All The PCCN Exam Questions And Answers 2022
Solutions With All Correct Answers
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 Answers: fluid volume overload.
What is normal Pulmonary artery occlusion pressure (PAOP)? Correct Answers: 5-12 mmhg
The resistance against which the left ventricle must pump to eject its volume is: Correct Answers:
systemic vascular resistance.
When the tricuspid valve is open, central venous pressure reflects the filling pressure in the: Correct
Answers: right ventricle.
Tachycardia is dangerous for the patient with ischemic heart disease because of: Correct Answers:
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 Answers: central cyanosis.
Priorities for palpation of the patient with cardiovascular disease include: Correct Answers: 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 Answers: 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 Answers: 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 Answers: 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 Answers: c.
Atrium is being paced.
The possibility of microshock when handling a temporary pacemaker can be minimized by: Correct
Answers: 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 Answers: 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 Answers: 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 Answers: 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 Answers: b. 80 mm Hg
What procedure secures an arteriovenous malformation when a pt's condition is too unstable for
surgery? Correct Answers: 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 Answers: a. Cerebrovascular dilation
The nurse's priority in eye care for the patient in a coma will be: Correct Answers: 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 Answers: 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 Answers: Sodium
Which of the following conditions occurs when the renal tubules are unable to reabsorb excess
glucose? Correct Answers: 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 Answers: metabolic syndrome.
To reverse the hyperglycemic hyperosmolar state, the nurse will first prepare to administer: Correct
Answers: fluids
The nurse is caring for a patient with central diabetes insipidus (DI). The nurse should anticipate
orders for the administration of: Correct Answers: vasopressin
In the syndrome of inappropriate antidiuretic hormone (SIADH), the physiological effect is: Correct
Answers: dilutional hyponatremia, reducing sodium concentration to critically low levels.
Which assessment findings would indicate fluid volume excess? Correct Answers: 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 Answers: c. Creatinine level.
,To determine whether edema in a patient's hands is due to circulatory compromise or another cause,
the nurse might: Correct Answers: elevate the patient's extremities for 1 hour and observe the degree
of edema still present.
Hypovolemia causes tachycardia and : Correct Answers: hypotension.
To avoid the complications that can result from administering furosemide (Lasix) to stimulate urinary
output, the nurse will carefully monitor: Correct Answers: 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 Answers: Intermittent hemodialysis
What are complications of continuous renal replacement therapy (CRRT)? Correct Answers: 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 Answers: Potassium and calcium
Peaked T-waves and a widening of the QRS interval in a pt with AKI are indicative of: Correct
Answers: 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 Answers:
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 Answers: 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 Answers: Intrarenal
Percussing the patient's stomach produces a tympanic sound is a sign that: Correct Answers: 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 Answers: ban ileus.
Auscultation of the abdomen reveals a bruit over the left renal artery. This is an indication of: Correct
Answers: renal hypertension.
The nurse observes that striae on the patient's abdomen are pink and purple. This may be a sign of:
Correct Answers: Cushing's syndrome.
During auscultation of the patient's abdomen, the nurse hears frequent high-pitched, tinkling sounds.
This is probably evidence of: Correct Answers: 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 Answers: 5
During palpation of the patient's abdomen, rebound tenderness indicates: Correct Answers:
inflammation of the peritoneum, such as with appenticitis and Chrohn's dz
Elevated alkaline phosphatase level and increasing nausea and abdominal pain indicate: Correct
Answers: 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 Answers: iron deficiency anemia.
The patient's alpha fetoprotein level is 200 ng/ml. This can indicate the presence of ____ cancer.
Correct Answers: 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 Answers: 50 to 75
The patient has advanced cirrhosis. Her serum albumin level is anticipated to be: Correct Answers:
decreased.
A vasopressin drip for a patient with bleeding esophagogastric varices would be contraindicated if the
patient has a history of: Correct Answers: coronary artery disease
What type of formula would be most appropriate for a patient with acute pancreatitis? Correct
Answers: Low fat
A person with a body mass index (BMI) of 32 would be considered: Correct Answers: obese
Diet therapy for a hypertensive person 1 day after a myocardial infarction would include all the
following except: Correct Answers: a fluid-restricted diet.
Kwashiorkor malnutrition results in: Correct Answers: 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 Answers: b. Elevated low-density lipoprotein (LDL) cholesterol and
decreased subcutaneous fat.
Serum proteins serve the function of: Correct Answers: maintaining osmotic pressure.
A patient on mechanical ventilation is receiving total parenteral nutrition (TPN). Why is appropriate
caloric intake important? Correct Answers: Excessive calorie intake can cause an increase in paco2.
A primary nutritional intervention for hypertension is: Correct Answers: limiting sodium
An effect of malnutrition on respiratory function is: Correct Answers: decreased surfactant.
Solutions With All Correct Answers
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 Answers: fluid volume overload.
What is normal Pulmonary artery occlusion pressure (PAOP)? Correct Answers: 5-12 mmhg
The resistance against which the left ventricle must pump to eject its volume is: Correct Answers:
systemic vascular resistance.
When the tricuspid valve is open, central venous pressure reflects the filling pressure in the: Correct
Answers: right ventricle.
Tachycardia is dangerous for the patient with ischemic heart disease because of: Correct Answers:
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 Answers: central cyanosis.
Priorities for palpation of the patient with cardiovascular disease include: Correct Answers: 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 Answers: 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 Answers: 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 Answers: 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 Answers: c.
Atrium is being paced.
The possibility of microshock when handling a temporary pacemaker can be minimized by: Correct
Answers: 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 Answers: 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 Answers: 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 Answers: 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 Answers: b. 80 mm Hg
What procedure secures an arteriovenous malformation when a pt's condition is too unstable for
surgery? Correct Answers: 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 Answers: a. Cerebrovascular dilation
The nurse's priority in eye care for the patient in a coma will be: Correct Answers: 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 Answers: 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 Answers: Sodium
Which of the following conditions occurs when the renal tubules are unable to reabsorb excess
glucose? Correct Answers: 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 Answers: metabolic syndrome.
To reverse the hyperglycemic hyperosmolar state, the nurse will first prepare to administer: Correct
Answers: fluids
The nurse is caring for a patient with central diabetes insipidus (DI). The nurse should anticipate
orders for the administration of: Correct Answers: vasopressin
In the syndrome of inappropriate antidiuretic hormone (SIADH), the physiological effect is: Correct
Answers: dilutional hyponatremia, reducing sodium concentration to critically low levels.
Which assessment findings would indicate fluid volume excess? Correct Answers: 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 Answers: c. Creatinine level.
,To determine whether edema in a patient's hands is due to circulatory compromise or another cause,
the nurse might: Correct Answers: elevate the patient's extremities for 1 hour and observe the degree
of edema still present.
Hypovolemia causes tachycardia and : Correct Answers: hypotension.
To avoid the complications that can result from administering furosemide (Lasix) to stimulate urinary
output, the nurse will carefully monitor: Correct Answers: 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 Answers: Intermittent hemodialysis
What are complications of continuous renal replacement therapy (CRRT)? Correct Answers: 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 Answers: Potassium and calcium
Peaked T-waves and a widening of the QRS interval in a pt with AKI are indicative of: Correct
Answers: 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 Answers:
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 Answers: 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 Answers: Intrarenal
Percussing the patient's stomach produces a tympanic sound is a sign that: Correct Answers: 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 Answers: ban ileus.
Auscultation of the abdomen reveals a bruit over the left renal artery. This is an indication of: Correct
Answers: renal hypertension.
The nurse observes that striae on the patient's abdomen are pink and purple. This may be a sign of:
Correct Answers: Cushing's syndrome.
During auscultation of the patient's abdomen, the nurse hears frequent high-pitched, tinkling sounds.
This is probably evidence of: Correct Answers: 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 Answers: 5
During palpation of the patient's abdomen, rebound tenderness indicates: Correct Answers:
inflammation of the peritoneum, such as with appenticitis and Chrohn's dz
Elevated alkaline phosphatase level and increasing nausea and abdominal pain indicate: Correct
Answers: 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 Answers: iron deficiency anemia.
The patient's alpha fetoprotein level is 200 ng/ml. This can indicate the presence of ____ cancer.
Correct Answers: 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 Answers: 50 to 75
The patient has advanced cirrhosis. Her serum albumin level is anticipated to be: Correct Answers:
decreased.
A vasopressin drip for a patient with bleeding esophagogastric varices would be contraindicated if the
patient has a history of: Correct Answers: coronary artery disease
What type of formula would be most appropriate for a patient with acute pancreatitis? Correct
Answers: Low fat
A person with a body mass index (BMI) of 32 would be considered: Correct Answers: obese
Diet therapy for a hypertensive person 1 day after a myocardial infarction would include all the
following except: Correct Answers: a fluid-restricted diet.
Kwashiorkor malnutrition results in: Correct Answers: 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 Answers: b. Elevated low-density lipoprotein (LDL) cholesterol and
decreased subcutaneous fat.
Serum proteins serve the function of: Correct Answers: maintaining osmotic pressure.
A patient on mechanical ventilation is receiving total parenteral nutrition (TPN). Why is appropriate
caloric intake important? Correct Answers: Excessive calorie intake can cause an increase in paco2.
A primary nutritional intervention for hypertension is: Correct Answers: limiting sodium
An effect of malnutrition on respiratory function is: Correct Answers: decreased surfactant.
