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AACN PCCN Certification Exam is intended for nurses who have at least two years of experience in progressive care nursing. Progressive Care Certified Nursing certification exam assesses a nurse’s knowledge and skills related to the care of patients who are moderately ill, but who require more intensive and vigilant monitoring than those in general medical-surgical units. PCCN exam covers a range of topics, including cardiac and pulmonary care, hemodynamics, neurology, renal and endocrine function, and pharmacology.
NEW QUESTION # 131
All of the following are examples of community acquired pneumonia except:
- A. Streptococcus pneumoniae
- B. Hemophilus influenzae
- C. Moraxella catarrhalis
- D. Legionella species
Answer: C
Explanation:
Explanation: All of the following are examples of community acquired pneumonia except Moraxella Catarrhalis, are common causes of community acquired pneumonia (CAP). Moraxella catarrhalis is a Gram-negative, aerobic, oxidase-positive diplococcus that may both colonize and cause respiratory tract-associated infection in humans.
NEW QUESTION # 132
Which of the following statements is true regarding artificial airways?
- A. Following the insertion of a tracheostomy or endotracheal tube, the cuff of the tube is inflated so that the pressure is maintained at less than 25 mm Hg
- B. More nutrition options are available to patients with endotracheal tubes than with tracheostomy tubes
- C. More communication options are available to patients with endotracheal tubes than with tracheostomy tubes
- D. A fenestration is necessary to be able to talk with a tracheostomy tube
Answer: A
Explanation:
Correct answer: Following the insertion of a tracheostomy or endotracheal tube, the cuff of the tube is inflated so that the pressure is maintained at less than 25 mm Hg Cuff pressure is maintained at less than 25 mm Hg; it is inflated with just enough air to create an effective seal. Overinflation can lead to obstruction of the distal airway as well as tracheal ischemia, necrosis, and erosion.
Some tracheostomy tubes have an additional opening along the outer tube cannula which is known as a fenestration. This facilitates vocalization by allowing the upward flow of air through the vocal cords, but it is not necessary to be able to talk with a tracheostomy tube. More communication and nutrition options are available to patients with tracheostomy tubes than with endotracheal tubes.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 110, 111.
NEW QUESTION # 133
All of the following are examples of proton pump inhibitors except:
- A. Aciphex (rabeprazole)
- B. Prilosec (omeprazole)
- C. Protonix (pantoprazole)
- D. Pepcid (Famotidine)
Answer: D
Explanation:
Correct answer: Pepcid (Famotidine)
Famotidine is a histamine blocker, not a proton pump inhibitor.
Protonix (pantoprazole)-IV, Prilosec (omeprazole), and Aciphex (rabeprazole) are proton pump inhibitors. Proton-pump inhibitors (PPIs) are the medication of choice for managing patients with non- variceal bleeding. The use of these drugs is especially helpful in patients who have had
H. pylori infection or who use nonsteroidal anti-inflammatory drugs.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 346-347.
NEW QUESTION # 134
Which of the following is the most widely-used opioid and is the gold standard against which other opioids are compared?
- A. Fentanyl
- B. Morphine sulfate
- C. Hydromorphone
- D. Dilaudid
Answer: B
Explanation:
Correct answer: Morphine sulfate
Morphine is the most widely-used opioid; it is the gold standard against which other opioids are compared. Other opioids commonly used in the care of the acutely ill include hydromorphone (Dilaudid) and fentanyl (Sublimaze).
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 147.
NEW QUESTION # 135
The nurse is assigned to administer insulin to a female client with diabetes mellitus II. Before administering the insulin, the nurse disinfects the area with alcohol and let it dry for:
- A. 15 seconds
- B. 30 seconds
- C. 10 seconds
- D. 60 seconds
Answer: D
Explanation:
Explanation: The nurse should let the disinfectant to dry for 1 minute or 60 seconds before giving the insulin. Administering the drug earlier allows the disinfectant to enter the tissues, increasing the risk for skin irritation.
NEW QUESTION # 136
To ensure consistency in QT-interval monitoring, a single method should be used by all practitioners who are responsible for cardiac monitoring. Each facility should have a protocol in place that defines this specific method of QT-interval monitoring and includes all of the following except:
- A. Defines the equipment to be used (manual or electronic)
- B. The method for determining the end of the Q wave
- C. Criteria for lead selection
- D. The formula for heart rate correction
Answer: B
Explanation:
Correct answer: The method for determining the end of the Q wave
The method for determined the end of the T wave, not the Q wave, needs to be consistent among all practitioners. Each facility should also require that whichever lead is chosen should be used for serial measurements in the same patient.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 443.
NEW QUESTION # 137
The term "Improving in the Outcomes evaluation" means:
- A. treatment with a different method
- B. careful observation
- C. reviewing records
- D. continuing treatments with additions or modifications
Answer: D
Explanation:
Explanation: Improving in the Outcomes Evaluation means continuing treatments with additions and modifications. Outcomes evaluation is a very important component of evidence based practice. It involves with both internal and external research.
NEW QUESTION # 138
When providing education and information in the progressive care unit, repetition of information is necessary because:
- A. Hospitalists often provide information to the patients that conflicts with what they have been told by their general practitioners
- B. Stress and the progressive care environment can alter comprehension
- C. In the progressive care unit, there is limited time allowed for the patient or family to ask questions
- D. All patients in the progressive care unit are heavily medicated
Answer: B
Explanation:
Correct answer: Stress and the progressive care environment can alter comprehension Repetition of information is necessary due to the stress and the progressive care environment which can alter comprehension.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 27.
NEW QUESTION # 139
Which of the following is an antiarrhythmic medication with a class IIa recommendation for pharmacological cardioversion of atrial fibrillation?
- A. Propafenone
- B. Amiodarone
- C. Ibutilide
- D. Flecainide
Answer: B
Explanation:
Correct answer: Amiodarone
Amiodarone has a class IIa recommendation in the pharmacological cardioversion of atrial fibrillation (benefit > > risk).
Ibutilide, propafenone, and flecainide are antiarrhythmics used in the pharmacological cardioversion of atrial fibrillation and carry a class I recommendation (benefit > > > risk).
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 51-52.
NEW QUESTION # 140
A nurse is assigned to monitor a client who had a thoracentesis of the left lung 1 hour ago. The nurse would maintain the client in which position?
- A. Right-side lying position
- B. Left-sided lying position
- C. Semi-Fowler's position
- D. Supine position
Answer: A
Explanation:
Explanation: After the procedure, the nurse should maintain the client on the unaffected side.
Thoracentesis is done in the left lung, so the client has to be maintained in the right side-lying position.
The other options are not correct.
NEW QUESTION # 141
A 50-year-old man presents with frequent pain during rest periods. The pain lasts for a long time and may radiate to his left upper limb and jaw. He also complains of sweating and shortness of breath with this episode of pain. The pain increases with the passage of time and does not settle with the usual dose of nitroglycerine. Which of the following conditions is responsible for it?
- A. Myocarditis
- B. Unstable angina
- C. Stable angina
- D. Pericarditis
Answer: B
Explanation:
Explanation: The condition responsible for the pain that occurs frequently even during rest and lasts for at least more than five minutes is unstable angina. No vasodilator has a significant role in reducing this pain. It occurs during times of rest because the very cause of unstable angina is a rupture of the plaque which occurs even during rest periods.
NEW QUESTION # 142
Which one of the following laboratory pictures is true for disseminated intravascular coagulation (DIC)?
- A. All of the above
- B. Decreased platelet counts and fragmented RBCs
- C. Prolonged prothrombin and partial prothrombin times
- D. Decreased fibrinogen
Answer: A
Explanation:
Explanation: All of the above are true for disseminated intravascular coagulation (DIC). Disseminated intravascular coagulation is a secondary disorder which has different reasons such as any trauma, congenital heart disease, necrotizing enterocolitis, sepsis, and severe viral infections. Its onset is rapid.
All the laboratory pictures listed are true for DIC.
NEW QUESTION # 143
Signs and symptoms specific to acute methanol intoxication include which of the following?
- A. Metabolic acidosis, visual disturbances
- B. Areflexia, gastrointestinal distress
- C. Hypothermia, hypotension, respiratory distress
- D. Pulmonary edema, cardiopulmonary complications
Answer: A
Explanation:
Correct answer: Metabolic acidosis, visual disturbances
The excess ingestion of any type of alcohol may lead to central nervous system symptoms, but there are differences in the way the different types of alcohol intoxication affect patients. Methanol intoxication generates the metabolites formic acid and formaldehyde which cause optic nerve damage and damage to the central nervous system.
Ethylene glycol intoxication leads to pulmonary edema and cardiopulmonary complications, as well as renal tubular degeneration. Hypothermia, hypotension, respiratory distress, areflexia, and gastrointestinal distress are all signs and symptoms that are specific to isopropyl alcohol intoxication.
Reference:
Burns, SuzanneM. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 284.
NEW QUESTION # 144
The nurse is creating a meal plan for a client who is a member of Judaism. The nurse should keep in mind which of the following dietary practices when caring for the client?
- A. Fish with scales and fins are not allowed
- B. Any food in which blood has been is not included in the menu
- C. Milk and meat are not served in one meal
- D. Coffee and tea are prohibited
Answer: C
Explanation:
Explanation: According to Kosher laws, meats are allowed as long as they are not given with milk on the same meal. Fish with scales and fins are allowed. Option A is a dietary practice of Seventh Day Adventists and option B is the dietary practice of Jehovah's Witnesses.
NEW QUESTION # 145
The framework of principle-based ethics is one of the most influential perspectives in biomedical ethics today. Inherent in this viewpoint, is the belief that four basic principles and derivative rules are binding, but not absolute, and define the essence of ethical obligations in human society. Which of the following is included in the derivative rules?
- A. Justice
- B. Beneficence
- C. Privacy
- D. Nonmaleficence
Answer: C
Explanation:
Correct answer: Privacy
The primary principles outlined by the principle-based approach to ethics are:
* Respect for persons (autonomy)
* Nonmaleficence
* Justice
* Beneficence
The derivative rules or imperatives include:
* Privacy
* Confidentiality
* Fidelity
* Veracity
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 194.
NEW QUESTION # 146
A young man presented to surgical emergency with a gunshot wound in chest and is in respiratory distress. On examination, chest is dull on percussion and absent on auscultation. Patient is bleeding profusely. What has happened to him?
- A. Thoracic hemothorax with pneumothorax
- B. Pneumothorax
- C. Thoracic hemothorax
- D. Atelectasis
Answer: A
Explanation:
Explanation: The patient has t horacic hemothorax with pneumothorax. The patient, presenting with a gunshot wound and is in respiratory distress has Thoracic Hemothorax with Pneumothorax, since he is bleeding profusely and his chest is dull on percussion and absent on auscultation. In gunshot wounds, there are more chances of Hemothorax with underlying Pneumothorax.
NEW QUESTION # 147
A comatose patient on the progressive care unit has a durable power of attorney for health care which indicates that both her adult son and daughter are assigned to make decisions in her place. These two adult children support opposing courses of treatment for their mother, making it unclear which course of action should be taken. Which type of ethical problem is this an example of?
- A. Allocation of resources
- B. Ethical dilemma
- C. Moral distress
- D. Locus of authority
Answer: D
Explanation:
Correct answer: Locus of authority
In locus of authority situations, two or more individuals have a claim to the role of decision-maker but do not agree on the course of action.
In cases of allocation of resources, a decision is required as to how a finite supply of goods or resources should be distributed across a group of people. In cases of moral distress, the moral agent knows the right action to take but is unable to take that action. In an ethical dilemma, the moral agent identifies two opposing but equally justifiable courses of action.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 193.
NEW QUESTION # 148
A 25-year-old patient presented to surgical OPD. Acute appendicitis was the likely diagnosis. Which other disease can mimic acute appendicitis among the following?
- A. Acute flare up of Crohn's disease
- B. Acute cholecystitis
- C. Acute pancreatitis
- D. Ulcerative colitis
Answer: A
Explanation:
Explanation: Acute flare up of Crohn's disease can mimic acute appendicitis. Crohn's disease is usually a chronic disorder which manifests itself with the inflammation of the gastrointestinal system. Common sites of inflammation are terminal ileum or cecum. However, acute flare up may mimic acute appendicitis.
NEW QUESTION # 149
The framework of principle-based ethics is one of the most influential perspectives in biomedical ethics today. Inherent in this viewpoint, is the belief that four basic principles and derivative rules are binding, but not absolute, and define the essence of ethical obligations in human society. The four basic principles used in principle-based ethics are:
- A. Respect for persons (autonomy), nonmaleficence, fidelity, beneficence
- B. Respect for persons (autonomy), nonmaleficence, justice, beneficence
- C. Respect for persons (autonomy), fidelity, justice, veracity
- D. Respect for persons (autonomy), fidelity, justice, beneficence
Answer: B
Explanation:
Correct answer: Respect for persons (autonomy), nonmaleficence, justice, beneficence The primary principles outlined by the principle-based approach to ethics are:
* Respect for persons (autonomy)
* Nonmaleficence
* Justice
* Beneficence
The derivative rules or imperatives include:
* Privacy
* Confidentiality
* Fidelity
* Veracity
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 194.
NEW QUESTION # 150
A patient is diagnosed with hypoglycemia due to injudicious insulin use and is out of hospital setting.
What will you do to alleviate the symptoms of patient right there?
- A. None of the above
- B. Wait for dextrose water drip to be arranged
- C. Give a glass of water with sufficient sugar in it
- D. Give him a glass of plain water
Answer: C
Explanation:
Explanation: If patient is confirmed to be hypoglycemic due to injudicious insulin use and is away from hospital setting, then it is always recommended to give him some sugar right at that time so that brain damage is avoided.
NEW QUESTION # 151
Which of the following statements is true related to electrocardiography (ECG)?
- A. On the calibrated graph paper used for electrocardiogram tracing, each small box on the vertical axis measures 1 mm and is equal to 1 mV
- B. On the calibrated graph paper used for electrocardiogram tracing, the horizontal axis measures voltage and also represents mm of ST segment deviation
- C. On the calibrated graph paper used for electrocardiogram tracing, the horizontal axis measures time and the vertical axis measures voltage
- D. On the calibrated graph paper used for electrocardiogram tracing, each small box on the horizontal axis is equal to 0.5 mV
Answer: C
Explanation:
Correct answer: On the calibrated graph paper used for electrocardiogram tracing, the horizontal axis measures time and the vertical axis measures voltage On the horizontal axis, which measures time, each small box is equal to 0.04 seconds, and each large box is equal to 0.20 second. On the vertical axis, which measures voltage, each small box measures 1 mm and is equal to 0.1 mV; one large box is equal to 5 mm or 5 mV. The vertical axis also represents mm of ST segment deviation.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 40.
NEW QUESTION # 152
Interventions to help prevent disagreement between staff and family perspectives about the type or priorities of family needs include all of the following except:
- A. Establishing methods to contact and communicate with the patient's family
- B. Identification of a family spokesman or contact person
- C. Relying on nurses to fulfill all family needs
- D. Providing information according to family needs
Answer: C
Explanation:
Correct answer: Relying on nurses to fulfill all family needs
Families need support in maintaining their strength and having needs met to be able to function as a positive influence for the patient rather than having a negative impact. However, relying on nurses to fulfill all family needs while caring for patients creates tension and frustration. Hospital resources must also be utilized and the family can also be assessed for resources they have which can be maximized.
Interventions to help prevent disagreement between staff and family perspectives about the type or priorities of family needs include: Establishing methods to contact and communicate with the patient's family, identification of a family spokesman or contact person, and providing information according to family needs.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 29.
NEW QUESTION # 153
Which of the following is a cardiac hormone that regulates cardiovascular homeostasis and fluid volume during states of volume and pressure overload?
- A. Hydralazine
- B. Nitroprusside
- C. Nesiritide
- D. Octreotide
Answer: C
Explanation:
Correct answer: Nesiritide
Nesiritide is a recombinant human b-type natriuretic peptide, which is a cardiac hormone that regulates cardiovascular homeostasis and fluid volume during states of volume and pressure overload.
Sodium nitroprusside is a vasodilator that affects both the venous and arterial systems; hydralazine is an arterial vasodilating agent; octreotide is the synthetic analog of somatostatin.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 171-172, 181.
NEW QUESTION # 154
The nurse is caring for a 59-year-old male client with a known case of chronic obstructive pulmonary disease. The client had an appendectomy a day before. Which of the following is a priority intervention in preventing respiratory complications?
- A. Have the client perform deep breathing exercises every morning and before sleeping
- B. Maintain the flow of oxygen at 4 to 5 L at all times
- C. Ensure that hourly nebulization is done
- D. Help client to turn to sides every 2 hours and ambulate around the room
Answer: D
Explanation:
Explanation: Hypostatic pneumonia is a dangerous complication of surgery. Frequent turning and early ambulation ensure that secretions do not pool in the lungs. Administering oxygen does not prevent respiratory complications. Option C is incorrect. The client should perform this exercise at least once every hour. Option D is unnecessary unless the condition has worsened.
NEW QUESTION # 155
The 6-minute-walk test is used in the diagnosis of:
- A. Interstitial lung disease
- B. Chronic obstructive lung disease
- C. Asthma
- D. Pulmonary arterial hypertension
Answer: D
Explanation:
Correct answer: Pulmonary arterial hypertension
The 6-minute-walk test is a measurement of distance used to monitor exercise tolerance, response to therapy and disease progression in pulmonary arterial hypertension.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 266.
NEW QUESTION # 156
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The PCCN exam is a computer-based exam that consists of 125 multiple-choice questions. It is a three-hour exam that covers a variety of topics, including cardiovascular, pulmonary, neurology, gastrointestinal, renal, endocrine, hematology, and multisystem issues. PCCN exam also evaluates the nurse's knowledge of patient safety, ethical and legal issues, and healthcare delivery systems.
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