PCCN EXAM REVIEW |ACTUAL QUESTIONS AND
VERIFIED ANSWERS 2026-2027 UPDATED
EDITION|GRADED A+
Question 1
A nurse is caring for a 71-year-old female patient with end-stage chronic obstructive
pulmonary disease (COPD) who is experiencing cardiac ischemia with increased shortness
of breath. The MOST appropriate goal of oxygen therapy for this patient would be to:
A. Limit supplemental oxygen to lower the risk of reducing respiratory drive
B. Maintain oxygen saturations between 86% and 89%
C. Administer oxygen until oxygen saturations are greater than 95% in order to relieve
ischemia
D. Maintain oxygen saturations between 90% and 92%
CORRECT ANSWER
D. Maintain oxygen saturations between 90% and 92%
Feedback
Maintaining oxygen saturations between 90% and 92% will serve the purpose of
providing enough oxygen to relieve cardiac ischemia while reducing the risk of
respiratory depression in a patient with COPD.
Question 2
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%
B. Low-density lipoprotein (LDL),
C. 94 mg/dLHematocrit (Hct), 53%
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,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
Question 3
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.
Question 4
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,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
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.
Question 5
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
3
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, together with her acute symptoms of weak pulses, edema, and hypotension all point to
cardiogenic shock.
Question 6
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.
Question 7
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
B. Drinking no more than 1 liter of fluid per day
C. Strictly avoiding caffeine or other stimulants
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VERIFIED ANSWERS 2026-2027 UPDATED
EDITION|GRADED A+
Question 1
A nurse is caring for a 71-year-old female patient with end-stage chronic obstructive
pulmonary disease (COPD) who is experiencing cardiac ischemia with increased shortness
of breath. The MOST appropriate goal of oxygen therapy for this patient would be to:
A. Limit supplemental oxygen to lower the risk of reducing respiratory drive
B. Maintain oxygen saturations between 86% and 89%
C. Administer oxygen until oxygen saturations are greater than 95% in order to relieve
ischemia
D. Maintain oxygen saturations between 90% and 92%
CORRECT ANSWER
D. Maintain oxygen saturations between 90% and 92%
Feedback
Maintaining oxygen saturations between 90% and 92% will serve the purpose of
providing enough oxygen to relieve cardiac ischemia while reducing the risk of
respiratory depression in a patient with COPD.
Question 2
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%
B. Low-density lipoprotein (LDL),
C. 94 mg/dLHematocrit (Hct), 53%
1
@https://www.stuvia.com/user/thestudyvault
,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
Question 3
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.
Question 4
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,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
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.
Question 5
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
3
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, together with her acute symptoms of weak pulses, edema, and hypotension all point to
cardiogenic shock.
Question 6
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.
Question 7
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
B. Drinking no more than 1 liter of fluid per day
C. Strictly avoiding caffeine or other stimulants
4
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