PCCN Sample Exam Questions

The PCCN exam, which focuses on the adult patient population, incorporates Professional Caring and Ethical Practice. This section is based on the AACN Synergy Model for Patient Care and makes up 20% of the exam. The remaining 80% of the exam covers Clinical Judgment. For more information, please read about the Synergy Model.

  1. A patient who had an MI one week ago suddenly becomes agitated, restless and diaphoretic. Pulse pressure drops to 20 mm Hg. Assessment also reveals faint radial and apical pulses that weaken significantly on inspiration. This patient is most likely experiencing:
    • mitral valve rupture.
    • pulmonary embolus.
    • pulmonary edema.
    • cardiac tamponade.
  2. Which of the following may predispose an individual to ventricular fibrillation?
    • hypernatremia and hypomagnesemia
    • hypophosphatemia and hyperchloremia
    • hypermagnesemia and hyponatremia
    • hyperkalemia and hypocalcemia
  3. Chest auscultation of a patient in status asthmaticus commonly reveals:
    • expiratory wheezes.
    • inspiratory crackles.
    • diminished bilateral breath sounds.
    • a pleural friction rub.
  4. 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:
    • adhere to the visiting policy.
    • allow the family to stay in the room.
    • obtain a motel room near the hospital where the family may spend the night.
    • allow one or two family members to stay, then evaluate the patient's response.
  5. Members of the nursing staff are developing written patient education materials for a group of patients with diverse reading abilities. It would be most effective for the staff to:
    • design individual handouts for each patient.
    • develop a computer-based education series.
    • write the materials at a fourth-grade reading level.
    • limit text and provide color pictures.
  6. Two days following admission for rapid atrial fibrillation, a patient has been weaned from IV diltiazem (Cardizem) to PO administration. The patient develops new onset of hallucinations, agitation and disorientation. The most appropriate initial nursing action is to:
    • obtain an order for lorazepam (Ativan) every six hours.
    • assess the patient’s SpO2 and neurological status.
    • obtain an order for haloperidol (Haldol) and monitor QT intervals.
    • consult with the pharmacy regarding possible drug interaction.
  7. Which of the following electrolyte abnormalities should the nurse anticipate in a patient with chronic alcoholism?
    • hypomagnesemia
    • hyperphosphatemia
    • hyponatremia
    • hyperkalemia

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PCCN Sample Exam Questions With Answers

  1. A patient who had an MI one week ago suddenly becomes agitated, restless and diaphoretic. Pulse pressure drops to 20 mm Hg. Assessment also reveals faint radial and apical pulses that weaken significantly on inspiration. This patient is most likely experiencing:
    • mitral valve rupture.
    • pulmonary embolus.
    • pulmonary edema.
    • CORRECT - cardiac tamponade.
  2. Which of the following may predispose an individual to ventricular fibrillation?
    • hypernatremia and hypomagnesemia
    • hypophosphatemia and hyperchloremia
    • hypermagnesemia and hyponatremia
    • CORRECT - hyperkalemia and hypocalcemia
  3. Chest auscultation of a patient in status asthmaticus commonly reveals:
    • CORRECT - expiratory wheezes.
    • inspiratory crackles.
    • diminished bilateral breath sounds. 
    • a pleural friction rub.
  4. 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:
    • adhere to the visiting policy.
    • allow the family to stay in the room.
    • obtain a motel room near the hospital where the family may spend the night.
    • CORRECT - allow one or two family members to stay, then evaluate the patient's response.
  5. Members of the nursing staff are developing written patient education materials for a group of patients with diverse reading abilities. It would be most effective for the staff to:
    • design individual handouts for each patient.
    • develop a computer-based education series.
    • CORRECT - write the materials at a fourth-grade reading level.
    • limit text and provide color pictures.
  6. Two days following admission for rapid atrial fibrillation, a patient has been weaned from IV diltiazem (Cardizem) to PO administration. The patient develops new onset of hallucinations, agitation and disorientation. The most appropriate initial nursing action is to:
    • obtain an order for lorazepam (Ativan) every six hours.
    • CORRECT - assess the patient’s SpO2 and neurological status.
    • obtain an order for haloperidol (Haldol) and monitor QT intervals.
    • consult with the pharmacy regarding possible drug interaction.
  7. Which of the following electrolyte abnormalities should the nurse anticipate in a patient with chronic alcoholism?
    • CORRECT - hypomagnesemia
    • hyperphosphatemia
    • hyponatremia
    • hyperkalemia