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The American Association of Critical-Care Nurses (AACN) Progressive Care Certified Nursing (PCCN) Certification Exam is a comprehensive certification exam designed specifically for registered nurses (RNs) working in progressive care units (PCUs). The PCCN certification is a widely recognized credential that validates the expertise and knowledge of nurses in providing care to critically ill patients in intermediate care settings. Progressive Care Certified Nursing certification exam covers a wide range of topics, including cardiovascular, pulmonary, neurological, renal, endocrine, gastrointestinal, and multisystem disorders, as well as patient assessment, monitoring, and interventions.
AACN PCCN Certification Exam is a valuable tool for nurses who work in progressive care. It recognizes their expertise and dedication to providing high-quality care to patients in this specialized area of nursing. By earning this certification, nurses can demonstrate their commitment to their profession and their patients, as well as open up new opportunities for career advancement.
NEW QUESTION # 58
The nurse is assessing a patient using the Full Outline of Unresponsive (FOUR) score tool. The patient she is assessing is not intubated, and his respirations are even and easy at rest. He opens his eyes on command, and his pupils are equal and reactive to light. He gives the nurse a "thumbs up" when asked.
What is this patient's FOUR score?
- A. 0
- B. 1
- C. 2
- D. 3
Answer: B
Explanation:
Correct answer: 16
The FOUR score is a tool used in the assessment of neurological patients that assigns a value of 0 through 4 in each of four categories: eyes, motor, brain stem reflexes, and respirations. The scores are added for a total score. This patient is given a score of 4 in each category, indicating no impairment detected by the tool in these areas at the time of the assessment.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 297-298.
NEW QUESTION # 59
Of the following pharmacological agents used in the prevention of stress gastritis, which is least likely to predispose patients to nosocomial pneumonias?
- A. Famotidine
- B. Antacids
- C. Ranitidine
- D. Sucralfate
Answer: D
Explanation:
Correct answer: Sucralfate
Sucralfate, an aluminum disaccharide compound, has been found to be both safe and effective in the prevention of stress gastritis and it has no effect on gastric pH. Because it does not affect gastric pH, it cannot alkalinize the gastric environment and may decrease the development of gram-negative hospital- acquired (nosocomial) pneumonias.
Ranitidine and famotidine, as well as antacids, alkalinize the GI tract, making patients more susceptible to gram-negative pneumonias.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 180-181.
NEW QUESTION # 60
Of the following, which is the most important indicator of elevated intracranial pressure?
- A. Pupillary changes
- B. Change in level of consciousness
- C. Abnormal posturing
- D. Changes in vital signs
Answer: B
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 # 61
Treatment of torsades de pointes may include all of the following except:
- A. Overdrive atrial or ventricular pacing at a rate of 80 beats per minute or faster to prevent the pauses that may precipitate episodes of torsades de pointes
- B. Managing the patient with pacing and magnesium as temporary strategies until the underlying cause of the disorder can be eliminated
- C. Teaching the patient lifestyle modifications such as avoidance of swimming and startling loud noises like alarm clocks
- D. Defibrillation with an unsynchronized shock to terminate the episode if torsades de pointes degenerates into ventricular fibrillation
Answer: C
Explanation:
Correct answer: Teaching the patient lifestyle modifications such as avoidance of swimming and startling loud noises like alarm clocks Lifestyle modifications may be necessary and appropriate in congenital long-QT syndromes, not in torsades de pointes (TdP).
Treatment of TdP includes identifying and managing the cause, discontinuing any causative drugs, and correcting electrolyte imbalances. IV magnesium can be administered to control episodes of TdP until the cause is corrected.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 444-445.
NEW QUESTION # 62
All of the following are signs and symptoms of cardiac tamponade except:
- A. Muffled heart sounds
- B. Pulsus paradoxus
- C. Sinus tachycardia
- D. Hypertension
Answer: D
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 # 63
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. Ketone bodies in urine
- B. Random blood glucose levels
- C. Fasting blood glucose levels
- D. HbA1c
Answer: D
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 # 64
As a nurse, you must be aware of the visiting policy of the health care center. What would you do if the family of a critically ill patient wishes to spend the night, which is contrary to visiting policy?
- A. allow one or two family members to stay, then evaluate the patient's response.
- B. obtain a motel room near the hospital where the family may spend the night.
- C. allow the family to stay in the room.
- D. adhere to the visiting policy.
Answer: A
Explanation:
Explanation: If the family of a critically ill patient wishes to spend the night, which is contrary to visiting policy, the nurse's best action would be to allow one or two family members to stay, then evaluate the patient's response.
NEW QUESTION # 65
In addition to an insulin infusion, most hyperglycemic patients will also require the simultaneous infusion of:
- A. Calcium
- B. Magnesium
- C. Potassium phosphate
- D. Potassium chloride
Answer: D
Explanation:
Correct answer: Potassium chloride
In addition to an insulin infusion, most hyperglycemic patients will also require the simultaneous infusion of potassium chloride. Insulin drives potassium into the cells, especially into muscle and liver cells, which may increase the risk of hypokalemia.
Magnesium, calcium, and phosphate levels should be monitored every two hours during rehydration.
Calcium and magnesium replacements are given based on serum levels. Phosphate deficiencies are typically corrected with volume replacement. If needed, the administration of potassium phosphate may be used as it replaces both potassium and phosphate simultaneously. Phosphate replacements should not be administered in patients with renal failure.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 392-393.
NEW QUESTION # 66
During the round of the ward, consultant was discussing about a 50 years old patient suffering from end stage renal disease. He said that certain metabolic problems start occurring in this condition and creatinine clearance decreased to < 10 ml/min. moreover fluid and electrolyte balance, acid base balance, hormone production and waste removal are also affected. What is he pointing towards?
- A. Nephritic syndrome
- B. Uremic syndrome
- C. None of the above
- D. Cushing syndrome
Answer: B
Explanation:
Explanation: Actually he is pointing towards uremic syndrome as in end stage renal disease uremic syndrome occurs in which there are certain metabolic disorders and creatinine clearance decreases to
<10 ml/min, due to extensive damage of the kidneys. Moreover all the other functions of kidneys are alsa decreased.
NEW QUESTION # 67
In documenting the care given, which statement shows good documentation?
- A. Omitting data pertaining to medications that are not given
- B. Documenting the client's response to the intervention
- C. Giving facts and opinions regarding the client's behavior
- D. Documenting the assumptions of the nurse
Answer: B
Explanation:
Explanation: Documentation is the process of putting down in writing all nursing care activities given to the client. Documentation should be factual, accurate, and precise. The nurse should refrain from giving assumptions and opinions regarding the client and the care given. The nurse should document the medications that were and were not given.
NEW QUESTION # 68
What would be identified on the arterial blood gas results as a reflection of acute respiratory distress syndrome?
- A. Increased HcO3
- B. High PaO2 levels
- C. Decreased PaCO2
- D. Low PaO2 levels
Answer: D
Explanation:
Explanation: The result of the arterial blood gas that would reflect the presence of acute respiratory distress syndrome would be a low PaO2 level. The paCO2 will initially decrease but increase as the patient becomes more fatigued.
NEW QUESTION # 69
Evidence-based practice guidelines related to family interventions that should occur during the evaluation stage of the nursing process includes which of following?
- A. Provide information according to family needs
- B. Make referrals as appropriate for support services
- C. Use multiple methods to evaluate achievement of meeting family needs
- D. Establish optimum methods to contact the family
Answer: C
Explanation:
Correct answer: Use multiple methods to evaluate achievement of meeting family needs Methods that may be used to evaluate if a family's needs are or have been met include satisfaction surveys, feedback, care conferences, and follow-up after discharge.
In the intervention stage of the nursing process in family interventions the following interventions are appropriate:
* Determine spokesperson and contact person
* Establish optimum methods to contact and communicate with family
* Make referrals for support services as appropriate
* Provide information according to family needs
* Provide a comfortable environment
* Include family in direct care as appropriate
* Encourage family participation and presence during team rounds
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 28.
NEW QUESTION # 70
Which of the following terms refers to the use of one's own skills and knowledge to promote the interests of another?
- A. Fidelity
- B. Nonmaleficence
- C. Paternalism
- D. Advocacy
Answer: D
Explanation:
Correct answer: Advocacy
Patient advocacy is an essential role of the nurse. The nurse is able to understand the impact of disease and interpret health care information in a unique way, then acts as a patient advocate by applying this understanding to ensure the patient's values and beliefs guide the plan of care.
Paternalism refers to circumstances in which the principle of doing good (beneficence) overrides that of autonomy. Nonmaleficence is the principle that imposes the duty to do no harm. Fidelity describes the obligation to be faithful to promises and commitments.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 198.
NEW QUESTION # 71
The nurse is assessing the tests of a patient with a diagnosis of acute right-sided Heart Failure. What parameter would be elevated in right-sided Heart Failure?
- A. Pulmonary Capillary Wedge Pressure (PCWP)
- B. Left-ventricular end-diastolic pressure
- C. Central Venous Pressure (CVP)
- D. Cardiac Output
Answer: C
Explanation:
Explanation: When looking at the parameters for a patient with a diagnosis of right-sided Heart Failure, the Central Venous Pressure (CVP) would be elevated. The Central Venous Pressure (CVP) describes the amount of blood that is returning to the heart and is a measure of the pressure of the blood in the thoracic vena cava.
NEW QUESTION # 72
Which ethical principle affirms the right of an individual to make decisions and choose actions based on his or her personal values and beliefs?
- A. Nonmaleficence
- B. Respect for persons or autonomy
- C. Beneficence
- D. Justice
Answer: B
Explanation:
Correct answer: Respect for persons or autonomy
The ethical principle of respect for persons or autonomy affirms the right of an individual to make decisions and choose actions based on his or her personal values and beliefs. An autonomous choice is an informed decision made without coercion that reflects one's interests and values.
Nonmaleficence is the duty to do no harm. Justice is fairness and is often used in association with the distribution of services, goods, or burdens among a population. Beneficence affirms the obligation to do good to others by helping them advance and achieve their interests.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 194-195.
NEW QUESTION # 73
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