PCCN CERTIFICATION EXAMS SET 2026
Progressive Care Certified Nurse (AACN) 150
Questions | Verified Answers with Rationales | Graded
A+
Academic Year: 2025/2026
SECTION 1: CARDIOVASCULAR – ACUTE CORONARY SYNDROMES & DYSRHYTHMIAS
Questions 1–25
Question 1
A patient with non-ST-elevation myocardial infarction (NSTEMI) develops recurrent chest pain
despite nitrate therapy. Which intervention should the progressive care nurse anticipate next?
A) Immediate thrombolytic therapy
B) Emergent percutaneous coronary intervention (PCI)
C) High-dose statin and discharge planning
D) Nitroprusside drip for afterload reduction
Correct answer: B
Rationale: For high-risk NSTEMI patients with refractory ischemia, urgent PCI (<24 hours) is
indicated. Thrombolytics are reserved for STEMI without PCI access .
Question 2
A patient's cardiac monitor shows a narrow QRS complex tachycardia at 180 bpm, regular
rhythm, without visible P waves. The patient is hypotensive and confused. What is the priority
action?
,A) Administer adenosine 6 mg IV push
B) Perform synchronized cardioversion
C) Give amiodarone 150 mg IV
D) Start vagal maneuvers
Correct answer: B
Rationale: Unstable supraventricular tachycardia (SVT) with hypotension requires immediate
synchronized cardioversion. Adenosine is for stable SVT .
Question 3
A patient with atrial fibrillation and rapid ventricular rate (HR 150) is hypotensive and confused.
The best immediate intervention is:
A) Synchronized cardioversion
B) IV amiodarone
C) IV metoprolol
D) IV digoxin
Correct answer: A
Rationale: Unstable AF with hypotension requires immediate synchronized cardioversion.
Medications are for stable patients .
Question 4
A post-cardiac arrest patient has a Glasgow Coma Scale (GCS) score of 7. Which order should
the nurse question?
A) Targeted temperature management (TTM) at 32-36°C
B) Continuous EEG monitoring
C) Early enteral nutrition
D) Routine administration of phenytoin
Correct answer: D
Rationale: Routine seizure prophylaxis is NOT recommended after cardiac arrest; treat only if
seizures occur. TTM and EEG are standard of care .
,Question 5
A patient's telemetry shows a regular wide QRS tachycardia at 200 bpm, no P waves. The
patient is stable. The nurse should:
A) Assume ventricular tachycardia and give amiodarone
B) Perform vagal maneuvers
C) Obtain a 12-lead ECG to differentiate VT vs SVT with aberrancy
D) Defibrillate immediately
Correct answer: C
Rationale: Stable wide-complex tachycardia requires 12-lead ECG for differentiation. If
uncertain, treat as VT .
Question 6
Which ECG finding is diagnostic for acute pericarditis?
A) ST-segment elevation in a single lead
B) Diffuse PR-segment depression with ST elevation
C) Pathologic Q waves in inferior leads
D) Deep symmetric T-wave inversions
Correct answer: B
Rationale: Diffuse PR depression and concave ST elevation are classic for pericarditis. Q waves
suggest prior MI .
Question 7
A patient with acute decompensated heart failure presents with dyspnea, crackles in both lungs,
and an S3 gallop. Which medication is the priority?
A) Metoprolol
B) Furosemide
C) Digoxin
, D) Spironolactone
Correct answer: B
Rationale: Furosemide rapidly reduces preload, relieving pulmonary congestion. Beta-blockers
are not given in acute decompensation .
Question 8
A patient with acute decompensated heart failure has SpO2 89% on 4L NC, crackles halfway up
lung fields, HR 110, BP 110/70. Which intervention is priority?
A) Administer furosemide IV push
B) Start dobutamine infusion
C) Apply non-invasive positive pressure ventilation (NIPPV)
D) Give morphine sulfate 2mg IV
Correct answer: C
Rationale: NIPPV (BiPAP/CPAP) improves oxygenation and reduces preload/afterload in acute
cardiogenic pulmonary edema. While furosemide is important, airway/breathing come first .
Question 9
Which lab value is most concerning in a patient taking digoxin?
A) K+ 4.0 mEq/L
B) Mg 2.0 mg/dL
C) K+ 2.8 mEq/L
D) Ca 9.5 mg/dL
Correct answer: C
Rationale: Hypokalemia (K+ <3.5) increases risk of digoxin toxicity and dysrhythmias .
Question 10
Progressive Care Certified Nurse (AACN) 150
Questions | Verified Answers with Rationales | Graded
A+
Academic Year: 2025/2026
SECTION 1: CARDIOVASCULAR – ACUTE CORONARY SYNDROMES & DYSRHYTHMIAS
Questions 1–25
Question 1
A patient with non-ST-elevation myocardial infarction (NSTEMI) develops recurrent chest pain
despite nitrate therapy. Which intervention should the progressive care nurse anticipate next?
A) Immediate thrombolytic therapy
B) Emergent percutaneous coronary intervention (PCI)
C) High-dose statin and discharge planning
D) Nitroprusside drip for afterload reduction
Correct answer: B
Rationale: For high-risk NSTEMI patients with refractory ischemia, urgent PCI (<24 hours) is
indicated. Thrombolytics are reserved for STEMI without PCI access .
Question 2
A patient's cardiac monitor shows a narrow QRS complex tachycardia at 180 bpm, regular
rhythm, without visible P waves. The patient is hypotensive and confused. What is the priority
action?
,A) Administer adenosine 6 mg IV push
B) Perform synchronized cardioversion
C) Give amiodarone 150 mg IV
D) Start vagal maneuvers
Correct answer: B
Rationale: Unstable supraventricular tachycardia (SVT) with hypotension requires immediate
synchronized cardioversion. Adenosine is for stable SVT .
Question 3
A patient with atrial fibrillation and rapid ventricular rate (HR 150) is hypotensive and confused.
The best immediate intervention is:
A) Synchronized cardioversion
B) IV amiodarone
C) IV metoprolol
D) IV digoxin
Correct answer: A
Rationale: Unstable AF with hypotension requires immediate synchronized cardioversion.
Medications are for stable patients .
Question 4
A post-cardiac arrest patient has a Glasgow Coma Scale (GCS) score of 7. Which order should
the nurse question?
A) Targeted temperature management (TTM) at 32-36°C
B) Continuous EEG monitoring
C) Early enteral nutrition
D) Routine administration of phenytoin
Correct answer: D
Rationale: Routine seizure prophylaxis is NOT recommended after cardiac arrest; treat only if
seizures occur. TTM and EEG are standard of care .
,Question 5
A patient's telemetry shows a regular wide QRS tachycardia at 200 bpm, no P waves. The
patient is stable. The nurse should:
A) Assume ventricular tachycardia and give amiodarone
B) Perform vagal maneuvers
C) Obtain a 12-lead ECG to differentiate VT vs SVT with aberrancy
D) Defibrillate immediately
Correct answer: C
Rationale: Stable wide-complex tachycardia requires 12-lead ECG for differentiation. If
uncertain, treat as VT .
Question 6
Which ECG finding is diagnostic for acute pericarditis?
A) ST-segment elevation in a single lead
B) Diffuse PR-segment depression with ST elevation
C) Pathologic Q waves in inferior leads
D) Deep symmetric T-wave inversions
Correct answer: B
Rationale: Diffuse PR depression and concave ST elevation are classic for pericarditis. Q waves
suggest prior MI .
Question 7
A patient with acute decompensated heart failure presents with dyspnea, crackles in both lungs,
and an S3 gallop. Which medication is the priority?
A) Metoprolol
B) Furosemide
C) Digoxin
, D) Spironolactone
Correct answer: B
Rationale: Furosemide rapidly reduces preload, relieving pulmonary congestion. Beta-blockers
are not given in acute decompensation .
Question 8
A patient with acute decompensated heart failure has SpO2 89% on 4L NC, crackles halfway up
lung fields, HR 110, BP 110/70. Which intervention is priority?
A) Administer furosemide IV push
B) Start dobutamine infusion
C) Apply non-invasive positive pressure ventilation (NIPPV)
D) Give morphine sulfate 2mg IV
Correct answer: C
Rationale: NIPPV (BiPAP/CPAP) improves oxygenation and reduces preload/afterload in acute
cardiogenic pulmonary edema. While furosemide is important, airway/breathing come first .
Question 9
Which lab value is most concerning in a patient taking digoxin?
A) K+ 4.0 mEq/L
B) Mg 2.0 mg/dL
C) K+ 2.8 mEq/L
D) Ca 9.5 mg/dL
Correct answer: C
Rationale: Hypokalemia (K+ <3.5) increases risk of digoxin toxicity and dysrhythmias .
Question 10
