PCCN Complete Exam with Questions and Answers (2025-2026) – 100% Solved
A 45-year old woman is admitted with type 1 diabetic mellitus. She is hyperventilating, has signs
of dehydration (increased urine output and increased thirst), and is tachycardic. Initial
treatment would include:
A. Diazoxide (Hyperstat) to inhibit the release of insulin
B. glucose for hypoglycemia
C. insulin therapy for ketoacidosis, fluid and electrolyte replacement
D. intravenous fluids for dehydration and glucose for hypoglycemia - ✔✔✔-C. insulin therapy
for ketoacidosis, fluid and electrolyte replacement
The patient is exhibiting the signs and symptoms of diabetic ketoacidosis (DKA). Signs of
dehydration, such as polydipsia and polyphagia, are due to large urine output, increased thirst is
secondary to dehydration and tachycardia is due to sympathetic nervous system stimulation
from an increased glucose level and ketosis. Initial treatment would include insulin therapy, re-
hydration with fluids and electrolyte replacement. Diazoxide would not be used since it inhibits
insulin release (this patient requires insulin to lower glucose). The patient is not hypoglycemia.
Signs and symptoms of hypoglycemia are similar; tachycardia, change in behavior (irritability) or
level of consciousness, sweating and shaking.
A 45-year-old female with history of bipolar disorder is one-day postoperative following
abdominal surgery. The patient slept only one or two hours during the night and is speaking
rapidly, throwing her belongings at the nurses and insists she is going to leave the hospital. The
nurse should:
A. Notify the mental health crisis team
B. Notify social services
C. Notify the nursing supervisor
D. Notify the patient's husband - ✔✔✔-A. Notify the mental health crisis team
In many hospitals, this can be the rapid response team. Not all hospitals have access to mental
health professionals so the rapid response team answers these calls. The mental health crisis
team is comprised of mental health professionals who can assess the mental status of the
patients as well as the medical-surgical assessment. After the complete assessment is made, the
decision of how to treat this possible exacerbation of her bipolar disorder may be made. The
patient is at risk for hurting herself and others and may need continuing assessment of mental
and surgical status beyond the rapid response team. Decisions will be made with the attending
,PCCN Complete Exam with Questions and Answers (2025-2026) – 100% Solved
physician. Social services may help with placement, but not during an acute situation. The
nursing supervisor may be notified as the rapid response team is notified; this is a great
strategy; however, the supervisor may not have the ability to assess this complex patient. The
supervisor is more able to delegate care and request more help to the area if needed. The
patient's husband will need to be called after the immediate assessment is made.
A 55 year old male postoperative patient is demonstrating signs of pain; tachycardia,
hypertension, abdominal guarding and increased respiratory rate. The patient refuses pain
medication because he believes he will become addicted to the narcotics. What is the nurse's
best response?
A. Acknowledge that the patient is entitled to refuse pain medications
B. Tell the patient that opioids have a low addiction rate when used for postoperative pain while
in the hospital
C. Admire the patient's stoicism
D. Acknowledge opioid addiction potential, and offer a back rub - ✔✔✔-B. Tell the patient that
opioids have a low addiction rate when used for postoperative pain while in the hospital
Many people are concerned about addiction rates of narcotics; however, the use of narcotics for
postoperative pain while in the hospital has a very low addiction rate. The risk for abuse
increases when patients go home with narcotics. Explaining to the patient that limited use in
the hospital will increase his recovery and reduce inflammation is the correct response. Any
patient may refuse medications after an explanation of the facts are given. A back rub or
alternative care is a way to treat the patient if they absolutely refuse medications; however, the
best answer is to correct the patient's misinformation about the use of narcotics during the
immediate postoperative period.
A 55-year old male is admitted from the ICU after an acute Type III aortic dissection. Treatment
plan includes blood pressure control. What medications would the nurse anticipate in this
patient?
A. digoxin (Lanoxin) and furosemide (Lasix)
B. metoprolol (Lopressor) and lisinopril (Prinivil)
C. furosemide and spironolactone (Aldactone)
,PCCN Complete Exam with Questions and Answers (2025-2026) – 100% Solved
D. bumetanide (Bumex) and amlodipine (Norvasc) - ✔✔✔-B. metoprolol (Lopressor) and
lisinopril (Prinivil)
The blood pressure control of this patient is the most important treatment in his care. The two
most common drugs for the treatment of an aortic dissection are a beta blocker and ACE
inhibitor. Diuretics may be added for more control of blood pressure, but are not first-line drugs.
Digoxin is not required for this patient.
A 68 year old male is 4 hours postoperative after percutaneous transluminal coronary
angioplasty and stent placement and complains of flank pain. He is restless, tachycardic,
hypotensive, and his hemoglobin and hematocrit levels (H+H) have dropped. Which of the
following nursing actions is correct?
A. Keep the head of the bed flat and apply pressure at the sheath site to stop bleeding.
B. Notify a physician immediately and anticipate ultrasound-guided compression and possible
surgery to stop the bleeding.
C. Notify a physician immediately, and anticipate anticoagulation or thrombolytic therapy.
D. Notify a physician immediately, stop anticoagulation therapy, and anticipate the need for
intravenous fluid and/or blood - ✔✔✔-D. Notify a physician immediately, stop anticoagulation
therapy, and anticipate the need for intravenous fluid and/or blood
This angioplasty and stent patient is probably experiencing a retroperitoneal arterial bleed into
the flank area, requiring cessation of anticoagulants and preparation for fluid administration
and/or blood. Lying the patient flat and applying pressure to the sheath site treats the bleeding
or hematoma at the sheath site. Ultrasound-guided compression and surgery is indicated if a
pulsatile mass or bruit occurs near the insertion site, indicating pseudoaneurysm or
arteriovenous fistula formation. Anticoagulation therapy is indicated for decreased circulation in
extrremity related to thrombus or embolus.
A 70 year old female presents in cardiogenic shock secondary to myocardial infarction. Which of
the following symptoms are consistent with cardiogenic shock?
A. hypertension with systolic blood pressure greater than 90 mm Hg, bradycardia, chest pain
and tachypnea
B. hypotension with systolic blood pressure less than 90 mm Hg, tachycardia, dysrhythmias and
tachypnea
, PCCN Complete Exam with Questions and Answers (2025-2026) – 100% Solved
C. hypotension with systolic blood pressure less than 90 mm Hg, dysrhythmias and slow, labored
breathing
D. hypotension with systolic blood pressure less than 90 mm Hg, bradycardia and slow, labored
breathing - ✔✔✔-B. hypotension with systolic blood pressure less than 90 mm Hg, tachycardia,
dysrhythmias and tachypnea
Cardiogenic shock presents with low cardiac output syndrome: tachycardia, low systolic
pressure, elevated diastolic pressure (decreased pulse pressure), tachypnea due to tissue
hypoxia, and dysrhythmias due to myocardial ischemia. Hypertension does not fit with low
cardiac output syndrome, nor does slow labored breathing.
A complete assessment of a patient with a wound includes which of the following:
A. a detailed description of the wound and vascular assessment
B. a nutrition assessment
C. laboratory findings, including hematology, microbiology and chemistries
D. all of the above - ✔✔✔-D. all of the above
Accurate wound assessment on admission includes: detailed description of the wound,
including wound location, length, width, depth and the presence and position of undermining,
presence of cellulitis and drainage. Calculation of wound area of volume should be performed
and documented at each patient visit. A nutrition assessment is key. Vascular assessment is also
essential, especially if a patient presents with a chronic wound. A thorough vascular exam
should be performed, including palpation of radial, femoral and pedal pulses. Signs of arterial
obstruction include lack of peripheral pulses with poor capillary refill, think atrophic skin and
hypertrophic deformed nails. Laboratory assessment to include hematology, complete blood
count and differential, chemistries including metabolic panel, liver function tests, albumin,
prealbumin, hemoglobin A1C, and microbiology, including previous cultures and pathology.
A family-centered approach to patient care recognizes that families:
A. may be harmful to patient's recovery
B. should be allowed to visit the patient anytime
C. are team members in the patient's healing process
A 45-year old woman is admitted with type 1 diabetic mellitus. She is hyperventilating, has signs
of dehydration (increased urine output and increased thirst), and is tachycardic. Initial
treatment would include:
A. Diazoxide (Hyperstat) to inhibit the release of insulin
B. glucose for hypoglycemia
C. insulin therapy for ketoacidosis, fluid and electrolyte replacement
D. intravenous fluids for dehydration and glucose for hypoglycemia - ✔✔✔-C. insulin therapy
for ketoacidosis, fluid and electrolyte replacement
The patient is exhibiting the signs and symptoms of diabetic ketoacidosis (DKA). Signs of
dehydration, such as polydipsia and polyphagia, are due to large urine output, increased thirst is
secondary to dehydration and tachycardia is due to sympathetic nervous system stimulation
from an increased glucose level and ketosis. Initial treatment would include insulin therapy, re-
hydration with fluids and electrolyte replacement. Diazoxide would not be used since it inhibits
insulin release (this patient requires insulin to lower glucose). The patient is not hypoglycemia.
Signs and symptoms of hypoglycemia are similar; tachycardia, change in behavior (irritability) or
level of consciousness, sweating and shaking.
A 45-year-old female with history of bipolar disorder is one-day postoperative following
abdominal surgery. The patient slept only one or two hours during the night and is speaking
rapidly, throwing her belongings at the nurses and insists she is going to leave the hospital. The
nurse should:
A. Notify the mental health crisis team
B. Notify social services
C. Notify the nursing supervisor
D. Notify the patient's husband - ✔✔✔-A. Notify the mental health crisis team
In many hospitals, this can be the rapid response team. Not all hospitals have access to mental
health professionals so the rapid response team answers these calls. The mental health crisis
team is comprised of mental health professionals who can assess the mental status of the
patients as well as the medical-surgical assessment. After the complete assessment is made, the
decision of how to treat this possible exacerbation of her bipolar disorder may be made. The
patient is at risk for hurting herself and others and may need continuing assessment of mental
and surgical status beyond the rapid response team. Decisions will be made with the attending
,PCCN Complete Exam with Questions and Answers (2025-2026) – 100% Solved
physician. Social services may help with placement, but not during an acute situation. The
nursing supervisor may be notified as the rapid response team is notified; this is a great
strategy; however, the supervisor may not have the ability to assess this complex patient. The
supervisor is more able to delegate care and request more help to the area if needed. The
patient's husband will need to be called after the immediate assessment is made.
A 55 year old male postoperative patient is demonstrating signs of pain; tachycardia,
hypertension, abdominal guarding and increased respiratory rate. The patient refuses pain
medication because he believes he will become addicted to the narcotics. What is the nurse's
best response?
A. Acknowledge that the patient is entitled to refuse pain medications
B. Tell the patient that opioids have a low addiction rate when used for postoperative pain while
in the hospital
C. Admire the patient's stoicism
D. Acknowledge opioid addiction potential, and offer a back rub - ✔✔✔-B. Tell the patient that
opioids have a low addiction rate when used for postoperative pain while in the hospital
Many people are concerned about addiction rates of narcotics; however, the use of narcotics for
postoperative pain while in the hospital has a very low addiction rate. The risk for abuse
increases when patients go home with narcotics. Explaining to the patient that limited use in
the hospital will increase his recovery and reduce inflammation is the correct response. Any
patient may refuse medications after an explanation of the facts are given. A back rub or
alternative care is a way to treat the patient if they absolutely refuse medications; however, the
best answer is to correct the patient's misinformation about the use of narcotics during the
immediate postoperative period.
A 55-year old male is admitted from the ICU after an acute Type III aortic dissection. Treatment
plan includes blood pressure control. What medications would the nurse anticipate in this
patient?
A. digoxin (Lanoxin) and furosemide (Lasix)
B. metoprolol (Lopressor) and lisinopril (Prinivil)
C. furosemide and spironolactone (Aldactone)
,PCCN Complete Exam with Questions and Answers (2025-2026) – 100% Solved
D. bumetanide (Bumex) and amlodipine (Norvasc) - ✔✔✔-B. metoprolol (Lopressor) and
lisinopril (Prinivil)
The blood pressure control of this patient is the most important treatment in his care. The two
most common drugs for the treatment of an aortic dissection are a beta blocker and ACE
inhibitor. Diuretics may be added for more control of blood pressure, but are not first-line drugs.
Digoxin is not required for this patient.
A 68 year old male is 4 hours postoperative after percutaneous transluminal coronary
angioplasty and stent placement and complains of flank pain. He is restless, tachycardic,
hypotensive, and his hemoglobin and hematocrit levels (H+H) have dropped. Which of the
following nursing actions is correct?
A. Keep the head of the bed flat and apply pressure at the sheath site to stop bleeding.
B. Notify a physician immediately and anticipate ultrasound-guided compression and possible
surgery to stop the bleeding.
C. Notify a physician immediately, and anticipate anticoagulation or thrombolytic therapy.
D. Notify a physician immediately, stop anticoagulation therapy, and anticipate the need for
intravenous fluid and/or blood - ✔✔✔-D. Notify a physician immediately, stop anticoagulation
therapy, and anticipate the need for intravenous fluid and/or blood
This angioplasty and stent patient is probably experiencing a retroperitoneal arterial bleed into
the flank area, requiring cessation of anticoagulants and preparation for fluid administration
and/or blood. Lying the patient flat and applying pressure to the sheath site treats the bleeding
or hematoma at the sheath site. Ultrasound-guided compression and surgery is indicated if a
pulsatile mass or bruit occurs near the insertion site, indicating pseudoaneurysm or
arteriovenous fistula formation. Anticoagulation therapy is indicated for decreased circulation in
extrremity related to thrombus or embolus.
A 70 year old female presents in cardiogenic shock secondary to myocardial infarction. Which of
the following symptoms are consistent with cardiogenic shock?
A. hypertension with systolic blood pressure greater than 90 mm Hg, bradycardia, chest pain
and tachypnea
B. hypotension with systolic blood pressure less than 90 mm Hg, tachycardia, dysrhythmias and
tachypnea
, PCCN Complete Exam with Questions and Answers (2025-2026) – 100% Solved
C. hypotension with systolic blood pressure less than 90 mm Hg, dysrhythmias and slow, labored
breathing
D. hypotension with systolic blood pressure less than 90 mm Hg, bradycardia and slow, labored
breathing - ✔✔✔-B. hypotension with systolic blood pressure less than 90 mm Hg, tachycardia,
dysrhythmias and tachypnea
Cardiogenic shock presents with low cardiac output syndrome: tachycardia, low systolic
pressure, elevated diastolic pressure (decreased pulse pressure), tachypnea due to tissue
hypoxia, and dysrhythmias due to myocardial ischemia. Hypertension does not fit with low
cardiac output syndrome, nor does slow labored breathing.
A complete assessment of a patient with a wound includes which of the following:
A. a detailed description of the wound and vascular assessment
B. a nutrition assessment
C. laboratory findings, including hematology, microbiology and chemistries
D. all of the above - ✔✔✔-D. all of the above
Accurate wound assessment on admission includes: detailed description of the wound,
including wound location, length, width, depth and the presence and position of undermining,
presence of cellulitis and drainage. Calculation of wound area of volume should be performed
and documented at each patient visit. A nutrition assessment is key. Vascular assessment is also
essential, especially if a patient presents with a chronic wound. A thorough vascular exam
should be performed, including palpation of radial, femoral and pedal pulses. Signs of arterial
obstruction include lack of peripheral pulses with poor capillary refill, think atrophic skin and
hypertrophic deformed nails. Laboratory assessment to include hematology, complete blood
count and differential, chemistries including metabolic panel, liver function tests, albumin,
prealbumin, hemoglobin A1C, and microbiology, including previous cultures and pathology.
A family-centered approach to patient care recognizes that families:
A. may be harmful to patient's recovery
B. should be allowed to visit the patient anytime
C. are team members in the patient's healing process
