Progressive Care RN A V1 Test 65 Questions with
100% Correct Answers Verified 2026/2027 |
Progressive Care Nursing Certification
Preparation
SECTION 1: CARDIOVASCULAR DISORDERS (Questions 1-16)
Q1: A patient presents with substernal chest pain radiating to the left arm, diaphoresis,
and nausea. ECG shows ST-segment elevation in leads V1-V4. Cardiac troponin is
elevated. Which of the following is the priority intervention?
A. Administer morphine sulfate 4 mg IV
B. Prepare for emergent percutaneous coronary intervention (PCI)
C. Apply oxygen at 2 L via nasal cannula
D. Administer sublingual nitroglycerin
Correct Answer: B
Rationale: STEMI requires emergent reperfusion (PCI within 90 minutes or
thrombolytics within 30 minutes if PCI unavailable). While oxygen, morphine, and
nitroglycerin are components of MONA therapy, reperfusion is the absolute priority to
salvage myocardium. Current guidelines indicate oxygen only if SpO2 <90%.
,Q2: A patient with acute decompensated heart failure has pulmonary edema, JVD, and
an S3 heart sound. Which of the following medications should the nurse anticipate
administering first?
A. Digoxin
B. Furosemide IV
C. Metoprolol succinate
D. Lisinopril
Correct Answer: B
Rationale: In acute decompensated HF with pulmonary edema, IV loop diuretics
(furosemide) are first-line to reduce preload and relieve symptoms rapidly. Digoxin is for
rate control in chronic HF with AFib. Beta-blockers and ACE inhibitors are chronic
therapies, not for acute decompensation.
Q3: A patient with atrial fibrillation has a heart rate of 140 bpm and is hemodynamically
stable. Which of the following medications should the nurse anticipate administering?
A. IV amiodarone
B. Synchronized cardioversion
C. IV adenosine
D. IV atropine
Correct Answer: A
,Rationale: For stable AFib with rapid ventricular response, rate control with IV
amiodarone, diltiazem, or beta-blockers is appropriate. Cardioversion is reserved for
unstable patients. Adenosine is for supraventricular tachycardia (SVT). Atropine
increases heart rate and is contraindicated.
Q4: A patient in the progressive care unit has a new onset of irregularly irregular heart
rhythm with no discernible P waves. Which of the following is the priority assessment?
A. Cardiac enzyme levels
B. Ventricular rate
C. Oxygen saturation
D. Blood pressure
Correct Answer: B
Rationale: In new-onset atrial fibrillation, the priority is assessing ventricular rate to
determine the need for immediate rate control. Rates >150 bpm can compromise
cardiac output and require urgent intervention. While oxygen saturation and blood
pressure are important, the ventricular rate determines immediate management.
Q5: A patient with acute coronary syndrome receives morphine for chest pain. Which of
the following assessments is most important after administration?
A. Pain level
B. Respiratory rate and oxygen saturation
C. Heart rate
, D. Level of consciousness
Correct Answer: B
Rationale: Morphine can cause respiratory depression and hypotension. Respiratory rate
and oxygen saturation must be monitored closely. While pain assessment is important,
respiratory status is the safety priority. Current evidence suggests morphine may be
associated with worse outcomes in ACS and should be used cautiously.
Q6: A patient with heart failure has a pulmonary artery catheter in place. The pulmonary
capillary wedge pressure (PCWP) is 24 mmHg. This finding indicates:
A. Hypovolemia
B. Left ventricular failure
C. Right ventricular failure
D. Cardiac tamponade
Correct Answer: B
Rationale: PCWP reflects left ventricular end-diastolic pressure. Normal is 6-12 mmHg.
Elevated PCWP (>18 mmHg) indicates left ventricular failure and fluid overload
(pulmonary congestion). Hypovolemia would present with low PCWP. Right ventricular
failure primarily affects CVP. Cardiac tamponade causes equalization of all pressures.
Q7: A patient with a myocardial infarction develops a harsh holosystolic murmur at the
apex radiating to the axilla. Which of the following complications is most likely?
A. Ventricular septal rupture
100% Correct Answers Verified 2026/2027 |
Progressive Care Nursing Certification
Preparation
SECTION 1: CARDIOVASCULAR DISORDERS (Questions 1-16)
Q1: A patient presents with substernal chest pain radiating to the left arm, diaphoresis,
and nausea. ECG shows ST-segment elevation in leads V1-V4. Cardiac troponin is
elevated. Which of the following is the priority intervention?
A. Administer morphine sulfate 4 mg IV
B. Prepare for emergent percutaneous coronary intervention (PCI)
C. Apply oxygen at 2 L via nasal cannula
D. Administer sublingual nitroglycerin
Correct Answer: B
Rationale: STEMI requires emergent reperfusion (PCI within 90 minutes or
thrombolytics within 30 minutes if PCI unavailable). While oxygen, morphine, and
nitroglycerin are components of MONA therapy, reperfusion is the absolute priority to
salvage myocardium. Current guidelines indicate oxygen only if SpO2 <90%.
,Q2: A patient with acute decompensated heart failure has pulmonary edema, JVD, and
an S3 heart sound. Which of the following medications should the nurse anticipate
administering first?
A. Digoxin
B. Furosemide IV
C. Metoprolol succinate
D. Lisinopril
Correct Answer: B
Rationale: In acute decompensated HF with pulmonary edema, IV loop diuretics
(furosemide) are first-line to reduce preload and relieve symptoms rapidly. Digoxin is for
rate control in chronic HF with AFib. Beta-blockers and ACE inhibitors are chronic
therapies, not for acute decompensation.
Q3: A patient with atrial fibrillation has a heart rate of 140 bpm and is hemodynamically
stable. Which of the following medications should the nurse anticipate administering?
A. IV amiodarone
B. Synchronized cardioversion
C. IV adenosine
D. IV atropine
Correct Answer: A
,Rationale: For stable AFib with rapid ventricular response, rate control with IV
amiodarone, diltiazem, or beta-blockers is appropriate. Cardioversion is reserved for
unstable patients. Adenosine is for supraventricular tachycardia (SVT). Atropine
increases heart rate and is contraindicated.
Q4: A patient in the progressive care unit has a new onset of irregularly irregular heart
rhythm with no discernible P waves. Which of the following is the priority assessment?
A. Cardiac enzyme levels
B. Ventricular rate
C. Oxygen saturation
D. Blood pressure
Correct Answer: B
Rationale: In new-onset atrial fibrillation, the priority is assessing ventricular rate to
determine the need for immediate rate control. Rates >150 bpm can compromise
cardiac output and require urgent intervention. While oxygen saturation and blood
pressure are important, the ventricular rate determines immediate management.
Q5: A patient with acute coronary syndrome receives morphine for chest pain. Which of
the following assessments is most important after administration?
A. Pain level
B. Respiratory rate and oxygen saturation
C. Heart rate
, D. Level of consciousness
Correct Answer: B
Rationale: Morphine can cause respiratory depression and hypotension. Respiratory rate
and oxygen saturation must be monitored closely. While pain assessment is important,
respiratory status is the safety priority. Current evidence suggests morphine may be
associated with worse outcomes in ACS and should be used cautiously.
Q6: A patient with heart failure has a pulmonary artery catheter in place. The pulmonary
capillary wedge pressure (PCWP) is 24 mmHg. This finding indicates:
A. Hypovolemia
B. Left ventricular failure
C. Right ventricular failure
D. Cardiac tamponade
Correct Answer: B
Rationale: PCWP reflects left ventricular end-diastolic pressure. Normal is 6-12 mmHg.
Elevated PCWP (>18 mmHg) indicates left ventricular failure and fluid overload
(pulmonary congestion). Hypovolemia would present with low PCWP. Right ventricular
failure primarily affects CVP. Cardiac tamponade causes equalization of all pressures.
Q7: A patient with a myocardial infarction develops a harsh holosystolic murmur at the
apex radiating to the axilla. Which of the following complications is most likely?
A. Ventricular septal rupture
