PCCN Practice Questions: AACN's Official Samples, Its Practice Exam, and Five Original Items Explained

Searching for PCCN practice questions turns up everything from AACN's own practice exam to files that claim to contain the real thing. The useful kind teaches you how AACN asks questions and shows you where your reasoning slips; the risky kind can cost you the credential. This guide sorts the official options, explains what to avoid, and then gives five original questions with the reasoning and source behind each answer.

Official PCCN practice: what AACN offers

Checked on AACN's pages and handbooks on October 27, 2026:

AACN's product pages say the questions "reflect the style of those on the actual exam" and align with the PCCN test plan's content areas, and offer a timed virtual test-day experience with notes, feedback and marking. They also say, plainly, that the practice exams "are not psychometrically valid exams and cannot be used to accurately predict or guarantee performance on an actual certification exam." AACN Certification Corporation also states that it doesn't approve, endorse or require any particular prep product. The PCCN exam cost guide puts these prices next to the exam fees.

What AACN's nine PCCN sample questions show

The handbook says the samples exist "to familiarize candidates with the style and format" of exam items. Read them in the handbook itself rather than in copies elsewhere. What they show, without reproducing them:

• Seven clinical, two professional practice. The clinical items span rhythm-related, vascular, infectious, respiratory and post-MI or post-PCI situations; the other two concern a family's request and patient education materials.
• Qualifiers in capitals. Five stems ask for the INITIAL, MOST LIKELY, IMMEDIATE, BEST or MOST EFFECTIVE choice, which means more than one option can look reasonable.
• One stem, four options. That matches the policy handbook's description of every exam item.
• No explanations. The answer key gives only letters, so work out why each wrong option is wrong yourself; that habit carries straight over to the real exam.

Free PCCN practice beyond AACN, and what to avoid

The free PCCN practice questions on this site are 20 original questions with an explanation for every answer, and they need no account. They are Passy's own items, not AACN's, and 20 questions are a sampler, not a score. For a full-length rehearsal later, full prep at launch includes the planned timed mock exam that mirrors the 150-question format.

For any other bank or book, two checks protect you:

• Is it current? The exam has had 150 questions in 3 hours under the February 2024 test plan; a resource built around a 125-question exam predates it.
• Is it original? The PCCN honor statement commits you to keep exam content confidential, and the policy handbook says anyone who receives, discloses or reconstructs exam questions, including through memorization, is subject to legal action, damages, and denial or revocation of certification. Material advertised as "real" or "recalled" PCCN questions is a risk to your credential, not a shortcut.

Five original PCCN-style questions, written by Passy

These are teaching items written for this guide. They are not AACN items and don't come from any exam. Each answer cites the source it rests on.

Question 1: trending a QTc (Cardiovascular)

A telemetry patient started a QT-prolonging antibiotic this morning, and you are asked to trend her QTc through the shift. Which approach gives the most reliable trend?

• A. Measure whichever lead shows the tallest R wave on each strip
• B. Measure the same lead each time with the same tool and formula
• C. Apply Bazett's correction only when her heart rate is above 100/min
• D. Measure only when the monitor's automated QTc alarm sounds

Keyed answer: B. The AHA/ACCF statement on preventing torsade de pointes says that before and after a drug is given, a consistent method should be used: the same recording device, ECG lead, measurement tool and heart rate correction formula. A is wrong because the statement asks for a lead with a T wave of at least 2 mm and a clearly defined end, kept the same over time. C is wrong because switching formulas breaks the trend; the statement also notes that Bazett tends to run long at faster rates, above about 85/min. D is wrong because the statement suggests documenting the QTc before and at least every 8 to 12 hours after a QT-prolonging drug is started. The PCCN cardiovascular review works through a full QTc calculation.

Question 2: a patient on BiPAP (Respiratory)

A patient with a COPD exacerbation has been on BiPAP for 90 minutes. She is now harder to rouse and has just vomited. What should the nurse do first?

• A. Increase the inspiratory pressure and reassess her in 30 minutes
• B. Remove the mask and get the provider to the bedside for possible intubation
• C. Switch her to a non-rebreather mask at high flow and keep observing
• D. Give an antiemetic and refit the mask more tightly to stop leaks

Keyed answer: B. The MSD Manual's NPPV chapter lists vomiting and obtundation among the absolute contraindications to noninvasive ventilation, because the airway is unprotected and aspiration is possible, and it names decreasing alertness as an indication to convert to intubation. Its COPD chapter also lists deteriorating mental status as an indication for intubation. A and D keep or intensify a therapy she can no longer safely receive. C is wrong because the MSD Manual's COPD chapter advises controlled oxygen, by nasal prongs or Venturi mask, in patients prone to hypercarbia, and says patients who deteriorate need more respiratory support, not less.

Question 3: screening for sepsis (Multisystem)

A step-down patient with suspected pneumonia has a temperature of 38.6 °C, heart rate 112/min, respiratory rate 24/min, blood pressure 104/62 mm Hg and WBC 14,000/mcL. He is alert and oriented. His qSOFA score is 1. What is the best conclusion?

• A. A qSOFA score below 2 rules out sepsis, so no escalation is needed
• B. His SIRS screen is positive, so escalate through the sepsis process
• C. Wait for the lactate result before notifying the provider
• D. He meets criteria for septic shock and needs a vasopressor

Keyed answer: B. By the MSD Manual's criteria he meets four of four SIRS criteria (temperature above 38 °C, heart rate above 90, respiratory rate above 20, WBC above 12,000) but only one qSOFA criterion (respiratory rate of 22 or more). The 2026 Surviving Sepsis Campaign guidelines recommend NEWS, NEWS2, MEWS or SIRS over qSOFA as a single screening tool, and state that sepsis shouldn't be ruled in or out by a single test, so A is wrong. C is wrong because SSC 2026 calls sepsis a medical emergency in which treatment should begin immediately; it suggests measuring lactate, not waiting for it. D is wrong because septic shock requires vasopressors to hold a MAP of 65 mm Hg or more, and nothing here shows that.

Question 4: urinary catheter care (Multisystem)

Which action by the nurse follows CDC's guideline for preventing catheter-associated urinary tract infections?

• A. Replacing the catheter and drainage bag every 72 hours
• B. Clamping the catheter before removal to retrain the bladder
• C. Keeping the drainage bag below bladder level and off the floor
• D. Irrigating the catheter daily with saline to keep it patent

Keyed answer: C. CDC's 2009 guideline (updated 2019) says to keep the collecting bag below the level of the bladder at all times and not to rest it on the floor (Category IB). A is wrong: changing catheters or bags at routine, fixed intervals isn't recommended. B is wrong: CDC says clamping before removal isn't necessary. D is wrong: bladder irrigation isn't recommended unless obstruction is anticipated.

Question 5: checking discharge teaching (Professional Caring and Ethical Practice)

You have taught a patient with heart failure to weigh himself every morning at home. Which question best confirms that he understood?

• A. "Do you understand when you should call us about your weight?"
• B. "Does everything I explained about weighing yourself make sense?"
• C. "In your own words, tell me how you'll weigh yourself each morning."
• D. "Would you like me to go over the weight instructions again?"

Keyed answer: C. This is facilitation of learning. AHRQ's teach-back tool describes checking understanding by asking patients to state in their own words what they need to know or do, and says "Do you understand?" and "Does that make sense?" are not teach-back questions, which rules out A and B. D offers more teaching without checking anything. The teaching itself is sound: the MSD Manual's chronic heart failure chapter says daily morning weights help detect fluid retention early. The PCCN Professional Caring and Ethical Practice guide covers the rest of the 20%.

When explanations like these help, the full planned bank of 850 PCCN questions is written the same way, with a reason for every option.

How to review PCCN practice so it changes your score

A practical approach, not an AACN rule:

1. Time yourself. Aim for about 72 seconds a question, the exam's average pace (Passy's arithmetic: 180 minutes for 150 questions).
2. Explain every option. For each question, say why the keyed answer is right and why each other option is wrong, as above. Getting a question right for the wrong reason is still a gap.
3. Log every miss twice. Note the test plan category and the reason: missing knowledge, a misread stem or qualifier, or second-guessing.
4. Mix the categories. The real exam doesn't announce the topic, so after a few category-focused sets, switch to mixed sets.
5. Track trends, not one number. Neither AACN's practice exam nor Passy's questions predict a result; the PCCN passing score guide explains why. Watch whether your misses per category shrink.
6. Rehearse once at full length. Sit 150 questions in 3 hours at least once before test day.

At launch, full prep is planned to keep a Fix It list of every PCCN question you miss, which handles part of step 3 for you.

Your next step with PCCN practice questions

Download the handbook and work the nine samples untimed, writing a one-line reason for each answer before you check the key. Then take the free 20-question set timed and sort your misses by category. In your final weeks, one timed 150-question sitting covers step 6, and the PCCN study plan guide shows how to fit practice into your weeks.