COMPLEX ADULT HEALTH CHAMBERLAIN 2
COMPREHENSIVE STUDY GUIDE 2026
PRACTICE QUESTIONS AND ACCURATE
ANSWERS GRADED A+
◉ The patient's heart rate is 165 beats per minute. His cardiac
monitor shows a rapid rate with narrow QRS complexes. The P
waves cannot be seen, but the rhythm is regular. The patient's blood
pressure has dropped from 124/62 to 78/30. His skin is cold and
diaphoretic and he is complaining of nausea. The nurse prepares the
patient for:
a. administration of beta-blockers.
b. administration of atropine.
c. transcutaneous pacemaker insertion.
d. emergent cardioversion. Answer: D
If an abnormal P wave cannot be visualized on the ECG but the QRS
complex is narrow, the term supraventricular tachycardia (SVT) is
often used. This is a generic term that describes any tachycardia that
is not ventricular in origin; it is also used when the source above the
ventricles cannot be identified, usually because the rate is too fast.
Treatment is directed at assessing the patient's tolerance of the
tachycardia. If the rate is higher than 150 beats per minute and the
patient is symptomatic, emergent cardioversion is considered.
Cardioversion is the delivery of a synchronized electrical shock to
the heart by an external defibrillator.
,◉ The nurse is reading the cardiac monitor and notes that the
patient's heart rhythm is extremely irregular and there are no
discernible P waves. The ventricular rate is 90 beats per minute, and
the patient is hemodynamically stable. The nurse realizes that the
patient's rhythm is:
a. atrial fibrillation.
b. atrial flutter.
c. atrial flutter with rapid ventricular response.
d. junctional escape rhythm.. Answer: a
◉ The patient's heart rhythm shows an inverted P wave with a PR
interval of 0.06 seconds. The heart rate is 54 beats per minute. The
nurse recognizes the rhythm as a junctional escape rhythm, and
understands that the rhythm is due to the:
a. loss of sinus node activity.
b. increased rate of the AV node.
c. increased rate of the SA node.
d. decreased rate of the AV node.. Answer: a
◉ . Answer:
,◉ The patient's heart rate is 70 beats per minute, but the P waves
come after the QRS complex. The nurse correctly determines that
the patient's heart rhythm is:
a. a normal junctional rhythm.
b. an accelerated junctional rhythm.
c. a junctional tachycardia.
d. atrial fibrillation.. Answer: b
The normal intrinsic rate for the AV node and junctional tissue is 40
to 60 beats per minute, but rates can accelerate. An accelerated
junctional rhythm has a rate between 60 and 100 beats per minute,
and the rate for junctional tachycardia is greater than 100 beats per
minute.
◉ The patient is having premature ventricular contractions (PVCs).
The nurse's greatest concern should be:
a. the proximity of the R wave of the PVC to the T wave of a normal
beat.
b. the fact that PVCs are occurring, because they are so rare.
c. if the number of PVCs are decreasing.
d. if the PVCs are wider than 0.12 seconds.. Answer: a
◉ The nurse notices that the patient has a first-degree AV block.
Everything else about the rhythm is normal. The nurse should:
a. prepare to place the patient on a transcutaneous pacemaker.
, b. give the patient atropine to shorten the PR interval.
c. monitor the rhythm and patient's condition.
d. give the patient an antiarrhythmic medication.. Answer: C
First-degree AV block is a common dysrhythmia in the elderly and in
patients with cardiac disease. As the normal conduction pathway
ages or becomes diseased, impulse conduction becomes slower than
normal. It is well tolerated. No treatment is required. Continue to
monitor the patient and the rhythm.
◉ The nurse understands that in a third-degree AV block:
a. every P wave is conducted to the ventricles.
b. some P waves are conducted to the ventricles.
c. none of the P waves are conducted to the ventricles.
d. the PR interval is prolonged.. Answer: C
In first-degree AV block, a P wave precedes every QRS complex,
which is followed by a T wave indicating complete conduction. It is
represented on the ECG as a prolonged PR interval. Second-degree
heart block refers to AV conduction that is intermittently blocked.
Therefore, some P waves are conducted and some are not. Third-
degree block is often called complete heart block because no atrial
impulses are conducted through the AV node to the ventricles.
◉ The patient is asymptomatic but is diagnosed with second-degree
heart block Mobitz I. The patient is on digitalis medication at home.
The nurse should expect that:
COMPREHENSIVE STUDY GUIDE 2026
PRACTICE QUESTIONS AND ACCURATE
ANSWERS GRADED A+
◉ The patient's heart rate is 165 beats per minute. His cardiac
monitor shows a rapid rate with narrow QRS complexes. The P
waves cannot be seen, but the rhythm is regular. The patient's blood
pressure has dropped from 124/62 to 78/30. His skin is cold and
diaphoretic and he is complaining of nausea. The nurse prepares the
patient for:
a. administration of beta-blockers.
b. administration of atropine.
c. transcutaneous pacemaker insertion.
d. emergent cardioversion. Answer: D
If an abnormal P wave cannot be visualized on the ECG but the QRS
complex is narrow, the term supraventricular tachycardia (SVT) is
often used. This is a generic term that describes any tachycardia that
is not ventricular in origin; it is also used when the source above the
ventricles cannot be identified, usually because the rate is too fast.
Treatment is directed at assessing the patient's tolerance of the
tachycardia. If the rate is higher than 150 beats per minute and the
patient is symptomatic, emergent cardioversion is considered.
Cardioversion is the delivery of a synchronized electrical shock to
the heart by an external defibrillator.
,◉ The nurse is reading the cardiac monitor and notes that the
patient's heart rhythm is extremely irregular and there are no
discernible P waves. The ventricular rate is 90 beats per minute, and
the patient is hemodynamically stable. The nurse realizes that the
patient's rhythm is:
a. atrial fibrillation.
b. atrial flutter.
c. atrial flutter with rapid ventricular response.
d. junctional escape rhythm.. Answer: a
◉ The patient's heart rhythm shows an inverted P wave with a PR
interval of 0.06 seconds. The heart rate is 54 beats per minute. The
nurse recognizes the rhythm as a junctional escape rhythm, and
understands that the rhythm is due to the:
a. loss of sinus node activity.
b. increased rate of the AV node.
c. increased rate of the SA node.
d. decreased rate of the AV node.. Answer: a
◉ . Answer:
,◉ The patient's heart rate is 70 beats per minute, but the P waves
come after the QRS complex. The nurse correctly determines that
the patient's heart rhythm is:
a. a normal junctional rhythm.
b. an accelerated junctional rhythm.
c. a junctional tachycardia.
d. atrial fibrillation.. Answer: b
The normal intrinsic rate for the AV node and junctional tissue is 40
to 60 beats per minute, but rates can accelerate. An accelerated
junctional rhythm has a rate between 60 and 100 beats per minute,
and the rate for junctional tachycardia is greater than 100 beats per
minute.
◉ The patient is having premature ventricular contractions (PVCs).
The nurse's greatest concern should be:
a. the proximity of the R wave of the PVC to the T wave of a normal
beat.
b. the fact that PVCs are occurring, because they are so rare.
c. if the number of PVCs are decreasing.
d. if the PVCs are wider than 0.12 seconds.. Answer: a
◉ The nurse notices that the patient has a first-degree AV block.
Everything else about the rhythm is normal. The nurse should:
a. prepare to place the patient on a transcutaneous pacemaker.
, b. give the patient atropine to shorten the PR interval.
c. monitor the rhythm and patient's condition.
d. give the patient an antiarrhythmic medication.. Answer: C
First-degree AV block is a common dysrhythmia in the elderly and in
patients with cardiac disease. As the normal conduction pathway
ages or becomes diseased, impulse conduction becomes slower than
normal. It is well tolerated. No treatment is required. Continue to
monitor the patient and the rhythm.
◉ The nurse understands that in a third-degree AV block:
a. every P wave is conducted to the ventricles.
b. some P waves are conducted to the ventricles.
c. none of the P waves are conducted to the ventricles.
d. the PR interval is prolonged.. Answer: C
In first-degree AV block, a P wave precedes every QRS complex,
which is followed by a T wave indicating complete conduction. It is
represented on the ECG as a prolonged PR interval. Second-degree
heart block refers to AV conduction that is intermittently blocked.
Therefore, some P waves are conducted and some are not. Third-
degree block is often called complete heart block because no atrial
impulses are conducted through the AV node to the ventricles.
◉ The patient is asymptomatic but is diagnosed with second-degree
heart block Mobitz I. The patient is on digitalis medication at home.
The nurse should expect that:
