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Earning the PCCN certification demonstrates a nurse's commitment to professional development and validates their expertise in the field. It also enhances their job prospects and opens up opportunities for career advancement. Nurses who hold the PCCN certification are recognized as experts in their field and are highly valued by employers. Overall, the AACN PCCN certification exam is a rigorous and respected credential that sets a high standard for nursing practice in progressive care units.
NEW QUESTION # 268
An Ethical Principle that means healthcare workers should provide care in a manner that does not cause direct intentional harm to the patient is called:
- A. Bargaining
- B. Non-maleficence
- C. Beneficence
- D. None of the above
Answer: B
Explanation:
Explanation: An Ethical Principle that means healthcare workers should provide care in a manner that does not cause direct intentional harm to the patient is called Non-maleficence. It is an Ethical Principle that ensures that the healthcare workers do not cause intentional harm to the patients. In these the nurse should be careful in providing the best and actual good effect to the patient. Must avoid bad effects or atleast good effect must be more benefited then the bad effect.
NEW QUESTION # 269
All of the following statements related to haloperidol are true except:
- A. Extrapyramidal reactions to haloperidol are possible
- B. It sedates without significant respiratory depression
- C. QTc interval monitoring is required when using haloperidol
- D. It is associated with the development of tolerance
Answer: D
Explanation:
Correct answer: It is associated with the development of tolerance
Haloperidol is not associated with the development of dependence tolerance or dependence and it induces sedation without significant respiratory depression. This made it popular in the past. However, it is associated with other potential side effects that must be closely monitored.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 156.
NEW QUESTION # 270
Which of the following statements is true related to nurses and the ethical problems they face?
- A. Due to the risk of breaching patient trust, a nurse should never seek the support of colleagues in solving an ethical dilemma
- B. A seasoned nurse rarely finds that obligations to oneself, the patient, other members of the health care team, or the institution are in conflict
- C. When faced with ethical problems, nurses are more likely to reach a resolution if a consistent process is applied
- D. A structured approach to ethical analysis increases the risk of overlooking relevant information
Answer: C
Explanation:
Correct answer: When faced with ethical problems, nurses are more likely to reach a resolution if a consistent process is applied Nurses often find that obligations to oneself, patients, other members of the health care team, or the institution are in conflict; these situations can be very troubling, and the support of colleagues is essential in resolving these situations. An approach to these problems which is structured decreases the risk of overlooking relevant information and invites thoughtful reflection. As an individual, a nurse may practice the skill of ethical analysis, but including others in addressing the situation is a more robust process. The support of colleagues is, at times, essential to solving ethical dilemmas.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 198-199.
NEW QUESTION # 271
Following intravenous administration of which of the following angiotensin-converting enzyme (ACE) inhibitors does blood pressure lowering occur within 15 minutes and last from 4 to 6 hours?
- A. Ramipril
- B. Enalapril
- C. Captopril
- D. Fosinopril
Answer: B
Explanation:
Correct answer: Enalapril
Enalapril is the only ACE inhibitor that is a prodrug; it is metabolized in the liver to its active and long- acting form, enalaprilat. Enalaprilat is available for IV administration; enalapril is available for oral administration.
ACE inhibitors currently available for oral administration include captopril, fosinopril, and ramipril.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 173.
NEW QUESTION # 272
Following the administration of a warfarin dose, the peak depression of coagulation occurs in approximately how long?
- A. 36 hours
- B. 12 hours
- C. 8 hours
- D. 24 hours
Answer: A
Explanation:
Correct answer: 36 hours
Following the administration of warfarin, the peak depression of coagulation occurs in approximately 36 hours. The timing of INR measurements in relation to changes in daily dosing is important. Coagulation tests should be consistently performed at an appropriate time during a given dosing schedule. After the first four to five doses, the fluctuation in the INR over a 24-hour dosing interval is minimal.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 184.
NEW QUESTION # 273
Which of the following statements related to valvular heart disease is true?
- A. Heart valve stenosis is also referred to as valvular regurgitation
- B. Bicuspid aortic valve is associated with senile aortic stenosis
- C. Rheumatic disease is a type of congenital valve disorder
- D. A stenotic valve is one that does not fully close, thereby permitting blood to flow backward rather than forward
Answer: B
Explanation:
Correct answer: Bicuspid aortic valve is associated with senile aortic stenosis Bicuspid aortic valve is an example of a congenital valve disorder and is associated with an increase in turbulence as blood flows through the narrowed orifice. Individuals with the disorder may become symptomatic and develop senile aortic stenosis later on in life, when fibrotic tissue and calcium deposits form on the abnormal valve (only two cusps instead of three), leading to stenosis.
An insufficient valve, rather than a stenotic valve, is one that does not fully close and so allows some blood to flow backward rather than forward. Heart valve insufficiency, rather than heart valve stenosis, is also referred to as valvular regurgitation. Rheumatic disease is a type of acquired, rather than congenital, valve disorder.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 472.
NEW QUESTION # 274
What are the findings evident in abdominal x-rays in case of Peritonitis?
- A. Coin stack appearance
- B. No specific changes
- C. Distention of intestines and air in peritoneum
- D. Air fluid levels
Answer: C
Explanation:
Explanation: Distention of intestines and air in peritoneum are the findings evident in abdominal x-rays in case of Peritonitis. Abdominal x-rays in case of Peritonitis show distention of intestines and air in peritoneum because decreased bowel movement results in abdominal distention, and perforation results in air in peritoneum.
NEW QUESTION # 275
The 2016 Sepsis guidelines recommend the use of the sequential (sepsis-related) organ failure (SOFA) score to predict patient outcomes from sepsis. The qSOFA (quick SOFA) can be used as a quick screening tool to identify those patients at risk of death due to sepsis. The qSOFA assesses which of the following variables?
- A. Heart rate, respiratory rate, mentation
- B. Systolic blood pressure, mentation, respiratory rate
- C. Systolic blood pressure, heart rate, mentation
- D. Temperature, pulse oximetry, systolic blood pressure, mentation
Answer: B
Explanation:
Correct answer: Systolic blood pressure, mentation, respiratory rate
The qSOFA is a much shorter version of the SOFA and is modified to include only three variables: systolic blood pressure, mentation, and respiratory rate. It is considered positive if a patient meets at least two of the following criteria:
* Altered mentation
* Respiratory rate greater than or equal to 22 breaths per minute
* Systolic blood pressure less than or equal to 100 mm Hg
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 279.
NEW QUESTION # 276
The skills needed for collaboration are:
- A. willingness to compromise
- B. clear communication
- C. ability to work with teams
- D. all the above
Answer: D
Explanation:
Explanation: All these skills are needed for collaboration. An important form of collaboration is that between the nurse and the patient/family, this type of collaboration must not be overlooked.
NEW QUESTION # 277
Of the following, which is not a type of cardiomyopathy?
- A. Hypotrophic
- B. Restrictive
- C. Dilated
- D. Hypertrophic
Answer: A
Explanation:
Correct answer: Hypotrophic
Hypotrophic is not a type of cardiomyopathy. Hypertrophic cardiomyopathy is a type of cardiomyopathy and is often characterized as obstructive or nonobstructive.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 467.
NEW QUESTION # 278
How many stages of grief are there in Kubler-Ross's proposal?
- A. 0
- B. 1
- C. 2
- D. 3
Answer: A
Explanation:
Explanation: There are 5 stages of grief in Kubler-Ross's proposal. Grief is a normal response to the death or any problem of a patient. Every person deals with grief is very personal, and differently.
NEW QUESTION # 279
The Ethical principle that the patient has the right to make decisions about his or her own care is called as:
- A. Informed consent
- B. Autonomy
- C. None of the above
- D. Bioethics
Answer: B
Explanation:
Explanation: The Ethical principle that the patient has the right to make decisions about his or her own care is called as autonomy. Autonomy is the Ethical Principle that gives the patient the right to make decisions about his or her own care. Patient family or parents are the legal autonomy of making decision if the patient is not in the state of making decisions. Nurse must keep the patient and his family well informed about this power of autonomy.
NEW QUESTION # 280
All of the following electrolyte imbalances are likely to occur as a result of liver failure except:
- A. Hypokalemia
- B. Hypomagnesemia
- C. Hyperglycemia
- D. Hypocalcemia
Answer: C
Explanation:
Correct answer: Hyperglycemia
Hypoglycemia, rather than hyperglycemia develops in liver failure due to massive necrosis of the hepatic cells, which leads to the loss of glycogen stores and decreased release of glucose.
Hypokalemia may result due to inadequate oral intake, diuretic therapy, or vomiting which causes loss of potassium. Hypomagnesemia often occurs in conjunction with hypokalemia. Hypocalcemia results as a complication of multiple blood transfusions as the citrate which is used as an anticoagulant in stored blood causes depletion of calcium.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 350.
NEW QUESTION # 281
Which of the following chest x-ray views best allows for better visualization of the trachea, great vessels, and the heart?
- A. Lateral decubitus
- B. Lateral
- C. Oblique
- D. Lordotic
Answer: C
Explanation:
Correct answer: Oblique
Oblique chest x-ray views allow for localization of lesions without interference from the thorax or allow for better visualization of the trachea, carina, great vessels, and the heart.
Lateral views are best used to help identify structures at the base of the lungs, along the spine, and behind the heart. Lordotic views assist to help differentiate posterior from anterior lesions and to allow for better visualization of the middle and apical regions of the lungs. Lateral decubitus views are used to assess for free-flowing pleural fluid or air-fluid levels.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 246.
NEW QUESTION # 282
All of the following statements regarding the QT interval on an electrocardiogram are true except:
- A. A prolonged QTc (corrected QT interval) is associated with torsades de pointes and sudden cardiac death
- B. A shortened corrected QTc (corrected QT interval) indicates abnormally prolonged ventricular repolarization
- C. A normal corrected QT interval (QTc) is < 0.46 second in women and < 0.45 second in men
- D. The most commonly used method of correcting the measured QT interval for heart rate is the Bazett formula
Answer: B
Explanation:
Correct answer: A shortened corrected QTc (corrected QT interval) indicates abnormally prolonged ventricular repolarization A prolonged QTc indicates abnormally prolonged ventricular repolarization and is associated with torsades de pointes and sudden cardiac death. To determined the corrected QT interval, the measured QT interval is divided by the square root of the preceding R-R interval (all measurements are in seconds); this is known as the Bazett formula and is the most commonly used method of correcting the measured QT interval for heart rate.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 443.
NEW QUESTION # 283
What investigation would you carry out after stabilizing a patient of head trauma with altered state of consciousness?
- A. ESR
- B. Blood CP
- C. CT scan brain
- D. Chest X-ray
Answer: C
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 # 284
For treatment of ventricular fibrillation or pulseless ventricular tachycardia, Advanced Cardiac Life Support (ACLS) guidelines recommend an initial energy of how many joules (J) with a monophasic defibrillator?
- A. 400 J
- B. 50-100 J
- C. 360 J
- D. 200 J
Answer: C
Explanation:
Correct answer: 360 J
360 J is the initial energy recommended for a monophasic defibrillator by the Advanced Cardiac Life Support guidelines. The manufacturer's recommended suggested energy level is to be used for biphasic defibrillators.
If the manufacturer's suggested energy level is unknown, a 200-J shock is recommended in biphasic defibrillators. 50-100 J is the typical initial energy level for cardioversion.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 68.
NEW QUESTION # 285
The 6-minute-walk test is used in the diagnosis of:
- A. Pulmonary arterial hypertension
- B. Interstitial lung disease
- C. Chronic obstructive lung disease
- D. Asthma
Answer: A
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 # 286
Reversible ST-T wave changes occur in ECG in which one of the following types of myocardial infarctions?
- A. Myocarditis
- B. Non Q wave MI
- C. Pericarditis
- D. Q wave MI
Answer: B
Explanation:
Explanation: Reversible ST-T wave changes occur in ECG in Non Q wave MI. A non-Q-wave MI (NQWMI) refers to damage to the heart muscle that is smaller than with your typical Q-wave MI. MI stands for myocardial infarction and that's what doctors call heart attacks.
NEW QUESTION # 287
The use of a ventilator with a heated moisture exchanger (HME) is contraindicated in all of the following except:
- A. Patients who have frank bloody secretions
- B. Patients with a body temperature greater than 37 degrees Celsius
- C. Patients who have uncuffed endotracheal tubes
- D. Patients with body temperatures less than 32 degree Celsius
Answer: B
Explanation:
Correct answer: Patients with a body temperature greater than 37 degrees Celsius A ventilator that uses a heated moisture exchanger (HME) is contraindicated in patients with frank bloody or thick, copious secretions, patients with large bronchopleural fistulas, uncuffed or malfunctioning ET tube cuffs, and patients with body temperatures less than 32 degree Celsius.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 119.
NEW QUESTION # 288
Of the following medications, which is a recombinant human b-type natriuretic peptide which is effective in decreasing pulmonary wedge pressure and improving dyspnea symptoms in acutely decompensated heart failure patients who have dyspnea at rest or with minimal activity?
- A. Nesiritide
- B. Ibutilide
- C. Dofetilide
- D. Clevidipine
Answer: A
Explanation:
Correct answer: Nesiritide
This agent is a recombinant human b-type natriuretic peptide, a cardiac hormone, which regulates cardiovascular homeostasis and fluid volume during times of volume and pressure overload.
Ibutilide is a class III antiarrhythmic medication which is indicated for the conversion of recent-onset atrial flutter and atrial fibrillation to normal sinus rhythm. Dofetilide is also a class III antiarrhythmic, indicated for rhythm conversion in patients with atrial fibrillation. Clevidipine is a calcium-channel blocker used for the treatment of hypertension; it is only available in IV form.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 171, 174-175.
NEW QUESTION # 289
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