NR 341 EXAM 1 COMPLETE STUDY GUIDE
WITH ACTUAL EXAM QUESTIONS OF 2026
WITH CORRECT ANSWERS
The patient has an irregular heart rhythm. To determine an
accurate heart rate, the nurse first:
a. identifies the markers on the ECG paper that indicate a 6-
second strip.
b. counts the number of large boxes between two consecutive P
waves.
c. counts the number of small boxes between two consecutive
QRS complexes.
d. divides the number of complexes in a 6-second strip by 10.
Correct Answer A
Six-second method: A quick and easy estimate of heart rate can
be accomplished by counting the number of P waves or QRS
waves within a 6-second strip to obtain atrial and ventricular heart
rates per minute. This is the optimal method for irregular rhythms.
Identify the lines above the ECG paper that represent 6 seconds,
and count the number of P waves within the lines; then add a zero
(multiply by 10) to identify the atrial heart rate estimate for 1
minute. Next, identify the number of QRS waves in the 6-second
strip and again add a zero to identify the ventricular rate.
,The nurse is calculating the rate for a regular rhythm. There are
20 small boxes between each P wave and 20 small boxes
between each R wave. What is the ventricular rate?
a. 50 beats/min
b. 75 beats/min
c. 85 beats/min
d. 100 beats/min Correct Answer B
The rule of 1500 is used to calculate the exact rate of a regular
rhythm. The number of small boxes between the highest points of
two consecutive R waves is counted, and that number of small
boxes is divided into 1500 to determine the ventricular rate.
1500/20 = 75 beats/min. This method is accurate only if the
rhythm is regular
The patient is admitted with a fever and rapid heart rate. The
patient's temperature is 103° F (39.4° C).The nurse places the
patient on a cardiac monitor and finds the patient's atrial and
ventricular rates are above 105 beats per minute. P waves are
clearly seen and appear normal in configuration. QRS complexes
are normal in appearance and 0.08 seconds wide. The rhythm is
regular, and blood pressure is normal. The nurse should focus on
providing:
a. medications to lower heart rate.
b. treatment to lower temperature.
c. treatment to lower cardiac output.
d. treatment to reduce heart rate. Correct Answer B
,Sinus tachycardia results when the SA node fires faster than 100
beats per minute. Sinus tachycardia is a normal response to
stimulation of the sympathetic nervous system. Sinus tachycardia
is also a normal finding in children younger than 6 years. Both
atrial and ventricular rates are greater than 100 beats per minute,
up to 160 beats per minute, but may be as high as 180 beats per
minute. Sinus tachycardia is regular or essentially regular. PR
interval is 0.12 to 0.20 seconds. QRS interval is 0.06 to 0.10
seconds. P and QRS waves are consistent in shape. P waves are
small and rounded. A P wave precedes every QRS complex,
which is then followed by a T wave.
Which of the following is true about a patient diagnosed with sinus
arrhythmia?
a. The heart rate varies, dependent on vagal tone and respiratory
pattern.
b. Immediate treatment is essential to prevent death.
c. Sinus arrhythmia is not well tolerated by most patients.
d. PR and QRS interval measurements are prolonged. Correct
Answer A
Sinus arrhythmia is a cyclical change in heart rate that is
associated with respiration. The heart rate increases slightly
during inspiration and slows slightly during exhalation because of
changes in vagal tone. The ECG tracing demonstrates an
alternating pattern of faster and slower heart rate that changes
with the respiratory cycle.
, Which of the following nursing activities demonstrates
implementation of the AACN Standards of Professional
Performance? (Select all that apply.)
a. Attending a meeting of the local chapter of the American
Association of Critical-Care Nurses in which a continuing
education program on sepsis is being taught
b. Collaborating with a pastoral services colleague to assist in
meeting spiritual needs of the patient and family
c. Participating on the unit's nurse practice council
d. Posting an article from Critical Care Nurse on management of
venous thromboembolism for your colleagues to read
e. Using evidence-based strategies to prevent ventilator-
associated pneumonia Correct Answer a,b,c,d,e
The patient is admitted with sinus pauses causing periods of loss
of consciousness. The patient is asymptomatic, awake and alert,
but fatigued. He answers questions appropriately. When admitting
this patient, the nurse should first:
a. prepare the patient for temporary pacemaker insertion.
b. prepare the patient for permanent pacemaker insertion.
c. assess the patient's medication profile.
d. apply transcutaneous pacemaker paddles. Correct Answer c
The patient's heart rate is 165 beats per minute. His cardiac
monitor shows a rapid rate with narrow QRS complexes. The P
WITH ACTUAL EXAM QUESTIONS OF 2026
WITH CORRECT ANSWERS
The patient has an irregular heart rhythm. To determine an
accurate heart rate, the nurse first:
a. identifies the markers on the ECG paper that indicate a 6-
second strip.
b. counts the number of large boxes between two consecutive P
waves.
c. counts the number of small boxes between two consecutive
QRS complexes.
d. divides the number of complexes in a 6-second strip by 10.
Correct Answer A
Six-second method: A quick and easy estimate of heart rate can
be accomplished by counting the number of P waves or QRS
waves within a 6-second strip to obtain atrial and ventricular heart
rates per minute. This is the optimal method for irregular rhythms.
Identify the lines above the ECG paper that represent 6 seconds,
and count the number of P waves within the lines; then add a zero
(multiply by 10) to identify the atrial heart rate estimate for 1
minute. Next, identify the number of QRS waves in the 6-second
strip and again add a zero to identify the ventricular rate.
,The nurse is calculating the rate for a regular rhythm. There are
20 small boxes between each P wave and 20 small boxes
between each R wave. What is the ventricular rate?
a. 50 beats/min
b. 75 beats/min
c. 85 beats/min
d. 100 beats/min Correct Answer B
The rule of 1500 is used to calculate the exact rate of a regular
rhythm. The number of small boxes between the highest points of
two consecutive R waves is counted, and that number of small
boxes is divided into 1500 to determine the ventricular rate.
1500/20 = 75 beats/min. This method is accurate only if the
rhythm is regular
The patient is admitted with a fever and rapid heart rate. The
patient's temperature is 103° F (39.4° C).The nurse places the
patient on a cardiac monitor and finds the patient's atrial and
ventricular rates are above 105 beats per minute. P waves are
clearly seen and appear normal in configuration. QRS complexes
are normal in appearance and 0.08 seconds wide. The rhythm is
regular, and blood pressure is normal. The nurse should focus on
providing:
a. medications to lower heart rate.
b. treatment to lower temperature.
c. treatment to lower cardiac output.
d. treatment to reduce heart rate. Correct Answer B
,Sinus tachycardia results when the SA node fires faster than 100
beats per minute. Sinus tachycardia is a normal response to
stimulation of the sympathetic nervous system. Sinus tachycardia
is also a normal finding in children younger than 6 years. Both
atrial and ventricular rates are greater than 100 beats per minute,
up to 160 beats per minute, but may be as high as 180 beats per
minute. Sinus tachycardia is regular or essentially regular. PR
interval is 0.12 to 0.20 seconds. QRS interval is 0.06 to 0.10
seconds. P and QRS waves are consistent in shape. P waves are
small and rounded. A P wave precedes every QRS complex,
which is then followed by a T wave.
Which of the following is true about a patient diagnosed with sinus
arrhythmia?
a. The heart rate varies, dependent on vagal tone and respiratory
pattern.
b. Immediate treatment is essential to prevent death.
c. Sinus arrhythmia is not well tolerated by most patients.
d. PR and QRS interval measurements are prolonged. Correct
Answer A
Sinus arrhythmia is a cyclical change in heart rate that is
associated with respiration. The heart rate increases slightly
during inspiration and slows slightly during exhalation because of
changes in vagal tone. The ECG tracing demonstrates an
alternating pattern of faster and slower heart rate that changes
with the respiratory cycle.
, Which of the following nursing activities demonstrates
implementation of the AACN Standards of Professional
Performance? (Select all that apply.)
a. Attending a meeting of the local chapter of the American
Association of Critical-Care Nurses in which a continuing
education program on sepsis is being taught
b. Collaborating with a pastoral services colleague to assist in
meeting spiritual needs of the patient and family
c. Participating on the unit's nurse practice council
d. Posting an article from Critical Care Nurse on management of
venous thromboembolism for your colleagues to read
e. Using evidence-based strategies to prevent ventilator-
associated pneumonia Correct Answer a,b,c,d,e
The patient is admitted with sinus pauses causing periods of loss
of consciousness. The patient is asymptomatic, awake and alert,
but fatigued. He answers questions appropriately. When admitting
this patient, the nurse should first:
a. prepare the patient for temporary pacemaker insertion.
b. prepare the patient for permanent pacemaker insertion.
c. assess the patient's medication profile.
d. apply transcutaneous pacemaker paddles. Correct Answer c
The patient's heart rate is 165 beats per minute. His cardiac
monitor shows a rapid rate with narrow QRS complexes. The P
