250 practice questions for the PCCN exam, the progressive care nursing certification for step-down, telemetry and intermediate care nurses, built on the PCCN Test Plan in use since February 6, 2024. They follow its 12 areas, weighted the way the real exam is, from Cardiovascular (20%), Multisystem (15%) and Respiratory (14%) to Neurology and Gastrointestinal (7% each), Endocrine (6%), Renal (4%) and the smaller areas, plus Professional Caring and Ethical Practice (20%), and cover every one of its 87 patient problems. Most are step-down cases: the sheath, the telemetry strip, the drip, the lab, and what the nurse should do FIRST, expect NEXT or question. Each is tagged to its test plan code, so your score report shows exactly which topics you miss, and every answer explains why the best choice is best and names its public source.
The real test: 150 multiple-choice questions (125 scored, 25 unscored) in 3 hours, at a PSI test center or by live remote proctoring, four choices each. AACN sets the passing score with an expert panel (a modified Angoff study) and does not publish a fixed number; you can take it up to four times in a rolling 12 months. Since February 6, 2024 it follows a test plan of 80% clinical judgment in ten body-system areas and 20% professional caring and ethical practice, for step-down, telemetry and intermediate care nurses. Our practice test is full length, 125 scored questions plus 25 unscored, split by the 12 areas like the test plan, passing at 70% (88 of 125).
Here: 250 questions. Our own practice questions, built on the PCCN Test Plan in use since February 6, 2024 and written from public sources (AHA, ACC/AHA and AHA/ASA guidelines, GOLD, GINA, the Surviving Sepsis Campaign, ADA, KDIGO, ACG, CDC, ASAM, CMS rules, the ANA Code of Ethics, AHRQ, ISMP, FDA labels and NIH StatPearls), with every answer's source named. Topics are the 12 areas of the test plan. Not AACN's test questions. Free.
Start studying, freeOpens the Step-Down Nurse Ticket study guide. No sign-up, nothing to install.| Topic | On the test | In the guide |
|---|---|---|
| 1A. Cardiovascular | ~25 | 50 |
| 2A. Respiratory | ~17 | 35 |
| 3A. Endocrine | ~7 | 15 |
| 3B. Hematology/Immunology/Oncology | ~4 | 8 |
| 3C. Neurology | ~9 | 17 |
| 3D. Gastrointestinal | ~9 | 17 |
| 3E. Renal | ~5 | 10 |
| 4A. Musculoskeletal | ~2 | 5 |
| 4B. Multisystem | ~19 | 36 |
| 4C. Behavioral/Psychosocial | ~4 | 7 |
| II. Advocacy, Caring Practices, Response to Diversity, Facilitation of Learning | ~14 | 28 |
| II. Collaboration, Systems Thinking, Clinical Inquiry | ~11 | 22 |
"On the test" is the rough share of a 125-question test for each topic, following the exam's published weights.
A patient on telemetry had chest pain at rest that eased with nitroglycerin. The ECG shows new ST depression in V4 to V6, and high-sensitivity troponin is normal at arrival and at 3 hours. What is the MOST likely diagnosis?
C. Unstable angina
Two days after admission for severe pancreatitis, a patient's SpO2 keeps falling despite moving from 4 L nasal cannula to a non-rebreather, and the chest x-ray shows new bilateral infiltrates. His BNP is normal. What does the nurse suspect?
C. ARDS
A patient asks what his hemoglobin A1c of 8.5% means. What should the nurse explain?
A. His average blood sugar over about 3 months
Which lab pattern fits iron deficiency anemia from slow GI blood loss?
C. Low hemoglobin, low MCV and low ferritin
A patient with cirrhosis who had been stable becomes confused and sleepy. Which recent event is MOST likely to have triggered hepatic encephalopathy?
A. A GI bleed, which adds protein to the gut
A patient with an adhesive small bowel obstruction is vomiting and has a distended abdomen. Which treatment does the nurse anticipate first?
D. NPO, IV fluids and a nasogastric tube to suction
A patient's urine output has dropped to almost nothing since surgery, and her bladder feels full. What should the nurse check FIRST?
A. A bladder scan for retention
An 80-year-old patient on the telemetry unit is at high risk for falls. Which intervention is MOST effective?
A. A tailored plan: scheduled toileting, nonskid footwear and a low bed
A patient with end-stage heart failure on comfort care now has mottled knees, cool hands, long pauses between breaths and very little urine. What should the nurse do?
D. Prepare the family that death may be near
A visitor is pacing, raising his voice and clenching his fists because his mother's discharge was delayed. What should the nurse do FIRST?
B. Calm voice, safe distance, acknowledge his frustration