PCCN CERTIFICATION EXAMS SET 2026 COMPLETE
QUESTIONS WITH ANSWERS ALREADY PASSED
,PCCN Certification Practice Examination 2026
Cardiovascular Disorders
Question 1
A patient with acute decompensated heart failure presents with pulmonary crackles, jugular
venous distention, and an S3 gallop. Which intervention should the nurse prioritize?
A. Administer IV furosemide
B. Encourage oral fluid intake
C. Place the patient flat in bed
D. Initiate chest physiotherapy
Correct Answer: A. Administer IV furosemide
Rationale: Acute decompensated heart failure with pulmonary congestion requires rapid
reduction of preload and fluid overload. IV furosemide decreases circulating volume and
improves pulmonary edema.
Question 2
A patient with atrial fibrillation suddenly develops slurred speech and right-sided weakness.
What is the priority nursing action?
A. Obtain a 12-lead ECG
B. Administer amiodarone
C. Activate the stroke response team
D. Reassure the patient and family
Correct Answer: C. Activate the stroke response team
Rationale: Sudden neurologic deficits in a patient with atrial fibrillation suggest embolic stroke.
Rapid stroke team activation is essential to preserve brain tissue and determine eligibility for
thrombolytic therapy.
,Question 3
A patient receiving nitroglycerin infusion for unstable angina reports severe headache and
dizziness. Which assessment finding requires immediate action?
A. Heart rate of 92 bpm
B. Blood pressure of 82/48 mm Hg
C. Mild facial flushing
D. Headache rated 4/10
Correct Answer: B. Blood pressure of 82/48 mm Hg
Rationale: Hypotension is a serious adverse effect of nitroglycerin and may compromise
coronary perfusion. The infusion may need titration or discontinuation.
Question 4
Which hemodynamic finding is most consistent with cardiogenic shock?
A. Decreased pulmonary artery wedge pressure and increased cardiac output
B. Increased cardiac output and decreased systemic vascular resistance
C. Increased pulmonary artery wedge pressure and decreased cardiac output
D. Normal preload and increased urine output
Correct Answer: C. Increased pulmonary artery wedge pressure and decreased cardiac output
Rationale: Cardiogenic shock results from pump failure leading to elevated preload and
inadequate cardiac output.
Question 5
A patient develops ventricular tachycardia without a pulse. What is the priority intervention?
A. Administer atropine
B. Synchronized cardioversion
C. Immediate defibrillation
D. Obtain arterial blood gases
Correct Answer: C. Immediate defibrillation
Rationale: Pulseless ventricular tachycardia is a shockable cardiac arrest rhythm requiring
immediate defibrillation and CPR.
, Question 6
A patient with infective endocarditis is at greatest risk for which complication?
A. Pulmonary fibrosis
B. Systemic embolization
C. Hyperthyroidism
D. Pancreatitis
Correct Answer: B. Systemic embolization
Rationale: Vegetations can dislodge and travel to major organs, causing embolic events such as
stroke or infarction.
Question 7
Which assessment finding is most concerning in a patient with an abdominal aortic aneurysm?
A. Pulsatile abdominal mass
B. Mild lower back discomfort
C. Sudden severe abdominal pain with hypotension
D. Blood pressure of 146/84 mm Hg
Correct Answer: C. Sudden severe abdominal pain with hypotension
Rationale: Sudden pain with hypotension may indicate aneurysm rupture, a life-threatening
emergency.
Question 8
A patient with heart failure has a BNP level of 1,200 pg/mL. How should the nurse interpret this
finding?
A. Indicates severe dehydration
B. Suggests worsening heart failure
C. Reflects improved ventricular function
D. Confirms pulmonary embolism
Correct Answer: B. Suggests worsening heart failure
Rationale: Elevated BNP levels correlate with ventricular stretch and worsening heart failure.
QUESTIONS WITH ANSWERS ALREADY PASSED
,PCCN Certification Practice Examination 2026
Cardiovascular Disorders
Question 1
A patient with acute decompensated heart failure presents with pulmonary crackles, jugular
venous distention, and an S3 gallop. Which intervention should the nurse prioritize?
A. Administer IV furosemide
B. Encourage oral fluid intake
C. Place the patient flat in bed
D. Initiate chest physiotherapy
Correct Answer: A. Administer IV furosemide
Rationale: Acute decompensated heart failure with pulmonary congestion requires rapid
reduction of preload and fluid overload. IV furosemide decreases circulating volume and
improves pulmonary edema.
Question 2
A patient with atrial fibrillation suddenly develops slurred speech and right-sided weakness.
What is the priority nursing action?
A. Obtain a 12-lead ECG
B. Administer amiodarone
C. Activate the stroke response team
D. Reassure the patient and family
Correct Answer: C. Activate the stroke response team
Rationale: Sudden neurologic deficits in a patient with atrial fibrillation suggest embolic stroke.
Rapid stroke team activation is essential to preserve brain tissue and determine eligibility for
thrombolytic therapy.
,Question 3
A patient receiving nitroglycerin infusion for unstable angina reports severe headache and
dizziness. Which assessment finding requires immediate action?
A. Heart rate of 92 bpm
B. Blood pressure of 82/48 mm Hg
C. Mild facial flushing
D. Headache rated 4/10
Correct Answer: B. Blood pressure of 82/48 mm Hg
Rationale: Hypotension is a serious adverse effect of nitroglycerin and may compromise
coronary perfusion. The infusion may need titration or discontinuation.
Question 4
Which hemodynamic finding is most consistent with cardiogenic shock?
A. Decreased pulmonary artery wedge pressure and increased cardiac output
B. Increased cardiac output and decreased systemic vascular resistance
C. Increased pulmonary artery wedge pressure and decreased cardiac output
D. Normal preload and increased urine output
Correct Answer: C. Increased pulmonary artery wedge pressure and decreased cardiac output
Rationale: Cardiogenic shock results from pump failure leading to elevated preload and
inadequate cardiac output.
Question 5
A patient develops ventricular tachycardia without a pulse. What is the priority intervention?
A. Administer atropine
B. Synchronized cardioversion
C. Immediate defibrillation
D. Obtain arterial blood gases
Correct Answer: C. Immediate defibrillation
Rationale: Pulseless ventricular tachycardia is a shockable cardiac arrest rhythm requiring
immediate defibrillation and CPR.
, Question 6
A patient with infective endocarditis is at greatest risk for which complication?
A. Pulmonary fibrosis
B. Systemic embolization
C. Hyperthyroidism
D. Pancreatitis
Correct Answer: B. Systemic embolization
Rationale: Vegetations can dislodge and travel to major organs, causing embolic events such as
stroke or infarction.
Question 7
Which assessment finding is most concerning in a patient with an abdominal aortic aneurysm?
A. Pulsatile abdominal mass
B. Mild lower back discomfort
C. Sudden severe abdominal pain with hypotension
D. Blood pressure of 146/84 mm Hg
Correct Answer: C. Sudden severe abdominal pain with hypotension
Rationale: Sudden pain with hypotension may indicate aneurysm rupture, a life-threatening
emergency.
Question 8
A patient with heart failure has a BNP level of 1,200 pg/mL. How should the nurse interpret this
finding?
A. Indicates severe dehydration
B. Suggests worsening heart failure
C. Reflects improved ventricular function
D. Confirms pulmonary embolism
Correct Answer: B. Suggests worsening heart failure
Rationale: Elevated BNP levels correlate with ventricular stretch and worsening heart failure.
