[2023] Pass AACN PCCN Exam in First Attempt Easily
The Most Efficient PCCN Pdf Dumps For Assured Success
The American Association of Critical-Care Nurses (AACN) offers various certification exams for nurses to demonstrate their expertise and proficiency in specialized fields of nursing. One of these certifications is the Progressive Care Certified Nursing (PCCN) exam, which is designed for nurses who care for acutely ill adult patients in progressive care units, telemetry, step-down, transitional care, or emergency departments.
The PCCN exam consists of 125 multiple-choice questions and is designed to test the nurse's knowledge in the areas of cardiovascular, pulmonary, renal, gastrointestinal, endocrine, hematologic, neurologic, multisystem, and behavioral health. In order to be eligible to take the exam, nurses must have a current, active RN license and at least two years of experience working in a PCU or similar environment. Nurses who pass the PCCN exam demonstrate a high level of expertise in caring for acutely ill patients and have proven their ability to provide safe and effective care in a fast-paced, high-stress environment.
NEW QUESTION # 285
Clinical situations that decrease the accuracy of pulse oximetry for assessing oxygen status include:
- A. Nail polish applications, movement of the sensor, hyperthermia
- B. Hypotension, vasoconstriction, hypothermia
- C. Vasoconstriction, hypertension, nail polish application
- D. Vasoactive drugs, hypertension, low cardiac output
Answer: B
Explanation:
Correct answer: Hypotension, vasoconstriction, hypothermia
Clinical situations that decrease the accuracy of pulse oximetry include:
* Hypotension
* Low cardiac output states
* Vasoconstriction or vasoactive drugs
* Hypothermia
* Poor skin adherence or movement of the sensor
* Direct exposure to ambient light
* Certain nail polish applications and treatments
* Venous pulsation
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 105-106.
NEW QUESTION # 286
The most common cause of cardiogenic shock is:
- A. Ventricular rupture
- B. Myocardial contusion
- C. Coronary artery disease
- D. Pericardial tamponade
Answer: C
Explanation:
Correct answer: Coronary artery disease
The most common cause of cardiogenic shock is coronary artery disease.
The causes of cardiogenic shock are often categorized as either coronary or non-coronary. Non-coronary causes of cardiogenic shock include conditions such as myocardial contusion, pericardial tamponade, ventricular rupture, arrhythmia (pulseless electrical activity) cardiomyopathies, and end-stage heart failure.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 235-236.
NEW QUESTION # 287
If a patient does not respond meaningfully to the examiner without the need for stimulation, which of the following are used first in assessing level of consciousness?
- A. Tactile stimuli
- B. Traumatic stimuli
- C. Painful stimuli
- D. Auditory stimuli
Answer: D
Explanation:
Correct answer: Auditory stimuli
Auditory stimuli are used first if a patient does not respond meaningfully to an examiner without the need for stimulation. If the patient does not rouse to auditory stimuli, tactile stimuli such a gentle touch or shake or used, followed by painful stimuli if necessary to elicit a response.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 297-298.
NEW QUESTION # 288
A 55-year-old type 2 diabetic with severe dementia was started on insulin during her stay in the progressive care unit. She will be discharged with orders for blood glucose monitoring and sliding scale insulin. The patient has a 24-hour a day live-in caregiver who has assisted with her oral medications in the past and who has visited the patient daily in the hospital. One daughter, who is the patient's power of attorney, lives out-of-state and has visited only one time during the patient's five-day stay in the hospital. She is leaving today. Home care nursing has been arranged to provide care for the patient at home following discharge.
Who is it essential for the nurse to include in instructions related to glucose testing and insulin administration?
- A. No instructions need to be given since the patient will be receiving home care nursing services
- B. The patient
- C. The in-home care giver
- D. The power of attorney
Answer: C
Explanation:
Correct answer: The in-home caregiver
Teaching strategies need to be planned carefully. When planning for education, assessment of the patient, the nature and severity of the patient's illness, the availability of significant others, and existing environmental barriers need to be assessed.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 15, 20.
NEW QUESTION # 289
The longer-acting synthetic analog of somatostatin which produces the same results as vasopressin in the control of acute variceal bleeding, but with significantly fewer adverse effects is:
- A. Propranolol
- B. Octreotide
- C. Ibutilide
- D. Pantoprazole
Answer: B
Explanation:
Correct answer: Octreotide
Octreotide is a longer-acting synthetic analog of somatostatin. It reduces splanchnic blood flow and has a modest effect on hepatic blood flow with little effect on systemic circulation. Although it produces the same results as vasopressin in the control of bleeding and transfusion requirements, octreotide produces significantly fewer adverse effects and has been shown to be as effective as injection sclerotherapy in control of variceal hemorrhage.
Propranolol is a beta blocker that treats high blood pressure, angina (chest pain), irregular heartbeat, migraine headaches, tremors, and lowers the risk of repeated heart attacks.
Pantoprazole is a proton pump inhibitor (PPI) that treats gastroesophageal reflux disease (GERD) and damage to the esophagus. It also treats high levels of acid in the stomach caused by a tumor (such as Zollinger-Ellison syndrome).
Ibutilide is an antiarrhythmic that is indicated for conversion of recent-onset atrial fib and atrial flutter to normal sinus rhythm. It is associated with minimal hemodynamic effects and has not been shown to worsen heart failure or to lower blood pressure.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 175, 181-182.
NEW QUESTION # 290
Which of the following statements related to epidural analgesia is true?
- A. Higher infusion rates of local anesthetic-containing solutions increase the density of the epidural blockade
- B. The risk of respiratory depression is greater with the administration of epidural opioids than with IV administration
- C. When administered in combination, epidural opioids and local anesthetics work synergistically. Less of each agent is needed to produce analgesia.
- D. Higher local anesthetic concentrations result in an increased spread of the epidural blockade
Answer: C
Explanation:
Correct answer: When administered in combination, epidural opioids and local anesthetics work synergistically. Less of each agent is needed to produce analgesia.
Epidural opioids can be combined with dilute concentrations of local anesthetics (LAs) to achieve analgesia. Opioids which are administered epidurally work in the dorsal horn of the spinal cord, and epidural LAs primarily block the conduction of afferent sensory fibers at the dorsal nerve root.
Higher infusion rates of local anesthetic-containing solutions increase the spread of the blockade; whereas higher LA concentrations result in an increased density of the blockade. Epidural opioids were once feared to be linked to an increased risk of respiratory depression but clinical studies have not confirmed this.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 151.
NEW QUESTION # 291
This medication is a calcium channel blocker indicated for the treatment of hypertension. Its onset is 2 minutes faster than nicardipine.
- A. Procainamide
- B. Clonidine
- C. Clevidipine
- D. Amiodarone
Answer: C
Explanation:
Correct answer: Clevidipine
Clevidipine is an IV calcium channel blocker that is also indicated for the treatment of hypertension.
While its onset is 2 minutes faster than nicardipine, its duration is shorter.
Clonidine is a central sympatholytic agent and is typically used orally in maintenance therapy of hypertension. Procainamide and amiodarone are antiarrhythmics.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 171-172.
NEW QUESTION # 292
Of the following, which is the most important indicator of elevated intracranial pressure?
- A. Changes in vital signs
- B. Pupillary changes
- C. Abnormal posturing
- D. Change in level of consciousness
Answer: D
Explanation:
Correct answer: Change in level of consciousness
Early signs of increased intracranial pressure (ICP) include restlessness, confusion, lethargy, disorientation, nausea and/or vomiting, headache, and visual abnormalities. The most important indicator of elevated ICP is change in level of consciousness.
Patients with increased ICP may develop motor deficits and changes in vital signs may occur. An increase in systolic blood pressure may occur as the body attempts to maintain cerebral perfusion. Pupillary changes are most often a late sign of elevated ICP. Abnormal posturing is also an ominous sign.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 310.
NEW QUESTION # 293
The following statements regarding Brugada syndrome are true, except:
- A. It typically manifests in the third or fourth decade of life
- B. It occurs most often in women
- C. It is seen worldwide but is most prevalent in Southeast Asia
- D. The mainstay of therapy for the condition is an implantable cardioverter defibrillator
Answer: B
Explanation:
Correct answer: It occurs most often in women
Brugada syndrome occurs most often in men (8:1 male to female ratio). Quinidine is the only drug that has been shown to be effective in preventing ventricular arrhythmias in patients with Brugada syndrome.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 442-443.
NEW QUESTION # 294
Common offenders in causing diarrhea in enterally-fed patients include:
- A. Acetaminophen elixir and aluminum-containing antacids
- B. Lactulose and sucralfate
- C. Acetaminophen and guaifenesin elixir
- D. Guaifenesin and aluminum-containing antacids
Answer: C
Explanation:
Correct answer: Acetaminophen and guaifenesin elixir
Common offenders in causing diarrhea in enterally-fed patients include acetaminophen and guaifenesin elixir.
Aluminum-containing antacids and sucralfate are not likely to cause diarrhea and are more prone to cause constipation.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 181, 366.
NEW QUESTION # 295
All of the following statements related to clevidipine are true except:
- A. The maximum recommended dose of clevidipine is 32 mg/hour
- B. Continuous infusion dose is 1 to 2 mg/hour, increased by doubling dose every 90-second intervals initially to achieve blood pressure reduction
- C. Vials of clevidipine and IV tubing must be changed every 12 hours during therapy
- D. The oral dose is typically used as maintenance hypertension therapy
Answer: D
Explanation:
Correct answer: The oral dose is typically used as maintenance hypertension therapy Clevidipine is an IV calcium channel blocker that is also indicated for the treatment of hypertension. It is not available in an oral dosage form.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 174.
NEW QUESTION # 296
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 # 297
An 85-year-old female patient, Ann, was admitted to the progressive care unit from a nursing home three days ago. She has a severely painful stage IV pressure ulcer and has been diagnosed with sepsis.
Ann is confused and frequently cries for "Fred." No family has been to visit. She has no advance directives. At 2 am, while the nurse is changing Ann's gown, she becomes unresponsive and stops breathing.
The correct action for the nurse to take is to:
- A. Initiate CPR
- B. Call Ann's physician to obtain a Do Not Resuscitate order
- C. Make Ann comfortable and do nothing, as she had no advance directive
- D. Run a "slow" code
Answer: A
Explanation:
Correct answer: Initiate CPR
Since the patient has no advance directive, the presumption exists that, unless stated otherwise, resuscitation efforts will be started immediately upon cardiopulmonary arrest. Appropriate discussions with the patient or surrogate must occur before a resuscitation decision is made. When CPR status is not addressed or the decision is not documented or communicated, then a code is initiated, risking the provision of unwanted care.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 204-205.
NEW QUESTION # 298
As a result of which of the following, when hemoglobin becomes desaturated with oxygen, the affinity for carbon dioxide increases. The administration of oxygen then displaces carbon dioxide on hemoglobin and increases carbon dioxide levels in the plasma:
- A. The Haldane effect
- B. Decreased minute ventilation
- C. Hypoxic vasoconstriction
- D. The Bohr effect
Answer: A
Explanation:
Correct answer: The Haldane effect
As a result of the Haldane effect, when hemoglobin becomes desaturated with oxygen, the affinity for carbon dioxide increases. The administration of oxygen then displaces carbon dioxide on hemoglobin and increases carbon dioxide levels in the plasma. Patients with COPD are unable to increase minute ventilation or "blow off" carbon dioxide. This leads to an increase in carbon dioxide, lowering the pH and resulting in respiratory acidosis.
Hypoxic vasoconstriction is an adaptive response that moves capillary blood flow from a closed alveolus to an open alveolus. Since this response no longer occurs in COPD patients, dead space ventilation or decreased perfusion occurs which results in increased carbon dioxide levels.
Decreased minute ventilation may occur in some patients with COPD as a result of dead space ventilation which increases levels of carbon dioxide; decreased minute ventilation then further limits the patient's inspiratory reserve capacity.
The Bohr effect refers to the lowered affinity of hemoglobin for oxygen in the presence of increases in carbon dioxide or decreased pH.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 260.
NEW QUESTION # 299
Understanding Jehovah's Witnesses is an example of:
- A. none of the above
- B. cultural sensitivity
- C. cultural competence
- D. response to diversity
Answer: B
Explanation:
Explanation: Understanding Jehovah's Witnesses is an example of cultural sensitivity. Jehovah Witnesses religiously have not been allowed for blood transfusions and blood products.
NEW QUESTION # 300
To patients who have been indicated as do-not-resuscitate (DNR), the nursing staff should do the following:
- A. Give curative treatment
- B. Give palliative treatment
- C. Give no treatment
- D. None of the above
Answer: B
Explanation:
Explanation: The nursing staff should give palliative treatment to patients who are indicated as DNR. To palliate a disease is to treat it partially and insofar as possible, but not cure it completely. Palliation cloaks a disease. Also, sometimes it is called symptomatic treatment.
NEW QUESTION # 301
The most common cause of small bowel obstruction is:
- A. Hernias
- B. Adhesions due to previous surgery
- C. Inflammatory bowel disease
- D. Malignant tumors
Answer: B
Explanation:
Correct answer: Adhesions due to previous surgery
The most common cause of a small bowel obstruction (SBO) is adhesions due to previous surgery.
Hernias, malignant tumors (peritoneal implants), and inflammatory bowel disease are other causes of SBO. Malignant tumors are the second most common cause of small bowel obstructions.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 358.
NEW QUESTION # 302
What investigation would you carry out after stabilizing a patient of head trauma with altered state of consciousness?
- A. Blood CP
- B. ESR
- C. Chest X-ray
- D. CT scan brain
Answer: D
Explanation:
Explanation: After stabilizing a patient of head trauma with altered state of consciousness, the CT brain scan is the most important investigation to carry out, since this can help reveal any concealed intracranial bleed due to trauma.
NEW QUESTION # 303
Assessment of pupil size and reaction to light provides information about the function of cranial nerves:
III and IV
II and III
I and III
I and II
Answer:
Explanation:
Correct answer: II and III
The optic nerve controls visual fields and visual acuity; the oculomotor nerve controls most extraocular eye movements, ability to elevate eyelid, muscular contraction of the iris in response to light.
* Olfactory Nerve - I
* Optic Nerve - II
* Oculomotor Nerve - III
* Trochlear Nerve - IV
* Trigeminal Nerve - V
* Abducens Nerve - VI
* Facial Nerve - VII
* Vestibulocochlear (Auditory) Nerve - VIII
* Glossopharyngeal Nerve - IX
* Vagus Nerve - X
* Accessory Nerve - XI
* Hypoglossal Nerve - XII
An illustration of the human brain highlights the 12 cranial nerves:
1. The olfactory nerve is located within the nasal cavity below the frontal lobe.
2. The optic nerve emerges from the optic disk in the forebrain.
3. The oculomotor nerve originates from the midbrain of the brainstem.
4. The trochlear nerve originates from the medial midbrain.
5. The trigeminal nerve emerges from the semilunar ganglion near the apex of the temporal bone.
6. The abducens is located on the floor of the fourth ventricle in pons.
7. The facial nerve emerges from pons.
8. The vestibulocochlear nerve is located in pons of the brainstem.
9. The glossopharyngeal nerve emerges from the medulla oblongata.
10. The vagus nerve arises from medulla oblongata.
11. The hypoglossal nerve originates near the top of the spinal cord at the base of the brain.
12. The accessory nerve arises from the cervical spinal cord and caudal medulla.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 302.
NEW QUESTION # 304
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