PCCN PREP EXAM |ACTUAL QUESTIONS AND
VERIFIED ANSWERS 2026-2027 UPDATED
EDITION|GRADED A+
Question 1
1. A 49-year-old male was recently admitted with an inferior wall
MI resulting from 100% occlusion of the right coronary artery
(RCA). The 12-Lead ECG reveals ST elevation in leads II, Ill, and avF.
You would expect to see reciprocal changes in which leads?
A. I, aVR
B. V, V2
C. V, VA
D I, aVL
CORRECT ANSWER
1. D. I, aVI. The RCA perfuses the inferior wall and the mirror image or reciprocal change
will be seen in the high latera wall, which is reflected in leads I, and aVL, on the 12-Lead
ECG. Leads V1 and V2 correlate with the septal area, leads V3 and V4 correlate With the
anterior area of the heart. The aVR lead does not provide much diagnostic value as all
energy is depolarizing away from this lead.
Question 2
You are summoned to the room of a 30-year-old female who is experiencing sustained
tonic-clonic convulsions while sitting in a chair. A family member states: "She was just
talking to us and suddenly she let out a shriek and started flopping like a fish out of
water." What is your initial priority of care?
A. Call for help and safely guide the patient to the floor
B. Call for help and administer a prescribed antiepileptic
C. Call for help and administer a prescribed benzodiazepine
1
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,D. Call for help and monitor the course of the seizure
CORRECT ANSWER
A. Call for help and safely guide the patient to the floor
Patient Safety is priority
Question 3
A 46-year-old patient presents with pneumonia and sepsis.
He was treated with 4 days of antibiotics and IV fluids. He is increasingly short of breath and
is now on 100% FiO, via non-re-breather mask. You obtain an ABG with the following results:
pH 7.20 / PaCO, 68/ PaO, 102/ HCO, 28. A chest x-ray reveals bilateral pulmonary infiltrates.
The patient is likely developing:
A. Worsening pneumonia
B. Acute Respiratory Distress Syndrome
C. Pulmonary embolus
D. Atelectasis
CORRECT ANSWER
B. Acute Respiratory Distress Syndrome
Question 4
A 56-year-old male is admitted to the PCU with a hypertensive crisis. His blood pressure is
now 205/125 mm Hg and he is complaining of a headache with nausea. He reports he ran
out of blood pressure medication three days ago, but also appears to be confused to the
date and situation. What is the most appropriate treatment approach?
A. Rapidly lower the systolic pressure to 100 mm Hg with IV antihypertensive medication,
then gradually reduce the diastolic pressure to 85 mm Hg with oral antihypertensive
medications
2
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,B. Slowly lower the systolic pressure to 120 mm Hg with IV antihypertensive medications,
then switch to oral antihypertensive medications for maintenance
C. Rapidly lower the diastolic pressure to 100 mm Hg with IV antihypertensive medications,
then continue to gradually reduce the diastolic pressure to 85 mm Hg with oral
antihypertensive medications
D. Slowly lower the diastolic pressure to 85 mm
CORRECT ANSWER
C. Rapidly lower the diastolic pressure to 100 mm Hg with IV antihypertensive
medications, then continue to gradually reduce the diastolic pressure to 85 mm Hg with
oral antihypertensive medication
Question 5
5. Which of the following labs must be closely monitored when administering Lisinopril to
a patient with systolic heart failure?
A. Sodium
B. Phosphate
C. Magnesium
D Potassium
CORRECT ANSWER
D. Potassium
Patients taking angiotensin converting enzyme inhibitors may experience hyperkalemia.
ACE inhibitors block angiotensin II, which may lead to decreased aldosterone.
Aldosterone is responsible forexcreting potassium from the kidneys. Therefore, ACE
inhibitors can cause potassium retension and potassium levels should be monitored
closely. In addition, renal labs such as BUN and creatinine should be monitored. If the
patient develops more than a 20% increase in the creatinine, the medication should be
discontinued.
3
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, Question 6
A 57-year-old man was admitted with an acute myocardial infarction and is rapidly
deteriorating. He has a BP of 86/42
(57), heart rate of 110, weak, thready pulses, and mottled skin-especially at the knees. He
has had minimal urine output the past 8 hours. A Rapid Response is activated. Which of the
following medications would be the best option to increase the patient's cardiac output?
A Dobutamine
B Norepinephrine
C Amiodarone
D Phenylephrine
CORRECT ANSWER
A Dobutamine. Dobutamine is a positive inotropic medication used to improve
myocardial dysfunction on patients with a low cardiac index and elevated afterload. It
will improve contractility and reduce afterload. Milrinone, which is a phosphodiesterase
inhibitor could also be used as an alternative to dobutamine, in the setting of
decompensated heart failure. It is used cautiously in patients experiencing cardiogiogenic
shock as one of the main side effects of Milrinone is hypotension. The half life of
Milrinone is about 6 hours. Norepinephrine and Phenylephrine cause vasoconstriction,
which would increase the SVR and may compromise cardiac output.
Question 7
You are caring for a patient post gastric bypass. Which of the following parameters should
you closely monitor after surgery?
A* HR, RR, temperature, WBC & MAP
B* Protein levels and vitamin B12
C* Albumin and pre-albumin levels
D* Signs of dumping syndrome
CORRECT ANSWER
A* HR, RR, temperature, WBC & MAP
4
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VERIFIED ANSWERS 2026-2027 UPDATED
EDITION|GRADED A+
Question 1
1. A 49-year-old male was recently admitted with an inferior wall
MI resulting from 100% occlusion of the right coronary artery
(RCA). The 12-Lead ECG reveals ST elevation in leads II, Ill, and avF.
You would expect to see reciprocal changes in which leads?
A. I, aVR
B. V, V2
C. V, VA
D I, aVL
CORRECT ANSWER
1. D. I, aVI. The RCA perfuses the inferior wall and the mirror image or reciprocal change
will be seen in the high latera wall, which is reflected in leads I, and aVL, on the 12-Lead
ECG. Leads V1 and V2 correlate with the septal area, leads V3 and V4 correlate With the
anterior area of the heart. The aVR lead does not provide much diagnostic value as all
energy is depolarizing away from this lead.
Question 2
You are summoned to the room of a 30-year-old female who is experiencing sustained
tonic-clonic convulsions while sitting in a chair. A family member states: "She was just
talking to us and suddenly she let out a shriek and started flopping like a fish out of
water." What is your initial priority of care?
A. Call for help and safely guide the patient to the floor
B. Call for help and administer a prescribed antiepileptic
C. Call for help and administer a prescribed benzodiazepine
1
@https://www.stuvia.com/user/thestudyvault
,D. Call for help and monitor the course of the seizure
CORRECT ANSWER
A. Call for help and safely guide the patient to the floor
Patient Safety is priority
Question 3
A 46-year-old patient presents with pneumonia and sepsis.
He was treated with 4 days of antibiotics and IV fluids. He is increasingly short of breath and
is now on 100% FiO, via non-re-breather mask. You obtain an ABG with the following results:
pH 7.20 / PaCO, 68/ PaO, 102/ HCO, 28. A chest x-ray reveals bilateral pulmonary infiltrates.
The patient is likely developing:
A. Worsening pneumonia
B. Acute Respiratory Distress Syndrome
C. Pulmonary embolus
D. Atelectasis
CORRECT ANSWER
B. Acute Respiratory Distress Syndrome
Question 4
A 56-year-old male is admitted to the PCU with a hypertensive crisis. His blood pressure is
now 205/125 mm Hg and he is complaining of a headache with nausea. He reports he ran
out of blood pressure medication three days ago, but also appears to be confused to the
date and situation. What is the most appropriate treatment approach?
A. Rapidly lower the systolic pressure to 100 mm Hg with IV antihypertensive medication,
then gradually reduce the diastolic pressure to 85 mm Hg with oral antihypertensive
medications
2
@https://www.stuvia.com/user/thestudyvault
,B. Slowly lower the systolic pressure to 120 mm Hg with IV antihypertensive medications,
then switch to oral antihypertensive medications for maintenance
C. Rapidly lower the diastolic pressure to 100 mm Hg with IV antihypertensive medications,
then continue to gradually reduce the diastolic pressure to 85 mm Hg with oral
antihypertensive medications
D. Slowly lower the diastolic pressure to 85 mm
CORRECT ANSWER
C. Rapidly lower the diastolic pressure to 100 mm Hg with IV antihypertensive
medications, then continue to gradually reduce the diastolic pressure to 85 mm Hg with
oral antihypertensive medication
Question 5
5. Which of the following labs must be closely monitored when administering Lisinopril to
a patient with systolic heart failure?
A. Sodium
B. Phosphate
C. Magnesium
D Potassium
CORRECT ANSWER
D. Potassium
Patients taking angiotensin converting enzyme inhibitors may experience hyperkalemia.
ACE inhibitors block angiotensin II, which may lead to decreased aldosterone.
Aldosterone is responsible forexcreting potassium from the kidneys. Therefore, ACE
inhibitors can cause potassium retension and potassium levels should be monitored
closely. In addition, renal labs such as BUN and creatinine should be monitored. If the
patient develops more than a 20% increase in the creatinine, the medication should be
discontinued.
3
@https://www.stuvia.com/user/thestudyvault
, Question 6
A 57-year-old man was admitted with an acute myocardial infarction and is rapidly
deteriorating. He has a BP of 86/42
(57), heart rate of 110, weak, thready pulses, and mottled skin-especially at the knees. He
has had minimal urine output the past 8 hours. A Rapid Response is activated. Which of the
following medications would be the best option to increase the patient's cardiac output?
A Dobutamine
B Norepinephrine
C Amiodarone
D Phenylephrine
CORRECT ANSWER
A Dobutamine. Dobutamine is a positive inotropic medication used to improve
myocardial dysfunction on patients with a low cardiac index and elevated afterload. It
will improve contractility and reduce afterload. Milrinone, which is a phosphodiesterase
inhibitor could also be used as an alternative to dobutamine, in the setting of
decompensated heart failure. It is used cautiously in patients experiencing cardiogiogenic
shock as one of the main side effects of Milrinone is hypotension. The half life of
Milrinone is about 6 hours. Norepinephrine and Phenylephrine cause vasoconstriction,
which would increase the SVR and may compromise cardiac output.
Question 7
You are caring for a patient post gastric bypass. Which of the following parameters should
you closely monitor after surgery?
A* HR, RR, temperature, WBC & MAP
B* Protein levels and vitamin B12
C* Albumin and pre-albumin levels
D* Signs of dumping syndrome
CORRECT ANSWER
A* HR, RR, temperature, WBC & MAP
4
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