PCCN® Exam Review

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Agenda

11 Contact Hours | Course Length: 611 Minutes

Introduction, Professional Caring and Ethical Practices 31 minutes
Module Description
The Introduction module will introduce the American Association of Critical-Care Nurses’ (AACN) test blueprint for the progressive care examination. Test requirements, application process, topic blueprint and scoring will be reviewed. The recertification, or renewal, process will also be outlined.

The Professional Caring and Ethical Practice module defines and discusses the professional caring and ethical concepts of caring for critically ill adult patients. AACN’s synergy model will be introduced with examples of patient, family and nursing characteristics. 

Module Learning Objectives
These modules prepare the learner to:
  1. Describe the application process for the PCCN Examination.
  2. Describe the blueprint of the examination.
  3. Define the Synergy Model of Care.
  4. Discuss the application of the Synergy Model to patient- and family-centered care.
  5. Define informatics as utilized by the bedside nurse.
Hematology and Immunology
47 minutes
Module Description
This module will review the hematology and immunology section of the examination. This review focuses on inflammatory response, shock states and platelet function. The vascular response to bleeding and the use of blood products is reviewed as well as immune responses in patients with inflammation.

Module Learning Objectives
This module prepares the learner to:
  1. Describe the normal immune system as it is related to the hospitalized adult patient.
  2. List the types of anemia that occur commonly in the critically ill adult.
  3. Discuss interventions for the patient with disseminated intravascular coagulation (DIC) and bleeding precautions.
  4. Discuss the use of blood products for the coagulopathic patient.
  5. Devise a plan of care for the patient who is immune-compromised.
Cardiovascular
131 minutes
Module Description
Since 27% of the PCCN Exam covers cardiac, this module provides a focused review of the cardiac essentials. Cardiac physiology, hemodynamics, pharmacology, acute coronary syndrome (ACS), acute myocardial infarction (AMI), heart failure, valvular disease, vascular, aortic aneurysm and dissection are reviewed in detail. A brief review of 12-Lead ECG interpretation, general monitoring, dysrhythmias, endocarditis and tamponade is included.

Module Learning Objectives
This module prepares the learner to:
  1. Describe the cardiovascular assessment parameters of the adult patient with low cardiac output syndrome.
  2. Discuss hemodynamics and the utilization of pharmacology to enhance cardiac performance.
  3. Devise nursing interventions for the patient with acute and chronic cardiac dysfunction.
  4. Discuss ACS and the nursing interventions needed to care for the population of patients affected.
  5. Devise a plan of care for the patient with acute and/or chronic heart failure.
  6. Describe the three types of aortic aneurysm and the nursing interventions for caring for each group of patients affected.
  7. Discuss valvular disease with medical and surgical interventions and nursing care.
  8. Devise nursing care for the patient with vascular disease.
Endocrine
40 minutes
Module Description
This module will focuses on diabetes insipidus (DI), syndrome of inappropriate secretion of antidiuretic hormone secretion  (SIADH), diabetic ketoacidosis (DKA), hyperosmolar hyperglycemic syndrome (HHS) and metabolic syndrome. Comparison of laboratory results and treatments are reviewed, including tight glucose control.

Module Learning Objectives
This module prepares the learner to:
  1. Describe the physiological effects of acute stress on the hospitalized adult patient.
  2. Compare and contrast DKA and HHS.
  3. List and discuss the nursing care of the patient with DI/SIADH.
  4. Define metabolic syndrome.
Gastrointestinal
47 minutes
Module Description
This module will focus on the gastrointestinal system. Gastrointestinal problems commonly seen in the progressive care environment are discussed with treatment rationale. Prevention of complications, such as bleeding, ulcerations, ileus, bowel obstruction, gastroesophageal reflux disease (GERD), irritable bowel syndrome (IBS) and translocation are discussed. The focus will include the topics: the gastrointestinal bleeding patient, pancreatitis, liver failure, intestinal ischemia/infarction and abdominal compartment syndrome. Review of diarrhea and C. difficile and metabolic alkalosis are also covered, as well as nutrition.

Module Learning Objectives
This module prepares the learner to:
  1. Discuss the pathophysiology of gastrointestinal bleeding, bowel ischemia, bowel obstruction, pancreatitis, liver failure and diarrhea, and how this relates to the critically ill adult patient.
  2. List and discuss strategies to prevent gastrointestinal complications in the critically ill adult.
  3. Devise a nutrition plan for the acutely and chronically ill adult patient.
  4. Discuss the need for preventive treatment of gastric complications.
Neurology
53 minutes
Module Description
This module covers the neurological portion of the PCCN examination. The review focuses on intracranial hypertension, nursing assessment and care of the brain-injured patient. A brief review of neurologic physiology including: increased cerebral pressure (ICP), cerebral perfusion pressure (CPP), stroke, intracranial hemorrhage, subarachnoid hemorrhage, encephalopathic events and seizure activity. Focus is nursing assessment with altered neurologic function. This section also includes care of the poststroke patient including: bedside assessment for dysphagia as well as aspiration precautions.

Module Learning Objectives
This module prepares the learner to:
  1. List and discuss the complete neurological assessment.
  2. Describe and list-nursing interventions for the patient with altered neurologic function.
  3. Define Stroke Alert and the use of the National Institutes of Health (NIH) Stroke Assessment Scale.
  4. Discuss the care of the patient after stroke, including assessment of swallow and speech.
  5. Discuss the primary treatment of seizure activity.
  6. Define encephalopathic causes of altered mental status.
  7. Devise a nursing assessment of the patient with altered mental status.
Behavioral and Psychosocial
28 minutes
Module Description
This module is combined with the neurological component of the review. Topics concerning altered mental status, delirium, dementia, depression, combative patients and suicidal patients are reviewed. Psychological disorders such as anxiety and depression are also reviewed. Substance abuse is discussed: alcohol, drugs and drug-seeking behavior are included. Altered neurological behavior requires aggressive nursing assessment and planning of care to protect the patient and staff.

Module Learning Objectives
This module prepares the learner to:
  1. Discuss current nursing therapeutic modalities to improve normal circadian rhythms for hospitalized and critically ill patients.
  2. Define and discuss the differences between delirium and dementia.
  3. Devise a plan of care for the patient with suicide precautions.
  4. Discuss the use of the delirium assessment toll for patient care.
  5. Review the effects of alcohol use and abuse, chronic drug abuse and drug withdrawal.
Renal
54 minutes
Module Description
This module reviews the renal portion of the PCCN Examination. This module has only a small number of questions on the exam, and this review will cover renal function, acute and chronic renal failure. Electrolytes, pharmacology and the indications for dialysis will be discussed.

Module Learning Objectives
This module prepares the learner to:
  1. Discuss renal assessment of the hospitalized adult patient.
  2. List and discuss the types and phases of acute renal failure.
  3. Devise a nursing care plan for the hospitalized patient with chronic renal failure.
  4. Review electrolyte disorders in the hospitalized adult patient.
  5. Review dialysis strategies for the patient with renal failure.

Pulmonary
106 minutes
Module Description
This module reviews the pulmonary blueprint for the PCCN Examination. This review of includes pulmonary physiology, pulmonary drugs, acute respiratory failure, mechanical ventilation strategies, pneumonia, aspiration pneumonia, chest-tube care, acute asthma, pulmonary embolus, acute respiratory distress syndrome (ARDS) and thoracic surgery. Nursing care of the patient with pulmonary failure is the focus. Monitoring oxygenation and ventilation are included.

Module Learning Objectives
This module prepares the learner to:
  1. Discuss the concepts of oxygenation and ventilation for the adult patient with or without pulmonary dysfunction.
  2. List and discuss strategies to enhance oxygenation and ventilation.
  3. Devise nursing interventions for the patient with pulmonary dysfunction.
  4. Discuss nursing strategies to prevent aspiration pneumonia, improve alveolar recruitment and prevention of deep vein thrombosis (DVT).
  5. Discuss monitoring techniques for the assessment of oxygenation and ventilation.
  6. List and discuss strategies of care for the patient with thoracic surgery.

Musculoskeletal/Multisystem
74 minutes
Module Description
This module reviews musculoskeletal dysfunction, multisystem organ failure (MSOF), sepsis, infection, pain control, toxic ingestion and wound care in preparation for the PCCN Examination. This review covers the physiology of shock: cardiogenic,  hypovolemic, anaphylactic and septic shock. Nursing assessment, hemodynamics and interventions are discussed. Also included is a review of urinary tract and blood stream infections.

Module Learning Objectives
This module prepares the learner to:
  1. Define hypoperfusion and the resultant “shock” state.
  2. List and discuss the types of shock: cardiogenic, hypovolemic and vasogenic.
  3. Discuss early goal-directed therapy in the identification and treatment of sepsis.
  4. Discuss the prevention of hospital-acquired infections (HAIs), such as urinary tract and bloodstream infections and skin injuries.
  5. Discuss the care of wounds in the critical care area.
  6. Discuss toxic ingestion and treatments of patients with overdose.

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