PCCN Exam All The Questions And Answers Are
Correctly Answered
The nurse observes that the patient's jugular veins distend in the semi-upright position to more than 5
cm above the sternal angle. This is an indication of: Correct Answer: fluid volume overload.
What is normal Pulmonary artery occlusion pressure (PAOP)? Correct Answer: 5-12 mmhg
The resistance against which the left ventricle must pump to eject its volume is: Correct Answer:
systemic vascular resistance.
When the tricuspid valve is open, central venous pressure reflects the filling pressure in the: Correct
Answer: right ventricle.
Tachycardia is dangerous for the patient with ischemic heart disease because of: Correct Answer:
compromised cardiac output.
During initial examination of a critical care patient, the nurse observes wide and convex nails and
bulbous fingertips. This is evidence of: Correct Answer: central cyanosis.
Priorities for palpation of the patient with cardiovascular disease include: Correct Answer: estimating
edema.
Checking capillary refill
Checking for DVT
Arterial pulses
By blocking the conversion of angiotensin I to angiotensin II, angiotensin-converting enzyme
inhibitors produce: Correct Answer: b. Vasodilation.
The nurse has read that the cardiologist recommends the use of class IV drugs to depress sinus and
atrioventricular node conduction and terminate supraventricular tachycardias in the patient at this
time. The nurse will anticipate orders for which medications? Correct Answer: a. Verapamil, diltiazem,
or amlodipine
The nurse has administered a drug that stimulates β1-adrenergic sites. Following administration of
the drug, the nurse will assess for: Correct Answer: a. Increased heart rate.
The nurse is observing the patient's electrocardiographic monitor after insertion of a temporary
pacemaker. Seeing a P-wave after the pacing artifact, the nurse knows that the: Correct Answer: c.
Atrium is being paced.
The possibility of microshock when handling a temporary pacemaker can be minimized by: Correct
Answer: b. Insulating the ends of the wires. And wearing gloves when handling the pacing wires
In the postoperative cardiovascular patient, the most frequent cause of a decreased cardiac output is:
Correct Answer: a. Reduced preload.
,A patient is being monitored by continuous electrocardiogram (ECG) after placement of a
transvenous pacemaker. "Loss of capture" is seen on the ECG. Which nursing intervention may
correct this situation? Correct Answer: a. Position the patient on the left side. Or reposition the leads
In analyzing the ECG strip, the nurse notices a spike before each QRS complex. The patient's heart
rate is 70 beats/min. This phenomenon is reflective of Correct Answer: b. Pacing artifact; the
pacemaker is sensing and capturing.
Calculate the cerebral perfusion pressure (CPP) for a patient with a mean arterial pressure (MAP) =
95 mm Hg and an intracranial pressure (ICP) = 15 mm Hg. Correct Answer: b. 80 mm Hg
What procedure secures an arteriovenous malformation when a pt's condition is too unstable for
surgery? Correct Answer: embolization that can be done to secure the lesion without surgery. When
the condition is more stable, an operation might be considered if needed.
Knowing that a patient has hypoxemia and ischemia in his brain, the nurse anticipates which of the
following? Correct Answer: a. Cerebrovascular dilation
The nurse's priority in eye care for the patient in a coma will be: Correct Answer: c. Keeping the eyes
moist to prevent corneal ulceration.
The patient has markedly deep, rapid respirations with a fruity breath odor. Based on the patient's
history, the nurse will: Correct Answer: perform a blood glucose measurement.
The patient with the syndrome of inappropriate antidiuretic hormone (SIADH) secretion will need to
have the imbalance of which electrolyte corrected as soon as possible? Correct Answer: Sodium
Which of the following conditions occurs when the renal tubules are unable to reabsorb excess
glucose? Correct Answer: Glycosuria
The patient has a waist measurement of 52 inches. His triglyceride level is 175 mg/dl, his high-
density lipoprotein (HDL) cholesterol level is 32 mg/dl, and his fasting plasma glucose level is 224
mg/dl. His blood pressure readings are usually approximately 140/90 mm Hg. The nurse recognizes
the characteristics of: Correct Answer: metabolic syndrome.
To reverse the hyperglycemic hyperosmolar state, the nurse will first prepare to administer: Correct
Answer: fluids
The nurse is caring for a patient with central diabetes insipidus (DI). The nurse should anticipate
orders for the administration of: Correct Answer: vasopressin
In the syndrome of inappropriate antidiuretic hormone (SIADH), the physiological effect is: Correct
Answer: dilutional hyponatremia, reducing sodium concentration to critically low levels.
Which assessment findings would indicate fluid volume excess? Correct Answer: edema,
auscultation of a third heart sound, crackles in lungs, bounding pulses, AMS, olguria, HTN
The report of a renal patient's laboratory results shows that the blood urea nitrogen (BUN) level is
less than 25 mg/dl. To fully understand the patient's renal status, the nurse must consider this value
along with: Correct Answer: c. Creatinine level.
,To determine whether edema in a patient's hands is due to circulatory compromise or another cause,
the nurse might: Correct Answer: elevate the patient's extremities for 1 hour and observe the degree
of edema still present.
Hypovolemia causes tachycardia and : Correct Answer: hypotension.
To avoid the complications that can result from administering furosemide (Lasix) to stimulate urinary
output, the nurse will carefully monitor: Correct Answer: levels of electrolytes, especially potassium.
Which dialysis method would be most appropriate for the hemodynamically stable patient in the
anuric phase of acute kidney injury (AKI)? Correct Answer: Intermittent hemodialysis
What are complications of continuous renal replacement therapy (CRRT)? Correct Answer: Air
embolism, decreased inflow pressure, electrolyte imbalance
Which electrolytes pose the most potential hazard if not within normal limits for the person with acute
kidney failure? Correct Answer: Potassium and calcium
Peaked T-waves and a widening of the QRS interval in a pt with AKI are indicative of: Correct
Answer: d. Hyperkalemia.
A patient presents with the following: HR, 120 beats/min; BP, 80/44 mm Hg; urine output averaging
20 ml/hr over the last 4 hours; afebrile; moist rales in the lungs bilaterally; BUN, 84 mg/dl; creatinine,
3.4 mg/dl. What is the probable cause of this patient's acute kidney injury (AKI)? Correct Answer: Left
ventricular failure causing prerenal AKI
An elderly patient is in a motor vehicle accident and incurs a significant internal hemorrhage. He is at
greatest risk for which category of acute kidney injury (AKI)? Correct Answer: Prerenal
A patient is admitted to the unit with the following laboratory values: urine specific gravity, 1.010;
urine osmolality, 210 mosm/kg; BUN/Cr ratio 10:1; urine sodium, 96 meq/L. The urine output has
been 60 ml since admission 2 hours ago. These values are most consistent with which of the
following types of acute kidney injury (AKI)? Correct Answer: Intrarenal
Percussing the patient's stomach produces a tympanic sound is a sign that: Correct Answer: the
patient's stomach is empty.
The nurse is unable to hear bowel sounds in any of the four quadrants of the patient's abdomen. This
may indicate the presence of: Correct Answer: ban ileus.
Auscultation of the abdomen reveals a bruit over the left renal artery. This is an indication of: Correct
Answer: renal hypertension.
The nurse observes that striae on the patient's abdomen are pink and purple. This may be a sign of:
Correct Answer: Cushing's syndrome.
During auscultation of the patient's abdomen, the nurse hears frequent high-pitched, tinkling sounds.
This is probably evidence of: Correct Answer: normal bowel sounds.
, The nurse has been unable to hear any bowel sounds during examination of the patient's abdomen.
The minimum interval for listening before concluding that bowel sounds are absent is ____ minute(s).
Correct Answer: 5
During palpation of the patient's abdomen, rebound tenderness indicates: Correct Answer:
inflammation of the peritoneum, such as with appenticitis and Chrohn's dz
Elevated alkaline phosphatase level and increasing nausea and abdominal pain indicate: Correct
Answer: gallbladder disease.
The patient's serum transferrin level is higher than 300 mcg/dl. The nurse will review other laboratory
results to evaluate for the possible presence of: Correct Answer: iron deficiency anemia.
The patient's alpha fetoprotein level is 200 ng/ml. This can indicate the presence of ____ cancer.
Correct Answer: liver
Knowing that the patient has advanced liver disease, the nurse expects his partial thromboplastin
time (PTT) to be in the range of ____ seconds. Correct Answer: 50 to 75
The patient has advanced cirrhosis. Her serum albumin level is anticipated to be: Correct Answer:
decreased.
A vasopressin drip for a patient with bleeding esophagogastric varices would be contraindicated if the
patient has a history of: Correct Answer: coronary artery disease
What type of formula would be most appropriate for a patient with acute pancreatitis? Correct
Answer: Low fat
A person with a body mass index (BMI) of 32 would be considered: Correct Answer: obese
Diet therapy for a hypertensive person 1 day after a myocardial infarction would include all the
following except: Correct Answer: a fluid-restricted diet.
Kwashiorkor malnutrition results in: Correct Answer: low levels of serum proteins, low lymphocyte
count, and hair loss.
Significant laboratory and clinical findings in the nutritional assessment of patient with cardiovascular
disease include: Correct Answer: b. Elevated low-density lipoprotein (LDL) cholesterol and decreased
subcutaneous fat.
Serum proteins serve the function of: Correct Answer: maintaining osmotic pressure.
A patient on mechanical ventilation is receiving total parenteral nutrition (TPN). Why is appropriate
caloric intake important? Correct Answer: Excessive calorie intake can cause an increase in paco2.
A primary nutritional intervention for hypertension is: Correct Answer: limiting sodium
An effect of malnutrition on respiratory function is: Correct Answer: decreased surfactant.
Correctly Answered
The nurse observes that the patient's jugular veins distend in the semi-upright position to more than 5
cm above the sternal angle. This is an indication of: Correct Answer: fluid volume overload.
What is normal Pulmonary artery occlusion pressure (PAOP)? Correct Answer: 5-12 mmhg
The resistance against which the left ventricle must pump to eject its volume is: Correct Answer:
systemic vascular resistance.
When the tricuspid valve is open, central venous pressure reflects the filling pressure in the: Correct
Answer: right ventricle.
Tachycardia is dangerous for the patient with ischemic heart disease because of: Correct Answer:
compromised cardiac output.
During initial examination of a critical care patient, the nurse observes wide and convex nails and
bulbous fingertips. This is evidence of: Correct Answer: central cyanosis.
Priorities for palpation of the patient with cardiovascular disease include: Correct Answer: estimating
edema.
Checking capillary refill
Checking for DVT
Arterial pulses
By blocking the conversion of angiotensin I to angiotensin II, angiotensin-converting enzyme
inhibitors produce: Correct Answer: b. Vasodilation.
The nurse has read that the cardiologist recommends the use of class IV drugs to depress sinus and
atrioventricular node conduction and terminate supraventricular tachycardias in the patient at this
time. The nurse will anticipate orders for which medications? Correct Answer: a. Verapamil, diltiazem,
or amlodipine
The nurse has administered a drug that stimulates β1-adrenergic sites. Following administration of
the drug, the nurse will assess for: Correct Answer: a. Increased heart rate.
The nurse is observing the patient's electrocardiographic monitor after insertion of a temporary
pacemaker. Seeing a P-wave after the pacing artifact, the nurse knows that the: Correct Answer: c.
Atrium is being paced.
The possibility of microshock when handling a temporary pacemaker can be minimized by: Correct
Answer: b. Insulating the ends of the wires. And wearing gloves when handling the pacing wires
In the postoperative cardiovascular patient, the most frequent cause of a decreased cardiac output is:
Correct Answer: a. Reduced preload.
,A patient is being monitored by continuous electrocardiogram (ECG) after placement of a
transvenous pacemaker. "Loss of capture" is seen on the ECG. Which nursing intervention may
correct this situation? Correct Answer: a. Position the patient on the left side. Or reposition the leads
In analyzing the ECG strip, the nurse notices a spike before each QRS complex. The patient's heart
rate is 70 beats/min. This phenomenon is reflective of Correct Answer: b. Pacing artifact; the
pacemaker is sensing and capturing.
Calculate the cerebral perfusion pressure (CPP) for a patient with a mean arterial pressure (MAP) =
95 mm Hg and an intracranial pressure (ICP) = 15 mm Hg. Correct Answer: b. 80 mm Hg
What procedure secures an arteriovenous malformation when a pt's condition is too unstable for
surgery? Correct Answer: embolization that can be done to secure the lesion without surgery. When
the condition is more stable, an operation might be considered if needed.
Knowing that a patient has hypoxemia and ischemia in his brain, the nurse anticipates which of the
following? Correct Answer: a. Cerebrovascular dilation
The nurse's priority in eye care for the patient in a coma will be: Correct Answer: c. Keeping the eyes
moist to prevent corneal ulceration.
The patient has markedly deep, rapid respirations with a fruity breath odor. Based on the patient's
history, the nurse will: Correct Answer: perform a blood glucose measurement.
The patient with the syndrome of inappropriate antidiuretic hormone (SIADH) secretion will need to
have the imbalance of which electrolyte corrected as soon as possible? Correct Answer: Sodium
Which of the following conditions occurs when the renal tubules are unable to reabsorb excess
glucose? Correct Answer: Glycosuria
The patient has a waist measurement of 52 inches. His triglyceride level is 175 mg/dl, his high-
density lipoprotein (HDL) cholesterol level is 32 mg/dl, and his fasting plasma glucose level is 224
mg/dl. His blood pressure readings are usually approximately 140/90 mm Hg. The nurse recognizes
the characteristics of: Correct Answer: metabolic syndrome.
To reverse the hyperglycemic hyperosmolar state, the nurse will first prepare to administer: Correct
Answer: fluids
The nurse is caring for a patient with central diabetes insipidus (DI). The nurse should anticipate
orders for the administration of: Correct Answer: vasopressin
In the syndrome of inappropriate antidiuretic hormone (SIADH), the physiological effect is: Correct
Answer: dilutional hyponatremia, reducing sodium concentration to critically low levels.
Which assessment findings would indicate fluid volume excess? Correct Answer: edema,
auscultation of a third heart sound, crackles in lungs, bounding pulses, AMS, olguria, HTN
The report of a renal patient's laboratory results shows that the blood urea nitrogen (BUN) level is
less than 25 mg/dl. To fully understand the patient's renal status, the nurse must consider this value
along with: Correct Answer: c. Creatinine level.
,To determine whether edema in a patient's hands is due to circulatory compromise or another cause,
the nurse might: Correct Answer: elevate the patient's extremities for 1 hour and observe the degree
of edema still present.
Hypovolemia causes tachycardia and : Correct Answer: hypotension.
To avoid the complications that can result from administering furosemide (Lasix) to stimulate urinary
output, the nurse will carefully monitor: Correct Answer: levels of electrolytes, especially potassium.
Which dialysis method would be most appropriate for the hemodynamically stable patient in the
anuric phase of acute kidney injury (AKI)? Correct Answer: Intermittent hemodialysis
What are complications of continuous renal replacement therapy (CRRT)? Correct Answer: Air
embolism, decreased inflow pressure, electrolyte imbalance
Which electrolytes pose the most potential hazard if not within normal limits for the person with acute
kidney failure? Correct Answer: Potassium and calcium
Peaked T-waves and a widening of the QRS interval in a pt with AKI are indicative of: Correct
Answer: d. Hyperkalemia.
A patient presents with the following: HR, 120 beats/min; BP, 80/44 mm Hg; urine output averaging
20 ml/hr over the last 4 hours; afebrile; moist rales in the lungs bilaterally; BUN, 84 mg/dl; creatinine,
3.4 mg/dl. What is the probable cause of this patient's acute kidney injury (AKI)? Correct Answer: Left
ventricular failure causing prerenal AKI
An elderly patient is in a motor vehicle accident and incurs a significant internal hemorrhage. He is at
greatest risk for which category of acute kidney injury (AKI)? Correct Answer: Prerenal
A patient is admitted to the unit with the following laboratory values: urine specific gravity, 1.010;
urine osmolality, 210 mosm/kg; BUN/Cr ratio 10:1; urine sodium, 96 meq/L. The urine output has
been 60 ml since admission 2 hours ago. These values are most consistent with which of the
following types of acute kidney injury (AKI)? Correct Answer: Intrarenal
Percussing the patient's stomach produces a tympanic sound is a sign that: Correct Answer: the
patient's stomach is empty.
The nurse is unable to hear bowel sounds in any of the four quadrants of the patient's abdomen. This
may indicate the presence of: Correct Answer: ban ileus.
Auscultation of the abdomen reveals a bruit over the left renal artery. This is an indication of: Correct
Answer: renal hypertension.
The nurse observes that striae on the patient's abdomen are pink and purple. This may be a sign of:
Correct Answer: Cushing's syndrome.
During auscultation of the patient's abdomen, the nurse hears frequent high-pitched, tinkling sounds.
This is probably evidence of: Correct Answer: normal bowel sounds.
, The nurse has been unable to hear any bowel sounds during examination of the patient's abdomen.
The minimum interval for listening before concluding that bowel sounds are absent is ____ minute(s).
Correct Answer: 5
During palpation of the patient's abdomen, rebound tenderness indicates: Correct Answer:
inflammation of the peritoneum, such as with appenticitis and Chrohn's dz
Elevated alkaline phosphatase level and increasing nausea and abdominal pain indicate: Correct
Answer: gallbladder disease.
The patient's serum transferrin level is higher than 300 mcg/dl. The nurse will review other laboratory
results to evaluate for the possible presence of: Correct Answer: iron deficiency anemia.
The patient's alpha fetoprotein level is 200 ng/ml. This can indicate the presence of ____ cancer.
Correct Answer: liver
Knowing that the patient has advanced liver disease, the nurse expects his partial thromboplastin
time (PTT) to be in the range of ____ seconds. Correct Answer: 50 to 75
The patient has advanced cirrhosis. Her serum albumin level is anticipated to be: Correct Answer:
decreased.
A vasopressin drip for a patient with bleeding esophagogastric varices would be contraindicated if the
patient has a history of: Correct Answer: coronary artery disease
What type of formula would be most appropriate for a patient with acute pancreatitis? Correct
Answer: Low fat
A person with a body mass index (BMI) of 32 would be considered: Correct Answer: obese
Diet therapy for a hypertensive person 1 day after a myocardial infarction would include all the
following except: Correct Answer: a fluid-restricted diet.
Kwashiorkor malnutrition results in: Correct Answer: low levels of serum proteins, low lymphocyte
count, and hair loss.
Significant laboratory and clinical findings in the nutritional assessment of patient with cardiovascular
disease include: Correct Answer: b. Elevated low-density lipoprotein (LDL) cholesterol and decreased
subcutaneous fat.
Serum proteins serve the function of: Correct Answer: maintaining osmotic pressure.
A patient on mechanical ventilation is receiving total parenteral nutrition (TPN). Why is appropriate
caloric intake important? Correct Answer: Excessive calorie intake can cause an increase in paco2.
A primary nutritional intervention for hypertension is: Correct Answer: limiting sodium
An effect of malnutrition on respiratory function is: Correct Answer: decreased surfactant.
