1|Page
PCCN Exam 2025/2026 Practice
Questions: 150 Questions with
Detailed Rationales
AACN-aligned PCCN practice questions for 2025/2026
exam preparation. Includes 150 multiple-choice
questions covering cardiovascular, respiratory,
neurology, multisystem, and professional caring topics.
Each question features detailed rationales explaining
the correct answer and clinical reasoning. Reflects the
latest PCCN test plan with 80% clinical judgment and
20% ethical practice focus. Updated content for the
revised exam format. Ideal study resource for
progressive care nurses preparing for certification.
Q1. A nurse is caring for a 71-year-old female patient with end-stage COPD
who is experiencing cardiac ischemia with increased shortness of breath. The
MOST appropriate goal of oxygen therapy for this patient would be to:
A. Limit supplemental oxygen to lower the risk of reducing respiratory drive
B. Maintain oxygen saturations between 86% and 89%
C. Administer oxygen until oxygen saturations are greater than 95% in order to
relieve ischemia
D. Maintain oxygen saturations between 90% and 92%
,2|Page
D. Maintain oxygen saturations between 90% and 92%.
Maintaining oxygen saturations between 90% and 92% will serve the purpose of
providing enough oxygen to relieve cardiac ischemia while reducing the risk of
respiratory depression in a patient with COPD.
Q2. According to the AACN Synergy Model, which patient characteristic refers
to the capacity to return to a restorative level of functioning using
compensatory or coping mechanisms?
A. Stability
B. Vulnerability
C. Resiliency
D. Predictability
C. Resiliency.
Resiliency is defined as the patient's ability to bounce back from an illness and
return to a restorative level of functioning using compensatory and coping
mechanisms. Stability refers to the ability to maintain steady physiological
parameters. Vulnerability describes susceptibility to stressors.
Q3. A patient is complaining of "ripping" chest pain that radiates to the back.
Their blood pressure is 190/110 mm Hg. The nurse should immediately suspect:
A. Myocardial infarction
B. Aortic dissection
C. Pulmonary embolism
D. Pericarditis
B. Aortic dissection.
Aortic dissection classically presents with sudden, severe, tearing or ripping
chest pain that radiates to the back, often accompanied by significantly
elevated blood pressure. This is a life-threatening emergency requiring
immediate medical intervention.
,3|Page
Q4. The nurse is preparing to administer adenosine (Adenocard) for a patient
with supraventricular tachycardia (SVT). What is the correct administration
technique?
A. Administer 6 mg over 2 minutes through a peripheral IV
B. Administer 6 mg rapid IV push followed by a 20 mL saline flush
C. Administer 12 mg slow IV push over 5 minutes
D. Administer 6 mg IM in the deltoid muscle
B. Administer 6 mg rapid IV push followed by a 20 mL saline flush.
Adenosine is administered as a rapid IV push (1-2 seconds) followed
immediately by a 20 mL normal saline flush to promote rapid delivery to the
heart. The initial dose is 6 mg. If ineffective, a 12 mg dose may be repeated.
Adenosine has a very short half-life (approximately 10 seconds).
Q5. A patient is admitted with an acute inferior wall ST-segment elevation
myocardial infarction (STEMI). Which ECG leads would show ST-segment
elevation?
A. Leads I, aVL, V1-V2
B. Leads II, III, aVF
C. Leads V3-V4
D. Leads V5-V6, I, aVL
B. Leads II, III, aVF.
Inferior wall STEMI involves the right coronary artery (RCA) and presents with
ST-segment elevation in the inferior leads: II, III, and aVF. Anterior STEMI
involves leads V1-V4. Lateral STEMI involves leads I, aVL, V5-V6.
Q6. A patient with a new diagnosis of heart failure is prescribed metoprolol
succinate. The patient asks, "Why do I need a beta-blocker for my heart?" The
nurse's best response is:
A. "Beta-blockers will make your heart beat stronger right away."
B. "Beta-blockers help reduce your heart's workload and prevent remodeling over
time."
C. "Beta-blockers are used only if other medications don't work."
D. "Beta-blockers increase your heart rate to pump more blood."
, 4|Page
B. "Beta-blockers help reduce your heart's workload and prevent remodeling
over time."
Beta-blockers (metoprolol succinate, carvedilol, bisoprolol) reduce heart rate
and contractility, decreasing myocardial oxygen demand. They also prevent
adverse ventricular remodeling, reduce hospitalizations, and improve mortality
in HFrEF. Benefits are seen over weeks to months.
Q7. A patient with heart failure is receiving furosemide (Lasix) 40 mg IV push.
Which finding is most important to monitor?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
B. Serum potassium.
Furosemide is a loop diuretic that causes potassium wasting in the distal tubule.
Hypokalemia can precipitate life-threatening arrhythmias, especially in
patients taking digoxin. Potassium levels must be monitored closely during and
after administration.
Q8. Which of the following is a correct intervention for a patient exhibiting
signs of transfusion-associated circulatory overload (TACO)?
A. Administer diphenhydramine (Benadryl)
B. Rapidly infuse normal saline
C. Administer prescribed diuretics
D. Restart the transfusion at a slower rate
C. Administer prescribed diuretics.
TACO is characterized by fluid volume excess resulting from too-rapid or
excessive transfusion. Administering prescribed diuretics helps remove excess
fluid. The transfusion must be stopped, not slowed. A fluid bolus would worsen
the condition. Diphenhydramine treats allergic reactions, not TACO.
PCCN Exam 2025/2026 Practice
Questions: 150 Questions with
Detailed Rationales
AACN-aligned PCCN practice questions for 2025/2026
exam preparation. Includes 150 multiple-choice
questions covering cardiovascular, respiratory,
neurology, multisystem, and professional caring topics.
Each question features detailed rationales explaining
the correct answer and clinical reasoning. Reflects the
latest PCCN test plan with 80% clinical judgment and
20% ethical practice focus. Updated content for the
revised exam format. Ideal study resource for
progressive care nurses preparing for certification.
Q1. A nurse is caring for a 71-year-old female patient with end-stage COPD
who is experiencing cardiac ischemia with increased shortness of breath. The
MOST appropriate goal of oxygen therapy for this patient would be to:
A. Limit supplemental oxygen to lower the risk of reducing respiratory drive
B. Maintain oxygen saturations between 86% and 89%
C. Administer oxygen until oxygen saturations are greater than 95% in order to
relieve ischemia
D. Maintain oxygen saturations between 90% and 92%
,2|Page
D. Maintain oxygen saturations between 90% and 92%.
Maintaining oxygen saturations between 90% and 92% will serve the purpose of
providing enough oxygen to relieve cardiac ischemia while reducing the risk of
respiratory depression in a patient with COPD.
Q2. According to the AACN Synergy Model, which patient characteristic refers
to the capacity to return to a restorative level of functioning using
compensatory or coping mechanisms?
A. Stability
B. Vulnerability
C. Resiliency
D. Predictability
C. Resiliency.
Resiliency is defined as the patient's ability to bounce back from an illness and
return to a restorative level of functioning using compensatory and coping
mechanisms. Stability refers to the ability to maintain steady physiological
parameters. Vulnerability describes susceptibility to stressors.
Q3. A patient is complaining of "ripping" chest pain that radiates to the back.
Their blood pressure is 190/110 mm Hg. The nurse should immediately suspect:
A. Myocardial infarction
B. Aortic dissection
C. Pulmonary embolism
D. Pericarditis
B. Aortic dissection.
Aortic dissection classically presents with sudden, severe, tearing or ripping
chest pain that radiates to the back, often accompanied by significantly
elevated blood pressure. This is a life-threatening emergency requiring
immediate medical intervention.
,3|Page
Q4. The nurse is preparing to administer adenosine (Adenocard) for a patient
with supraventricular tachycardia (SVT). What is the correct administration
technique?
A. Administer 6 mg over 2 minutes through a peripheral IV
B. Administer 6 mg rapid IV push followed by a 20 mL saline flush
C. Administer 12 mg slow IV push over 5 minutes
D. Administer 6 mg IM in the deltoid muscle
B. Administer 6 mg rapid IV push followed by a 20 mL saline flush.
Adenosine is administered as a rapid IV push (1-2 seconds) followed
immediately by a 20 mL normal saline flush to promote rapid delivery to the
heart. The initial dose is 6 mg. If ineffective, a 12 mg dose may be repeated.
Adenosine has a very short half-life (approximately 10 seconds).
Q5. A patient is admitted with an acute inferior wall ST-segment elevation
myocardial infarction (STEMI). Which ECG leads would show ST-segment
elevation?
A. Leads I, aVL, V1-V2
B. Leads II, III, aVF
C. Leads V3-V4
D. Leads V5-V6, I, aVL
B. Leads II, III, aVF.
Inferior wall STEMI involves the right coronary artery (RCA) and presents with
ST-segment elevation in the inferior leads: II, III, and aVF. Anterior STEMI
involves leads V1-V4. Lateral STEMI involves leads I, aVL, V5-V6.
Q6. A patient with a new diagnosis of heart failure is prescribed metoprolol
succinate. The patient asks, "Why do I need a beta-blocker for my heart?" The
nurse's best response is:
A. "Beta-blockers will make your heart beat stronger right away."
B. "Beta-blockers help reduce your heart's workload and prevent remodeling over
time."
C. "Beta-blockers are used only if other medications don't work."
D. "Beta-blockers increase your heart rate to pump more blood."
, 4|Page
B. "Beta-blockers help reduce your heart's workload and prevent remodeling
over time."
Beta-blockers (metoprolol succinate, carvedilol, bisoprolol) reduce heart rate
and contractility, decreasing myocardial oxygen demand. They also prevent
adverse ventricular remodeling, reduce hospitalizations, and improve mortality
in HFrEF. Benefits are seen over weeks to months.
Q7. A patient with heart failure is receiving furosemide (Lasix) 40 mg IV push.
Which finding is most important to monitor?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
B. Serum potassium.
Furosemide is a loop diuretic that causes potassium wasting in the distal tubule.
Hypokalemia can precipitate life-threatening arrhythmias, especially in
patients taking digoxin. Potassium levels must be monitored closely during and
after administration.
Q8. Which of the following is a correct intervention for a patient exhibiting
signs of transfusion-associated circulatory overload (TACO)?
A. Administer diphenhydramine (Benadryl)
B. Rapidly infuse normal saline
C. Administer prescribed diuretics
D. Restart the transfusion at a slower rate
C. Administer prescribed diuretics.
TACO is characterized by fluid volume excess resulting from too-rapid or
excessive transfusion. Administering prescribed diuretics helps remove excess
fluid. The transfusion must be stopped, not slowed. A fluid bolus would worsen
the condition. Diphenhydramine treats allergic reactions, not TACO.
