PCCN Exam 2023 with 100% correct answ
P PP P P P P
ers
ThePnursePobservesPthatPthePpatient'sPjugularPveinsPdistendPinPthePsemi-
uprightPpositionPtoPmorePthanP5PcmPabovePthePsternalPangle.PThisPisPanPindicationPof:P-PcorrectPanswerP-
fluidPvolumePoverload.
whatPisPnormalPPulmonaryParteryPocclusionPpressureP(PAOP)?P-PcorrectPanswerP-5-12PmmHg
ThePresistancePagainstPwhichPthePleftPventriclePmustPpumpPtoPejectPitsPvolumePis:P-PcorrectPanswerP-
systemicPvascularPresistance.
WhenPthePtricuspidPvalvePisPopen,PcentralPvenousPpressurePreflectsPthePfillingPpressurePinPthe:P-
PcorrectPanswerP-rightPventricle.
TachycardiaPisPdangerousPforPthePpatientPwithPischemicPheartPdiseasePbecausePof:P-PcorrectPanswerP-
compromisedPcardiacPoutput.
DuringPinitialPexaminationPofPaPcriticalPcarePpatient,PthePnursePobservesPwidePandPconvexPnailsPandPbulbo
usPfingertips.PThisPisPevidencePof:P-PcorrectPanswerP-centralPcyanosis.
PrioritiesPforPpalpationPofPthePpatientPwithPcardiovascularPdiseasePinclude:P-PcorrectPanswerP-
estimatingPedema.
checkingPcapillaryPrefill
checkingPforPDVT
arterialPpulses
ByPblockingPthePconversionPofPangiotensinPIPtoPangiotensinPII,Pangiotensin-
convertingPenzymePinhibitorsPproduce:P-PcorrectPanswerP-b.Pvasodilation.
,ThePnursePhasPreadPthatPthePcardiologistPrecommendsPthePusePofPclassPIVPdrugsPtoPdepressPsinusPandPatrio
ventricularPnodePconductionPandPterminatePsupraventricularPtachycardiasPinPthePpatientPatPthisPtime.PThe
PnursePwillPanticipatePordersPforPwhichPmedications?P-PcorrectPanswerP-
a.PVerapamil,Pdiltiazem,PorPamlodipine
ThePnursePhasPadministeredPaPdrugPthatPstimulatesPβ1-
adrenergicPsites.PFollowingPadministrationPofPthePdrug,PthePnursePwillPassessPfor:P-PcorrectPanswerP-
a.PincreasedPheartPrate.
ThePnursePisPobservingPthePpatient'sPelectrocardiographicPmonitorPafterPinsertionPofPaPtemporaryPpacema
ker.PSeeingPaPP-wavePafterPthePpacingPartifact,PthePnursePknowsPthatPthe:P-PcorrectPanswerP-
c.PatriumPisPbeingPpaced.
ThePpossibilityPofPmicroshockPwhenPhandlingPaPtemporaryPpacemakerPcanPbePminimizedPby:P-
PcorrectPanswerP-b.PinsulatingPthePendsPofPthePwires.PandPwearingPglovesPwhenPhandlingPthePpacingPwires
InPthePpostoperativePcardiovascularPpatient,PthePmostPfrequentPcausePofPaPdecreasedPcardiacPoutputPis:P-
PcorrectPanswerP-a.PreducedPpreload.
APpatientPisPbeingPmonitoredPbyPcontinuousPelectrocardiogramP(ECG)PafterPplacementPofPaPtransvenousPp
acemaker.P"LossPofPcapture"PisPseenPonPthePECG.PWhichPnursingPinterventionPmayPcorrectPthisPsituation?P-
PcorrectPanswerP-a.PPositionPthePpatientPonPthePleftPside.PorPrepositionPthePleads
InPanalyzingPthePECGPstrip,PthePnursePnoticesPaPspikePbeforePeachPQRSPcomplex.PThePpatient'sPheartPratePis
P70Pbeats/min.PThisPphenomenonPisPreflectivePofP-PcorrectPanswerP-
b.PpacingPartifact;PthePpacemakerPisPsensingPandPcapturing.
CalculatePthePcerebralPperfusionPpressureP(CPP)PforPaPpatientPwithPaPmeanParterialPpressureP(MAP)P=P95Pm
mPHgPandPanPintracranialPpressureP(ICP)P=P15PmmPHg.P-PcorrectPanswerP-b.P80PmmPHg
WhatPprocedurePsecuresPanParteriovenousPmalformationPwhenPaPpt'sPconditionPisPtooPunstablePforPsurger
y?P-PcorrectPanswerP-
embolizationPthatPcanPbePdonePtoPsecurePthePlesionPwithoutPsurgery.PWhenPthePconditionPisPmorePstable,P
anPoperationPmightPbePconsideredPifPneeded.
,KnowingPthatPaPpatientPhasPhypoxemiaPandPischemiaPinPhisPbrain,PthePnursePanticipatesPwhichPofPthePfollo
wing?P-PcorrectPanswerP-a.PCerebrovascularPdilation
ThePnurse'sPpriorityPinPeyePcarePforPthePpatientPinPaPcomaPwillPbe:P-PcorrectPanswerP-
c.PkeepingPthePeyesPmoistPtoPpreventPcornealPulceration.
ThePpatientPhasPmarkedlyPdeep,PrapidPrespirationsPwithPaPfruityPbreathPodor.PBasedPonPthePpatient'sPhisto
ry,PthePnursePwill:P-PcorrectPanswerP-performPaPbloodPglucosePmeasurement.
ThePpatientPwithPthePsyndromePofPinappropriatePantidiureticPhormoneP(SIADH)PsecretionPwillPneedPtoPhav
ePthePimbalancePofPwhichPelectrolytePcorrectedPasPsoonPasPpossible?P-PcorrectPanswerP-Sodium
WhichPofPthePfollowingPconditionsPoccursPwhenPthePrenalPtubulesParePunablePtoPreabsorbPexcessPglucose?
P-PcorrectPanswerP-Glycosuria
ThePpatientPhasPaPwaistPmeasurementPofP52Pinches.PHisPtriglyceridePlevelPisP175Pmg/dL,PhisPhigh-
densityPlipoproteinP(HDL)PcholesterolPlevelPisP32Pmg/dL,PandPhisPfastingPplasmaPglucosePlevelPisP224Pmg/dL
.PHisPbloodPpressurePreadingsParePusuallyPapproximatelyP140/90PmmPHg.PThePnursePrecognizesPthePcharac
teristicsPof:P-PcorrectPanswerP-metabolicPsyndrome.
ToPreversePthePhyperglycemicPhyperosmolarPstate,PthePnursePwillPfirstPpreparePtoPadminister:P-
PcorrectPanswerP-fluids
ThePnursePisPcaringPforPaPpatientPwithPcentralPdiabetesPinsipidusP(DI).PThePnursePshouldPanticipatePordersPf
orPthePadministrationPof:P-PcorrectPanswerP-vasopressin
InPthePsyndromePofPinappropriatePantidiureticPhormoneP(SIADH),PthePphysiologicalPeffectPis:P-
PcorrectPanswerP-dilutionalPhyponatremia,PreducingPsodiumPconcentrationPtoPcriticallyPlowPlevels.
WhichPassessmentPfindingsPwouldPindicatePfluidPvolumePexcess?P-PcorrectPanswerP-
edema,PauscultationPofPaPthirdPheartPsound,PcracklesPinPlungs,PboundingPpulses,PAMS,Polguria,PHTN
, ThePreportPofPaPrenalPpatient'sPlaboratoryPresultsPshowsPthatPthePbloodPureaPnitrogenP(BUN)PlevelPisPlessPt
hanP25Pmg/dL.PToPfullyPunderstandPthePpatient'sPrenalPstatus,PthePnursePmustPconsiderPthisPvaluePalongPwi
th:P-PcorrectPanswerP-c.PcreatininePlevel.
ToPdeterminePwhetherPedemaPinPaPpatient'sPhandsPisPduePtoPcirculatoryPcompromisePorPanotherPcause,Pth
ePnursePmight:P-PcorrectPanswerP-
elevatePthePpatient'sPextremitiesPforP1PhourPandPobservePthePdegreePofPedemaPstillPpresent.
HypovolemiaPcausesPtachycardiaPandP:P-PcorrectPanswerP-hypotension.
ToPavoidPthePcomplicationsPthatPcanPresultPfromPadministeringPfurosemideP(Lasix)PtoPstimulatePurinaryPou
tput,PthePnursePwillPcarefullyPmonitor:P-PcorrectPanswerP-levelsPofPelectrolytes,PespeciallyPpotassium.
WhichPdialysisPmethodPwouldPbePmostPappropriatePforPthePhemodynamicallyPstablePpatientPinPthePanuricP
phasePofPacutePkidneyPinjuryP(AKI)?P-PcorrectPanswerP-IntermittentPhemodialysis
WhatParePcomplicationsPofPcontinuousPrenalPreplacementPtherapyP(CRRT)?P-PcorrectPanswerP-
AirPembolism,PdecreasedPinflowPpressure,PelectrolytePimbalance
WhichPelectrolytesPposePthePmostPpotentialPhazardPifPnotPwithinPnormalPlimitsPforPthePpersonPwithPacuteP
kidneyPfailure?P-PcorrectPanswerP-PotassiumPandPcalcium
peakedPT-wavesPandPaPwideningPofPthePQRSPintervalPinPaPptPwithPAKIParePindicativePof:P-PcorrectPanswerP-
d.Phyperkalemia.
APpatientPpresentsPwithPthePfollowing:PHR,P120Pbeats/min;PBP,P80/44PmmPHg;PurinePoutputPaveragingP20P
mL/hrPoverPthePlastP4Phours;Pafebrile;PmoistPralesPinPthePlungsPbilaterally;PBUN,P84Pmg/dL;Pcreatinine,P3.4P
mg/dL.PWhatPisPthePprobablePcausePofPthisPpatient'sPacutePkidneyPinjuryP(AKI)?P-PcorrectPanswerP-
LeftPventricularPfailurePcausingPprerenalPAKI
AnPelderlyPpatientPisPinPaPmotorPvehiclePaccidentPandPincursPaPsignificantPinternalPhemorrhage.PHePisPatPgr
eatestPriskPforPwhichPcategoryPofPacutePkidneyPinjuryP(AKI)?P-PcorrectPanswerP-Prerenal
P PP P P P P
ers
ThePnursePobservesPthatPthePpatient'sPjugularPveinsPdistendPinPthePsemi-
uprightPpositionPtoPmorePthanP5PcmPabovePthePsternalPangle.PThisPisPanPindicationPof:P-PcorrectPanswerP-
fluidPvolumePoverload.
whatPisPnormalPPulmonaryParteryPocclusionPpressureP(PAOP)?P-PcorrectPanswerP-5-12PmmHg
ThePresistancePagainstPwhichPthePleftPventriclePmustPpumpPtoPejectPitsPvolumePis:P-PcorrectPanswerP-
systemicPvascularPresistance.
WhenPthePtricuspidPvalvePisPopen,PcentralPvenousPpressurePreflectsPthePfillingPpressurePinPthe:P-
PcorrectPanswerP-rightPventricle.
TachycardiaPisPdangerousPforPthePpatientPwithPischemicPheartPdiseasePbecausePof:P-PcorrectPanswerP-
compromisedPcardiacPoutput.
DuringPinitialPexaminationPofPaPcriticalPcarePpatient,PthePnursePobservesPwidePandPconvexPnailsPandPbulbo
usPfingertips.PThisPisPevidencePof:P-PcorrectPanswerP-centralPcyanosis.
PrioritiesPforPpalpationPofPthePpatientPwithPcardiovascularPdiseasePinclude:P-PcorrectPanswerP-
estimatingPedema.
checkingPcapillaryPrefill
checkingPforPDVT
arterialPpulses
ByPblockingPthePconversionPofPangiotensinPIPtoPangiotensinPII,Pangiotensin-
convertingPenzymePinhibitorsPproduce:P-PcorrectPanswerP-b.Pvasodilation.
,ThePnursePhasPreadPthatPthePcardiologistPrecommendsPthePusePofPclassPIVPdrugsPtoPdepressPsinusPandPatrio
ventricularPnodePconductionPandPterminatePsupraventricularPtachycardiasPinPthePpatientPatPthisPtime.PThe
PnursePwillPanticipatePordersPforPwhichPmedications?P-PcorrectPanswerP-
a.PVerapamil,Pdiltiazem,PorPamlodipine
ThePnursePhasPadministeredPaPdrugPthatPstimulatesPβ1-
adrenergicPsites.PFollowingPadministrationPofPthePdrug,PthePnursePwillPassessPfor:P-PcorrectPanswerP-
a.PincreasedPheartPrate.
ThePnursePisPobservingPthePpatient'sPelectrocardiographicPmonitorPafterPinsertionPofPaPtemporaryPpacema
ker.PSeeingPaPP-wavePafterPthePpacingPartifact,PthePnursePknowsPthatPthe:P-PcorrectPanswerP-
c.PatriumPisPbeingPpaced.
ThePpossibilityPofPmicroshockPwhenPhandlingPaPtemporaryPpacemakerPcanPbePminimizedPby:P-
PcorrectPanswerP-b.PinsulatingPthePendsPofPthePwires.PandPwearingPglovesPwhenPhandlingPthePpacingPwires
InPthePpostoperativePcardiovascularPpatient,PthePmostPfrequentPcausePofPaPdecreasedPcardiacPoutputPis:P-
PcorrectPanswerP-a.PreducedPpreload.
APpatientPisPbeingPmonitoredPbyPcontinuousPelectrocardiogramP(ECG)PafterPplacementPofPaPtransvenousPp
acemaker.P"LossPofPcapture"PisPseenPonPthePECG.PWhichPnursingPinterventionPmayPcorrectPthisPsituation?P-
PcorrectPanswerP-a.PPositionPthePpatientPonPthePleftPside.PorPrepositionPthePleads
InPanalyzingPthePECGPstrip,PthePnursePnoticesPaPspikePbeforePeachPQRSPcomplex.PThePpatient'sPheartPratePis
P70Pbeats/min.PThisPphenomenonPisPreflectivePofP-PcorrectPanswerP-
b.PpacingPartifact;PthePpacemakerPisPsensingPandPcapturing.
CalculatePthePcerebralPperfusionPpressureP(CPP)PforPaPpatientPwithPaPmeanParterialPpressureP(MAP)P=P95Pm
mPHgPandPanPintracranialPpressureP(ICP)P=P15PmmPHg.P-PcorrectPanswerP-b.P80PmmPHg
WhatPprocedurePsecuresPanParteriovenousPmalformationPwhenPaPpt'sPconditionPisPtooPunstablePforPsurger
y?P-PcorrectPanswerP-
embolizationPthatPcanPbePdonePtoPsecurePthePlesionPwithoutPsurgery.PWhenPthePconditionPisPmorePstable,P
anPoperationPmightPbePconsideredPifPneeded.
,KnowingPthatPaPpatientPhasPhypoxemiaPandPischemiaPinPhisPbrain,PthePnursePanticipatesPwhichPofPthePfollo
wing?P-PcorrectPanswerP-a.PCerebrovascularPdilation
ThePnurse'sPpriorityPinPeyePcarePforPthePpatientPinPaPcomaPwillPbe:P-PcorrectPanswerP-
c.PkeepingPthePeyesPmoistPtoPpreventPcornealPulceration.
ThePpatientPhasPmarkedlyPdeep,PrapidPrespirationsPwithPaPfruityPbreathPodor.PBasedPonPthePpatient'sPhisto
ry,PthePnursePwill:P-PcorrectPanswerP-performPaPbloodPglucosePmeasurement.
ThePpatientPwithPthePsyndromePofPinappropriatePantidiureticPhormoneP(SIADH)PsecretionPwillPneedPtoPhav
ePthePimbalancePofPwhichPelectrolytePcorrectedPasPsoonPasPpossible?P-PcorrectPanswerP-Sodium
WhichPofPthePfollowingPconditionsPoccursPwhenPthePrenalPtubulesParePunablePtoPreabsorbPexcessPglucose?
P-PcorrectPanswerP-Glycosuria
ThePpatientPhasPaPwaistPmeasurementPofP52Pinches.PHisPtriglyceridePlevelPisP175Pmg/dL,PhisPhigh-
densityPlipoproteinP(HDL)PcholesterolPlevelPisP32Pmg/dL,PandPhisPfastingPplasmaPglucosePlevelPisP224Pmg/dL
.PHisPbloodPpressurePreadingsParePusuallyPapproximatelyP140/90PmmPHg.PThePnursePrecognizesPthePcharac
teristicsPof:P-PcorrectPanswerP-metabolicPsyndrome.
ToPreversePthePhyperglycemicPhyperosmolarPstate,PthePnursePwillPfirstPpreparePtoPadminister:P-
PcorrectPanswerP-fluids
ThePnursePisPcaringPforPaPpatientPwithPcentralPdiabetesPinsipidusP(DI).PThePnursePshouldPanticipatePordersPf
orPthePadministrationPof:P-PcorrectPanswerP-vasopressin
InPthePsyndromePofPinappropriatePantidiureticPhormoneP(SIADH),PthePphysiologicalPeffectPis:P-
PcorrectPanswerP-dilutionalPhyponatremia,PreducingPsodiumPconcentrationPtoPcriticallyPlowPlevels.
WhichPassessmentPfindingsPwouldPindicatePfluidPvolumePexcess?P-PcorrectPanswerP-
edema,PauscultationPofPaPthirdPheartPsound,PcracklesPinPlungs,PboundingPpulses,PAMS,Polguria,PHTN
, ThePreportPofPaPrenalPpatient'sPlaboratoryPresultsPshowsPthatPthePbloodPureaPnitrogenP(BUN)PlevelPisPlessPt
hanP25Pmg/dL.PToPfullyPunderstandPthePpatient'sPrenalPstatus,PthePnursePmustPconsiderPthisPvaluePalongPwi
th:P-PcorrectPanswerP-c.PcreatininePlevel.
ToPdeterminePwhetherPedemaPinPaPpatient'sPhandsPisPduePtoPcirculatoryPcompromisePorPanotherPcause,Pth
ePnursePmight:P-PcorrectPanswerP-
elevatePthePpatient'sPextremitiesPforP1PhourPandPobservePthePdegreePofPedemaPstillPpresent.
HypovolemiaPcausesPtachycardiaPandP:P-PcorrectPanswerP-hypotension.
ToPavoidPthePcomplicationsPthatPcanPresultPfromPadministeringPfurosemideP(Lasix)PtoPstimulatePurinaryPou
tput,PthePnursePwillPcarefullyPmonitor:P-PcorrectPanswerP-levelsPofPelectrolytes,PespeciallyPpotassium.
WhichPdialysisPmethodPwouldPbePmostPappropriatePforPthePhemodynamicallyPstablePpatientPinPthePanuricP
phasePofPacutePkidneyPinjuryP(AKI)?P-PcorrectPanswerP-IntermittentPhemodialysis
WhatParePcomplicationsPofPcontinuousPrenalPreplacementPtherapyP(CRRT)?P-PcorrectPanswerP-
AirPembolism,PdecreasedPinflowPpressure,PelectrolytePimbalance
WhichPelectrolytesPposePthePmostPpotentialPhazardPifPnotPwithinPnormalPlimitsPforPthePpersonPwithPacuteP
kidneyPfailure?P-PcorrectPanswerP-PotassiumPandPcalcium
peakedPT-wavesPandPaPwideningPofPthePQRSPintervalPinPaPptPwithPAKIParePindicativePof:P-PcorrectPanswerP-
d.Phyperkalemia.
APpatientPpresentsPwithPthePfollowing:PHR,P120Pbeats/min;PBP,P80/44PmmPHg;PurinePoutputPaveragingP20P
mL/hrPoverPthePlastP4Phours;Pafebrile;PmoistPralesPinPthePlungsPbilaterally;PBUN,P84Pmg/dL;Pcreatinine,P3.4P
mg/dL.PWhatPisPthePprobablePcausePofPthisPpatient'sPacutePkidneyPinjuryP(AKI)?P-PcorrectPanswerP-
LeftPventricularPfailurePcausingPprerenalPAKI
AnPelderlyPpatientPisPinPaPmotorPvehiclePaccidentPandPincursPaPsignificantPinternalPhemorrhage.PHePisPatPgr
eatestPriskPforPwhichPcategoryPofPacutePkidneyPinjuryP(AKI)?P-PcorrectPanswerP-Prerenal
