PCCN - Pulmonary Care and Disorders Questions and Answers

Question 1

A patient in the progressive care unit is being treated for a severe exacerbation of chronic obstructive pulmonary disease (COPD).
Which of the following assessment findings would indicate the most urgent need for intervention?

Accepted Answer

Decreased level of consciousness and confusion

Answer

Use of accessory muscles and a respiratory rate of 28 breaths/min

Answer

Oxygen saturation of 91% on 2L nasal cannula

Answer

Reports of increased sputum production and cough

Question 2

A nurse is caring for a patient who was recently extubated after several days of mechanical ventilation. Which of the following parameters is the BEST indicator of the patient's readiness to be weaned from mechanical ventilation?

Accepted Answer

A rapid shallow breathing index (RSBI) of 95

Answer

PaO2 of 85 mmHg on FiO2 of 40%

Answer

Tidal volume of 450 mL with a respiratory rate of 18 breaths/min

Answer

Maximal inspiratory pressure (MIP) of -20 cm H2O

Question 3

A patient with acute respiratory distress syndrome (ARDS) is receiving mechanical ventilation with a low tidal volume strategy. What is the primary rationale for this intervention?

Accepted Answer

To reduce the risk of barotrauma and volutrauma.

Answer

To prevent hypotension and cardiovascular collapse.

Answer

To decrease the patient's work of breathing and improve comfort.

Answer

To facilitate sedation and neuromuscular blockade.

Question 4

A 68-year-old male with a history of heart failure is admitted with a diagnosis of community-acquired pneumonia. He presents with a productive cough, fever of 38.9°C, and crackles in the right lower lobe. Which of the following orders should the nurse prioritize?

Accepted Answer

Titrate oxygen to maintain SpO2 > 92%.

Answer

Administer intravenous antibiotics.

Answer

Obtain blood and sputum cultures.

Answer

Administer PRN antipyretics.

Question 5

Which of the following is a key nursing intervention for a patient admitted with a suspected pulmonary embolism (PE)?

Accepted Answer

Placing the patient in a high Fowler's position.

Answer

Encouraging frequent ambulation to improve circulation.

Answer

Administering anticoagulation therapy as ordered.

Answer

Initiating a fluid bolus to improve cardiac output.

Question 6

A progressive care nurse is educating a patient being discharged after an asthma exacerbation. Which statement by the patient indicates a need for further teaching?

Accepted Answer

"If I feel short of breath, I will take my oral prednisone immediately."

Answer

"I will use my albuterol inhaler 15 minutes before I exercise."

Answer

"I need to use my inhaled corticosteroid every day, even when I feel fine."

Answer

"I should use my rescue inhaler more often if my symptoms get worse."