Page 1 of 85
PCCN-K ADULT
PROGRESSIVE CARE CERTIFICATION
|ADULT CCRN| PCCN CERTIFICATION
PRACTICE TEST PCCN EXAM QUESTIONS
AND ANSWERS
Which of the following will most likely confirm the patient's diagnosis?
A. Pulmonary radioisotope scan
B. Echocardiogram
C. Cardiac enzyme studies
D. Chest x-ray and arterial blood gases -- ANSWER--A. Pulmonary radioisotope scan
The nursing staff does not wish to be assigned a difficult patient who continues to
demonstrate disorderly behavior. Which of the following is an acceptable solution?
A. Request the family control the patient's behavior.
B. Transfer the patient
C. The patient assignment should be decided by the Charge Nurse.
D. Alternate the patient assignment among the nursing staff. -- ANSWER--D. Alternate
the patient assignment among the nursing staff.
,Page 2 of 85
A patient who is 72 hours postoperative repair of a bowel obstruction suddenly demonstrates
shortness of breath and his respiratory rate increases from 22 to 45/min. His SpO2 went from
95% to 88% acutely. An arterial blood gas sample obtained while the patient is receiving
oxygen via a nasal cannula at 6L/min reveals the following results:
pH 7.40 pCO2 27 pO2 50
A chest x-ray is obtained and a "ground-glass-like appearance" is reported. Auscultation of
the lungs reveals diffuse crackles that were not present previously.
The findings described above should lead the nurse to believe that the patient has:
A. Acute respiratory distress syndrome
B. A pulmonary embolus
C. A spontaneous pneumothorax
D. Aspiration pneumonia -- ANSWER--A. Acute respiratory distress syndrome
A patient who is 72 hours postoperative repair of a bowel obstruction suddenly demonstrates
shortness of breath and his respiratory rate increases from 22 to 45/min. His SpO2 went from
95% to 88% acutely. An arterial blood gas sample obtained while the patient is receiving
oxygen via a nasal cannula at 6L/min reveals the following results:
pH 7.40 pCO2 27 pO2 50
A chest x-ray is obtained and a "ground-glass-like appearance" is reported. Auscultation of
the lungs reveals diffuse crackles that were not present previously.
On admission, your patient's arterial blood gas on room air is: pH 7.23, PaCO2 55, PaO2 90,
HCO3 30. The correct arterial blood gas interpretation is:
A. Uncompensated metabolic acidosis
,Page 3 of 85
B. Uncompensated respiratory alkalosis
C. Uncompensated respiratory acidosis
D. Uncompensated metabolic alkalosis -- ANSWER--C. Uncompensated respiratory
acidosis
A 55 y/o steroid dependent woman with rheumatoid arthritis undergoes a CABG x 4. She was
doing well in the ICU 1 day post op, but then has a run of V-Tach and V-Fibrillation. The
nurse recognizes this may be due to the following:
A. Reperfusion after CABG
B. Reocclusion after CABG
C. Acute adrenal crisis from being off her medications preoperatively
D. Hypervolemia and hypokalemia -- ANSWER--C. Acute adrenal crisis from being off
her medications preoperatively
A 68 y/o male had a AAA repair 3 days ago but is now in renal failure. The nurse
understands the likely causes for this may be:
A. Post renal kidney stone obstruction
B. Malignant hyperthermia
C. Rhabdomyolysis
D. Acute tubular necrosis due to aortic cross clamping for longer than 30 minutes in
surgery. -- ANSWER--D. Acute tubular necrosis due to aortic cross clamping for longer than
30 minutes in surgery.
Rationale: Kidney stones, malignant hyperthermia, and rhabdomyolysis are not results of a
AAA surgical procedure specifically.
, Page 4 of 85
A 72 y/o man is in the ICU for chronic renal failure. What electrolyte abnormalities would
the nurse watch for?
A. Decreased BUN and Creatinine from diseased kidneys
B. High pH and alkalosis
C. Hyperkalemia
D. Thrombocytopenia -- ANSWER--C. Hyperkalemia
The nurse is providing care for a patient with pyelonephritis. What treatment is appropriate
for this patient?
A. Restrict oral and IV fluids to prevent renal failure
B. 2 L hypertonic solution with magnesium rider
C. 2 Grams Ceftriaxone
D. Prepare patient for emergent dialysis -- ANSWER--C. 2 Grams Ceftriaxone
Rationale: Appropriate therapy for pyelonephritis includes: Give 2 L of IV fluid, Give 2
Tylenol #3 or similar pain control. Give 2 gm ceftriaxone. If the patient can tolerate two
glasses of water and fever decreases by 2 degrees: Trimethoprim/Sulfamethoxazole
(TMP/SMX) double-strength BID for two weeks; follow-up in two days for progress check.
Toxic Shock, Myxedema coma, and Addisonian Crisis are all types of what type of shock?
A. Neurogenic
PCCN-K ADULT
PROGRESSIVE CARE CERTIFICATION
|ADULT CCRN| PCCN CERTIFICATION
PRACTICE TEST PCCN EXAM QUESTIONS
AND ANSWERS
Which of the following will most likely confirm the patient's diagnosis?
A. Pulmonary radioisotope scan
B. Echocardiogram
C. Cardiac enzyme studies
D. Chest x-ray and arterial blood gases -- ANSWER--A. Pulmonary radioisotope scan
The nursing staff does not wish to be assigned a difficult patient who continues to
demonstrate disorderly behavior. Which of the following is an acceptable solution?
A. Request the family control the patient's behavior.
B. Transfer the patient
C. The patient assignment should be decided by the Charge Nurse.
D. Alternate the patient assignment among the nursing staff. -- ANSWER--D. Alternate
the patient assignment among the nursing staff.
,Page 2 of 85
A patient who is 72 hours postoperative repair of a bowel obstruction suddenly demonstrates
shortness of breath and his respiratory rate increases from 22 to 45/min. His SpO2 went from
95% to 88% acutely. An arterial blood gas sample obtained while the patient is receiving
oxygen via a nasal cannula at 6L/min reveals the following results:
pH 7.40 pCO2 27 pO2 50
A chest x-ray is obtained and a "ground-glass-like appearance" is reported. Auscultation of
the lungs reveals diffuse crackles that were not present previously.
The findings described above should lead the nurse to believe that the patient has:
A. Acute respiratory distress syndrome
B. A pulmonary embolus
C. A spontaneous pneumothorax
D. Aspiration pneumonia -- ANSWER--A. Acute respiratory distress syndrome
A patient who is 72 hours postoperative repair of a bowel obstruction suddenly demonstrates
shortness of breath and his respiratory rate increases from 22 to 45/min. His SpO2 went from
95% to 88% acutely. An arterial blood gas sample obtained while the patient is receiving
oxygen via a nasal cannula at 6L/min reveals the following results:
pH 7.40 pCO2 27 pO2 50
A chest x-ray is obtained and a "ground-glass-like appearance" is reported. Auscultation of
the lungs reveals diffuse crackles that were not present previously.
On admission, your patient's arterial blood gas on room air is: pH 7.23, PaCO2 55, PaO2 90,
HCO3 30. The correct arterial blood gas interpretation is:
A. Uncompensated metabolic acidosis
,Page 3 of 85
B. Uncompensated respiratory alkalosis
C. Uncompensated respiratory acidosis
D. Uncompensated metabolic alkalosis -- ANSWER--C. Uncompensated respiratory
acidosis
A 55 y/o steroid dependent woman with rheumatoid arthritis undergoes a CABG x 4. She was
doing well in the ICU 1 day post op, but then has a run of V-Tach and V-Fibrillation. The
nurse recognizes this may be due to the following:
A. Reperfusion after CABG
B. Reocclusion after CABG
C. Acute adrenal crisis from being off her medications preoperatively
D. Hypervolemia and hypokalemia -- ANSWER--C. Acute adrenal crisis from being off
her medications preoperatively
A 68 y/o male had a AAA repair 3 days ago but is now in renal failure. The nurse
understands the likely causes for this may be:
A. Post renal kidney stone obstruction
B. Malignant hyperthermia
C. Rhabdomyolysis
D. Acute tubular necrosis due to aortic cross clamping for longer than 30 minutes in
surgery. -- ANSWER--D. Acute tubular necrosis due to aortic cross clamping for longer than
30 minutes in surgery.
Rationale: Kidney stones, malignant hyperthermia, and rhabdomyolysis are not results of a
AAA surgical procedure specifically.
, Page 4 of 85
A 72 y/o man is in the ICU for chronic renal failure. What electrolyte abnormalities would
the nurse watch for?
A. Decreased BUN and Creatinine from diseased kidneys
B. High pH and alkalosis
C. Hyperkalemia
D. Thrombocytopenia -- ANSWER--C. Hyperkalemia
The nurse is providing care for a patient with pyelonephritis. What treatment is appropriate
for this patient?
A. Restrict oral and IV fluids to prevent renal failure
B. 2 L hypertonic solution with magnesium rider
C. 2 Grams Ceftriaxone
D. Prepare patient for emergent dialysis -- ANSWER--C. 2 Grams Ceftriaxone
Rationale: Appropriate therapy for pyelonephritis includes: Give 2 L of IV fluid, Give 2
Tylenol #3 or similar pain control. Give 2 gm ceftriaxone. If the patient can tolerate two
glasses of water and fever decreases by 2 degrees: Trimethoprim/Sulfamethoxazole
(TMP/SMX) double-strength BID for two weeks; follow-up in two days for progress check.
Toxic Shock, Myxedema coma, and Addisonian Crisis are all types of what type of shock?
A. Neurogenic
