2023 Provide Updated AACN PCCN Dumps as Practice Test and PDF
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The PCCN certification exam is a valuable credential for nurses who work in progressive care units. Progressive Care Certified Nursing certification demonstrates that the nurse has the knowledge and skills necessary to provide high-quality care to acutely ill adult patients. Progressive Care Certified Nursing certification can also lead to career advancement and increased earning potential. Nurses who pass the exam can use the credential to demonstrate their expertise and commitment to their profession.
NEW QUESTION # 190
The nurse is assessing a client who, admitted due to difficulty breathing, underwent a bronchoscopy. On assessment, the nurse notes absence of the gag reflex. Which of the following interventions is the least appropriate for the client?
- A. Limit oral fluid intake to 1000 mL per day
- B. Re-assess the client's gag reflex in 2 hours
- C. Assist the client in upright position
- D. Withhold oral medications
Answer: A
Explanation:
Explanation: A client must not be given anything by mouth until the gag reflex returns. The other options are appropriate for a post-bronchoscopy client.
NEW QUESTION # 191
Ketones accumulate in the blood when which of the following are being broken down faster than they can be metabolized?
- A. Proteins
- B. Triglycerides
- C. Fats
- D. Complex carbohydrates
Answer: C
Explanation:
Correct answer: Fats
Ketones accumulate in the blood when fats are being broken down faster than they can be metabolized.
When insulin is not available, glucose cannot enter cells. This triggers a mobilization of stored glucose via the breakdown of protein and fat and the release of stored glucose from the liver. Ketones are given off when fat is broken down for energy. If the ketogenic pathway is overwhelmed, ketone acids accumulate in the bloodstream where hydrogen ions (H+) dissociate, leading to a profound metabolic acidosis.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 389.
NEW QUESTION # 192
While checking the abducens nerve of the candidate, the nurse will ask the candidate to follow the finger from?
- A. 2 o'clock to 6 o'clock position
- B. 3 o'clock to 12 o'clock position
- C. 1 o'clock position to 11 o'clock position, clockwise
- D. 11 o'clock to 1 o'clock position
Answer: C
Explanation:
Explanation: While checking the abducens nerve, the nurse will ask the candidate to follow the finger from the 1 o'clock to 11 o'clock position, in a clockwise direction.
NEW QUESTION # 193
Which of the following statements is true regarding arterial catheters?
- A. The Allen test is performed prior to insertion in the radial artery
- B. The most common insertion site is the femoral artery
- C. Following the removal of an arterial catheter, firm, direct pressure is applied at the site for a minimum of 2 minutes, followed by the application of a pressure dressing
- D. Following the removal of an arterial catheter, firm, direct pressure is maintained over the site for a minimum of 90 seconds, followed by the application of a pressure dressing
Answer: A
Explanation:
Correct answer: The Allen test is performed prior to insertion in the radial artery An arterial catheter is used to directly measure blood pressure in acutely ill patients. These short catheters are most commonly inserted in the radial artery; however, prior to insertion, the Allen test is completed to ensure the adequacy of circulation to the hand.
Following removal of an arterial catheter, firm direct pressure is maintained over the site for at least 5 minutes or until hemostasis is achieved. Manual pressure may need to be applied for 10 minutes or longer for patients with coagulation abnormalities. Pressure dressings, as a substitute for manual pressure, to obtain hemostasis are not recommended.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 84-85.
NEW QUESTION # 194
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. 1-15 scale
- B. 1-10 scale
- C. 1-5 scale
- D. 1-20 scale
Answer: B
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 # 195
The Society of Critical Care Medicine recommends that which of the following should be considered as first-line treatment for non-neuropathic pain?
- A. Corticosteroids
- B. Opioids
- C. Nonsteroidal anti-inflammatory drugs
- D. Acetaminophen
Answer: B
Explanation:
Correct answer: Opioids
The principle modality of pain management in the acute care setting is opioids. These agents, traditionally referred to as narcotics, produce analgesic effects primarily by binding with specialized opiate receptors throughout the central nervous system which, therefore, alters the perception of pain.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 147.
NEW QUESTION # 196
A patient who is scheduled for coronary angiography states, "I want to be asleep during my procedure. I can't stand any kind of pain." Of the following, the best response for the nurse to make to this patient is:
- A. "You will have to be awake during the procedure so you can control your breathing."
- B. "You have to stay awake, but the procedure is painless."
- C. "Don't worry. You will be given medicine to make you very sleepy and you won't remember anything."
- D. "It sounds like you're feeling anxious. What has your doctor told you about your procedure?"
Answer: D
Explanation:
Correct answer: "It sounds like you're feeling anxious. What has your doctor told you about your procedure?" It is most therapeutic to acknowledge the patient's feelings, find out what they have been told, and not to minimize fear. Typically, patients remain awake during the procedure, allowing them to facilitate the catheterization process by controlling respiratory patterns. An anxiolytic agent, such as diazepam, is frequently administered during the procedure to decrease anxiety.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 213-214.
NEW QUESTION # 197
All of the following are true concerning the administration of recombinant human erythropoietin except:
- A. This treatment may help restore bone marrow production of red blood cells
- B. This treatment may benefit patients with chronic renal failure
- C. This treatment may benefit chemotherapy patients
- D. This treatment is appropriate when acute correction of anemia is needed
Answer: D
Explanation:
Correct answer: This treatment is appropriate when acute correction of anemia is needed The administration of recombinant human erythropoietin to restore bone marrow production of red blood cells is not appropriate in situations in which acute correction of anemia is necessary as the response may take several weeks.
Chronic renal failure patients and patients receiving chemotherapy may benefit from this treatment as it may help restore bone marrow production of red blood cells.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 328.
NEW QUESTION # 198
Arterial blood gases have been taken of the patient admitted into ICU with respiratory failure. All of the following information can be achieved with the help of ABGs except:
- A. partial pressure of oxygen
- B. pH (acidity/alkalinity)
- C. partial pressure of carbon dioxide
- D. white blood cell count for infection
Answer: D
Explanation:
Explanation: All of the following information can be achieved with the help of ABGs except white blood cell count for infection. For the patient admitted with respiratory failure, ABGs that were taken will provide all information except for the white cell count. To get the white cell count, complete blood picture needs to be done.
NEW QUESTION # 199
All of the following are common causes of Peritonitis except:
- A. Ruptured appendix
- B. Cholelithiasis
- C. Perforated bowel
- D. Abdominal trauma/ Abdominal surgery
Answer: B
Explanation:
Explanation: All of the following are common causes of Peritonitis except cholelithiasis. Peritonitis is the inflammation of the peritoneum which is due to any trauma to the gastrointestinal tract. Cholelithiasis can never be the cause of Peritonitis because Cholelithiasis means stones in gallbladder, which can never lead to Peritonitis.
NEW QUESTION # 200
Palliation is:
- A. The relief of troubling symptoms
- B. Only available for Medicaid recipients
- C. Hospice care
- D. Pain relief through the administration of means other than drugs
Answer: A
Explanation:
Correct answer: The relief of troubling symptoms
Palliation is the relief of troubling symptoms and, while it is a priority in all patients, once the decision to forego life-sustaining measures is made it is the primary focus of care.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 203.
NEW QUESTION # 201
An old man was on ventilator support because of his worsening pulmonary edema. In spite of the ventilator's support, after a few days the patient's condition further deteriorated. He became breathless and complained of pain in left side of chest. Chest x-ray revealed mediastinal shift towards right and pneumothorax right. What has suddenly happened to the patient?
- A. Pulmonary emphysema
- B. Atelectasis
- C. Ventilator induced lung injury
- D. COPD
Answer: C
Explanation:
Explanation: The patient has experienced a ventilator induced lung injury. The patient with worsening pulmonary edema and breathlessness, and whose x-ray revealed mediastinal shift towards right and pneumothorax right, has suddenly developed ventilator induced lung injury. This occurs because of continuous positive pressure. Sometimes the pleural sac ruptures and a pneumothorax and mediastinal shift occur.
NEW QUESTION # 202
To patients who have been indicated as do-not-resuscitate (DNR), the nursing staff should do the following:
- A. None of the above
- B. Give curative treatment
- C. Give palliative treatment
- D. Give no treatment
Answer: C
Explanation:
Explanation: The nursing staff should give palliative treatment to patients who are indicated as DNR. To palliate a disease is to treat it partially and insofar as possible, but not cure it completely. Palliation cloaks a disease. Also, sometimes it is called symptomatic treatment.
NEW QUESTION # 203
All of the following statements are true except:
- A. Complete bowel obstruction always requires surgical management
- B. Hypotension, bronchospasm, and tachycardia are side effects of neostigmine
- C. An ileus is categorized as a functional, rather than a mechanical obstruction
- D. Colorectal cancer is the most common cause of a large bowel obstruction in the United States
Answer: B
Explanation:
Correct answer: Hypotension, bronchospasm, and tachycardia are side effects of neostigmine Hypotension and bronchospasm are side effects of neostigmine, but bradycardia is more likely than tachycardia to occur. Patients who are treated with IV neostigmine must be monitored with telemetry, and atropine must be readily available.
Complete bowel obstruction always requires surgical management; a partial bowel obstruction can be treated conservatively with serial exams and supportive treatment. In an ileus, no mechanical cause can be identified. In the United States, colorectal cancer is the leading cause of large bowel obstruction, with the sigmoid colon and the descending colon being the most common sites of obstruction.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 358.
NEW QUESTION # 204
Which of the following statements is true related to tracheostomy tubes?
- A. Tracheostomy cuff pressure is maintained at no less than 25 mm Hg
- B. A standard 15-mm adaptor at the distal end ensures a universal connection to ventilator circuits
- C. The majority of tracheostomy tubes used in acutely ill patients are made of medical-grade plastic or silicone
- D. All tracheostomy tubes are cuffed
Answer: C
Explanation:
Correct answer: The majority of tracheostomy tubes used in acutely ill patients are made of medical- grade plastic or silicone Tracheostomy tubes may be cuffed or uncuffed. A standard 15-mm adaptor at the proximal, not distal, end ensures universal connection to ventilator circuits. Following insertion of a tracheostomy tube, the cuff is inflated with the minimum amount of air needed to create an effective seal. Cuff pressure is maintained at less than 25 mm Hg.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 110-111.
NEW QUESTION # 205
To prevent Wernicke encephalopathy, patients may require which of the following?
- A. Lactulose
- B. Endotracheal intubation
- C. Intravenous thiamine
- D. Vitamin K
Answer: C
Explanation:
Correct answer: Intravenous thiamine
Wernicke encephalopathy is caused by a depletion of thiamine stores and is most commonly seen in patients who are severely malnourished or those with alcoholism. Patients who have alcohol-related hepatic disease may need intravenous thiamine to prevent this encephalopathy.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 285, 351.
NEW QUESTION # 206
Patients in renal failure often develop metabolic acidosis. Treatment is usually not initiated for this condition until the serum bicarbonate level drops to:
- A. Less than 25 mEq/L
- B. Less than 5 mEq/L
- C. Less than 15 to 18 mEq/L
- D. Less than 35 mEq/L
Answer: C
Explanation:
Correct answer: Less than 15 to 18 mEq/L
Renal failure patients often develop metabolic acidosis, with mild respiratory alkalosis compensation.
Treatment is usually not instituted until the serum bicarbonate level drops to less than 15 to 18 mEq/L to avoid over-correction of the pH.
A serum bicarbonate level of less than 5 mEq/L is critically low. To avoid over-correction of the pH, treatment of metabolic acidosis in renal failure patients is not instituted until the serum bicarbonate level is less than 15 to 18 mEq/L. Serum bicarbonate levels of less than 35 or less than 25 mEq/L are not indicative of acidosis.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 375.
NEW QUESTION # 207
The FOUR score is a validated tool used in the assessment of neurological patients. The categories scored in this tool are:
- A. Eye response, verbal, motor, respiration
- B. Eyes, pain response, brain stem reflexes, respirations
- C. Eyes, motor, brain stem reflexes, respirations
- D. Eye response, pain response, verbal response, respirations
Answer: C
Explanation:
Correct answer: Eyes, motor, brain stem reflexes, respirations
The FOUR score assigns a score of 0 through 4 in each of the four categories and, because it includes respirations and brain stem reflexes, this tool allows for the identification of changes in patients who are comatose, non-verbal, or who have very limited responses.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 299-300.
NEW QUESTION # 208
An old lady presented to emergency department with dyspnea, tachypnea, hemoptysis, rales and chest pain. On examination, her pulse was irregularly irregular and rate was 350 bpm. What is the most likely diagnosis?
- A. Pulmonary emphysema
- B. Pulmonary embolism
- C. Pulmonary infarction
- D. Pulmonary tuberculosis
Answer: B
Explanation:
Explanation: The most likely diagnosis of this woman presenting with, tachypnea, hemoptysis, rales, chest pain and irregular pulse is pulmonary embolism because these are all typical symptoms.
Moreover, patient pulse irregularity shows that she is having Atrial Fibrillation which is notorious for causing thrombi in right side of heart, which do embolize.
NEW QUESTION # 209
A young girl presented in medical OPD with 3 days history of intermittent fever with rigors and chills, hemoptysis, pleuritic chest pain and nausea. On examination, she was ill looking, had fever of 101 degrees Fahrenheit, her chest was dull on percussion and there was a pleural rub. What is the most likely diagnosis?
- A. Asthma
- B. COPD
- C. Pneumonia
- D. Pulmonary tuberculosis
Answer: C
Explanation:
Explanation: The most likely diagnosis with the history of fever, chills, pleuralistic chest pain and nausea, is Pneumonia because it is an infectious disease presenting with fever. When lung parenchyma is damaged, hemoptysis also occurs. Moreover, pleural rub also indicates Pneumonia.
NEW QUESTION # 210
A patient's decision-making capacity is based on:
- A. Mental health and the ability to concur with family members
- B. Mental health and the ability to concur with members of the health care team
- C. Physical health, mental health and the ability to be consistent in addressing issues
- D. Physical health and the ability to concur with the family members
Answer: C
Explanation:
Correct answer: Physical health, mental health and the ability to be consistent in addressing issues Capacity to make decisions is based on the patient's physical and mental health and the ability to be consistent in addressing issues.
Capacity is not based on the ability to concur with health care providers or family members.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 200.
NEW QUESTION # 211
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