PCCN — Progressive Care Certified Nurse WITH
CORRECT ACTUAL QUESTIONS AND
CORRECTLY WELL DEFINED ANSWERS LATEST
ALREADY GRADED A+ (2025/2026)
Question 1
A 65-year-old patient on a telemetry unit develops new-onset atrial
fibrillation with a rapid ventricular response (HR 130 bpm, BP 110/70 mm
Hg). The patient is stable but symptomatic with palpitations. What is the
priority nursing intervention?
• A) Administer metoprolol 5 mg IV as ordered
• B) Prepare for synchronized cardioversion
• C) Start amiodarone infusion
• D) Obtain an echocardiogram immediately
Correct ,,,,Answer,,,,: A) Administer metoprolol 5 mg IV as ordered
Rationale: For stable atrial fibrillation with rapid ventricular response,
rate control with beta-blockers like metoprolol is first-line to slow AV
conduction and reduce symptoms. The patient is hemodynamically stable
(BP 110/70), so synchronized cardioversion is not indicated. AACN
cardiovascular guidelines align with AHA recommendations for
progressive care settings.
,Question 2
A patient with heart failure exacerbation has a BNP of 800 pg/mL, crackles
in the bases, and weight gain of 5 lbs in 2 days. What pharmacologic
intervention is most appropriate to reduce preload?
• A) Furosemide 40 mg IV
• B) Digoxin 0.125 mg PO
• C) Lisinopril 10 mg PO
• D) Spironolactone 25 mg PO
Correct ,,,,Answer,,,,: A) Furosemide 40 mg IV
Rationale: Loop diuretics like furosemide promote fluid loss to alleviate
congestion in acute heart failure. The elevated BNP (normal <100 pg/mL)
and weight gain indicate fluid overload. Rapid diuresis is prioritized in
progressive care settings to reduce preload and relieve symptoms.
Question 3
During assessment of a patient with suspected pulmonary embolism,
which clinical finding is most indicative of hemodynamic instability?
• A) Hypotension (SBP <90 mm Hg) and tachycardia
• B) Mild dyspnea only
• C) Leg swelling
• D) Normal vital signs
Correct ,,,,Answer,,,,: A) Hypotension (SBP <90 mm Hg) and
tachycardia
Rationale: Hemodynamic instability in pulmonary embolism is marked by
shock signs (hypotension, tachycardia, altered mental status), requiring
,immediate thrombolysis or embolectomy. AACN pulmonary embolism
protocols prioritize stability assessment. Patients with normal vital signs
can be managed with anticoagulation alone.
Question 4
A post-op cardiac surgery patient on a step-down unit has a central line
showing CVP 12 mm Hg and urine output 20 mL/hr. What is the most likely
cause of oliguria?
• A) Fluid overload
• B) Hypovolemia
• C) Renal artery stenosis
• D) Medication effect
Correct ,,,,Answer,,,,: A) Fluid overload
Rationale: Elevated CVP (normal 2-8 mm Hg) with low urine output
suggests fluid overload, which is common post-cardiac surgery due to
fluid resuscitation and decreased cardiac function. AACN hemodynamic
monitoring guides fluid management; diuretics rather than fluids are
indicated.
Question 5
A patient with stable angina develops chest pain at rest. ECG shows T-
wave inversions. What is the next step?
• A) Administer sublingual nitroglycerin and monitor
• B) Prepare for emergent PCI
, • C) Start heparin infusion
• D) Discharge home
Correct ,,,,Answer,,,,: A) Administer sublingual nitroglycerin and
monitor
Rationale: Unstable angina requires anti-ischemic therapy (nitroglycerin,
oxygen, morphine if needed) and observation. ECG shows T-wave
inversions without ST elevation, indicating non-ST elevation ACS.
Emergent PCI is not indicated unless hemodynamic instability or
refractory ischemia occurs.
Question 6
In a patient with a permanent pacemaker, the telemetry strip shows
failure to capture. What is the priority action?
• A) Assess the patient for symptoms and notify the provider
• B) Increase the pacing rate
• C) Administer atropine
• D) Perform CPR
Correct ,,,,Answer,,,,: A) Assess the patient for symptoms and notify the
provider
Rationale: Failure to capture means the pacemaker spike is not followed
by a QRS complex. The priority is to assess the patient for symptoms
(dizziness, syncope, hypotension). If the patient is asymptomatic,
observation and provider notification are appropriate. CPR is only needed
if pulseless.
CORRECT ACTUAL QUESTIONS AND
CORRECTLY WELL DEFINED ANSWERS LATEST
ALREADY GRADED A+ (2025/2026)
Question 1
A 65-year-old patient on a telemetry unit develops new-onset atrial
fibrillation with a rapid ventricular response (HR 130 bpm, BP 110/70 mm
Hg). The patient is stable but symptomatic with palpitations. What is the
priority nursing intervention?
• A) Administer metoprolol 5 mg IV as ordered
• B) Prepare for synchronized cardioversion
• C) Start amiodarone infusion
• D) Obtain an echocardiogram immediately
Correct ,,,,Answer,,,,: A) Administer metoprolol 5 mg IV as ordered
Rationale: For stable atrial fibrillation with rapid ventricular response,
rate control with beta-blockers like metoprolol is first-line to slow AV
conduction and reduce symptoms. The patient is hemodynamically stable
(BP 110/70), so synchronized cardioversion is not indicated. AACN
cardiovascular guidelines align with AHA recommendations for
progressive care settings.
,Question 2
A patient with heart failure exacerbation has a BNP of 800 pg/mL, crackles
in the bases, and weight gain of 5 lbs in 2 days. What pharmacologic
intervention is most appropriate to reduce preload?
• A) Furosemide 40 mg IV
• B) Digoxin 0.125 mg PO
• C) Lisinopril 10 mg PO
• D) Spironolactone 25 mg PO
Correct ,,,,Answer,,,,: A) Furosemide 40 mg IV
Rationale: Loop diuretics like furosemide promote fluid loss to alleviate
congestion in acute heart failure. The elevated BNP (normal <100 pg/mL)
and weight gain indicate fluid overload. Rapid diuresis is prioritized in
progressive care settings to reduce preload and relieve symptoms.
Question 3
During assessment of a patient with suspected pulmonary embolism,
which clinical finding is most indicative of hemodynamic instability?
• A) Hypotension (SBP <90 mm Hg) and tachycardia
• B) Mild dyspnea only
• C) Leg swelling
• D) Normal vital signs
Correct ,,,,Answer,,,,: A) Hypotension (SBP <90 mm Hg) and
tachycardia
Rationale: Hemodynamic instability in pulmonary embolism is marked by
shock signs (hypotension, tachycardia, altered mental status), requiring
,immediate thrombolysis or embolectomy. AACN pulmonary embolism
protocols prioritize stability assessment. Patients with normal vital signs
can be managed with anticoagulation alone.
Question 4
A post-op cardiac surgery patient on a step-down unit has a central line
showing CVP 12 mm Hg and urine output 20 mL/hr. What is the most likely
cause of oliguria?
• A) Fluid overload
• B) Hypovolemia
• C) Renal artery stenosis
• D) Medication effect
Correct ,,,,Answer,,,,: A) Fluid overload
Rationale: Elevated CVP (normal 2-8 mm Hg) with low urine output
suggests fluid overload, which is common post-cardiac surgery due to
fluid resuscitation and decreased cardiac function. AACN hemodynamic
monitoring guides fluid management; diuretics rather than fluids are
indicated.
Question 5
A patient with stable angina develops chest pain at rest. ECG shows T-
wave inversions. What is the next step?
• A) Administer sublingual nitroglycerin and monitor
• B) Prepare for emergent PCI
, • C) Start heparin infusion
• D) Discharge home
Correct ,,,,Answer,,,,: A) Administer sublingual nitroglycerin and
monitor
Rationale: Unstable angina requires anti-ischemic therapy (nitroglycerin,
oxygen, morphine if needed) and observation. ECG shows T-wave
inversions without ST elevation, indicating non-ST elevation ACS.
Emergent PCI is not indicated unless hemodynamic instability or
refractory ischemia occurs.
Question 6
In a patient with a permanent pacemaker, the telemetry strip shows
failure to capture. What is the priority action?
• A) Assess the patient for symptoms and notify the provider
• B) Increase the pacing rate
• C) Administer atropine
• D) Perform CPR
Correct ,,,,Answer,,,,: A) Assess the patient for symptoms and notify the
provider
Rationale: Failure to capture means the pacemaker spike is not followed
by a QRS complex. The priority is to assess the patient for symptoms
(dizziness, syncope, hypotension). If the patient is asymptomatic,
observation and provider notification are appropriate. CPR is only needed
if pulseless.
