Progressive Care RN A 100% Verified Answers
Instructions
This document contains 80 multiple-choice questions designed to prepare for the Pro-
gressive Care RN A exam. Each question includes four answer choices (AD), the correct
answer, and a detailed explanation grounded in progressive care nursing standards, cov-
ering cardiac monitoring, pharmacology, ventilator management, and progressive care
protocols. This material is intended for educational purposes to enhance knowledge for
progressive care certification.
Questions
1. A 62-year-old male in the progressive care unit (PCU) develops a new onset of
atrial fibrillation with a heart rate of 140 bpm. Blood pressure is 110/70 mm Hg.
What is the priority nursing action?
A. Administer IV metoprolol 5 mg
B. Prepare for synchronized cardioversion
C. Initiate IV heparin infusion
D. Obtain a 12-lead ECG
Correct Answer: D. Obtain a 12-lead ECG
Explanation: Progressive care protocols prioritize confirming the rhythm with
a 12-lead ECG to differentiate atrial fibrillation from other dysrhythmias (e.g.,
atrial flutter or multifocal atrial tachycardia). While rate control (metoprolol),
anticoagulation (heparin), or cardioversion may be indicated, accurate diagnosis is
the first step to guide treatment.
2. A patient on mechanical ventilation shows a high-pressure alarm. The nurse as-
sesses bilateral breath sounds and notes decreased air entry on the right. What is
the most likely cause?
A. Endotracheal tube dislodgement
B. Pneumothorax
C. Mucus plugging
D. Ventilator circuit disconnection
Correct Answer: B. Pneumothorax
Explanation: A high-pressure alarm with unilateral decreased breath sounds sug-
gests an obstructive process like pneumothorax, which increases airway resistance.
Progressive care ventilator management requires immediate assessment for tension
pneumothorax (e.g., tracheal deviation, hypoxia) and potential needle decompres-
sion or chest tube insertion. Tube dislodgement or disconnection typically causes
low-pressure alarms, and mucus plugging may affect both lungs.
3. A 55-year-old female with acute coronary syndrome is receiving IV nitroglycerin.
Her blood pressure drops to 85/50 mm Hg, and she reports dizziness. What is the
nurses first action?
A. Administer IV fluid bolus
B. Stop the nitroglycerin infusion
1
, C. Administer IV dopamine
D. Place the patient in Trendelenburg
Correct Answer: B. Stop the nitroglycerin infusion
Explanation: Nitroglycerin, a vasodilator, can cause hypotension. Progressive
care pharmacology protocols mandate stopping the infusion immediately to reverse
hypotension. Fluid boluses may follow if hypovolemia is suspected, dopamine is re-
served for refractory shock, and Trendelenburg is not recommended due to increased
cardiac workload.
4. A patients telemetry shows a sudden onset of ventricular tachycardia with a pulse.
Blood pressure is 90/60 mm Hg. What is the priority intervention?
A. Administer IV amiodarone 150 mg
B. Perform defibrillation
C. Initiate CPR
D. Administer IV magnesium 2 g
Correct Answer: A. Administer IV amiodarone 150 mg
Explanation: Stable ventricular tachycardia with a pulse is treated with antiar-
rhythmics like amiodarone per progressive care cardiac protocols. Defibrillation is
indicated for pulseless rhythms, CPR is unnecessary with a pulse, and magnesium
is used for torsades de pointes or hypomagnesemia.
5. A 70-year-old male with COPD is on BiPAP with settings of IPAP 12 cm HO and
EPAP 5 cm HO. He becomes agitated and hypoxic. What is the nurses first action?
A. Increase IPAP to 16 cm HO
B. Assess mask fit and patient synchrony
C. Administer IV lorazepam
D. Switch to high-flow nasal cannula
Correct Answer: B. Assess mask fit and patient synchrony
Explanation: Agitation and hypoxia on BiPAP suggest poor mask fit, air leaks, or
asynchrony with the ventilator. Progressive care protocols prioritize assessing and
correcting these issues before adjusting settings, sedating, or changing modalities.
6. A patient with heart failure is receiving furosemide 40 mg IV. Which electrolyte
imbalance should the nurse monitor for?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypermagnesemia
Correct Answer: B. Hypokalemia
Explanation: Furosemide, a loop diuretic, causes potassium loss in urine, leading
to hypokalemia. Progressive care pharmacology requires monitoring potassium
levels and replacing as needed to prevent dysrhythmias. The other imbalances are
less common with furosemide.
7. A 58-year-old male post-myocardial infarction develops a third-degree AV block
with a heart rate of 35 bpm and blood pressure of 80/50 mm Hg. What is the
priority intervention?
A. Administer IV atropine 0.5 mg
B. Prepare for transcutaneous pacing
C. Administer IV dopamine
2
, D. Insert a temporary transvenous pacemaker
Correct Answer: B. Prepare for transcutaneous pacing
Explanation: Symptomatic third-degree AV block requires immediate pacing.
Transcutaneous pacing is the fastest intervention in progressive care to stabilize
heart rate and perfusion. Atropine is ineffective for complete heart block, dopamine
addresses hypotension but not the bradycardia, and transvenous pacing is a longer-
term solution.
8. A patient on a heparin infusion has an aPTT of 95 seconds (therapeutic range:
6080 seconds). What is the nurses first action?
A. Increase the heparin dose
B. Stop the heparin infusion
C. Administer protamine sulfate
D. Continue the infusion and recheck aPTT
Correct Answer: B. Stop the heparin infusion
Explanation: An aPTT above the therapeutic range indicates excessive antico-
agulation, increasing bleeding risk. Progressive care protocols require stopping the
heparin infusion and notifying the provider. Protamine is reserved for severe bleed-
ing, and continuing or increasing the dose is unsafe.
9. A patient with acute respiratory distress syndrome (ARDS) is on volume-controlled
ventilation with a tidal volume of 6 mL/kg and PEEP of 10 cm HO. The PaO is
55 mm Hg. What is the next step?
A. Increase tidal volume to 8 mL/kg
B. Increase PEEP to 12 cm HO
C. Decrease FIO to 0.4
D. Switch to pressure-controlled ventilation
Correct Answer: B. Increase PEEP to 12 cm HO
Explanation: Low PaO in ARDS indicates refractory hypoxemia. Progressive
care ventilator management follows lung-protective strategies, increasing PEEP to
improve oxygenation while maintaining low tidal volumes (6 mL/kg). Increasing
tidal volume risks barotrauma, decreasing FIO worsens hypoxia, and mode change
is not indicated.
10. A 65-year-old female with septic shock is receiving norepinephrine at 10 mcg/min.
Her mean arterial pressure (MAP) is 55 mm Hg. What is the next step?
A. Administer IV fluid bolus
B. Increase norepinephrine dose
C. Add vasopressin infusion
D. Administer hydrocortisone
Correct Answer: B. Increase norepinephrine dose
Explanation: A MAP <65 mm Hg indicates inadequate perfusion in septic shock.
Progressive care protocols prioritize titrating vasopressors like norepinephrine to
achieve MAP 65 mm Hg. Fluids may be given if hypovolemia is suspected, vaso-
pressin is added for refractory shock, and hydrocortisone is used for adrenal insuf-
ficiency.
11. A patients telemetry shows premature ventricular contractions (PVCs) at 10 per
minute. The patient is asymptomatic with stable vital signs. What is the nurses
first action?
3
Instructions
This document contains 80 multiple-choice questions designed to prepare for the Pro-
gressive Care RN A exam. Each question includes four answer choices (AD), the correct
answer, and a detailed explanation grounded in progressive care nursing standards, cov-
ering cardiac monitoring, pharmacology, ventilator management, and progressive care
protocols. This material is intended for educational purposes to enhance knowledge for
progressive care certification.
Questions
1. A 62-year-old male in the progressive care unit (PCU) develops a new onset of
atrial fibrillation with a heart rate of 140 bpm. Blood pressure is 110/70 mm Hg.
What is the priority nursing action?
A. Administer IV metoprolol 5 mg
B. Prepare for synchronized cardioversion
C. Initiate IV heparin infusion
D. Obtain a 12-lead ECG
Correct Answer: D. Obtain a 12-lead ECG
Explanation: Progressive care protocols prioritize confirming the rhythm with
a 12-lead ECG to differentiate atrial fibrillation from other dysrhythmias (e.g.,
atrial flutter or multifocal atrial tachycardia). While rate control (metoprolol),
anticoagulation (heparin), or cardioversion may be indicated, accurate diagnosis is
the first step to guide treatment.
2. A patient on mechanical ventilation shows a high-pressure alarm. The nurse as-
sesses bilateral breath sounds and notes decreased air entry on the right. What is
the most likely cause?
A. Endotracheal tube dislodgement
B. Pneumothorax
C. Mucus plugging
D. Ventilator circuit disconnection
Correct Answer: B. Pneumothorax
Explanation: A high-pressure alarm with unilateral decreased breath sounds sug-
gests an obstructive process like pneumothorax, which increases airway resistance.
Progressive care ventilator management requires immediate assessment for tension
pneumothorax (e.g., tracheal deviation, hypoxia) and potential needle decompres-
sion or chest tube insertion. Tube dislodgement or disconnection typically causes
low-pressure alarms, and mucus plugging may affect both lungs.
3. A 55-year-old female with acute coronary syndrome is receiving IV nitroglycerin.
Her blood pressure drops to 85/50 mm Hg, and she reports dizziness. What is the
nurses first action?
A. Administer IV fluid bolus
B. Stop the nitroglycerin infusion
1
, C. Administer IV dopamine
D. Place the patient in Trendelenburg
Correct Answer: B. Stop the nitroglycerin infusion
Explanation: Nitroglycerin, a vasodilator, can cause hypotension. Progressive
care pharmacology protocols mandate stopping the infusion immediately to reverse
hypotension. Fluid boluses may follow if hypovolemia is suspected, dopamine is re-
served for refractory shock, and Trendelenburg is not recommended due to increased
cardiac workload.
4. A patients telemetry shows a sudden onset of ventricular tachycardia with a pulse.
Blood pressure is 90/60 mm Hg. What is the priority intervention?
A. Administer IV amiodarone 150 mg
B. Perform defibrillation
C. Initiate CPR
D. Administer IV magnesium 2 g
Correct Answer: A. Administer IV amiodarone 150 mg
Explanation: Stable ventricular tachycardia with a pulse is treated with antiar-
rhythmics like amiodarone per progressive care cardiac protocols. Defibrillation is
indicated for pulseless rhythms, CPR is unnecessary with a pulse, and magnesium
is used for torsades de pointes or hypomagnesemia.
5. A 70-year-old male with COPD is on BiPAP with settings of IPAP 12 cm HO and
EPAP 5 cm HO. He becomes agitated and hypoxic. What is the nurses first action?
A. Increase IPAP to 16 cm HO
B. Assess mask fit and patient synchrony
C. Administer IV lorazepam
D. Switch to high-flow nasal cannula
Correct Answer: B. Assess mask fit and patient synchrony
Explanation: Agitation and hypoxia on BiPAP suggest poor mask fit, air leaks, or
asynchrony with the ventilator. Progressive care protocols prioritize assessing and
correcting these issues before adjusting settings, sedating, or changing modalities.
6. A patient with heart failure is receiving furosemide 40 mg IV. Which electrolyte
imbalance should the nurse monitor for?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypermagnesemia
Correct Answer: B. Hypokalemia
Explanation: Furosemide, a loop diuretic, causes potassium loss in urine, leading
to hypokalemia. Progressive care pharmacology requires monitoring potassium
levels and replacing as needed to prevent dysrhythmias. The other imbalances are
less common with furosemide.
7. A 58-year-old male post-myocardial infarction develops a third-degree AV block
with a heart rate of 35 bpm and blood pressure of 80/50 mm Hg. What is the
priority intervention?
A. Administer IV atropine 0.5 mg
B. Prepare for transcutaneous pacing
C. Administer IV dopamine
2
, D. Insert a temporary transvenous pacemaker
Correct Answer: B. Prepare for transcutaneous pacing
Explanation: Symptomatic third-degree AV block requires immediate pacing.
Transcutaneous pacing is the fastest intervention in progressive care to stabilize
heart rate and perfusion. Atropine is ineffective for complete heart block, dopamine
addresses hypotension but not the bradycardia, and transvenous pacing is a longer-
term solution.
8. A patient on a heparin infusion has an aPTT of 95 seconds (therapeutic range:
6080 seconds). What is the nurses first action?
A. Increase the heparin dose
B. Stop the heparin infusion
C. Administer protamine sulfate
D. Continue the infusion and recheck aPTT
Correct Answer: B. Stop the heparin infusion
Explanation: An aPTT above the therapeutic range indicates excessive antico-
agulation, increasing bleeding risk. Progressive care protocols require stopping the
heparin infusion and notifying the provider. Protamine is reserved for severe bleed-
ing, and continuing or increasing the dose is unsafe.
9. A patient with acute respiratory distress syndrome (ARDS) is on volume-controlled
ventilation with a tidal volume of 6 mL/kg and PEEP of 10 cm HO. The PaO is
55 mm Hg. What is the next step?
A. Increase tidal volume to 8 mL/kg
B. Increase PEEP to 12 cm HO
C. Decrease FIO to 0.4
D. Switch to pressure-controlled ventilation
Correct Answer: B. Increase PEEP to 12 cm HO
Explanation: Low PaO in ARDS indicates refractory hypoxemia. Progressive
care ventilator management follows lung-protective strategies, increasing PEEP to
improve oxygenation while maintaining low tidal volumes (6 mL/kg). Increasing
tidal volume risks barotrauma, decreasing FIO worsens hypoxia, and mode change
is not indicated.
10. A 65-year-old female with septic shock is receiving norepinephrine at 10 mcg/min.
Her mean arterial pressure (MAP) is 55 mm Hg. What is the next step?
A. Administer IV fluid bolus
B. Increase norepinephrine dose
C. Add vasopressin infusion
D. Administer hydrocortisone
Correct Answer: B. Increase norepinephrine dose
Explanation: A MAP <65 mm Hg indicates inadequate perfusion in septic shock.
Progressive care protocols prioritize titrating vasopressors like norepinephrine to
achieve MAP 65 mm Hg. Fluids may be given if hypovolemia is suspected, vaso-
pressin is added for refractory shock, and hydrocortisone is used for adrenal insuf-
ficiency.
11. A patients telemetry shows premature ventricular contractions (PVCs) at 10 per
minute. The patient is asymptomatic with stable vital signs. What is the nurses
first action?
3
