1
PCCN TEST BANK 2026/2027 | NURSING |
PROGRESSIVE CARE | 250 VERIFIED Q&A |
DETAILED RATIONALES | PASS
GUARANTEED – A+ GRADED
SECTION 1: CARDIOVASCULAR - Questions 1-60
Q1: Acute Coronary Syndrome
The student is reviewing acute coronary syndrome. Which finding is most concerning in a client with
chest pain?
A. Pain relieved by nitroglycerin
B. ST-segment elevation on ECG
C. Blood pressure 130/80 mm Hg
D. Heart rate 88 bpm
Correct Answer: B
Rationale: ST-segment elevation indicates an acute myocardial infarction (STEMI) requiring
immediate reperfusion therapy. Pain relief with nitroglycerin, normal BP, and normal HR are less
concerning. [100% CORRECT]
Q2: Heart Failure
The student is reviewing heart failure. Which assessment finding indicates worsening left-sided heart
failure?
A. Peripheral edema
B. Jugular vein distention
C. Crackles in the lungs
D. Weight gain
Correct Answer: C
Rationale: Left-sided heart failure causes pulmonary congestion, leading to crackles, dyspnea, and
orthopnea. Right-sided failure causes peripheral edema, JVD, and weight gain. [100% CORRECT]
Q3: Digoxin Toxicity
The student is reviewing digoxin. Which sign indicates digoxin toxicity?
A. Tachycardia
B. Hypertension
C. Visual disturbances (yellow halos)
D. Polyuria
,2
Correct Answer: C
Rationale: Digoxin toxicity causes bradycardia, visual changes (yellow-green halos), nausea, and
arrhythmias. Hypokalemia increases toxicity risk. [100% CORRECT]
Q4: Nitroglycerin Administration
The student is reviewing nitroglycerin. What is the priority nursing action before administering
sublingual nitroglycerin?
A. Check blood pressure
B. Check heart rate
C. Check respiratory rate
D. Check temperature
Correct Answer: A
Rationale: Nitroglycerin causes vasodilation and hypotension. Hold if systolic BP < 90 mm Hg or 30
mm Hg below baseline. [100% CORRECT]
Q5: Post-MI Complications
The student is reviewing myocardial infarction. Which complication is most common within 24 hours
post-MI?
A. Heart failure
B. Arrhythmias
C. Cardiogenic shock
D. Pericarditis
Correct Answer: B
Rationale: Arrhythmias, especially ventricular fibrillation, are the most common cause of death
within the first 24 hours after MI. [100% CORRECT]
Q6: Hypertension Management
The student is reviewing hypertension. Which lifestyle modification is most effective for reducing
blood pressure?
A. Increasing sodium intake
B. Weight reduction
C. Caffeine restriction
D. Increasing alcohol intake
Correct Answer: B
Rationale: Weight reduction significantly lowers blood pressure. Other modifiable factors include
sodium restriction, DASH diet, exercise, and limiting alcohol. [100% CORRECT]
Q7: Peripheral Arterial Disease
The student is reviewing PAD. Which assessment finding is expected in peripheral arterial disease?
A. Warm, edematous extremities
B. Intermittent claudication
,3
C. Bounding pulses
D. Brown discoloration of ankles
Correct Answer: B
Rationale: PAD causes intermittent claudication (pain with exercise, relieved by rest), diminished
pulses, cool skin, and shiny hairless legs. [100% CORRECT]
Q8: DVT Prevention
The student is reviewing DVT. Which intervention is most effective for preventing DVT in a
postoperative client?
A. Bed rest
B. Early ambulation
C. Massaging the legs
D. Elevating the legs only
Correct Answer: B
Rationale: Early ambulation and sequential compression devices prevent venous stasis. Massaging
legs is contraindicated due to risk of dislodging a clot. [100% CORRECT]
Q9: Warfarin Teaching
The student is reviewing warfarin. Which statement by the client indicates understanding?
A. "I will increase my intake of green leafy vegetables."
B. "I will use a soft toothbrush and electric razor."
C. "I will take aspirin for headaches."
D. "I will stop taking warfarin if I feel better."
Correct Answer: B
Rationale: Warfarin increases bleeding risk. Use soft toothbrush and electric razor. Consistent
vitamin K intake is important; aspirin increases bleeding risk. [100% CORRECT]
Q10: Heart Failure Medications
The student is reviewing heart failure. Which medication is a first-line treatment for heart failure
with reduced ejection fraction?
A. Beta-blocker
B. Calcium channel blocker
C. NSAID
D. Antacid
Correct Answer: A
Rationale: Beta-blockers, ACE inhibitors, ARBs, and diuretics are first-line for HFrEF. Calcium channel
blockers may worsen heart failure. [100% CORRECT]
Q11: Aneurysm Precautions
The student is reviewing aortic aneurysm. Which instruction should be given to a client with an
abdominal aortic aneurysm?
, 4
A. Increase physical activity
B. Avoid straining and heavy lifting
C. Take aspirin daily
D. Increase fiber intake
Correct Answer: B
Rationale: Straining and heavy lifting increase intra-abdominal pressure and risk of rupture. Clients
should avoid constipation and strenuous activity. [100% CORRECT]
Q12: Cardiac Tamponade
The student is reviewing cardiac tamponade. Which finding is classic for cardiac tamponade?
A. Muffled heart sounds, hypotension, JVD (Beck's triad)
B. Hypertension, bradycardia, crackles
C. Fever, murmur, petechiae
D. Peripheral edema, weight gain, ascites
Correct Answer: A
Rationale: Beck's triad: hypotension, muffled heart sounds, and jugular venous distention. Pulsus
paradoxus may also be present. [100% CORRECT]
Q13: Pacemaker Care
The student is reviewing pacemakers. Which instruction should be given to a client with a new
pacemaker?
A. Avoid using a cell phone near the pacemaker
B. Avoid all physical activity
C. Sleep on the side of the pacemaker
D. Avoid microwaves completely
Correct Answer: A
Rationale: Cell phones should be kept at least 6 inches from the pacemaker. Moderate activity is
encouraged. Microwaves are generally safe if not faulty. [100% CORRECT]
Q14: Cholesterol Management
The student is reviewing hyperlipidemia. Which medication is a statin?
A. Atorvastatin
B. Amlodipine
C. Metoprolol
D. Furosemide
Correct Answer: A
Rationale: Atorvastatin is an HMG-CoA reductase inhibitor (statin). It lowers LDL and is first-line for
hyperlipidemia. [100% CORRECT]
Q15: Heart Failure Daily Weight
The student is reviewing heart failure. Why should a client with heart failure weigh daily?
PCCN TEST BANK 2026/2027 | NURSING |
PROGRESSIVE CARE | 250 VERIFIED Q&A |
DETAILED RATIONALES | PASS
GUARANTEED – A+ GRADED
SECTION 1: CARDIOVASCULAR - Questions 1-60
Q1: Acute Coronary Syndrome
The student is reviewing acute coronary syndrome. Which finding is most concerning in a client with
chest pain?
A. Pain relieved by nitroglycerin
B. ST-segment elevation on ECG
C. Blood pressure 130/80 mm Hg
D. Heart rate 88 bpm
Correct Answer: B
Rationale: ST-segment elevation indicates an acute myocardial infarction (STEMI) requiring
immediate reperfusion therapy. Pain relief with nitroglycerin, normal BP, and normal HR are less
concerning. [100% CORRECT]
Q2: Heart Failure
The student is reviewing heart failure. Which assessment finding indicates worsening left-sided heart
failure?
A. Peripheral edema
B. Jugular vein distention
C. Crackles in the lungs
D. Weight gain
Correct Answer: C
Rationale: Left-sided heart failure causes pulmonary congestion, leading to crackles, dyspnea, and
orthopnea. Right-sided failure causes peripheral edema, JVD, and weight gain. [100% CORRECT]
Q3: Digoxin Toxicity
The student is reviewing digoxin. Which sign indicates digoxin toxicity?
A. Tachycardia
B. Hypertension
C. Visual disturbances (yellow halos)
D. Polyuria
,2
Correct Answer: C
Rationale: Digoxin toxicity causes bradycardia, visual changes (yellow-green halos), nausea, and
arrhythmias. Hypokalemia increases toxicity risk. [100% CORRECT]
Q4: Nitroglycerin Administration
The student is reviewing nitroglycerin. What is the priority nursing action before administering
sublingual nitroglycerin?
A. Check blood pressure
B. Check heart rate
C. Check respiratory rate
D. Check temperature
Correct Answer: A
Rationale: Nitroglycerin causes vasodilation and hypotension. Hold if systolic BP < 90 mm Hg or 30
mm Hg below baseline. [100% CORRECT]
Q5: Post-MI Complications
The student is reviewing myocardial infarction. Which complication is most common within 24 hours
post-MI?
A. Heart failure
B. Arrhythmias
C. Cardiogenic shock
D. Pericarditis
Correct Answer: B
Rationale: Arrhythmias, especially ventricular fibrillation, are the most common cause of death
within the first 24 hours after MI. [100% CORRECT]
Q6: Hypertension Management
The student is reviewing hypertension. Which lifestyle modification is most effective for reducing
blood pressure?
A. Increasing sodium intake
B. Weight reduction
C. Caffeine restriction
D. Increasing alcohol intake
Correct Answer: B
Rationale: Weight reduction significantly lowers blood pressure. Other modifiable factors include
sodium restriction, DASH diet, exercise, and limiting alcohol. [100% CORRECT]
Q7: Peripheral Arterial Disease
The student is reviewing PAD. Which assessment finding is expected in peripheral arterial disease?
A. Warm, edematous extremities
B. Intermittent claudication
,3
C. Bounding pulses
D. Brown discoloration of ankles
Correct Answer: B
Rationale: PAD causes intermittent claudication (pain with exercise, relieved by rest), diminished
pulses, cool skin, and shiny hairless legs. [100% CORRECT]
Q8: DVT Prevention
The student is reviewing DVT. Which intervention is most effective for preventing DVT in a
postoperative client?
A. Bed rest
B. Early ambulation
C. Massaging the legs
D. Elevating the legs only
Correct Answer: B
Rationale: Early ambulation and sequential compression devices prevent venous stasis. Massaging
legs is contraindicated due to risk of dislodging a clot. [100% CORRECT]
Q9: Warfarin Teaching
The student is reviewing warfarin. Which statement by the client indicates understanding?
A. "I will increase my intake of green leafy vegetables."
B. "I will use a soft toothbrush and electric razor."
C. "I will take aspirin for headaches."
D. "I will stop taking warfarin if I feel better."
Correct Answer: B
Rationale: Warfarin increases bleeding risk. Use soft toothbrush and electric razor. Consistent
vitamin K intake is important; aspirin increases bleeding risk. [100% CORRECT]
Q10: Heart Failure Medications
The student is reviewing heart failure. Which medication is a first-line treatment for heart failure
with reduced ejection fraction?
A. Beta-blocker
B. Calcium channel blocker
C. NSAID
D. Antacid
Correct Answer: A
Rationale: Beta-blockers, ACE inhibitors, ARBs, and diuretics are first-line for HFrEF. Calcium channel
blockers may worsen heart failure. [100% CORRECT]
Q11: Aneurysm Precautions
The student is reviewing aortic aneurysm. Which instruction should be given to a client with an
abdominal aortic aneurysm?
, 4
A. Increase physical activity
B. Avoid straining and heavy lifting
C. Take aspirin daily
D. Increase fiber intake
Correct Answer: B
Rationale: Straining and heavy lifting increase intra-abdominal pressure and risk of rupture. Clients
should avoid constipation and strenuous activity. [100% CORRECT]
Q12: Cardiac Tamponade
The student is reviewing cardiac tamponade. Which finding is classic for cardiac tamponade?
A. Muffled heart sounds, hypotension, JVD (Beck's triad)
B. Hypertension, bradycardia, crackles
C. Fever, murmur, petechiae
D. Peripheral edema, weight gain, ascites
Correct Answer: A
Rationale: Beck's triad: hypotension, muffled heart sounds, and jugular venous distention. Pulsus
paradoxus may also be present. [100% CORRECT]
Q13: Pacemaker Care
The student is reviewing pacemakers. Which instruction should be given to a client with a new
pacemaker?
A. Avoid using a cell phone near the pacemaker
B. Avoid all physical activity
C. Sleep on the side of the pacemaker
D. Avoid microwaves completely
Correct Answer: A
Rationale: Cell phones should be kept at least 6 inches from the pacemaker. Moderate activity is
encouraged. Microwaves are generally safe if not faulty. [100% CORRECT]
Q14: Cholesterol Management
The student is reviewing hyperlipidemia. Which medication is a statin?
A. Atorvastatin
B. Amlodipine
C. Metoprolol
D. Furosemide
Correct Answer: A
Rationale: Atorvastatin is an HMG-CoA reductase inhibitor (statin). It lowers LDL and is first-line for
hyperlipidemia. [100% CORRECT]
Q15: Heart Failure Daily Weight
The student is reviewing heart failure. Why should a client with heart failure weigh daily?
