PCCN Questions and Answers (2024) Latest Exam.
Two days following a near-drowning accident, a pt is dyspneic, using accessory muscles, expectorating
large amounts of secretions and reporting feeling of impending death. Changes to the assessment data
include
RR- 24 TO 36
CXR clear to bilateral ...
,PCCN Questions and Answers (2024).
Two days following a near-drowning accident, a pt is dyspneic, using accessory muscles, expectorating
large amounts of secretions and reporting feeling of impending death. Changes to the assessment data
include
RR- 24 TO 36
CXR clear to bilateral diffuse infiltrates
ABG 40% face mask or 100% non-rebreather mask
pO2 120 mm Hg to 56 mm Hg
pCO2 33 mmHg to 56 mmHg
pH 7.42 to 7.35
HCO3 24 meq/L to 27 mEq/L
Which of the ff do these changes most likely represent
A. aspiration pneumonia
B. pulmonary embolism
C. interstitial pneumonitis
D. ARDS correct answerD. The onset of symptoms occured within 48 hours of the incident. THe bilateral
diffuse infiltrates and ABG results indicating hypoxemia and CO2 retention are all consistent with ARDS.
Aspiration pneumonia should include hypoxxemia, respiratory alkalosis. The CXR results would reveal an
area of opacity with aspiration pneumonia rather than diffuse infiltrates.
Interstitial lung disease invlolves an inflammation of supportive tissue between the air sacs rather than
inflammation in the air sacs themselves. Symptoms would be SOB and a dry cough.
A pt reports chest pain that is sharp, constant, worse when lying down and alleviated with sitting up and
leaning forward. The most likely cause of these findings is
A. ACS
B. pericarditis
C. PE
,D. AAA correct answerB Pericarditis is inflammation of the pericardial sac. The damaged epicardium
becomes rough and inflamed and irritates the pericardium lying adjacent to it, precipitating pericarditis.
Pain is the most common symptom of pericarditis. THe pain is sharp, constant and is alleviated when
sitting up and leaning forward.
A pt tells a nurse, "I don't know how I'm going to pay for this hospitalization." The nurse should
A. arrange a meeting with hospital social services staff
B. Notify the business office so a payment plan can be designed
C. redirect the pt toward meeting psychologic needs
D. give the pt applications for public assistance medical coverage correct answerA. Collaboration with a
social worker is indicated in this case the social worker can assist the pt in identifying ways to address
the financial implications of this hospitalization and help identify methods of payments.
A cardiac pt with with DNR status is being managed medically. The nurse notes a new cough, thick
yellow sputum and a temperature of 101.4 (38.4) Coarse crackles are present in the right upper field.
The nurse should most immediately anticipate
A. blood and sputum cultures followed by a broad spectrum abx
B. mucolytics and judicious IV fluid administration
C. an antyipyretic and conservative management
D. NPO status and encouragement of frequent activity correct answerA. This pt symptoms are consistent
with pneumonia. Management should include abx therapy, oxygen therapy for hypoxemia, mechanical
ventilation if acute respiratory failure develops, fluid management for hydration, nutritional support,
and treatment of associated medical problems and complications.
Which of the ff findings is most indicative of a ruptured aortic aneurysm
A. Back pain
B. bounding peripheral pulses
C. intermittent claudication
D. warm, flushed skin correct answerA. An aneurysm is the localized dilation of an artery. Should an
aneurysm rupture, blood will build up under pressure in the tissues surrounding the aorta, which can
result in acute pain and tenderness in theses areas. This is particularly the case if the aneurysm leaks
from the back of the aorta. Ruptured AAA presents with a classic triad of pain in the flank or back,
hypotension and a pulsatile abdominal mass; however, only about half of the full triad. The pt will
, complain of the pain and may feel cold, sweaty and faint on standing. The pt may also report abdominal
pain. A small percentage may have vomiting
According to recommendations based on research findings, pain assessment should occur
A. based on changes in vital signs
B. only when the pt movements indicate the pt is seeking attention
C. routinely, regardless of physical findings
D. only when the presence of pain can be validated correct answerC. Pain is considered the fifth vital
sign and must be assessed regularly. Presence of physical findings may be part of the comprehensive
assessment of pain. However, physical findings may not be present in all patients with pain
A pt with a tracheostomy requires frequent suctioning for thick sputum, A nurse finds a colleague
instilling saline in the endotracheal tube prior to suctioning. The most appropriate response by the nurse
would be to
A. report the colleague to the charge nurse or manager
B. noted the practice on the pt chart to ensure consistency of suctioning techniques
C. ask the attending physician to review the suctioning policy.
D. collaborate with the colleague to review the evidence about this practice. correct answerD. In
addition to an unappreciable increase in sputum recovery, use of NS adversely affects arterial and global
tissue oxygenation and dislodges bacterial colonies, thus contributing to lower airway contamination.
Other harmful pt outcomes have been reported in the nursing literature, including delays in return to
baseline vital signs, Spo2 and intracranial pressure. Because no solid scientifically based benefits for
routine use of normal saline have been shown, it is highly recommended that this potentially harmful
practice be abandoned. Instead, treatment considerations should center on ways to prevent the
development of thick tenacious secretions. A review of these data should take place with the colleague
to help mitigate continuation of this dangerous practice
Upon admission to the PCU, you screen a pt to determine whether to administer an influenza vaccine.
Which of the following is a contraindication to the vaccine?
A. Guillian-Barre syndrome
B. chronic renal failure
C. COPD
D. cirrhosis correct answerA. Persons who developed Guillain-Barre syndrome after receiving an
influenza vaccine should not receive the influenza vaccine without checking with their provider
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller ProfValentinestudyshop. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $10.99. You're not tied to anything after your purchase.
