PCCN EXAM - PROGRESSIVE CARE CERTIFIED
NURSE
COMPREHENSIVE PRACTICE (2026/2027 EDITION)
150 Items (Reflecting the revised PCCN exam structure) - Complete Practice
Independent-Study Disclaimer
This practice examination is an independent study aid and is not affiliated with, endorsed by, or sponsored by the
AACN Certification Corporation or any other testing organization. It is provided for educational and
self-assessment purposes only and is not a substitute for official AACN PCCN study materials, the test plan, or
professional guidance. Standards are subject to change; always consult current AACN and evidence-based
clinical resources.
, Section 1A: Clinical Judgment – Cardiovascular (36% – 54 questions)
Q1: Which of the following ECG findings is most characteristic of an acute STEMI?
A. PR-interval prolongation
B. Peaked T waves only
C. ST-segment depression in all leads
D. ST-segment elevation in contiguous leads [CORRECT]
Correct Answer: D
Rationale: STEMI is characterized by ST-segment elevation in leads representing a specific coronary
territory. The others are not STEMI findings.
Q2: A patient with chest pain that is relieved by rest or nitroglycerin and has no elevated troponin is most likely
experiencing:
A. An acute STEMI
B. Pericarditis
C. Unstable angina or stable angina [CORRECT]
D. Aortic dissection
Correct Answer: C
Rationale: Angina is relieved by rest/nitro with no troponin elevation. STEMI and MI would show biomarker
elevation and ECG changes.
Q3: Which of the following is the priority for a patient with an acute ST-segment elevation MI?
A. Delaying treatment
B. Early reperfusion (PCI or thrombolytics) per protocol [CORRECT]
C. Giving oral glucose
D. Wait and observe
Correct Answer: B
Rationale: Early reperfusion is the priority for STEMI. The others delay definitive treatment.
Q4: Which of the following is a classic finding of cardiac tamponade?
A. Widened pulse pressure
B. Muffled heart sounds, hypotension, and distended neck veins (Beck's triad) [CORRECT]
C. Pulsus alternans
D. Bounding pulses
Correct Answer: B
Rationale: Beck's triad (muffled heart sounds, hypotension, JVD) characterizes tamponade. The others are
not tamponade findings.
Q5: Which of the following is the priority for a patient with cardiac tamponade?
A. Prepare for pericardiocentesis and provide hemodynamic support [CORRECT]
B. Give oral fluids
C. Apply a tourniquet
D. Do nothing
Correct Answer: A
Rationale: Tamponade requires pericardiocentesis and hemodynamic support. The others are incorrect.
PCCN Exam Practice - 2026/2027 Edition Page 2
, Q6: Which of the following is a sign of cardiogenic shock?
A. Hypertension with warm skin
B. Hypotension, cool extremities, and signs of poor perfusion despite adequate volume [CORRECT]
C. Bounding pulses
D. Normal urine output
Correct Answer: B
Rationale: Cardiogenic shock causes hypotension and poor perfusion despite adequate volume. The others
are not cardiogenic shock.
Q7: Which of the following is the goal of treatment for cardiogenic shock?
A. Improve cardiac output and perfusion while supporting the failing heart [CORRECT]
B. Increase afterload
C. Decrease cardiac output
D. Withhold inotropes
Correct Answer: A
Rationale: Treatment improves cardiac output and perfusion. The others are incorrect.
Q8: Which of the following is a finding of a dilated cardiomyopathy?
A. A small, thick ventricle
B. Hypertrophy of the septum
C. Normal cardiac function
D. Enlarged, poorly contractile heart with heart failure symptoms [CORRECT]
Correct Answer: D
Rationale: Dilated cardiomyopathy features an enlarged, poorly contractile heart. Hypertrophic has a thick
ventricle, and the others differ.
Q9: Which of the following is a finding of hypertrophic cardiomyopathy?
A. A dilated, thin ventricle
B. Normal thickness
C. Left ventricular hypertrophy, often with an outflow tract obstruction [CORRECT]
D. A small ventricle with normal wall
Correct Answer: C
Rationale: Hypertrophic cardiomyopathy causes LV hypertrophy, often with outflow obstruction. The others
are different.
Q10: Which of the following is TRUE about Takotsubo (stress) cardiomyopathy?
A. It is a permanent ischemic injury
B. It is always fatal
C. It is a transient, reversible left ventricular dysfunction often triggered by stress [CORRECT]
D. It is a congenital defect
Correct Answer: C
Rationale: Takotsubo is transient, stress-related LV dysfunction. The others are incorrect.
PCCN Exam Practice - 2026/2027 Edition Page 3
, Q11: Which of the following is the treatment of choice for a stable, symptomatic bradycardia?
A. Atropine (per ACLS) when indicated [CORRECT]
B. A defibrillator
C. Amiodarone for rate control
D. Cardioversion
Correct Answer: A
Rationale: Atropine is used for symptomatic bradycardia per ACLS. The others are for different rhythms.
Q12: Which of the following is the initial treatment for a pulseless ventricular tachycardia?
A. Defibrillation [CORRECT]
B. Synchronized cardioversion
C. Atropine
D. Adenosine
Correct Answer: A
Rationale: Pulseless VT is treated with defibrillation. Synchronized cardioversion is for stable VT, and the
others differ.
Q13: Which of the following is the treatment for a stable narrow-complex SVT?
A. Defibrillation
B. Atropine
C. Adenosine (after vagal maneuvers) [CORRECT]
D. Synchronized cardioversion
Correct Answer: C
Rationale: Adenosine is used for stable SVT after vagal maneuvers. The others are for different rhythms.
Q14: Which of the following is the treatment for an unstable patient with a tachyarrhythmia?
A. Adenosine for all
B. Defibrillation
C. Atropine
D. Synchronized cardioversion [CORRECT]
Correct Answer: D
Rationale: Unstable tachyarrhythmias are treated with synchronized cardioversion. The others are incorrect.
Q15: Which of the following is TRUE about a patient with an ICD?
A. The ICD is for bradycardia only
B. The ICD delivers a shock for life-threatening dysrhythmias; the nurse should know the device and
response [CORRECT]
C. The ICD replaces all monitoring
D. The ICD is never activated
Correct Answer: B
Rationale: An ICD shocks life-threatening tachyarrhythmias. The others are incorrect.
PCCN Exam Practice - 2026/2027 Edition Page 4
NURSE
COMPREHENSIVE PRACTICE (2026/2027 EDITION)
150 Items (Reflecting the revised PCCN exam structure) - Complete Practice
Independent-Study Disclaimer
This practice examination is an independent study aid and is not affiliated with, endorsed by, or sponsored by the
AACN Certification Corporation or any other testing organization. It is provided for educational and
self-assessment purposes only and is not a substitute for official AACN PCCN study materials, the test plan, or
professional guidance. Standards are subject to change; always consult current AACN and evidence-based
clinical resources.
, Section 1A: Clinical Judgment – Cardiovascular (36% – 54 questions)
Q1: Which of the following ECG findings is most characteristic of an acute STEMI?
A. PR-interval prolongation
B. Peaked T waves only
C. ST-segment depression in all leads
D. ST-segment elevation in contiguous leads [CORRECT]
Correct Answer: D
Rationale: STEMI is characterized by ST-segment elevation in leads representing a specific coronary
territory. The others are not STEMI findings.
Q2: A patient with chest pain that is relieved by rest or nitroglycerin and has no elevated troponin is most likely
experiencing:
A. An acute STEMI
B. Pericarditis
C. Unstable angina or stable angina [CORRECT]
D. Aortic dissection
Correct Answer: C
Rationale: Angina is relieved by rest/nitro with no troponin elevation. STEMI and MI would show biomarker
elevation and ECG changes.
Q3: Which of the following is the priority for a patient with an acute ST-segment elevation MI?
A. Delaying treatment
B. Early reperfusion (PCI or thrombolytics) per protocol [CORRECT]
C. Giving oral glucose
D. Wait and observe
Correct Answer: B
Rationale: Early reperfusion is the priority for STEMI. The others delay definitive treatment.
Q4: Which of the following is a classic finding of cardiac tamponade?
A. Widened pulse pressure
B. Muffled heart sounds, hypotension, and distended neck veins (Beck's triad) [CORRECT]
C. Pulsus alternans
D. Bounding pulses
Correct Answer: B
Rationale: Beck's triad (muffled heart sounds, hypotension, JVD) characterizes tamponade. The others are
not tamponade findings.
Q5: Which of the following is the priority for a patient with cardiac tamponade?
A. Prepare for pericardiocentesis and provide hemodynamic support [CORRECT]
B. Give oral fluids
C. Apply a tourniquet
D. Do nothing
Correct Answer: A
Rationale: Tamponade requires pericardiocentesis and hemodynamic support. The others are incorrect.
PCCN Exam Practice - 2026/2027 Edition Page 2
, Q6: Which of the following is a sign of cardiogenic shock?
A. Hypertension with warm skin
B. Hypotension, cool extremities, and signs of poor perfusion despite adequate volume [CORRECT]
C. Bounding pulses
D. Normal urine output
Correct Answer: B
Rationale: Cardiogenic shock causes hypotension and poor perfusion despite adequate volume. The others
are not cardiogenic shock.
Q7: Which of the following is the goal of treatment for cardiogenic shock?
A. Improve cardiac output and perfusion while supporting the failing heart [CORRECT]
B. Increase afterload
C. Decrease cardiac output
D. Withhold inotropes
Correct Answer: A
Rationale: Treatment improves cardiac output and perfusion. The others are incorrect.
Q8: Which of the following is a finding of a dilated cardiomyopathy?
A. A small, thick ventricle
B. Hypertrophy of the septum
C. Normal cardiac function
D. Enlarged, poorly contractile heart with heart failure symptoms [CORRECT]
Correct Answer: D
Rationale: Dilated cardiomyopathy features an enlarged, poorly contractile heart. Hypertrophic has a thick
ventricle, and the others differ.
Q9: Which of the following is a finding of hypertrophic cardiomyopathy?
A. A dilated, thin ventricle
B. Normal thickness
C. Left ventricular hypertrophy, often with an outflow tract obstruction [CORRECT]
D. A small ventricle with normal wall
Correct Answer: C
Rationale: Hypertrophic cardiomyopathy causes LV hypertrophy, often with outflow obstruction. The others
are different.
Q10: Which of the following is TRUE about Takotsubo (stress) cardiomyopathy?
A. It is a permanent ischemic injury
B. It is always fatal
C. It is a transient, reversible left ventricular dysfunction often triggered by stress [CORRECT]
D. It is a congenital defect
Correct Answer: C
Rationale: Takotsubo is transient, stress-related LV dysfunction. The others are incorrect.
PCCN Exam Practice - 2026/2027 Edition Page 3
, Q11: Which of the following is the treatment of choice for a stable, symptomatic bradycardia?
A. Atropine (per ACLS) when indicated [CORRECT]
B. A defibrillator
C. Amiodarone for rate control
D. Cardioversion
Correct Answer: A
Rationale: Atropine is used for symptomatic bradycardia per ACLS. The others are for different rhythms.
Q12: Which of the following is the initial treatment for a pulseless ventricular tachycardia?
A. Defibrillation [CORRECT]
B. Synchronized cardioversion
C. Atropine
D. Adenosine
Correct Answer: A
Rationale: Pulseless VT is treated with defibrillation. Synchronized cardioversion is for stable VT, and the
others differ.
Q13: Which of the following is the treatment for a stable narrow-complex SVT?
A. Defibrillation
B. Atropine
C. Adenosine (after vagal maneuvers) [CORRECT]
D. Synchronized cardioversion
Correct Answer: C
Rationale: Adenosine is used for stable SVT after vagal maneuvers. The others are for different rhythms.
Q14: Which of the following is the treatment for an unstable patient with a tachyarrhythmia?
A. Adenosine for all
B. Defibrillation
C. Atropine
D. Synchronized cardioversion [CORRECT]
Correct Answer: D
Rationale: Unstable tachyarrhythmias are treated with synchronized cardioversion. The others are incorrect.
Q15: Which of the following is TRUE about a patient with an ICD?
A. The ICD is for bradycardia only
B. The ICD delivers a shock for life-threatening dysrhythmias; the nurse should know the device and
response [CORRECT]
C. The ICD replaces all monitoring
D. The ICD is never activated
Correct Answer: B
Rationale: An ICD shocks life-threatening tachyarrhythmias. The others are incorrect.
PCCN Exam Practice - 2026/2027 Edition Page 4
