PCCN Psychosocial and Behavioral Health 2

Question 1

The nurse is differentiating between delirium, dementia, and depression ('the 3 Ds') in a progressive care patient. Which feature is MOST characteristic of delirium compared to the other two?

Accepted Answer

Acute onset with fluctuating level of consciousness

Answer

Gradual onset over months to years

Answer

Persistent low mood with anhedonia

Answer

Intact short-term memory with personality changes

Question 2

A patient with acute coronary syndrome is found to have comorbid major depression. The nurse understands that depression in cardiac patients is significant because it:

Accepted Answer

Is associated with increased mortality, poor medication adherence, and worse cardiac outcomes

Answer

Decreases pain perception and therefore reduces analgesic requirements

Answer

Is a normal adjustment reaction that typically resolves without intervention within 6 months

Answer

Primarily affects quality of life but has no impact on physiologic cardiac function

Question 3

A progressive care nurse is supporting the family of a patient who has just been told the prognosis is terminal. The family members are arguing among themselves and appear angry. The nurse should recognize this behavior as:

Accepted Answer

A normal grief response that may reflect denial, fear, and helplessness

Answer

A dysfunctional family dynamic requiring immediate social work referral

Answer

Evidence that the family has not been adequately informed of the diagnosis

Answer

A sign that family members require psychiatric evaluation

Question 4

Which assessment tool is specifically validated for measuring delirium in acute care settings?

Accepted Answer

Confusion Assessment Method (CAM)

Answer

Glasgow Coma Scale (GCS)

Answer

Mini-Mental State Examination (MMSE)

Answer

Montreal Cognitive Assessment (MoCA)

Question 5

A patient with a history of benzodiazepine dependence is admitted for a non-related procedure. The nurse anticipates withdrawal symptoms will most likely begin:

Accepted Answer

12–24 hours after the last dose for short-acting agents and up to 5–7 days for long-acting agents

Answer

Within 1–2 hours of last dose

Answer

Only if the patient has been using benzodiazepines for more than 10 years

Answer

After 72 hours regardless of the benzodiazepine used

Question 6

A nurse is providing culturally competent care to a patient from a culture where direct eye contact is considered disrespectful. Which approach should the nurse take?

Accepted Answer

Adapt communication style to avoid prolonged direct eye contact while continuing to provide complete care

Answer

Insist on eye contact to ensure the patient is engaged and understands instructions

Answer

Avoid all eye contact and communicate only through written materials

Answer

Defer all communication to a family member who acts as a cultural intermediary

Question 7

Which intervention best addresses sleep deprivation in a progressive care patient?

Accepted Answer

Clustering care activities, minimizing nighttime interruptions, and reducing lighting and noise at night

Answer

Administering nightly sedative-hypnotics routinely for all patients

Answer

Encouraging napping throughout the day to make up for nighttime disruptions

Answer

Restricting family visitation during evening hours only