PCCN EXAM PREP 2026: 117 MUST-KNOW QUESTIONS
AND 100% VERIFIED ANSWERS | GRADED A+ |
GUARANTEED PASS!!
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
- answer-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.
5. Which of the following labs must be closely monitored when administering
Lisinopril to a patient with systolic heart failure?
A. Sodium
B. Phosphate
C. Magnesium
D Potassium
- answer-D. Potassium
Patients taking angiotensin converting enzyme inhibitors may experience
hyperkalemia. ACE inhibitors block angiotensin II, which may lead to decreased
aldosterone. Aldosterone is responsible forexcreting potassium from the kidneys.
Therefore, ACE inhibitors can cause potassium retension and potassium levels
should be monitored closely. In addition, renal labs such as BUN and creatinine
should be monitored. If the patient develops more than a 20% increase in the
creatinine, the medication should be discontinued.
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
- answer-C* Initial lactate level 4.2 mmol/L, now 1.8 mmol/L
Early goal directed therapy for sepsis include early fluid resuscitation at 30 mL/kg
to maintain the MAP greater than 65 mm Hg, ScvO2 greater that 70%, and urine
output greater than 0.5 mL/kg/hr. The goal is always to normalize the lactate level.
The lactate clearance (lactate decreasing to 1.8 mmol/L) is a trend in the right
direction and an indirect sign of increased perfusion.
12. A 72-year-old male patient has been in the PCU for 6 days for treatment of a
COPD exacerbation. He has been receiving VTE prophylaxis with subcutaneous
Heparin since admission. Today, his platelet count decreased significantly to
43,000 and he was found to have a new DVT on his right upper extremity. What
do you suspect is the most likely cause of these new findings?
A DIC
B* ITP
C* HIT
D* TRALI
- answer-C HIT
The hallmark sign of Heparin Induced Thrombocytopenia (HIT) is a significant
decrease in platelet count over a 24 hour period (>50% within 5-10 days of
administering Heparin. The other hallmark sign is a new development of a DVT
despite being on VTE prophylaxis. DIC and ITP can decrease platelet counts but
with the specific scenario of a new DVT and precipitous drop in platelets the best
answer is HIT. Transfusion related acute lung injury (TRALI) is a complication
from a blood transfusion reaction, which causes acute lung injury typically within
6 hours of a blood transfusion.
18. Several nurses on the unit are concerned with the accuracy of a new
noninvasive device measuring stroke volume. The best way to initially address
their concerns is to:•
A. Research new devices to replace the existing equipment•
B. Discuss concerns with the attending physician during rounds•
,C. Request an in-service from the device company•
D. Take the issue to the unit nursing research council to investigate
- answer-C. Request an in-service from the device company•
19. A 22-year-old female complains of palpitations. You see the following rhythm
at the monitor:
AAAAA
You interpret the rhythm as:
A • Atrial fibrillation
B • Atrial flutter
C• Atrial tachycardia
D• Ventricular tachycardia
- answer-C• Atrial tachycardia
20. Which laboratory values are consistent in a patient with acute pancreatitis?
A. Elevated lipase, elevated amylase, hypocalcemia & hyperglycemia
B• Elevated lipase, elevated amylase, hypercalcemia & hyperkalemia
C• Decreased lipase, elevated amylase, hypocalcemia & hyperkalemia
D. Decreased lipase, decreased amylase, hypercalcemia & hypokalemia
- answer-A. Elevated lipase, elevated amylase, hypocalcemia & hyperglycemia
21. A 54-year-old male was admitted four days ago with a pulmonary embolism.
The patient has been receiving low-molecular-weight Heparin for treatment.
During your assessment you notice ecchymosis and necrotic areas around the
injection sites. You also note that the patient's platelet count has dropped from
189,000 to 65,000. HIT is diagnosed. Which intervention should you anticipate
first?
• Stop Heparin and administer an alternate direct thrombin inhibitor
• Administer Protamine, corticosteroids, and diphenhydramine
• Ultrasound of extremities to assess for arterial and/ or venous thrombosis
• Stop Heparin and administer Warfarin instead
- answer-• Stop Heparin and administer an alternate direct thrombin inhibitor
22. A 38-year-old female with a 1 week history of productive cough, progressive
shortness of breath and fever is admitted with a diagnosis of pneumonia. Her vital
, signs are: HR 108, RR 24, BP 106/54 (62), T 38.9° C. What are top priorities in
her care?
• Administration of Heparin, IV fluids and SCD
• application
• Administration of IV fluids, antibiotics & assessing a lactate level
• Administration of IV fluids and Dopamine
• Administration of IV fluids, Dobutamine and acetaminophen
- answer-B. Administration of IV fluids, antibiotics & assessing a lactate level
23. Which acid/base disturbance is associated with massive volume resuscitation
with 0.9% saline?
• Metabolic acidosis
• Metabolic alkalosis
• Respiratory acidosis
• Respiratory alkalosis
- answer-A
24. Which of the following medications should be avoided in a patient with a right
ventricular infarction who is experiencing tachycardia and hypotension?
• Calcium channel blockers and ACE inhibitors
• Morphine and Nitroglycerin
• IV fluids and aspirin
• Plavix and Dobutamine
- answer-
25. The emergency drug therapy of choice for polymorphic ventricular tachycardia
is:
• Atropine
• Amiodarone
• Adenosine
• Magnesium
- answer-• Magnesium
26. The nurse is caring for a patient admitted to the PCU after a motor vehicle
collision. The patient sustained a severe cardiac contusion. Which of the following
AND 100% VERIFIED ANSWERS | GRADED A+ |
GUARANTEED PASS!!
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
- answer-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.
5. Which of the following labs must be closely monitored when administering
Lisinopril to a patient with systolic heart failure?
A. Sodium
B. Phosphate
C. Magnesium
D Potassium
- answer-D. Potassium
Patients taking angiotensin converting enzyme inhibitors may experience
hyperkalemia. ACE inhibitors block angiotensin II, which may lead to decreased
aldosterone. Aldosterone is responsible forexcreting potassium from the kidneys.
Therefore, ACE inhibitors can cause potassium retension and potassium levels
should be monitored closely. In addition, renal labs such as BUN and creatinine
should be monitored. If the patient develops more than a 20% increase in the
creatinine, the medication should be discontinued.
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
- answer-C* Initial lactate level 4.2 mmol/L, now 1.8 mmol/L
Early goal directed therapy for sepsis include early fluid resuscitation at 30 mL/kg
to maintain the MAP greater than 65 mm Hg, ScvO2 greater that 70%, and urine
output greater than 0.5 mL/kg/hr. The goal is always to normalize the lactate level.
The lactate clearance (lactate decreasing to 1.8 mmol/L) is a trend in the right
direction and an indirect sign of increased perfusion.
12. A 72-year-old male patient has been in the PCU for 6 days for treatment of a
COPD exacerbation. He has been receiving VTE prophylaxis with subcutaneous
Heparin since admission. Today, his platelet count decreased significantly to
43,000 and he was found to have a new DVT on his right upper extremity. What
do you suspect is the most likely cause of these new findings?
A DIC
B* ITP
C* HIT
D* TRALI
- answer-C HIT
The hallmark sign of Heparin Induced Thrombocytopenia (HIT) is a significant
decrease in platelet count over a 24 hour period (>50% within 5-10 days of
administering Heparin. The other hallmark sign is a new development of a DVT
despite being on VTE prophylaxis. DIC and ITP can decrease platelet counts but
with the specific scenario of a new DVT and precipitous drop in platelets the best
answer is HIT. Transfusion related acute lung injury (TRALI) is a complication
from a blood transfusion reaction, which causes acute lung injury typically within
6 hours of a blood transfusion.
18. Several nurses on the unit are concerned with the accuracy of a new
noninvasive device measuring stroke volume. The best way to initially address
their concerns is to:•
A. Research new devices to replace the existing equipment•
B. Discuss concerns with the attending physician during rounds•
,C. Request an in-service from the device company•
D. Take the issue to the unit nursing research council to investigate
- answer-C. Request an in-service from the device company•
19. A 22-year-old female complains of palpitations. You see the following rhythm
at the monitor:
AAAAA
You interpret the rhythm as:
A • Atrial fibrillation
B • Atrial flutter
C• Atrial tachycardia
D• Ventricular tachycardia
- answer-C• Atrial tachycardia
20. Which laboratory values are consistent in a patient with acute pancreatitis?
A. Elevated lipase, elevated amylase, hypocalcemia & hyperglycemia
B• Elevated lipase, elevated amylase, hypercalcemia & hyperkalemia
C• Decreased lipase, elevated amylase, hypocalcemia & hyperkalemia
D. Decreased lipase, decreased amylase, hypercalcemia & hypokalemia
- answer-A. Elevated lipase, elevated amylase, hypocalcemia & hyperglycemia
21. A 54-year-old male was admitted four days ago with a pulmonary embolism.
The patient has been receiving low-molecular-weight Heparin for treatment.
During your assessment you notice ecchymosis and necrotic areas around the
injection sites. You also note that the patient's platelet count has dropped from
189,000 to 65,000. HIT is diagnosed. Which intervention should you anticipate
first?
• Stop Heparin and administer an alternate direct thrombin inhibitor
• Administer Protamine, corticosteroids, and diphenhydramine
• Ultrasound of extremities to assess for arterial and/ or venous thrombosis
• Stop Heparin and administer Warfarin instead
- answer-• Stop Heparin and administer an alternate direct thrombin inhibitor
22. A 38-year-old female with a 1 week history of productive cough, progressive
shortness of breath and fever is admitted with a diagnosis of pneumonia. Her vital
, signs are: HR 108, RR 24, BP 106/54 (62), T 38.9° C. What are top priorities in
her care?
• Administration of Heparin, IV fluids and SCD
• application
• Administration of IV fluids, antibiotics & assessing a lactate level
• Administration of IV fluids and Dopamine
• Administration of IV fluids, Dobutamine and acetaminophen
- answer-B. Administration of IV fluids, antibiotics & assessing a lactate level
23. Which acid/base disturbance is associated with massive volume resuscitation
with 0.9% saline?
• Metabolic acidosis
• Metabolic alkalosis
• Respiratory acidosis
• Respiratory alkalosis
- answer-A
24. Which of the following medications should be avoided in a patient with a right
ventricular infarction who is experiencing tachycardia and hypotension?
• Calcium channel blockers and ACE inhibitors
• Morphine and Nitroglycerin
• IV fluids and aspirin
• Plavix and Dobutamine
- answer-
25. The emergency drug therapy of choice for polymorphic ventricular tachycardia
is:
• Atropine
• Amiodarone
• Adenosine
• Magnesium
- answer-• Magnesium
26. The nurse is caring for a patient admitted to the PCU after a motor vehicle
collision. The patient sustained a severe cardiac contusion. Which of the following
