PCCN FINAL REVIEW PAPER 2026
COMPLETE QUESTIONS AND SOLUTIONS
GRADED A+
◉A nurse is developing a teaching plan for the family of a patient
being discharged home with a tracheostomy. Which of the following
steps should be taken FIRST?
A. Consult home health care to conduct the teaching
B. Arrange a schedule for a teaching demonstration
C. Assess the family's current knowledge base
D. Gather written materials about tracheostomy care. Answer: C.
Assess the family's current knowledge base
Feedback
Assessment is the first step in the nursing process. In order to
facilitate learning, the learner's knowledge and skills should be
assessed before a teaching plan is formed.
◉The Hour-1 bundle for treatment of sepsis and septic shock is
issued by the Society of Critical Care Medicine (SCCM) and the
European Society of Intensive Care Medicine (ESICM) through the
Surviving Sepsis Campaign. The purpose of the Hour-1 bundle is to:
,A. Decrease serum lactate levels
B. Increase fluid resuscitation and antibiotic use in septic patients
C. Maintain minimum mean arterial pressures (MAPs)
D. Optimize oxygen delivery to organs. Answer: D. Optimize oxygen
delivery to organs
Feedback
This item measures a nurse's knowledge to identify the purpose of
the Hour-1 bundle of the SSC.Knowledge of this content is necessary
for successful job performance. The nurse should recall that the
purpose of the Hour-1 bundle is early and aggressive treatment for
the purpose of maximizing oxygen delivery/perfusion to the tissues
and organs of the body during a septic event.
◉The nurse is performing a skin assessment on a 79 year old female
patient with dementia. The nurse notes a pressure injury on the
patient's right heel. It is approximately 3 cm x 4 cm in dimension,
with thick, whitish-yellow slough and a small amount of foul-
smelling drainage. The nurse charts this wound as what type of
pressure injury?
A. Deep tissue injury
B. Stage 3
C. Stage 4
D. Unstageable. Answer: D. Unstageable
Feedback
,The nurse should recall that the presence of slough or eschar on a
wound means that it is unstageable. The slough or eschar must be
removed in order for the wound to be staged; underneath will be a
stage 3 or 4 pressure injury.
◉A 25-year-old male client is admitted with a diagnosis of
pericarditis. The nurse should prepare to assist with a
pericardiocentesis when the client exhibits which of the following
signs or symptoms?
A. Pericardial friction rub
B. Sharp chest pain over the sternal area
C. Elevated blood C-reactive protein level
D. Pulsus paradoxus. Answer: D. Pulsus paradoxus
Feedback
Pulsus paradoxus is defined as a drop of 10 mmHg or more in
systolic blood pressure during inspiration. Pulsus paradoxus is an
indicator of cardiac tamponade, a life-threatening complication of
pericarditis. Other listed signs and symptoms may be exhibited by a
client with pericarditis with or without cardiac tamponade.
◉The nurse is caring for a Vietnamese patient who is a practicing
Buddhist, and the patient passes away. The family is present and
requests that per tradition, the body be left undisturbed in the
hospital bed for four hours. The charge nurse informs the patient's
nurse that the emergency department is currently full and badly
, needs beds for admitting patients. Which of the following is the most
appropriate action for the patient's nurse to take?
A. Apologize and tell the family that the bed is needed for another
family and the body must be moved to the morgue
B. Inform the charge nurse of the patient and family's cultural
practices related to death and ask that the patient's body be allowed
to remain undisturbed for the requested four hours
c. Tell the family that the body must be moved in order to make
room for another patient, but offer the family the opportunity to
participate in post-mortem care
D. Tell the fa. Answer: B. Inform the charge nurse of the patient and
family's cultural practices related to death and ask that the patient's
body be allowed to remain undisturbed for the requested four hours
Feedback
The nurse should recall that according to the AACN Synergy Model
for Patient Care, Response to Diversity involves the ability to
recognize and integrate different cultural practices into patient care.
The nurse understands that Buddhist culture states that the body
must remain undisturbed for at least four hours to give the soul time
to leave the body and educates the charge nurse on the patient and
family's cultural standards as well.
◉A 60-year-old male patient is admitted following a percutaneous
transluminal coronary angioplasty (PTCA) and stent placement to
the left anterior descending (LAD) artery. During shift change three
hours later, the patient complains of flank pain. Assessment reveals
hypotension and tachycardia. The nurse suspects:
COMPLETE QUESTIONS AND SOLUTIONS
GRADED A+
◉A nurse is developing a teaching plan for the family of a patient
being discharged home with a tracheostomy. Which of the following
steps should be taken FIRST?
A. Consult home health care to conduct the teaching
B. Arrange a schedule for a teaching demonstration
C. Assess the family's current knowledge base
D. Gather written materials about tracheostomy care. Answer: C.
Assess the family's current knowledge base
Feedback
Assessment is the first step in the nursing process. In order to
facilitate learning, the learner's knowledge and skills should be
assessed before a teaching plan is formed.
◉The Hour-1 bundle for treatment of sepsis and septic shock is
issued by the Society of Critical Care Medicine (SCCM) and the
European Society of Intensive Care Medicine (ESICM) through the
Surviving Sepsis Campaign. The purpose of the Hour-1 bundle is to:
,A. Decrease serum lactate levels
B. Increase fluid resuscitation and antibiotic use in septic patients
C. Maintain minimum mean arterial pressures (MAPs)
D. Optimize oxygen delivery to organs. Answer: D. Optimize oxygen
delivery to organs
Feedback
This item measures a nurse's knowledge to identify the purpose of
the Hour-1 bundle of the SSC.Knowledge of this content is necessary
for successful job performance. The nurse should recall that the
purpose of the Hour-1 bundle is early and aggressive treatment for
the purpose of maximizing oxygen delivery/perfusion to the tissues
and organs of the body during a septic event.
◉The nurse is performing a skin assessment on a 79 year old female
patient with dementia. The nurse notes a pressure injury on the
patient's right heel. It is approximately 3 cm x 4 cm in dimension,
with thick, whitish-yellow slough and a small amount of foul-
smelling drainage. The nurse charts this wound as what type of
pressure injury?
A. Deep tissue injury
B. Stage 3
C. Stage 4
D. Unstageable. Answer: D. Unstageable
Feedback
,The nurse should recall that the presence of slough or eschar on a
wound means that it is unstageable. The slough or eschar must be
removed in order for the wound to be staged; underneath will be a
stage 3 or 4 pressure injury.
◉A 25-year-old male client is admitted with a diagnosis of
pericarditis. The nurse should prepare to assist with a
pericardiocentesis when the client exhibits which of the following
signs or symptoms?
A. Pericardial friction rub
B. Sharp chest pain over the sternal area
C. Elevated blood C-reactive protein level
D. Pulsus paradoxus. Answer: D. Pulsus paradoxus
Feedback
Pulsus paradoxus is defined as a drop of 10 mmHg or more in
systolic blood pressure during inspiration. Pulsus paradoxus is an
indicator of cardiac tamponade, a life-threatening complication of
pericarditis. Other listed signs and symptoms may be exhibited by a
client with pericarditis with or without cardiac tamponade.
◉The nurse is caring for a Vietnamese patient who is a practicing
Buddhist, and the patient passes away. The family is present and
requests that per tradition, the body be left undisturbed in the
hospital bed for four hours. The charge nurse informs the patient's
nurse that the emergency department is currently full and badly
, needs beds for admitting patients. Which of the following is the most
appropriate action for the patient's nurse to take?
A. Apologize and tell the family that the bed is needed for another
family and the body must be moved to the morgue
B. Inform the charge nurse of the patient and family's cultural
practices related to death and ask that the patient's body be allowed
to remain undisturbed for the requested four hours
c. Tell the family that the body must be moved in order to make
room for another patient, but offer the family the opportunity to
participate in post-mortem care
D. Tell the fa. Answer: B. Inform the charge nurse of the patient and
family's cultural practices related to death and ask that the patient's
body be allowed to remain undisturbed for the requested four hours
Feedback
The nurse should recall that according to the AACN Synergy Model
for Patient Care, Response to Diversity involves the ability to
recognize and integrate different cultural practices into patient care.
The nurse understands that Buddhist culture states that the body
must remain undisturbed for at least four hours to give the soul time
to leave the body and educates the charge nurse on the patient and
family's cultural standards as well.
◉A 60-year-old male patient is admitted following a percutaneous
transluminal coronary angioplasty (PTCA) and stent placement to
the left anterior descending (LAD) artery. During shift change three
hours later, the patient complains of flank pain. Assessment reveals
hypotension and tachycardia. The nurse suspects:
