PCCN Cheat Sheet 2026

The 30 highest-yield PCCN facts, distilled from real exam questions. Print it, save it as a PDF, or study it here — free, no sign-up.

1. Which of the following best describes the mechanism of action of ACE inhibitors? → Inhibits conversion of angiotensin I to angiotensin II
2. A patient receiving heparin begins to develop signs of heparin-induced thrombocytopenia (HIT). What is the most appropriate action? → Discontinue heparin and notify the provider
3. A patient receiving total parenteral nutrition (TPN) via a central line suddenly becomes febrile and hypotensive. What is the nurse’s priority action? → Stop the TPN and obtain blood cultures
4. Which laboratory result is most indicative of acute pancreatitis? → Elevated amylase and lipase
5. Which ethical principle involves doing no harm to the patient? → Nonmaleficence
6. Which complication is most associated with persistent ST-segment elevation following a myocardial infarction? → Ventricular aneurysm
7. Which intervention is contraindicated in a patient with severe thrombocytopenia (platelets < 20,000/mm³)? → Rectal temperature measurement
8. Which laboratory result requires immediate reporting in a patient suspected of having thrombotic thrombocytopenic purpura (TTP)? → Peripheral smear showing schistocytes
9. A patient is prescribed a fentanyl patch for chronic pain. Which of the following instructions is most important? → Avoid exposing the patch to heat
10. Which laboratory finding is most consistent with disseminated intravascular coagulation (DIC)? → Low fibrinogen and elevated D-dimer
11. What principle of ethical practice is demonstrated by respecting a patient’s right to refuse treatment? → Autonomy
12. A patient with liver cirrhosis is at risk for hepatic encephalopathy. Which assessment finding most supports this diagnosis? → Asterixis (flapping hand tremor)
13. Which assessment finding indicates the progressive care patient with systemic inflammatory response is developing organ hypoperfusion? → Urine output of 0.3 mL/kg/hr for 3 hours
14. Which medication is typically administered to reverse the effects of opioid overdose? → Naloxone
15. A patient with chronic kidney disease reports nausea, fatigue, and a metallic taste. Which lab result supports uremia? → BUN 80 mg/dL
16. Which symptom is most specific for myocardial infarction (MI) in older adult women? → Jaw pain and fatigue
17. Which condition is characterized by a sudden onset of sharp chest pain and dyspnea, often associated with a pneumothorax? → Pneumothorax
18. When preparing to transfuse irradiated blood products, the nurse understands this measure prevents which complication? → Transfusion-associated graft-versus-host disease
19. A patient has a central venous catheter. Which sign most suggests a catheter-related bloodstream infection? → Fever with no obvious source
20. Which adverse effect should the nurse monitor for when a patient is receiving furosemide? → Hypokalemia
21. Which electrolyte imbalance is most associated with mental status changes and muscle cramps? → Hyponatremia
22. Which intervention is most appropriate for a patient with upper gastrointestinal bleeding and hematemesis? → Administering proton pump inhibitor
23. What is the primary goal of thrombolytic therapy in patients with acute myocardial infarction (MI)? → Dissolve the existing blood clot
24. A patient with immune thrombocytopenic purpura (ITP) has a platelet count of 10,000/mm³. Which finding would require the most urgent intervention? → Sudden severe headache and altered mental status
25. What is the primary concern when administering IV potassium chloride to a patient? → Arrhythmias
26. Which assessment tool is specifically validated for measuring delirium in acute care settings? → Confusion Assessment Method (CAM)
27. A patient on heparin infusion has a PTT of 210 seconds (goal 60–100 seconds). What is the priority nursing action? → Hold the infusion and notify the provider
28. Confidentiality is best maintained in the progressive care setting by: → Speaking quietly during handoff at the nurses' station
29. Which of the following signs is most concerning for impending brain herniation in a patient with traumatic brain injury? → Dilated, non-reactive pupils
30. A nurse notices that a colleague is documenting vital signs without actually taking them. What is the most appropriate first step? → Report the behavior to the nurse manager