PCCN
Exam Prep Practice Questions |
Answers & Detailed Rationales | 2026
Resource Features
➢ PCCN exam-prep practice questions
➢ Answers for self-assessment
➢ Detailed rationales
➢ Clinical case scenarios
➢ Cardiovascular and respiratory review
, PCCN Exam Prep Practice Questions | Answers &
Detailed Rationales | 2026
Question 1
A 49-year-old male was recently admitted with an inferior wall MI resulting
from 100% occlusion of the right coronary artery (RCA). The 12-Lead ECG
reveals ST elevation in leads II, III, and aVF. You would expect to see
reciprocal changes in which leads?
A. I, aVR
B. V1, V2
C. V3, V4
D. I, aVL
Correct Answer: D. I, aVL
Rationale: The RCA perfuses the inferior wall and the mirror image or
reciprocal change will be seen in the high lateral wall, which is reflected in
leads I and aVL on the 12-Lead ECG. Leads V1 and V2 correlate with the
septal area, leads V3 and V4 correlate with the anterior area of the heart.
The aVR lead does not provide much diagnostic value as all energy is
depolarizing away from this lead.
Question 2
,You are summoned to the room of a 30-year-old female who is
experiencing sustained tonic-clonic convulsions while sitting in a chair. A
family member states: "She was just talking to us and suddenly she let out
a shriek and started flopping like a fish out of water." What is your initial
priority of care?
A. Call for help and safely guide the patient to the floor
B. Call for help and administer a prescribed antiepileptic
C. Call for help and administer a prescribed benzodiazepine
D. Call for help and monitor the course of the seizure
Correct Answer: A. Call for help and safely guide the patient to the
floor
Rationale: Patient safety is the priority. During a seizure, the patient is at
risk for injury from falling. The nurse should call for help and safely guide
the patient to the floor to prevent injury. Medications should not be
administered during active convulsions due to aspiration risk. Monitoring is
important but safety comes first.
Question 3
A 46-year-old patient presents with pneumonia and sepsis. He was treated
with 4 days of antibiotics and IV fluids. He is increasingly short of breath
and is now on 100% FiO2 via non-rebreather mask. You obtain an ABG with
the following results: pH 7.20 / PaCO2 68 / PaO2 102 / HCO3 28. A chest x-
ray reveals bilateral pulmonary infiltrates. The patient is likely developing:
, A. Worsening pneumonia
B. Acute Respiratory Distress Syndrome
C. Pulmonary embolus
D. Atelectasis
Correct Answer: B. Acute Respiratory Distress Syndrome
Rationale: The patient meets the criteria for ARDS: acute onset, bilateral
infiltrates on chest x-ray, severe hypoxemia (PaO2/FiO2 ratio < 300), and no
evidence of cardiogenic pulmonary edema. The ABG shows respiratory
acidosis with hypoxemia requiring high FiO2. ARDS is a common
complication of sepsis and pneumonia.
Question 4
A 56-year-old male is admitted to the PCU with a hypertensive crisis. His
blood pressure is now 205/125 mm Hg and he is complaining of a
headache with nausea. He reports he ran out of blood pressure medication
three days ago, but also appears to be confused to the date and situation.
What is the most appropriate treatment approach?
A. Rapidly lower the systolic pressure to 100 mm Hg with IV
antihypertensive medication, then gradually reduce the diastolic pressure
to 85 mm Hg with oral antihypertensive medications
B. Slowly lower the systolic pressure to 120 mm Hg with IV antihypertensive
medications, then switch to oral antihypertensive medications for
maintenance
Exam Prep Practice Questions |
Answers & Detailed Rationales | 2026
Resource Features
➢ PCCN exam-prep practice questions
➢ Answers for self-assessment
➢ Detailed rationales
➢ Clinical case scenarios
➢ Cardiovascular and respiratory review
, PCCN Exam Prep Practice Questions | Answers &
Detailed Rationales | 2026
Question 1
A 49-year-old male was recently admitted with an inferior wall MI resulting
from 100% occlusion of the right coronary artery (RCA). The 12-Lead ECG
reveals ST elevation in leads II, III, and aVF. You would expect to see
reciprocal changes in which leads?
A. I, aVR
B. V1, V2
C. V3, V4
D. I, aVL
Correct Answer: D. I, aVL
Rationale: The RCA perfuses the inferior wall and the mirror image or
reciprocal change will be seen in the high lateral wall, which is reflected in
leads I and aVL on the 12-Lead ECG. Leads V1 and V2 correlate with the
septal area, leads V3 and V4 correlate with the anterior area of the heart.
The aVR lead does not provide much diagnostic value as all energy is
depolarizing away from this lead.
Question 2
,You are summoned to the room of a 30-year-old female who is
experiencing sustained tonic-clonic convulsions while sitting in a chair. A
family member states: "She was just talking to us and suddenly she let out
a shriek and started flopping like a fish out of water." What is your initial
priority of care?
A. Call for help and safely guide the patient to the floor
B. Call for help and administer a prescribed antiepileptic
C. Call for help and administer a prescribed benzodiazepine
D. Call for help and monitor the course of the seizure
Correct Answer: A. Call for help and safely guide the patient to the
floor
Rationale: Patient safety is the priority. During a seizure, the patient is at
risk for injury from falling. The nurse should call for help and safely guide
the patient to the floor to prevent injury. Medications should not be
administered during active convulsions due to aspiration risk. Monitoring is
important but safety comes first.
Question 3
A 46-year-old patient presents with pneumonia and sepsis. He was treated
with 4 days of antibiotics and IV fluids. He is increasingly short of breath
and is now on 100% FiO2 via non-rebreather mask. You obtain an ABG with
the following results: pH 7.20 / PaCO2 68 / PaO2 102 / HCO3 28. A chest x-
ray reveals bilateral pulmonary infiltrates. The patient is likely developing:
, A. Worsening pneumonia
B. Acute Respiratory Distress Syndrome
C. Pulmonary embolus
D. Atelectasis
Correct Answer: B. Acute Respiratory Distress Syndrome
Rationale: The patient meets the criteria for ARDS: acute onset, bilateral
infiltrates on chest x-ray, severe hypoxemia (PaO2/FiO2 ratio < 300), and no
evidence of cardiogenic pulmonary edema. The ABG shows respiratory
acidosis with hypoxemia requiring high FiO2. ARDS is a common
complication of sepsis and pneumonia.
Question 4
A 56-year-old male is admitted to the PCU with a hypertensive crisis. His
blood pressure is now 205/125 mm Hg and he is complaining of a
headache with nausea. He reports he ran out of blood pressure medication
three days ago, but also appears to be confused to the date and situation.
What is the most appropriate treatment approach?
A. Rapidly lower the systolic pressure to 100 mm Hg with IV
antihypertensive medication, then gradually reduce the diastolic pressure
to 85 mm Hg with oral antihypertensive medications
B. Slowly lower the systolic pressure to 120 mm Hg with IV antihypertensive
medications, then switch to oral antihypertensive medications for
maintenance
