©NINJANERD 2024/2025. YEAR PUBLISHED 2024.
PCCN Exam Practice Questions with
100% Correct Answers
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, Ill, and avF.
You would expect to see reciprocal changes in which leads?
A. I, aVR
B. V, V2
C. V, VA
D I, aVL - ✔✔1. D. I, aVI. The RCA perfuses the inferior wall and the mirror
image or reciprocal change will be seen in the high latera 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.
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
,©NINJANERD 2024/2025. YEAR PUBLISHED 2024.
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 - ✔✔A. Call for help
and safely guide the patient to the floor
Patient Safety is priority
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% FiO, via non-re-breather mask. You
obtain an ABG with the following results: pH 7.20 / PaCO, 68/ PaO, 102/
HCO, 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 - ✔✔B. Acute Respiratory Distress Syndrome
,©NINJANERD 2024/2025. YEAR PUBLISHED 2024.
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
C. Rapidly lower the diastolic pressure to 100 mm Hg with IV
antihypertensive medications, then continue to gradually reduce the
diastolic pressure to 85 mm Hg with oral antihypertensive medications
D. Slowly lower the diastolic pressure to 85 mm - ✔✔C. Rapidly lower the
diastolic pressure to 100 mm Hg with IV antihypertensive medications, then
, ©NINJANERD 2024/2025. YEAR PUBLISHED 2024.
continue to gradually reduce the diastolic pressure to 85 mm Hg with oral
antihypertensive medication
5. Which of the following labs must be closely monitored when
administering Lisinopril to a patient with systolic heart failure?
A. Sodium
B. Phosphate
C. Magnesium
D Potassium - ✔✔D. Potassium
Patients taking angiotensin converting enzyme inhibitors may experience
hyperkalemia. ACE inhibitors block angiotensin II, which may lead to
decreased aldosterone. Aldosterone is responsible forexcreting potassium
from the kidneys. Therefore, ACE inhibitors can cause potassium retension
and potassium levels should be monitored closely. In addition, renal labs
such as BUN and creatinine should be monitored. If the patient develops
more than a 20% increase in the creatinine, the medication should be
discontinued.
A 57-year-old man was admitted with an acute myocardial infarction and is
rapidly deteriorating. He has a BP of 86/42
(57), heart rate of 110, weak, thready pulses, and mottled skin-especially at
the knees. He has had minimal urine output the past 8 hours. A Rapid
PCCN Exam Practice Questions with
100% Correct Answers
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, Ill, and avF.
You would expect to see reciprocal changes in which leads?
A. I, aVR
B. V, V2
C. V, VA
D I, aVL - ✔✔1. D. I, aVI. The RCA perfuses the inferior wall and the mirror
image or reciprocal change will be seen in the high latera 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.
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
,©NINJANERD 2024/2025. YEAR PUBLISHED 2024.
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 - ✔✔A. Call for help
and safely guide the patient to the floor
Patient Safety is priority
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% FiO, via non-re-breather mask. You
obtain an ABG with the following results: pH 7.20 / PaCO, 68/ PaO, 102/
HCO, 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 - ✔✔B. Acute Respiratory Distress Syndrome
,©NINJANERD 2024/2025. YEAR PUBLISHED 2024.
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
C. Rapidly lower the diastolic pressure to 100 mm Hg with IV
antihypertensive medications, then continue to gradually reduce the
diastolic pressure to 85 mm Hg with oral antihypertensive medications
D. Slowly lower the diastolic pressure to 85 mm - ✔✔C. Rapidly lower the
diastolic pressure to 100 mm Hg with IV antihypertensive medications, then
, ©NINJANERD 2024/2025. YEAR PUBLISHED 2024.
continue to gradually reduce the diastolic pressure to 85 mm Hg with oral
antihypertensive medication
5. Which of the following labs must be closely monitored when
administering Lisinopril to a patient with systolic heart failure?
A. Sodium
B. Phosphate
C. Magnesium
D Potassium - ✔✔D. Potassium
Patients taking angiotensin converting enzyme inhibitors may experience
hyperkalemia. ACE inhibitors block angiotensin II, which may lead to
decreased aldosterone. Aldosterone is responsible forexcreting potassium
from the kidneys. Therefore, ACE inhibitors can cause potassium retension
and potassium levels should be monitored closely. In addition, renal labs
such as BUN and creatinine should be monitored. If the patient develops
more than a 20% increase in the creatinine, the medication should be
discontinued.
A 57-year-old man was admitted with an acute myocardial infarction and is
rapidly deteriorating. He has a BP of 86/42
(57), heart rate of 110, weak, thready pulses, and mottled skin-especially at
the knees. He has had minimal urine output the past 8 hours. A Rapid
