Page 1 of 331
PCCN PRACTICE 2026 EXAM BANK ALL
COMPLETE (735) CURRENT TESTING
QUESTIONS AND DETAILED CORRECT
ANSWERS|GUARANTEED PASS.
PCCN
Prepare for the PCCN Practice Exam with this concise study
resource covering progressive care nursing, cardiac monitoring,
and patient assessment. It reinforces key concepts aligned with
certification standards from the American Association of
Critical-Care Nurses. Suitable for nurses preparing for the
Progressive Care Certified Nurse (PCCN) certification exam.
Coronary artery perfusion is dependent upon:
A. diastolic pressure
B. systolic pressure
C. afterload
D. systemic vascular resistance (SVR) ✓ ✓ ...... ANSWER
....... A. diastolic pressure
Diastolic pressure in the aortic root is higher than left
ventricular end-diastolic pressure (LVEDP), the pressure
exerted on the ventricular muscle at the end of diastole
when the ventricle is full. This enables blood to flow from a
, Page 2 of 331
higher pressure through open arteries to a lower pressure, a
pressure gradient known as coronary artery prefusion
pressure. As diastolic pressure drops, there is a decrease in
coronary artery blood flow. Coronary artery perfusion is not
affected by systolic pressure, afterload or SVR, but they all
increase the demand of oxygen in the heart.
A post-STEMI (ST elevation myocardial infarction) patient is
started on an angiotensin-converting enzyme (ACE) inhibitor
during his hospital stay. Which of the following is the most
common serious side effect that may occur?
A. a nonproductive cough
B. pedal edema
C. swelling of the tongue and face
D. rhinorrhea ✓ ✓ ...... ANSWER ....... C. swelling of the
tongue and face
Although all of the answers may occur, swelling og the
tongue and face is the most serious and may require
intervention. Patients should be instructed to seek medical
attention immediately for any signs of swelling in the tongue
or throat.
, Page 3 of 331
Which of the following best describes the fourth heart sound
(S4):
A. It occurs after ventricular contraction
B. It is best heard with the diaphragm of the stethoscope
C. It is a normal finding in children
D. It occurs during late diastole when the atria contracts ✓
✓ ...... ANSWER ....... D. It occurs during late diastole
when the atria contracts
The presence of the extra heart sound S4 signifies a poorly
compliant (stiff) left ventricle. An S4 is also called an atrial
heart sound since it occurs at the end of diastolic filling
when the atria contracts and fully fills the left ventricle.
Known as "atrial kick", this filling is important to cardiac
output. The increased end-diastolic volume in the ventricle
improves cardiac output. When the left ventricle is stiff
(decreased compliance with long term hypertension, aortic
stenosis or with acute STEMI), the atrium has to pump
harder to move blood from the atrium to the ventricle,
causing a turbulent blood flow and extra heart sound. This
heart sound is always pathologic. It occurs before
ventricular contraction, is best heard with the bell of the
stethoscope and is never a normal heart sound, even in
children.
, Page 4 of 331
Which pathologic changes found on the 12-lead ECG
indicate myocardial ischemia?
A. ST-segment elevation
B. ST-segment depression and T-wave elevation
C. Q-wave formation
D. ST-segment depression and T-wave inversion ✓ ✓ ......
ANSWER ....... D. ST segment depression and T wave
inversion
Myocardial ischemia changes the repolarization of the
ventricular muscle. That change is seen on the 12 lead ECG
as ST-segment depression and T wave inversion, which
demonstrate subendocardial ischemia -- the innermost
layer of muscle in the myocardium. ST-segment elevation
indicates acute injury or infarction, ST segment depression
and T wave elevation may indicate an electrolyte
abnormality, while Q wave formation indicates total
infarction.
Positive inotropic agents are used to:
A. improve cardiac output and tissue perfusion
B. decrease water loss through the kidneys
PCCN PRACTICE 2026 EXAM BANK ALL
COMPLETE (735) CURRENT TESTING
QUESTIONS AND DETAILED CORRECT
ANSWERS|GUARANTEED PASS.
PCCN
Prepare for the PCCN Practice Exam with this concise study
resource covering progressive care nursing, cardiac monitoring,
and patient assessment. It reinforces key concepts aligned with
certification standards from the American Association of
Critical-Care Nurses. Suitable for nurses preparing for the
Progressive Care Certified Nurse (PCCN) certification exam.
Coronary artery perfusion is dependent upon:
A. diastolic pressure
B. systolic pressure
C. afterload
D. systemic vascular resistance (SVR) ✓ ✓ ...... ANSWER
....... A. diastolic pressure
Diastolic pressure in the aortic root is higher than left
ventricular end-diastolic pressure (LVEDP), the pressure
exerted on the ventricular muscle at the end of diastole
when the ventricle is full. This enables blood to flow from a
, Page 2 of 331
higher pressure through open arteries to a lower pressure, a
pressure gradient known as coronary artery prefusion
pressure. As diastolic pressure drops, there is a decrease in
coronary artery blood flow. Coronary artery perfusion is not
affected by systolic pressure, afterload or SVR, but they all
increase the demand of oxygen in the heart.
A post-STEMI (ST elevation myocardial infarction) patient is
started on an angiotensin-converting enzyme (ACE) inhibitor
during his hospital stay. Which of the following is the most
common serious side effect that may occur?
A. a nonproductive cough
B. pedal edema
C. swelling of the tongue and face
D. rhinorrhea ✓ ✓ ...... ANSWER ....... C. swelling of the
tongue and face
Although all of the answers may occur, swelling og the
tongue and face is the most serious and may require
intervention. Patients should be instructed to seek medical
attention immediately for any signs of swelling in the tongue
or throat.
, Page 3 of 331
Which of the following best describes the fourth heart sound
(S4):
A. It occurs after ventricular contraction
B. It is best heard with the diaphragm of the stethoscope
C. It is a normal finding in children
D. It occurs during late diastole when the atria contracts ✓
✓ ...... ANSWER ....... D. It occurs during late diastole
when the atria contracts
The presence of the extra heart sound S4 signifies a poorly
compliant (stiff) left ventricle. An S4 is also called an atrial
heart sound since it occurs at the end of diastolic filling
when the atria contracts and fully fills the left ventricle.
Known as "atrial kick", this filling is important to cardiac
output. The increased end-diastolic volume in the ventricle
improves cardiac output. When the left ventricle is stiff
(decreased compliance with long term hypertension, aortic
stenosis or with acute STEMI), the atrium has to pump
harder to move blood from the atrium to the ventricle,
causing a turbulent blood flow and extra heart sound. This
heart sound is always pathologic. It occurs before
ventricular contraction, is best heard with the bell of the
stethoscope and is never a normal heart sound, even in
children.
, Page 4 of 331
Which pathologic changes found on the 12-lead ECG
indicate myocardial ischemia?
A. ST-segment elevation
B. ST-segment depression and T-wave elevation
C. Q-wave formation
D. ST-segment depression and T-wave inversion ✓ ✓ ......
ANSWER ....... D. ST segment depression and T wave
inversion
Myocardial ischemia changes the repolarization of the
ventricular muscle. That change is seen on the 12 lead ECG
as ST-segment depression and T wave inversion, which
demonstrate subendocardial ischemia -- the innermost
layer of muscle in the myocardium. ST-segment elevation
indicates acute injury or infarction, ST segment depression
and T wave elevation may indicate an electrolyte
abnormality, while Q wave formation indicates total
infarction.
Positive inotropic agents are used to:
A. improve cardiac output and tissue perfusion
B. decrease water loss through the kidneys
