• PCCN EXAM 09/12/2026
PCCN EXAM 2 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!!)
Your patient had an exacerbation of COPD. The rapid response team was called and is currently intubating the
patient and preparing him for transfer to ICU. When the family visits, they are shocked to see the people working
with the patient. No one had told them the patient had deteriorated and required intubation. After the patient is
intubated and is being wheeled past them, family members try to communicate verbally with the patient, but he
does not respond except to gesture. The nurse should tell the family members:
P 1
, • PCCN EXAM 09/12/2026
-They must leave the area because they are exciting the patient.
-The tube used for breathing prevents the patient from speaking
-They must speak with the doctor, who will explain why the patient cannot speak
-The patient is very ill and may die. –
Correct Answer :The tube used for breathing prevents the patient from speaking
This is a case where communication is clearly the problem. The family should have been informed by someone
that the patient needed assistance with breathing and that they should expect a transfer. It should also have
been mentioned how the patient might look in the ICU. In addition, it could have been communicated about the
patient's inability to speak.
The other answers are all non-theraputic responses. The family is clearly distressed, so a simple explaination in
best.
To provide competent and efficient nursing care to all patients, the team leader should:
A. Develop and implement a structured routine plan of care.
B. Assign nurses with the same cultural backgrounds as their patients
C. Require family members to participate in patient care
D. Perform a cultural assessment of each patient and individualize care –
Correct Answer :D. Perform a cultural assessment of each patient and individualize care
The team leader's response to diversity should include incorporation of cultural differences into the plan of care.
Development of a structured routine plan of care may not identify individual needs of patients and families. The
nurse does not need to be of the same cultural background as the patient, only to respect the patient's
individuality and their respective needs. No team leader can require family members to participate in patient
care.
Coronary artery perfusion is dependent upon:
A. diastolic pressure
B. systolic pressure
C. afterload
D. systemic vascular resistance (SVR) - Correct Answer :A. diastolic pressure
P 2
, • PCCN EXAM 09/12/2026
Diastolic pressure in the aortic root is higher than left ventricular end-diastolic pressure (LVEDP), the pressure
exerted on the ventricular muscle at the end of diastole when the ventricle is full. This enables blood to flow
from a higher pressure through open arteries to a lower pressure, a pressure gradient known as coronary artery
prefusion pressure. As diastolic pressure drops, there is a decrease in coronary artery blood flow. Coronary artery
perfusion is not affected by systolic pressure, afterload or SVR, but they all increase the demand of oxygen in the
heart.
A post-STEMI (ST elevation myocardial infarction) patient is started on an angiotensin-converting enzyme (ACE)
inhibitor during his hospital stay. Which of the following is the most common serious side effect that may occur?
A. a nonproductive cough
B. pedal edema
C. swelling of the tongue and face
D. rhinorrhea –
Correct Answer :C. swelling of the tongue and face
Although all of the answers may occur, swelling og the tongue and face is the most serious and may require
intervention. Patients should be instructed to seek medical attention immediately for any signs of swelling in the
tongue or throat.
Which of the following best describes the fourth heart sound (S4):
A. It occurs after ventricular contraction
B. It is best heard with the diaphragm of the stethoscope
C. It is a normal finding in children
D. It occurs during late diastole when the atria contracts –
Correct Answer :D. It occurs during late diastole when the atria contracts
The presence of the extra heart sound S4 signifies a poorly compliant (stiff) left ventricle. An S4 is also called an
atrial heart sound since it occurs at the end of diastolic filling when the atria contracts and fully fills the left
ventricle. Known as "atrial kick", this filling is important to cardiac output. The increased end-diastolic volume in
the ventricle improves cardiac output. When the left ventricle is stiff (decreased compliance with long term
hypertension, aortic stenosis or with acute STEMI), the atrium has to pump harder to move blood from the
atrium to the ventricle, causing a turbulent blood flow and extra heart sound. This heart sound is always
pathologic. It occurs before ventricular contraction, is best heard with the bell of the stethoscope and is never a
normal heart sound, even in children.
P 3
, • PCCN EXAM 09/12/2026
Which pathologic changes found on the 12-lead ECG indicate myocardial ischemia?
A. ST-segment elevation
B. ST-segment depression and T-wave elevation
C. Q-wave formation
D. ST-segment depression and T-wave inversion
- Correct Answer :D. ST segment depression and T wave inversion
Myocardial ischemia changes the repolarization of the ventricular muscle. That change is seen on the 12 lead ECG
as ST-segment depression and T wave inversion, which demonstrate subendocardial ischemia -- the innermost
layer of muscle in the myocardium. ST-segment elevation indicates acute injury or infarction, ST segment
depression and T wave elevation may indicate an electrolyte abnormality, while Q wave formation indicates total
infarction.
Positive inotropic agents are used to:
A. improve cardiac output and tissue perfusion
B. decrease water loss through the kidneys
C. increase heart rate
D. vasodilate vessels - Correct Answer :A. improve cardiac output and tissue perfusion
The term "inotropic" refers to affecting the force of myocardial contraction. Improvement of cardiac muscle
contraction leads to improved cardiac output and tissue perfusion.
Question 1. A patient with chest pain has ST elevation in leads II, III, and aVF. Which complication is the nurse
MOST concerned about?
A. Left ventricular failure
B. Right ventricular infarction with preload dependence
C. Aortic dissection
D. Pericarditis
Question 1: Correct Answer - B
Rationale: Inferior STEMI (II, III, aVF) may involve the RV. RV infarct patients are preload dependent;
nitrates/diuretics can cause profound hypotension.
Question 2. A patient with NSTEMI is started on heparin infusion. Which lab value is MOST important to trend for
therapeutic effect?
P 4
PCCN EXAM 2 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!!)
Your patient had an exacerbation of COPD. The rapid response team was called and is currently intubating the
patient and preparing him for transfer to ICU. When the family visits, they are shocked to see the people working
with the patient. No one had told them the patient had deteriorated and required intubation. After the patient is
intubated and is being wheeled past them, family members try to communicate verbally with the patient, but he
does not respond except to gesture. The nurse should tell the family members:
P 1
, • PCCN EXAM 09/12/2026
-They must leave the area because they are exciting the patient.
-The tube used for breathing prevents the patient from speaking
-They must speak with the doctor, who will explain why the patient cannot speak
-The patient is very ill and may die. –
Correct Answer :The tube used for breathing prevents the patient from speaking
This is a case where communication is clearly the problem. The family should have been informed by someone
that the patient needed assistance with breathing and that they should expect a transfer. It should also have
been mentioned how the patient might look in the ICU. In addition, it could have been communicated about the
patient's inability to speak.
The other answers are all non-theraputic responses. The family is clearly distressed, so a simple explaination in
best.
To provide competent and efficient nursing care to all patients, the team leader should:
A. Develop and implement a structured routine plan of care.
B. Assign nurses with the same cultural backgrounds as their patients
C. Require family members to participate in patient care
D. Perform a cultural assessment of each patient and individualize care –
Correct Answer :D. Perform a cultural assessment of each patient and individualize care
The team leader's response to diversity should include incorporation of cultural differences into the plan of care.
Development of a structured routine plan of care may not identify individual needs of patients and families. The
nurse does not need to be of the same cultural background as the patient, only to respect the patient's
individuality and their respective needs. No team leader can require family members to participate in patient
care.
Coronary artery perfusion is dependent upon:
A. diastolic pressure
B. systolic pressure
C. afterload
D. systemic vascular resistance (SVR) - Correct Answer :A. diastolic pressure
P 2
, • PCCN EXAM 09/12/2026
Diastolic pressure in the aortic root is higher than left ventricular end-diastolic pressure (LVEDP), the pressure
exerted on the ventricular muscle at the end of diastole when the ventricle is full. This enables blood to flow
from a higher pressure through open arteries to a lower pressure, a pressure gradient known as coronary artery
prefusion pressure. As diastolic pressure drops, there is a decrease in coronary artery blood flow. Coronary artery
perfusion is not affected by systolic pressure, afterload or SVR, but they all increase the demand of oxygen in the
heart.
A post-STEMI (ST elevation myocardial infarction) patient is started on an angiotensin-converting enzyme (ACE)
inhibitor during his hospital stay. Which of the following is the most common serious side effect that may occur?
A. a nonproductive cough
B. pedal edema
C. swelling of the tongue and face
D. rhinorrhea –
Correct Answer :C. swelling of the tongue and face
Although all of the answers may occur, swelling og the tongue and face is the most serious and may require
intervention. Patients should be instructed to seek medical attention immediately for any signs of swelling in the
tongue or throat.
Which of the following best describes the fourth heart sound (S4):
A. It occurs after ventricular contraction
B. It is best heard with the diaphragm of the stethoscope
C. It is a normal finding in children
D. It occurs during late diastole when the atria contracts –
Correct Answer :D. It occurs during late diastole when the atria contracts
The presence of the extra heart sound S4 signifies a poorly compliant (stiff) left ventricle. An S4 is also called an
atrial heart sound since it occurs at the end of diastolic filling when the atria contracts and fully fills the left
ventricle. Known as "atrial kick", this filling is important to cardiac output. The increased end-diastolic volume in
the ventricle improves cardiac output. When the left ventricle is stiff (decreased compliance with long term
hypertension, aortic stenosis or with acute STEMI), the atrium has to pump harder to move blood from the
atrium to the ventricle, causing a turbulent blood flow and extra heart sound. This heart sound is always
pathologic. It occurs before ventricular contraction, is best heard with the bell of the stethoscope and is never a
normal heart sound, even in children.
P 3
, • PCCN EXAM 09/12/2026
Which pathologic changes found on the 12-lead ECG indicate myocardial ischemia?
A. ST-segment elevation
B. ST-segment depression and T-wave elevation
C. Q-wave formation
D. ST-segment depression and T-wave inversion
- Correct Answer :D. ST segment depression and T wave inversion
Myocardial ischemia changes the repolarization of the ventricular muscle. That change is seen on the 12 lead ECG
as ST-segment depression and T wave inversion, which demonstrate subendocardial ischemia -- the innermost
layer of muscle in the myocardium. ST-segment elevation indicates acute injury or infarction, ST segment
depression and T wave elevation may indicate an electrolyte abnormality, while Q wave formation indicates total
infarction.
Positive inotropic agents are used to:
A. improve cardiac output and tissue perfusion
B. decrease water loss through the kidneys
C. increase heart rate
D. vasodilate vessels - Correct Answer :A. improve cardiac output and tissue perfusion
The term "inotropic" refers to affecting the force of myocardial contraction. Improvement of cardiac muscle
contraction leads to improved cardiac output and tissue perfusion.
Question 1. A patient with chest pain has ST elevation in leads II, III, and aVF. Which complication is the nurse
MOST concerned about?
A. Left ventricular failure
B. Right ventricular infarction with preload dependence
C. Aortic dissection
D. Pericarditis
Question 1: Correct Answer - B
Rationale: Inferior STEMI (II, III, aVF) may involve the RV. RV infarct patients are preload dependent;
nitrates/diuretics can cause profound hypotension.
Question 2. A patient with NSTEMI is started on heparin infusion. Which lab value is MOST important to trend for
therapeutic effect?
P 4
