合格させるAACN Certification PCCNテスト問題集で[2023年12月26日] 更新された502問あります
AACN PCCN実際の問題と100%カバー率でリアル試験問題
米国クリティカルケア看護師協会（AACN）プログレッシブケア認定看護（PCCN）認定試験は、プログレッシブケアユニット（PCU）で働く登録看護師（RNS）向けに特別に設計された包括的な認定試験です。 PCCN認定は、中間ケア環境で重病患者にケアを提供する際に看護師の専門知識と知識を検証する広く認識されている資格情報です。認証試験では、心血管、肺、神経学、腎臓、内分泌、胃腸、および多系系障害、および患者の評価、監視、介入など、幅広いトピックをカバーしています。
AACN PCCN（Progressive Care Certified Nursing）試験は、プログレッシブケアユニットで働く看護師の知識とスキルをテストするために設計された認定試験です。これらのユニットは通常、病院で見られ、急性疾患であるが集中治療を必要としない患者にケアを提供します。プログレッシブケアユニットで働く看護師は、複雑な病状の患者を監視および治療する責任があります。
AACN PCCN認定試験は、プログレッシブケア看護で少なくとも2年の経験がある看護師を対象としています。この認定試験では、中程度の病気であるが、一般的な医療外科ユニットの患者よりも集中的で警戒している監視が必要な患者のケアに関連する看護師の知識とスキルを評価します。この試験では、心臓および肺のケア、血行動態、神経学、腎臓および内分泌機能、薬理学など、さまざまなトピックをカバーしています。
質問 # 263
Gastrointestinal distress, hepatotoxicity, and hepatic necrosis are signs and symptoms of an overdose of:
- A. Phencyclidine
- B. Acetaminophen
- C. Salicylates
- D. Barbituates
正解：B
解説：
Correct answer: Acetaminophen
Acetaminophen, readily available as an agent to treat pain or fever and also present in many combination medications, both prescribed and over-the-counter, is a significant cause of drug overdose.
It can cause hepatocellular damage to the extent that liver transplantation is required. Concerns about acetaminophen overdose led to changes in recommended dosing and relabeling of the product in 2015.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 287-288.
質問 # 264
All of the following are causes of fulminant hepatic failure except:
- A. Wilson's disease
- B. Acetaminophen
- C. Cholelithiasis
- D. Carbon tetrachloride
正解：C
解説：
Explanation: All of the following are causes of fulminant hepatic failure except Cholelithiasis. It is stones in gall bladder and can never lead to fulminant hepatic failure. Cholelithiasis is the presence of one or more calculi (gallstones) in the gallbladder. In developed countries, about 10% of adults and 20% of people > 65 yr have gallstones. Gallstones tend to be asymptomatic.
質問 # 265
Clinically significant respiratory depression resulting from opioid use is usually treated with which of the following?
- A. Intravenous ondansetron (Zofran)
- B. Subcutaneous ondansetron (Zofran)
- C. Intravenous naloxone (Narcan)
- D. Subcutaneous naloxone (Narcan)
正解：C
解説：
Correct answer: Intravenous naloxone (Narcan)
Clinically significant respiratory depression due to opioid use is usually treated with intravenous naloxone (Narcan).
IV naloxone (Narcan) is an opioid antagonist. It should be administered in very small doses and titrated to the desired level of alertness. The half-life of Narcan is very short, approximately 30 to 45 minutes, so careful assessment of the patient is necessary because additional doses may be needed.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 148.
質問 # 266
Mallory-Weiss Syndrome is most often associated with which of the following?
- A. Alcoholism
- B. Diabetes
- C. Morbid obesity
- D. Hypertension
正解：A
解説：
Correct answer: Alcoholism
Mallory-Weiss syndrome is a non-perforating tear in the gastric mucosa located near the gastroesophageal junction. It occurs due to the changes in intra-abdominal pressure in the stomach which occur with forceful vomiting. Classically, Mallory-Weiss syndrome is associated with alcoholics (who binge drink and then retch and forcefully vomit); however, the tears may occur in any patient with a history of repeated vomiting and in other circumstances with intra-abdominal pressure suddenly increases.
Mallory-Weiss syndrome is not typically associated with diabetes, hypertension, or morbid obesity.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 340.
質問 # 267
Nurses can develop advocacy and moral agency by using the following approach:
- A. All of the above.
- B. Modeling and role modeling
- C. Coaching and mentoring
- D. Role modeling
正解：A
解説：
Explanation: Nurses can develop advocacy and moral agency by using all of the above approaches. The ACCN synergy model ensures Nurse Competencies with advocacy/moral agency. There are different approaches that can help in developing nurse advocacy and moral agency. Nurses can develop advocacy and moral agency through role modeling, modeling, coaching and mentoring.
質問 # 268
A patient with suspected head injury presented to surgical emergency. A nurse is assigned to check the olfactory senses of the patient. How will she do that?
- A. Nostrils are checked one by one
- B. Both the nostrils are closed and then checked
- C. Both the nostrils are checked simultaneously
- D. None of the above
正解：A
解説：
Explanation: In order to check the olfactory senses of the patient with a suspected head injury, the nostrils are exposed to the smell of either coffee or soap, with 1 nostril closed, and the exercise is repeated with the other nostril.
質問 # 269
All of the following statements related to ventricular assist devices are true except:
- A. Once a ventricular assist device is inserted, a patient may be removed from the transplant list
- B. Ventricular assist device support is predominately utilized for the left ventricle
- C. Once inserted, a ventricular assist device is never removed
- D. An appropriate diagnosis for placement of a ventricular assist device is acute myocardial infarction with cardiogenic shock
正解：C
解説：
Correct answer: Once inserted, a ventricular assist device is never removed The ventricular assist device is removed when the myocardium has recovered to the point of consistently ejecting an adequate cardiac output.
Ventricular assist devices can be used as "bridge to recovery." For example, once the VAD is inserted and the patient recovers, he or she is discharged home. The VAD may then be removed in patients who experience myocardial recovery to the point of consistently ejecting an adequate cardiac output.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 489.
質問 # 270
A nurse is using an indwelling arterial catheter to obtain a blood sample for arterial blood gas analysis.
How much blood is withdrawn prior to obtaining the sample to clear the catheter system of any flush system fluid?
- A. 1 mL
- B. 3 to 5 mL
- C. 20 mL
- D. 8 to 10 mL
正解：B
解説：
Correct answer: 3 to 5 mL
Before obtaining the sample to be used for arterial blood gas analysis, a 3 to 5 mL sample of blood is withdrawn to clear the catheter system of any flush system fluid. A 1-mL sample for ABG analysis is then obtained in a heparinized syringe.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 99.
質問 # 271
The FOUR score is a validated tool used in the assessment of neurological patients. The categories scored in this tool are:
- A. Eye response, verbal, motor, respiration
- B. Eyes, pain response, brain stem reflexes, respirations
- C. Eyes, motor, brain stem reflexes, respirations
- D. Eye response, pain response, verbal response, respirations
正解：C
解説：
Correct answer: Eyes, motor, brain stem reflexes, respirations
The FOUR score assigns a score of 0 through 4 in each of the four categories and, because it includes respirations and brain stem reflexes, this tool allows for the identification of changes in patients who are comatose, non-verbal, or who have very limited responses.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 299-300.
質問 # 272
A 50-year-old man presents with frequent pain during rest periods. The pain lasts for a long time and may radiate to his left upper limb and jaw. He also complains of sweating and shortness of breath with this episode of pain. The pain increases with the passage of time and does not settle with the usual dose of nitroglycerine. Which of the following conditions is responsible for it?
- A. Pericarditis
- B. Stable angina
- C. Myocarditis
- D. Unstable angina
正解：D
解説：
Explanation: The condition responsible for the pain that occurs frequently even during rest and lasts for at least more than five minutes is unstable angina. No vasodilator has a significant role in reducing this pain. It occurs during times of rest because the very cause of unstable angina is a rupture of the plaque which occurs even during rest periods.
質問 # 273
The nurse is expected to protect the client's right to confidentiality of medical records. Which is the correct action of the nurse?
- A. Allowing the relative of the client who is a physician to gain access to the medical record with the client's permission
- B. Leaving the medical record in the nurse station while attending to other clients
- C. The information about the client's condition is shared with another health care provider who belongs to another department but is directly involved in client care
- D. Letting the relatives photocopy a few pages of the medical record with the client's permission
正解：C
解説：
Explanation: Members of the health care team who are directly involved in client care can access the information included in the client's record. Option C is incorrect. Only the staff directly involved in the care of the client is allowed to gain access to the medical record.
質問 # 274
When faced with decisions which involve disagreements over care between care providers, which of the following is the best potential referral for the nurse to consider making?
- A. Ethics committee
- B. Care coordinator
- C. Social work
- D. Pastoral care
正解：A
解説：
Correct answer: Ethics committee
Referrals to the ethics committee often include:
* Decisions which involve significant ethical complexity
* Decisions involving disagreements over care between care providers
* Decisions involving disagreements regarding care between care providers and the patient or family Referrals to pastoral care are often made for spiritual guidance or coping resources for the patient and/or the family. Referrals to social work are often made for financial needs or coping resources for the patient or family or for resources to help with transition planning. Referrals to the care coordinator are often made to assist with anticipated transition needs throughout and post-hospitalization.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 15.
質問 # 275
The most common cause of tracheal deviation seen on chest x-ray is:
- A. Emphysema
- B. Pleural effusion
- C. Atelectasis
- D. Pneumothorax
正解：D
解説：
Correct answer: Pneumothorax
On chest x-ray, the trachea should appear midline, with the carina seen at the level of the aortic knob or second intercostal space. Pneumothorax, which is the most common cause of tracheal deviation, causes a mediastinal and tracheal shift to the area away from the pneumothorax.
Pleural effusion and atelectasis can also cause tracheal deviation from midline; however, pneumothorax is the most common cause. Emphysema does not typically cause tracheal deviation. More common chest x-ray findings in emphysema include hyperinflated lungs, flattened diaphragm, and widened intercostal spaces.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 247-248.
質問 # 276
All of the following are examples of community acquired pneumonia except:
- A. Legionella species
- B. Moraxella catarrhalis
- C. Streptococcus pneumoniae
- D. Hemophilus influenzae
正解：B
解説：
Explanation: All of the following are examples of community acquired pneumonia except Moraxella Catarrhalis, are common causes of community acquired pneumonia (CAP). Moraxella catarrhalis is a Gram-negative, aerobic, oxidase-positive diplococcus that may both colonize and cause respiratory tract-associated infection in humans.
質問 # 277
An example of primary brain injury is:
- A. Hypoxemia
- B. Hypocapnia
- C. Increased intracranial pressure
- D. Epidural hematoma
正解：D
解説：
Correct answer: Epidural hematoma
Primary brain injury can be described as focal (resulting in local damage at the site of damage) or diffuse (affecting the whole brain). Secondary brain injury is ongoing neuronal damage that occurs following the traumatic brain injury as the result of systemic and intracranial complications.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 500-502.
質問 # 278
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. 200 J
- C. 360 J
- D. 50-100 J
正解：C
解説：
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.
質問 # 279
Regarding hospital-acquired infections, the nurse realizes that:
- A. Pneumonias are the most common hospital-acquired infections in the progressive care setting
- B. If a urinary catheter was placed in an emergency situation, it should be left in place and antibiotics initiated rather than increasing the risk of infection caused by replacing the catheter.
- C. It is estimated that at least 65% of progressive care patients acquire some type of infection
- D. Urinary tract infections are the most common hospital-acquired infections in the progressive care setting
正解：D
解説：
Correct answer: Urinary tract infections are the most common hospital-acquired infections in the progressive care setting Pneumonias are the second most common hospital-acquired infections in the progressive care setting and the leading cause of mortality from infections. It is estimated that 20% to 60% of progressive care patients acquire some type of infection, not 65%. If a urinary catheter was inserted in an emergency situation, it should be replaced as soon as possible or within 48 hours.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 22-23.
質問 # 280
Oversensing of a pacemaker can be caused by:
- A. Intrinsic ventricular activity falling in the pacemaker's refractory period
- B. Asynchronous mode
- C. The sensitivity control being set too high
- D. Intrinsic QRS voltage too low to be sensed by the pacemaker
正解：C
解説：
Correct answer: The sensitivity control being set too high
Oversensing is usually due to the sensitivity control being set too high, which can be corrected by turning the sensitivity dial counter-clockwise and reducing the pacemaker's sensitivity. Unless a higher sensitivity is needed to make the pacemaker sense QRS complexes, it is recommended the sensitivity control be set at about 2 mV (between the 1 and 3 o'clock positions on the dial) and not all the way to the right.
The other answer choices would result in failure to sense or undersensing rather than oversensing.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 458-460.
質問 # 281
Which of the following statements is true related to the principle of double effect?
- A. It states that the administration of medications that may inadvertently hasten death is illegal
- B. It asserts that a provider who assists in a patient's death cannot be legally charged
- C. It attests that inadequate pain management in palliative care patients is illegal
- D. It helps to distinguish palliative care from assisted suicide
正解：D
解説：
Correct answer: It helps to distinguish palliative care from assisted suicide The principle of double effect states that if an action has both a good and bad effect, a nurse is justified in taking that action if the intent was the good effect and the bad effect was a possible, but not a certain outcome, and there was no other option which could produce the good effect and avoid the bad one.
This principle was cited by the United States Supreme Court in a decision that distinguished palliative care from assisted suicide.
Providers who assist in the death of a patient intend to do harm and can be legally charged. Inadequate pain management in palliative care patients is unethical, not illegal.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 203-204.
質問 # 282
A 35-year-old female client is diagnosed with peritonitis. Which of the following assessments warrants an immediate intervention?
- A. Pulse rate of 120, blood pressure of 90/60
- B. Shallow respiration
- C. Temperature of 100OF
- D. Decreased bowel sounds
正解：A
解説：
Explanation: Tachycardia and hypotension are initial signs of shock. Immediate attention should be given to hydrate the client and correct electrolyte imbalances. Fever is the body's response to infection and fluid loss. Decreased bowel sounds may be due to paralytic ileus and abdominal distention. Shallow respiration may result from upward displacement of the diaphragm due to ascites.
質問 # 283
Which of the following statements is true regarding hypoglycemia?
- A. Only type 1 diabetics may experience deficiencies in counterregulation systems, leading to hypoglycemic unawareness
- B. The American Diabetes Association defines clinically significant hypoglycemia as any low blood glucose value associated with cognitive impairment
- C. The American Diabetes Association defines clinically significant hypoglycemia as less than 70 mg/dL
- D. The American Diabetes Association defines clinically significant hypoglycemia as less than 54 mg/dL
正解：D
解説：
Correct answer: The American Diabetes Association defines clinically significant hypoglycemia as less than 54 mg/dL Hypoglycemia is an endocrine emergency. The American Diabetes Association (ADA) defines clinically significant hypoglycemia as less than 54 mg/dL; any value associated with cognitive impairment is considered to be severe hypoglycemia. A blood glucose level of less than 70 mg/dL is often used as an alert level in hospitals.
Hypoglycemic unawareness is the loss of the adrenergic symptoms which prompt a patient to act to prevent the progression of severe hypoglycemia. It occurs as a result of alterations in counterregulation physiology and both type 1 and type 2 diabetics may have deficiencies in counterregulation systems.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 394, 396.
質問 # 284
Understanding Jehovah's Witnesses is an example of:
- A. cultural competence
- B. none of the above
- C. response to diversity
- D. cultural sensitivity
正解：D
解説：
Explanation: Understanding Jehovah's Witnesses is an example of cultural sensitivity. Jehovah Witnesses religiously have not been allowed for blood transfusions and blood products.
質問 # 285
After having a fight, a young man presented to the trauma center with a lacerated wound in the right chest. Patient was in severe respiratory distress. Examination showed there was tachycardia and tachypnea. Moreover, breath sounds were absent in right chest. Chest x-ray showed mediastinal shift to left. What is the most likely diagnosis?
- A. Emphysema
- B. Spontaneous pneumothorax
- C. Tension pneumothorax
- D. Pneumonia
正解：C
解説：
Explanation: The most likely diagnosis in this case, where patient has long history of fighting, during which he got lacerations that could have ruptured the pleura and led to pneumothorax is tension pneumothorax. Tension pneumothorax is evident from patient's dyspnea and mediastinal shift in CXR (PA).
質問 # 286
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AACN PCCNリアル2023年最新のブレーン問題集で模擬試験問題集：https://www.jpntest.com/shiken/PCCN-mondaishu
PCCN無料試験問題と解答PDF更新されたのは2023年12月：https://drive.google.com/open?id=1oTj7eMV8VUKAxLBrnvDKjVIG8EcFTUpP