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AACN PCCN exam comprises 125 multiple-choice questions, which must be completed within two and a half hours. The questions cover a range of topics, including cardiovascular, pulmonary, gastrointestinal, renal, neurological, endocrine, and multisystem problems, as well as professional caring and ethical practices. PCCN exam is challenging, and candidates must have a thorough understanding of the concepts and principles of progressive care nursing.
The PCCN certification exam is designed to assess the nurse's knowledge and skills in patient care, clinical judgment, and patient advocacy. PCCN exam covers a wide range of topics, including cardiovascular, pulmonary, renal, and neurological systems, as well as professional caring and ethical practice. Nurses who successfully pass the PCCN certification exam demonstrate their commitment to providing the highest level of care to their patients and their dedication to ongoing professional development.
AACN PCCN Certification Exam is an important credential for nurses who work in progressive care units. PCCN exam tests a nurse’s knowledge and skills in caring for patients in these units, and passing the exam demonstrates a nurse’s expertise in this specialty area. Nurses who are interested in pursuing PCCN certification can access a variety of study materials to help them prepare for the exam.
NEW QUESTION # 127
A man was diagnosed with a stroke. Which type of stroke is most common?
- A. Hypovolemic
- B. Ischemic
- C. Hemorrhagic
- D. All of the above
Answer: B
Explanation:
Explanation: Ischemic type of stroke is most common. Stroke occurs due to the blockade of blood supply to the brain. This blockade may be due to ischemia or any hemorrhage. The ischemic stroke accounts for almost 80 percent of all the strokes, making it the most common.
NEW QUESTION # 128
The Braden scale is a validated risk assessment scale for evaluating a patient's risk for:
- A. Pressure injury development
- B. Falls
- C. Stroke
- D. Self-harm
Answer: A
Explanation:
Correct answer: Pressure injury development
Both the Braden and the Norton scale are validated risk assessment scales for assessing patient risk for the development of pressure injuries. The Braden scale takes into account the following six subcategories:
* Sensory perception
* Moisture
* Activity
* Mobility
* Nutrition
* Friction/shear
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 291.
NEW QUESTION # 129
Nurses can develop advocacy and moral agency by using the following approach:
- A. All of the above.
- B. Role modeling
- C. Coaching and mentoring
- D. Modeling and role modeling
Answer: A
Explanation:
Explanation: Nurses can develop advocacy and moral agency by using all of the above approaches. The ACCN synergy model ensures Nurse Competencies with advocacy/moral agency. There are different approaches that can help in developing nurse advocacy and moral agency. Nurses can develop advocacy and moral agency through role modeling, modeling, coaching and mentoring.
NEW QUESTION # 130
All of the following factors can increase the level of glucose in the blood except:
- A. Renal failure
- B. Insulinoma
- C. Hyperthyroidism
- D. Stress
Answer: B
Explanation:
Explanation: All of the following factors can increase the level of glucose in the blood except Inulinoma.
Different conditions can increase the levels of glucose in the body. Stress, renal failure, Cushing syndrome, hyperthyroidism, and pancreas disorders are one of the leading causes of high glucose levels in the body. Insulinoma, that causes blood glucose levels to be lowered, is a tumor of the pancreas where there is increased secretion of insulin.
NEW QUESTION # 131
Which of the following is an appropriate treatment option for pulmonary arterial hypertension to slow the progression of the disease and minimize symptoms?
- A. Decongestant therapy
- B. Diuretics if left-sided failure is present
- C. Beta-blockers
- D. Anticoagulation therapy
Answer: D
Explanation:
Correct answer: Anticoagulation therapy
Anticoagulation therapy is appropriate to prevent thrombosis. Patients should be educated on the long- term use of these agents.
Diuretics are appropriate to control edema and ascites if right-sided heart failure is present. Beta blockers, decongestants or other medications that worsen pulmonary hypertension or decrease right heart function should be avoided.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 266.
NEW QUESTION # 132
Which of the following statements is true related to cerebral blood flow?
- A. It is determined by heart rate and intracranial pressure
- B. It is determined by heart rate and cerebral vascular resistance
- C. It is determined by blood pressure and cerebral vascular resistance
- D. It is determined by blood pressure and intracranial pressure
Answer: C
Explanation:
Correct answer: It is determined by blood pressure and cerebral vascular resistance Constant blood flow to the brain is required to maintain cerebral metabolism because the brain cannot store glucose or oxygen is significant amounts. If blood flow to the brain is not sufficient, brain cells eventually die. Cerebral blood flow (CBF) is determined by blood pressure and cerebral vascular resistance. Autoregulation refers to the ability of the brain's blood vessels to maintain consistent CBF by constricting or dilating in response to changes in blood pressure.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 308.
NEW QUESTION # 133
Initially, when caring for a patient with a temporary pacemaker, stimulation threshold testing should be done:
- A. Every 24 hours
- B. By the physician
- C. Hourly
- D. Every shift
Answer: D
Explanation:
Correct answer: Every shift
When caring for a patient with a temporary pacemaker, stimulation threshold testing should be done every shift until a stable threshold is reached. This is because the stimulation threshold (the minimum output of the pacemaker needed to consistently capture the heart) changes over time; it generally is very low when the pacing lead is initially placed and increases over time. This means it will take more output to result in capture.
Stimulation threshold testing is typically a nursing function.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 460.
NEW QUESTION # 134
A patient being managed in in-patient department is suspected to have pulmonary embolism. What is the confirmatory test for this?
- A. D-dimers
- B. V/Q scintigraphy
- C. Chest x-ray
- D. ABG analysis
Answer: B
Explanation:
Explanation: The confirmatory test for this is V/Q scintigraphy. Acute pulmonary embolism occurs due to blockade of pulmonary artery or arteriole with a blood clot originating in the venous system or the right heart. Different laboratory test can help in diagnosing the disease like ABG analysis, Chest X-ray, ECG but the V/Q scintigraphy is the confirmatory test for patient with suspected pulmonary embolism.
NEW QUESTION # 135
Evidence-based practice guidelines for the prevention of ventilator-associated pneumonia include which of the following?
- A. Do not routinely change the patient's ventilator circuit
- B. Large-volume room-air humidifiers which create aerosols (nebulizers) must be sanitized at least daily and filled only with distilled water
- C. Unless contraindicated by the patient's condition, perform nasotracheal rather than orotracheal intubation
- D. In patients at increased risk for aspiration (e.g., enteral tube in place) the head of the bed should remain elevated at 30 to 45 degrees at all times. For other mechanically ventilated patients, supine positioning is preferred.
Answer: A
Explanation:
Correct answer: Do not routinely change the patient's ventilator circuit Evidence-based practice guidelines for the prevention of ventilator-associated pneumonia include maintaining a closed system on ventilator/humidifier circuits and do not routinely change the ventilator circuit; change only when it is visibly soiled or mechanically malfunctioning.
Other evidence-based practice guidelines include:
* Unless contraindicated by the patient's condition, perform orotracheal rather than nasotracheal intubation
* Large-volume room-air humidifiers or nebulizers should not be used unless they can be sterilized or subjected to high-level disinfection at least daily and filled with sterile water
* All mechanically ventilated patients, as well as those with an enteral tube in place, should have the head of the bed elevated at 30 to 45 degrees unless medically contraindicated Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 270.
NEW QUESTION # 136
Of the following, which is not a type of cardiomyopathy?
- A. Restrictive
- B. Hypotrophic
- C. Hypertrophic
- D. Dilated
Answer: B
Explanation:
Correct answer: Hypotrophic
Hypotrophic is not a type of cardiomyopathy. Hypertrophic cardiomyopathy is a type of cardiomyopathy and is often characterized as obstructive or nonobstructive.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 467.
NEW QUESTION # 137
In which of the following situations would it be most appropriate for a surrogate decision-maker to apply the best interests standard to the informed consent process?
- A. The surrogate's own 78-year-old mother
- B. A 35-year-old who has suffered a brain aneurysm but has a living will
- C. An 18-month-old who was struck by a car
- D. A female patient with terminal lung cancer who is on hospice
Answer: C
Explanation:
Correct answer: An 18-month-old who was struck by a car
The best interests standard allows surrogate decision-makers to arrive at a decision that is in the best interest of patients who never have had a capacity to express their preferences related to medical decisions. Examples of patients who have never had capacity include infants, children, and people of all ages with disabilities that prevent this capacity. An 18-month-old is included here, whereas the patients included in the other answer choices likely have had the opportunity to express their preferences regarding informed consent.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 201.
NEW QUESTION # 138
It is generally not acceptable to override an autonomous patient's decisions without their consent. In instances of paternalism, what principle overrides autonomy?
- A. Fidelity
- B. Veracity
- C. Justice
- D. Beneficence
Answer: D
Explanation:
Correct answer: Beneficence
It is generally not acceptable to override an autonomous patient's decisions without their consent.
However, in cases of paternalism, beneficence overrides autonomy. In these cases, interventions are selected by health care providers which they believe will result in the best outcomes without consent from the patient. These decisions are made very carefully.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 194-196.
NEW QUESTION # 139
Following the administration of recombinant tissue plasminogen activator, antiplatelet or anticoagulant medicines are avoided for:
- A. 12 hours
- B. 24 hours
- C. 48 hours
- D. 8 hours
Answer: B
Explanation:
Correct answer: 24 hours
Fibrinolytic therapy is administered after an acute stroke in an attempt to restore perfusion to the affected area. There is an increased risk of intracerebral hemorrhage following rtPA administration.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 313.
NEW QUESTION # 140
The FOUR score is a validated tool used in the assessment of neurological patients. The categories scored in this tool are:
- A. Eyes, motor, brain stem reflexes, respirations
- B. Eye response, verbal, motor, respiration
- C. Eyes, pain response, brain stem reflexes, respirations
- D. Eye response, pain response, verbal response, respirations
Answer: A
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 # 141
A nurse is caring for a client with congestive heart failure. The most recent laboratory test revealed that the client has a serum sodium level of 155 mEq/L and a serum potassium level of 3.1 mEq/L. The nurse would expect the physician to prescribe which medication for the client?
- A. Bumetanide (Bumex)
- B. Furosemide (Lasix)
- C. Acetazolamide (Diamox)
- D. Spironolactone (Aldactone)
Answer: D
Explanation:
Explanation: Based on the laboratory findings, the nurse should expect the physician to prescribe a diuretic that excretes sodium and retains potassium. Spironolactone is the only diuretic from the list that may help achieve the treatment goals.
NEW QUESTION # 142
Signs and symptoms of acute heart failure related to pericardial effusion include:
- A. Hypertension, tachycardia, increased respiratory rate
- B. Decreased respiratory rate, decreased oxygen saturation, decreased peripheral pulses
- C. Hypotension, tachycardia, increased urinary output
- D. Decreased peripheral pulses, decreased urinary output, decreased oxygen saturation
Answer: D
Explanation:
Correct answer: Decreased peripheral pulses, decreased urinary output, decreased oxygen saturation Signs and symptoms of acute heart failure related to pericardial effusion include:
* Hypotension
* Tachycardia
* Increased respiratory rate
* Dyspnea
* Decreased oxygen saturation
* Decreased peripheral pulses
* Decreased urinary output
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 480.
NEW QUESTION # 143
Primary causes of acute respiratory distress syndrome include:
- A. Near drowning, smoke inhalation, systemic sepsis
- B. Aspiration of gastric contents, near drowning, fat emboli
- C. Acute pancreatitis, fat emboli, massive blood transfusions
- D. Aspiration of gastric contents, inhalation of smoke, pulmonary contusion
Answer: D
Explanation:
Correct answer: Aspiration of gastric contents, inhalation of smoke, pulmonary contusion Primary causes of acute respiratory distress syndrome directly damage the alveolar membrane and include:
* Aspiration of stomach contents
* Pulmonary contusion
* Near drowning
* Inhalation of smoke or toxic substances
* Diffuse pneumonias (viral and bacterial)
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 258.
NEW QUESTION # 144
A 60-year-old patient is admitted to the progressive care unit with pulmonary disease. She and her family speak very little English. Which of the following actions are the most appropriate for the nurse to take to help the patient and family understand what evaluation for hypoxemia will involve?
- A. Assume the pulmonary technician will explain the evaluation procedure
- B. Explain the procedure in English, using short sentences
- C. Show the patient and her family the unit's simple printed brochure describing the evaluation, which includes a picture of a treadmill, and write out simple instructions
- D. Request a respiratory therapist come to the unit to demonstrate the procedure
Answer: C
Explanation:
Correct answer: Show the patient and her family the unit's simple printed brochure describing the evaluation, which includes a picture of a treadmill, and write out simple instructions This teaching incorporates individualized education into patient care, involves the family, and is based on their needs and level of understanding.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 28.
NEW QUESTION # 145
he Code of Ethics for Nurses was developed by:
- A. The state boards of nursing
- B. The American Association of Critical-Care Nurses
- C. The Centers for Medicare and Medicaid Services
- D. The American Nurses Association
Answer: D
Explanation:
Correct answer: The American Nurses Association
The Code of Ethics for Nurses was developed by the American Nurses Association and it articulates the principles, values, and obligations which are essential in guiding nursing actions.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 193.
NEW QUESTION # 146
All of the following statements are true related to Wolff-Parkinson-White syndrome except:
- A. It is the most common type of preexcitation syndrome
- B. It is also known as Brugada syndrome
- C. Preexcitation results in ventricular fusion beats as the ventricles are depolarized simultaneously by the impulse coming through the accessory pathway and through the normal atrioventricular node
- D. It is recognized on the electrocardiogram by the presence of a short PR interval and delta waves in many leads
Answer: B
Explanation:
Correct answer: It is also known as Brugada syndrome
Brugada syndrome is an inherited channelopathy; it is not the same condition as Wolff-Parkinson-White syndrome. Wolff-Parkinson-White syndrome does not require treatment unless it is associated with symptomatic tachycardias.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 440, 442.
NEW QUESTION # 147
A patient with a tracheostomy spontaneously opens his eyes to verbal stimuli and obeys verbal commands. His Glasgow Coma Scale score is:
- A. 0
- B. 10T
- C. 0 or NA
- D. 1
Answer: B
Explanation:
Correct answer: 10T
Patients with tracheostomies are commonly assigned a verbal score of T and the total Glasgow Coma Scale is (GSC) is denoted as the sum of the eye opening and motor scores followed by T.
Alternately, the examiner assigns a verbal score based on an estimation of the patient's abilities, often determined by noting the patient's response when presented with multiple choices.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 298-299.
NEW QUESTION # 148
A 20 years old girl presented with high fever, diarrhea, myalgia and widespread erythematous rash that has the appearance of bad sunburn, with subsequent desquamation. On examination he had hypotension. She gives history of recent tampon use. What is the likely diagnosis?
- A. Necrotizing fasciitis
- B. Shingles
- C. Herpes zoster
- D. Toxic shock syndrome
Answer: D
Explanation:
Explanation: The likely diagnosis is toxic shock syndrome which occurs in females due to tampon use. Its characteristic features are high grade fever, myalgia, diarrhea and widespread erythematous rash. It is caused by staphylococcus aureus.
NEW QUESTION # 149
Of the cardiomyopathies, which is the least common?
- A. Hypertrophic obstructive
- B. Hypotrophic
- C. Restrictive
- D. Dilated
Answer: C
Explanation:
Correct answer: Restrictive
In restrictive cardiomyopathy, ventricular fibrosis is caused by infiltration of the cardiac cells with abnormal cells such as sarcoid or amyloid disease.
Dilated cardiomyopathy is the most common type of cardiomyopathy. Hypertrophic obstructive cardiopathy is the congenital form of the disease. Hypotrophic cardiomyopathy is a fabricated term.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 467.
NEW QUESTION # 150
Which of the following represents normal left ventricular end-diastolic pressure?
- A. 60% to 75%
- B. 55% to 70%
- C. 6 to 12 mm Hg
- D. 10 to 20 mm Hg
Answer: C
Explanation:
Correct answer: 6 to 12 mm Hg
Left ventricular end-diastolic pressure (LVEDP) is the pressure in the left ventricle of the heart at the end of diastole and is an important determinant of ventricular function. It is considered to be a predictor of mortality and morbidity in patients who have heart failure and in those undergoing cardiac surgical procedures.
The left ventricular ejection fraction (LVEF) is the percentage of blood volume that is ejected from the left ventricle of the heart with each contraction. A normal LVEF is 55% to 70%.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 214.
NEW QUESTION # 151
An ethical dilemma occurs when:
- A. Two opposing but equally justifiable courses of action are identified
- B. A person has identified what is the correct action that needs to be taken but is unable to take that action
- C. A person is unable to identify the correct action to take
- D. More than one person has the right to make a decision and they do not agree on the correct course of action to take
Answer: A
Explanation:
Correct answer: Two opposing but equally justifiable courses of action are identified Moral uncertainty is described as being unable to determine what is the right action to take. Moral distress is knowing the right course of action but being unable to take it. Locus of authority is described as a condition in which more than one person has the right to make a decision and the individuals do not agree on the correct course of action to take.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 192.
NEW QUESTION # 152
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