PCCN GRADE A+ COMPLETE EXAM
QUESTIONS AND 100% VERIFIED
ANSWERS (2026/2027) PASS
GUARANTEE
CoronaryRarteryRperfusionRisRdependentRupon:
A.RdiastolicRpressure
B.RsystolicRpressure
C.Rafterload
D.RsystemicRvascularRresistanceR(SVR)R-RCORRECTRANSWERA.RdiastolicRpressure
DiastolicRpressureRinRtheRaorticRrootRisRhigherRthanRleftRventricularRend-
diastolicRpressureR(LVEDP),RtheRpressureRexertedRonRtheRventricularRmuscleRatRtheRendRofRdiastoleR
whenRtheRventricleRisRfull.RThisRenablesRbloodRtoRflowRfromRaRhigherRpressureRthroughRopenRarteri
esRtoRaRlowerRpressure,RaRpressureRgradientRknownRasRcoronaryRarteryRprefusionRpressure.RAsRdias
tolicRpressureRdrops,RthereRisRaRdecreaseRinRcoronaryRarteryRbloodRflow.RCoronaryRarteryRperfusio
nRisRnotRaffectedRbyRsystolicRpressure,RafterloadRorRSVR,RbutRtheyRallRincreaseRtheRdemandRofRoxyg
enRinRtheRheart.
ARpost-STEMIR(STRelevationRmyocardialRinfarction)RpatientRisRstartedRonRanRangiotensin-
convertingRenzymeR(ACE)RinhibitorRduringRhisRhospitalRstay.RWhichRofRtheRfollowingRisRtheRmostRco
mmonRseriousRsideReffectRthatRmayRoccur?
A.RaRnonproductiveRcough
B.RpedalRedema
C.RswellingRofRtheRtongueRandRface
D.RrhinorrheaR-RCORRECTRANSWERC.RswellingRofRtheRtongueRandRface
AlthoughRallRofRtheRanswersRmayRoccur,RswellingRogRtheRtongueRandRfaceRisRtheRmostRseriousRandR
mayRrequireRintervention.RPatientsRshouldRbeRinstructedRtoRseekRmedicalRattentionRimmediatelyRf
orRanyRsignsRofRswellingRinRtheRtongueRorRthroat.
WhichRofRtheRfollowingRbestRdescribesRtheRfourthRheartRsoundR(S4):
,A.RItRoccursRafterRventricularRcontraction
B.RItRisRbestRheardRwithRtheRdiaphragmRofRtheRstethoscope
C.RItRisRaRnormalRfindingRinRchildren
D.RItRoccursRduringRlateRdiastoleRwhenRtheRatriaRcontractsR-
RCORRECTRANSWERD.RItRoccursRduringRlateRdiastoleRwhenRtheRatriaRcontracts
TheRpresenceRofRtheRextraRheartRsoundRS4RsignifiesRaRpoorlyRcompliantR(stiff)RleftRventricle.RAnRS4Ri
sRalsoRcalledRanRatrialRheartRsoundRsinceRitRoccursRatRtheRendRofRdiastolicRfillingRwhenRtheRatriaRcon
tractsRandRfullyRfillsRtheRleftRventricle.RKnownRasR"atrialRkick",RthisRfillingRisRimportantRtoRcardiacRou
tput.RTheRincreasedRend-
diastolicRvolumeRinRtheRventricleRimprovesRcardiacRoutput.RWhenRtheRleftRventricleRisRstiffR(decrea
sedRcomplianceRwithRlongRtermRhypertension,RaorticRstenosisRorRwithRacuteRSTEMI),RtheRatriumRh
asRtoRpumpRharderRtoRmoveRbloodRfromRtheRatriumRtoRtheRventricle,RcausingRaRturbulentRbloodRflo
wRandRextraRheartRsound.RThisRheartRsoundRisRalwaysRpathologic.RItRoccursRbeforeRventricularRcont
raction,RisRbestRheardRwithRtheRbellRofRtheRstethoscopeRandRisRneverRaRnormalRheartRsound,RevenRi
nRchildren.
WhichRpathologicRchangesRfoundRonRtheR12-leadRECGRindicateRmyocardialRischemia?
A.RST-segmentRelevation
B.RST-segmentRdepressionRandRT-waveRelevation
C.RQ-waveRformation
D.RST-segmentRdepressionRandRT-waveRinversionR-
RCORRECTRANSWERD.RSTRsegmentRdepressionRandRTRwaveRinversion
MyocardialRischemiaRchangesRtheRrepolarizationRofRtheRventricularRmuscle.RThatRchangeRisRseenRo
nRtheR12RleadRECGRasRST-
segmentRdepressionRandRTRwaveRinversion,RwhichRdemonstrateRsubendocardialRischemiaR--
RtheRinnermostRlayerRofRmuscleRinRtheRmyocardium.RST-
segmentRelevationRindicatesRacuteRinjuryRorRinfarction,RSTRsegmentRdepressionRandRTRwaveRelevat
ionRmayRindicateRanRelectrolyteRabnormality,RwhileRQRwaveRformationRindicatesRtotalRinfarction.
PositiveRinotropicRagentsRareRusedRto:
A.RimproveRcardiacRoutputRandRtissueRperfusion
,B.RdecreaseRwaterRlossRthroughRtheRkidneys
C.RincreaseRheartRrate
D.RvasodilateRvesselsR-RCORRECTRANSWERA.RimproveRcardiacRoutputRandRtissueRperfusion
TheRtermR"inotropic"RrefersRtoRaffectingRtheRforceRofRmyocardialRcontraction.RImprovementRofRcar
diacRmuscleRcontractionRleadsRtoRimprovedRcardiacRoutputRandRtissueRperfusion.
ARpatientRinRtheREDRisRnowRbeingRadmittedRtoRtelemetryRbwithRcomplaintRofRchestRpainRandRhasRbe
enRjudgedRtoRbeRaRpossibleRcandidateRforRtherapyRwithRalteplaseR(Activase).RWhichRofRtheRfollowin
gRisRnotRconsideredRaRcontraindicationRforRtheRuseRofRthisRmedication?
A.RcurrentRantibioticRuse
B.RrecentRabdominalRsurgery
C.RrecentRgastrointestinalRbleed
D.RrecentRintracranialRbleedR-RCORRECTRANSWERA.RcurrentRantibioticRuse
UseRofRantibioticsRisRnotRaRcontraindicationRforRtheRuseRofRalteplase.RAllRtheRotherRanswersR--
RrecentRabdominalRsurgery,RrecentRgastrointestinalRbleedingRandRaRrecentRintracranialRbleedR--
RareRcontraindicationsRforRtheRuseRofRanyRfibrinolytic.
TheRtwoRmajorRcomponentsRthatRdetermineRbloodRpressureRare:
A.RsystemicRvascularRresistanceR(SVR)R(afterload)RandRcardiacRoutput
B.RcontractilityRandRSVRR(afterload)
C.RpreloadRandRSVRR(afterload)
D.RcontractilityRandRSVRR(afterload)R-RCORRECTRANSWERA.RSVRR(afterload)RandRcardiacRoutput
TheRequationRforRBPRis:RBPR=RSVRRxRcardiacRoutput.
BPRisRdeterminedRbyRresistanceRofRtheRarterialRbedRandRtheRcardiacRoutput.RIfRtheRSVRR(afterload)Ri
sRhighRandRtheRcardiacRoutputRlow,RtheRpatientRmayRstillRhaveRaRnormalRBP.RtheRpulseRpressureRwillR
beRlower,RbutRthisRisRaRcompensatoryRresponseRbyRtheRheartRtoRmaintainRBP.RIfRtheRSVRR(afterload)R
isRlowR(asRinRearlyRsepticRshock),RtheRcardiacRoutputRisRveryRhigh,RtherebyRtryingRtoRsupportRBP.
, TheRlayerRofRtheRarterialRvesselRwallRresponsibleRforRchangesRinRtheRdiameterRofRtheRarteryRisRthe:
A.Rmedia
B.Rintima
C.Rexterna
D.RadventitiaR-RCORRECTRANSWERA.Rmedia
TheRmediaRlayerRofRtheRarterialRwallRcontainsRvascularRsmoothRmuscleRcellsRandRisRresponsibleRforR
arterialRtone.RVasoactiveRsubstancesRreleasedRinRresponseRtoRtheRsympatheticRnervousRsystemRan
d/orRtheRrenin-
angiotensinRsystemRdetermineRarterialRtone.RIntima,RexternaRandRadventitiaRareRincorrect.
ARpatientRpresentsRinRacuteRdistressRwithRralesRhalfwayRupRbilaterally;RcoolRandRclammyRextremitie
s;RelevatedRjugularRvenousRdistentionR(JVD);RoxygenRsaturationsRatR95%,RdownRfromR99%;RandRco
mplaintsRofRshortnessRofRbreath.RWhichRofRtheRfollowingRfindingsRcorrespondRtoRtheRpatient'sRcar
diacRstatus?
A.RnoRpulmonaryRcongestion,RnormalRperfusion
B.RnoRpulmonaryRcongestion,RlowRperfusion
C.RpulmonaryRcongestion,RnormalRperfusion
D.RpulmonaryRcongestion,RlowRperfusionR-
RCORRECTRANSWERD.RpulmonaryRcongestion,RlowRperfusion
RalesRindicateRfluidRinRtheRalveolarRsacs,RpossiblyRsecondaryRtoRpulmonaryRedema,RcausingRpulmo
naryRcongestion.RPneumoniaRcanRalsoRcauseRfluidRinRtheRalveolarRsacs.RTheRpatientRisRcomplainingR
ofRshortnessRofRbreath,RandRtheRoxygenRsaturationsRareRlowering,RalsoRindicatingRthatRtheRpatientR
hasRpulmonaryRcongestion.RTheRpatient'sRskinRisRcoolRandRclammy,RindicatingRthatRtheRskinRisRpoor
lyRperfused.RSkinRdoesRnotRrequireRoxygenRandRshuntsRbloodRawayRinRdecreasedRcardiacRfunction;R
therefore,RthisRpatientRhasRpulmonaryRcongestionRandRlowRperfusionRstate.RTheRotherRanswersRar
eRincorrect.
WhenRlisteningRtoRheartRsounds,RS1RsignifiesRwhichRofRtheRfollowing?
A.RtheRbeginningRofRventricularRsystole
B.RtheRbeginningRofRventricularRdiastole
QUESTIONS AND 100% VERIFIED
ANSWERS (2026/2027) PASS
GUARANTEE
CoronaryRarteryRperfusionRisRdependentRupon:
A.RdiastolicRpressure
B.RsystolicRpressure
C.Rafterload
D.RsystemicRvascularRresistanceR(SVR)R-RCORRECTRANSWERA.RdiastolicRpressure
DiastolicRpressureRinRtheRaorticRrootRisRhigherRthanRleftRventricularRend-
diastolicRpressureR(LVEDP),RtheRpressureRexertedRonRtheRventricularRmuscleRatRtheRendRofRdiastoleR
whenRtheRventricleRisRfull.RThisRenablesRbloodRtoRflowRfromRaRhigherRpressureRthroughRopenRarteri
esRtoRaRlowerRpressure,RaRpressureRgradientRknownRasRcoronaryRarteryRprefusionRpressure.RAsRdias
tolicRpressureRdrops,RthereRisRaRdecreaseRinRcoronaryRarteryRbloodRflow.RCoronaryRarteryRperfusio
nRisRnotRaffectedRbyRsystolicRpressure,RafterloadRorRSVR,RbutRtheyRallRincreaseRtheRdemandRofRoxyg
enRinRtheRheart.
ARpost-STEMIR(STRelevationRmyocardialRinfarction)RpatientRisRstartedRonRanRangiotensin-
convertingRenzymeR(ACE)RinhibitorRduringRhisRhospitalRstay.RWhichRofRtheRfollowingRisRtheRmostRco
mmonRseriousRsideReffectRthatRmayRoccur?
A.RaRnonproductiveRcough
B.RpedalRedema
C.RswellingRofRtheRtongueRandRface
D.RrhinorrheaR-RCORRECTRANSWERC.RswellingRofRtheRtongueRandRface
AlthoughRallRofRtheRanswersRmayRoccur,RswellingRogRtheRtongueRandRfaceRisRtheRmostRseriousRandR
mayRrequireRintervention.RPatientsRshouldRbeRinstructedRtoRseekRmedicalRattentionRimmediatelyRf
orRanyRsignsRofRswellingRinRtheRtongueRorRthroat.
WhichRofRtheRfollowingRbestRdescribesRtheRfourthRheartRsoundR(S4):
,A.RItRoccursRafterRventricularRcontraction
B.RItRisRbestRheardRwithRtheRdiaphragmRofRtheRstethoscope
C.RItRisRaRnormalRfindingRinRchildren
D.RItRoccursRduringRlateRdiastoleRwhenRtheRatriaRcontractsR-
RCORRECTRANSWERD.RItRoccursRduringRlateRdiastoleRwhenRtheRatriaRcontracts
TheRpresenceRofRtheRextraRheartRsoundRS4RsignifiesRaRpoorlyRcompliantR(stiff)RleftRventricle.RAnRS4Ri
sRalsoRcalledRanRatrialRheartRsoundRsinceRitRoccursRatRtheRendRofRdiastolicRfillingRwhenRtheRatriaRcon
tractsRandRfullyRfillsRtheRleftRventricle.RKnownRasR"atrialRkick",RthisRfillingRisRimportantRtoRcardiacRou
tput.RTheRincreasedRend-
diastolicRvolumeRinRtheRventricleRimprovesRcardiacRoutput.RWhenRtheRleftRventricleRisRstiffR(decrea
sedRcomplianceRwithRlongRtermRhypertension,RaorticRstenosisRorRwithRacuteRSTEMI),RtheRatriumRh
asRtoRpumpRharderRtoRmoveRbloodRfromRtheRatriumRtoRtheRventricle,RcausingRaRturbulentRbloodRflo
wRandRextraRheartRsound.RThisRheartRsoundRisRalwaysRpathologic.RItRoccursRbeforeRventricularRcont
raction,RisRbestRheardRwithRtheRbellRofRtheRstethoscopeRandRisRneverRaRnormalRheartRsound,RevenRi
nRchildren.
WhichRpathologicRchangesRfoundRonRtheR12-leadRECGRindicateRmyocardialRischemia?
A.RST-segmentRelevation
B.RST-segmentRdepressionRandRT-waveRelevation
C.RQ-waveRformation
D.RST-segmentRdepressionRandRT-waveRinversionR-
RCORRECTRANSWERD.RSTRsegmentRdepressionRandRTRwaveRinversion
MyocardialRischemiaRchangesRtheRrepolarizationRofRtheRventricularRmuscle.RThatRchangeRisRseenRo
nRtheR12RleadRECGRasRST-
segmentRdepressionRandRTRwaveRinversion,RwhichRdemonstrateRsubendocardialRischemiaR--
RtheRinnermostRlayerRofRmuscleRinRtheRmyocardium.RST-
segmentRelevationRindicatesRacuteRinjuryRorRinfarction,RSTRsegmentRdepressionRandRTRwaveRelevat
ionRmayRindicateRanRelectrolyteRabnormality,RwhileRQRwaveRformationRindicatesRtotalRinfarction.
PositiveRinotropicRagentsRareRusedRto:
A.RimproveRcardiacRoutputRandRtissueRperfusion
,B.RdecreaseRwaterRlossRthroughRtheRkidneys
C.RincreaseRheartRrate
D.RvasodilateRvesselsR-RCORRECTRANSWERA.RimproveRcardiacRoutputRandRtissueRperfusion
TheRtermR"inotropic"RrefersRtoRaffectingRtheRforceRofRmyocardialRcontraction.RImprovementRofRcar
diacRmuscleRcontractionRleadsRtoRimprovedRcardiacRoutputRandRtissueRperfusion.
ARpatientRinRtheREDRisRnowRbeingRadmittedRtoRtelemetryRbwithRcomplaintRofRchestRpainRandRhasRbe
enRjudgedRtoRbeRaRpossibleRcandidateRforRtherapyRwithRalteplaseR(Activase).RWhichRofRtheRfollowin
gRisRnotRconsideredRaRcontraindicationRforRtheRuseRofRthisRmedication?
A.RcurrentRantibioticRuse
B.RrecentRabdominalRsurgery
C.RrecentRgastrointestinalRbleed
D.RrecentRintracranialRbleedR-RCORRECTRANSWERA.RcurrentRantibioticRuse
UseRofRantibioticsRisRnotRaRcontraindicationRforRtheRuseRofRalteplase.RAllRtheRotherRanswersR--
RrecentRabdominalRsurgery,RrecentRgastrointestinalRbleedingRandRaRrecentRintracranialRbleedR--
RareRcontraindicationsRforRtheRuseRofRanyRfibrinolytic.
TheRtwoRmajorRcomponentsRthatRdetermineRbloodRpressureRare:
A.RsystemicRvascularRresistanceR(SVR)R(afterload)RandRcardiacRoutput
B.RcontractilityRandRSVRR(afterload)
C.RpreloadRandRSVRR(afterload)
D.RcontractilityRandRSVRR(afterload)R-RCORRECTRANSWERA.RSVRR(afterload)RandRcardiacRoutput
TheRequationRforRBPRis:RBPR=RSVRRxRcardiacRoutput.
BPRisRdeterminedRbyRresistanceRofRtheRarterialRbedRandRtheRcardiacRoutput.RIfRtheRSVRR(afterload)Ri
sRhighRandRtheRcardiacRoutputRlow,RtheRpatientRmayRstillRhaveRaRnormalRBP.RtheRpulseRpressureRwillR
beRlower,RbutRthisRisRaRcompensatoryRresponseRbyRtheRheartRtoRmaintainRBP.RIfRtheRSVRR(afterload)R
isRlowR(asRinRearlyRsepticRshock),RtheRcardiacRoutputRisRveryRhigh,RtherebyRtryingRtoRsupportRBP.
, TheRlayerRofRtheRarterialRvesselRwallRresponsibleRforRchangesRinRtheRdiameterRofRtheRarteryRisRthe:
A.Rmedia
B.Rintima
C.Rexterna
D.RadventitiaR-RCORRECTRANSWERA.Rmedia
TheRmediaRlayerRofRtheRarterialRwallRcontainsRvascularRsmoothRmuscleRcellsRandRisRresponsibleRforR
arterialRtone.RVasoactiveRsubstancesRreleasedRinRresponseRtoRtheRsympatheticRnervousRsystemRan
d/orRtheRrenin-
angiotensinRsystemRdetermineRarterialRtone.RIntima,RexternaRandRadventitiaRareRincorrect.
ARpatientRpresentsRinRacuteRdistressRwithRralesRhalfwayRupRbilaterally;RcoolRandRclammyRextremitie
s;RelevatedRjugularRvenousRdistentionR(JVD);RoxygenRsaturationsRatR95%,RdownRfromR99%;RandRco
mplaintsRofRshortnessRofRbreath.RWhichRofRtheRfollowingRfindingsRcorrespondRtoRtheRpatient'sRcar
diacRstatus?
A.RnoRpulmonaryRcongestion,RnormalRperfusion
B.RnoRpulmonaryRcongestion,RlowRperfusion
C.RpulmonaryRcongestion,RnormalRperfusion
D.RpulmonaryRcongestion,RlowRperfusionR-
RCORRECTRANSWERD.RpulmonaryRcongestion,RlowRperfusion
RalesRindicateRfluidRinRtheRalveolarRsacs,RpossiblyRsecondaryRtoRpulmonaryRedema,RcausingRpulmo
naryRcongestion.RPneumoniaRcanRalsoRcauseRfluidRinRtheRalveolarRsacs.RTheRpatientRisRcomplainingR
ofRshortnessRofRbreath,RandRtheRoxygenRsaturationsRareRlowering,RalsoRindicatingRthatRtheRpatientR
hasRpulmonaryRcongestion.RTheRpatient'sRskinRisRcoolRandRclammy,RindicatingRthatRtheRskinRisRpoor
lyRperfused.RSkinRdoesRnotRrequireRoxygenRandRshuntsRbloodRawayRinRdecreasedRcardiacRfunction;R
therefore,RthisRpatientRhasRpulmonaryRcongestionRandRlowRperfusionRstate.RTheRotherRanswersRar
eRincorrect.
WhenRlisteningRtoRheartRsounds,RS1RsignifiesRwhichRofRtheRfollowing?
A.RtheRbeginningRofRventricularRsystole
B.RtheRbeginningRofRventricularRdiastole