PCCN EXAM 2026 – CARDIAC QUESTIONS WITH CORRECT ANSWERS

PCCN EXAM 2026 – CARDIAC QUESTIONS WITH
CORRECT ANSWERS

Where to listen to xc xc xc xc




- aortic Valve
xc xc




- pulmonic valve
xc xc




- tricuspid valve
xc xc




- mitral valve - ans-- R 2nd ICS
xc xc xc xc xc xc xc




- L 2nd ICS
xc xc xc




- L 4-5th ICS
xc xc xc




- L 5th ICS
xc xc xc




S1 - ans-closure of mitral and tricuspid valve, systole, 1/3 of cardiac cycle
xc xc xc xc xc xc xc xc xc xc xc xc




S2 - ans-closure of pulmonic and aortic valve, diastolic, 2/3 of cardiac cycle
xc xc xc xc xc xc xc xc xc xc xc xc




S3 (extra) - ans-
xc xc xc




VENTRICULAR gallop, dilated overfilled ventricle, FLUID OVERLOAD, INCREASED PRE xc xc xc xc xc xc xc xc x




LOAD, HIGH CO
c xc xc




S4 (extra) - ans-
xc xc xc




ATRIAL gallop, atria pushing blood into ventricles that don't want it, ISCHEMIA, VENTRICL
xc xc xc xc xc xc xc xc xc xc xc xc




ES DON'T WANT TO FILL
xc xc xc xc




Split S1 - ans-mitral closes before tricuspid, RBBB, PVCs, Ventricular pacing
xc xc xc xc xc xc xc xc xc xc




Split S2 - ans-aortic closes before pulmonic valve, R ventricle too overfilled
xc xc xc xc xc xc xc xc xc xc xc




ACS (Acute Coronary Syndrome) - ans-
xc xc xc xc xc




imbalance of O2 supply and demand, Trop can be high, will return to normal, PQRST Quest
xc xc xc xc xc xc xc xc xc xc xc xc xc xc xc




ions

Angina - ans-Stable vs. Unstable vs. Variant
xc xc xc xc xc xc




NSTEMI - ans- xc xc




PARTIAL OCCLUSION of coronary artery, T wave inversion or ST depression = ischemia,
xc xc xc xc xc xc xc xc xc xc xc xc xc




heaviness and pressure, fast onset, LAD or Left main arteries occlusion, high cardiac labs,
xc xc xc xc xc xc xc xc xc xc xc xc xc xc




PCI THERAPY xc




STEMI - ans- xc xc




COMPLETE OCCLUSION of coronary artery, ST elevation or T wave elevation = infarction xc xc xc xc xc xc xc xc xc xc xc xc




, angina/SOB/diaphoresis/
xc




arm pain, blood clot formation from plaque moving, positive on cardiac labs EMERGENCY
xc xc xc xc xc xc xc xc xc xc xc xc xc




CATH LAB xc

, NSTEMI/STEMI Medications/Interventions - ans-1) ASPIRIN xc xc xc xc




2) NITROGLYCERIN (avoid if ventricular or on ED meds)
xc xc xc xc xc xc xc xc xc




3) O2 (if <90% or in distress)
xc xc xc xc xc xc




4) Morphine (avoid if ventricular infarction)
xc xc xc xc xc




Post PCI Management (Big 5) - ans-1) Aspirin (lifetime)
xc xc xc xc xc xc xc xc




2) P2Y12 Receptor Inhibitors - Plavix (1 year)
xc xc xc xc xc xc xc




3) Beta Blocker - lols (lifetime)
xc xc xc xc xc




4) Statin (lifetime)
xc xc xc




5) ACE/ARB/ARNi Inhibitors -tans/prils (lifetime UNLESS anterior MI EF>40%)
xc xc xc xc xc xc xc xc xc




*ALWAYS consider TNKase/Alteplase if PCI not available* xc xc xc xc xc xc




ACE/ARB/ARNi Inhibitors Side Effects - ans-- Decrease preload xc xc xc xc xc xc xc




- Decrease afterload
xc xc xc




- Potassium changes
xc xc




- Dry cough (no ARBs)
xc xc xc xc




- Hypotension
xc




- Rash
xc




- RARE Angioedema
xc xc




P Wave - ans-atrial depolarization
xc xc xc xc




PR Interval - ans-0.12-0.20s, AV conduction
xc xc xc xc xc




QRS Complex - ans-0.06-0.10s, ventricular depolarization
xc xc xc xc xc




T Wave - ans-ventricular repolarization
xc xc xc xc




QT Interval - ans-0.35-0.44s, ventricular repolarization time
xc xc xc xc xc xc




QTc Interval - ans-0.40-0.44s, corrected for heart rate
xc xc xc xc xc xc xc




Q Wave - ans-
xc xc xc




>0.04s, depth >/= 25% of height of R wave, present in contiguous leads MI damage/
xc xc xc xc xc xc xc xc xc xc xc xc xc xc




necrosis

Anterior/Septal Location - ans-Elevation in: V1-V4 xc xc xc xc xc




Reciprocal Changes in: II, III, aVF xc xc xc xc xc




ARTERY AFFECTED: LAD/L main xc xc xc




Monitor for: shock, L ventricle failure, fluid overload, BBB
xc xc xc xc xc xc xc xc




Lateral Location - ans-Elevation in: I and aVL (high) V5-V6 (low)
xc xc xc xc xc xc xc xc xc xc




Reciprocal Changes in: NONE xc xc xc




ARTERY AFFECTED: L circumflex proximal LAD, L main xc xc xc xc xc xc xc




Monitor for: heart block xc xc xc