Page 1 of 154
Progressive Care Certified Nurse (PCCN
EXAM PREP TEST BANK (NEWLY UPDATED
2026!!) Questions & Answers with
Explanations PDF
Q1. A patient with non-ST-elevation myocardial infarction
(NSTEMI) develops recurrent chest pain despite nitrate
therapy. Which intervention should the progressive care nurse
anticipate next?
A) Immediate thrombolytic therapy
B) Emergent percutaneous coronary intervention (PCI)
C) High-dose statin and discharge planning
D) Nitroprusside drip for afterload reduction
Answer: B
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Rationale: For high-risk NSTEMI patients with refractory ischemia,
urgent PCI (<24 hours) is indicated. Thrombolytics are reserved
for STEMI without PCI access, not NSTEMI .
Q2. Which laboratory finding is most specific for diagnosing
acute myocardial infarction?
A) Elevated C-reactive protein (CRP)
B) Elevated troponin I
C) Elevated B-type natriuretic peptide (BNP)
D) Elevated creatine kinase (CK)
Answer: B
Rationale: Cardiac troponins (I and T) are the most specific
biomarkers for myocardial necrosis. While CK-MB may be
elevated, troponins have greater sensitivity and specificity for
MI .
,Page 3 of 154
Q3. A patient presents with ST-segment elevation in leads II,
III, and aVF. Which coronary artery is most likely affected?
A) Left anterior descending (LAD)
B) Right coronary artery (RCA)
C) Left circumflex (LCx)
D) Left main coronary artery
Answer: B
Rationale: Inferior wall ST elevations in leads II, III, and aVF
indicate right coronary artery involvement. LAD occlusion causes
anterior/septal elevations, while LCx causes lateral wall
changes .
Q4. Which medication is contraindicated in acute STEMI with
ST-segment elevation?
, Page 4 of 154
A) Aspirin
B) Nitroglycerin
C) IV Ibuprofen
D) Morphine
Answer: C
Rationale: NSAIDs (except aspirin) should be avoided in STEMI
due to increased risk of myocardial rupture, thrombotic events,
and worsened outcomes. Aspirin is critical for reducing mortality .
Q5. A patient with acute coronary syndrome has a creatinine
clearance of 25 mL/min. Which antiplatelet agent requires
dose adjustment or is relatively contraindicated?
A) Aspirin 81 mg
B) Clopidogrel 300 mg load
C) Ticagrelor 180 mg load
D) Prasugrel 60 mg load
Progressive Care Certified Nurse (PCCN
EXAM PREP TEST BANK (NEWLY UPDATED
2026!!) Questions & Answers with
Explanations PDF
Q1. A patient with non-ST-elevation myocardial infarction
(NSTEMI) develops recurrent chest pain despite nitrate
therapy. Which intervention should the progressive care nurse
anticipate next?
A) Immediate thrombolytic therapy
B) Emergent percutaneous coronary intervention (PCI)
C) High-dose statin and discharge planning
D) Nitroprusside drip for afterload reduction
Answer: B
,Page 2 of 154
Rationale: For high-risk NSTEMI patients with refractory ischemia,
urgent PCI (<24 hours) is indicated. Thrombolytics are reserved
for STEMI without PCI access, not NSTEMI .
Q2. Which laboratory finding is most specific for diagnosing
acute myocardial infarction?
A) Elevated C-reactive protein (CRP)
B) Elevated troponin I
C) Elevated B-type natriuretic peptide (BNP)
D) Elevated creatine kinase (CK)
Answer: B
Rationale: Cardiac troponins (I and T) are the most specific
biomarkers for myocardial necrosis. While CK-MB may be
elevated, troponins have greater sensitivity and specificity for
MI .
,Page 3 of 154
Q3. A patient presents with ST-segment elevation in leads II,
III, and aVF. Which coronary artery is most likely affected?
A) Left anterior descending (LAD)
B) Right coronary artery (RCA)
C) Left circumflex (LCx)
D) Left main coronary artery
Answer: B
Rationale: Inferior wall ST elevations in leads II, III, and aVF
indicate right coronary artery involvement. LAD occlusion causes
anterior/septal elevations, while LCx causes lateral wall
changes .
Q4. Which medication is contraindicated in acute STEMI with
ST-segment elevation?
, Page 4 of 154
A) Aspirin
B) Nitroglycerin
C) IV Ibuprofen
D) Morphine
Answer: C
Rationale: NSAIDs (except aspirin) should be avoided in STEMI
due to increased risk of myocardial rupture, thrombotic events,
and worsened outcomes. Aspirin is critical for reducing mortality .
Q5. A patient with acute coronary syndrome has a creatinine
clearance of 25 mL/min. Which antiplatelet agent requires
dose adjustment or is relatively contraindicated?
A) Aspirin 81 mg
B) Clopidogrel 300 mg load
C) Ticagrelor 180 mg load
D) Prasugrel 60 mg load
