PCCN CERTIFICATION EXAMS SET 2026 COMPLETE QUESTIONS WITH ANSWERS
ALREADY PASSED.
SECTION 1: Cardiovascular System (Questions 1-50)
Question 1
A 68-year-old male patient is admitted to the progressive care unit with
suspected inferior wall myocardial infarction. Which ECG finding would the nurse
anticipate?
A) ST elevation in leads I and aVL
B) ST elevation in leads II, III, and aVF
C) ST depression in leads V1-V4
D) Tall, peaked T waves in V3-V4
Answer: B
Rationale: Inferior wall MI involves the right coronary artery in most cases and
presents with ST elevation in the inferior leads (II, III, aVF). Leads I and aVL
indicate lateral wall MI, while anterior MI is seen in V1-V4 .
Question 2
A patient with heart failure has an ejection fraction of 25%. The nurse
understands that this value indicates:
,A) Normal systolic function
B) Mildly reduced systolic function
C) Moderately to severely reduced systolic function
D) Hyperdynamic systolic function
Answer: C
Rationale: A normal ejection fraction is 55-70%. An EF of 25% indicates
moderately to severely reduced systolic function (HFrEF - heart failure with
reduced ejection fraction). This guides medication management including ACE
inhibitors, beta-blockers, and possibly digoxin.
Question 3
A patient is receiving an amiodarone infusion for recurrent ventricular
tachycardia. Which assessment finding requires immediate nursing intervention?
A) Heart rate of 62 beats per minute
B) Blood pressure of 110/70 mmHg
C) New-onset prolonged QT interval on telemetry
D) Mild nausea reported by patient
,Answer: C
Rationale: Amiodarone can prolong the QT interval, increasing the risk of torsade
de pointes, a life-threatening ventricular dysrhythmia. Prolonged QT requires
immediate provider notification and possible medication adjustment or
discontinuation.
Question 4
Which finding is most specific to cardiac tamponade?
A) Widening pulse pressure
B) Pulsus paradoxus >10 mmHg
C) Decreased jugular venous pressure
D) Hypertension
Answer: B
Rationale: Pulsus paradoxus (an exaggerated decrease in systolic blood pressure
>10 mmHg during inspiration) is a classic finding in cardiac tamponade. Other
findings include narrowed pulse pressure, elevated JVP, muffled heart sounds
(Beck's triad), and hypotension.
, Question 5
A patient post-percutaneous coronary intervention has a right radial arterial
access site. The nurse notes expanding hematoma and the patient reports severe
pain. What is the priority action?
A) Apply ice to the site
B) Elevate the arm above heart level
C) Notify the provider immediately and prepare for possible surgical intervention
D) Document the finding and continue to monitor
Answer: C
Rationale: Expanding hematoma with severe pain after arterial access suggests
possible retroperitoneal bleeding or compartment syndrome. This is a medical
emergency requiring immediate provider notification. Ice and elevation are not
sufficient interventions for active bleeding .
Question 6
A patient with end-stage COPD is experiencing cardiac ischemia with increased
shortness of breath. The most appropriate goal of oxygen therapy is to maintain
oxygen saturations between:
ALREADY PASSED.
SECTION 1: Cardiovascular System (Questions 1-50)
Question 1
A 68-year-old male patient is admitted to the progressive care unit with
suspected inferior wall myocardial infarction. Which ECG finding would the nurse
anticipate?
A) ST elevation in leads I and aVL
B) ST elevation in leads II, III, and aVF
C) ST depression in leads V1-V4
D) Tall, peaked T waves in V3-V4
Answer: B
Rationale: Inferior wall MI involves the right coronary artery in most cases and
presents with ST elevation in the inferior leads (II, III, aVF). Leads I and aVL
indicate lateral wall MI, while anterior MI is seen in V1-V4 .
Question 2
A patient with heart failure has an ejection fraction of 25%. The nurse
understands that this value indicates:
,A) Normal systolic function
B) Mildly reduced systolic function
C) Moderately to severely reduced systolic function
D) Hyperdynamic systolic function
Answer: C
Rationale: A normal ejection fraction is 55-70%. An EF of 25% indicates
moderately to severely reduced systolic function (HFrEF - heart failure with
reduced ejection fraction). This guides medication management including ACE
inhibitors, beta-blockers, and possibly digoxin.
Question 3
A patient is receiving an amiodarone infusion for recurrent ventricular
tachycardia. Which assessment finding requires immediate nursing intervention?
A) Heart rate of 62 beats per minute
B) Blood pressure of 110/70 mmHg
C) New-onset prolonged QT interval on telemetry
D) Mild nausea reported by patient
,Answer: C
Rationale: Amiodarone can prolong the QT interval, increasing the risk of torsade
de pointes, a life-threatening ventricular dysrhythmia. Prolonged QT requires
immediate provider notification and possible medication adjustment or
discontinuation.
Question 4
Which finding is most specific to cardiac tamponade?
A) Widening pulse pressure
B) Pulsus paradoxus >10 mmHg
C) Decreased jugular venous pressure
D) Hypertension
Answer: B
Rationale: Pulsus paradoxus (an exaggerated decrease in systolic blood pressure
>10 mmHg during inspiration) is a classic finding in cardiac tamponade. Other
findings include narrowed pulse pressure, elevated JVP, muffled heart sounds
(Beck's triad), and hypotension.
, Question 5
A patient post-percutaneous coronary intervention has a right radial arterial
access site. The nurse notes expanding hematoma and the patient reports severe
pain. What is the priority action?
A) Apply ice to the site
B) Elevate the arm above heart level
C) Notify the provider immediately and prepare for possible surgical intervention
D) Document the finding and continue to monitor
Answer: C
Rationale: Expanding hematoma with severe pain after arterial access suggests
possible retroperitoneal bleeding or compartment syndrome. This is a medical
emergency requiring immediate provider notification. Ice and elevation are not
sufficient interventions for active bleeding .
Question 6
A patient with end-stage COPD is experiencing cardiac ischemia with increased
shortness of breath. The most appropriate goal of oxygen therapy is to maintain
oxygen saturations between:
