LATEST 2025 UPDATED PCCN EXAM QUESTIONS WITH CORRECT ANSWERS GRADED 100% (2025)

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• pccn

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• Institution PCCN,
• Course PCCN,

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LATEST 2025 UPDATED PCCN EXAM QUESTIONS
WITH CORRECT ANSWERS GRADED 100%

A frail, elderly pt recovering from an exploratory laparotomy was extubated following a
prolonged period of mechanical ventilation and IV sedation. She continues to receive PRN
opioids for pain. Today, the nurse notes occasional combativeness, fluctuating lethargy and poor
short-term memory. Data are as follows

BP 104/60

HR 87

RR 24

O2 sat 95% on 2L via NC

The nurse should recognize that

A. mobilization should be limited to prevent injury

B. the RASS scale should guide medication administration

C. the use of Haldol is associated with lethal dysrhythmias

D. moving the pt to a room with a window is a useful distraction technique - RIGHT ANSWER -C.
The most current guidelines advise cautious use of antipsychotic meds to manage delirium, as
risk versus benefits data remain unclear. Another choice may be a short-term trial of an atypical
antipsychotic such as Quetiapine (Seroquel)

A nurse caring for a 76 year old patient in the PCU. Which of the ff age related cardiac changes
should the nurse anticipate.

A. decreased response to catecholamines

B. increased myocardial complaince

C. decreased audibility of S1

D. increased resting heart rate - RIGHT ANSWER -A. Aging is associated with a decreased
response to catecholamines. It is also associated with decrease in myocardial compliance. It is

,also associated with an increased audibility of S1 because of increased rigidity of the ventricular
wall. It is associated with a decrease in resting HR.

A nurse overhears a student recommending a popular high-protein weight loss program to a
patient admitted with an exacerbation of heart failure. When the nurse asks the student why the
recommendation was made, the student replies, "The patient is obese." The nurse should
explain that

A. this is an appropriate recommendation, since heart failure patients are often obese because
of lack of energy

B. heart failure patients may appear to be obese are often nutritionally challenged because of
poor appetite.

C. the pt should be cautioned instead to decreased protein intake to avoid azotemia

D. nutritional counseling should be done by the physician - RIGHT ANSWER -B. The pt with heart
failure may be volume overloaded by 5 to 50 pounds over dry weight.

A patient admitted following an episode of new onset sepsis. assessment reveals new onset
dyspnea, intercostal retractions and crackles in all lung fields, pt is placed on oxygen via NC at
4Lpm which criteria ABG results should the nurse anticipate.

pH pCO2 pO2 O2sat HCO3

A. 7.5 30 59 89 23

B. 7.3 51 49 81 18

C. 7.26 32 63 91 14

D. 7.48 46 52 85 28 - RIGHT ANSWER -A. As the pt is dyspneic, the initial change in arterial blood
gases will be respiratory alkalosis. This will be reflected in a decrease in CO2 and corresponding
increase in pH.

A patient develops chest pain, shortness of breath and coughing 3 days after STEMI. The nurse
should suspect

A. Pneumothorax

B. aortic dissection

,C. Pulmonary embolism

D. Pericarditis - RIGHT ANSWER -C. This pt is exhibiting symptoms of PE

A patient reports severe nonradiating substernal chest pain. ECG reveals a 2 mm ST segment
elevation in the precordial leads. After pain relief is achieved with nitroglycerin, the ECG returns
to normal. Which of the following data is most useful in the acute management of this patient.

A. troponin I

B. serum electrolytes

C. coagulation studies

D. lipid profile - RIGHT ANSWER -A. This pt is demonstrating symptoms of ACS. In order to
determine if cardiac damage has occurred, troponin levels are obtain. When myocardial cells
become damaged, troponin levels will begin to rise in the bloodstream. Determination of the
presence of myocardial damage will help guide pt care management.

A cardiac pt with with DNR status is being managed medically. The nurse notes a new cough,
thick yellow sputum and a temperature of 101.4 (38.4) Coarse crackles are present in the right
upper field. The nurse should most immediately anticipate

A. blood and sputum cultures followed by a broad spectrum abx

B. mucolytics and judicious IV fluid administration

C. an antyipyretic and conservative management

D. NPO status and encouragement of frequent activity - RIGHT ANSWER -A. This pt symptoms
are consistent with pneumonia. Management should include abx therapy, oxygen therapy for
hypoxemia, mechanical ventilation if acute respiratory failure develops, fluid management for
hydration, nutritional support, and treatment of associated medical problems and complications.

A fellow employee confides to you about a personal addiction to narcotics. The colleague has
not sought professional help but is considering the need to do so. Conversation further reveals
she has been forging prescriptions to obtain drugs. When you ask her to report this to the
supervisor, she refuses and asks you not to share what you spoke about. What is the nurse best
course of action

A. confidentially report the conversation to the EDA

B. disregard the conversation and hope the situation resolves

, C. remove the prescription pads and limit her access to them

D. speak with the nursing supervisor - RIGHT ANSWER -D. Nurses who divert drugs pose a
significant threats to patient safety but also become a liability to healthcare organizations and
the nursing department where the diversion occurred. Healthcare and nursing leaders have a
responsibility to ensure that security systems are in place to prevent diversion and protect pt if
nursing impairment is suspected as a result of drug diversion. Nursing leaders must consider
legal, regulatory, ethical, humanistic and practical considerations in resolving this issue. The
nursing supervisor must be notified immediately and in a private area. This is a very sensitve
issue.

A patient with dilated cardiomyopathy is admitted with dyspnea, cough, palpitations and
decreased level of consciousness. The patient is in sinus tach with no ectopy. The nurse should
anticipate management to include

A. administration of captopril (Capoten)

B. insertion of a temporary left ventricular assist device

C. loading the pt with digoxin

D. preparation for dynamic cardiomyopathy procedure - RIGHT ANSWER -A. This pt is showing
symptoms of heart failure related to dilated cardiomyopathy. ACE inhibitors have been effective
in improving both symptoms and survival in these pt. Most pt will tolerate ACE inhibitor therapy
as well.

A post op CABG pt questions why he is receiving an insulin drip. The nurse explains the rationale
is

A. prevent the development of DM

B. reduce the risk of infection

C. prevent the development of intestinal ischemia

D. reduce the risk of acute renal failure - RIGHT ANSWER -B. Good glycemic control helps prevent
the risk of postoperative infections