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243+ Free PCCN (Adult) Practice Questions

Pass your AACN Adult PCCN Progressive Care Certification exam on the first try — instant access, no signup required.

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2026 Statistics

Key Facts: PCCN (Adult) Exam

150

Total Items

AACN PCCN direct-care handbook (Nov 2025)

125 + 25

Scored + Unscored

AACN PCCN direct-care handbook (Nov 2025)

3h

Exam Time

AACN PCCN direct-care handbook (Nov 2025)

82/125

Passing Cut Score

AACN exam statistics (effective 2024-01-31)

80/20

Clinical Judgment / Professional Caring

AACN PCCN test plan (effective 2024-02-06)

$255/$370

Member / Nonmember Fee

AACN PCCN direct-care handbook (Nov 2025)

AACN's PCCN (Adult) direct-care handbook lists 150 total items (125 scored + 25 unscored) with a 3-hour testing appointment. AACN's PCCN cut score is 82 correct answers out of 125 scored items (effective January 31, 2024). The current test plan framework remains 80% Clinical Judgment and 20% Professional Caring & Ethical Practice, with cardiovascular and multisystem decision-making heavily represented in progressive-care scenarios.

Sample PCCN (Adult) Practice Questions

Try these sample questions to test your PCCN (Adult) exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 243+ question experience with AI tutoring.

1A 62-year-old patient in the PCU reports new substernal chest pressure radiating to the left arm. The cardiac monitor shows sinus tachycardia. Which initial nursing action is MOST appropriate?
A.Obtain a 12-lead ECG, administer aspirin 162 mg chewed, and measure cardiac biomarkers
B.Administer sublingual nitroglycerin immediately before any assessment
C.Apply oxygen at 4 L/min by nasal cannula to all patients regardless of SpO2
D.Wait for the provider's order before obtaining the 12-lead ECG
Explanation: AACN PCCN practice expects the nurse to immediately obtain a 12-lead ECG within 10 minutes of chest pain onset, administer aspirin 162-325 mg chewed, and draw cardiac biomarkers (troponin). Oxygen is given only if SpO2 is below 90-92% per current AHA guidance.
2A patient with an ST-elevation myocardial infarction (STEMI) is awaiting transfer for PCI. The cardiac monitor suddenly shows coarse ventricular fibrillation and the patient is unresponsive. What is the FIRST action?
A.Call for help and defibrillate immediately with 200 J (biphasic)
B.Administer amiodarone 300 mg IV push before any shock
C.Begin carotid pulse assessment for a full 60 seconds
D.Insert an advanced airway before delivering any shock
Explanation: Per AHA ACLS, the immediate response to witnessed VF is defibrillation as rapidly as possible. Pulse checks and drug administration come after the initial shock. Amiodarone 300 mg is given after the third shock for refractory VF/pulseless VT.
3A patient on a nitroglycerin drip for unstable angina develops a systolic BP of 84 mmHg. Which nursing action is MOST appropriate?
A.Decrease or stop the nitroglycerin infusion and notify the provider
B.Increase the drip rate to improve coronary perfusion
C.Administer a 500 mL normal saline fluid bolus without adjusting the drip
D.Document the finding and recheck BP in 30 minutes
Explanation: Nitroglycerin is a potent vasodilator; hypotension (SBP <90) requires decreasing or stopping the infusion immediately and notifying the provider. Fluid bolus alone without stopping the vasodilator will not correct the cause.
4A patient has a chest pain score of 8/10 with suspected acute coronary syndrome. Sublingual nitroglycerin 0.4 mg has been given once with no relief. Vital signs: BP 148/92, HR 102, SpO2 96%. What is the next appropriate step?
A.Repeat sublingual nitroglycerin 0.4 mg every 5 minutes up to a total of 3 doses, monitoring BP
B.Administer 40 mg intravenous furosemide to reduce preload
C.Give intravenous labetalol 20 mg to lower both pain and blood pressure
D.Apply a non-rebreather mask at 15 L/min even though SpO2 is 96%
Explanation: For ongoing ischemic chest pain, sublingual nitroglycerin 0.4 mg may be repeated every 5 minutes (up to 3 doses) as long as hemodynamics allow (SBP >=90). Furosemide and labetalol are not first-line for ACS pain. Routine oxygen is not indicated when SpO2 is >=90-92%.
5A patient with acute decompensated heart failure has the following arterial line waveform. MAP = 58 mmHg, HR 118, SpO2 90% on 4 L O2. Bilateral crackles to mid-lung. Which intervention should the nurse anticipate FIRST?
A.Administer IV furosemide 40 mg and initiate noninvasive positive pressure ventilation (BiPAP)
B.Give a 500 mL crystalloid bolus to improve MAP
C.Start a dobutamine drip at 5 mcg/kg/min to support cardiac output
D.Administer IV metoprolol 5 mg to control heart rate
Explanation: Acute pulmonary edema with hypoxemia and crackles is treated with IV loop diuretics and noninvasive ventilation (BiPAP/CPAP) to reduce preload/afterload and work of breathing. Fluid bolus worsens pulmonary edema. Beta-blockers are contraindicated in acute decompensation.
6A patient on amiodarone 1 mg/min maintenance infusion after cardiac arrest develops a widened QRS and prolonged QT interval. Which action is MOST important?
A.Monitor for torsades de pointes and hold the infusion if QTc exceeds 500 ms or QRS widens >50%
B.Increase the amiodarone rate to 2 mg/min for better dysrhythmia control
C.Administer IV calcium gluconate 1 g to reverse the ECG changes
D.Discontinue all cardiac monitoring to reduce alarm fatigue
Explanation: Amiodarone prolongs the QT interval and can cause torsades de pointes; it also widens the QRS. The infusion should be held/re-evaluated if QTc exceeds 500 ms or QRS widens >50% of baseline. Calcium gluconate is for hyperkalemia or calcium channel blocker overdose, not amiodarone toxicity.
7A PCU patient with acute MI develops third-degree AV block with a ventricular rate of 38 bpm and SBP 78 mmHg. What is the priority intervention?
A.Apply transcutaneous pacing pads and begin TCP at 60-80 mA until capture is achieved
B.Administer adenosine 6 mg rapid IV push to convert the rhythm
C.Give atropine 1 mg IV push and repeat up to 3 mg total
D.Start a dopamine drip at 20 mcg/kg/min as the sole intervention
Explanation: Symptomatic high-grade AV block (third-degree with hypotension) requires immediate transcutaneous pacing. Atropine may be tried for symptomatic bradycardia but is often ineffective for infranodal (Mobitz II/third-degree) blocks. Adenosine is contraindicated (it will further block conduction).
8A patient with cardiogenic shock has a pulmonary artery catheter showing: PCWP 28 mmHg (elevated), CI 1.8 L/min/m^2 (low), SVR high. Which pharmacologic combination is most consistent with guideline-directed therapy?
A.Dobutamine (inotrope) to improve cardiac output and a low-dose vasopressor only if MAP remains <65
B.Aggressive 30 mL/kg crystalloid bolus followed by norepinephrine alone
C.Nitroprusside alone to reduce afterload without any inotropic support
D.Furosemide infusion plus beta-blocker to reduce myocardial oxygen demand
Explanation: Cardiogenic shock with high PCWP (pulmonary congestion) and low CI requires inotropic support (dobutamine or milrinone) to improve contractility and output; a vasopressor (norepinephrine) is added only if MAP remains <65. Large fluid boluses worsen pulmonary edema. Beta-blockers are contraindicated in acute shock.
9A patient is on a norepinephrine drip at 0.3 mcg/kg/min for septic shock. The IV site is swollen, cool, and pale. What is the priority nursing action?
A.Stop the infusion at that site, notify the provider, and prepare for local vasodilator (phentolamine) per protocol
B.Increase the drip rate to overcome the extravasation effect
C.Apply a cold compress to the site to reduce swelling
D.Document the finding and continue the infusion through the same IV
Explanation: Norepinephrine extravasation causes severe tissue ischemia/necrosis due to alpha-1 vasoconstriction. The infusion must be stopped at that site immediately; phentolamine (alpha-blocker) 5-10 mg in 10 mL saline infiltrated subcutaneously at the site is the antidote. Cold compresses worsen vasoconstriction.
10A patient with new-onset atrial fibrillation has a ventricular rate of 148 and BP 80/50. Which intervention is MOST appropriate per ACLS?
A.Synchronized cardioversion beginning at 120-200 J (biphasic)
B.Administer diltiazem 0.25 mg/kg IV to slow the rate
C.Give amiodarone 150 mg IV over 10 minutes as first-line for the unstable patient
D.Administer adenosine 6 mg rapid IV push to attempt rhythm conversion
Explanation: Unstable atrial fibrillation (hypotension, altered mental status, chest pain, or heart failure) requires immediate synchronized cardioversion. Rate-control agents (diltiazem) and amiodarone are for the stable patient. Adenosine is for reentrant SVT, not AFib.

About the PCCN (Adult) Exam

PCCN is AACN's specialty certification for adult progressive care nurses in step-down, telemetry, and intermediate-acuity environments. The exam emphasizes clinical judgment, early deterioration recognition, and professional caring practice.

Questions

150 scored questions

Time Limit

3 hours

Passing Score

82 out of 125 scored items

Exam Fee

$255 AACN members / $370 non-members (AACN Certification Corporation / PSI)

PCCN (Adult) Exam Content Outline

20%

Cardiovascular

Perfusion trends, dysrhythmia priorities, ACS/heart-failure escalation, and step-down hemodynamic surveillance

14%

Respiratory

Oxygenation and ventilation deterioration patterns, ABG interpretation, and progressive-care respiratory escalation

27%

Endocrine/Hematology/Immunology/Oncology/Neurology/GI/Renal

Cross-system instability, metabolic derangements, neurologic changes, and renal/GI complication response priorities

20%

Musculoskeletal/Multisystem/Behavioral-Psychosocial

Mobility-risk safety, sepsis/multiorgan progression, and behavioral-psychosocial nursing judgment in intermediate-acuity care

20%

Professional Caring & Ethical Practice

Advocacy, moral agency, systems thinking, collaboration, diversity, and end-of-life communication in progressive care

How to Pass the PCCN (Adult) Exam

What You Need to Know

  • Passing score: 82 out of 125 scored items
  • Exam length: 150 questions
  • Time limit: 3 hours
  • Exam fee: $255 AACN members / $370 non-members

Keys to Passing

  • Complete 500+ practice questions
  • Score 80%+ consistently before scheduling
  • Focus on highest-weighted sections
  • Use our AI tutor for tough concepts

PCCN (Adult) Study Tips from Top Performers

1Train first-action recognition for step-down deterioration patterns (respiratory decline, perfusion drift, neurologic change) before full differential workups
2Use trend-based reasoning across vitals, labs, telemetry, and mental status instead of isolated single-value interpretation
3Build timed mixed sets that reflect the 80/20 PCCN framework so clinical judgment stays primary while professional practice remains protected
4Practice escalation-language drills: what to report, when to activate higher-level support, and how to close the communication loop
5Review ethics and advocacy scenarios weekly, especially goals-of-care alignment, family communication, and culturally responsive decision-making

Frequently Asked Questions

How many questions are on the PCCN (Adult) exam?

AACN's PCCN direct-care handbook lists 150 total items: 125 scored questions and 25 unscored pretest questions.

How long is the PCCN exam?

AACN lists a 3-hour testing appointment for the adult PCCN exam.

What score is needed to pass PCCN?

AACN's certification exam statistics page lists the adult PCCN cut score as 82 correct answers out of 125 scored items, effective January 31, 2024.

What are the PCCN test-plan weightings?

AACN's PCCN direct-care test plan uses an 80/20 framework: Clinical Judgment (80%) and Professional Caring & Ethical Practice (20%). Domain weights in the current plan include cardiovascular 20%, respiratory 14%, endocrine/hematology/immunology/oncology/neurology/GI/renal 27%, and musculoskeletal/multisystem/behavioral-psychosocial 20%.

What are PCCN eligibility requirements for direct care hours?

AACN's handbook lists two options: 1) 1,750 RN/APRN direct-care hours with acutely ill adult patients in the previous 2 years (including 875 in the most recent year), or 2) 2,000 hours in the previous 5 years (including 144 in the most recent year).

How much does PCCN certification cost?

AACN's current handbook lists the initial PCCN exam fee as $255 for AACN members and $370 for non-members.

What is the difference between PCCN and CCRN?

PCCN targets progressive-care/intermediate-acuity nursing practice, while CCRN targets acute/critical-care practice. Both exams use AACN's Synergy Model, but question emphasis differs by patient acuity and care setting.