PCCN試験問題集、PCCN練習テスト問題
PDF問題（2024年最新）実際のAACN PCCN試験問題
AACN PCCN認定試験は、プログレッシブケア看護で少なくとも2年の経験がある看護師を対象としています。この認定試験では、中程度の病気であるが、一般的な医療外科ユニットの患者よりも集中的で警戒している監視が必要な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。この試験では、心臓および肺のケア、血行動態、神経学、腎臓および内分泌機能、薬理学など、さまざまなトピックをカバーしています。
質問 # 290
The use of a ventilator with a heated moisture exchanger (HME) is contraindicated in all of the following except:
- A. Patients with body temperatures less than 32 degree Celsius
- B. Patients with a body temperature greater than 37 degrees Celsius
- C. Patients who have frank bloody secretions
- D. Patients who have uncuffed endotracheal tubes
正解：B
解説：
Correct answer: Patients with a body temperature greater than 37 degrees Celsius A ventilator that uses a heated moisture exchanger (HME) is contraindicated in patients with frank bloody or thick, copious secretions, patients with large bronchopleural fistulas, uncuffed or malfunctioning ET tube cuffs, and patients with body temperatures less than 32 degree Celsius.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 119.
質問 # 291
The intent of the informed consent process is based on which bioethical principle?
- A. Justice
- B. Autonomy
- C. Fidelity
- D. Privacy
正解：B
解説：
Correct answer: Autonomy
From an ethical standpoint, informed consent is a process whereby members of the health care team honor the patient's autonomy and that of the family. Autonomy is the ethical principle which affirms the right of an individual to make choices based on his or her personal values and beliefs.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 195, 200.
質問 # 292
A young man presented in pulmonology OPD with dyspnea and tachypnea, off and on fever, and cough with sputum streaked blood. On examination, there was occasional wheeze in his chest. He has tried antibiotics for this condition, but has not responded to them. What is the cause of this condition of the patient?
- A. Asthma
- B. Pneumonia
- C. Acute bronchitis (viral cause)
- D. Pulmonary tuberculosis
正解：C
解説：
Explanation: The cause of this young man's condition is acute bronchitis most probably due to viral infection because it has not responded to antibiotics and he is showing symptoms of fever, cough and sputum streaked blood, and has an occasional wheeze in his chest.
質問 # 293
An old lady presented to emergency department with dyspnea, tachypnea, hemoptysis, rales and chest pain. On examination, her pulse was irregularly irregular and rate was 350 bpm. What is the most likely diagnosis?
- A. Pulmonary infarction
- B. Pulmonary embolism
- C. Pulmonary emphysema
- D. Pulmonary tuberculosis
正解：B
解説：
Explanation: The most likely diagnosis of this woman presenting with, tachypnea, hemoptysis, rales, chest pain and irregular pulse is pulmonary embolism because these are all typical symptoms.
Moreover, patient pulse irregularity shows that she is having Atrial Fibrillation which is notorious for causing thrombi in right side of heart, which do embolize.
質問 # 294
An old man was on ventilator support because of his worsening pulmonary edema. In spite of the ventilator's support, after a few days the patient's condition further deteriorated. He became breathless and complained of pain in left side of chest. Chest x-ray revealed mediastinal shift towards right and pneumothorax right. What has suddenly happened to the patient?
- A. Ventilator induced lung injury
- B. Atelectasis
- C. Pulmonary emphysema
- D. COPD
正解：A
解説：
Explanation: The patient has experienced a ventilator induced lung injury. The patient with worsening pulmonary edema and breathlessness, and whose x-ray revealed mediastinal shift towards right and pneumothorax right, has suddenly developed ventilator induced lung injury. This occurs because of continuous positive pressure. Sometimes the pleural sac ruptures and a pneumothorax and mediastinal shift occur.
質問 # 295
Requiring a mentally competent patient to call for assistance before getting out of bed to use the bathroom is an example of which of the following?
- A. Paternalism
- B. Veracity
- C. Autonomy
- D. Fidelity
正解：A
解説：
Correct answer: Paternalism
Paternalism, in ethics, refers to instances in which the principle of beneficence overrides that of autonomy. In this case, fall prevention overrides the patient's autonomy but is justified by the benefit of ensuring the patient's safety.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 196.
質問 # 296
In the basic research concepts, a sample that is too small may lack:
- A. internal and external validity
- B. neither internal nor external validity
- C. internal validity
- D. external validity alone
正解：A
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 # 297
A physician has ordered cardiac catheterization for a patient in the progressive care unit. After explaining the procedure, the patient, who is alert, oriented, and competent to make decisions is refusing to give informed consent.
The nurse's role is to:
- A. Have the consent signed by the patient's spouse, since she has power of attorney
- B. Respect and support the patient's decision
- C. Threaten to call the physician
- D. Try to get the patient to change his mind by providing more information
正解：B
解説：
Correct answer: Respect and support the patient's decision
The nurse must respect the competent patient's choice and support the patient's decisions even if the decision is contrary to the judgments of the health care team.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 195, 198.
質問 # 298
Which of the following risk factors for the development of acute respiratory distress syndrome is considered to be a secondary rather than a primary cause?
- A. Sepsis
- B. Smoke inhalation
- C. Aspiration
- D. Pulmonary contusion
正解：A
解説：
Correct answer: Sepsis
Conditions that result in direct damage to the alveolar-capillary membrane are categorized as primary causes of acute respiratory distress syndrome (ARDS). Secondary causes are those which are believed to be mediated by cellular or humoral injury to the capillary endothelial wall. In conditions such as trauma and sepsis, capillary beds throughout the body are affected by abnormal microvascular permeability, but clinical manifestations are often isolated to the respiratory system.
Aspiration, pulmonary contusion, and smoke inhalation result in direct damage to the alveolar-capillary membrane and are categorized as primary causes of ARDS.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 257-258.
質問 # 299
Oversensing of a pacemaker can be caused by:
- A. The sensitivity control being set too high
- B. Asynchronous mode
- C. Intrinsic QRS voltage too low to be sensed by the pacemaker
- D. Intrinsic ventricular activity falling in the pacemaker's refractory period
正解：A
解説：
Correct answer: The sensitivity control being set too high
Oversensing is usually due to the sensitivity control being set too high, which can be corrected by turning the sensitivity dial counter-clockwise and reducing the pacemaker's sensitivity. Unless a higher sensitivity is needed to make the pacemaker sense QRS complexes, it is recommended the sensitivity control be set at about 2 mV (between the 1 and 3 o'clock positions on the dial) and not all the way to the right.
The other answer choices would result in failure to sense or undersensing rather than oversensing.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 458-460.
質問 # 300
A child presented with sharp piercing chest pain, fever, malaise, irritability, poor appetite and Dysrhythmia. He had undergone a recent surgery for valvular abnormality of the heart. What is the most likely disease to occur?
- A. Pleural effusion
- B. Infective endocarditis
- C. Pericarditis
- D. Cardiac contusion
正解：C
解説：
Explanation: The most likely disease to occur is Pericarditis. If a child presents with sharp, piercing, chest pain, fever, malaise, irritability, poor appetite and Dysrhythmia, and has recently undergone surgery for valvular abnormality of the heart, Pericarditis is the disease most likely to occur. Pericarditis usually occurs after cardiac surgeries done for structural abnormalities. Moreover sharp, piercing, chest pain is typical for Pericarditis, as is fever, because it usually has some infective cause like virus, bacteria etc.
質問 # 301
A diagnosed case of subarachnoid hemorrhage is admitted into ICU. What management points are to be taken care of in that individual?
- A. Identifying and treating the cause
- B. Surgical repair if needed
- C. All of the above
- D. Observing for re-bleeding
正解：C
解説：
Explanation: The management points to be followed for a diagnosed case of subarachnoid hemorrhage admitted into ICU are to identify the cause and treat them, continuous monitoring for re-bleed and eventual surgical repair if needed.
質問 # 302
All of the following are clinical manifestations of hyperosmolar hyperglycemic state (HHS) except:
- A. Serum ketones below 2+
- B. Serum glucose at least 600 mg/dL
- C. Kussmaul respirations
- D. Serum osmolality > 350 mOsm/kg
正解：C
解説：
Correct answer: Kussmaul respirations
Hyperosmolar hyperglycemic state (HHS) is classified as hyperglycemia with profound dehydration in the absence of ketosis. Kussmaul breathing is a deep and labored breathing pattern and is not a clinical manifestation of hyperosmolar hyperglycemic states.
The severe hyperglycemia in HHS results in profound extracellular fluid volume contraction, marked intracellular dehydration, and excessive loss of electrolytes. Also, because there is some insulin secretion, the breakdown of fat is suppressed, and no overproduction of ketones takes place. In the absence of signs and symptoms of ketosis, patients are not aware their blood sugar is rising and that they need treatment.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 390.
質問 # 303
Perirectal abscesses and fistulae are common complications of:
- A. Pancreatitis
- B. Irritable bowel syndrome
- C. Ulcerative colitis
- D. Crohn's disease
正解：D
解説：
Explanation: Perirectal abscesses and fistulae are common complications of Crohn's disease. Crohn's disease is a condition in which there is inflammation of the GI system. Inflammation is transmural, focal and discontinuous with linear and irregular shaped ulcerations. Granulomas may be present Condition is chronic disease.
質問 # 304
Which of the following statements related to endotracheal tube suctioning is true?
- A. The presence of an endotracheal tube inhibits effective coughing in that it prevents opening of the epiglottis
- B. Signs of airway obstruction include tachypnea, decrease in peak airway pressures, and expiratory crackles
- C. Hyperoxygenation is not required prior to suctioning using a closed suctioning technique
- D. The open method of suctioning requires disconnection of the endotracheal tube from the ventilator every time the patient requires suctioning
正解：D
解説：
Correct answer: The open method of suctioning requires disconnection of the endotracheal tube from the ventilator every time the patient requires suctioning In open suctioning, the ventilator circuit is removed or opened during suctioning. In closed suctioning, the ventilator circuit remains closed during suctioning. Hyperoxygenation is required with 100% oxygen for a minimum of 30 seconds prior to suctioning whether using a closed or open technique.
Effective coughing and the expulsion of secretions requires a closed epiglottis, which the presence of an ET prevents. In a forceful cough, the epiglottis closes, increasing intrathoracic pressure prior to the sudden opening of the epiglottis and the expulsion of secretions. Signs of airway obstruction include an increase, rather than a decrease in peak airway pressures.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 112.
質問 # 305
A known diabetic presented in accident and emergency department with Hyperventilation, and was also very thirsty. On examination, the patient was having kussmaul breathing and specific ketone breath was there as well. He was dehydrated and glucose level was 500 mg /dl. What is the most likely diagnosis?
- A. Diabetes mellitus
- B. Diabetes insipidus
- C. Hyperglycemia
- D. Ketoacidosis
正解：D
解説：
Explanation: The most likely diagnosis for this patient that is dehydrated and thirsty is keotacidosis because in ketoacidosis, there are kussmaul respirations and ketone breath. The glucose levels are between 300 to 800 mg/dl in ketoacidosis.
質問 # 306
All of the following statements are true regarding the atrioventricular (AV) node except:
- A. Its rate of automaticity is 40 to 60 beats per minute and it can function as a backup pacemaker if the sinus node fails
- B. It functions to slow conduction of the impulse from the atria to the ventricles to allow time for the atria to contract and empty their blood into the ventricles
- C. It screens out rapid atrial impulses to protect the ventricles from dangerously rapid rates when the atrial rate is very fast
- D. It is a small group of cells located in the upper right atrium
正解：D
解説：
Correct answer: It is a small group of cells located in the upper right atrium The atrioventricular node is a small group of cells in the lower right atrium, not the upper right atrium..
The sinus node is located in the upper right atrium.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 37-38.
質問 # 307
All of the following statements regarding diazoxide are true except:
- A. Blood pressure reduction occurs within 1 to 2 minutes and lasts 3 to 12 hours after a dose
- B. IV bolus dose is typically 50 to 150 mg every 5 minutes
- C. Diazoxide is a non-diuretic
- 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 # 308
Which of the following represents normal left ventricular end-diastolic pressure?
- A. 6 to 12 mm Hg
- B. 55% to 70%
- C. 60% to 75%
- D. 10 to 20 mm Hg
正解：A
解説：
Correct answer: 6 to 12 mm Hg
Left ventricular end-diastolic pressure (LVEDP) is the pressure in the left ventricle of the heart at the end of diastole and is an important determinant of ventricular function. It is considered to be a predictor of mortality and morbidity in patients who have heart failure and in those undergoing cardiac surgical procedures.
The left ventricular ejection fraction (LVEF) is the percentage of blood volume that is ejected from the left ventricle of the heart with each contraction. A normal LVEF is 55% to 70%.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 214.
質問 # 309
An 89-year-old male Asian patient in the terminal stages of lung cancer has many family members visiting at all hours of the day and night. His family brings various ethnic foods and performs ritualistic activities. Which of the following activities should be taken by the nurse?
- A. Notify the patient's physician of the unusual activities
- B. Provide comfort and privacy for the patient and family by keeping the other bed in the room unassigned
- C. Restrict visiting hours so other patients are not disturbed
- D. Post large signs above the head of the bed and on the door clearly stating that the patient is allowed to have no solid food
正解：B
解説：
Correct answer: Provide comfort and privacy for the patient and family by keeping the other bed in the room unassigned The family's access to the patient is vital, and open visitation is to be encouraged. Each family system is unique and varies by culture, religion, values, socioeconomic status, previous experience with crisis, role expectations, psychological integrity, communication patterns, ages, and health beliefs. It is crucial to assess the family's needs and resources and support family collaboration with the health care team.
Reference:
Burns, Suzanne
M. AACN Essentials of Progressive Care Nursing, Fourth Edition. Pg 15.
質問 # 310
......
米国クリティカルケア看護師協会（AACN）は、プログレッシブケア看護の習熟度を実証しようとする看護師に認定試験を提供しています。この認定は、プログレッシブケア認定看護（PCCN）試験として知られています。 PCCN認定は、テレメトリー、ステップダウン、中級ケアユニット、救急部門などのプログレッシブケアの設定で働く看護師向けに設計されています。 AACN PCCN認定試験は、看護師が急性疾患患者に高品質のケアを提供する知識、スキル、専門知識を紹介する機会です。
更新された2024年05月合格させるPCCN試験リアル練習テスト問題：https://jp.fast2test.com/PCCN-premium-file.html