PERFUSION NCLEX UPDATED COMPREHENSIVE
EXAM QUESTIONS AND ANSWERS SURE A+
✔✔When a patient has long-term atrial fibrillation, the nurse would expect to include
which drug in the plan of care to minimize the greatest risk that is commonly associated
with atrial fibrillation?
a. Beta blockers
b. Digitalis
c. Anticoagulants
d. Antiarrhythmics - ✔✔c. Anticoagulants
Rationale:
c. is correct because it reflects the greatest risk or complication of thrombi or emboli that
occurs with long-term atrial fibrillation. Coumadin is often given prophylactically to
prevent stroke, clots, or emboli from developing when hospitalizing a patient with long-
term atrial fibrillation.
✔✔The nurse should understand that which of the following treatments for Second
Degree Type II AV Block would be appropriate?
(Select all that apply)
, a. Temporary pacemaker insertion
b. Close monitoring without intervention
c. Atropine to increase heart rate if symptomatic
d. Coronary stent placement to improve blood flow to myocardium
e. An implantable defibrillator surgically implanted - ✔✔a. Temporary pacemaker
insertion
c. Atropine to increase heart rate if symptomatic
d. Coronary stent placement to improve blood flow to myocardium
Rationale:
Rationale: a,c, and d are correct. Temporary pacing may be needed and atropine will
temporarily improve heart rate cardiac output until the pacemaker can be inserted.
b. is incorrect because Type II has a tendency to develop complete heart block where
adequate cardiac output is not maintained and arrest is likely. Type I can be monitored
and minimal treatment is needed unless unstable hemodynamics are present.
e. is incorrect because a defibrillator is not called for since it is the ventricle that is trying
to maintain the cardiac output from the decreased conduction between the atria and the
ventricles. An implanted pacemaker may be needed permanently.
✔✔A nurse is watching the cardiac monitor and notices that the rhythm suddenly
changes. There are no P waves, the QRS complexes are wide, and the ventricular rate
is regular but over 100. The nurse determines that the client is experiencing:
a. premature ventricular contractions
b. ventricular tachycardia
c. ventricular fibrillation
d. sinus tachycardia - ✔✔b. ventricular tachycardia is characterized by the absence of P
waves, wide QRS complexes (greater than 0.14) and a rate between 100 and 250
impulses per minute. The rhythm is usually regular.
✔✔The nurse is caring for a client with unstable angina whose cardiac monitor shows
ventricular tachycardia. Which action is appropriate to implement first?
a. Defibrillate the client at 200 J.
b. Check the client for a pulse.
c. Cardiovert the client at 50 J.
d. Give the client IV lidocaine. - ✔✔b. Check the client for a pulse.
Rationale: The nurse needs to assess the client to determine stability before proceeding
with further interventions. If the client has a pulse and is relatively stable, elective
cardioversion or antidysrhythmic medications may be prescribed.
✔✔You are the charge nurse on the telemetry unit and are responsible for making client
assignments. Which client would be appropriate to assign to the float RN from the
medical-surgical unit?
EXAM QUESTIONS AND ANSWERS SURE A+
✔✔When a patient has long-term atrial fibrillation, the nurse would expect to include
which drug in the plan of care to minimize the greatest risk that is commonly associated
with atrial fibrillation?
a. Beta blockers
b. Digitalis
c. Anticoagulants
d. Antiarrhythmics - ✔✔c. Anticoagulants
Rationale:
c. is correct because it reflects the greatest risk or complication of thrombi or emboli that
occurs with long-term atrial fibrillation. Coumadin is often given prophylactically to
prevent stroke, clots, or emboli from developing when hospitalizing a patient with long-
term atrial fibrillation.
✔✔The nurse should understand that which of the following treatments for Second
Degree Type II AV Block would be appropriate?
(Select all that apply)
, a. Temporary pacemaker insertion
b. Close monitoring without intervention
c. Atropine to increase heart rate if symptomatic
d. Coronary stent placement to improve blood flow to myocardium
e. An implantable defibrillator surgically implanted - ✔✔a. Temporary pacemaker
insertion
c. Atropine to increase heart rate if symptomatic
d. Coronary stent placement to improve blood flow to myocardium
Rationale:
Rationale: a,c, and d are correct. Temporary pacing may be needed and atropine will
temporarily improve heart rate cardiac output until the pacemaker can be inserted.
b. is incorrect because Type II has a tendency to develop complete heart block where
adequate cardiac output is not maintained and arrest is likely. Type I can be monitored
and minimal treatment is needed unless unstable hemodynamics are present.
e. is incorrect because a defibrillator is not called for since it is the ventricle that is trying
to maintain the cardiac output from the decreased conduction between the atria and the
ventricles. An implanted pacemaker may be needed permanently.
✔✔A nurse is watching the cardiac monitor and notices that the rhythm suddenly
changes. There are no P waves, the QRS complexes are wide, and the ventricular rate
is regular but over 100. The nurse determines that the client is experiencing:
a. premature ventricular contractions
b. ventricular tachycardia
c. ventricular fibrillation
d. sinus tachycardia - ✔✔b. ventricular tachycardia is characterized by the absence of P
waves, wide QRS complexes (greater than 0.14) and a rate between 100 and 250
impulses per minute. The rhythm is usually regular.
✔✔The nurse is caring for a client with unstable angina whose cardiac monitor shows
ventricular tachycardia. Which action is appropriate to implement first?
a. Defibrillate the client at 200 J.
b. Check the client for a pulse.
c. Cardiovert the client at 50 J.
d. Give the client IV lidocaine. - ✔✔b. Check the client for a pulse.
Rationale: The nurse needs to assess the client to determine stability before proceeding
with further interventions. If the client has a pulse and is relatively stable, elective
cardioversion or antidysrhythmic medications may be prescribed.
✔✔You are the charge nurse on the telemetry unit and are responsible for making client
assignments. Which client would be appropriate to assign to the float RN from the
medical-surgical unit?
