PROGRESSIVE CARE · AACN CERTIFICATION STYLE
PCCN EXAM TEST BANK 2026/2027
WITH QUESTIONS AND CORRECT DETAILED ANSWERS A+
(100% CORRECT ANSWERS)
PCCN EXAM PREP TEST BANK
(NEWLY UPDATED 2026/2027!!)
50 Multiple-Choice Questions · Progressive Care Nursing · Application & Analysis Level
A+ QUESTIONS 5 SECTIONS 100%
VERIFIED COVERED RATIONALES
CATEGORIES
■ Cardiovascular
■ Pulmonary
■ Neurology & Multisystem
■ Behavioral, Psychosocial & Hematology
■ Professional Caring & Ethical Practice
Examination Specifications
Difficulty: Advanced (Progressive Care Certification) · Bloom’s: Application / Analysis
Question Format: Multiple Choice (A–D) · Marks: 1 per question
Passing Score: 80% · Total Marks: 50
Content Alignment
This examination is aligned to the publicly available AACN PCCN test plan, emphasizing clinical judgment in progressive/intermediate care settings
across cardiovascular, pulmonary, neurologic, multisystem, behavioral, and professional caring domains.
STUVIAACTUALEXAM
, Section 1: Cardiovascular
Q1.
A progressive-care patient with acute decompensated heart failure is receiving continuous IV nitroglycerin. The nurse notes the blood
pressure has dropped from 138/82 to 88/54 mm Hg and the patient reports dizziness. The priority nursing action is to:
A. Increase the nitroglycerin rate to improve coronary perfusion
B. Administer a fluid bolus of 1 L normal saline immediately without orders
C. Stop or reduce the nitroglycerin infusion and notify the provider while supporting blood pressure
D. Place the patient in Trendelenburg and continue the current infusion rate
Correct Answer: C
Rationale: Hypotension is a primary limiting side effect of nitroglycerin. The infusion should be reduced or held, the provider notified, and supportive measures
instituted to restore adequate perfusion pressure.
Q2.
A patient two days after inferior-wall STEMI develops a heart rate of 42 bpm with blood pressure 78/48 mm Hg and cool extremities. The
rhythm strip shows sinus bradycardia. After ensuring airway and oxygen, the nurse anticipates which initial pharmacologic intervention?
A. Immediate IV amiodarone bolus
B. IV atropine while preparing for possible pacing
C. IV beta-blocker to reduce myocardial oxygen demand
D. Oral digoxin loading dose
Correct Answer: B
Rationale: Symptomatic bradycardia is treated first with atropine. Inferior MI often involves AV-node ischemia; atropine is the initial drug while readiness for
transcutaneous pacing is maintained.
Q3.
A patient with atrial fibrillation of unknown duration is being prepared for elective cardioversion. The nurse’s priority pre-procedure
assessment focuses on:
A. Confirming that the patient has been therapeutically anticoagulated or has had a negative TEE to reduce stroke risk
B. Ensuring the patient has not eaten for at least 12 hours
C. Verifying that the defibrillator is set to synchronized mode only after the shock is delivered
D. Administering a full dose of aspirin immediately before the procedure
Correct Answer: A
Rationale: Cardioversion of AF of unknown or >48-hour duration carries thromboembolic risk. Therapeutic anticoagulation or TEE exclusion of left-atrial
appendage thrombus is required before elective cardioversion.
Q4.
A progressive-care patient is receiving a continuous heparin infusion for a pulmonary embolism. The most recent aPTT is 110 seconds
(therapeutic range 60–80 seconds). The nurse should:
A. Increase the heparin rate by 200 units/hour
B. Hold the infusion, notify the provider, and anticipate a rate reduction or temporary interruption per protocol
C. Administer protamine sulfate 50 mg IV push immediately without an order
D. Continue the current rate because aPTT values above target are desirable
Correct Answer: B
Rationale: An aPTT significantly above the therapeutic range increases bleeding risk. Standard response is to hold or reduce the infusion according to the
institution’s heparin nomogram and notify the provider.
Q5.
A patient with chronic heart failure is started on an ACE inhibitor. Twenty-four hours later the patient develops angioedema with lip swelling
and mild stridor. The nurse’s first action is to:
A. Administer the next scheduled dose of the ACE inhibitor with food
B. Give an extra dose of diuretic to reduce swelling
C. Discontinue the ACE inhibitor, ensure airway patency, and notify the provider immediately
D. Reassure the patient that mild swelling is expected and will resolve
Correct Answer: C
Rationale: Angioedema is a potentially life-threatening adverse effect of ACE inhibitors. The drug must be stopped at once and airway management
prioritized; future ACE-inhibitor use is contraindicated.
PCCN Exam Test Bank | Page 2
PCCN EXAM TEST BANK 2026/2027
WITH QUESTIONS AND CORRECT DETAILED ANSWERS A+
(100% CORRECT ANSWERS)
PCCN EXAM PREP TEST BANK
(NEWLY UPDATED 2026/2027!!)
50 Multiple-Choice Questions · Progressive Care Nursing · Application & Analysis Level
A+ QUESTIONS 5 SECTIONS 100%
VERIFIED COVERED RATIONALES
CATEGORIES
■ Cardiovascular
■ Pulmonary
■ Neurology & Multisystem
■ Behavioral, Psychosocial & Hematology
■ Professional Caring & Ethical Practice
Examination Specifications
Difficulty: Advanced (Progressive Care Certification) · Bloom’s: Application / Analysis
Question Format: Multiple Choice (A–D) · Marks: 1 per question
Passing Score: 80% · Total Marks: 50
Content Alignment
This examination is aligned to the publicly available AACN PCCN test plan, emphasizing clinical judgment in progressive/intermediate care settings
across cardiovascular, pulmonary, neurologic, multisystem, behavioral, and professional caring domains.
STUVIAACTUALEXAM
, Section 1: Cardiovascular
Q1.
A progressive-care patient with acute decompensated heart failure is receiving continuous IV nitroglycerin. The nurse notes the blood
pressure has dropped from 138/82 to 88/54 mm Hg and the patient reports dizziness. The priority nursing action is to:
A. Increase the nitroglycerin rate to improve coronary perfusion
B. Administer a fluid bolus of 1 L normal saline immediately without orders
C. Stop or reduce the nitroglycerin infusion and notify the provider while supporting blood pressure
D. Place the patient in Trendelenburg and continue the current infusion rate
Correct Answer: C
Rationale: Hypotension is a primary limiting side effect of nitroglycerin. The infusion should be reduced or held, the provider notified, and supportive measures
instituted to restore adequate perfusion pressure.
Q2.
A patient two days after inferior-wall STEMI develops a heart rate of 42 bpm with blood pressure 78/48 mm Hg and cool extremities. The
rhythm strip shows sinus bradycardia. After ensuring airway and oxygen, the nurse anticipates which initial pharmacologic intervention?
A. Immediate IV amiodarone bolus
B. IV atropine while preparing for possible pacing
C. IV beta-blocker to reduce myocardial oxygen demand
D. Oral digoxin loading dose
Correct Answer: B
Rationale: Symptomatic bradycardia is treated first with atropine. Inferior MI often involves AV-node ischemia; atropine is the initial drug while readiness for
transcutaneous pacing is maintained.
Q3.
A patient with atrial fibrillation of unknown duration is being prepared for elective cardioversion. The nurse’s priority pre-procedure
assessment focuses on:
A. Confirming that the patient has been therapeutically anticoagulated or has had a negative TEE to reduce stroke risk
B. Ensuring the patient has not eaten for at least 12 hours
C. Verifying that the defibrillator is set to synchronized mode only after the shock is delivered
D. Administering a full dose of aspirin immediately before the procedure
Correct Answer: A
Rationale: Cardioversion of AF of unknown or >48-hour duration carries thromboembolic risk. Therapeutic anticoagulation or TEE exclusion of left-atrial
appendage thrombus is required before elective cardioversion.
Q4.
A progressive-care patient is receiving a continuous heparin infusion for a pulmonary embolism. The most recent aPTT is 110 seconds
(therapeutic range 60–80 seconds). The nurse should:
A. Increase the heparin rate by 200 units/hour
B. Hold the infusion, notify the provider, and anticipate a rate reduction or temporary interruption per protocol
C. Administer protamine sulfate 50 mg IV push immediately without an order
D. Continue the current rate because aPTT values above target are desirable
Correct Answer: B
Rationale: An aPTT significantly above the therapeutic range increases bleeding risk. Standard response is to hold or reduce the infusion according to the
institution’s heparin nomogram and notify the provider.
Q5.
A patient with chronic heart failure is started on an ACE inhibitor. Twenty-four hours later the patient develops angioedema with lip swelling
and mild stridor. The nurse’s first action is to:
A. Administer the next scheduled dose of the ACE inhibitor with food
B. Give an extra dose of diuretic to reduce swelling
C. Discontinue the ACE inhibitor, ensure airway patency, and notify the provider immediately
D. Reassure the patient that mild swelling is expected and will resolve
Correct Answer: C
Rationale: Angioedema is a potentially life-threatening adverse effect of ACE inhibitors. The drug must be stopped at once and airway management
prioritized; future ACE-inhibitor use is contraindicated.
PCCN Exam Test Bank | Page 2
