PCCN Test Information
In order to receive a specialty certification for providing care to acutely ill adult patients, progressive care nurses must pass the Progressive Care Certified Nurse (PCCN) examination. This examination has been developed by the American Association of Critical-Care Nurses in order to guarantee that those charged with providing care have met the minimum competency for their job. The PCCN exam is divided into two main sections: clinical judgment (80% of the exam) and professional caring and ethical practice (20%). The content of the clinical judgment section can be further broken down as follows: cardiovascular (37%); pulmonary (13%); endocrine (4%); hematology/immunology (5%); neurology (4%); gastrointestinal (5%); renal (6%); and multisystem (6%). The content of the professional caring and ethical practice section can be further broken down as follows: advocacy/moral agency (2%); caring practices (4%); collaboration (4%); systems thinking (2%); response to diversity (2%); clinical inquiry (2%); facilitation of learning (4%).
The PCCN examination consists of 125 multiple-choice questions and must be completed within 2 and a half hours. 25 of the questions on the test do not count towards the candidate's score, but are used to develop future versions of the exam. Score is determined by the number of questions answered correctly; there is no deduction for answering a question incorrectly. A computerized score report will be available to the candidate immediately after the exam, and a hard copy of the report will be mailed 6 to 8 weeks later. If the candidate has passed the exam, proof of certification will accompany the hard copy. The PCCN exam is administered by Applied Measurement Professionals five days a week, all year long. Nurses who are interested in taking the exam should visit the AMP website. In rare cases, individuals may be allowed to take a paper-based version of the exam; for more information, see the AACN website.
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PCCN Study Guide
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PCCN Certification Exam
Progressive Care Certified Nurse (PCCN) Practice Questions
1. Thoracic electrical bioimpedence monitoring with 4 sets of bioimpedence electrodes and 3 ECG electrodes is used to evaluate hemodynamic status of a postsurgical cardiac patient. Where are the bioimpedence electrodes placed?
- One set on the arms, one set on the legs, and one set on the sides of the chest.
- Two sets bilaterally at the base of the neck and two sets on each side of the chest.
- One set on the legs and three sets on each side of the chest.
- One set on the arms, one set bilaterally at the base of the neck, and two sets on each side of the chest.
2. A 52-year-old female with a history of bipolar disease is one-day post-operative following a hip replacement. The patient slept only one or two hours during the night and is speaking rapidly, throwing her belongings at the nurses, and insisting she is going to leave the hospital against medical advice. The nurse should notify:
- The mental health crisis team
- Social services
- A home health agency
- The patient's husband
3. If all patients who develop urinary infections are evaluated per urine culture and sensitivities for microbial resistance, but only those with clinically-evident infections are included, then those with subclinical infections may be missed, skewing results. This is an example of:
- Information bias
- Selection bias
- Hypothesis testing
4. A 28-year-old male with extensive second and third-degree burns develops abdominal discomfort and vomits coffee ground emesis and frank blood. The most likely cause is:
- A peptic ulcer
- The erosion of the esophagus from burns
- Paralytic ileus
- Stress-related erosive syndrome
5. Beck's triad (increased central venous pressure with distended neck veins, muffled heart sounds, and hypotension) is indicative of which condition?
- Myocardial infarction
- Aortic valve prolapse
- Cardiac tamponade
- Pulmonary embolism
Progressive Care Certified Nurse (PCCN) Answer Key
1. Answer: B
Two sets of bioimpedance electrodes are placed bilaterally at the base of the neck and then two sets on each side of the chest. ECG leads are placed where they consistently monitor the QRS signal, and they may need to be moved to achieve this. Chest electrodes measure changes in electrical output associated with the volume of blood through the aorta and its velocity. The monitor converts the signals to waveforms. The heart rate is shown on an ECG monitor. The equipment calculates the cardiac output based on the heart rate and fluid volume.
2. Answer: A
The nurse should call the mental health crisis team. Crisis teams are comprised of mental health professionals. The teams are typically available to non-psychiatric units in order to evaluate the mental status of a patient. In this case, the patient is most likely experiencing an exacerbation of her bipolar disease as a result of the stress related to surgery, and could irreparably damage her surgical repair, so the crisis team will determine whether the patient is a danger to herself or others and whether she should remain hospitalized for treatment.
3. Answer: B
Selection bias occurs when the method of selecting subjects results in a cohort that is not representative of the target population because of inherent error in design. Information bias occurs when there are errors in classification, so an estimate of association is incorrect. A hypothesis should be generated about the probable cause based on the information available in laboratory and medical records, epidemiologic study, literature review, and expert opinion. Hypothesis testing includes data analysis, laboratory findings, and outcomes of testing. Generalizability is when results of research are true for similar populations.
4. Answer: D
Stress-related erosive syndrome (SRES), or stress ulcers, occur most frequently in those who are critically ill, such as those with severe or multi-organ trauma, mechanical ventilation, sepsis, severe burns, and head injury with increased intracranial pressure. Stress induces changes in the gastric mucosal lining and decreased perfusion of the mucosa, causing ischemia. SRES involves hemorrhage in >= 30% of patients with mortality rates of 30% to 80%. The lesions tend to be diffuse, so they are more difficult to treat than peptic ulcers. Symptoms include coffee ground emesis, hematemesis, and abdominal discomfort.
5. Answer: C
Beck's triad (increased central venous pressure with distended neck veins, muffled heart sounds, and hypotension) is commonly found with cardiac tamponade. Other symptoms may include a feeling of pressure or pain in the chest as well as dyspnea, and pulsus paradoxus >10 mm Hg (systolic blood pressure heard during exhalation but not during inhalation). Cardiac tamponade occurs with pericardial effusion in which fluid accumulates in the pericardial sac causing pressure against the heart. It may be a complication of trauma, pericarditis, cardiac surgery, or heart failure.
Last Updated: 01/19/2018