PCCN Exam Prep Practice Questions and Answers – (2025-2026 Updated) – 100%
Solved
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 - ✔✔✔-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.
100. You are caring for a patient with end stage liver disease (ESLD) admitted with confusion,
elevated ammonia, hypoalbuminemia, and ascites. The blood pressure has been trending
downward and is now 82/46. What is the best immediate intervention to improve the blood
pressure?
Give a 1 liter fluid bolus over 20 min
Position the patient on his left side
Start a Dopamine infusion at 5 mcg/kg/min
Attempt the passive leg raise technique for 3 minutes - ✔✔✔-
101. A patient with severe sepsis and a new pulmonary embolism is being worked up for
disseminated intravascular coagulation
(DIC). Which of the following additional lab value changes should the nurse anticipate?
Fibrinogen decreased, Fibrin split products elevated, platelets decreased, and D-dimer elevated
Fibrinogen increased, Fibrin split products elevated, platelets elevated, D-dimer decreased
Fibrinogen decreased, Fibrin split products decreased, platelets decreased, D-dimer decreased
,PCCN Exam Prep Practice Questions and Answers – (2025-2026 Updated) – 100%
Solved
Fibrinogen decreased, Fibrin split products elevated, platelets elevated, D-dimer elevated -
✔✔✔-
102. The purpose of assessing a lactate level in a patient with sepsis is:
Assess for signs of internal bleeding
Assess for adequate oxygen saturation
Assess for signs of hypoxia
Assess oxygen consumption of the tissues - ✔✔✔-
103. Which of the following will cause a shift to the left on the oxyhemoglobin dissociation
curve?
Increased levels of 2, 3-DPG
Acidosis
Hyperthermia
Alkalosis - ✔✔✔-
104. During the admission process, you discover your patient is estranged from his family and
does not have an advanced directive or durable power of attorney for health care decision
making.
Which of the following actions would align with being a moral agent for your patient?
Tell the patient it is required by law to have a power of attorney to guide all health care
decisions
Put a note in the chart requesting the physician speak to him about a durable power of attorney
Initiate a discussion with the patient about health care decisions and the importance of a
durable power of attorney
Respect the patient's wishes and do not discuss matters of death and dying during the
hospitalization - ✔✔✔-
,PCCN Exam Prep Practice Questions and Answers – (2025-2026 Updated) – 100%
Solved
105. Vasopressin is ordered for your patient who experienced a GI bleed. Which of the following
patients should be monitored closely while administering Vasopressin?
Coronary artery disease (CAD)
COPD
Liver failure
Type Il diabetes - ✔✔✔-
106. Which hemodynamic profile is consistent with early stages of septic shock?
Decreased afterload, decreased cardiac output, decreased preload
Increased afterload, decreased cardiac output, decreased preload
Decreased afterload, increased cardiac output, decreased preload
Increased afterload, decreased cardiac output, increased preload - ✔✔✔-
107. A trauma patient with multiple comorbid issues has been in the progressive care unit for
several weeks and has a large surgical wound with poor healing. Which lab value is most
concerning?
Hematocrit 28 mL/dL
Calcium 7.0 mg/dL
Albumin 2.2 mg/di.
Glucose 135 mg/dL - ✔✔✔-
108. You are assessing a patient 24 hours after an anterior-septal wall myocardial infarction.
Findings include a new, harsh holosystolic murmur and a thrill, BP 88/56 (66), HR 108, RR 35 and
0, sat 86% on 2L NC. You should anticipate which of the following diagnostics to investigate the
new murmur, hypotension, rapid breathing and desaturation?
Lab work and re-administration of fibrinolytics
Transesophageal echo and cardiac catheterization
, PCCN Exam Prep Practice Questions and Answers – (2025-2026 Updated) – 100%
Solved
Intubation and mechanical ventilation
Echocardiogram and cardiac surgery - ✔✔✔-
109. A patient is prescribed to receive a transfusion of two units of PRBCs. The nurse verifies
pre-transfusion vital signs, and consent.
Patient identification and the unit of blood are also verified with another registered nurse
before starting the transfusion. After fifteen minutes the vital signs are assessed and the patient
is chilled, with hematuria noted in the urinary catheter. Vitals signs are as follows:
Т 39.0° С
HR 135
RR 34
BP 86/42 (56)
The nurse stops the transfusion and begins infusing normal saline.
The nurse anticipates the patient is experiencing what type of transfusion reaction?
Delayed hemolytic reaction
Febrile/non-hemolytic reaction
Mild allergic reaction
Acute hemolytic reaction - ✔✔✔-
11. A 45-year-old male is admitted to 1500m With Severe sepsis.
You are administering lactated ringers 500 ml IV boluses. A central line has been placed. Which
of the findings below indicate the fluid boluses are having its intended effect?
A* MAP of 55 mm Hg
B* ScvO, of 52%
C* Initial lactate level 4.2 mmol/L, now 1.8 mmol/L
D* Urine output of 15 ml/hour - ✔✔✔-C* Initial lactate level 4.2 mmol/L, now 1.8 mmol/L
Solved
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 - ✔✔✔-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.
100. You are caring for a patient with end stage liver disease (ESLD) admitted with confusion,
elevated ammonia, hypoalbuminemia, and ascites. The blood pressure has been trending
downward and is now 82/46. What is the best immediate intervention to improve the blood
pressure?
Give a 1 liter fluid bolus over 20 min
Position the patient on his left side
Start a Dopamine infusion at 5 mcg/kg/min
Attempt the passive leg raise technique for 3 minutes - ✔✔✔-
101. A patient with severe sepsis and a new pulmonary embolism is being worked up for
disseminated intravascular coagulation
(DIC). Which of the following additional lab value changes should the nurse anticipate?
Fibrinogen decreased, Fibrin split products elevated, platelets decreased, and D-dimer elevated
Fibrinogen increased, Fibrin split products elevated, platelets elevated, D-dimer decreased
Fibrinogen decreased, Fibrin split products decreased, platelets decreased, D-dimer decreased
,PCCN Exam Prep Practice Questions and Answers – (2025-2026 Updated) – 100%
Solved
Fibrinogen decreased, Fibrin split products elevated, platelets elevated, D-dimer elevated -
✔✔✔-
102. The purpose of assessing a lactate level in a patient with sepsis is:
Assess for signs of internal bleeding
Assess for adequate oxygen saturation
Assess for signs of hypoxia
Assess oxygen consumption of the tissues - ✔✔✔-
103. Which of the following will cause a shift to the left on the oxyhemoglobin dissociation
curve?
Increased levels of 2, 3-DPG
Acidosis
Hyperthermia
Alkalosis - ✔✔✔-
104. During the admission process, you discover your patient is estranged from his family and
does not have an advanced directive or durable power of attorney for health care decision
making.
Which of the following actions would align with being a moral agent for your patient?
Tell the patient it is required by law to have a power of attorney to guide all health care
decisions
Put a note in the chart requesting the physician speak to him about a durable power of attorney
Initiate a discussion with the patient about health care decisions and the importance of a
durable power of attorney
Respect the patient's wishes and do not discuss matters of death and dying during the
hospitalization - ✔✔✔-
,PCCN Exam Prep Practice Questions and Answers – (2025-2026 Updated) – 100%
Solved
105. Vasopressin is ordered for your patient who experienced a GI bleed. Which of the following
patients should be monitored closely while administering Vasopressin?
Coronary artery disease (CAD)
COPD
Liver failure
Type Il diabetes - ✔✔✔-
106. Which hemodynamic profile is consistent with early stages of septic shock?
Decreased afterload, decreased cardiac output, decreased preload
Increased afterload, decreased cardiac output, decreased preload
Decreased afterload, increased cardiac output, decreased preload
Increased afterload, decreased cardiac output, increased preload - ✔✔✔-
107. A trauma patient with multiple comorbid issues has been in the progressive care unit for
several weeks and has a large surgical wound with poor healing. Which lab value is most
concerning?
Hematocrit 28 mL/dL
Calcium 7.0 mg/dL
Albumin 2.2 mg/di.
Glucose 135 mg/dL - ✔✔✔-
108. You are assessing a patient 24 hours after an anterior-septal wall myocardial infarction.
Findings include a new, harsh holosystolic murmur and a thrill, BP 88/56 (66), HR 108, RR 35 and
0, sat 86% on 2L NC. You should anticipate which of the following diagnostics to investigate the
new murmur, hypotension, rapid breathing and desaturation?
Lab work and re-administration of fibrinolytics
Transesophageal echo and cardiac catheterization
, PCCN Exam Prep Practice Questions and Answers – (2025-2026 Updated) – 100%
Solved
Intubation and mechanical ventilation
Echocardiogram and cardiac surgery - ✔✔✔-
109. A patient is prescribed to receive a transfusion of two units of PRBCs. The nurse verifies
pre-transfusion vital signs, and consent.
Patient identification and the unit of blood are also verified with another registered nurse
before starting the transfusion. After fifteen minutes the vital signs are assessed and the patient
is chilled, with hematuria noted in the urinary catheter. Vitals signs are as follows:
Т 39.0° С
HR 135
RR 34
BP 86/42 (56)
The nurse stops the transfusion and begins infusing normal saline.
The nurse anticipates the patient is experiencing what type of transfusion reaction?
Delayed hemolytic reaction
Febrile/non-hemolytic reaction
Mild allergic reaction
Acute hemolytic reaction - ✔✔✔-
11. A 45-year-old male is admitted to 1500m With Severe sepsis.
You are administering lactated ringers 500 ml IV boluses. A central line has been placed. Which
of the findings below indicate the fluid boluses are having its intended effect?
A* MAP of 55 mm Hg
B* ScvO, of 52%
C* Initial lactate level 4.2 mmol/L, now 1.8 mmol/L
D* Urine output of 15 ml/hour - ✔✔✔-C* Initial lactate level 4.2 mmol/L, now 1.8 mmol/L
