Progressive Care Nursing

PCCN exam study guide

I. Clinical Judgment (80%)

A. Cardiovascular (37%)
1. Acute coronary syndromes/unstable angina
2. Acute heart failure/pulmonary edema
3. Acute myocardial infarction/ischemia
4. Acute peripheral vascular insufficiency (e.g., acute arterial occlusion, carotid artery stenosis)
5. Cardiac surgery (e.g. valve replacement, CABG)
6. Cardiomyopathies (e.g. hypertrophic, dilated, restrictive, idiopathic)
7. Dysrhythmias
8. Heart failure
9. Hypertensive crisis
10. Myocardial conduction system defects
11. Pulmonary hypertension (e.g., valvular defects, aortic stenosis, mitral stenosis)
12. Ruptured or dissecting aneurysm
13. Shock states (e.g. cardiogenic, hypovolemic)

B. Pulmonary (13%)
1. Acute pulmonary embolus, fat embolus
2. Acute respiratory distress syndrome (ARDS)
3. Acute respiratory failure
4. Acute respiratory infections (e.g. pneumonia, strep pneumonia, RSV)
5. Aspirations (e.g., aspiration pneumonia, foreign-body aspiration)
6. Chronic lung disease
7. Pulmonary hypertension
8. Respiratory distress (e.g. emphysema, bronchitis)
9. Status asthmaticus, exacerbation of COPD, emphysema, bronchitis
10. Thoracic surgery (e.g., lung contusions, fractured ribs, hemothorax, pulmonary hemorrhage, lung reduction, pneumonectomy, lobectomy, tracheal surgery)

C. Endocrine (4%)
1. Acute hypoglycemia
2. Adrenal disorders (e.g. adrenal insufficiency)
3. Diabetes insipidus
4. Diabetic ketoacidosis
5. Hyperglycemic hyperosmolar nonketotic coma (HHNK)

D. Hematology/Immunology (5%)
1. Immunosuppression-acquired (e.g., HIV, AIDS, neoplasms)
2. Life-threatening coagulopathies (e.g. ITP, DIC, hemophilia, HITTS) and non life-threatening coagulopathies
3. Organ transplantation (e.g. liver, bone marrow, kidney, heart, pancreas, lung)
4. Sickle cell crisis

E. Neurology (4%)
1. Intracranial hemorrhage/intraventricular hemorrhage (e.g. subarachnoid, epidural, subdural)
2. Seizure disorders
3. Stroke (embolic events, hemorrhagic)

F. Gastrointestinal (5%)
1. Acute GI hemorrhage (e.g. esophageal, upper and lower)
2. Bowel infarction/obstruction/ perforation
3. Gastro-esophageal reflux
4. GI surgeries (e.g. Whipple, esophago-gastrectomy, gastric bypass)
5. Pancreatitis

G. Renal (6%)
1. Acute renal failure (e.g. acute tubular necrosis, hypoxia, dialysis)
2. Chronic renal failure and dialysis
3. Life-threatening electrolyte imbalances (e.g., potassium, sodium, calcium, phosphorus, magnesium)

H. Multisystem (6%)
1. Multisystem trauma
2. Septic shock/infectious diseases (e.g. congenital viral, bacterial, line sepsis, nosocomial infections, immunosuppression)
3. Systemic inflammatory response syndrome (SIRS)/sepsis/MODS
4. Toxic ingestions and inhalations (e.g., drug/alcohol overdose, poisoning)

II. Professional Caring and Ethical Practice (20%)

A. Advocacy/Moral Agency (2%)
B. Caring Practices (4%)
C. Collaboration (4%)
D. Systems Thinking (2%)
E. Response to Diversity (2%)
F. Clinical Inquiry (2%)



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Source: AACN