NURS 332 MIDTERM 1 | PRACTICE QUESTIONS & ANSWERS | COMPREHENSIVE NURSING
STUDY GUIDE 2026/2027
WHO defines acute care as: - ANS ✔✔actions aimed at contributing to improved health or the
diagnosis, treatment, and rehabilitation of sick people.
e.g. ICU, ER, Med-surg
Interprofessional collaboration - ANS ✔✔A partnership between a team of health providers and
a client in a participatory, collaborative and coordinated approach to shared decision-making
around health and social issues.
Critical thinking/shared decision making incorporates what 4 components? - ANS ✔✔1) Patient
values and priorities
2) Healthcare Resources
3) Clinical Context
9 Steps of ECG - ANS ✔✔1) P-wave?
2) P-P Regular?
3) P-P Rate
4) PR interval
5) R-R Regular?
6) R-R Rate
7) QRS complex
8) QT interval
9) ST segment
Presence of a P-wave - ANS ✔✔- Depolarization of atria
,- Sometimes notched, peaked, and inverted (below isometric line). We would measure the time
still, just check
- Inverted: It is depolarizing backwards
- If SA node doesn't kick in, it is AV node working backwards.
Absence of a P-wave - ANS ✔✔- Atrium is not contracting/not contracting effectively
Irregular P-waves - ANS ✔✔Atrial fluter or arrhythmias
Normal PR interval - ANS ✔✔0.12-0.20 seconds; represents total time depolarizing the atria
(time from electrical impulse from SA to AV node)
Long PR interval - ANS ✔✔AV block (first-degree)
What does regular R-R mean? - ANS ✔✔- ventricular contraction
- elicits pulse (this is essentially the heart rate)
- normal is 60-100
QRS complex - ANS ✔✔- ventricular depolarization and atrial repolarization
- it is essentially the time to depolarize the ventricle before it contracts
- action potential
Normal QRS complex - ANS ✔✔0.12 seconds or less
QRS greater than 0.12 - ANS ✔✔- PVCs, bundle branch block, MIs.
- It is not depolarizing quick enough. When it is too wide, that part of the heart cannot conduct
electricity in an MI so it has to go around it (thus making it longer).
,Normal QT interval - ANS ✔✔Women = 0.46s or longer
Men = 0.45s or longer
QT interval - ANS ✔✔- cells are busy in this stage
- contraction is occurring
What happens if QT interval is prolonged? - ANS ✔✔Next depolarization could kick in during
resting phase. This is when arrhythmias happen. Medication that can prolong QT interval can
lead to arrhythmias
ST segment - ANS ✔✔- state whether it is isoelectric, elevated, or depressed
ST segment elevation - ANS ✔✔myocardial infarction/ischemia/infarct
ST segment depression - ANS ✔✔- ischemia
- pulmonary emboli
- pneumonia
- N-stemi
4 A's of ethical dilemmas - ANS ✔✔1) Ask: if we are feeling distress
2) Affirm: rationalize and validate
3) Assess situation: weigh pros and cons, take action
4) Act on distress
Schuman's Stages - ANS ✔✔1) Shock and disbelief
2) Denial
, 3) Awareness
4) Restitution
5) Resolution
CTAS Level 1 - ANS ✔✔· Conditions that are threats to life or limb (or imminent risk of
deterioration) requiring immediate aggressive interventions *resuscitation*
· Examples: Cardiac/Respiratory arrest, major trauma, shock states, unconscious patients, severe
respiratory distress
· Seen by MD immediately
CTAS Level 2 - ANS ✔✔· Conditions that are a potential threat to life limb or function, requiring
rapid medical intervention or delegated acts *emergent
· Examples: altered mental states, head injury, severe trauma, neonates, MI, overdose and CVA,
throat swelling up from allergy
· Seen by MD within 15 min
CTAS Level 3 - ANS ✔✔· Conditions that could potentially progress to a serious problem
requiring emergency intervention *urgent
· May be associated with significant discomfort or affecting ability to function at work or
activities of daily living
· Examples: moderate trauma, asthma, GI bleed, vaginal bleeding and pregnancy, acute
psychosis and/or suicidal thoughts and acute pain
· Bleeding, abdominal pain, slightly abnormal vital signs
· Triage nurse does an assessment
· Seen by MD within 30 min
CTAS Level 4 - ANS ✔✔· Conditions that are related to patient age, distress, or potential for
deterioration or complications would benefit from intervention or reassurance within 1-2 hours
*semi-urgent
STUDY GUIDE 2026/2027
WHO defines acute care as: - ANS ✔✔actions aimed at contributing to improved health or the
diagnosis, treatment, and rehabilitation of sick people.
e.g. ICU, ER, Med-surg
Interprofessional collaboration - ANS ✔✔A partnership between a team of health providers and
a client in a participatory, collaborative and coordinated approach to shared decision-making
around health and social issues.
Critical thinking/shared decision making incorporates what 4 components? - ANS ✔✔1) Patient
values and priorities
2) Healthcare Resources
3) Clinical Context
9 Steps of ECG - ANS ✔✔1) P-wave?
2) P-P Regular?
3) P-P Rate
4) PR interval
5) R-R Regular?
6) R-R Rate
7) QRS complex
8) QT interval
9) ST segment
Presence of a P-wave - ANS ✔✔- Depolarization of atria
,- Sometimes notched, peaked, and inverted (below isometric line). We would measure the time
still, just check
- Inverted: It is depolarizing backwards
- If SA node doesn't kick in, it is AV node working backwards.
Absence of a P-wave - ANS ✔✔- Atrium is not contracting/not contracting effectively
Irregular P-waves - ANS ✔✔Atrial fluter or arrhythmias
Normal PR interval - ANS ✔✔0.12-0.20 seconds; represents total time depolarizing the atria
(time from electrical impulse from SA to AV node)
Long PR interval - ANS ✔✔AV block (first-degree)
What does regular R-R mean? - ANS ✔✔- ventricular contraction
- elicits pulse (this is essentially the heart rate)
- normal is 60-100
QRS complex - ANS ✔✔- ventricular depolarization and atrial repolarization
- it is essentially the time to depolarize the ventricle before it contracts
- action potential
Normal QRS complex - ANS ✔✔0.12 seconds or less
QRS greater than 0.12 - ANS ✔✔- PVCs, bundle branch block, MIs.
- It is not depolarizing quick enough. When it is too wide, that part of the heart cannot conduct
electricity in an MI so it has to go around it (thus making it longer).
,Normal QT interval - ANS ✔✔Women = 0.46s or longer
Men = 0.45s or longer
QT interval - ANS ✔✔- cells are busy in this stage
- contraction is occurring
What happens if QT interval is prolonged? - ANS ✔✔Next depolarization could kick in during
resting phase. This is when arrhythmias happen. Medication that can prolong QT interval can
lead to arrhythmias
ST segment - ANS ✔✔- state whether it is isoelectric, elevated, or depressed
ST segment elevation - ANS ✔✔myocardial infarction/ischemia/infarct
ST segment depression - ANS ✔✔- ischemia
- pulmonary emboli
- pneumonia
- N-stemi
4 A's of ethical dilemmas - ANS ✔✔1) Ask: if we are feeling distress
2) Affirm: rationalize and validate
3) Assess situation: weigh pros and cons, take action
4) Act on distress
Schuman's Stages - ANS ✔✔1) Shock and disbelief
2) Denial
, 3) Awareness
4) Restitution
5) Resolution
CTAS Level 1 - ANS ✔✔· Conditions that are threats to life or limb (or imminent risk of
deterioration) requiring immediate aggressive interventions *resuscitation*
· Examples: Cardiac/Respiratory arrest, major trauma, shock states, unconscious patients, severe
respiratory distress
· Seen by MD immediately
CTAS Level 2 - ANS ✔✔· Conditions that are a potential threat to life limb or function, requiring
rapid medical intervention or delegated acts *emergent
· Examples: altered mental states, head injury, severe trauma, neonates, MI, overdose and CVA,
throat swelling up from allergy
· Seen by MD within 15 min
CTAS Level 3 - ANS ✔✔· Conditions that could potentially progress to a serious problem
requiring emergency intervention *urgent
· May be associated with significant discomfort or affecting ability to function at work or
activities of daily living
· Examples: moderate trauma, asthma, GI bleed, vaginal bleeding and pregnancy, acute
psychosis and/or suicidal thoughts and acute pain
· Bleeding, abdominal pain, slightly abnormal vital signs
· Triage nurse does an assessment
· Seen by MD within 30 min
CTAS Level 4 - ANS ✔✔· Conditions that are related to patient age, distress, or potential for
deterioration or complications would benefit from intervention or reassurance within 1-2 hours
*semi-urgent
