• PCCN EXAM 09/12/2026
PCCN EXAM 3 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!!)
.
Laboratory studies from a 22-year-old male client with Type I diabetes mellitus are evaluated during an admission
for severe pneumonia. Which of the following laboratory results should the nurse report to the physician?
A. Glycosylated hemoglobin (HbA1c), 9.8%
P 1
, • PCCN EXAM 09/12/2026
B. Low-density lipoprotein (LDL),
C. 94 mg/dLHematocrit (Hct), 53%
D. Urine specific gravity, 1.250 –
Correct Answer :A. Glycosylated hemoglobin (HbA1c), 9.8%
Feedback
Glycosylated hemoglobin measures the average blood sugar levels over a 2 to 3 month time period. Clients with
previously diagnosed diabetes mellitus should aim to keep their HbA1c levels below 7%.CONTENT AREA: Clinical
Judgement: Endocrine/Hematology/Neurology/GI/Renal
The nurse is assessing a 68 year old female patient with a history of chronic obstructive pulmonary disease
(COPD). The patient presents with complaints of recent confusion, increased fatigue, and syncopal episodes
when walking. The nurse assesses S3 and S4 sounds on auscultation, jugular vein distention, and +3 pitting
edema of the ankles and feet. Which of the following complications of COPD does the nurse suspect the patient
is most likely experiencing?
A. Acute respiratory distress syndrome (ARDS)
B. Bronchiectasis
C. Heart failure
D. Cor pulmonale - Correct Answer :D. Cor pulmonale
Feedback
The nurse should recognize that a history of COPD together with the signs and symptoms listed here are
suggestive of cor pulmonale. The patient requires further workup to confirm this diagnosis.
A 42-year-old male with Marfan syndrome and complaint of dizziness is admitted to the telemetry unit for
monitoring. Which of the following accompanying symptoms may indicate the need for immediate surgical
attention?
A. Cough with vocal hoarseness
B. Limited rotation of the left shoulder
C.Headache that resolved after breakfast, but has returned
D. Sudden stabbing pain in the right elbow - Correct Answer :A. Cough with vocal hoarseness
Feedback
P 2
, • PCCN EXAM 09/12/2026
Patients diagnosed with Marfan syndrome are at higher risk for aortic aneurysms. Changes in vocal quality
accompanied by a cough or dysphagia (difficulty swallowing) may indicate that a thoracic aortic aneurysm is
becoming more enlarged.
The nurse is assessing a 74 year old female patient who has presented with the following symptoms: cool,
clammy skin; faint, irregular peripheral pulses, and +3 pitting edema in her bilateral lower extremities. Her partner
tells the nurse the patient has a history of heart failure with a recent LVEF of 20%, as well as type 2 diabetes. The
patient's HR is 132, BP is 79/48, and blood glucose is 349. Which of the following conditions does the nurse
suspect?
A. Cardiogenic shock
B. Diabetic ketoacidosis
C. Fluid overload
D. Obstructive shock - Correct Answer :A. Cardiogenic shock
Feedback
The nurse should identify that cardiogenic shock is an emergency that has extremely high mortality rates without
timely intervention. The patient's history of heart failure together with her acute symptoms of weak pulses,
edema, and hypotension all point to cardiogenic shock.
The nurse is caring for a patient with stage 5 chronic kidney disease who normally receives hemodialysis three
times a week on Monday, Wednesday, and Friday. It is now Sunday and the patient states they have missed their
last two dialysis sessions. The patient is complaining of shortness of breath and fatigue, and their labs show a
creatinine of 3.9 and potassium of 6.8. What is the BEST treatment for this patient ?
A. 80 mg IV push furosemide followed by rechecking the potassium level, with more IV furosemide as needed
B. 15 g kayexalate PO twice daily
C. Intravenous calcium infusion
D. Urgent hemodialysis - Correct Answer :D. Urgent hemodialysis
Feedback
The nurse should recognize that dialysis is the best option for this patient since they are already a regular dialysis
patient and are a likely candidate to receive urgent dialysis due to their missed dialysis sessions, shortness of
breath, and critical potassium level.
A 17-year-old male client is recovering from idiopathic infective endocarditis. The nurse should include which of
the following teaching points in the discharge care plan for this client?
A. Taking prophylactic antibiotics before dental procedures
P 3
, • PCCN EXAM 09/12/2026
B. Drinking no more than 1 liter of fluid per day
C. Strictly avoiding caffeine or other stimulants
D. Encouraging a healthy low-fat diet that includes at least 2 grams of sodium intake per day - Correct Answer
:A. Taking prophylactic antibiotics before dental procedures
Feedback
Client with a history of infective endocarditis should take prophylactic antibiotics before dental procedures and
some surgical procedures.
The nurse is caring for a 21 year old female who is being treated with IV magnesium for pre-eclampsia. Upon
assessment, the nurse notes that the patient's skin is flushed, her blood pressure is 88/56, and her respiratory
rate is 12. The nurse checks the patient's magnesium level and finds that it is 7.2 mg/dL. Which of the following
actions does the nurse anticipate taking next?
A. Administering intravenous calcium gluconate
B. Increasing the rate of the magnesium infusion
C. Placing the patient in Trendelenburg and administering a bolus of IV fluid
D.Preparing the patient for a bedside cardioversion. - Correct Answer :A. Administering intravenous calcium
gluconate
Feedback
The nurse should identify that the signs and symptoms here are reflective of a critically high magnesium level,
reflected by the lab level of 7.2 mg/dL, and that the correct treatment is an infusion of calcium gluconate.
A 22-year-old male patient is admitted for observation following a linear temporal skull fracture from a skiing
accident. Upon admission at 2 pm, the patient was alert and oriented, and reports that he "passed out for a
second" immediately after his accident. At 4 pm, the nurse notes that the patient's Glasgow Coma Scale (GCS) is
8. The nurse should:
A. Continue to monitor for changes
B. Place the patient in Trendelenburg position
C. Prepare the patient for burr hole placement with clot evacuation
D. Prepare to administer tissue plasminogen activator (tPA) to reverse occlusive stroke - Correct Answer :C.
Prepare the patient for burr hole placement with clot evacuation
Feedback
This patient is exhibiting classic signs and symptoms of an epidural hematoma. Surgical intervention to remove
the hematoma and relieve pressure on the brain should be performed as soon as possible.
P 4
PCCN EXAM 3 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!!)
.
Laboratory studies from a 22-year-old male client with Type I diabetes mellitus are evaluated during an admission
for severe pneumonia. Which of the following laboratory results should the nurse report to the physician?
A. Glycosylated hemoglobin (HbA1c), 9.8%
P 1
, • PCCN EXAM 09/12/2026
B. Low-density lipoprotein (LDL),
C. 94 mg/dLHematocrit (Hct), 53%
D. Urine specific gravity, 1.250 –
Correct Answer :A. Glycosylated hemoglobin (HbA1c), 9.8%
Feedback
Glycosylated hemoglobin measures the average blood sugar levels over a 2 to 3 month time period. Clients with
previously diagnosed diabetes mellitus should aim to keep their HbA1c levels below 7%.CONTENT AREA: Clinical
Judgement: Endocrine/Hematology/Neurology/GI/Renal
The nurse is assessing a 68 year old female patient with a history of chronic obstructive pulmonary disease
(COPD). The patient presents with complaints of recent confusion, increased fatigue, and syncopal episodes
when walking. The nurse assesses S3 and S4 sounds on auscultation, jugular vein distention, and +3 pitting
edema of the ankles and feet. Which of the following complications of COPD does the nurse suspect the patient
is most likely experiencing?
A. Acute respiratory distress syndrome (ARDS)
B. Bronchiectasis
C. Heart failure
D. Cor pulmonale - Correct Answer :D. Cor pulmonale
Feedback
The nurse should recognize that a history of COPD together with the signs and symptoms listed here are
suggestive of cor pulmonale. The patient requires further workup to confirm this diagnosis.
A 42-year-old male with Marfan syndrome and complaint of dizziness is admitted to the telemetry unit for
monitoring. Which of the following accompanying symptoms may indicate the need for immediate surgical
attention?
A. Cough with vocal hoarseness
B. Limited rotation of the left shoulder
C.Headache that resolved after breakfast, but has returned
D. Sudden stabbing pain in the right elbow - Correct Answer :A. Cough with vocal hoarseness
Feedback
P 2
, • PCCN EXAM 09/12/2026
Patients diagnosed with Marfan syndrome are at higher risk for aortic aneurysms. Changes in vocal quality
accompanied by a cough or dysphagia (difficulty swallowing) may indicate that a thoracic aortic aneurysm is
becoming more enlarged.
The nurse is assessing a 74 year old female patient who has presented with the following symptoms: cool,
clammy skin; faint, irregular peripheral pulses, and +3 pitting edema in her bilateral lower extremities. Her partner
tells the nurse the patient has a history of heart failure with a recent LVEF of 20%, as well as type 2 diabetes. The
patient's HR is 132, BP is 79/48, and blood glucose is 349. Which of the following conditions does the nurse
suspect?
A. Cardiogenic shock
B. Diabetic ketoacidosis
C. Fluid overload
D. Obstructive shock - Correct Answer :A. Cardiogenic shock
Feedback
The nurse should identify that cardiogenic shock is an emergency that has extremely high mortality rates without
timely intervention. The patient's history of heart failure together with her acute symptoms of weak pulses,
edema, and hypotension all point to cardiogenic shock.
The nurse is caring for a patient with stage 5 chronic kidney disease who normally receives hemodialysis three
times a week on Monday, Wednesday, and Friday. It is now Sunday and the patient states they have missed their
last two dialysis sessions. The patient is complaining of shortness of breath and fatigue, and their labs show a
creatinine of 3.9 and potassium of 6.8. What is the BEST treatment for this patient ?
A. 80 mg IV push furosemide followed by rechecking the potassium level, with more IV furosemide as needed
B. 15 g kayexalate PO twice daily
C. Intravenous calcium infusion
D. Urgent hemodialysis - Correct Answer :D. Urgent hemodialysis
Feedback
The nurse should recognize that dialysis is the best option for this patient since they are already a regular dialysis
patient and are a likely candidate to receive urgent dialysis due to their missed dialysis sessions, shortness of
breath, and critical potassium level.
A 17-year-old male client is recovering from idiopathic infective endocarditis. The nurse should include which of
the following teaching points in the discharge care plan for this client?
A. Taking prophylactic antibiotics before dental procedures
P 3
, • PCCN EXAM 09/12/2026
B. Drinking no more than 1 liter of fluid per day
C. Strictly avoiding caffeine or other stimulants
D. Encouraging a healthy low-fat diet that includes at least 2 grams of sodium intake per day - Correct Answer
:A. Taking prophylactic antibiotics before dental procedures
Feedback
Client with a history of infective endocarditis should take prophylactic antibiotics before dental procedures and
some surgical procedures.
The nurse is caring for a 21 year old female who is being treated with IV magnesium for pre-eclampsia. Upon
assessment, the nurse notes that the patient's skin is flushed, her blood pressure is 88/56, and her respiratory
rate is 12. The nurse checks the patient's magnesium level and finds that it is 7.2 mg/dL. Which of the following
actions does the nurse anticipate taking next?
A. Administering intravenous calcium gluconate
B. Increasing the rate of the magnesium infusion
C. Placing the patient in Trendelenburg and administering a bolus of IV fluid
D.Preparing the patient for a bedside cardioversion. - Correct Answer :A. Administering intravenous calcium
gluconate
Feedback
The nurse should identify that the signs and symptoms here are reflective of a critically high magnesium level,
reflected by the lab level of 7.2 mg/dL, and that the correct treatment is an infusion of calcium gluconate.
A 22-year-old male patient is admitted for observation following a linear temporal skull fracture from a skiing
accident. Upon admission at 2 pm, the patient was alert and oriented, and reports that he "passed out for a
second" immediately after his accident. At 4 pm, the nurse notes that the patient's Glasgow Coma Scale (GCS) is
8. The nurse should:
A. Continue to monitor for changes
B. Place the patient in Trendelenburg position
C. Prepare the patient for burr hole placement with clot evacuation
D. Prepare to administer tissue plasminogen activator (tPA) to reverse occlusive stroke - Correct Answer :C.
Prepare the patient for burr hole placement with clot evacuation
Feedback
This patient is exhibiting classic signs and symptoms of an epidural hematoma. Surgical intervention to remove
the hematoma and relieve pressure on the brain should be performed as soon as possible.
P 4
