[2024年最新] 高合格率な最新PCCNテストノートとPCCN高合格率な試験ガイドを試そう
PCCN実際の問題アンサーPDFには100%カバーリアル試験問題
AACN PCCN認定試験は、プログレッシブケアの設定で働く看護師にとって不可欠な資格情報プログラムです。この認定試験は、より集中的な監視を必要とする中程度の病気の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。 PCCN認定を取得することは、看護師の専門能力開発へのコミットメントを示し、雇用主に対する信頼性と市場性を高めます。
質問 # 246
Optimal cellular functioning occurs when the pH of the blood is:
- A. Between 7.35 and 7.45
- B. Between 7.45 and 7.55
- C. Between 7.25 and 7.35
- D. Between 7.55 and 7.60
正解：A
解説：
Correct answer: Between 7.35 and 7.45
Optimal cellular functioning occurs when the pH of the blood is between 7.35 and 7.45. Decreases in pH below 7.35 are termed acidemia and increases in pH above 7.45 are termed alkalemia.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 101.
質問 # 247
A patient with a tracheostomy spontaneously opens his eyes to verbal stimuli and obeys verbal commands. His Glasgow Coma Scale score is:
- A. 10T
- B. 0
- C. 1
- D. 0 or NA
正解：A
解説：
Correct answer: 10T
Patients with tracheostomies are commonly assigned a verbal score of T and the total Glasgow Coma Scale is (GSC) is denoted as the sum of the eye opening and motor scores followed by T.
Alternately, the examiner assigns a verbal score based on an estimation of the patient's abilities, often determined by noting the patient's response when presented with multiple choices.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 298-299.
質問 # 248
All of the following statements are true regarding the current guideline recommendations on red blood cell transfusion except:
- A. Transfusions decisions should be made according to patient symptoms as well as hemoglobin levels
- B. For hospitalized patients who are stable, transfusions should be restricted to patients with a hemoglobin below 7 g/dL
- C. In hospitalized patients with preexisting cardiovascular disease, transfusions should be limited to patients with symptoms or hemoglobin levels of 10 g/dL or less
- D. In hospitalized patients, a hemoglobin threshold of 8 g/dL is recommended for those undergoing orthopedic surgery
正解：C
解説：
Correct answer: In hospitalized patients with preexisting cardiovascular disease, transfusions should be limited to patients with symptoms or hemoglobin levels of 10 g/dL or less For hospitalized patients, a restrictive transfusion threshold of 8 g/dL is recommended for patients with preexisting cardiovascular disease and those undergoing cardiac or orthopedic surgery.
For hospitalized patients, including the critically ill, who are hemodynamically stable, a restrictive transfusion threshold of 7 g/dL is recommended.
In all cases, decisions regarding the need for transfusion of red blood cells should include an assessment of patient preference, the patient's status, and alternative therapy.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 328.
質問 # 249
A woman presented in medical OPD with epigastric pain, heart burn and dysphagi a. On further inquiry, she also has earache and chronic cough, especially at night. What is she suffering from?
- A. Pancreatitis
- B. None of the above
- C. Respiratory tract infection
- D. Gastroesophageal reflux disease
正解：D
解説：
Explanation: According to the symptoms described, she is suffering from GERD, in which there is epigastric pain, heartburn and dysphagia. Gastroesophageal reflux disease (GERD) is regurgitation of stomach contents back into the esophagus. This is involuntary phenomenon. It is due to decreased tone in the gastroesophageal valve and hiatal hernia, causing damage to the mucosal lining of the esophagus.
質問 # 250
In the basic research concepts, a sample that is too small may lack:
- A. internal validity
- B. internal and external validity
- C. neither internal nor external validity
- D. external validity alone
正解：B
解説：
Explanation: Internal and External validity are absent in samples that are too small in basic research concepts. The nurse must critically analysis and can conduct a survey of the literature. External validity is ensured if the results hold true in different environments and circumstances with different populations.
質問 # 251
Treatment of torsades de pointes may include all of the following except:
- A. Overdrive atrial or ventricular pacing at a rate of 80 beats per minute or faster to prevent the pauses that may precipitate episodes of torsades de pointes
- B. Teaching the patient lifestyle modifications such as avoidance of swimming and startling loud noises like alarm clocks
- C. Defibrillation with an unsynchronized shock to terminate the episode if torsades de pointes degenerates into ventricular fibrillation
- D. Managing the patient with pacing and magnesium as temporary strategies until the underlying cause of the disorder can be eliminated
正解：B
解説：
Correct answer: Teaching the patient lifestyle modifications such as avoidance of swimming and startling loud noises like alarm clocks Lifestyle modifications may be necessary and appropriate in congenital long-QT syndromes, not in torsades de pointes (TdP).
Treatment of TdP includes identifying and managing the cause, discontinuing any causative drugs, and correcting electrolyte imbalances. IV magnesium can be administered to control episodes of TdP until the cause is corrected.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 444-445.
質問 # 252
All of the following are correct nursing actions to be taken if acute dissection or rupture of an aneurysm occurs while waiting for the operating room team to arrive except:
- A. Administer blood replacement products to maintain adequate hemoglobin and hematocrit levels
- B. Titrate vasoconstrictors to maintain the patient's blood pressure
- C. Administer narcotics for pain
- D. Administer fluids to prevent hypovolemia
正解：B
解説：
Correct answer: Titrate vasoconstrictors to maintain the patient's blood pressure Vasodilators, not vasoconstrictors, should be titrated to maintain the patient's blood pressure as low as possible (90-120 mm Hg if tolerated). This decreases the pressure on the aneurysm.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 483.
質問 # 253
A middle-aged woman came to the emergency department with worsening dyspnea, pressure in head and increased respiratory rate. She was known to have pulmonary edema secondary to heart failure. On examination, there was tachycardia, tachypnea, and hypertension. ABGs were carried out which showed pH < 7.35, paCO2>42 mm of HG, and H2CO3 was also high. What is the likely diagnosis?
- A. Metabolic acidosis
- B. Respiratory alkalosis
- C. Metabolic alkalosis
- D. Respiratory acidosis
正解：D
解説：
Explanation: The most likely diagnosis in the patient with pulmonary edema presenting with increased respiratory rates is respiratory acidosis because ph < 7.35, paCO2 >42 mm of Hg and H2CO3 is also high.
These, along with her symptoms of worsening dyspnea and pressure in the head are all indicators of respiratory acidosis.
質問 # 254
The third element of the synergy model, healthcare environment provides which of the following?
- A. Empowers the practice of nursing.
- B. Nurtures the practice of caring.
- C. Empowers and nurtures the practice of caring and ethical practice.
- D. Empowers and nurtures the practice of nursing, caring and ethical practice.
正解：D
解説：
Explanation: The third element of synergy model provides support for the needs of the patients. The needs of the patient are the driving force for nurse competencies. The synergy model comprises of Patient Characteristics, Nurse Competencies, and the third element, the system or healthcare environment.
質問 # 255
If a patient does not respond meaningfully to the examiner without the need for stimulation, which of the following are used first in assessing level of consciousness?
- A. Tactile stimuli
- B. Auditory stimuli
- C. Traumatic stimuli
- D. Painful stimuli
正解：B
解説：
Correct answer: Auditory stimuli
Auditory stimuli are used first if a patient does not respond meaningfully to an examiner without the need for stimulation. If the patient does not rouse to auditory stimuli, tactile stimuli such a gentle touch or shake or used, followed by painful stimuli if necessary to elicit a response.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 297-298.
質問 # 256
Of the following, which insulin would be expected to peak the most quickly:
- A. Glulisine
- B. Aspart
- C. Regular
- D. NPH
正解：A
解説：
Correct: Glulisine
Glulisine (Aprida) is a rapid-acting insulin and peaks in 0.5 to 1.5 hours.
Aspart (Novolog) peaks in 1 to 2 hours. NPH (Humulin N) is an intermediate-acting insulin and takes at least 4 hours to peak. Regular insulin takes at least 2 hours to peak.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 392.
質問 # 257
All of the following statements are true related to valvular heart disease except:
- A. An insufficient valve does not close properly
- B. Normally, when a heart valve opens, there are no pressure gradients between the chambers or vessels above and below the valve
- C. Valves on the right side of the heart are more commonly affected
- D. A stenotic valve has a narrowed opening
正解：C
解説：
Correct answer: Valves on the right side of the heart are more commonly affected Valves on the left side of the heart are more commonly affected in valvular heart disease as they are constantly exposed to higher pressures.
Under normal conditions, when a heart valve opens, no pressure gradients exist between the vessels or chambers below and above the valve. As valvular heart disease progresses, pressure gradients between the chambers or vessels develop.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 473.
質問 # 258
Evidence-based strategies for the prevention of infection in central lines include the use of which of the following barriers during catheter insertion?
- A. Mask, cap, sterile gown, sterile gloves, large sterile drape
- B. Mask, sterile gown, sterile gloves, large sterile drape
- C. Mask, sterile gloves, large sterile drape
- D. Sterile gown, sterile gloves, large sterile drape
正解：A
解説：
Correct answer: Mask, cap, sterile gown, sterile gloves, large sterile drape According to the Centers for Disease Control and Prevention (CDC), the incidence of central line- associated bloodstream infections (CLABSI) decreased by 50% from 2009 to 2014. However, these infections continue to cause the death of thousands of hospitalized patients each year. Several practices have been evaluated to decrease the risk of these infections, and evidence-based strategies include the use of maximal sterile barriers during catheter insertion.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 292-293.
質問 # 259
Which of the following is an antiarrhythmic medication with a class IIa recommendation for pharmacological cardioversion of atrial fibrillation?
- A. Ibutilide
- B. Amiodarone
- C. Flecainide
- 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 # 260
Which of the following statements is true related to high-flow nasal cannula (HFNC) oxygen devices?
- A. HFNC is an invasive method of administering continuous oxygen to patients with chronic hypoxemia
- B. HFNC can provide oxygen at high-flow rates between 30 and 60 L/minute
- C. HFNC is the most common method for delivering oxygen invasively
- D. Caution must be exercised when using HFNC as it may result in intrinsic (auto) PEEP
正解：B
解説：
Correct answer: HFNC can provide oxygen at high-flow rates between 30 and 60 L/minute High-flow nasal cannula (HFNC) devices are a non-invasive method of oxygen delivery. HFNC can deliver actively warmed and well-humidified oxygen at rates between 30 and 60 liters per minute. The small amount of PEEP generated with this method may help decrease lung collapse, enable improved gas exchange, and decrease the work of breathing.
The most common method for delivering oxygen invasively is with a mechanical ventilator.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 116.
質問 # 261
All of the following statements regarding diazoxide are true except:
- A. Diazoxide is a non-diuretic
- B. Blood pressure reduction occurs within 1 to 2 minutes and lasts 3 to 12 hours after a dose
- C. IV bolus dose is typically 50 to 150 mg every 5 minutes
- D. Side effects including hypotension, vomiting, hypoglycemia, and reflex tachycardia have been associated with the use of this medication
正解：D
解説：
Correct answer: Side effects including hypotension, vomiting, hypoglycemia, and reflex tachycardia have been associated with the use of this medication Diazoxide is not a diuretic. It reduces peripheral vascular resistance by directly relaxing arterial smooth muscle. Side effects such as hypotension, nausea and vomiting, dizziness, weakness, reflex tachycardia and hyperglycemia (the opposite of hypoglycemia) have been associated with the use of the higher than
300-mg dosing regimen.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 172.
質問 # 262
A patient presents in the cardiac emergency department with left-sided chest pain. His ECG shows ST segment elevations. Patient complains that this pain occurs cyclically, i.e., at the same time each day and during rest period. Which of the following conditions is most likely to occur?
- A. Myocardial infarction
- B. Variant angina
- C. Costochondritis
- D. Myocardial contusion
正解：B
解説：
Explanation: The condition that is most likely to occur if pain occurs cyclically and with ST segment elevations evident in ECG, is Variant angina, where the pain also occurs during times of rest.
質問 # 263
The clinical syndrome that results from ineffective pumping of the heart is known as:
- A. Distributive shock
- B. Hypovolemic shock
- C. Cardiogenic shock
- D. Anaerobic shock
正解：C
解説：
Correct answer: Cardiogenic shock
In cardiogenic shock, the heart fails to pump enough blood to meet the metabolic and oxygen demands of the body. Several factors can cause pump failure; the most common cause is coronary artery disease.
Insufficient volume of circulating blood may result in hypovolemic shock. Massive vasodilation of the vascular bed causing maldistribution of blood may result in distributive shock.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 235-236.
質問 # 264
Evidence-based practice guidelines related to family interventions that should occur during the evaluation stage of the nursing process includes which of following?
- A. Provide information according to family needs
- B. Make referrals as appropriate for support services
- C. Establish optimum methods to contact the family
- D. Use multiple methods to evaluate achievement of meeting family needs
正解：D
解説：
Correct answer: Use multiple methods to evaluate achievement of meeting family needs Methods that may be used to evaluate if a family's needs are or have been met include satisfaction surveys, feedback, care conferences, and follow-up after discharge.
In the intervention stage of the nursing process in family interventions the following interventions are appropriate:
* Determine spokesperson and contact person
* Establish optimum methods to contact and communicate with family
* Make referrals for support services as appropriate
* Provide information according to family needs
* Provide a comfortable environment
* Include family in direct care as appropriate
* Encourage family participation and presence during team rounds
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 28.
質問 # 265
Ketorolac should not be used for more than:
- A. 2 weeks
- B. 72 hours
- C. 48 hours
- D. 5 days
正解：D
解説：
Correct answer: 5 days
The severity of side effects related to the use of nonsteroidal anti-inflammatory drugs (NSAIDs) increases with high doses or prolonged use. For this reason, ketorolac and other NSAIDs are designed for short-term use only and should not be used for more than five days.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 147.
質問 # 266
A patient being managed in in-patient department is suspected to have pulmonary embolism. What is the confirmatory test for this?
- A. V/Q scintigraphy
- B. ABG analysis
- C. Chest x-ray
- D. D-dimers
正解：A
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 # 267
The dosing regimen of this recombinant plasminogen activator requires double bolus doses. What is the drug?
- A. Reteplase
- B. Alteplase
- C. Bivalirudin
- D. Argatroban
正解：A
解説：
Correct answer: Reteplase
Reteplase is a recombinant plasminogen activator for use as a thrombolytic agent in acute MI and pulmonary embolism. It requires two 10-U IV bolus doses, infused over 2 minutes via a dedicated line.
The second dose is administered 30 minutes after the initiation of the first injection.
Alteplase does not require double bolus doses. Argatroban and bivalirudin are not recombinant plasminogen activators. Argatroban is a selective thrombin inhibitor, and bivalirudin is an anticoagulant with direct thrombin inhibitor properties.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 185-187.
質問 # 268
The skills needed for collaboration are:
- A. ability to work with teams
- B. all the above
- C. clear communication
- D. willingness to compromise
正解：B
解説：
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.
質問 # 269
Normal blood carbon dioxide tension (PaCO2 ) ranges from:
- A. 22 - 26 mm Hg
- B. 7.35 - 7.45 mm Hg
- C. 40 - 45 mm Hg
- D. 35 - 45 mm Hg
正解：D
解説：
Correct answer: 35 - 45 mm Hg
Normal blood carbon dioxide tension, known as PaCO2, ranges from 35 - 45 mm Hg.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 100.
質問 # 270
Initially, when caring for a patient with a temporary pacemaker, stimulation threshold testing should be done:
- A. Every shift
- B. By the physician
- C. Hourly
- D. Every 24 hours
正解：A
解説：
Correct answer: Every shift
When caring for a patient with a temporary pacemaker, stimulation threshold testing should be done every shift until a stable threshold is reached. This is because the stimulation threshold (the minimum output of the pacemaker needed to consistently capture the heart) changes over time; it generally is very low when the pacing lead is initially placed and increases over time. This means it will take more output to result in capture.
Stimulation threshold testing is typically a nursing function.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 460.
質問 # 271
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PCCN試験は、進行性のケア環境での患者のケアに関連する看護師の知識とスキルを評価する包括的なテストです。この試験では、心血管、肺、神経学、胃腸、腎、内分泌、多系統の問題を含む幅広いトピックをカバーしています。この試験では、安全で効果的なケアを提供し、患者のケアを管理し、患者、家族、その他の医療専門家とコミュニケーションをとる看護師の能力も評価しています。
PCCN試験問題とアンサー：https://www.jpntest.com/shiken/PCCN-mondaishu
合格できるPCCN試験情報と無料練習テスト：https://drive.google.com/open?id=1oTj7eMV8VUKAxLBrnvDKjVIG8EcFTUpP