最上級のPCCN試験問題AACNテスト最高成績で最速合格をゲットせよ！
試験準備には最適なPCCN試験問題2023年最新のAACN Certification究極な502問があります
PCCN認定試験は、アメリカ急性期看護協会（AACN）によって実施されます。AACNは、急性期医療および進行期医療の現場で働く10万人以上の看護師を代表する専門組織です。この組織は、急性に病気の患者にケアを提供する看護師に教育、リソース、サポートを提供しています。PCCN認定試験は、AACNが提供するいくつかの認定試験の一つです。
PCCN認定を獲得することは、専門能力開発に対する看護師のコミットメントを示し、分野での専門知識を検証します。また、彼らの仕事の見通しを強化し、キャリアの進歩の機会を開きます。 PCCN認定を保持している看護師は、自分の分野の専門家として認識されており、雇用主から高く評価されています。全体として、AACN PCCN認定試験は、プログレッシブケアユニットでの看護実践の高い基準を設定する厳格で尊敬される資格情報です。
質問 # 163
This physiologic adaptive mechanism is a response to a decrease in alveolar oxygen and moves capillary blood flow from a closed or atelectatic alveolus to an open alveolus:
- A. Decreased minute ventilation
- B. Hypoxic vasoconstriction
- C. The Haldane effect
- D. The Bohr effect
正解：B
解説：
Correct answer: Hypoxic vasoconstriction
Hypoxic vasoconstriction is an adaptive response that moves capillary blood flow from a closed alveolus to an open alveolus. Since this response no longer occurs in COPD patients, dead space ventilation or decreased perfusion occurs which results in increased carbon dioxide levels.
The Haldane effect describes the condition in which, as hemoglobin is desaturated with oxygen, the affinity for carbon dioxide is increased. When oxygen is then administered, it displaces carbon dioxide on hemoglobin and the carbon dioxide levels in plasma is increased. Since COPD patients are unable to blow off carbon dioxide, blood pH levels decrease and respiratory acidosis ensues.
Decreased minute ventilation may occur in some patients with COPD as a result of dead space ventilation which increases levels of carbon dioxide; decreased minute ventilation then further limits the patient's inspiratory reserve capacity.
The Bohr effect refers to the lowered affinity of hemoglobin for oxygen in the presence of increases in carbon dioxide or decreased pH.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 260.
質問 # 164
Aortic dissections are classified as acute if they have occurred:
- A. Less than 6 weeks since the onset of symptoms
- B. Less than 2 weeks since the onset of symptoms
- C. Less than 2 months since the onset of symptoms
- D. Less than 4 weeks since the onset of symptoms
正解：B
解説：
Correct answer: Less than 2 weeks since the onset of symptoms
Patients seldom demonstrate early signs of an aortic aneurysm. The diagnosis is often made during a chest x-ray or a routine physical examination. Dissections are classified as acute if they have occurred less than two weeks since the onset of symptoms and chronic if they occurred more than two weeks since the onset of symptoms.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 481.
質問 # 165
Which of the following are considered cornerstone therapy for heart failure in an effort to reverse the remodeling of the left ventricle?
- A. ACE inhibitors and digoxin
- B. ACE inhibitors and angiotensin receptor blockers
- C. ACE inhibitors and beta-blockers
- D. ACE inhibitors and aldosterone antagonists
正解：C
解説：
Correct answer: ACE inhibitors and beta-blockers
ACE inhibitors and beta-blockers are considered cornerstone therapy for heart failure in an effort to reverse the remodeling of the left ventricle.
Aldosterone antagonists may be used as add-on therapy. Digoxin is no longer considered to be first-line therapy unless paroxysmal atrial fibrillation or atrial flutter is present. An angiotensin receptor blocker may be used if ACE inhibitors are contraindicated.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 233.
質問 # 166
Mr. John, who is suffering from advanced dementia, has presented to emergency after being hit by a car. The nurse will assess the pain by:
- A. Numerical pain assessment scale
- B. Both A and B
- C. Careful observation of non-verbal behavior
- D. Careful observation of verbal behavior
正解：C
解説：
Explanation: The nurse will assess the pain of a dementia patient who was hit by a car through careful observation of non-verbal behavior. Nonverbal communication (NVC) is usually understood as the process of communication through sending and receiving wordless messages. i.e., language is not the only source of communication, there are other means also. NVC can be communicated through gestures and touch (Haptic communication), by body language or posture, by facial expression and eye contact.
NVC can be communicated through object communication such as clothing, hairstyles or even architecture, symbols and infographics.
質問 # 167
A young man presented to surgical emergency with a gunshot wound in chest and is in respiratory distress. On examination, chest is dull on percussion and absent on auscultation. Patient is bleeding profusely. What has happened to him?
- A. Thoracic hemothorax with pneumothorax
- B. Atelectasis
- C. Pneumothorax
- D. Thoracic hemothorax
正解：A
解説：
Explanation: The patient has t horacic hemothorax with pneumothorax. The patient, presenting with a gunshot wound and is in respiratory distress has Thoracic Hemothorax with Pneumothorax, since he is bleeding profusely and his chest is dull on percussion and absent on auscultation. In gunshot wounds, there are more chances of Hemothorax with underlying Pneumothorax.
質問 # 168
All of the following statements made by a patient reflect caring practice by the nurse on the unit except:
- A. "The nurse took over an hour to bring me a pain pill."
- B. "The nurse is always cheerful."
- C. "The nurse brought me an extra blanket."
- D. "The nurse took time to answer my questions."
正解：A
解説：
Correct answer: "The nurse took over an hour to bring me a pain pill."
Taking over an hour to deliver medication for pain is not an example of creating a compassionate, supportive and therapeutic environment for the patient.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 194-196.
質問 # 169
In the approaches to teaching, internet modules are suitable for:
- A. small groups
- B. giving targeted instructions for individuals
- C. independent learners
- D. academic or detailed information
正解：C
解説：
Explanation: Internet modules are suitable for independent learners. There are different approaches to teaching, and the teacher must prepare, present, and coordinate a wide range of educational workshops, lectures and discussions.
質問 # 170
Which of the following is an antiarrhythmic medication with a class IIa recommendation for pharmacological cardioversion of atrial fibrillation?
- A. Flecainide
- B. Amiodarone
- C. Ibutilide
- D. Propafenone
正解：B
解説：
Correct answer: Amiodarone
Amiodarone has a class IIa recommendation in the pharmacological cardioversion of atrial fibrillation (benefit > > risk).
Ibutilide, propafenone, and flecainide are antiarrhythmics used in the pharmacological cardioversion of atrial fibrillation and carry a class I recommendation (benefit > > > risk).
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 51-52.
質問 # 171
The nurse is caring for a 59-year-old male client with a known case of chronic obstructive pulmonary disease. The client had an appendectomy a day before. Which of the following is a priority intervention in preventing respiratory complications?
- A. Maintain the flow of oxygen at 4 to 5 L at all times
- B. Have the client perform deep breathing exercises every morning and before sleeping
- C. Help client to turn to sides every 2 hours and ambulate around the room
- D. Ensure that hourly nebulization is done
正解：C
解説：
Explanation: Hypostatic pneumonia is a dangerous complication of surgery. Frequent turning and early ambulation ensure that secretions do not pool in the lungs. Administering oxygen does not prevent respiratory complications. Option C is incorrect. The client should perform this exercise at least once every hour. Option D is unnecessary unless the condition has worsened.
質問 # 172
Trousseau sign is considered to be positive when carpopedal spasm is produced in response to occlusion of circulation to the extremity for:
- A. One minute
- B. Three minutes
- C. 90 seconds
- D. 30 seconds
正解：B
解説：
Correct answer: Three minutes
Trousseau sign is considered to be positive when carpopedal spasm is produced in response to occlusion of circulation to the extremity for three minutes.
Trousseau sign is an indication of latent tetany in which carpal spasm occurs when the upper arm is compressed, as by a tourniquet or a blood pressure cuff. Trousseau sign is positive in conditions such as hypocalcemia and hypomagnesemia.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 379.
質問 # 173
In communicating with families and patients, the least therapeutic interaction by the nurse is to:
- A. Apologize for inconveniences
- B. Elicit care provider preferences
- C. Provide concise explanations without using medical shorthand
- D. Maintain confidentiality
正解：B
解説：
Correct answer: Elicit care provider preferences
In communicating with families and patients, the least therapeutic interaction by the nurse is to elicit care provider preferences; accommodating requests for preferred care providers should be avoided.
Communication with the patient and the family should be open and honest. Clinicians should avoid contracting for secrets, keep promises, describe expectations, and maintain confidentiality.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 29.
質問 # 174
A patient being managed in in-patient department is suspected to have pulmonary embolism. What is the confirmatory test for this?
- A. ABG analysis
- B. Chest x-ray
- C. D-dimers
- D. V/Q scintigraphy
正解：D
解説：
Explanation: The confirmatory test for this is V/Q scintigraphy. Acute pulmonary embolism occurs due to blockade of pulmonary artery or arteriole with a blood clot originating in the venous system or the right heart. Different laboratory test can help in diagnosing the disease like ABG analysis, Chest X-ray, ECG but the V/Q scintigraphy is the confirmatory test for patient with suspected pulmonary embolism.
質問 # 175
Risk factors for meningitis include all of the following except:
- A. Trauma
- B. Crowded living conditions
- C. Immunocompromise
- D. Gender
正解：D
解説：
Correct answer: Gender
Meningitis is an acute inflammation of the meninges of the brain and spinal cord. It can be caused by bacteria, viruses, fungi, or parasites. Risk factors include crowded living conditions, immunocompromise, trauma, surgery that disrupts the meninges, and trauma.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 318.
質問 # 176
Which of the following occurs in liver failure due to a decrease in function of Kupffer cells?
- A. Mental status change
- B. Malnutrition
- C. Infection
- D. Bleeding
正解：C
解説：
Correct answer: Infection
Infection occurs in liver failure as a result of reduced metabolic processes and decreased phagocytic function of Kupffer cells.
Malnutrition occurs in liver disease due to altered fat, protein, and carbohydrate metabolism. Bleeding occurs related to portal hypertension and decreased synthesis of blood clotting components. Impaired metabolic processes also decrease the liver's detoxification ability, leading to mental status changes.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 350.
質問 # 177
Bruising of the spinal cord that includes bleeding into the spinal cord is known as:
- A. Contusion
- B. Concussion
- C. Laceration
- D. Hemorrhage
正解：A
解説：
Correct answer: Contusion
Concussion of the spinal cord causes temporary loss of function. Laceration describes a tear in the spinal cord that results in permanent injury. Transection is a severing of the spinal cord resulting in complete loss of function below the level of the injury.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 505.
質問 # 178
An aortic aneurysm dissection begins with a tear in which of the following?
- A. The intima
- B. The media
- C. The lamina
- D. The tunica adventitia
正解：A
解説：
Correct answer: The intima
The aorta is made up of three layers: the intima, the media, and the tunica adventitia. Dissection of an aortic aneurysm begins with a tear in the intima. Blood leaves the central aorta through this tear and flows through the medial layer and creates a false lumen. As the volume of blood increases in the media, pressure in the false lumen also increases and compresses the central aorta. The compression can decrease or totally obstruct the flow of blood through the aorta and/or its arterial branches.
The lamina is part of the neural arch of a vertebra.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 481.
質問 # 179
A patient presented in neurology OPD with CT angiogram of the brain vessels, and an aneurysm, saccular in shape, was seen at bifurcation of the artery. Moreover, the aneurysm was thought to be congenital. Which is the most likely type of aneurysm in this case?
- A. Fusiform
- B. Mycotic
- C. Berry aneurysm
- D. Dissecting
正解：C
解説：
Explanation: Berry aneurysm the most likely type of aneurysm in this case. The most likely type of aneurysm in this case is the berry aneurysm, because it is congenital, saccular in shape and is seen at bifurcation of basilar artery.
質問 # 180
Which of the following is used to treat pruritus caused by opioids?
- A. Nalbuphine (Nubain)
- B. Ondansetron (Zofran)
- C. Metoclopramide (Reglan)
- D. Methylnaltrexone (Relistor)
正解：A
解説：
Correct answer: Nalbuphine (Nubain)
Opioid-induced pruritus can be treated with Nubain at small doses of 2.5 to 5.0 milligrams IV every 6 hours as needed.
Relistor is sometimes used for constipation in palliative care patients. Reglan and Zofran are used to treat opioid-induced nausea and vomiting.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 147.
質問 # 181
Which of the following types of generalized seizures is characterized by rhythmic muscle jerking?
- A. Tonic-clonic
- B. Tonic
- C. Clonic
- D. Atonic
正解：C
解説：
Correct answer: Clonic
Clonic seizures are characterized by rhythmic jerking of the muscles.
Atonic seizures are characterized by the sudden loss of muscle tone and are also known as drop attacks.
Tonic seizures are characterized by sustained muscle contractions. In tonic-clonic seizures, muscle activity varies between sustained muscle contraction and jerking.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 316.
質問 # 182
A patient being managed in the pulmonology ward for COPD should get all the medications except:
- A. Corticosteroids
- B. Analgesics
- C. Bronchodilators
- D. Supplemental oxygen therapy
正解：B
解説：
Explanation: A patient being managed in the pulmonology ward for COPD should get all the medications except analgesics. Analgesics have no role in relieving COPD as it is not a painful condition. The problem in this case to be managed in the pulmonology ward is that of airway constriction.
質問 # 183
In an adult, which of the following generally indicates severe bronchoconstriction?
- A. An absolute peak flow measurement of less than 275 L/minute
- B. An absolute peak flow measurement of less than 200 L/minute
- C. An absolute peak flow measurement of less than 100 L/minute
- D. An absolute peak flow measurement of less than 500 L/minute
正解：C
解説：
Correct answer: An absolute peak flow measurement of less than 100 L/minute Severe airflow obstruction in an acute asthma exacerbation results in several clinical findings and may include wheezing, pulsus, paradoxus, diaphoresis, and the inability to say an entire sentence. However, peak flow measurement is an excellent tool for determining the severity of the exacerbation. An absolute peak flow measurement of less than 100 L/minute in an adult generally indicates severe bronchoconstriction, especially in combination with a failure to respond to aggressive bronchodilator treatments.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 263-264.
質問 # 184
Medication errors can be minimized by:
- A. all the above
- B. avoiding error-prone abbreviations
- C. preventing illegible handwriting
- D. instituting bar coding and scanners for verification
正解：A
解説：
Explanation: All these are important in minimizing medication errors. Almost 7000 deaths are reported yearly in the United States are de to medication errors. These errors typically occur in the doses of medication given to patients in hospitals. A caring environment must be ensured for patient safety in proper handling and administering of medications.
質問 # 185
A nurse is assigned to suction a client's tracheostomy. The nurse would wear which personal protective equipment during the procedure?
- A. Sterile gloves, mask, gown
- B. Clean gloves, mask, gown, goggles
- C. Sterile gloves, mask, gown, goggles
- D. Clean gloves, mask, gown
正解：C
解説：
Explanation: When suctioning the client's tracheostomy, the nurse should wear sterile gloves, mask, gown, and goggles. Tracheal suctioning is a sterile procedure.
質問 # 186
The Medicare and Medicaid Electronic Health Record (EHR) Incentive Program, established by the Centers for Medicare and Medicaid Services, began offering incentives for hospitals and providers who demonstrated meaningful use of EHRs in:
- A. 0
- B. 1
- C. 2
- D. 3
正解：D
解説：
Correct answer: 2011
The incentives offered by this program led to the rapid replacement of traditional paper charting with electronic documentation in most health care settings. Electronic health records (EHR) are able to improve the quality of care for patients by facilitating communication, but not all systems were designed around health care workflow, and implementation of the systems became a source of moral distress for many providers.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 206.
質問 # 187
The responsibility of the patient and his/her family is to:
- A. all the above
- B. ask for clarification if they don't understand information provided
- C. provide honest information about health issues and medical history
- D. follow the plan of care that is outlined
正解：A
解説：
Explanation: All of these are the responsibility of the patient and family. Patients and families must act as their own advocates and should have a clear understanding of their rights and responsibilities. They should provide honest information about health issues and medical history.
質問 # 188
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注目のPCCN豪華セット試験ガイドで最速合格を目指そう：https://www.jpntest.com/shiken/PCCN-mondaishu
PCCN試験ガイド豪華セットで最速合格を目指そう：https://drive.google.com/open?id=1dPXQlZHzVyVEutL_kYvagGCziEZJoooJ