PCCN EXAMINATION STUDY SHEET 2026
QUESTIONS WITH ANSWERS GRADED A+
◉When assessing myocardial chest pain, which of the following is
not a common characteristic of angina:
A. discomfort that is precipitated by exercise
B. discomfort that is described as pressure or tightness
C. discomfort that is relieved with rest or nitroglycerin
D. pain that is intermittent and that comes and goes. Answer: D. pain
that is intermittent and that comes and goes
Myocardial ischemia causing pain has the usual characteristics of
precipitation by exercise or exertion, described as pressure or
tightness, and relief by rest and/or nitroglycerin. Intermittent pain
that comes and goes is not the usual presentation of myocardial
ischemia.
◉Signs of venous peripheral vascular disease in the legs include:
A. brown pigmentation at the ankles, warm legs, open area over the
lateral malleolus
B. normal color, severe pain, open sore at the end of the great toe
C. shiny skin with no hair, pale extremities, pain with ambulation
,D. pitting edema, absent pulses, thick toenails, feet becoming
cyanotic when dependent. Answer: A. brown pigmentation at the
ankles, warm legs, open area over the lateral malleolus
Arterial insufficiency
Etiology: arteriosclerosis
Risk factors: smoking, DM, HTN
Pain: severe muscle ischemia, intermittent claudication, worse with
exercise, pain at rest, muscle fatigue, cramping, numbness
Vascular: decreased or absent pulses, pallor and rubor
Skin changes: shiny, dry, nail changes, coolness
Venous insufficiency
Pain: minimal to moderate steady pain, aching
Skin: thickening in tissues, dark, cyanotic, thickened and brown,
with ulceration at sides of ankles (a medial malleolus classic), and
legs are warm since there is normal arterial circulation
◉A patient presents with pulmonary edema characterized by
tachycardia, hypertension and cough with frothy sputum. What
initial treatments are most common?
A. oxygen, nitroglycerin, loop diuretics, and morphine
B. oxygen, thiazide diuretics, and ACE inhibitors
C. oxygen and thiazide diuretics
,D. oxygen, morphine, and calcium channel blockers. Answer: A.
oxygen, nitroglycerin, loop diuretics, and morphine
The first line drugs of choice for acute pulmonary edema are oxygen,
loop diuretics such as furosemide (Lasix), nitroglycerin (preload
reducer and increased myocardial blood flow), and morphine
(vasodilator to reduce preload, decrease pain and anxiety; pain and
anxiety increase the oxygen needs of the myocardium). Thiazide
diuretics, ACE inhibitors and calcium channel blockers are not used
as first line drugs in treatment of pulmonary edema.
◉A patient who experienced an episode of severe chest pain and
weakness four days earlier is undergoing diagnostic tests. Which
test would provide the most accurate information to diagnose a
myocardial infarction after four days?
A. an ECG
B. creatine-kinase and isoenzyme (CK-MB)
C. myoglobin
D. troponin and its isomers (C, I, and T). Answer: D. troponin and its
isomers (C, I, and T)
Troponin and its isomers regulate contractions and levels increase
as with CK-MB with an MI, but remian elevated for up to 2 weeks. An
ECG is most helpful if taken immediately after an MI so ECG changes
can be monitored. Myoglobin levels increase in 1-4 hrs after an MI
and peak within 6-12 hrs. CK-MB levels increase within a few hours
and peak at about 24-27 hrs.
, ◉A 55-year old male is admitted from the ICU after an acute Type III
aortic dissection. Treatment plan includes blood pressure control.
What medications would the nurse anticipate in this patient?
A. digoxin (Lanoxin) and furosemide (Lasix)
B. metoprolol (Lopressor) and lisinopril (Prinivil)
C. furosemide and spironolactone (Aldactone)
D. bumetanide (Bumex) and amlodipine (Norvasc). Answer: B.
metoprolol (Lopressor) and lisinopril (Prinivil)
The blood pressure control of this patient is the most important
treatment in his care. The two most common drugs for the
treatment of an aortic dissection are a beta blocker and ACE
inhibitor. Diuretics may be added for more control of blood pressure,
but are not first-line drugs. Digoxin is not required for this patient.
◉A 68 year old male is 4 hours postoperative after percutaneous
transluminal coronary angioplasty and stent placement and
complains of flank pain. He is restless, tachycardic, hypotensive, and
his hemoglobin and hematocrit levels (H+H) have dropped. Which of
the following nursing actions is correct?
A. Keep the head of the bed flat and apply pressure at the sheath site
to stop bleeding.
B. Notify a physician immediately and anticipate ultrasound-guided
compression and possible surgery to stop the bleeding.
C. Notify a physician immediately, and anticipate anticoagulation or
thrombolytic therapy.
QUESTIONS WITH ANSWERS GRADED A+
◉When assessing myocardial chest pain, which of the following is
not a common characteristic of angina:
A. discomfort that is precipitated by exercise
B. discomfort that is described as pressure or tightness
C. discomfort that is relieved with rest or nitroglycerin
D. pain that is intermittent and that comes and goes. Answer: D. pain
that is intermittent and that comes and goes
Myocardial ischemia causing pain has the usual characteristics of
precipitation by exercise or exertion, described as pressure or
tightness, and relief by rest and/or nitroglycerin. Intermittent pain
that comes and goes is not the usual presentation of myocardial
ischemia.
◉Signs of venous peripheral vascular disease in the legs include:
A. brown pigmentation at the ankles, warm legs, open area over the
lateral malleolus
B. normal color, severe pain, open sore at the end of the great toe
C. shiny skin with no hair, pale extremities, pain with ambulation
,D. pitting edema, absent pulses, thick toenails, feet becoming
cyanotic when dependent. Answer: A. brown pigmentation at the
ankles, warm legs, open area over the lateral malleolus
Arterial insufficiency
Etiology: arteriosclerosis
Risk factors: smoking, DM, HTN
Pain: severe muscle ischemia, intermittent claudication, worse with
exercise, pain at rest, muscle fatigue, cramping, numbness
Vascular: decreased or absent pulses, pallor and rubor
Skin changes: shiny, dry, nail changes, coolness
Venous insufficiency
Pain: minimal to moderate steady pain, aching
Skin: thickening in tissues, dark, cyanotic, thickened and brown,
with ulceration at sides of ankles (a medial malleolus classic), and
legs are warm since there is normal arterial circulation
◉A patient presents with pulmonary edema characterized by
tachycardia, hypertension and cough with frothy sputum. What
initial treatments are most common?
A. oxygen, nitroglycerin, loop diuretics, and morphine
B. oxygen, thiazide diuretics, and ACE inhibitors
C. oxygen and thiazide diuretics
,D. oxygen, morphine, and calcium channel blockers. Answer: A.
oxygen, nitroglycerin, loop diuretics, and morphine
The first line drugs of choice for acute pulmonary edema are oxygen,
loop diuretics such as furosemide (Lasix), nitroglycerin (preload
reducer and increased myocardial blood flow), and morphine
(vasodilator to reduce preload, decrease pain and anxiety; pain and
anxiety increase the oxygen needs of the myocardium). Thiazide
diuretics, ACE inhibitors and calcium channel blockers are not used
as first line drugs in treatment of pulmonary edema.
◉A patient who experienced an episode of severe chest pain and
weakness four days earlier is undergoing diagnostic tests. Which
test would provide the most accurate information to diagnose a
myocardial infarction after four days?
A. an ECG
B. creatine-kinase and isoenzyme (CK-MB)
C. myoglobin
D. troponin and its isomers (C, I, and T). Answer: D. troponin and its
isomers (C, I, and T)
Troponin and its isomers regulate contractions and levels increase
as with CK-MB with an MI, but remian elevated for up to 2 weeks. An
ECG is most helpful if taken immediately after an MI so ECG changes
can be monitored. Myoglobin levels increase in 1-4 hrs after an MI
and peak within 6-12 hrs. CK-MB levels increase within a few hours
and peak at about 24-27 hrs.
, ◉A 55-year old male is admitted from the ICU after an acute Type III
aortic dissection. Treatment plan includes blood pressure control.
What medications would the nurse anticipate in this patient?
A. digoxin (Lanoxin) and furosemide (Lasix)
B. metoprolol (Lopressor) and lisinopril (Prinivil)
C. furosemide and spironolactone (Aldactone)
D. bumetanide (Bumex) and amlodipine (Norvasc). Answer: B.
metoprolol (Lopressor) and lisinopril (Prinivil)
The blood pressure control of this patient is the most important
treatment in his care. The two most common drugs for the
treatment of an aortic dissection are a beta blocker and ACE
inhibitor. Diuretics may be added for more control of blood pressure,
but are not first-line drugs. Digoxin is not required for this patient.
◉A 68 year old male is 4 hours postoperative after percutaneous
transluminal coronary angioplasty and stent placement and
complains of flank pain. He is restless, tachycardic, hypotensive, and
his hemoglobin and hematocrit levels (H+H) have dropped. Which of
the following nursing actions is correct?
A. Keep the head of the bed flat and apply pressure at the sheath site
to stop bleeding.
B. Notify a physician immediately and anticipate ultrasound-guided
compression and possible surgery to stop the bleeding.
C. Notify a physician immediately, and anticipate anticoagulation or
thrombolytic therapy.
