10 free, exam-style Progressive Care Nursing (Adult) (PCCN) (PCCN) practice questions with answers and explanations. No signup required. Work through them below, then take the full free PCCN practice test to study every exam domain.
The PCCN exam has 150 questions and runs 3 hours.
These 10 free PCCN questions are organized by exam domain, so you can see how each part of the Progressive Care Nursing (Adult) (PCCN) blueprint is tested. Reveal the answer and explanation under each question.
A patient with a known inferior wall STEMI reports ongoing chest pain. The nurse prepares to administer the ordered sublingual nitroglycerin when the blood pressure drops from 118/70 to 78/44 mmHg. Which action is MOST appropriate?
Correct answer: B - Hold the nitroglycerin and give a normal saline fluid bolus
A monitored patient suddenly develops a wide-complex rhythm at a rate of 180/min that varies in amplitude, twisting around the baseline. The most recent labs show a magnesium of 1.2 mg/dL. After ensuring the patient has a pulse and is stable, the nurse anticipates administering:
Correct answer: C - Magnesium sulfate IV
A patient who is two days post-myocardial infarction becomes acutely short of breath and hypotensive. The nurse notes jugular venous distention, muffled heart sounds, and a 14 mmHg drop in systolic pressure during inspiration. Which complication is MOST likely?
Correct answer: D - Cardiac tamponade
A telemetry strip shows a regular atrial rate of 300/min with a 'sawtooth' baseline and a ventricular response of 75/min. Which rhythm does this BEST describe?
Correct answer: A - Atrial flutter with 4:1 conduction
A patient with a COPD exacerbation has a SpO2 of 86% on room air. Thirty minutes after oxygen is increased to 6 L/min via simple face mask, the patient becomes difficult to arouse. An ABG shows pH 7.26, PaCO2 78 mmHg, HCO3 33 mEq/L, PaO2 88 mmHg. The deterioration is BEST explained by:
Correct answer: B - Oxygen-induced hypercapnia from suppression of the hypoxic drive and worsened V/Q matching
A nurse is monitoring a patient with a chest tube connected to a water-seal drainage system. Continuous, vigorous bubbling is noted in the water-seal chamber. What does this finding indicate?
Correct answer: C - An air leak in the system or the patient
An ABG is obtained on an acutely dyspneic patient: pH 7.49, PaCO2 28 mmHg, HCO3 23 mEq/L, PaO2 70 mmHg. Which interpretation is correct?
Correct answer: C - Uncompensated respiratory alkalosis
A patient in diabetic ketoacidosis is receiving an insulin infusion and IV fluids. The initial potassium was 5.4 mEq/L; a repeat level is now 3.3 mEq/L. The patient remains acidotic with a glucose of 320 mg/dL. The nurse should anticipate which action?
Correct answer: B - Continue the insulin infusion and notify the provider to add potassium replacement
A patient presents with a glucose of 940 mg/dL, pH 7.34, HCO3 20 mEq/L, negative serum ketones, and a serum osmolality of 355 mOsm/kg. The patient is profoundly dehydrated and lethargic. This presentation is MOST consistent with:
Correct answer: B - Hyperosmolar hyperglycemic state
A patient receiving a heparin infusion for a pulmonary embolism has a platelet count that falls from 245,000 to 88,000/mm3 on day 6 of therapy. The patient also develops a new clot at the IV site. The nurse should FIRST anticipate:
Correct answer: C - Discontinuing all heparin and starting a non-heparin anticoagulant
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