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AACN Progressive Critical Care Nursing 2024 Practice Test

PCCN test Format | Course Contents | Course Outline | test Syllabus | test Objectives

The PCCN certification exams focus 80 percent on clinical judgment and 20 percent on professional caring and ethical practice. Our comprehensive course prepares you in the following categories:

Clinical Judgment

- Cardiovascular
- Pulmonary
- Endocrine
- Hematology
- Gastrointestinal
- Renal
- Neurology
- Behavioral/Psychosocial
- Musculoskeletal
- Professional Caring and Ethical Practice
- Advocacy/Moral Agency
- Caring Practices
- Response to Diversity
- Facilitation of Learning
- Collaboration
- Systems Thinking
- Clinical Inquiry
- Learning Outcomes

At the completion of this learning activity, participants should be able to:

Validate their knowledge of progressive care nursing Briefly review the pathophysiology of single and multisystem dysfunction in adult patients and the medical and pharmacologic management of each Identify the progressive care nursing management needs for adult patients with single or multisystem organ abnormalities Successful Completion

Learners must complete 100 percent of the activity and the associated evaluation to be awarded the contact hours or CERP. No partial credit will be awarded.
12.8 contact hours awarded, CERP Category A
Exam Eligibility

Are you eligible to take the PCCN or PCCN-K exam- Eligibility requirements and links to handbooks with test plans are available on our “Get Certified” pages — click here to get started: PCCN (Adult) or PCCN-K (Adult) .

PCCN and PCCN-K certifications emphasize the knowledge that the progressive nursing specialty requires and the essential acute care nursing practices that you can apply in your role every day in a step-down unit, emergency or telemetry department or another progressive care environment.

PCCN and PCCN-K specialty certifications also demonstrate your knowledge and dedication to hospital administrators, peers and patients, while giving you the satisfaction of your achievement. PCCN and PCCN-K credentials are granted by AACN Certification Corporation.

Validate and enhance your knowledge and Boost patient outcomes. Take advantage of this detailed review course and earn your PCCN or PCCN-K certification.

The American Association of Critical-Care Nurses (AACN) is accredited as a provider of continuing nursing education by the American Nurses Credentialing Centers (ANCC's) Commission on Accreditation, ANCC Provider Number 0012. AACN has been approved as a provider of continuing education in nursing by the California Board of Registered Nursing (CBRN), Provider number CEP 1036. This activity is approved for 12.8 contact hours.

AACN programming meets the standards of most states that require mandatory CE contact hours for license and/or certification renewal. AACN recommends consulting with your state board of nursing or credentialing organization before submitting CE to fulfill continuing education requirements.

AACN and AACN Certification Corporation consider the American Nurses Association (ANA) Code of Ethics for Nurses foundational for nursing practice, providing a framework for making ethical decisions and fulfilling responsibilities to the public, colleagues and the profession. AACN Certification Corporations mission of public protection supports a standard of excellence where certified nurses have a responsibility to read about, understand and act in a manner congruent with the ANA Code of Ethics for Nurses.

I. CLINICAL JUDGMENT (80%)
A. Cardiovascular (27%)
1. Acute coronary syndromes
a. non-ST segment elevation myocardial infarction
b. ST segment elevation myocardial infarction
c. unstable angina
2. Acute inflammatory disease (e.g., myocarditis, endocarditis, pericarditis)
3. Aneurysm
a. dissecting
b. repair
4. Cardiac surgery (e.g., post ICU care)
5. Cardiac tamponade
6. Cardiac/vascular catheterization
a. diagnostic
b. interventional
7. Cardiogenic shock
8. Cardiomyopathies
a. dilated (e.g., ischemic/non-ischemic)
b. hypertrophic
c. restrictive
9. Dysrhythmias
10. Heart failure
a. acute exacerbations (e.g., pulmonary edema)
b. chronic
11. Hypertension (uncontrolled)
12. Hypertensive crisis
13. Minimally-invasive cardiac surgery (i.e. nonsternal approach)
14. Valvular heart disease
15. Vascular disease
B. Pulmonary (17%)
1. Acute respiratory distress syndrome (ARDS)
2. Asthma (severe)
3. COPD exacerbation
4. Minimally-invasive thoracic surgery (e.g., VATS)
5. Obstructive sleep apnea
6. Pleural space complications (e.g., pneumothorax, hemothorax, pleural effusion, empyema, chylothorax)
7. Pulmonary embolism
8. Pulmonary hypertension
9. Respiratory depression (e.g., medicationinduced, decreased-LOC-induced)
10. Respiratory failure
a. acute
b. chronic
c. failure to wean
11. Respiratory infections (e.g., pneumonia)
12. Thoracic surgery (e.g., lobectomy, pneumonectomy)
C. Endocrine/Hematology/Neurology/Gastrointestinal/Renal (20%)
1. Endocrine
a. diabetes mellitus
b. diabetic ketoacidosis
c. hyperglycemia
d. hypoglycemia
2. Hematology/Immunology/Oncology
a. anemia
b. coagulopathies: medication-induced (e.g., Coumadin, platelet inhibitors, heparin [HIT])
3. Neurology
a. encephalopathy (e.g., hypoxic-ischemic, metabolic, infectious, hepatic)
b. seizure disorders
c. stroke
4. Gastrointestinal
a. functional GI disorders (e.g., obstruction, ileus, diabetic gastroparesis, gastroesophageal reflux, irritable bowel syndrome)
b. GI bleed
i. lower
ii. upper
c. GI infections (e.g., C. difficile)
d. GI surgeries (e.g., resections, esophagogastrectomy, bariatric)
e. hepatic disorders (e.g., cirrhosis, hepatitis, portal hypertension)
f. ischemic bowel
g. malnutrition (e.g., failure to thrive, malabsorption disorders)
h. pancreatitis
5. Renal
a. acute kidney injury (AKI)
b. chronic kidney disease (CKD)
c. electrolyte imbalances
d. end-stage renal disease (ESRD)
D. Musculoskeletal/Multisystem/Psychosocial (16%)
1. Musculoskeletal
a. functional issues (e.g., immobility, falls, gait disorders)
2. Multisystem
a. end of life
b. healthcare-acquired infections
i. catheter-associated urinary tract infections (CAUTI)
ii. central-line-associated bloodstream infections (CLABSI)
iii. surgical site infection (SSI)
c. infectious diseases
i. influenza
ii. multidrug-resistant organisms (e.g., MRSA, VRE, CRE, ESBL)
d. pain
i. acute
ii. chronic
e. palliative care
f. pressure injuries (ulcers)
g. rhabdomyolysis
h. sepsis
i. shock states
i. anaphylactic
ii. hypovolemic
j. toxic ingestion/inhalation/drug overdose
k. wounds (e.g., infectious, surgical, trauma)
3. Behavioral/Psychosocial
a. altered mental status
b. delirium
c. dementia
d. disruptive behaviors, aggression, violence
e. psychological disorders
i. anxiety
ii. depression
f. substance abuse
i. alcohol withdrawal
ii. chronic alcohol abuse
iii. chronic drug abuse
iv. drug-seeking behavior
v. drug withdrawal
II. PROFESSIONAL CARING AND ETHICAL PRACTICE (20%)
A. Advocacy/Moral Agency
B. Caring Practices
C. Response to Diversity
D. Facilitation of Learning
E. Collaboration
F. Systems Thinking
G. Clinical Inquiry Cardiovascular
• Identify, interpret and monitor
o dysrhythmias
o QTc intervals
o ST segments
• Manage patients requiring
o ablation
o arterial closure devices
o arterial/venous sheaths
o cardiac catheterization
o cardioversion
o defibrillation
o pacemakers
o percutaneous coronary intervention (PCI)
o transesophageal echocardiogram (TEE)
• Monitor hemodynamic status and recognize signs and symptoms of hemodynamic instability
• Select leads for cardiac monitoring for the indicated disease process
• Titrate vasoactive medications
o Dobutamine
o Dopamine
o Nitroglycerin Pulmonary
• Interpret ABGs
• Maintain airway
• Monitor patients pre and post
o bronchoscopy
o chest tube insertion
o thoracentesis
• Manage patients requiring mechanical ventilation
• Manage patients requiring non-invasive O2 or ventilation delivery systems
o BiPAP
o CPAP
o face masks
o high-flow therapy
o nasal cannula
o non-breather mask
o venti-masks
• Manage patients requiring respiratory monitoring devices:
o continuous SpO2
o end-tidal CO2 (capnography)
Manage patients requiring tracheostomy tubes
• Manage patients with chest tubes (including pleural drains)
• Recognize respiratory complications and initiate interventions
Endocrine/Hematology/Neurology/Gastrointestinal/Renal
• Endocrine
o manage and titrate insulin infusions
• Hematology/Immunology/Oncology
o administer blood products and monitor patient response
• Neurology
o perform bedside screening for dysphagia
o use NIH Stroke Scale (NIHSS)
• Gastrointestinal
o manage patients pre- and post-procedure (e.g., EGD, colonoscopy)
o manage patients who have fecal containment devices
o manage patients who have tubes and drains
o recognize indications for and complications of enteral and parenteral nutrition
• Renal
o identify medications that can be removed during dialysis
o identify medications that may cause nephrotoxicity
o initiate renal protective measures for nephrotoxic procedures
o manage patients pre- and post-hemodialysis Musculoskeletal/Multisystem/Psychosocial
• Musculoskeletal
o initiate and monitor progressive mobility measures
• Multisystem
o administer medications for procedural sedation and monitor patient response
o differentiate types of wounds, pressure injuries
o manage patients with complex wounds (e.g., fistulas, drains and vacuum-assisted closure devices)
o manage patients with infections
• Psychosocial
o implement suicide prevention measures
o screen patients using a delirium assessment tool (e.g., CAM)
o use alcohol withdrawal assessment tools (e.g., CIWA)
General
• Administer medications and monitor patient response
• Anticipate therapeutic regimens
• Monitor diagnostic test results
• Perform an assessment pertinent to the system
• Provide health promotion interventions for patients, populations and diseases
• Provide patient and family education unique to the clinical situation
• Recognize procedural and surgical complications
• Recognize urgent situations and initiate interventions
• Use complementary alternative medicine techniques and non-pharmacologic interventions

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Nursing
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AACN Progressive Critical Care Nursing
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Question: 83
What would be identified on the arterial blood gas results as a reflection of acute
respiratory distress syndrome?
A. Low PaO2 levels
B. High PaO2 levels
C. Decreased PaCO2
D. Increased HcO3
Answer: A
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.
Question: 84
What characteristics would the nurse most likely assess in a patient with reduced
Renal Reserve (early stages of renal disease)?
A. Elevated BUN (blood, urea, nitrogen) lab value.
B. Mild anemia and hypertension
C. Terminal uremia
D. Nocturia
Answer: A
In the beginning stages of renal disease, known as reduced renal reserve, the
characteristics that the nurse would assess is a Glomerular Filtration Rate that is
reduced to 50% of what it normally is. The BUN (blood, urea, nitrogen lab value)
will be slightly elevated- but there will be minimal, if any, clinical symptoms.
Question: 85
In end stage renal disease, what lab value should be monitored in relation to
bleeding?
A. Hemoglobin
B. Hematocrit
C. Platelet
D. Prothrombin time
Answer: C
The lab value that should be monitored in relation to bleeding is the level of
platelets in the patient's blood. The patient with end stage renal disease is at risk
for platelet dysfunction, putting them at risk for bleeding.
Question: 86
One of the qualities of an expert nurse is her ability to collaborate with the
interdisciplinary team as well as patients and their families. All of the following
are qualities of an "expert"� in collaboration except for:
A. Serves as a role model and teacher
B. Facilitates team meetings
C. Involved in patient outcomes
D. Is open to assistance
Answer: D
The qualities of a nurse with "expert"� collaborative qualities would have the
qualities of serving as a role model and teacher, facilitating meetings and
involvement in patient outcomes. While they are always ready to learn, the expert
collaborator is the teacher, not the one who needs assistance.
Question: 87
A female client with diabetes mellitus II comes to the facility complaining of
weakness and dizziness. Initial assessment reveals a heart rate of 105 beats per
minute, cold extremities, and pallor. The client reported that she had her insulin
shot about 2 hours ago. Which of the following actions of the nurse is the least
appropriate?
A. Check the client's blood glucose
B. Offer � can of orange juice
C. Prepare insulin
D. Offer about 4 Lifesavers
Answer: C
Based on the findings, the client is experiencing hypoglycemia. Insulin must not
be administered because it can further decrease the client's blood sugar levels. The
nurse should offer foods that contain about 10 to 15 grams of glucose, such as �
can of juice, 4 Lifesavers, and 4 teaspoons of sugar.
Question: 88
A man presented in surgical OPD with steady pain in left lower quadrant, change
in bowel habits, Tenesmus and Dysuria. He also complains of recurrent urinary
infections from fistulae. What necessary investigations would you like to do?
A. CT scan abdomen
B. Barium meal
C. Barium follow through
D. All of the above
Answer: D
All of the above investigations are necessary for diagnosing the condition called
Diverticulosis in a patient presenting with steady pain in left lower quadrant,
change in bowel habits, Tenesmus and Dysuria and recurrent urinary infections
from fistulae. Barium will show diverticula if present and CT scan will help
identify Diverticulitis.
Question: 89
89. A woman presented to surgical emergency with fever, nausea, vomiting and
diffuse abdominal pain. On examination, there was rebound tenderness and
rigidity. Patient gives history of recent abdominal surgery. What is the likely
diagnosis?
A. Appendicitis
B. Cholecystitis
C. Peritonitis
D. Pancreatitis
Answer: C
The most likely diagnosis is peritonitis, due to the diffuse abdominal pain, fever,
nausea and vomiting.

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References


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