All the PCCN Exam Questions and All
Correct Answers 2026 Updated.
Exam coverage for the AACN PCCN Exam includes the comprehensive clinical knowledge and
professional competencies required for progressive care nursing. It focuses on cardiovascular,
pulmonary, neurological, endocrine, renal, gastrointestinal, hematologic, and multisystem
disorders, emphasizing the care of acutely ill adult patients. The exam evaluates understanding
of hemodynamic monitoring, dysrhythmia interpretation, pharmacology, and evidence-based
interventions for complex patient conditions. It also covers professional caring and ethical
practice, including advocacy, collaboration, systems thinking, and clinical inquiry. Emphasis is
placed on clinical judgment, patient safety, early recognition of complications, and the
application of advanced nursing skills in progressive and step-down care settings.
what is normal Pulmonary artery occlusion pressure (PAOP)? - Answer 5-12 mmHg
The nurse observes that the patient's jugular veins distend in the semi-upright position to more
than 5 cm above the sternal angle. This is an indication of: - Answer fluid volume overload.
The resistance against which the left ventricle must pump to eject its volume is: - Answer
systemic vascular resistance.
When the tricuspid valve is open, central venous pressure reflects the filling pressure in the: -
Answer right ventricle.
Tachycardia is dangerous for the patient with ischemic heart disease because of: - Answer
compromised cardiac output.
During initial examination of a critical care patient, the nurse observes wide and convex nails
and bulbous fingertips. This is evidence of: - Answer central cyanosis.
Priorities for palpation of the patient with cardiovascular disease include: - Answer
estimating edema.
checking capillary refill
checking for DVT
arterial pulses
By blocking the conversion of angiotensin I to angiotensin II, angiotensin-converting enzyme
inhibitors produce: - Answer b. vasodilation.
,The nurse has read that the cardiologist recommends the use of class IV drugs to depress sinus
and atrioventricular node conduction and terminate supraventricular tachycardias in the patient
at this time. The nurse will anticipate orders for which medications? - Answer a. Verapamil,
diltiazem, or amlodipine
The nurse has administered a drug that stimulates β1-adrenergic sites. Following administration
of the drug, the nurse will assess for: - Answer a. increased heart rate.
The nurse is observing the patient's electrocardiographic monitor after insertion of a temporary
pacemaker. Seeing a P-wave after the pacing artifact, the nurse knows that the: - Answer c.
atrium is being paced.
The possibility of microshock when handling a temporary pacemaker can be minimized by: -
Answer b. insulating the ends of the wires. and wearing gloves when handling the pacing
wires
In the postoperative cardiovascular patient, the most frequent cause of a decreased cardiac
output is: - Answer a. reduced preload.
A patient is being monitored by continuous electrocardiogram (ECG) after placement of a
transvenous pacemaker. "Loss of capture" is seen on the ECG. Which nursing intervention may
correct this situation? - Answer a. Position the patient on the left side. or reposition the
leads
In analyzing the ECG strip, the nurse notices a spike before each QRS complex. The patient's
heart rate is 70 beats/min. This phenomenon is reflective of - Answer b. pacing artifact; the
pacemaker is sensing and capturing.
Calculate the cerebral perfusion pressure (CPP) for a patient with a mean arterial pressure
(MAP) = 95 mm Hg and an intracranial pressure (ICP) = 15 mm Hg. - Answer b. 80 mm Hg
What procedure secures an arteriovenous malformation when a pt's condition is too unstable
for surgery? - Answer embolization that can be done to secure the lesion without surgery.
When the condition is more stable, an operation might be considered if needed.
Knowing that a patient has hypoxemia and ischemia in his brain, the nurse anticipates which of
the following? - Answer a. Cerebrovascular dilation
The nurse's priority in eye care for the patient in a coma will be: - Answer c. keeping the eyes
moist to prevent corneal ulceration.
,The patient has markedly deep, rapid respirations with a fruity breath odor. Based on the
patient's history, the nurse will: - Answer perform a blood glucose measurement.
The patient with the syndrome of inappropriate antidiuretic hormone (SIADH) secretion will
need to have the imbalance of which electrolyte corrected as soon as possible? - Answer
Sodium
Which of the following conditions occurs when the renal tubules are unable to reabsorb excess
glucose? - Answer Glycosuria
The patient has a waist measurement of 52 inches. His triglyceride level is 175 mg/dL, his high-
density lipoprotein (HDL) cholesterol level is 32 mg/dL, and his fasting plasma glucose level is
224 mg/dL. His blood pressure readings are usually approximately 140/90 mm Hg. The nurse
recognizes the characteristics of: - Answer metabolic syndrome.
To reverse the hyperglycemic hyperosmolar state, the nurse will first prepare to administer: -
Answer fluids
The nurse is caring for a patient with central diabetes insipidus (DI). The nurse should anticipate
orders for the administration of: - Answer vasopressin
In the syndrome of inappropriate antidiuretic hormone (SIADH), the physiological effect is: -
Answer dilutional hyponatremia, reducing sodium concentration to critically low levels.
Which assessment findings would indicate fluid volume excess? - Answer edema,
auscultation of a third heart sound, crackles in lungs, bounding pulses, AMS, olguria, HTN
The report of a renal patient's laboratory results shows that the blood urea nitrogen (BUN) level
is less than 25 mg/dL. To fully understand the patient's renal status, the nurse must consider
this value along with: - Answer c. creatinine level.
To determine whether edema in a patient's hands is due to circulatory compromise or another
cause, the nurse might: - Answer elevate the patient's extremities for 1 hour and observe the
degree of edema still present.
Hypovolemia causes tachycardia and : - Answer hypotension.
To avoid the complications that can result from administering furosemide (Lasix) to stimulate
urinary output, the nurse will carefully monitor: - Answer levels of electrolytes, especially
potassium.
, Which dialysis method would be most appropriate for the hemodynamically stable patient in
the anuric phase of acute kidney injury (AKI)? - Answer Intermittent hemodialysis
What are complications of continuous renal replacement therapy (CRRT)? - Answer Air
embolism, decreased inflow pressure, electrolyte imbalance
Which electrolytes pose the most potential hazard if not within normal limits for the person
with acute kidney failure? - Answer Potassium and calcium
peaked T-waves and a widening of the QRS interval in a pt with AKI are indicative of: - Answer
d. hyperkalemia.
A patient presents with the following: HR, 120 beats/min; BP, 80/44 mm Hg; urine output
averaging 20 mL/hr over the last 4 hours; afebrile; moist rales in the lungs bilaterally; BUN, 84
mg/dL; creatinine, 3.4 mg/dL. What is the probable cause of this patient's acute kidney injury
(AKI)? - Answer Left ventricular failure causing prerenal AKI
An elderly patient is in a motor vehicle accident and incurs a significant internal hemorrhage. He
is at greatest risk for which category of acute kidney injury (AKI)? - Answer Prerenal
A patient is admitted to the unit with the following laboratory values: urine specific gravity,
1.010; urine osmolality, 210 mOsm/kg; BUN/Cr ratio 10:1; urine sodium, 96 mEq/L. The urine
output has been 60 mL since admission 2 hours ago. These values are most consistent with
which of the following types of acute kidney injury (AKI)? - Answer Intrarenal
Percussing the patient's stomach produces a tympanic sound is a sign that: - Answer the
patient's stomach is empty.
The nurse is unable to hear bowel sounds in any of the four quadrants of the patient's
abdomen. This may indicate the presence of: - Answer ban ileus.
Auscultation of the abdomen reveals a bruit over the left renal artery. This is an indication of: -
Answer renal hypertension.
The nurse observes that striae on the patient's abdomen are pink and purple. This may be a sign
of: - Answer Cushing's syndrome.
During auscultation of the patient's abdomen, the nurse hears frequent high-pitched, tinkling
sounds. This is probably evidence of: - Answer normal bowel sounds.
Correct Answers 2026 Updated.
Exam coverage for the AACN PCCN Exam includes the comprehensive clinical knowledge and
professional competencies required for progressive care nursing. It focuses on cardiovascular,
pulmonary, neurological, endocrine, renal, gastrointestinal, hematologic, and multisystem
disorders, emphasizing the care of acutely ill adult patients. The exam evaluates understanding
of hemodynamic monitoring, dysrhythmia interpretation, pharmacology, and evidence-based
interventions for complex patient conditions. It also covers professional caring and ethical
practice, including advocacy, collaboration, systems thinking, and clinical inquiry. Emphasis is
placed on clinical judgment, patient safety, early recognition of complications, and the
application of advanced nursing skills in progressive and step-down care settings.
what is normal Pulmonary artery occlusion pressure (PAOP)? - Answer 5-12 mmHg
The nurse observes that the patient's jugular veins distend in the semi-upright position to more
than 5 cm above the sternal angle. This is an indication of: - Answer fluid volume overload.
The resistance against which the left ventricle must pump to eject its volume is: - Answer
systemic vascular resistance.
When the tricuspid valve is open, central venous pressure reflects the filling pressure in the: -
Answer right ventricle.
Tachycardia is dangerous for the patient with ischemic heart disease because of: - Answer
compromised cardiac output.
During initial examination of a critical care patient, the nurse observes wide and convex nails
and bulbous fingertips. This is evidence of: - Answer central cyanosis.
Priorities for palpation of the patient with cardiovascular disease include: - Answer
estimating edema.
checking capillary refill
checking for DVT
arterial pulses
By blocking the conversion of angiotensin I to angiotensin II, angiotensin-converting enzyme
inhibitors produce: - Answer b. vasodilation.
,The nurse has read that the cardiologist recommends the use of class IV drugs to depress sinus
and atrioventricular node conduction and terminate supraventricular tachycardias in the patient
at this time. The nurse will anticipate orders for which medications? - Answer a. Verapamil,
diltiazem, or amlodipine
The nurse has administered a drug that stimulates β1-adrenergic sites. Following administration
of the drug, the nurse will assess for: - Answer a. increased heart rate.
The nurse is observing the patient's electrocardiographic monitor after insertion of a temporary
pacemaker. Seeing a P-wave after the pacing artifact, the nurse knows that the: - Answer c.
atrium is being paced.
The possibility of microshock when handling a temporary pacemaker can be minimized by: -
Answer b. insulating the ends of the wires. and wearing gloves when handling the pacing
wires
In the postoperative cardiovascular patient, the most frequent cause of a decreased cardiac
output is: - Answer a. reduced preload.
A patient is being monitored by continuous electrocardiogram (ECG) after placement of a
transvenous pacemaker. "Loss of capture" is seen on the ECG. Which nursing intervention may
correct this situation? - Answer a. Position the patient on the left side. or reposition the
leads
In analyzing the ECG strip, the nurse notices a spike before each QRS complex. The patient's
heart rate is 70 beats/min. This phenomenon is reflective of - Answer b. pacing artifact; the
pacemaker is sensing and capturing.
Calculate the cerebral perfusion pressure (CPP) for a patient with a mean arterial pressure
(MAP) = 95 mm Hg and an intracranial pressure (ICP) = 15 mm Hg. - Answer b. 80 mm Hg
What procedure secures an arteriovenous malformation when a pt's condition is too unstable
for surgery? - Answer embolization that can be done to secure the lesion without surgery.
When the condition is more stable, an operation might be considered if needed.
Knowing that a patient has hypoxemia and ischemia in his brain, the nurse anticipates which of
the following? - Answer a. Cerebrovascular dilation
The nurse's priority in eye care for the patient in a coma will be: - Answer c. keeping the eyes
moist to prevent corneal ulceration.
,The patient has markedly deep, rapid respirations with a fruity breath odor. Based on the
patient's history, the nurse will: - Answer perform a blood glucose measurement.
The patient with the syndrome of inappropriate antidiuretic hormone (SIADH) secretion will
need to have the imbalance of which electrolyte corrected as soon as possible? - Answer
Sodium
Which of the following conditions occurs when the renal tubules are unable to reabsorb excess
glucose? - Answer Glycosuria
The patient has a waist measurement of 52 inches. His triglyceride level is 175 mg/dL, his high-
density lipoprotein (HDL) cholesterol level is 32 mg/dL, and his fasting plasma glucose level is
224 mg/dL. His blood pressure readings are usually approximately 140/90 mm Hg. The nurse
recognizes the characteristics of: - Answer metabolic syndrome.
To reverse the hyperglycemic hyperosmolar state, the nurse will first prepare to administer: -
Answer fluids
The nurse is caring for a patient with central diabetes insipidus (DI). The nurse should anticipate
orders for the administration of: - Answer vasopressin
In the syndrome of inappropriate antidiuretic hormone (SIADH), the physiological effect is: -
Answer dilutional hyponatremia, reducing sodium concentration to critically low levels.
Which assessment findings would indicate fluid volume excess? - Answer edema,
auscultation of a third heart sound, crackles in lungs, bounding pulses, AMS, olguria, HTN
The report of a renal patient's laboratory results shows that the blood urea nitrogen (BUN) level
is less than 25 mg/dL. To fully understand the patient's renal status, the nurse must consider
this value along with: - Answer c. creatinine level.
To determine whether edema in a patient's hands is due to circulatory compromise or another
cause, the nurse might: - Answer elevate the patient's extremities for 1 hour and observe the
degree of edema still present.
Hypovolemia causes tachycardia and : - Answer hypotension.
To avoid the complications that can result from administering furosemide (Lasix) to stimulate
urinary output, the nurse will carefully monitor: - Answer levels of electrolytes, especially
potassium.
, Which dialysis method would be most appropriate for the hemodynamically stable patient in
the anuric phase of acute kidney injury (AKI)? - Answer Intermittent hemodialysis
What are complications of continuous renal replacement therapy (CRRT)? - Answer Air
embolism, decreased inflow pressure, electrolyte imbalance
Which electrolytes pose the most potential hazard if not within normal limits for the person
with acute kidney failure? - Answer Potassium and calcium
peaked T-waves and a widening of the QRS interval in a pt with AKI are indicative of: - Answer
d. hyperkalemia.
A patient presents with the following: HR, 120 beats/min; BP, 80/44 mm Hg; urine output
averaging 20 mL/hr over the last 4 hours; afebrile; moist rales in the lungs bilaterally; BUN, 84
mg/dL; creatinine, 3.4 mg/dL. What is the probable cause of this patient's acute kidney injury
(AKI)? - Answer Left ventricular failure causing prerenal AKI
An elderly patient is in a motor vehicle accident and incurs a significant internal hemorrhage. He
is at greatest risk for which category of acute kidney injury (AKI)? - Answer Prerenal
A patient is admitted to the unit with the following laboratory values: urine specific gravity,
1.010; urine osmolality, 210 mOsm/kg; BUN/Cr ratio 10:1; urine sodium, 96 mEq/L. The urine
output has been 60 mL since admission 2 hours ago. These values are most consistent with
which of the following types of acute kidney injury (AKI)? - Answer Intrarenal
Percussing the patient's stomach produces a tympanic sound is a sign that: - Answer the
patient's stomach is empty.
The nurse is unable to hear bowel sounds in any of the four quadrants of the patient's
abdomen. This may indicate the presence of: - Answer ban ileus.
Auscultation of the abdomen reveals a bruit over the left renal artery. This is an indication of: -
Answer renal hypertension.
The nurse observes that striae on the patient's abdomen are pink and purple. This may be a sign
of: - Answer Cushing's syndrome.
During auscultation of the patient's abdomen, the nurse hears frequent high-pitched, tinkling
sounds. This is probably evidence of: - Answer normal bowel sounds.
