AACN PCCN Real 2024 Braindumps Mock Exam Dumps
PCCN Exam Questions | Real PCCN Practice Dumps
NEW QUESTION # 179
In patients with spinal cord injury, an in-exsufflator is sometimes used to help prevent:
- A. Respiratory complications
- B. Orthostatic hypotension
- C. Skin breakdown
- D. Gastrointestinal problems
Answer: A
Explanation:
Correct answer: Respiratory complications
An in-exsufflator is a mechanical cough assist device that imitates a physiologic cough by providing a deep breath via positive pressure followed by negative pressure. This can help prevent respiratory complications in patients with spinal cord injuries by assisting to clear secretions.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 510.
NEW QUESTION # 180
A known diabetic is taking anti-diabetic medications regularly. What is the best lab investigation that can tell us about the long-term good blood glucose control?
- A. Fasting blood glucose levels
- B. HbA1c
- C. Random blood glucose levels
- D. Ketone bodies in urine
Answer: B
Explanation:
Explanation: The best lab investigation which can tell us about 2 to 3 month glucose control is HBA1c (hemoglobin A1c). As hemoglobin holds sugar for longer duration, so it can tell us about long-term control of diabetes.
NEW QUESTION # 181
Of the following spinal cord injury syndromes, which describes injury to the central gray matter with preservation of the outer white matter?
- A. Anterior cord syndrome
- B. Brown-Sequard syndrome
- C. Central cord syndrome
- D. Posterior cord syndrome
Answer: C
Explanation:
Correct answer: Central cord syndrome
Central cord syndrome is an incomplete spinal cord injury syndrome in which the central gray matter of the cord is affected with preservation of the outer white matter. In this syndrome, weakness/paralysis, as well as sensory loss, is greater in the upper extremities is greater than in the lower extremities.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 507.
NEW QUESTION # 182
Causes of hypovolemic shock may include:
- A. Hyperglycemic osmotic diuresis, third spacing, sepsis
- B. Sepsis, anaphylaxis, hemorrhage
- C. An allergic reaction, thermal injury, diabetes insipidus
- D. Internal hemorrhage, dysfunctional ischemia, diuretic administration
Answer: C
Explanation:
Correct answer: An allergic reaction, thermal injury, diabetes insipidus Causes of hypovolemic shock can be a result of external or internal losses of bodily fluid and include an allergic reaction, thermal injury, diabetes insipidus, internal or external hemorrhage, losses of fluids from the gastrointestinal tract, diuretic administration, Addison disease, or hyperglycemic osmotic diuresis.
Dysfunctional ischemia is a cause of cardiogenic shock. Sepsis and anaphylaxis cause distributive shock.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 236.
NEW QUESTION # 183
Which of the following describes the injury which occurs in Brown-Sequard syndrome?
- A. Injury to the anterior portion of the spinal cord with disruption of blood flow through the anterior spinal artery
- B. Lateral injury to one side of the spinal cord
- C. Injury to the central gray matter of the spinal cord with preservation of the outer white matter
- D. Injury to the posterior spinal column
Answer: B
Explanation:
Correct answer: Lateral injury to one side of the spinal cord
Lateral injury to one side of the spinal cord results in ipsilateral motor paralysis, loss of position and vibration sense with contralateral loss of temperature and pain sensation.
Injury to the anterior portion of the spinal cord with disruption of blood flow through the anterior spinal artery describes anterior cord syndrome. Injury to the posterior column describes posterior cord syndrome. Injury to the central gray matter of the spinal cord with preservation of the outer white matter describes central cord syndrome.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 507.
NEW QUESTION # 184
A 50-year-old man is suspected to have paralytic ileus. All of the following symptoms are of paralytic ileus except:
- A. Abdominal distention
- B. Large number of bowel sounds in abdomen
- C. Constipation and lack of flatulence
- D. Nausea and vomiting
Answer: B
Explanation:
Explanation: All of the above symptoms are of paralytic ileus except large number of bowel sounds in abdomen. The lack of bowel sounds is characteristic of paralytic ileus. Paralytic ileus is obstruction of the intestine due to paralysis of the intestinal muscles. The paralysis does not need to be complete to cause ileus, but the intestinal muscles must be so inactive that it prevents the passage of food and leads to a functional blockage of the intestine.
NEW QUESTION # 185
Which of the following risk factors for the development of acute respiratory distress syndrome is considered to be a secondary rather than a primary cause?
- A. Aspiration
- B. Pulmonary contusion
- C. Smoke inhalation
- D. Sepsis
Answer: D
Explanation:
Correct answer: Sepsis
Conditions that result in direct damage to the alveolar-capillary membrane are categorized as primary causes of acute respiratory distress syndrome (ARDS). Secondary causes are those which are believed to be mediated by cellular or humoral injury to the capillary endothelial wall. In conditions such as trauma and sepsis, capillary beds throughout the body are affected by abnormal microvascular permeability, but clinical manifestations are often isolated to the respiratory system.
Aspiration, pulmonary contusion, and smoke inhalation result in direct damage to the alveolar-capillary membrane and are categorized as primary causes of ARDS.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 257-258.
NEW QUESTION # 186
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. Ibutilide
- B. Propranolol
- C. Octreotide
- D. Pantoprazole
Answer: C
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 # 187
All of the following statements are true except:
- A. An ileus is categorized as a functional, rather than a mechanical obstruction
- B. Complete bowel obstruction always requires surgical management
- C. Colorectal cancer is the most common cause of a large bowel obstruction in the United States
- D. Hypotension, bronchospasm, and tachycardia are side effects of neostigmine
Answer: D
Explanation:
Correct answer: Hypotension, bronchospasm, and tachycardia are side effects of neostigmine Hypotension and bronchospasm are side effects of neostigmine, but bradycardia is more likely than tachycardia to occur. Patients who are treated with IV neostigmine must be monitored with telemetry, and atropine must be readily available.
Complete bowel obstruction always requires surgical management; a partial bowel obstruction can be treated conservatively with serial exams and supportive treatment. In an ileus, no mechanical cause can be identified. In the United States, colorectal cancer is the leading cause of large bowel obstruction, with the sigmoid colon and the descending colon being the most common sites of obstruction.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 358.
NEW QUESTION # 188
A child was diagnosed with Acute Epiglotitis. Which one of the following features is a symptom of Epiglotitis?
- A. All of the above
- B. Tripod position
- C. Agitation
- D. Drooling and frog like voice
Answer: A
Explanation:
Explanation: All of the above are symptoms of Epiglotitis. Epiglotitis has all the above mentioned features. Tripod position, agitation, drooling and frog like voice all are symptoms of epiglotitis.
NEW QUESTION # 189
A nurse is assigned to care for a client with a tracheostomy. The nurse is aware that suctioning should be limited to no more than:
- A. 25 seconds
- B. 20 seconds
- C. 30 seconds
- D. 15 seconds
Answer: D
Explanation:
Explanation: The nurse should ensure that the time for suctioning should be limited to no more than 15 seconds. Suctioning greater than 15 seconds results in decreased oxygen supply to the brain, which may cause changes in the vital signs.
NEW QUESTION # 190
Clinical situations that decrease the accuracy of pulse oximetry for assessing oxygen status include:
- A. Vasoactive drugs, hypertension, low cardiac output
- B. Vasoconstriction, hypertension, nail polish application
- C. Nail polish applications, movement of the sensor, hyperthermia
- D. Hypotension, vasoconstriction, hypothermia
Answer: D
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 # 191
An admitted patient being managed for infected wound, developed severe sepsis. He started having upper GI bleed and blood in stools. On examination, petechiae and purpurae were seen and patient was going in shock with evident Hypotension and Tachycardia. What is the likely diagnosis?
- A. Anemia
- B. DIC (Disseminated Intravascular Coagulation)
- C. Cardiogenic shock
- D. Polycythemia
Answer: B
Explanation:
Explanation: The likely diagnosis in this patient with the infected wound is DIC, since sepsis is a triggering factor for DIC. Moreover, combined picture of hemolysis and coagulation is seen in disseminated intravascular coagulation.
NEW QUESTION # 192
Which is the key quality concept below?
- A. Respect
- B. Coordination
- C. All the above
- D. Accessibility
Answer: C
Explanation:
Explanation: All the qualities listed are part of the key quality concept. All the key concepts related to quality must be communicated to the members of the organization through workshops, newsletters, fact sheets, general meetings.
NEW QUESTION # 193
If the patient has temp >38 degree centigrade or subnormal rectal temperature < 36 degress centigrade, tachypnea or PaCO2 < 32 mm of Hg, what is the diagnosis?
- A. Neurogenic shock
- B. Systemic inflammatory response syndrome
- C. None of the above
- D. Septic shock
Answer: B
Explanation:
Explanation: The patient is suffering from systemic inflammatory response syndrome, because it is ageneralized inflammatory response of the body including many systems,in this temp > 38 degree centigrade or subnormal rectal temperature, moreover there is tachypnea, tachycardia. Its features also include leukocytosis or leucopenia.
NEW QUESTION # 194
A 15-year-old alert female is admitted to the progressive care unit for treatment of acute osteomyelitis.
The nurse is not sure how to pronounce her name. Which of the following is the best course of action for the nurse to take?
- A. Address the patient by a term of endearment such as "sweetheart"
- B. Ask the patient's mother how to pronounce the patient's name
- C. Take a chance at pronouncing the name and wait to be corrected
- D. Ask the patient how she would like the nurse to pronounce her name
Answer: D
Explanation:
Correct answer: Ask the patient how she would like the nurse to pronounce her name Asking the patient how to pronounce her name shows respect for her unique identity.
Asking the mother, when the patient is capable of answering, belittles the patient, as does the use of terms of endearment. Mispronouncing a name, done in the hope of being corrected shows disrespect for the patient.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 195.
NEW QUESTION # 195
A nurse is determining a patient's heart rate using the large boxes on the electrocardiogram. There are five large boxes between R waves. The nurse correctly determines the patient's heart rate in beats per minute is:
- A. 0
- B. 1
- C. 2
- D. 3
Answer: B
Explanation:
Correct answer: 60
One method of obtaining heart rate from the ECG strip is to count the number of large boxes between two R waves, and then divide that number into 300. One large box equals 0.20 seconds.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 41-43.
NEW QUESTION # 196
The 6-minute-walk test is used in the diagnosis of:
- A. Chronic obstructive lung disease
- B. Interstitial 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 # 197
A known diabetic and hypertensive presented in medical emergency with acute onset of right-sided hemiplegia, altered level of consciousness and inability to speak. On examination, gag reflex was absent, plantars were upgoing and the power on the right side was markedly decreased. What is the likely diagnosis?
- A. Stroke
- B. Parkinsonism
- C. Epilepsy
- D. Dementia
Answer: A
Explanation:
Explanation: Stroke is the likely diagnosis. In cases of hemiplegia, altered level of consciousness, inability to speak and difficulty in swallowing due to loss of gag reflex, the most likely diagnosis would be Stroke.
Also, plantar reflex is upgoing in the case of Stroke.
NEW QUESTION # 198
Related to family members of hospitalized patients, research has consistently identified five major areas of family needs. Included in these are all of the following except:
- A. Need to remain near the patient
- B. Need to receive reassurance
- C. Need to receive information
- D. Need for diversion
Answer: D
Explanation:
Correct answer: Need for diversion
The five major areas of family needs which have been consistently identified are:
* Receiving reassurance
* Being comfortable
* Remaining near the patient
* Receiving information
* Having support available
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 28.
NEW QUESTION # 199
Which of the following insulins has the longest duration of action?
- A. Humalog (lispro H)
- B. Ultralente
- C. NPH
- D. Regular
Answer: B
Explanation:
Explanation: Insulin with longest duration of action is Ultralente with 24 to 28 hours duration. A synthetic type of insulin used to treat diabetes. Also classified as long acting, Ultralatene have peak action occurring 12-16 hours after administering.
NEW QUESTION # 200
A cortical bruise caused by the brain impacting the inside of the skull at the site of impact is described as:
- A. Battle's sign
- B. A diffuse axonal injury
- C. Coup
- D. Contrecoup
Answer: C
Explanation:
Correct answer: Coup
Contusions are cortical bruises caused by the brain impacting the inside of the skull. They may be described as coup (occurring at the site of impact) or contrecoup (occurring opposite the site of impact).
Battle's sign is mastoid ecchymosis, a clinical sign of basilar skull fracture. Patients with severe diffuse axonal injury typically experience an immediate and prolonged loss of consciousness and abnormal posturing.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 500, 502.
NEW QUESTION # 201
A 38-year-old woman presented to accident and emergency department with short history of abdominal pain and distention, severe constipation, vomiting, dehydration and respiratory distress. On examination, she was having abdominal rigidity and no bowel sounds were audible. What is the most likely diagnosis based on this clinical scenario?
- A. Bowel or intestinal obstruction
- B. Appendicitis
- C. Pancreatitis
- D. Peritonitis
Answer: A
Explanation:
Explanation: The most likely diagnosis is bowel or intestinal obstruction because severe constipation, vomiting and resulting dehydration are features of this. Moreover, absent bowel sounds also indicate intestinal obstruction. The condition will be confirmed by doing abdominal x-rays.
NEW QUESTION # 202
When reviewing discharge instructions with a patient who is going home with new orders for dabigatran, the nurse includes all of the following information except:
- A. Monitoring parameters will include hemoglobin, hematocrit, aPTT, ecarin clotting time (ECT), and signs of active bleeding
- B. The medication is usually taken twice daily
- C. If the patient has difficulty swallowing the capsule, it can be opened and the contents taken with a small bite of soft food such as applesauce
- D. The medication is indicated for stroke prevention and for the prevention of systemic embolism
Answer: C
Explanation:
Correct answer: If the patient has difficulty swallowing the capsule, it can be opened and the contents taken with a small bite of soft food such as applesauce It is important to note that dabigatran capsules cannot be opened for oral or feeding tube administration.
Dabigatran prevents stroke and blood clots in patients who have nonvalvular atrial fibrillation. This medicine is an anticoagulant (blood thinner). In clinical trials, this medication was superior to warfarin in reducing the risk for systemic embolism and stroke with comparatively lower minor bleed risk.
Dabigatran also has the potential for use as VTE prophylaxis after total hip or knee replacement surgery, as well as in the treatment of pulmonary embolism and DVT. The usual dose of dabigatran is 150 mg PO twice daily.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 185.
NEW QUESTION # 203
Tracheostomy cuff pressure is maintained at:
- A. Less than 2.5 mm Hg
- B. Greater than 25 mm Hg
- C. Less than 25 mm Hg
- D. Greater than 30 mm Hg
Answer: C
Explanation:
Correct answer: Less than 25 mm Hg
Excessive cuff pressure causes tracheal ischemia, necrosis, and erosion and can also lead to overinflation-related obstruction of the distal airway from cuff herniation.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 111.
NEW QUESTION # 204
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