PCCN EXAM REVIEW 2026: 150+ QUESTIONS
AND 100% VERIFIED ANSWERS | GRADED A+
| GUARANTEED PASS!!
A 34-year old male is admitted to the PCU with a history of ETOH use and
multiple previous admissions. He is now in severe end-stage hepatic failure. He is
currently sedated and is in restraints for self protection. Vital signs are:
RR 16
BP 140/84
EKG ST at 112
SpO2 96%
The patient's wife visits and you inform her about the need for the restraints and
the patient's need to sleep. She acknowledges this information and says she will sit
quietly at the patient's bedside. About 5 minutes later, you find the patient
extubated and very agitated. His wife states she released the restraints because she
felt they were "too tight." Your priority in the care of this patient is:
-Immediate sedation for the agitation
-Remove the wife from the unit
-Notify the charge nurse
-Place the patient on a 40% mask and observe his response.
- answer-Place the patient on a 40% mask and observe his response
The airway is always a priority. After placing the mask and notifying the charge
nurse, you have other options. If the patient is stable, you can notify the attending
doctor and see if he wants to reintubate the patient or leave on the mask, change to
another form of O2 delivery and/ or FiO2, draw ABGs or do nothing. If the
patient's condition deterioriates, you may have the option of asking the ED doctor
to intubate the patient.
,The wife may have innocently believed she was doing good, but she may be a
facilitator for her husband's drinking and behavior. She would certainly bear close
watching if she is allowed to stay on the unit.
A 42 year old female was admitted to the PCU following a fall down some patio
stairs. She sustained a fracture of the 4th rib on the right and fractures of the 4th
and 5th ribs on the left. She was medicated for pain and, while visiting with her
husband, becomes dyspneic. Her respiratory rate increases to 36 from 16. The
patient's trachea is noted to deviate to the left and diminished breath sounds are
heard throughout the left lung fields. you also note crepitus over the site of the
fracture on the right side. She is probably developing:
-A pericardial tamponade
-A pneumothorax
-A hemothorax
-A chylothorax
- answer-A pneumothorax
A cause of decreased SVO2 would be:
-An increased metabolic rate
-Sedation
-A decerased metabolic rate
-An increased cardiac output
- answer-An increased metabolic rate
Increased metabolic rate would increase O2 uptake by tissues, resulting in a lower
value as measured by venous blood gases.
The other answers result in a lower tissue oxygen requirement and, therefore,
higher values of oxygen remaining in the bloodsteam.
A common site for the placement of electrodes for a peripheral nerve is on the:
-Posterior tibial
-Medial nerve
-Temporal nerve
,-Radial nerve
- answer-Posterior tibial
Stimulation of the posterior tibial nerve results in plantar fixation of the great toe.
Other locations for peripheral nerve stimulation electrode placement include the
ulnar nerve and the facial nerve.
A complication of a tracheostomy tube would be that:
-It allows for right mainstem intubation
-It increases airway resistance
-It leaves a permanent scar
-The airway is less stable
- answer-It leaves a permanent scar
The tracheal tube provides a more stable airway, can be placed in a PCU setting,
and decreases airway resistance. Because the tube is not positioned near the right
mainstem bronchus, it will not facilitate intubation of the bronchus.
There are a large number of potential complications with the use of a tracheostomy
tube such as:
Tracheal stenosis
Tracheal malacia (flaccidity of the tracheal
support cartilage )
Aspiration
Infection
Hemorrhage
Subcutaneous emphysema
Pneumothorax
A complication/ contraindication of a nasal endotracheal tube could be:
-The patient cannot drink
-The tube offers easy access to the right mainstem bronchus
-The tube cannot be used for a patient with a cervical spine injury
-The tube may cause otitis
- answer-The tube may cause otitis
, Because of the direct connection via the eustachian tube, infection in the ear is
possible. If a cervial injury has been stabalized, it is certainly possible for a skilled
intubator to place the tube. Additional complications associated with nasal
endotracheal tubes include nasal bleeding, sinusitis, accidental esophageal
intubation, vocal cord injuries, necrosis, cuff leak or failure, and obstruction.
A condition that increases lung compliance is:
-Kyphoscoliosis
-Emphysema
-ARDS
-Pulmonary edema
- answer-Emphysema
Compliance is the ability of the lung and the chest wall to freely move
(distensibility)-- that is, the ability of the lung and chest wall to stretch.
Emphysema patients often exhibit a barrel-shaped chest.
ARDS, atelectasis, obesity, pulmonary fibrosis, pulmonary edema, kyphoscoliosis,
and PNA are conditions that inhibit lung and chest wall movement (compliance).
A contraindication for use of a nasal trumpet would include:
-Use as an alternative to oral intubation
-Basilar skull fracture
-Use with unconscious patients
-A situation in which the nasal trumpet might be easily dislodged
- answer-Basilar skull fracture
The nasopharyngeal airway should not be used on patients with basial skull
fractures, sepsis, bleeding disorders, malformations or injuries to the nares, or nasal
obstructions. Use this type of airway with caution in patients who arereceiving
anticoagulants, fibrinolytics, or thrombolytics.
A disadvantage of closed catheter suctioning of a tracheally ventilated patient
would be:
AND 100% VERIFIED ANSWERS | GRADED A+
| GUARANTEED PASS!!
A 34-year old male is admitted to the PCU with a history of ETOH use and
multiple previous admissions. He is now in severe end-stage hepatic failure. He is
currently sedated and is in restraints for self protection. Vital signs are:
RR 16
BP 140/84
EKG ST at 112
SpO2 96%
The patient's wife visits and you inform her about the need for the restraints and
the patient's need to sleep. She acknowledges this information and says she will sit
quietly at the patient's bedside. About 5 minutes later, you find the patient
extubated and very agitated. His wife states she released the restraints because she
felt they were "too tight." Your priority in the care of this patient is:
-Immediate sedation for the agitation
-Remove the wife from the unit
-Notify the charge nurse
-Place the patient on a 40% mask and observe his response.
- answer-Place the patient on a 40% mask and observe his response
The airway is always a priority. After placing the mask and notifying the charge
nurse, you have other options. If the patient is stable, you can notify the attending
doctor and see if he wants to reintubate the patient or leave on the mask, change to
another form of O2 delivery and/ or FiO2, draw ABGs or do nothing. If the
patient's condition deterioriates, you may have the option of asking the ED doctor
to intubate the patient.
,The wife may have innocently believed she was doing good, but she may be a
facilitator for her husband's drinking and behavior. She would certainly bear close
watching if she is allowed to stay on the unit.
A 42 year old female was admitted to the PCU following a fall down some patio
stairs. She sustained a fracture of the 4th rib on the right and fractures of the 4th
and 5th ribs on the left. She was medicated for pain and, while visiting with her
husband, becomes dyspneic. Her respiratory rate increases to 36 from 16. The
patient's trachea is noted to deviate to the left and diminished breath sounds are
heard throughout the left lung fields. you also note crepitus over the site of the
fracture on the right side. She is probably developing:
-A pericardial tamponade
-A pneumothorax
-A hemothorax
-A chylothorax
- answer-A pneumothorax
A cause of decreased SVO2 would be:
-An increased metabolic rate
-Sedation
-A decerased metabolic rate
-An increased cardiac output
- answer-An increased metabolic rate
Increased metabolic rate would increase O2 uptake by tissues, resulting in a lower
value as measured by venous blood gases.
The other answers result in a lower tissue oxygen requirement and, therefore,
higher values of oxygen remaining in the bloodsteam.
A common site for the placement of electrodes for a peripheral nerve is on the:
-Posterior tibial
-Medial nerve
-Temporal nerve
,-Radial nerve
- answer-Posterior tibial
Stimulation of the posterior tibial nerve results in plantar fixation of the great toe.
Other locations for peripheral nerve stimulation electrode placement include the
ulnar nerve and the facial nerve.
A complication of a tracheostomy tube would be that:
-It allows for right mainstem intubation
-It increases airway resistance
-It leaves a permanent scar
-The airway is less stable
- answer-It leaves a permanent scar
The tracheal tube provides a more stable airway, can be placed in a PCU setting,
and decreases airway resistance. Because the tube is not positioned near the right
mainstem bronchus, it will not facilitate intubation of the bronchus.
There are a large number of potential complications with the use of a tracheostomy
tube such as:
Tracheal stenosis
Tracheal malacia (flaccidity of the tracheal
support cartilage )
Aspiration
Infection
Hemorrhage
Subcutaneous emphysema
Pneumothorax
A complication/ contraindication of a nasal endotracheal tube could be:
-The patient cannot drink
-The tube offers easy access to the right mainstem bronchus
-The tube cannot be used for a patient with a cervical spine injury
-The tube may cause otitis
- answer-The tube may cause otitis
, Because of the direct connection via the eustachian tube, infection in the ear is
possible. If a cervial injury has been stabalized, it is certainly possible for a skilled
intubator to place the tube. Additional complications associated with nasal
endotracheal tubes include nasal bleeding, sinusitis, accidental esophageal
intubation, vocal cord injuries, necrosis, cuff leak or failure, and obstruction.
A condition that increases lung compliance is:
-Kyphoscoliosis
-Emphysema
-ARDS
-Pulmonary edema
- answer-Emphysema
Compliance is the ability of the lung and the chest wall to freely move
(distensibility)-- that is, the ability of the lung and chest wall to stretch.
Emphysema patients often exhibit a barrel-shaped chest.
ARDS, atelectasis, obesity, pulmonary fibrosis, pulmonary edema, kyphoscoliosis,
and PNA are conditions that inhibit lung and chest wall movement (compliance).
A contraindication for use of a nasal trumpet would include:
-Use as an alternative to oral intubation
-Basilar skull fracture
-Use with unconscious patients
-A situation in which the nasal trumpet might be easily dislodged
- answer-Basilar skull fracture
The nasopharyngeal airway should not be used on patients with basial skull
fractures, sepsis, bleeding disorders, malformations or injuries to the nares, or nasal
obstructions. Use this type of airway with caution in patients who arereceiving
anticoagulants, fibrinolytics, or thrombolytics.
A disadvantage of closed catheter suctioning of a tracheally ventilated patient
would be:
