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PCCN Good questions and answers (Newest 2024/2025) 100- verified correct answers
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PCCN Good questions and answers (Newest 2024/2025) 100- verified correct answers
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PCCN Goodquestions and
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2024/2025)
100% verified
correct answers
,PCCN questions And answers
Two days following a near-drowning accident, a pt is dyspneic, using accessory
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IImuscles, expectorating large amounts of secretions and reporting feeling of
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IIimpending death. Changes to the assessment data include II II II II II II II
RR- 24 TO 36 II II II
CXR clear to bilateral diffuse infiltrates
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ABG 40% face mask or 100% non-rebreather mask
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pO2 II120 IImm IIHg IIto II56 IImm IIHg pCO2 33 mmHg to II II II
II56 mmHg pH 7.42 to 7.35
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HCO3 24 meq/L to 27 mEq/L II II II II II
Which of the ff do these changes most likely represent
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A. aspiration pneumonia
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B. pulmonary embolism
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C. interstitial pneumonitis
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D. ARDS - D. The onset of symptoms occured within 48 hours of the incident. THe
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IIbilateral diffuse infiltrates and ABG results indicating hypoxemia and CO2 retention
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IIare all consistent with ARDS.
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Aspiration pneumonia should include hypoxxemia, respiratory alkalosis. The CXR
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IIresults would reveal an area of opacity with aspiration pneumonia rather than diffuse
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IIinfiltrates.
Interstitial lung disease invlolves an inflammation of supportive tissue between the air
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IIsacs rather than inflammation in the air sacs themselves. Symptoms would be SOB
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IIand a dry cough. II II II
IIA pt reports chest pain that is sharp, constant, worse when lying down and alleviated
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IIwith sitting up and leaning forward. The most likely cause of these findings is A.
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IIACS
B. pericarditis C.
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IIPE
D. AAA - B Pericarditis is inflammation of the pericardial sac. The damaged
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IIepicardium becomes rough and inflamed and irritates the pericardium lying adjacent IIto
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IIit, precipitating pericarditis. Pain is the most common symptom of pericarditis. THe
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IIpain is sharp, constant and is alleviated when sitting up and leaning forward.
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IIA pt tells a nurse, "I don't know how I'm going to pay for this hospitalization." The
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IInurse should II
A. arrange a meeting with hospital social services staff
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B. Notify the business office so a payment plan can be designed
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, C. redirect the pt toward meeting psychologic needs
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D. give the pt applications for public assistance medical coverage - II IIA. Collaboration
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IIwith a social worker is indicated in this case the social worker can assist the pt in
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IIidentifying ways to address the financial implications of this hospitalization and help
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IIidentify methods of payments. II II II
A cardiac pt with with DNR status is being managed medically. The nurse notes a
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IInew cough, thick yellow sputum and a temperature of 101.4 (38.4) Coarse crackles
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IIare present in the right upper field. The nurse should most immediately anticipate
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A. blood and sputum cultures followed by a broad spectrum abx
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B. mucolytics and judicious IV fluid administration
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C. an antyipyretic and conservative management
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D. NPO status and encouragement of frequent activity - A. This pt symptoms are
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IIconsistent with pneumonia. Management should include abx therapy, oxygen therapy
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IIfor hypoxemia, mechanical ventilation if acute respiratory failure develops, fluid
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IImanagement for hydration, nutritional support, and treatment of associated medical II II II II II II II II II
IIproblems and complications. II II
Which of the ff findings is most indicative of a ruptured aortic aneurysm A.
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IIBack pain II
B. bounding peripheral pulses
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C. intermittent claudication
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D. warm, flushed skin - A. An aneurysm is the localized dilation of an artery. Should
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IIan aneurysm rupture, blood will build up under pressure in the tissues surrounding
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IIthe aorta, which can result in acute pain and tenderness in theses areas. This is
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IIparticularly the case if the aneurysm leaks from the back of the aorta. Ruptured AAA
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IIpresents with a classic triad of pain in the flank or back, hypotension and a pulsatile
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IIabdominal mass; however, only about half of the full triad. The pt will complain of the
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IIpain and may feel cold, sweaty and faint on standing. The pt may also report
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IIabdominal pain. A small percentage may have vomiting II II II II II II II
According to recommendations based on research findings, pain assessment should
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IIoccur
A. based on changes in vital signs
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B. only when the pt movements indicate the pt is seeking attention
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C. routinely, regardless of physical findings
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D. only when the presence of pain can be validated - C. Pain is considered the fifth
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IIvital sign and must be assessed regularly. Presence of physical findings may be part
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IIof the comprehensive assessment of pain. However, physical findings may not be
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IIpresent in all patients with pain II II II II II
II A pt with a tracheostomy requires frequent suctioning for thick sputum, A nurse finds
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II a colleague instilling saline in the endotracheal tube prior to suctioning. The most
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, IIappropriate response by the nurse would be to II II II II II II II
A. report the colleague to the charge nurse or manager
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B. noted the practice on the pt chart to ensure consistency of suctioning techniques
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C. ask the attending physician to review the suctioning policy.
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D. IIcollaborate with the colleague to review the evidence about this IIpractice. - D. In II II II II II II II II II II II II II
IIaddition to an unappreciable increase in sputum recovery, use of NS adversely
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IIaffects arterial and global tissue oxygenation and dislodges bacterial colonies, thus
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IIcontributing to lower airway contamination. Other harmful pt outcomes have been II II II II II II II II II II
IIreported in the nursing literature, including delays in return to baseline vital signs,
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IISpo2 and intracranial pressure. Because no solid scientifically based benefits for
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IIroutine use of normal saline have been shown, it is highly recommended that this
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IIpotentially harmful practice be abandoned. Instead, treatment considerations should
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IIcenter on ways to prevent the development of thick tenacious secretions. A review of
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IIthese data should take place with the colleague to help mitigate continuation of this
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IIdangerous practice II
Upon admission to the PCU, you screen a pt to determine whether to administer an
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IIinfluenza vaccine. Which of the following is a contraindication to the vaccine?
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A. Guillian-Barre syndrome
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B. chronic renal failure
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C. COPD
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D. cirrhosis - A. Persons who developed Guillain-Barre syndrome after receiving an
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IIinfluenza vaccine should not receive the influenza vaccine without checking with their
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IIprovider
Emergency treatment of ventricular dysrhythmias for the pt who has an ICD
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IIpacemaker includes which of the following II II II II II
A. If a pt develops vfib, the nurse should not defibrillate with external paddles
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B. if the ICD is firing correctly and the pt does not have pulse, CPR is not indicated
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C. when preparing for external defibrillation, avoid placing the paddle directly over the
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IIICD pulse generator II II
D. when you need to turn off all functions of the ICD or pacemaker, apply a magnet -
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IIC. Defibrillation has been known to cause malfunction of an ICD or pacemaker. Care
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IIshould be taken to ensure the defibrillation paddle/ pads are applied at least 4-finger
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IIbreaths away from the device. The anterior-lateral and anterior-posterior positions for
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IIpaddle/pad placement are acceptable in a pt with a permanent ICD or pacemaker.
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IIThe pads may also be placed safely away from the ICD with 1 pad at the apex left
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IImid-axillary, 5th ICS., and the other pad right of the sternum just below the clavicle.
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Based on the device implanted and the manufacturer, application of a magnet may
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IIturn device off or reset to the default settings.
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A pt is admitted following mitral valve replacement. Which of the following should
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IImost likely be included in the patent's plan of care
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