NUR 445 EVALUATION EXAM 2026 QUESTIONS AND
ANSWERS GRADED A+
✔✔How is a first degree heart block treated? - ✔✔typically asymptomatic
withhold digitalis
✔✔First Degree Heart Block - ✔✔
✔✔What are some characteristics of a second degree AV block (Mobitz I or
Wenckebach)? - ✔✔PR interval lengthens with each beat until QRS is dropped or
missing
RR irregular
Atrial > ventricular
✔✔What cause a second degree AV block (Mobitz I or Wenckebach)? - ✔✔hypoxemia,
MI, heart disease, rheumatic fever, vagal stimulation, electrolyte imbalance, drugs
✔✔How is a second degree AV block (Mobitz 1 or Wenckebach) treated? - ✔✔atropine,
dopamine, epinephrine, temporary pacemaker, permanent pacemaker, withhold digitalis
✔✔Second Degree Heart Block (Mobitz I/Wenckebach) - ✔✔
✔✔What are some characteristics of a second degree AV block (Mobitz II)? -
✔✔constantly dropping QRS complex
RR irregular
Atrial > ventricular
✔✔How is a second degree AV block (Mobitz II) treated? - ✔✔atropine, dopamine,
epinephrine, temporary pacemaker, permanent pacemaker
✔✔What are some characteristics of a third degree AV block (complete block)? - ✔✔No
relationship between P and QRS, as they are paced by separate pacemakers
QRS may be widened
✔✔Second Degree Heart Block (Mobitz II) - ✔✔
✔✔How is a third degree AV block (complete block) treated? - ✔✔atropine, dopamine,
epinephrine, temporary pacemaker, permanent pacemaker
✔✔Third Degree Heart Block (Complete Heart Block) - ✔✔
✔✔What drug class is amiodarone? - ✔✔Potassium Channel Blocker
,✔✔What is the action of amiodarone? - ✔✔acts on cardiac tissue to prolong the
duration of the action potential refractory period, without altering the resting membrane
potential
✔✔What is amiodarone used for? - ✔✔Ventricular dysrhythmias, supraventricular
dysrhythmias, a-fib
✔✔What is the loading dose of amiodarone? - ✔✔150 mg/10 minutes
360 mg/6 hours
✔✔What is the maintenance dose of amiodarone? - ✔✔540 mg, 0.5 mg/min for 18
hours, and then continue after 24 hours, then convert from IV to PO
✔✔What are some side effects of amiodarone? - ✔✔hypotension, dizziness,
brachycardia, sinus arrest, pulmonary toxicity
✔✔What are some nursing actions for amiodarone? - ✔✔correct hypotension, check K+
and Mg+ prior to administration, infuse slowly, sustained monitoring
✔✔What assessment is necessary prior to administering an antidysrhythmic? - ✔✔VS,
ECG (8-step), CV, respiratory, neuro
✔✔What should the nurse instruct the patient to report regarding SE of
antidysrhythmics? - ✔✔dizziness, palpitations, skin rashes, wheezing
✔✔What is cardioversion? - ✔✔a form of countershock that delivers electrical current
synchronized with the patient's heart rhythm
typically 50-200 joules
✔✔What is defibrillation? - ✔✔unsynchronized electric shock that delivers a large
number of joules
typically 200-360
✔✔What rhythms might be cardioverted? - ✔✔SVT, a-fib, a-flutter, v-tach with pulse
✔✔What complications must be assessed after cardioversion? - ✔✔embolic event,
respiratory depression, skin burns, dysrhythmias
✔✔What rhythms would be defibrillated? - ✔✔v-tach or v-fib
✔✔What are pacemakers? - ✔✔a pulse generator used to provide an electrical stimulus
to the heart when the heart can't create its own impulses at a rate that maintains CO
, ✔✔What are 4 different methods that a patient could be paced? - ✔✔external
pacemaker, epicardial pacemaker, transvenous pacemaker, permanent implanted
pacemaker
✔✔What is failure to sense? - ✔✔if a pacemaker doesn't recognize the patient's own
rhythm
✔✔Failure to Sense - ✔✔
✔✔What is failure to capture? - ✔✔the pacemaker initiates an impulse but the heart
does not respond, or impulse is not strong enough
✔✔Failure To Capture - ✔✔
✔✔What is failure to fire/pace? - ✔✔pacemaker fails to send out an electrical impulse
✔✔Failure to Fire/Pace - ✔✔
✔✔What is an ICD? - ✔✔implantable cardioverter-defibrillator designed to recognize
and terminate ventricular tachyarrhythmias that cause sudden death
✔✔Why might a patient need an ICD? - ✔✔Prior aborted sudden cardiac death, proven
sustained v-tach, special groups (cardiomyopathy)
✔✔What education is necessary for a patient with an ICD? - ✔✔expect an internal
shock (pull over, sit down)
keep diary of shocks/activities/symptoms/response
contact cardiologist after a shock
understand and adhere to restrictions/limitations
avoid strong electromagnetic fields
consult provider before MRI
Avoid arc welders and large industrial motors
Use phone on opposite side of ICD
✔✔What is regurgitation? - ✔✔the backward flow of blood
✔✔What is stenosis? - ✔✔When a valve thickens/stiffens/fuses together, causing the
opening to narrow and not fully opening or closing
✔✔What stream of blood flow is obstructed in mitral stenosis? - ✔✔from the LA to the
LV during diastole
ANSWERS GRADED A+
✔✔How is a first degree heart block treated? - ✔✔typically asymptomatic
withhold digitalis
✔✔First Degree Heart Block - ✔✔
✔✔What are some characteristics of a second degree AV block (Mobitz I or
Wenckebach)? - ✔✔PR interval lengthens with each beat until QRS is dropped or
missing
RR irregular
Atrial > ventricular
✔✔What cause a second degree AV block (Mobitz I or Wenckebach)? - ✔✔hypoxemia,
MI, heart disease, rheumatic fever, vagal stimulation, electrolyte imbalance, drugs
✔✔How is a second degree AV block (Mobitz 1 or Wenckebach) treated? - ✔✔atropine,
dopamine, epinephrine, temporary pacemaker, permanent pacemaker, withhold digitalis
✔✔Second Degree Heart Block (Mobitz I/Wenckebach) - ✔✔
✔✔What are some characteristics of a second degree AV block (Mobitz II)? -
✔✔constantly dropping QRS complex
RR irregular
Atrial > ventricular
✔✔How is a second degree AV block (Mobitz II) treated? - ✔✔atropine, dopamine,
epinephrine, temporary pacemaker, permanent pacemaker
✔✔What are some characteristics of a third degree AV block (complete block)? - ✔✔No
relationship between P and QRS, as they are paced by separate pacemakers
QRS may be widened
✔✔Second Degree Heart Block (Mobitz II) - ✔✔
✔✔How is a third degree AV block (complete block) treated? - ✔✔atropine, dopamine,
epinephrine, temporary pacemaker, permanent pacemaker
✔✔Third Degree Heart Block (Complete Heart Block) - ✔✔
✔✔What drug class is amiodarone? - ✔✔Potassium Channel Blocker
,✔✔What is the action of amiodarone? - ✔✔acts on cardiac tissue to prolong the
duration of the action potential refractory period, without altering the resting membrane
potential
✔✔What is amiodarone used for? - ✔✔Ventricular dysrhythmias, supraventricular
dysrhythmias, a-fib
✔✔What is the loading dose of amiodarone? - ✔✔150 mg/10 minutes
360 mg/6 hours
✔✔What is the maintenance dose of amiodarone? - ✔✔540 mg, 0.5 mg/min for 18
hours, and then continue after 24 hours, then convert from IV to PO
✔✔What are some side effects of amiodarone? - ✔✔hypotension, dizziness,
brachycardia, sinus arrest, pulmonary toxicity
✔✔What are some nursing actions for amiodarone? - ✔✔correct hypotension, check K+
and Mg+ prior to administration, infuse slowly, sustained monitoring
✔✔What assessment is necessary prior to administering an antidysrhythmic? - ✔✔VS,
ECG (8-step), CV, respiratory, neuro
✔✔What should the nurse instruct the patient to report regarding SE of
antidysrhythmics? - ✔✔dizziness, palpitations, skin rashes, wheezing
✔✔What is cardioversion? - ✔✔a form of countershock that delivers electrical current
synchronized with the patient's heart rhythm
typically 50-200 joules
✔✔What is defibrillation? - ✔✔unsynchronized electric shock that delivers a large
number of joules
typically 200-360
✔✔What rhythms might be cardioverted? - ✔✔SVT, a-fib, a-flutter, v-tach with pulse
✔✔What complications must be assessed after cardioversion? - ✔✔embolic event,
respiratory depression, skin burns, dysrhythmias
✔✔What rhythms would be defibrillated? - ✔✔v-tach or v-fib
✔✔What are pacemakers? - ✔✔a pulse generator used to provide an electrical stimulus
to the heart when the heart can't create its own impulses at a rate that maintains CO
, ✔✔What are 4 different methods that a patient could be paced? - ✔✔external
pacemaker, epicardial pacemaker, transvenous pacemaker, permanent implanted
pacemaker
✔✔What is failure to sense? - ✔✔if a pacemaker doesn't recognize the patient's own
rhythm
✔✔Failure to Sense - ✔✔
✔✔What is failure to capture? - ✔✔the pacemaker initiates an impulse but the heart
does not respond, or impulse is not strong enough
✔✔Failure To Capture - ✔✔
✔✔What is failure to fire/pace? - ✔✔pacemaker fails to send out an electrical impulse
✔✔Failure to Fire/Pace - ✔✔
✔✔What is an ICD? - ✔✔implantable cardioverter-defibrillator designed to recognize
and terminate ventricular tachyarrhythmias that cause sudden death
✔✔Why might a patient need an ICD? - ✔✔Prior aborted sudden cardiac death, proven
sustained v-tach, special groups (cardiomyopathy)
✔✔What education is necessary for a patient with an ICD? - ✔✔expect an internal
shock (pull over, sit down)
keep diary of shocks/activities/symptoms/response
contact cardiologist after a shock
understand and adhere to restrictions/limitations
avoid strong electromagnetic fields
consult provider before MRI
Avoid arc welders and large industrial motors
Use phone on opposite side of ICD
✔✔What is regurgitation? - ✔✔the backward flow of blood
✔✔What is stenosis? - ✔✔When a valve thickens/stiffens/fuses together, causing the
opening to narrow and not fully opening or closing
✔✔What stream of blood flow is obstructed in mitral stenosis? - ✔✔from the LA to the
LV during diastole
