedure, the client is at risk of clot formation. Weakened or absent pulses distal to the insertion site may suggest its occurrence. Options A and B are also assessed, but assessment of the pulses distal to the insertion site is the priority. Option D is not correct.
NEW QUESTION # 183
Goals of patient management in heart failure revolve around principles which include all of the following except:
- A. Micromanagement of hemodynamic parameters
- B. Treatment of the underlying cause
- C. Improvement in ventricular function
- D. Management of fluid volume overload
Answer: A
Explanation:
Correct answer: Micromanagement of hemodynamic parameters
Micromanagement of hemodynamic parameters, primarily using positive inotropes, is no longer emphasized in the acute management of heart failure.
The emphasis in the acute management of heart failure primarily now focuses on functional capacity and long-term survival with the use of neurohormonal blocking agents. Goals of patient management in heart failure revolve around the following general principals: Treating the underlying cause, managing fluid volume overload, improving ventricular function, and patient and family education.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 232.
NEW QUESTION # 184
Requiring a mentally competent patient to call for assistance before getting out of bed to use the bathroom is an example of which of the following?
- A. Paternalism
- B. Fidelity
- C. Veracity
- D. Autonomy
Answer: A
Explanation:
Correct answer: Paternalism
Paternalism, in ethics, refers to instances in which the principle of beneficence overrides that of autonomy. In this case, fall prevention overrides the patient's autonomy but is justified by the benefit of ensuring the patient's safety.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 196.
NEW QUESTION # 185
The nurse is taking care of a Hispanic patient who has a large family. She pulls in extra chairs and lets the patient know what times where multiple family members would be allowed. She gets the patient water without ice. The nurse is showing what professional caring quality?
- A. Clinical inquiry
- B. Caring practice
- C. Systems thinking
- D. Response to diversity
Answer: D
Explanation:
Explanation: When the nurse shows respect for the patient's family, pulls in more chairs for family members, works with the family to accommodate larger groups and is sensitive to culture traditions, they are showing a response to diversity. This response is sensitive to recognize, appreciate and incorporate differences into the plan of care.
NEW QUESTION # 186
A female client with diabetes mellitus II comes to the facility complaining of weakness and dizziness.
Initial assessment reveals a heart rate of 105 beats per minute, cold extremities, and pallor. The client reported that she had her insulin shot about 2 hours ago. Which of the following actions of the nurse is the least appropriate?
- A. Offer about 4 Lifesavers
- B. Offer 1/2 can of orange juice
- C. Check the client's blood glucose
- D. Prepare insulin
Answer: D
Explanation:
Explanation: Based on the findings, the client is experiencing hypoglycemia. Insulin must not be administered because it can further decrease the client's blood sugar levels. The nurse should offer foods that contain about 10 to 15 grams of glucose, such as 1/2 can of juice, 4 Lifesavers, and 4 teaspoons of sugar.
NEW QUESTION # 187
The three most common congenital long-QT syndromes are:
- A. LQT1, LQT12, LQT13
- B. LQT1, LQT3, LQT5
- C. LQT11, LQT12, LQT13
- D. LQT1, LQT2, LQT3
Answer: D
Explanation:
Correct answer: LQT1, LQT2, LQT3
The most common congenital long-QT syndromes are LQT1, LQT2, and LQT3, which are responsible for up to 90% of genotyped cases LQTS.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 444.
NEW QUESTION # 188
A 10-year-old boy comes to the emergency department crying after being hit in the face by a baseball.
The nurse will assess the pain on a scale of:
- A. 1-20 scale
- B. 1-15 scale
- C. 1-10 scale
- D. 1-5 scale
Answer: C
Explanation:
Explanation: The nurse will assess the pain on a scale of 1-10. Pain is a subjective feeling which depends on the individual's pain threshold and pain tolerance for a pain. But certainly onset of pain, its duration and its intensity does effects and so help in gradation of pain. The pain of being hit in the face by a baseball is assessed on a 1-10 scale.
NEW QUESTION # 189
All of the following statements related to haloperidol are true except:
- A. It sedates without significant respiratory depression
- B. Extrapyramidal reactions to haloperidol are possible
- C. QTc interval monitoring is required when using haloperidol
- D. It is associated with the development of tolerance
Answer: D
Explanation:
Correct answer: It is associated with the development of tolerance
Haloperidol is not associated with the development of dependence tolerance or dependence and it induces sedation without significant respiratory depression. This made it popular in the past. However, it is associated with other potential side effects that must be closely monitored.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 156.
NEW QUESTION # 190
All of the following conditions are among the American Heart Association's practice standards for electrocardiogram monitoring in hospital settings list of indications for QT-interval monitoring except:
- A. Severe hyponatremia
- B. Severe hypokalemia or hypomagnesemia
- C. New-onset bradyarrhythmias
- D. Initiation of a drug known to cause torsades de pointes
Answer: A
Explanation:
Correct answer: Severe hyponatremia
Severe hyponatremia is not included in the American Heart Association's list of indications for QT interval monitoring.
The AHA practice standards for ECG monitoring in hospital settings lists the following indications for QT monitoring: Initiation of a drug known to cause TdP, overdose from potentially proarrhythmic agents, new-onset bradyarrhythmias, and severe hypokalemia or hypomagnesemia.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 443.
NEW QUESTION # 191
Which of the following is the best method of evaluating aspiration risk for patients who are receiving enteral feedings?
- A. Evaluating the patient's gag reflex
- B. Evaluating the patient's cough reflex
- C. Routine monitoring of gastric residual volume
- D. Testing tracheal secretions for the presence of glucose
Answer: B
Explanation:
Correct answer: Evaluating the patient's cough reflex
The cough and swallow reflexes are important to airway protection and would be the best method of evaluating aspiration risk for patients who are receiving enteral feedings.
The least reliable protective reflex in assessing for aspiration risk is the gag reflex. Routine monitoring of gastric residual volume has not been validated. The presence of glucose in tracheal secretions is not a sensitive or specific method of detecting aspiration of enteral feeding. Tracheal glucose may be positive in patients who are not receiving enteral nutrition, and some tube-feeding formulas have low-glucose concentrations and do not test positive when aspirated.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 364.
NEW QUESTION # 192
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