• PCCN EXAM 09/12/2026
PCCN EXAM NEW 2025/ 2026 ACTUAL EXAM TEST
BANK| 2 VERSIONS (VERSION A & B) WITH
COMPLETE 650 REAL EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED
ANSWERS) ALREADY GRADED A+| PROGRESSIVE
CARE CERTIFIED NURSE EXAM PREP (MOST
RECENT!!)
The primary function of beta blocker therapy in heart failure is to:
A. increase BP
B. block compensatory vasoconstriction and increase heart rate
C. increase urine output
P 1
, • PCCN EXAM 09/12/2026
D. decrease preload –
Correct Answer :B. block compensatory vasoconstriction and increase heart rate
The treatment of heart failure is to reduce the actions of the sympathetic nervous system and the renin-
angiotensin system. Beta blockers block the SNS and reduce afterload, slightly reduce contractility and improve
heart rate regulation. These decrease the demands of oxygen for the patient with reduced ventricular function.
Beta blockers do not increase heart rate, nor do they increase urine output or change preload in any way.
Early symptoms of fluid overload and pulmonary edema are:
A. rales and hypoxia
B. S3 heart sound and tachycardia
C. complaint of shortness of breath and orthopnea
D. ST segment elevation in the chest leads
- Correct Answer :C. complaint of shortness of breath and orthopnea
Remember that symptoms are what the patient complains of, not signs that the nurse measures. Rales and
hypoxia, S3 and tachycardia are signs that are measured at the bedside. ST segment elevation is a sign of cardiac
injury/infarction. A complaint of shortness of breath and the inability to lie down are symptoms of early left-
ventricular failure.
An elderly patient is admitted and placed on warfarin (Coumadin) for arterial fibrillation. What is a therapeutic
range for anticoagulation for this patient?
A. international normalized ration (INR) less than 1.0
B. INR between 1.0 and 1.5
C. INR between 2.5 and 3.5
D. INR between 4.5 and 6.0 –
Correct Answer :C. INR between 2.5 and 3.5
The therapeutic range of INR for any patient with atrial fibrillation is 2.5-3.5, no matter what their age. A normal
INR is 1.0, and 4.5-6.0 is a high INR.
P 2
, • PCCN EXAM 09/12/2026
After cardiac transplantation, the patient is placed on cyclosporine modified (Gengraf). In assessing this patient,
the nurse should monitor:
A. Blood glucose
B. serum creatinine
C. serum amylase
D. serum magnesium - Correct Answer :B. serum creatinine
When a patient is on cyclosporine for antirejection, serum creatinine should be followed closely. Cyclosporine is
eliminated via the kidneys and can cause renal injury and failure. Of course, blood glucose should be monitored;
however, this questions is looking for the consequence of a drug on renal function. Serum amylase is affected by
liver disease or pancreatitis, and serum magnesium should always be monitored; however, it is not affected by
cyclosporine.
An elderly patient on warfarin (Coumadin) therapy has been admitted with an INR of 6.0. What is the antidote
that can be used to counteract the effects of warfarin and decrease the risk of bleeding?
A. vitamin A
B. vitamin B12
C. vitamin C
D. vitamin K - Correct Answer :D. vitamin K
Vitamin K is the antidote for warfarin overdose. None of the other vitamins are antagonists of warfarin.
A physiologic reason for sinus tachycardia is:
A. elevated serum potassium
B. elevated creatinine
C. decreased urine output
D. tissue hypoxia –
Correct Answer :D. tissue hypoxia
Sinus tachycardia is generally a compensatory mechanism for decreased tissue oxygenation. Fever, pain, anxiety,
hypovolemia and decreased blood pressure all are reasons for tachycardia. The physiology in all is the lack of
oxygen delivery at the tissue level. Elevated potassium does not increase heart rate, but if it is high enough,
causes sinus bradycardia. Elevated creatinine is a marker of renal failure, and increased potassium would cause
sinus bradycardia. Decreased urine output may or may not affect heart rate.
P 3
, • PCCN EXAM 09/12/2026
A patient is admitted with decompensated heart failure. The patient is receiving furosemide (Lasix), digoxin
(Lanoxin), metoprolol (Lopressor) and lisinopril (Zestril) at home. What drug can be added to reduce preload?
A. spironolactone (Aldactone)
b. verapamil (Calan)
c. dabigatran etexilate (Pradaza)
d. No other drugs are essential - Correct Answer :A. spironolactone (Aldactone)
When the heart failure patient continues to have volume overload on appropriate medications, an aldosterone
inhibitor such as spironolactone or eplerenone (Inspera) should be added. Aldosterone inhibition will decrease
sodium reabsorption from the kidneys and therefore decrease intravascular volume. The nurse would carefully
monitor potassium since aldosterone blockers are potassium-sparing diuretics. Remember not to use verapamil
in heart failure; it will increase sodium and water retention. Dabigatran etexilate is an anticoagulant used only for
non-vascular atrial fibrillation.
Which condition would stimulate renin production?
A. increased blood supply to the renal tubules
B. decreased blood pressure
C. decreased sympathetic output
D. increased sodium concentration - Correct Answer :B. decreased blood pressure
Renin secretion is regulated by blood flow to the juxtaglomerular apparatus. Decreased blood pressure would
be identified, and renin secretion would occur. This begins a compensatory mechanism that causes
vasoconstriction with increased blood pressure as well as sodium and water reabsorption in the kidneys, thereby
effectively increasing blood pressure. Increased blood flow would maintain normal renin production. Decreased
sympathetic output would not affect renin secretion from the kidneys (it is stimulated by low renal blood flow).
Low serum sodium concentrations would stimulate renin production due to decreased osmolality.
Symptoms of acute endocarditis of the mitral valve cause:
A. symptoms similar to heart failure
B. severe chest pain mimicking STEMI
C. Claudication-type pain
D. pain that is relieved by sitting up - Correct Answer :A. symptoms similar to heart failure
P 4
PCCN EXAM NEW 2025/ 2026 ACTUAL EXAM TEST
BANK| 2 VERSIONS (VERSION A & B) WITH
COMPLETE 650 REAL EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED
ANSWERS) ALREADY GRADED A+| PROGRESSIVE
CARE CERTIFIED NURSE EXAM PREP (MOST
RECENT!!)
The primary function of beta blocker therapy in heart failure is to:
A. increase BP
B. block compensatory vasoconstriction and increase heart rate
C. increase urine output
P 1
, • PCCN EXAM 09/12/2026
D. decrease preload –
Correct Answer :B. block compensatory vasoconstriction and increase heart rate
The treatment of heart failure is to reduce the actions of the sympathetic nervous system and the renin-
angiotensin system. Beta blockers block the SNS and reduce afterload, slightly reduce contractility and improve
heart rate regulation. These decrease the demands of oxygen for the patient with reduced ventricular function.
Beta blockers do not increase heart rate, nor do they increase urine output or change preload in any way.
Early symptoms of fluid overload and pulmonary edema are:
A. rales and hypoxia
B. S3 heart sound and tachycardia
C. complaint of shortness of breath and orthopnea
D. ST segment elevation in the chest leads
- Correct Answer :C. complaint of shortness of breath and orthopnea
Remember that symptoms are what the patient complains of, not signs that the nurse measures. Rales and
hypoxia, S3 and tachycardia are signs that are measured at the bedside. ST segment elevation is a sign of cardiac
injury/infarction. A complaint of shortness of breath and the inability to lie down are symptoms of early left-
ventricular failure.
An elderly patient is admitted and placed on warfarin (Coumadin) for arterial fibrillation. What is a therapeutic
range for anticoagulation for this patient?
A. international normalized ration (INR) less than 1.0
B. INR between 1.0 and 1.5
C. INR between 2.5 and 3.5
D. INR between 4.5 and 6.0 –
Correct Answer :C. INR between 2.5 and 3.5
The therapeutic range of INR for any patient with atrial fibrillation is 2.5-3.5, no matter what their age. A normal
INR is 1.0, and 4.5-6.0 is a high INR.
P 2
, • PCCN EXAM 09/12/2026
After cardiac transplantation, the patient is placed on cyclosporine modified (Gengraf). In assessing this patient,
the nurse should monitor:
A. Blood glucose
B. serum creatinine
C. serum amylase
D. serum magnesium - Correct Answer :B. serum creatinine
When a patient is on cyclosporine for antirejection, serum creatinine should be followed closely. Cyclosporine is
eliminated via the kidneys and can cause renal injury and failure. Of course, blood glucose should be monitored;
however, this questions is looking for the consequence of a drug on renal function. Serum amylase is affected by
liver disease or pancreatitis, and serum magnesium should always be monitored; however, it is not affected by
cyclosporine.
An elderly patient on warfarin (Coumadin) therapy has been admitted with an INR of 6.0. What is the antidote
that can be used to counteract the effects of warfarin and decrease the risk of bleeding?
A. vitamin A
B. vitamin B12
C. vitamin C
D. vitamin K - Correct Answer :D. vitamin K
Vitamin K is the antidote for warfarin overdose. None of the other vitamins are antagonists of warfarin.
A physiologic reason for sinus tachycardia is:
A. elevated serum potassium
B. elevated creatinine
C. decreased urine output
D. tissue hypoxia –
Correct Answer :D. tissue hypoxia
Sinus tachycardia is generally a compensatory mechanism for decreased tissue oxygenation. Fever, pain, anxiety,
hypovolemia and decreased blood pressure all are reasons for tachycardia. The physiology in all is the lack of
oxygen delivery at the tissue level. Elevated potassium does not increase heart rate, but if it is high enough,
causes sinus bradycardia. Elevated creatinine is a marker of renal failure, and increased potassium would cause
sinus bradycardia. Decreased urine output may or may not affect heart rate.
P 3
, • PCCN EXAM 09/12/2026
A patient is admitted with decompensated heart failure. The patient is receiving furosemide (Lasix), digoxin
(Lanoxin), metoprolol (Lopressor) and lisinopril (Zestril) at home. What drug can be added to reduce preload?
A. spironolactone (Aldactone)
b. verapamil (Calan)
c. dabigatran etexilate (Pradaza)
d. No other drugs are essential - Correct Answer :A. spironolactone (Aldactone)
When the heart failure patient continues to have volume overload on appropriate medications, an aldosterone
inhibitor such as spironolactone or eplerenone (Inspera) should be added. Aldosterone inhibition will decrease
sodium reabsorption from the kidneys and therefore decrease intravascular volume. The nurse would carefully
monitor potassium since aldosterone blockers are potassium-sparing diuretics. Remember not to use verapamil
in heart failure; it will increase sodium and water retention. Dabigatran etexilate is an anticoagulant used only for
non-vascular atrial fibrillation.
Which condition would stimulate renin production?
A. increased blood supply to the renal tubules
B. decreased blood pressure
C. decreased sympathetic output
D. increased sodium concentration - Correct Answer :B. decreased blood pressure
Renin secretion is regulated by blood flow to the juxtaglomerular apparatus. Decreased blood pressure would
be identified, and renin secretion would occur. This begins a compensatory mechanism that causes
vasoconstriction with increased blood pressure as well as sodium and water reabsorption in the kidneys, thereby
effectively increasing blood pressure. Increased blood flow would maintain normal renin production. Decreased
sympathetic output would not affect renin secretion from the kidneys (it is stimulated by low renal blood flow).
Low serum sodium concentrations would stimulate renin production due to decreased osmolality.
Symptoms of acute endocarditis of the mitral valve cause:
A. symptoms similar to heart failure
B. severe chest pain mimicking STEMI
C. Claudication-type pain
D. pain that is relieved by sitting up - Correct Answer :A. symptoms similar to heart failure
P 4
