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ADULT CCRN/PCCN CERTIFICATION
PRACTICE TEST PCCN/PCCN-K ADULT
PROGRESSIVE CARE CERTIFICATION EXAM
GUIDE 2025/2026 LATEST EXAM QUESTIONS
WITH CORRECT ANSWERS
A 55 y/o steroid dependent woman with rheumatoid arthritis undergoes a CABG x 4. She was
doing well in the ICU 1 day post op, but then has a run of V-Tach and V-Fibrillation. The
nurse recognizes this may be due to the following:
A. Reperfusion after CABG
B. Reocclusion after CABG
C. Acute adrenal crisis from being off her medications preoperatively
D. Hypervolemia and hypokalemia -- ANSWER--C. Acute adrenal crisis from being off her
medications preoperatively
A 68 y/o male had a AAA repair 3 days ago but is now in renal failure. The nurse
understands the likely causes for this may be:
A. Post renal kidney stone obstruction
B. Malignant hyperthermia
C. Rhabdomyolysis
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D. Acute tubular necrosis due to aortic cross clamping for longer than 30 minutes in surgery.
-- ANSWER--D. Acute tubular necrosis due to aortic cross clamping for longer than 30
minutes in surgery.
Rationale: Kidney stones, malignant hyperthermia, and rhabdomyolysis are not results of a
AAA surgical procedure specifically.
A 72 y/o man is in the ICU for chronic renal failure. What electrolyte abnormalities would
the nurse watch for?
A. Decreased BUN and Creatinine from diseased kidneys
B. High pH and alkalosis
C. Hyperkalemia
D. Thrombocytopenia -- ANSWER--C. Hyperkalemia
The nurse is providing care for a patient with pyelonephritis. What treatment is appropriate
for this patient?
A. Restrict oral and IV fluids to prevent renal failure
B. 2 L hypertonic solution with magnesium rider
C. 2 Grams Ceftriaxone
D. Prepare patient for emergent dialysis -- ANSWER--C. 2 Grams Ceftriaxone
Rationale: Appropriate therapy for pyelonephritis includes: Give 2 L of IV fluid, Give 2
Tylenol #3 or similar pain control. Give 2 gm ceftriaxone. If the patient can tolerate two
glasses of water and fever decreases by 2 degrees: Trimethoprim/Sulfamethoxazole
(TMP/SMX) double-strength BID for two weeks; follow-up in two days for progress check.
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Toxic Shock, Myxedema coma, and Addisonian Crisis are all types of what type of shock?
A. Neurogenic
B. Anaphylactic
C. Distributive
D. Hypovolemic -- ANSWER--C. Distributive
Positive cultures distinguish what two stages of the sepsis spectrum?
A. SIRS and sepsis
B. Sepsis and severe sepsis
C. Sepsis and septic shock
D. SIRS and severe shock -- ANSWER--A. SIRS and sepsis
Which scenario would be the best example of secondary MODS?
A. Respiratory failure due to pneumonia
B. Acute respiratory distress syndrome secondary to pancreatitis
C. Neurologic anoxia due to hypoxemia
D. Renal Failure due to prolonged hypovolemic shock -- ANSWER--B. Acute respiratory
distress syndrome secondary to pancreatitis
Example of catecholamines are:
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A. Mast cells, basophils, and eosinophils
B. Histamine, tryptase, and heparin
C. Histamine, epinephrine, and steroids
D. Epinephrine, norepinephrine, and dopamine -- ANSWER--D. Epinephrine,
norepinephrine, and dopamine
One day following posterior spinal fusion surgery a 35 year old female suddenly exhibits
restlessness, labored breathing and acute chest pain. Her heart rate is 122/min., she is afebrile,
and exhibits slightly diminished breath sounds on the right side.
The findings described above should lead the nurse to suspect that the patient has developed:
A. A spontaneous pneumothorax
B. A pulmonary embolus
C. Aspiration pneumonia
D. A pleural effusion -- ANSWER--B. A pulmonary embolus
One day following posterior spinal fusion surgery a 35 year old female suddenly exhibits
restlessness, labored breathing and acute chest pain. Her heart rate is 122/min., she is afebrile,
and exhibits slightly diminished breath sounds on the right side.
Which of the following will most likely confirm the patient's diagnosis?
A. Pulmonary radioisotope scan
B. Echocardiogram
C. Cardiac enzyme studies
ADULT CCRN/PCCN CERTIFICATION
PRACTICE TEST PCCN/PCCN-K ADULT
PROGRESSIVE CARE CERTIFICATION EXAM
GUIDE 2025/2026 LATEST EXAM QUESTIONS
WITH CORRECT ANSWERS
A 55 y/o steroid dependent woman with rheumatoid arthritis undergoes a CABG x 4. She was
doing well in the ICU 1 day post op, but then has a run of V-Tach and V-Fibrillation. The
nurse recognizes this may be due to the following:
A. Reperfusion after CABG
B. Reocclusion after CABG
C. Acute adrenal crisis from being off her medications preoperatively
D. Hypervolemia and hypokalemia -- ANSWER--C. Acute adrenal crisis from being off her
medications preoperatively
A 68 y/o male had a AAA repair 3 days ago but is now in renal failure. The nurse
understands the likely causes for this may be:
A. Post renal kidney stone obstruction
B. Malignant hyperthermia
C. Rhabdomyolysis
,2|Page
D. Acute tubular necrosis due to aortic cross clamping for longer than 30 minutes in surgery.
-- ANSWER--D. Acute tubular necrosis due to aortic cross clamping for longer than 30
minutes in surgery.
Rationale: Kidney stones, malignant hyperthermia, and rhabdomyolysis are not results of a
AAA surgical procedure specifically.
A 72 y/o man is in the ICU for chronic renal failure. What electrolyte abnormalities would
the nurse watch for?
A. Decreased BUN and Creatinine from diseased kidneys
B. High pH and alkalosis
C. Hyperkalemia
D. Thrombocytopenia -- ANSWER--C. Hyperkalemia
The nurse is providing care for a patient with pyelonephritis. What treatment is appropriate
for this patient?
A. Restrict oral and IV fluids to prevent renal failure
B. 2 L hypertonic solution with magnesium rider
C. 2 Grams Ceftriaxone
D. Prepare patient for emergent dialysis -- ANSWER--C. 2 Grams Ceftriaxone
Rationale: Appropriate therapy for pyelonephritis includes: Give 2 L of IV fluid, Give 2
Tylenol #3 or similar pain control. Give 2 gm ceftriaxone. If the patient can tolerate two
glasses of water and fever decreases by 2 degrees: Trimethoprim/Sulfamethoxazole
(TMP/SMX) double-strength BID for two weeks; follow-up in two days for progress check.
,3|Page
Toxic Shock, Myxedema coma, and Addisonian Crisis are all types of what type of shock?
A. Neurogenic
B. Anaphylactic
C. Distributive
D. Hypovolemic -- ANSWER--C. Distributive
Positive cultures distinguish what two stages of the sepsis spectrum?
A. SIRS and sepsis
B. Sepsis and severe sepsis
C. Sepsis and septic shock
D. SIRS and severe shock -- ANSWER--A. SIRS and sepsis
Which scenario would be the best example of secondary MODS?
A. Respiratory failure due to pneumonia
B. Acute respiratory distress syndrome secondary to pancreatitis
C. Neurologic anoxia due to hypoxemia
D. Renal Failure due to prolonged hypovolemic shock -- ANSWER--B. Acute respiratory
distress syndrome secondary to pancreatitis
Example of catecholamines are:
, 4|Page
A. Mast cells, basophils, and eosinophils
B. Histamine, tryptase, and heparin
C. Histamine, epinephrine, and steroids
D. Epinephrine, norepinephrine, and dopamine -- ANSWER--D. Epinephrine,
norepinephrine, and dopamine
One day following posterior spinal fusion surgery a 35 year old female suddenly exhibits
restlessness, labored breathing and acute chest pain. Her heart rate is 122/min., she is afebrile,
and exhibits slightly diminished breath sounds on the right side.
The findings described above should lead the nurse to suspect that the patient has developed:
A. A spontaneous pneumothorax
B. A pulmonary embolus
C. Aspiration pneumonia
D. A pleural effusion -- ANSWER--B. A pulmonary embolus
One day following posterior spinal fusion surgery a 35 year old female suddenly exhibits
restlessness, labored breathing and acute chest pain. Her heart rate is 122/min., she is afebrile,
and exhibits slightly diminished breath sounds on the right side.
Which of the following will most likely confirm the patient's diagnosis?
A. Pulmonary radioisotope scan
B. Echocardiogram
C. Cardiac enzyme studies
