PCCN Psychosocial and Behavioral Health

Question 1

A progressive care patient who has been hospitalized for 5 days becomes confused at night, attempts to pull out his IV, and reports seeing insects on the ceiling.
Which condition does this presentation most likely indicate?

Accepted Answer

ICU/hospital-acquired delirium

Answer

Hyponatremia

Answer

New-onset dementia

Answer

Psychotic depression

Question 2

The nurse is assessing a patient for alcohol withdrawal using the Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) scale. Which finding would indicate the most severe level of withdrawal?

Accepted Answer

Severe agitation, hallucinations, and seizures with a score of 22

Answer

Mild diaphoresis and anxiety with a score of 8

Answer

Moderate tremor and nausea with a score of 15

Answer

Tachycardia and hypertension only with a score of 10

Question 3

A patient admitted for cardiac monitoring discloses feelings of hopelessness and that life is not worth living. What is the nurse's priority action?

Accepted Answer

Perform a structured suicidal ideation assessment and notify the care team immediately

Answer

Document the statement and notify the physician at the next scheduled rounding

Answer

Administer an as-needed anxiolytic medication

Answer

Reassure the patient that these feelings are normal after a cardiac event

Question 4

Which intervention is MOST effective in preventing delirium in a progressive care patient?

Accepted Answer

Promoting sleep hygiene, early mobility, and reorientation strategies

Answer

Administering prophylactic haloperidol nightly

Answer

Providing continuous physical restraints to prevent falls

Answer

Keeping the room darkened and quiet at all times

Question 5

A nurse is caring for a patient experiencing opioid withdrawal. Which cluster of symptoms should the nurse expect?

Accepted Answer

Tachycardia, diaphoresis, piloerection, and yawning

Answer

Bradycardia, hypotension, miosis, and sedation

Answer

Hypertension, fever, hallucinations, and seizures

Answer

Bradypnea, hypothermia, constipation, and euphoria

Question 6

When using therapeutic communication with a patient who is anxious about an upcoming procedure, which nurse response is MOST appropriate?

Accepted Answer

"I understand you're concerned. Can you tell me more about what's worrying you?"

Answer

"Don't worry — this procedure is done all the time and is perfectly safe."

Answer

"You should focus on the positive outcome and not think about the risks."

Answer

"The physician already explained everything; is there anything specific you didn't understand?"

Question 7

A family member of a dying patient asks the nurse, 'Is my mother suffering?' The patient is unconscious and receiving palliative sedation. Which response best reflects palliative care principles?

Accepted Answer

"She is not suffering; the medications are keeping her comfortable and peaceful."

Answer

"We cannot know for certain what she is experiencing."

Answer

"You should speak with the physician about your concerns."

Answer

"It's hard to say — she may still be aware of pain at some level."