PCCN Prep Practice Exam
2026/2027 Updated Verified
Questions and Solutions A+
Pass Guaranteed
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
- ANS - 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
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
- ANS - 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
- ANS - B. Acute Respiratory Distress Syndrome
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
- ANS - 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 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
- ANS - 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
Response is activated. Which of the following medications would be the
best option to increase the patient's cardiac output?
A Dobutamine
B Norepinephrine
C Amiodarone
D Phenylephrine
- ANS - A Dobutamine. Dobutamine is a positive inotropic medication
used to improve myocardial dysfunction on patients with a low cardiac
index and elevated afterload. It will improve contractility and reduce
afterload. Milrinone, which is a phosphodiesterase inhibitor could also be
used as an alternative to dobutamine, in the setting of decompensated
heart failure. It is used cautiously in patients experiencing cardiogiogenic
shock as one of the main side effects of Milrinone is hypotension. The
half life of Milrinone is about 6 hours. Norepinephrine and Phenylephrine
cause vasoconstriction, which would increase the SVR and may
compromise cardiac output.
You are caring for a patient post gastric bypass. Which of the following
parameters should you closely monitor after surgery?
A* HR, RR, temperature, WBC & MAP
B* Protein levels and vitamin B12
2026/2027 Updated Verified
Questions and Solutions A+
Pass Guaranteed
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
- ANS - 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
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
- ANS - 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
- ANS - B. Acute Respiratory Distress Syndrome
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
- ANS - 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 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
- ANS - 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
Response is activated. Which of the following medications would be the
best option to increase the patient's cardiac output?
A Dobutamine
B Norepinephrine
C Amiodarone
D Phenylephrine
- ANS - A Dobutamine. Dobutamine is a positive inotropic medication
used to improve myocardial dysfunction on patients with a low cardiac
index and elevated afterload. It will improve contractility and reduce
afterload. Milrinone, which is a phosphodiesterase inhibitor could also be
used as an alternative to dobutamine, in the setting of decompensated
heart failure. It is used cautiously in patients experiencing cardiogiogenic
shock as one of the main side effects of Milrinone is hypotension. The
half life of Milrinone is about 6 hours. Norepinephrine and Phenylephrine
cause vasoconstriction, which would increase the SVR and may
compromise cardiac output.
You are caring for a patient post gastric bypass. Which of the following
parameters should you closely monitor after surgery?
A* HR, RR, temperature, WBC & MAP
B* Protein levels and vitamin B12
