A+ VERIFIED
PROGRESSIVE CARE CERTIFICATION · OBJECTIVE ASSESSMENT
PCCN Exam — Complete
Official Exam
50 Questions Full Rationales Verified Answers
50 5 100%
QUESTIONS SECTIONS RATIONALES
Complete coverage Core exam domains Every answer explained
WHAT THIS COVERS
01 Cardiovascular Disorders
02 Pulmonary Disorders
03 Neurologic, Renal & Endocrine Disorders
04 Gastrointestinal, Hematologic & Multisystem Disorders
05 Professional Caring & Ethical Practice
ABOUT THIS ASSESSMENT
Build mastery in progressive care nursing — from cardiovascular
and pulmonary disorders to neurologic, renal, endocrine,
gastrointestinal, hematologic, and multisystem conditions, with
professional caring and ethical practice. This original study
bank targets application and analysis skills for the PCCN Exam,
with full rationales for every answer. For review use only; not
an institutional proctored assessment.
PASSING SCORE LEVEL FORMAT
80% Advanced (Progressive Care Certification) Application / Analysis
STUVIA ACTUAL EXAM Page 1
, SECTION 1: Cardiovascular Disorders
Q1. A progressive care client with non–ST-elevation acute coronary syndrome develops new ST depression in leads V4–V6
and reports increasing chest pressure. Troponin is rising. Which intervention is the highest priority while awaiting transfer to
the cardiac catheterization laboratory?
A. Withhold all anticoagulants until after catheterization is complete
B. Encourage ambulation to the bathroom to reduce anxiety
C. Rely solely on oral acetaminophen for pain control
D. Administer prescribed anti-ischemic therapy (nitroglycerin, beta-blocker if appropriate), antiplatelet agents, and
anticoagulation while maintaining continuous ECG monitoring
Correct Answer: D
Rationale: Ongoing ischemia with dynamic ECG changes and rising troponin requires prompt anti-ischemic, antiplatelet, and anticoagulant
therapy per ACS guidelines. Continuous monitoring detects deterioration. Ambulation or withholding indicated therapy increases risk of
infarction progression.
Q2. A client with acute decompensated heart failure has a pulmonary artery catheter in place. The nurse notes a cardiac
index of 1.8 L/min/m², PAOP of 28 mm Hg, and SVR of 1800 dynes·sec·cm■■. Which pharmacologic strategy is most
appropriate?
A. Immediate discontinuation of all vasoactive medications
B. High-dose pure alpha-agonist vasopressors as first-line therapy
C. Afterload reduction with a vasodilator and careful diuresis to lower preload while supporting contractility as needed
D. Aggressive volume loading to further increase PAOP
Correct Answer: C
Rationale: Low cardiac index with elevated filling pressure and high SVR indicates the need to reduce afterload and preload while
supporting forward flow. Pure volume loading or unopposed vasoconstriction would worsen pulmonary congestion and cardiac workload.
Q3. A progressive care client develops sudden onset of atrial fibrillation with a ventricular rate of 145 bpm and a blood
pressure of 78/50 mm Hg. The client is diaphoretic and reports dizziness. Which action is the priority?
A. Administer a full loading dose of digoxin and reassess in two hours
B. Document the rhythm and continue routine monitoring without intervention
C. Encourage the client to perform a Valsalva maneuver only
D. Prepare for synchronized cardioversion because the client is hemodynamically unstable
Correct Answer: D
Rationale: Atrial fibrillation with rapid ventricular response causing hypotension and signs of hypoperfusion requires immediate
synchronized cardioversion. Pharmacologic rate control alone is insufficient when instability is present.
Q4. A client is receiving a continuous nitroglycerin infusion for unstable angina. The nurse notes the blood pressure has
fallen from 138/82 to 88/54 mm Hg. Which action should the nurse take first?
A. Increase the infusion rate to achieve greater coronary dilation
B. Administer a fluid bolus without assessing volume status or contacting the provider
C. Stop or markedly reduce the nitroglycerin infusion and notify the provider while supporting blood pressure
D. Continue the current rate and reassess in one hour
Correct Answer: C
Rationale: Hypotension is a dose-limiting effect of nitroglycerin. The infusion must be reduced or stopped and the provider notified.
Continuing or increasing the rate would further compromise coronary perfusion pressure.
Q5. A client with a recent ST-elevation myocardial infarction develops a new harsh holosystolic murmur at the left sternal
border and progressive hypotension. Which complication should the nurse suspect?
A. Uncomplicated pericarditis without hemodynamic consequence
STUVIA ACTUAL EXAM · Page 2
PROGRESSIVE CARE CERTIFICATION · OBJECTIVE ASSESSMENT
PCCN Exam — Complete
Official Exam
50 Questions Full Rationales Verified Answers
50 5 100%
QUESTIONS SECTIONS RATIONALES
Complete coverage Core exam domains Every answer explained
WHAT THIS COVERS
01 Cardiovascular Disorders
02 Pulmonary Disorders
03 Neurologic, Renal & Endocrine Disorders
04 Gastrointestinal, Hematologic & Multisystem Disorders
05 Professional Caring & Ethical Practice
ABOUT THIS ASSESSMENT
Build mastery in progressive care nursing — from cardiovascular
and pulmonary disorders to neurologic, renal, endocrine,
gastrointestinal, hematologic, and multisystem conditions, with
professional caring and ethical practice. This original study
bank targets application and analysis skills for the PCCN Exam,
with full rationales for every answer. For review use only; not
an institutional proctored assessment.
PASSING SCORE LEVEL FORMAT
80% Advanced (Progressive Care Certification) Application / Analysis
STUVIA ACTUAL EXAM Page 1
, SECTION 1: Cardiovascular Disorders
Q1. A progressive care client with non–ST-elevation acute coronary syndrome develops new ST depression in leads V4–V6
and reports increasing chest pressure. Troponin is rising. Which intervention is the highest priority while awaiting transfer to
the cardiac catheterization laboratory?
A. Withhold all anticoagulants until after catheterization is complete
B. Encourage ambulation to the bathroom to reduce anxiety
C. Rely solely on oral acetaminophen for pain control
D. Administer prescribed anti-ischemic therapy (nitroglycerin, beta-blocker if appropriate), antiplatelet agents, and
anticoagulation while maintaining continuous ECG monitoring
Correct Answer: D
Rationale: Ongoing ischemia with dynamic ECG changes and rising troponin requires prompt anti-ischemic, antiplatelet, and anticoagulant
therapy per ACS guidelines. Continuous monitoring detects deterioration. Ambulation or withholding indicated therapy increases risk of
infarction progression.
Q2. A client with acute decompensated heart failure has a pulmonary artery catheter in place. The nurse notes a cardiac
index of 1.8 L/min/m², PAOP of 28 mm Hg, and SVR of 1800 dynes·sec·cm■■. Which pharmacologic strategy is most
appropriate?
A. Immediate discontinuation of all vasoactive medications
B. High-dose pure alpha-agonist vasopressors as first-line therapy
C. Afterload reduction with a vasodilator and careful diuresis to lower preload while supporting contractility as needed
D. Aggressive volume loading to further increase PAOP
Correct Answer: C
Rationale: Low cardiac index with elevated filling pressure and high SVR indicates the need to reduce afterload and preload while
supporting forward flow. Pure volume loading or unopposed vasoconstriction would worsen pulmonary congestion and cardiac workload.
Q3. A progressive care client develops sudden onset of atrial fibrillation with a ventricular rate of 145 bpm and a blood
pressure of 78/50 mm Hg. The client is diaphoretic and reports dizziness. Which action is the priority?
A. Administer a full loading dose of digoxin and reassess in two hours
B. Document the rhythm and continue routine monitoring without intervention
C. Encourage the client to perform a Valsalva maneuver only
D. Prepare for synchronized cardioversion because the client is hemodynamically unstable
Correct Answer: D
Rationale: Atrial fibrillation with rapid ventricular response causing hypotension and signs of hypoperfusion requires immediate
synchronized cardioversion. Pharmacologic rate control alone is insufficient when instability is present.
Q4. A client is receiving a continuous nitroglycerin infusion for unstable angina. The nurse notes the blood pressure has
fallen from 138/82 to 88/54 mm Hg. Which action should the nurse take first?
A. Increase the infusion rate to achieve greater coronary dilation
B. Administer a fluid bolus without assessing volume status or contacting the provider
C. Stop or markedly reduce the nitroglycerin infusion and notify the provider while supporting blood pressure
D. Continue the current rate and reassess in one hour
Correct Answer: C
Rationale: Hypotension is a dose-limiting effect of nitroglycerin. The infusion must be reduced or stopped and the provider notified.
Continuing or increasing the rate would further compromise coronary perfusion pressure.
Q5. A client with a recent ST-elevation myocardial infarction develops a new harsh holosystolic murmur at the left sternal
border and progressive hypotension. Which complication should the nurse suspect?
A. Uncomplicated pericarditis without hemodynamic consequence
STUVIA ACTUAL EXAM · Page 2
