PCCN 2025 Exam NK review complete update
A .nurse .is .caring .for .a .71-year-old .female .patient .with .end-stage .chronic .obstructive .pulmonary
.disease .(COPD) .who .is .experiencing .cardiac .ischemia .with .increased .shortness .of .breath. .The .MOST
.appropriate .goal .of .oxygen .therapy .for .this .patient .would .be .to:
A. Limit .supplemental .oxygen .to .lower .the .risk .of .reducing .respiratory .drive
B. Maintain .oxygen .saturations .between .86% .and .89%
C. Administer .oxygen .until .oxygen .saturations .are .greater .than .95% .in .order .to .relieve .ischemia
D. Maintain .oxygen .saturations .between .90% .and .92% .- .D. .Maintain .oxygen .saturations .between
.90% .and .92%
Feedback
Maintaining .oxygen .saturations .between .90% .and .92% .will .serve .the .purpose .of .providing .enough
.oxygen .to .relieve .cardiac .ischemia .while .reducing .the .risk .of .respiratory .depression .in .a .patient .with
.COPD.
Laboratory .studies .from .a .22-year-old .male .client .with .Type .I .diabetes .mellitus .are .evaluated .during
.an .admission .for .severe .pneumonia. .Which .of .the .following .laboratory .results .should .the .nurse
.report .to .the .physician?
A. Glycosylated .hemoglobin .(HbA1c), .9.8%
B. Low-density .lipoprotein .(LDL),
C. 94 .mg/dLHematocrit .(Hct), .53%
D. Urine .specific .gravity, .1.250 .- .A. .Glycosylated .hemoglobin .(HbA1c),
.9.8% .Feedback
Glycosylated .hemoglobin .measures .the .average .blood .sugar .levels .over .a .2 .to .3 .month .time .period.
.Clients .with .previously .diagnosed .diabetes .mellitus .should .aim .to .keep .their .HbA1c .levels .below
.7%.CONTENT .AREA: .Clinical .Judgement: .Endocrine/Hematology/Neurology/GI/Renal
,The .nurse .is .assessing .a .68 .year .old .female .patient .with .a .history .of .chronic .obstructive .pulmonary
.disease .(COPD). .The .patient .presents .with .complaints .of .recent .confusion, .increased .fatigue, .and
,syncopal .episodes .when .walking. .The .nurse .assesses .S3 .and .S4 .sounds .on .auscultation, .jugular .vein
.distention, .and .+3 .pitting .edema .of .the .ankles .and .feet. .Which .of .the .following .complications .of
.COPD .does .the .nurse .suspect .the .patient .is .most .likely .experiencing?
A. Acute .respiratory .distress .syndrome .(ARDS)
B. Bronchiectasis
C. Heart .failure
D. Cor .pulmonale .- .D. .Cor
.pulmonale .Feedback
The .nurse .should .recognize .that .a .history .of .COPD .together .with .the .signs .and .symptoms .listed .here
.are .suggestive .of .cor .pulmonale. .The .patient .requires .further .workup .to .confirm .this .diagnosis.
A .42-year-old .male .with .Marfan .syndrome .and .complaint .of .dizziness .is .admitted .to .the .telemetry
.unit .for .monitoring. .Which .of .the .following .accompanying .symptoms .may .indicate .the .need .for
.immediate .surgical .attention?
A. Cough .with .vocal .hoarseness
B. Limited .rotation .of .the .left .shoulder
C. Headache .that .resolved .after .breakfast, .but .has .returned
D. Sudden .stabbing .pain .in .the .right .elbow .- .A. .Cough .with .vocal
.hoarseness .Feedback
Patients .diagnosed .with .Marfan .syndrome .are .at .higher .risk .for .aortic .aneurysms. .Changes .in .vocal
.quality .accompanied .by .a .cough .or .dysphagia .(difficulty .swallowing) .may .indicate .that .a .thoracic
.aortic .aneurysm .is .becoming .more .enlarged.
The .nurse .is .assessing .a .74 .year .old .female .patient .who .has .presented .with .the .following
.symptoms: .cool, .clammy .skin; .faint, .irregular .peripheral .pulses, .and .+3 .pitting .edema .in .her
.bilateral .lower .extremities. .Her .partner .tells .the .nurse .the .patient .has .a .history .of .heart .failure .with
.a .recent .LVEF .of .20%, .as .well .as .type .2 .diabetes. .The .patient's .HR .is .132, .BP .is .79/48, .and .blood
.glucose .is .349. .Which .of .the .following .conditions .does .the .nurse .suspect?
A. Cardiogenic .shock
B. Diabetic .ketoacidosis
, C. Fluid .overload
D. Obstructive .shock .- .A. .Cardiogenic
.shock .Feedback
The .nurse .should .identify .that .cardiogenic .shock .is .an .emergency .that .has .extremely .high .mortality
.rates .without .timely .intervention. .The .patient's .history .of .heart .failure .together .with .her .acute
.symptoms .of .weak .pulses, .edema, .and .hypotension .all .point .to .cardiogenic .shock.
The .nurse .is .caring .for .a .patient .with .stage .5 .chronic .kidney .disease .who .normally .receives
.hemodialysis .three .times .a .week .on .Monday, .Wednesday, .and .Friday. .It .is .now .Sunday .and .the
.patient .states .they .have .missed .their .last .two .dialysis .sessions. .The .patient .is .complaining .of
.shortness .of .breath .and .fatigue, .and .their .labs .show .a .creatinine .of .3.9 .and .potassium .of .6.8. .What
.is .the .BEST .treatment .for .this .patient .?
A. 80 .mg .IV .push .furosemide .followed .by .rechecking .the .potassium .level, .with .more .IV
.furosemide .as .needed
B. 15 .g .kayexalate .PO .twice .daily
C. Intravenous .calcium .infusion
D. Urgent .hemodialysis .- .D. .Urgent
.hemodialysis .Feedback
The .nurse .should .recognize .that .dialysis .is .the .best .option .for .this .patient .since .they .are .already .a
.regular .dialysis .patient .and .are .a .likely .candidate .to .receive .urgent .dialysis .due .to .their .missed
.dialysis .sessions, .shortness .of .breath, .and .critical .potassium .level.
A .17-year-old .male .client .is .recovering .from .idiopathic .infective .endocarditis. .The .nurse .should
.include .which .of .the .following .teaching .points .in .the .discharge .care .plan .for .this .client?
A. Taking .prophylactic .antibiotics .before .dental .procedures
B. Drinking .no .more .than .1 .liter .of .fluid .per .day
C. Strictly .avoiding .caffeine .or .other .stimulants
D. Encouraging .a .healthy .low-fat .diet .that .includes .at .least .2 .grams .of .sodium .intake .per .day .- .A.
.Taking .prophylactic .antibiotics .before .dental .procedures
Feedback
A .nurse .is .caring .for .a .71-year-old .female .patient .with .end-stage .chronic .obstructive .pulmonary
.disease .(COPD) .who .is .experiencing .cardiac .ischemia .with .increased .shortness .of .breath. .The .MOST
.appropriate .goal .of .oxygen .therapy .for .this .patient .would .be .to:
A. Limit .supplemental .oxygen .to .lower .the .risk .of .reducing .respiratory .drive
B. Maintain .oxygen .saturations .between .86% .and .89%
C. Administer .oxygen .until .oxygen .saturations .are .greater .than .95% .in .order .to .relieve .ischemia
D. Maintain .oxygen .saturations .between .90% .and .92% .- .D. .Maintain .oxygen .saturations .between
.90% .and .92%
Feedback
Maintaining .oxygen .saturations .between .90% .and .92% .will .serve .the .purpose .of .providing .enough
.oxygen .to .relieve .cardiac .ischemia .while .reducing .the .risk .of .respiratory .depression .in .a .patient .with
.COPD.
Laboratory .studies .from .a .22-year-old .male .client .with .Type .I .diabetes .mellitus .are .evaluated .during
.an .admission .for .severe .pneumonia. .Which .of .the .following .laboratory .results .should .the .nurse
.report .to .the .physician?
A. Glycosylated .hemoglobin .(HbA1c), .9.8%
B. Low-density .lipoprotein .(LDL),
C. 94 .mg/dLHematocrit .(Hct), .53%
D. Urine .specific .gravity, .1.250 .- .A. .Glycosylated .hemoglobin .(HbA1c),
.9.8% .Feedback
Glycosylated .hemoglobin .measures .the .average .blood .sugar .levels .over .a .2 .to .3 .month .time .period.
.Clients .with .previously .diagnosed .diabetes .mellitus .should .aim .to .keep .their .HbA1c .levels .below
.7%.CONTENT .AREA: .Clinical .Judgement: .Endocrine/Hematology/Neurology/GI/Renal
,The .nurse .is .assessing .a .68 .year .old .female .patient .with .a .history .of .chronic .obstructive .pulmonary
.disease .(COPD). .The .patient .presents .with .complaints .of .recent .confusion, .increased .fatigue, .and
,syncopal .episodes .when .walking. .The .nurse .assesses .S3 .and .S4 .sounds .on .auscultation, .jugular .vein
.distention, .and .+3 .pitting .edema .of .the .ankles .and .feet. .Which .of .the .following .complications .of
.COPD .does .the .nurse .suspect .the .patient .is .most .likely .experiencing?
A. Acute .respiratory .distress .syndrome .(ARDS)
B. Bronchiectasis
C. Heart .failure
D. Cor .pulmonale .- .D. .Cor
.pulmonale .Feedback
The .nurse .should .recognize .that .a .history .of .COPD .together .with .the .signs .and .symptoms .listed .here
.are .suggestive .of .cor .pulmonale. .The .patient .requires .further .workup .to .confirm .this .diagnosis.
A .42-year-old .male .with .Marfan .syndrome .and .complaint .of .dizziness .is .admitted .to .the .telemetry
.unit .for .monitoring. .Which .of .the .following .accompanying .symptoms .may .indicate .the .need .for
.immediate .surgical .attention?
A. Cough .with .vocal .hoarseness
B. Limited .rotation .of .the .left .shoulder
C. Headache .that .resolved .after .breakfast, .but .has .returned
D. Sudden .stabbing .pain .in .the .right .elbow .- .A. .Cough .with .vocal
.hoarseness .Feedback
Patients .diagnosed .with .Marfan .syndrome .are .at .higher .risk .for .aortic .aneurysms. .Changes .in .vocal
.quality .accompanied .by .a .cough .or .dysphagia .(difficulty .swallowing) .may .indicate .that .a .thoracic
.aortic .aneurysm .is .becoming .more .enlarged.
The .nurse .is .assessing .a .74 .year .old .female .patient .who .has .presented .with .the .following
.symptoms: .cool, .clammy .skin; .faint, .irregular .peripheral .pulses, .and .+3 .pitting .edema .in .her
.bilateral .lower .extremities. .Her .partner .tells .the .nurse .the .patient .has .a .history .of .heart .failure .with
.a .recent .LVEF .of .20%, .as .well .as .type .2 .diabetes. .The .patient's .HR .is .132, .BP .is .79/48, .and .blood
.glucose .is .349. .Which .of .the .following .conditions .does .the .nurse .suspect?
A. Cardiogenic .shock
B. Diabetic .ketoacidosis
, C. Fluid .overload
D. Obstructive .shock .- .A. .Cardiogenic
.shock .Feedback
The .nurse .should .identify .that .cardiogenic .shock .is .an .emergency .that .has .extremely .high .mortality
.rates .without .timely .intervention. .The .patient's .history .of .heart .failure .together .with .her .acute
.symptoms .of .weak .pulses, .edema, .and .hypotension .all .point .to .cardiogenic .shock.
The .nurse .is .caring .for .a .patient .with .stage .5 .chronic .kidney .disease .who .normally .receives
.hemodialysis .three .times .a .week .on .Monday, .Wednesday, .and .Friday. .It .is .now .Sunday .and .the
.patient .states .they .have .missed .their .last .two .dialysis .sessions. .The .patient .is .complaining .of
.shortness .of .breath .and .fatigue, .and .their .labs .show .a .creatinine .of .3.9 .and .potassium .of .6.8. .What
.is .the .BEST .treatment .for .this .patient .?
A. 80 .mg .IV .push .furosemide .followed .by .rechecking .the .potassium .level, .with .more .IV
.furosemide .as .needed
B. 15 .g .kayexalate .PO .twice .daily
C. Intravenous .calcium .infusion
D. Urgent .hemodialysis .- .D. .Urgent
.hemodialysis .Feedback
The .nurse .should .recognize .that .dialysis .is .the .best .option .for .this .patient .since .they .are .already .a
.regular .dialysis .patient .and .are .a .likely .candidate .to .receive .urgent .dialysis .due .to .their .missed
.dialysis .sessions, .shortness .of .breath, .and .critical .potassium .level.
A .17-year-old .male .client .is .recovering .from .idiopathic .infective .endocarditis. .The .nurse .should
.include .which .of .the .following .teaching .points .in .the .discharge .care .plan .for .this .client?
A. Taking .prophylactic .antibiotics .before .dental .procedures
B. Drinking .no .more .than .1 .liter .of .fluid .per .day
C. Strictly .avoiding .caffeine .or .other .stimulants
D. Encouraging .a .healthy .low-fat .diet .that .includes .at .least .2 .grams .of .sodium .intake .per .day .- .A.
.Taking .prophylactic .antibiotics .before .dental .procedures
Feedback
