NSG 4100 Exam 3 Actual exam 2026/2027 with
100% correct answers
1. A 58-year-old client with a history of anterior wall MI and reduced ejection fraction is admitted
for chest pain. While in the telemetry unit, the client suddenly becomes unresponsive, apneic,
and pulseless. The cardiac monitor displays the rhythm below. The crash cart is at the bedside.
What is the nurse's priority action?
A. Initiate CPR and ventilate with bag-mask
B. Deliver an unsynchronized shock immediately
C. Administer epinephrine 1 mg IV
D. Check for a carotid pulse for 10 seconds
B — Unsynchronized defibrillation is priority for witnessed pulseless V-fib/V-tach. CPR continues
while charging.
,Ventricular Fibrillation (VF) • LITFL • ECG Library Diagnosis
2. A 72-year-old female client with hypokalemia and prolonged QT interval from diuretic therapy
develops episodes of syncope. The monitor shows the rhythm below during one episode. The
client is now hemodynamically stable but the rhythm persists intermittently. Which intervention
should the nurse anticipate as the most appropriate initial treatment?
A. IV lidocaine bolus
B. IV magnesium sulfate
C. Synchronized cardioversion
D. IV amiodarone infusion
1. B — Torsades with prolonged QT is treated with magnesium sulfate as first-line.
, Polymorphic VT and Torsades de Pointes (TdP) • LITFL
3. A 65-year-old male with known ischemic cardiomyopathy presents to the ED complaining of
palpitations and dizziness. BP is 88/56 mmHg, HR 180 bpm. The rhythm strip below is obtained.
The client is alert but diaphoretic. What is the most appropriate immediate intervention?
A. Administer adenosine
B. 6 mg IV push B. Prepare for synchronized cardioversion
C. C. Administer amiodarone 150 mg IV
D. D. Perform vagal maneuvers
B — Unstable monomorphic V-tach requires synchronized cardioversion.
100% correct answers
1. A 58-year-old client with a history of anterior wall MI and reduced ejection fraction is admitted
for chest pain. While in the telemetry unit, the client suddenly becomes unresponsive, apneic,
and pulseless. The cardiac monitor displays the rhythm below. The crash cart is at the bedside.
What is the nurse's priority action?
A. Initiate CPR and ventilate with bag-mask
B. Deliver an unsynchronized shock immediately
C. Administer epinephrine 1 mg IV
D. Check for a carotid pulse for 10 seconds
B — Unsynchronized defibrillation is priority for witnessed pulseless V-fib/V-tach. CPR continues
while charging.
,Ventricular Fibrillation (VF) • LITFL • ECG Library Diagnosis
2. A 72-year-old female client with hypokalemia and prolonged QT interval from diuretic therapy
develops episodes of syncope. The monitor shows the rhythm below during one episode. The
client is now hemodynamically stable but the rhythm persists intermittently. Which intervention
should the nurse anticipate as the most appropriate initial treatment?
A. IV lidocaine bolus
B. IV magnesium sulfate
C. Synchronized cardioversion
D. IV amiodarone infusion
1. B — Torsades with prolonged QT is treated with magnesium sulfate as first-line.
, Polymorphic VT and Torsades de Pointes (TdP) • LITFL
3. A 65-year-old male with known ischemic cardiomyopathy presents to the ED complaining of
palpitations and dizziness. BP is 88/56 mmHg, HR 180 bpm. The rhythm strip below is obtained.
The client is alert but diaphoretic. What is the most appropriate immediate intervention?
A. Administer adenosine
B. 6 mg IV push B. Prepare for synchronized cardioversion
C. C. Administer amiodarone 150 mg IV
D. D. Perform vagal maneuvers
B — Unstable monomorphic V-tach requires synchronized cardioversion.
