Pass AACN PCCN With Prep4sures Exam Dumps - Updated on Apr-2024
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AACN PCCN exam is a certification exam designed specifically for nurses working in progressive care units (PCU) or similar healthcare settings. PCCN exam is administered by the American Association of Critical-Care Nurses (AACN) and is meant to assess the nurse's knowledge and skills in managing and caring for patients with complex health conditions.
NEW QUESTION # 257
A physician orders increased dose of clonidine (Catapres). It is most essential for the nurse to assess for which parameter before drug administration?
- A. Urine output
- B. Blood glucose
- C. Blood pressure
- D. Heart rate
Answer: C
Explanation:
Explanation: Clonidine is an alpha-agonist used to lower the blood pressure. It is most essential for the nurse to check for the client's blood pressure before administering the drug. Orthostatic hypotension may occur with the initial administration of increased dose of clonidine and an existing orthostatic hypotension can cause severe reactions.
NEW QUESTION # 258
According to Kubler-Ross's 5 Stages of Grief, the last stage is:
- A. Denial
- B. Depression
- C. Anger
- D. Acceptance
Answer: D
Explanation:
Explanation: According to Kubler-Ross's 5 Stages of Grief, the last stage is acceptance. Grief is a very genuine response to any ethernal loss. Every person deals with grief in different way. Elisabeth Kubler- Ross identified 5 stages of grief in which can apply to both patients and family members. A person must not have to pass through each and all stages but usually goes through 2 of the 5 stages: The final stage of Kubler-Ross's 5 Stages of Grief is Acceptance.
NEW QUESTION # 259
A nurse is monitoring a client who was recently admitted to the unit after a cardiac catheterization.
Which of the following ordered assignments is the nurse's priority?
- A. Monitor the client's urinary output
- B. Assess the client's heart rate
- C. Assess pulses distal to insertion site
- D. Assess pulses proximal to the insertion site
Answer: C
Explanation:
Explanation: After the procedure, the client is at risk of clot formation. Weakened or absent pulses distal to the insertion site may suggest its occurrence. Options A and B are also assessed, but assessment of the pulses distal to the insertion site is the priority. Option D is not correct.
NEW QUESTION # 260
A young man presents with chest discomfort, dyspnea, fatigue, pressure in epigastrium and palpitations.
He had a history of viral flu a few days back. Moreover, the ECG showed non-specific changes and the lab culture had a growth of influenza virus. What is the diagnosis?
- A. Pulmonary edema
- B. Myocarditis
- C. Endocarditis
- D. Pericarditis
Answer: B
Explanation:
Explanation: The diagnosis for an individual presenting with chest discomfort, dyspnoea, fatigue, pressure in epigastrium and palpitations, as well as a recent history of viral flu, is Myocarditis. A viral cause is common for Myocarditis, where non-specific changes in an ECG and a lab culture with a growth of influenza virus are also indicated.
NEW QUESTION # 261
Which of the following drugs are used for treatment of Crohn's disease as immunomodulatory agents?
- A. None of the above
- B. Both a and b
- C. Methotrexate
- D. Cyclosporine
Answer: B
Explanation:
Explanation: Cyclosporine and Methotrexate are used for treatment of Crohn's disease. Crohn's disease (also known as granulomatous, and colitis) is an inflammatory disease of the intestines that may affect any part of the gastrointestinal tract from mouth to anus, causing a wide variety of symptoms.
NEW QUESTION # 262
Unless contraindicated or not tolerated, ACE inhibitors are recommended in all heart failure patients with a left ventricular ejection fraction of less than:
- A. 50%
- B. 40%
- C. 60%
- D. 90%
Answer: B
Explanation:
Correct answer: 40%
ACE inhibitors and vasodilators are used to decrease afterload in patients with heart failure. Unless they are not tolerated or are otherwise contraindicated, ACE inhibitors are recommended in all heart failure patients with a left ventricular ejection fraction of less than 40%.
If the patient is not able to tolerate ACE inhibitors, an angiotensin II receptor blocker (ARB) may be used.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 233.
NEW QUESTION # 263
The Child-Pugh classification bases assessment of hepatic function on two clinical variables and three biochemical tests. Which of the following criteria are included in the Child-Pugh assessment?
- A. Total bilirubin, hepatic encephalopathy, age
- B. Serum albumin, total bilirubin, age
- C. Total bilirubin, prothrombin time, ascites
- D. Serum sodium, total bilirubin, ascites
Answer: C
Explanation:
Correct answer: Total bilirubin, prothrombin time, ascites
The Child-Pugh criteria for hepatic functional reserve include the following clinical and laboratory measurements: hepatic encephalopathy (grade), ascites, bilirubin, albumin and prothrombin time (increase).
The Model for End-Stage Liver Disease (MELD) is also a frequently used scoring tool that can measure the severity of liver disease. This tool takes into account age, INR, serum creatinine, albumin, and serum creatinine. Additional points are added if the patient undergoes dialysis at least twice weekly.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 349.
NEW QUESTION # 264
The loss of the Frank-Starling response occurs in which of the following?
- A. Acute gastrointestinal bleeding
- B. The late stages of dementia
- C. Liver failure
- D. Heart failure
Answer: D
Explanation:
Correct answer: Heart failure
The loss of the Frank-Starling response occurs in heart failure.
In phase II of heart failure, as overstretching of the ventricle occurs, the Frank-Starling response is lost, resulting in left ventricular decompensation and myocardial hypertrophy. In response to the loss of this adaptive response, the left ventricle dilates and hypertrophies.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 229.
NEW QUESTION # 265
The nurse manager on the progressive care unit asks Liz to work an extra shift to cover a staff member who called out sick. Liz had planned to go to dinner with her mother after work this evening. What type of ethical problem does Liz face in this scenario?
- A. Allocation of resources
- B. Ethical dilemma
- C. Moral distress
- D. Locus of authority
Answer: B
Explanation:
Correct answer: Ethical dilemma
An ethical dilemma is a situation in which one can identify two opposing but equally justifiable courses of action. On one hand, Liz feels the obligation to work the extra shift to ensure the patients on the unit are taken care of, but at the same time, she has a duty to herself and her mother to honor her prior commitment. She cannot choose both options; they are mutually exclusive but equally justifiable.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 192.
NEW QUESTION # 266
In ethics, paternalism refers to instances in which the principle of beneficence overrides which of the following?
- A. Justice
- B. Veracity
- C. Advocacy
- D. Autonomy
Answer: D
Explanation:
Correct answer: Autonomy
In ethics, paternalism refers to instances in which the principle of beneficence overrides that of autonomy.
In cases of paternalism, health care providers select and implement interventions which they believe will lead to the best outcomes without (or even against) the patient's consent. However, interventions that restrict a patient's autonomy are only applied with careful consideration.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 196.
NEW QUESTION # 267
According to the United States Food and Drug Administration, the acceptable discrepancy between laboratory values and point-of-care glucometer values is:
- A. + 5%
- B. + 15%
- C. + 2.5%
- D. + 10%
Answer: B
Explanation:
Correct answer: + 15%
Point-of-care (POC) blood glucose level monitoring allows for more rapid intervention than is possible from laboratory glucose analysis and effective glycemic control is vital in critically ill patients. Despite improved technology and the benefits of POC monitoring of glucose levels, inaccuracies can occur, and large discrepancies must be investigated. The FDA sets strict industry guidelines for glucometer efficacy and identifies acceptable ranges for POC and lab glucose value discrepancies.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 391.
NEW QUESTION # 268
All of the following statements are true related to the visually displayed breath-to-breath values on a ventilator except:
- A. Respiratory rate, exhaled volumes and the inspiratory to expiratory ratio are common visually displayed breath-to-breath values
- B. Airway pressures are monitored during inspiration and exhalation and are often displayed as peak pressure, mean pressure and end-expiratory pressure
- C. The display of the patient's exhaled Vt reflects the amount of gas returned to the ventilator via the expiratory tubing with each respiratory cycle
- D. The presence of positive end-expiratory pressure (PEEP) is indicated by a negative value at the end of expiration
Answer: D
Explanation:
Correct answer: The presence of positive end-expiratory pressure (PEEP) is indicated by a negative value at the end of expiration The presence of positive end-expiratory pressure (PEEP) is indicated by a positive, rather than a negative value at the end of expiration.
Careful observation of the airway pressures provides the clinician with a great deal of information about the patient's respiratory effort, coordination with the ventilator and changes in lung compliance.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 119-120.
NEW QUESTION # 269
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. Auditory stimuli
- B. Painful stimuli
- C. Tactile stimuli
- D. Traumatic stimuli
Answer: A
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 # 270
All of the following are signs and symptoms of cardiac tamponade except:
- A. Muffled heart sounds
- B. Sinus tachycardia
- C. Hypertension
- D. Pulsus paradoxus
Answer: C
Explanation:
Correct answer: Hypertension
Signs and symptoms of cardiac tamponade include decreased blood pressure (hypotension), tachycardia, shortness of breath, anxiety/decreased level of consciousness, pulsus paradoxus, sinus tachycardia, decreased mediastinal tube drainage, diastolic plateau, muffled heart sounds, and decreased cardiac output.
Cardiac tamponade is pressure on the heart that occurs when blood or fluid builds up in the space between the heart muscle (myocardium) and the outer covering sac of the heart (pericardium).
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 226, 413.
NEW QUESTION # 271
Which of the following is used to make decisions regarding a patient's care when the patient is unable to speak for themselves and the patient's values, ideals, attitudes or philosophy are not known?
- A. Values clarification standard
- B. Patient wishes standard
- C. Substituted judgment
- D. Best interest standard
Answer: D
Explanation:
Correct answer: Best interest standard
The best interest standard is used to make decisions regarding a patient's care when the patient is unable to speak for themselves and the patient's values, ideals, attitudes or philosophy are not known.
For example, a patient who never gained decision-making capacity and lacked competence throughout life would not have the opportunity to articulate wishes and beliefs about health care. Using best interest standard, the surrogate decision maker determines the course of treatment based on what would be in the patient's best interest, considering the needs, risks, and benefits to the affected person.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 201.
NEW QUESTION # 272
The framework of principle-based ethics is one of the most influential perspectives in biomedical ethics today. This perspective arose in the 1970s through the work of Beauchamp and:
- A. Collins
- B. Champion
- C. Chapmann
- D. Childress
Answer: D
Explanation:
Correct answer: Childress
Inherent in principle-based ethics 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 respect for persons (autonomy), justice, nonmaleficence, and beneficence. This framework remains a dominant method of bioethical thinking today.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 194.
NEW QUESTION # 273
A patient with suspected head injury presented to surgical emergency. A nurse is assigned to check the olfactory senses of the patient. How will she do that?
- A. None of the above
- B. Both the nostrils are closed and then checked
- C. Nostrils are checked one by one
- D. Both the nostrils are checked simultaneously
Answer: C
Explanation:
Explanation: In order to check the olfactory senses of the patient with a suspected head injury, the nostrils are exposed to the smell of either coffee or soap, with 1 nostril closed, and the exercise is repeated with the other nostril.
NEW QUESTION # 274
Which of the following statements is true related to high-flow nasal cannula (HFNC) oxygen devices?
- A. HFNC is the most common method for delivering oxygen invasively
- B. HFNC can provide oxygen at high-flow rates between 30 and 60 L/minute
- C. HFNC is an invasive method of administering continuous oxygen to patients with chronic hypoxemia
- D. Caution must be exercised when using HFNC as it may result in intrinsic (auto) PEEP
Answer: B
Explanation:
Correct answer: HFNC can provide oxygen at high-flow rates between 30 and 60 L/minute High-flow nasal cannula (HFNC) devices are a non-invasive method of oxygen delivery. HFNC can deliver actively warmed and well-humidified oxygen at rates between 30 and 60 liters per minute. The small amount of PEEP generated with this method may help decrease lung collapse, enable improved gas exchange, and decrease the work of breathing.
The most common method for delivering oxygen invasively is with a mechanical ventilator.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 116.
NEW QUESTION # 275
A patient who is scheduled for coronary angiography states, "I want to be asleep during my procedure. I can't stand any kind of pain." Of the following, the best response for the nurse to make to this patient is:
- A. "It sounds like you're feeling anxious. What has your doctor told you about your procedure?"
- B. "You have to stay awake, but the procedure is painless."
- C. "You will have to be awake during the procedure so you can control your breathing."
- D. "Don't worry. You will be given medicine to make you very sleepy and you won't remember anything."
Answer: A
Explanation:
Correct answer: "It sounds like you're feeling anxious. What has your doctor told you about your procedure?" It is most therapeutic to acknowledge the patient's feelings, find out what they have been told, and not to minimize fear. Typically, patients remain awake during the procedure, allowing them to facilitate the catheterization process by controlling respiratory patterns. An anxiolytic agent, such as diazepam, is frequently administered during the procedure to decrease anxiety.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 213-214.
NEW QUESTION # 276
A child presented with sharp piercing chest pain, fever, malaise, irritability, poor appetite and Dysrhythmia. He had undergone a recent surgery for valvular abnormality of the heart. What is the most likely disease to occur?
- A. Infective endocarditis
- B. Pericarditis
- C. Pleural effusion
- D. Cardiac contusion
Answer: B
Explanation:
Explanation: The most likely disease to occur is Pericarditis. If a child presents with sharp, piercing, chest pain, fever, malaise, irritability, poor appetite and Dysrhythmia, and has recently undergone surgery for valvular abnormality of the heart, Pericarditis is the disease most likely to occur. Pericarditis usually occurs after cardiac surgeries done for structural abnormalities. Moreover sharp, piercing, chest pain is typical for Pericarditis, as is fever, because it usually has some infective cause like virus, bacteria etc.
NEW QUESTION # 277
......
To qualify for the PCCN certification exam, nurses must have a current, unrestricted RN license and at least two years of experience working with acutely ill adult patients in progressive care or related units. They must also have completed at least 1,750 hours of clinical practice in the previous two years or at least five years of experience in progressive care nursing.
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