CERTIFIED PROGRESSIVE CARE NURSE (PCCN)
COMPLETE QUESTIONS AND CORRECT ANSWERS|
ALREADY GRADED A+
1. A patient with acute decompensated heart failure presents with dyspnea,
orthopnea, and pulmonary edema. The initial priority nursing intervention is:
A. Administer intravenous furosemide
B. Apply supplemental oxygen **
C. Restrict fluid intake
D. Initiate daily weight monitoring
Rationale: Oxygen administration addresses immediate hypoxemia and
respiratory distress, which is the priority in acute decompensated heart failure.
2. A patient in the progressive care unit has a new onset of chest pain
radiating to the jaw with diaphoresis. The nurse should first:
A. Administer sublingual nitroglycerin
B. Obtain a 12-lead ECG **
C. Start an IV line
D. Give aspirin
Rationale: Immediate ECG is essential to identify myocardial ischemia or
infarction before administering medications.
3. Which of the following ECG changes is most concerning for hyperkalemia?
A. Peaked T waves **
B. Prolonged PR interval
C. ST depression
,D. U waves
Rationale: Hyperkalemia commonly presents with tall, peaked T waves, which
can precede dangerous arrhythmias.
4. A patient with sepsis is hypotensive and tachycardic despite fluid
resuscitation. The next priority intervention is:
A. Administer broad-spectrum antibiotics
B. Initiate vasopressor therapy **
C. Obtain blood cultures
D. Restrict fluids
Rationale: Persistent hypotension after fluids requires vasopressors to maintain
organ perfusion.
5. The nurse observes a patient post-CABG with a sudden drop in blood
pressure, elevated central venous pressure (CVP), and muffled heart sounds.
The nurse should suspect:
A. Cardiac tamponade **
B. Acute myocardial infarction
C. Heart failure exacerbation
D. Pulmonary embolism
Rationale: Beck’s triad (hypotension, muffled heart sounds, elevated CVP)
indicates cardiac tamponade, a medical emergency.
6. Which of the following interventions is most appropriate for a patient with
acute respiratory distress and SpO₂ of 86% on room air?
A. Encourage deep breathing
B. Apply supplemental oxygen **
C. Perform incentive spirometry
D. Start nebulized albuterol
Rationale: Hypoxemia must be corrected immediately with oxygen therapy to
prevent organ dysfunction.
7. A patient with atrial fibrillation is at risk for:
, A. Stroke **
B. Pulmonary edema
C. Acute kidney injury
D. Sepsis
Rationale: Atrial fibrillation can lead to blood stasis in the atria and increase
the risk of thromboembolic stroke.
8. The early signs of hypovolemic shock include:
A. Hypertension and bradycardia
B. Hypotension and tachycardia **
C. Warm, flushed skin
D. Bounding pulses
Rationale: Initial compensatory mechanisms for hypovolemia include
tachycardia and hypotension as the body attempts to maintain perfusion.
9. A patient with COPD has Paco₂ of 60 mmHg and pH of 7.32. This ABG
result indicates:
A. Respiratory alkalosis
B. Respiratory acidosis **
C. Metabolic alkalosis
D. Metabolic acidosis
Rationale: Elevated Paco₂ and low pH indicate primary respiratory acidosis,
often seen in COPD exacerbations.
10. Which electrolyte imbalance is most commonly associated with
prolonged QT interval?
A. Hyperkalemia
B. Hypokalemia **
C. Hypercalcemia
D. Hypermagnesemia
Rationale: Hypokalemia and hypomagnesemia prolong ventricular
repolarization, leading to prolonged QT interval.
COMPLETE QUESTIONS AND CORRECT ANSWERS|
ALREADY GRADED A+
1. A patient with acute decompensated heart failure presents with dyspnea,
orthopnea, and pulmonary edema. The initial priority nursing intervention is:
A. Administer intravenous furosemide
B. Apply supplemental oxygen **
C. Restrict fluid intake
D. Initiate daily weight monitoring
Rationale: Oxygen administration addresses immediate hypoxemia and
respiratory distress, which is the priority in acute decompensated heart failure.
2. A patient in the progressive care unit has a new onset of chest pain
radiating to the jaw with diaphoresis. The nurse should first:
A. Administer sublingual nitroglycerin
B. Obtain a 12-lead ECG **
C. Start an IV line
D. Give aspirin
Rationale: Immediate ECG is essential to identify myocardial ischemia or
infarction before administering medications.
3. Which of the following ECG changes is most concerning for hyperkalemia?
A. Peaked T waves **
B. Prolonged PR interval
C. ST depression
,D. U waves
Rationale: Hyperkalemia commonly presents with tall, peaked T waves, which
can precede dangerous arrhythmias.
4. A patient with sepsis is hypotensive and tachycardic despite fluid
resuscitation. The next priority intervention is:
A. Administer broad-spectrum antibiotics
B. Initiate vasopressor therapy **
C. Obtain blood cultures
D. Restrict fluids
Rationale: Persistent hypotension after fluids requires vasopressors to maintain
organ perfusion.
5. The nurse observes a patient post-CABG with a sudden drop in blood
pressure, elevated central venous pressure (CVP), and muffled heart sounds.
The nurse should suspect:
A. Cardiac tamponade **
B. Acute myocardial infarction
C. Heart failure exacerbation
D. Pulmonary embolism
Rationale: Beck’s triad (hypotension, muffled heart sounds, elevated CVP)
indicates cardiac tamponade, a medical emergency.
6. Which of the following interventions is most appropriate for a patient with
acute respiratory distress and SpO₂ of 86% on room air?
A. Encourage deep breathing
B. Apply supplemental oxygen **
C. Perform incentive spirometry
D. Start nebulized albuterol
Rationale: Hypoxemia must be corrected immediately with oxygen therapy to
prevent organ dysfunction.
7. A patient with atrial fibrillation is at risk for:
, A. Stroke **
B. Pulmonary edema
C. Acute kidney injury
D. Sepsis
Rationale: Atrial fibrillation can lead to blood stasis in the atria and increase
the risk of thromboembolic stroke.
8. The early signs of hypovolemic shock include:
A. Hypertension and bradycardia
B. Hypotension and tachycardia **
C. Warm, flushed skin
D. Bounding pulses
Rationale: Initial compensatory mechanisms for hypovolemia include
tachycardia and hypotension as the body attempts to maintain perfusion.
9. A patient with COPD has Paco₂ of 60 mmHg and pH of 7.32. This ABG
result indicates:
A. Respiratory alkalosis
B. Respiratory acidosis **
C. Metabolic alkalosis
D. Metabolic acidosis
Rationale: Elevated Paco₂ and low pH indicate primary respiratory acidosis,
often seen in COPD exacerbations.
10. Which electrolyte imbalance is most commonly associated with
prolonged QT interval?
A. Hyperkalemia
B. Hypokalemia **
C. Hypercalcemia
D. Hypermagnesemia
Rationale: Hypokalemia and hypomagnesemia prolong ventricular
repolarization, leading to prolonged QT interval.
