BARKLEY PCCN PRACTICE EXAM 3 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | LATEST EXAM UPDATE 2026/2027.
Core Domains
Cardiovascular System
Pulmonary System
Endocrine System
Neurological System
Renal System
Gastrointestinal System
Hematology and Immunology
Multisystem and Professional Issues
Introduction
This comprehensive examination is designed to assess the knowledge, critical thinking, and clinical judgment skills
essential for success on the Progressive Care Certified Nurse (PCCN) examination. The assessment covers
foundational theory and applied professional knowledge across multiple body systems, with an emphasis on
regulatory compliance, ethical standards, and real-world decision-making in the progressive care setting.
Questions are presented in a multiple-choice format and include scenario-based items that require the integration
of clinical data to determine the most appropriate nursing action. This examination prepares the candidate to
demonstrate competency in managing acutely ill adult patients in a progressive care environment.
,SECTION ONE: QUESTIONS 1 – 100
1. A patient with acute decompensated heart failure is receiving continuous infusion of dobutamine. Which
assessment finding indicates a therapeutic response to the medication?
A. Decreased cardiac output
B. Increased systemic vascular resistance
C. Increased urine output
D. Decreased heart rate
🟢 C. Increased urine output
🔴 RATIONALE: Dobutamine is a positive inotropic agent that increases cardiac contractility and cardiac output,
leading to improved renal perfusion and increased urine output. A decrease in cardiac output would indicate a
lack of therapeutic effect. Dobutamine typically decreases systemic vascular resistance and may increase heart
rate due to its beta-1 effects.
2. The nurse is caring for a patient with status asthmaticus who is receiving mechanical ventilation. Which
arterial blood gas finding is most consistent with the development of dynamic hyperinflation (auto-PEEP)?
A. pH 7.38, PaCO2 42, PaO2 88
B. pH 7.32, PaCO2 55, PaO2 70
,C. pH 7.45, PaCO2 38, PaO2 92
D. pH 7.28, PaCO2 48, PaO2 65
🟢 B. pH 7.32, PaCO2 55, PaO2 70
🔴 RATIONALE: Dynamic hyperinflation (auto-PEEP) occurs when air becomes trapped in the alveoli due to
inadequate expiratory time, leading to increased intrathoracic pressure, decreased venous return, and
respiratory acidosis. The ABG finding of respiratory acidosis (elevated PaCO2 with decreased pH) in a patient
with status asthmaticus on mechanical ventilation is consistent with this complication.
3. A patient with type 1 diabetes mellitus is exhibiting signs of hypoglycemia. The patient is alert and able to
swallow. What is the initial nursing intervention?
A. Administer 50% dextrose IV push
B. Give 15 grams of rapid-acting carbohydrate orally
C. Administer glucagon 1 mg IM
D. Provide a regular meal with complex carbohydrates
🟢 B. Give 15 grams of rapid-acting carbohydrate orally
🔴 RATIONALE: For an alert patient with hypoglycemia who can safely swallow, the initial treatment is 15 grams
of rapid-acting oral carbohydrate (such as glucose tablets, fruit juice, or regular soda). IV dextrose is reserved
for patients who are unconscious or unable to swallow. Glucagon is used when IV access is not available and the
patient is severely hypoglycemic.
, 4. The nurse is assessing a patient with a suspected pulmonary embolism. Which finding is most consistent
with this diagnosis?
A. Bradycardia and hypotension
B. Sudden onset of pleuritic chest pain and dyspnea
C. Productive cough with green sputum
D. Bilateral crackles and peripheral edema
🟢 B. Sudden onset of pleuritic chest pain and dyspnea
🔴 RATIONALE: Pulmonary embolism typically presents with the sudden onset of pleuritic chest pain, dyspnea,
tachypnea, and tachycardia. Hemoptysis may also occur. Bradycardia is not a typical finding; tachycardia is more
common. Productive cough with green sputum suggests infection, and bilateral crackles with edema suggest
heart failure.
5. A patient with chronic kidney disease stage 4 has a serum potassium level of 6.2 mEq/L. Which
intervention should the nurse anticipate?
A. Administration of oral potassium supplements
B. Preparation for hemodialysis
C. Restriction of dietary protein
D. Administration of calcium carbonate
RATIONALES 2026 Q&A | LATEST EXAM UPDATE 2026/2027.
Core Domains
Cardiovascular System
Pulmonary System
Endocrine System
Neurological System
Renal System
Gastrointestinal System
Hematology and Immunology
Multisystem and Professional Issues
Introduction
This comprehensive examination is designed to assess the knowledge, critical thinking, and clinical judgment skills
essential for success on the Progressive Care Certified Nurse (PCCN) examination. The assessment covers
foundational theory and applied professional knowledge across multiple body systems, with an emphasis on
regulatory compliance, ethical standards, and real-world decision-making in the progressive care setting.
Questions are presented in a multiple-choice format and include scenario-based items that require the integration
of clinical data to determine the most appropriate nursing action. This examination prepares the candidate to
demonstrate competency in managing acutely ill adult patients in a progressive care environment.
,SECTION ONE: QUESTIONS 1 – 100
1. A patient with acute decompensated heart failure is receiving continuous infusion of dobutamine. Which
assessment finding indicates a therapeutic response to the medication?
A. Decreased cardiac output
B. Increased systemic vascular resistance
C. Increased urine output
D. Decreased heart rate
🟢 C. Increased urine output
🔴 RATIONALE: Dobutamine is a positive inotropic agent that increases cardiac contractility and cardiac output,
leading to improved renal perfusion and increased urine output. A decrease in cardiac output would indicate a
lack of therapeutic effect. Dobutamine typically decreases systemic vascular resistance and may increase heart
rate due to its beta-1 effects.
2. The nurse is caring for a patient with status asthmaticus who is receiving mechanical ventilation. Which
arterial blood gas finding is most consistent with the development of dynamic hyperinflation (auto-PEEP)?
A. pH 7.38, PaCO2 42, PaO2 88
B. pH 7.32, PaCO2 55, PaO2 70
,C. pH 7.45, PaCO2 38, PaO2 92
D. pH 7.28, PaCO2 48, PaO2 65
🟢 B. pH 7.32, PaCO2 55, PaO2 70
🔴 RATIONALE: Dynamic hyperinflation (auto-PEEP) occurs when air becomes trapped in the alveoli due to
inadequate expiratory time, leading to increased intrathoracic pressure, decreased venous return, and
respiratory acidosis. The ABG finding of respiratory acidosis (elevated PaCO2 with decreased pH) in a patient
with status asthmaticus on mechanical ventilation is consistent with this complication.
3. A patient with type 1 diabetes mellitus is exhibiting signs of hypoglycemia. The patient is alert and able to
swallow. What is the initial nursing intervention?
A. Administer 50% dextrose IV push
B. Give 15 grams of rapid-acting carbohydrate orally
C. Administer glucagon 1 mg IM
D. Provide a regular meal with complex carbohydrates
🟢 B. Give 15 grams of rapid-acting carbohydrate orally
🔴 RATIONALE: For an alert patient with hypoglycemia who can safely swallow, the initial treatment is 15 grams
of rapid-acting oral carbohydrate (such as glucose tablets, fruit juice, or regular soda). IV dextrose is reserved
for patients who are unconscious or unable to swallow. Glucagon is used when IV access is not available and the
patient is severely hypoglycemic.
, 4. The nurse is assessing a patient with a suspected pulmonary embolism. Which finding is most consistent
with this diagnosis?
A. Bradycardia and hypotension
B. Sudden onset of pleuritic chest pain and dyspnea
C. Productive cough with green sputum
D. Bilateral crackles and peripheral edema
🟢 B. Sudden onset of pleuritic chest pain and dyspnea
🔴 RATIONALE: Pulmonary embolism typically presents with the sudden onset of pleuritic chest pain, dyspnea,
tachypnea, and tachycardia. Hemoptysis may also occur. Bradycardia is not a typical finding; tachycardia is more
common. Productive cough with green sputum suggests infection, and bilateral crackles with edema suggest
heart failure.
5. A patient with chronic kidney disease stage 4 has a serum potassium level of 6.2 mEq/L. Which
intervention should the nurse anticipate?
A. Administration of oral potassium supplements
B. Preparation for hemodialysis
C. Restriction of dietary protein
D. Administration of calcium carbonate
