NSG 4100 Exam 3 Actual
SECTION 1: CARDIAC DYSRHYTHMIAS AND HEMODYNAMIC MONITORING
Question 1
The nurse is attending to a client who has orders for central venous pressure
monitoring. The nurse understands the catheter attached to a pressure monitoring
system will be placed in the:
A. Left to right ventricle
B. Vena cava or L. atrium
C. Vena cava or R. atrium
D. Pulmonary artery or vein
Correct Answer: C
Rationale: Central venous pressure (CVP) monitoring requires a catheter placed in
the vena cava or right atrium to measure pressure in the right side of the heart and
assess fluid volume status. A CVP catheter is typically inserted into the superior
vena cava via the internal jugular or subclavian vein .
,Question 2
The absence of impulse initiation in the heart results in electrical asystole. This
results in:
A. Decreased cardiac output
B. Zero cardiac output
C. Increased cardiac output
D. Irregular cardiac output
Correct Answer: B
Rationale: Asystole is the complete absence of electrical activity in the heart,
resulting in zero cardiac output. This is a non-shockable rhythm that requires
immediate intervention with CPR and epinephrine .
Question 3
Which of the following is a cause of asystole? (Select all that apply.)
A. Myocardial infarction
B. Electrical shock
C. Electrolyte disturbances
D. Acidosis
E. All of the above
Correct Answer: E
Rationale: Causes of asystole include myocardial infarction, electrical shock,
severe electrolyte disturbances (particularly hyperkalemia), acidosis, and
excessive parasympathetic activity. All of these can disrupt normal cardiac
conduction .
,Question 4
Management of asystole includes which of the following?
A. Defibrillation
B. Cardioversion
C. Intubation and epinephrine
D. Amiodarone bolus
Correct Answer: C
Rationale: Asystole is managed with high-quality CPR, intubation for airway
management, and administration of epinephrine (1 mg IV every 3-5 minutes).
Defibrillation is not indicated for asystole as it is a non-shockable rhythm .
Question 5
The interval between the sinus beat preceding the premature beat and the sinus
beat following the premature beat is twice the regular interval. This describes:
A. Atrial fibrillation
B. Premature ventricular contractions (PVCs)
C. Ventricular tachycardia
D. Supraventricular tachycardia
Correct Answer: B
Rationale: Premature ventricular contractions (PVCs) are characterized by a full
compensatory pause, meaning the interval between the sinus beat before and the
sinus beat after the PVC is twice the normal R-R interval. This occurs because the
PVC resets the sinus node timing .
, Question 6
Causes of PVCs include: (Select all that apply.)
A. Coronary artery disease
B. Drug overdose
C. Electrolyte disturbances
D. Hypokalemia and hypomagnesemia
E. All of the above
Correct Answer: E
Rationale: PVCs can be caused by coronary artery disease, drug overdose,
electrolyte disturbances (especially hypokalemia and hypomagnesemia), caffeine,
nicotine, alcohol, heart failure, tachycardia, digitalis toxicity, hypoxia, and acidosis .
Question 7
What is the first-line treatment for symptomatic PVCs?
A. Lidocaine
B. Amiodarone
C. Atropine
D. Epinephrine
Correct Answer: B
Rationale: Amiodarone is the treatment of choice for symptomatic PVCs. It is a
potassium channel blocker that stabilizes cardiac membranes and suppresses
ventricular ectopy .
SECTION 1: CARDIAC DYSRHYTHMIAS AND HEMODYNAMIC MONITORING
Question 1
The nurse is attending to a client who has orders for central venous pressure
monitoring. The nurse understands the catheter attached to a pressure monitoring
system will be placed in the:
A. Left to right ventricle
B. Vena cava or L. atrium
C. Vena cava or R. atrium
D. Pulmonary artery or vein
Correct Answer: C
Rationale: Central venous pressure (CVP) monitoring requires a catheter placed in
the vena cava or right atrium to measure pressure in the right side of the heart and
assess fluid volume status. A CVP catheter is typically inserted into the superior
vena cava via the internal jugular or subclavian vein .
,Question 2
The absence of impulse initiation in the heart results in electrical asystole. This
results in:
A. Decreased cardiac output
B. Zero cardiac output
C. Increased cardiac output
D. Irregular cardiac output
Correct Answer: B
Rationale: Asystole is the complete absence of electrical activity in the heart,
resulting in zero cardiac output. This is a non-shockable rhythm that requires
immediate intervention with CPR and epinephrine .
Question 3
Which of the following is a cause of asystole? (Select all that apply.)
A. Myocardial infarction
B. Electrical shock
C. Electrolyte disturbances
D. Acidosis
E. All of the above
Correct Answer: E
Rationale: Causes of asystole include myocardial infarction, electrical shock,
severe electrolyte disturbances (particularly hyperkalemia), acidosis, and
excessive parasympathetic activity. All of these can disrupt normal cardiac
conduction .
,Question 4
Management of asystole includes which of the following?
A. Defibrillation
B. Cardioversion
C. Intubation and epinephrine
D. Amiodarone bolus
Correct Answer: C
Rationale: Asystole is managed with high-quality CPR, intubation for airway
management, and administration of epinephrine (1 mg IV every 3-5 minutes).
Defibrillation is not indicated for asystole as it is a non-shockable rhythm .
Question 5
The interval between the sinus beat preceding the premature beat and the sinus
beat following the premature beat is twice the regular interval. This describes:
A. Atrial fibrillation
B. Premature ventricular contractions (PVCs)
C. Ventricular tachycardia
D. Supraventricular tachycardia
Correct Answer: B
Rationale: Premature ventricular contractions (PVCs) are characterized by a full
compensatory pause, meaning the interval between the sinus beat before and the
sinus beat after the PVC is twice the normal R-R interval. This occurs because the
PVC resets the sinus node timing .
, Question 6
Causes of PVCs include: (Select all that apply.)
A. Coronary artery disease
B. Drug overdose
C. Electrolyte disturbances
D. Hypokalemia and hypomagnesemia
E. All of the above
Correct Answer: E
Rationale: PVCs can be caused by coronary artery disease, drug overdose,
electrolyte disturbances (especially hypokalemia and hypomagnesemia), caffeine,
nicotine, alcohol, heart failure, tachycardia, digitalis toxicity, hypoxia, and acidosis .
Question 7
What is the first-line treatment for symptomatic PVCs?
A. Lidocaine
B. Amiodarone
C. Atropine
D. Epinephrine
Correct Answer: B
Rationale: Amiodarone is the treatment of choice for symptomatic PVCs. It is a
potassium channel blocker that stabilizes cardiac membranes and suppresses
ventricular ectopy .
