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The PCCN certification exam is a comprehensive test that covers a wide range of topics related to progressive care nursing. PCCN exam consists of 125 multiple-choice questions that are designed to assess the nurse's knowledge and skills in areas such as cardiovascular, pulmonary, renal, endocrine, gastrointestinal, and neurological systems. The test also covers topics such as hemodynamics, pharmacology, and patient monitoring. PCCN exam is computer-based and takes approximately three hours to complete.
AACN PCCN (Progressive Care Certified Nursing) Exam is a certification exam offered by the American Association of Critical-Care Nurses (AACN). PCCN exam is designed to assess a nurse's knowledge and skills in caring for patients in progressive care or intermediate care units. Nurses who successfully pass PCCN exam will earn the PCCN certification, which is a widely recognized credential in the nursing field.
NEW QUESTION # 18
All of the following statements are true regarding the level of consciousness known as arousal except:
- A. It reflects the content and quality of interactions with the environment
- B. It refers to the state of wakefulness
- C. It reflects function of the reticular-activating system
- D. It reflects function of the brain stem
Answer: A
Explanation:
Correct answer: It reflects the content and quality of interactions with the environment Awareness, not arousal reflects the content and quality of interactions with the environment. Arousal refers to the state of wakefulness.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 297.
NEW QUESTION # 19
Management of a patient with increased intracranial pressure most likely includes:
- A. Maintaining hip flexion
- B. Instituting a bowel regimen to avoid constipation
- C. Long-acting analgesic administration to ensure agitation due to pain does not occur
- D. Keeping the head of the bed elevated to no more than 15 degrees
Answer: B
Explanation:
Correct answer: Instituting a bowel regimen to avoid constipation
A bowel regimen is used to prevent constipation as intra-abdominal pressure reduces venous return and increases intracranial pressure.
In general, the head of the bed is elevated to 30 degrees and hip flexion is minimized. If analgesics or sedatives are used, short-acting agents are preferred because of the importance of on-going neurological assessment.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 310.
NEW QUESTION # 20
The progressive care environment can be anxiety-provoking for patients. Which of the following statements is most correct related to sedation and delirium in the progressive care unit?
- A. The use of sedatives decreases the risk of delirium in acutely ill patients as sedatives induce the stages of sleep that provide a restorative state
- B. Lorazepam, a benzodiazepine, has a rapid onset of action and a short duration of effect
- C. Sedative-induced amnesia protects patients from the psychological stress associated with the progressive care environment and sedation infusions must not be interrupted
- D. In clinical trials, oral quetiapine has been shown to reduce the duration of delirium
Answer: D
Explanation:
Correct answer: In clinical trials, oral quetiapine has been shown to reduce the duration of delirium The use of atypical antipsychotics as possible alternatives to haloperidol to manage delirium in acutely ill patients has increased over the past several years. To this point, quetiapine has been the most well- studied. Sedation is quetiapine's most commonly associated side effect, and it can only be administered orally.
Acutely ill patients are especially at risk for delirium if they have been on sedatives; especially per infusion for longer than 24 hours. Daily interruptions in the administration of sedatives have been associated with better outcomes and do not appear to increase psychological stress. Lorazepam, the most common benzodiazepine, is an intermediate-term sedative; it has an intermediate onset of action and duration of effect.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 154-156, 165-166.
NEW QUESTION # 21
Interventions to help maintain skin integrity may include all of the following except:
- A. Using an inflatable cushion or "donut" for the head
- B. Elevating the heels off of the mattress
- C. Using elbow protectors
- D. Repositioning every hour
Answer: A
Explanation:
Correct answer: Using an inflatable cushion or "donut" for the head
An inflatable cushion or "donut" should never be used for the sacrum or the head as these can cause increased pressure on the surrounding skin surfaces.
Repositioning should occur minimally at 2-hour intervals; more frequently if the patient is incontinent, currently has areas of skin breakdown, or is severely debilitated. Elevating the heels off of the mattress is recommended to prevent skin breakdown. The use of elbow protectors is recommended to protect bony surfaces.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 24.
NEW QUESTION # 22
An aneurysm located between the aortic valve and the innominate artery is classified as which of the following?
- A. Transverse
- B. Descending
- C. Ascending
- D. Thoracoabdominal
Answer: C
Explanation:
Correct answer: Ascending
An aneurysm located between the aortic valve and the innominate artery is classified as ascending.
An aneurysm located between the innominate artery and the left subclavian artery is classified as transverse. An aneurysm located from the left subclavian artery to the diaphragm is classified as descending, and an aneurysm located from above the diaphragm to the aortic bifurcation is classified as thoracoabdominal.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 480.
NEW QUESTION # 23
Which of the following risk factors for the development of acute respiratory distress syndrome is considered to be a secondary rather than a primary cause?
- A. Sepsis
- B. Pulmonary contusion
- C. Aspiration
- D. Smoke inhalation
Answer: A
Explanation:
Correct answer: Sepsis
Conditions that result in direct damage to the alveolar-capillary membrane are categorized as primary causes of acute respiratory distress syndrome (ARDS). Secondary causes are those which are believed to be mediated by cellular or humoral injury to the capillary endothelial wall. In conditions such as trauma and sepsis, capillary beds throughout the body are affected by abnormal microvascular permeability, but clinical manifestations are often isolated to the respiratory system.
Aspiration, pulmonary contusion, and smoke inhalation result in direct damage to the alveolar-capillary membrane and are categorized as primary causes of ARDS.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 257-258.
NEW QUESTION # 24
A young man had a motorcycle accident and sustained major injury to the head. He was brought in this condition to the accident and emergency department. The monitor showed that he was having alternating bradycardia and tachycardia, his BP was 180/110 mm of Hg and he was in an altered state of consciousness. What would be the first step in saving the life of this patient?
- A. Checking circulation
- B. Checking breathing
- C. All of the above
- D. Checking airway
Answer: C
Explanation:
Explanation: All of the above are the first steps in saving the life of this patient. When the victim of motorcycle accident presents to the emergency with sustained head injury and the monitor shows that he is having alternating bradycardia and tachycardia, his BP is 180/110 mm of Hg and he is in an altered state of consciousness, all the steps listed above are very important to be followed in sequence: checking airway, checking breathing, checking circulation.
NEW QUESTION # 25
Pancytopenia is a drop in which of the following?
- A. Red blood cells, sodium, and potassium
- B. Red blood cells, white blood cells, and sodium
- C. Red blood cells, hemoglobin, and hematocrit
- D. White blood cells, red blood cells, and platelets
Answer: D
Explanation:
Correct answer: White blood cells, red blood cells, and platelets
Pancytopenia (a drop in white blood cells, red blood cells, and platelets) often occurs in cancer patients as a result of bone marrow suppression due to their specific treatment. In this case, the bone marrow fails to produce all three types of blood cells. Medications such as some antibiotics and chemotherapeutic agents suppress the bone marrow and lead to anemia.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 326.
NEW QUESTION # 26
Jehovah's Witnesses can receive all of the following transfusions as part of their religious belief except:
- A. Plasma
- B. Whole blood
- C. White cells
- D. Fractions from red cells
Answer: B
Explanation:
Explanation: Jehova's Witnesses cannot receive Whole blood as transfusions. Whole Blood is the term used in transfusion medicine for human blood from a standard blood donation. The blood is typically combined with an anticoagulant during the collection process, but is generally otherwise unprocessed.
In the US, the capitalized "Whole Blood" means a specific standardized
product for transfusion or further processing, where "whole blood" is any unmodified collected blood.
NEW QUESTION # 27
Acute respiratory failure (ARF) can occur as a result of many abnormalities but, regardless of the specific underlying condition, the etiology of ARF in adults can be categorized into four main components:
impaired ventilation, impaired gas exchange, airway obstruction, and ventilation-perfusion abnormalities. Which of the following conditions causes airway obstruction?
- A. Asthma
- B. Pulmonary embolism
- C. Spinal cord injury at C4 or higher
- D. Phrenic nerve damage
Answer: A
Explanation:
Correct answer: Asthma
Airway obstruction may occur as a result of the following:
* Conditions that blook the inner airway lumen
o fluid in the airways
o excessive secretions
o inhaled foreign bodies
* Conditions that increase airway wall thickness or decrease airway circumference o increase wall thickness: fibrosis or edema o decrease circumference: asthmatic bronchoconstriction
* Conditions that increase peribronchial compression of the airway
o tumors
o interstitial edema
o enlarged lymph nodes
Phrenic nerve damage and spinal cord injury at C4 or higher cause impaired ventilation. Pulmonary embolism causes ventilation-perfusion abnormalities.
Reference:
Burns,
Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 253-254.
NEW QUESTION # 28
Clinical situations or conditions that cause respiratory acidosis include:
- A. Neurogenic hyperventilation
- B. Hypokalemia
- C. Hypoventilation associated with respiratory failure
- D. Excessive mechanical ventilation
Answer: C
Explanation:
Correct answer: Hypoventilation associated with respiratory failure
Respiratory acidosis occurs with the pH is less than 7.35 and the PaiCsOgreater than 45 mm Hg.
Conditions or clinical situations that result in respiratory acidosis include:
* Hypoventilation associated with respiratory failure, for example:
o acute respiratory distress syndrome
o pneumonia
o severe asthma
o sleep apnea
o chronic obstructive pulmonary diseases
* Pulmonary edema
* Pulmonary embolism
* Respiratory center depression
* Pneumothorax
* Inadequate mechanical ventilation
* Neuromuscular disturbances in the presence of normal lungs
Neurogenic hyperventilation results in respiratory alkalosis, as does excessive mechanical ventilation.
Hypokalemia leads to metabolic alkalosis.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 102-103.
NEW QUESTION # 29
Typical treatment for the management of acute respiratory failure patients with chronic obstructive pulmonary disorder includes:
- A. Lower than usual doses of short-acting beta-agonists with or without anticholinergics
- B. Limiting fluid intake
- C. Patient mobilization, coughing, and heated, moist aerosolization
- D. Routine chest physiotherapy
Answer: C
Explanation:
Correct answer: Patient mobilization, coughing, and heated, moist aerosolization The routine use of chest physiotherapy is not recommended. Adequate hydration is needed to improve the removal of secretions. Higher than the usual doses of short-acting beta-agonists, with or without anticholinergics, may be required until the precipitating event is resolved.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 259-260.
NEW QUESTION # 30
A nurse is assigned to suction a client's tracheostomy. The nurse would wear which personal protective equipment during the procedure?
- A. Clean gloves, mask, gown, goggles
- B. Clean gloves, mask, gown
- C. Sterile gloves, mask, gown
- D. Sterile gloves, mask, gown, goggles
Answer: D
Explanation:
Explanation: When suctioning the client's tracheostomy, the nurse should wear sterile gloves, mask, gown, and goggles. Tracheal suctioning is a sterile procedure.
NEW QUESTION # 31
Signs and symptoms of oxygen toxicity mainly target which systems?
- A. Pulmonary and musculoskeletal systems
- B. Pulmonary and central nervous systems
- C. Pulmonary and endocrine systems
- D. Central nervous system and musculoskeletal system
Answer: B
Explanation:
Correct answer: Pulmonary and central nervous systems
The toxic effects of oxygen primarily target the pulmonary and central nervous systems. They include:
* Nausea
* Numbness
* Anxiety
* Muscular twitching
* Visual disturbances
* Seizures
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 114.
NEW QUESTION # 32
Occlusion of circumflex coronary artery results in:
- A. Anterior MI
- B. Posterior wall infarction
- C. Left Lateral MI
- D. Inferior MI
Answer: C
Explanation:
Explanation: Occlusion of circumflex coronary artery results in Left Lateral MI. The Myocardial Infarction most commonly damages the left ventricle and its associated septum. Right ventricle damage is only if there is any occlusion of the supplying vessel. Occlusion of circumflex coronary artery results in Left Lateral MI because circumflex artery supplies left lateral wall of the heart. This also causes damage to the anterior wall of the heart.
NEW QUESTION # 33
The ability to recognize needs and take action to influence the outcome of a conflict is called:
- A. Agency
- B. Moral agency
- C. Justice
- D. None of the above
Answer: B
Explanation:
Explanation: The ability to recognize needs and take action to influence the outcome of a conflict is called moral agency. In ACCN synergy model of Nurse Competency, Moral agency is the ability to recognize needs and take action to influence the outcome of a conflict .The other two are advocacy and agency.
NEW QUESTION # 34
All the following will help in relieving the pain and discomfort caused by Pericarditis except:
- A. Use of nitroglycerines
- B. Use of corticosteroids
- C. Use of anti-inflammatory drugs like ibuprofen, etc.
- D. Use of analgesics
Answer: A
Explanation:
Explanation: All the following will help in relieving the pain and discomfort caused by Pericarditis except use of nitroglycerines. Nitroglycerines have no role in relieving the pain and discomfort of treating Pericarditis. However, analgesics will relieve pain from Pericarditis, anti-inflammatory drugs will decrease inflammation, thus relieving discomfort and improving the rate of fluid reabsorption. Steroids also have an anti-inflammatory component.
NEW QUESTION # 35
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