NUR 283 ADULT HEALTH NURSING EXAM 2 (PDF) | 2026
EXAM QUESTIONS AND ANSWERS + RATIONALES | STUDY
GUIDE | 100% CORRECT
1. A patient presents with a regular, wide-complex tachycardia at a rate of 180 bpm. The
patient is pulseless and unresponsive. What is the priority intervention?
A) Synchronized cardioversion
B) Defibrillation
C) Administration of amiodarone
D) Administration of adenosine
Correct Answer: B) Defibrillation
Rationale: Ventricular tachycardia (VT) without a pulse is treated as a pulseless arrest.
Immediate defibrillation is the priority intervention. Synchronized cardioversion is for unstable
VT with a pulse, and amiodarone and adenosine are not the initial treatment for this rhythm .
2. The nurse is assessing a patient who is experiencing ventricular tachycardia with a
palpable pulse and is now unstable. What is the most appropriate initial intervention?
A) Immediate defibrillation
B) Synchronized cardioversion
C) Administration of amiodarone
D) Administration of lidocaine
Correct Answer: B) Synchronized cardioversion
Rationale: For a patient in ventricular tachycardia who is unstable but has a pulse, synchronized
cardioversion is the treatment of choice. Defibrillation is used for pulseless rhythms, and
medications like amiodarone are used after cardioversion or in stable patients .
3. The nurse is caring for a patient with new-onset atrial fibrillation. The patient is stable but
is experiencing rapid ventricular response (RVR). Which medication combination is most
appropriate to manage this rhythm?
A) Lidocaine and epinephrine
B) Amiodarone and Cardizem (diltiazem)
C) Heparin and amiodarone
D) Defibrillation and oxygen
Correct Answer: B) Amiodarone and Cardizem (diltiazem)
Rationale: For stable atrial fibrillation with RVR, treatment includes an antidysrhythmic like
amiodarone and a calcium channel blocker like Cardizem (diltiazem) to control the ventricular
rate. Anticoagulation is also indicated, but amiodarone and Cardizem directly manage the rate .
4. The nurse is assessing a patient who is experiencing atrial fibrillation and is unstable with
a rapid ventricular response. What is the appropriate intervention?
A) Defibrillation
, B) Synchronized cardioversion
C) Administration of atropine
D) Administration of diltiazem
Correct Answer: B) Synchronized cardioversion
Rationale: Unstable atrial fibrillation with RVR requires synchronized cardioversion to restore a
normal sinus rhythm. Defibrillation is used for pulseless rhythms, and atropine is for
bradycardia. Diltiazem is used for rate control in stable patients .
5. Which of the following rhythms is characterized by no electrical activity on the cardiac
monitor?
A) Ventricular fibrillation
B) Asystole
C) Pulseless electrical activity (PEA)
D) Ventricular tachycardia
Correct Answer: B) Asystole
Rationale: Asystole is the absence of any cardiac electrical activity, also known as a "flat line."
Ventricular fibrillation (VF) is a chaotic rhythm, PEA has organized electrical activity without a
pulse, and VT is a rapid, wide-complex rhythm .
6. In treating asystole, which two interventions are most critical?
A) Defibrillation and epinephrine
B) CPR and epinephrine
C) CPR and amiodarone
D) Defibrillation and amiodarone
Correct Answer: B) CPR and epinephrine
Rationale: The treatment for asystole is high-quality CPR and the administration of epinephrine.
Defibrillation is not indicated for asystole, as it has no electrical activity to defibrillate.
Amiodarone is used for shockable rhythms .
7. The nurse is observing a premature ventricular contraction (PVC) on the cardiac monitor.
What is the priority nursing action?
A) Immediately defibrillate the patient
B) Treat the underlying cause, such as hypoxia or electrolyte imbalance
C) Administer atropine
D) Prepare for transcutaneous pacing
Correct Answer: B) Treat the underlying cause, such as hypoxia or electrolyte imbalance
Rationale: While PVCs can be concerning, treatment focuses on addressing the underlying cause,
such as correcting hypoxia or electrolyte imbalances. Atropine is for bradycardia, and
defibrillation is not indicated .
, 8. A patient with atrial fibrillation is at risk for a stroke. What is the most important
intervention to prevent this complication?
A) Administering a calcium channel blocker
B) Administering an antidysrhythmic
C) Anticoagulation
D) Synchronized cardioversion
Correct Answer: C) Anticoagulation
Rationale: Patients with atrial fibrillation are at risk for blood clot formation in the atria due to
stasis. Anticoagulation is essential to prevent these clots from traveling to the brain and causing
an embolic stroke. "Control the rate and anticoagulate" is a key principle .
9. The nurse is assessing a patient in atrial fibrillation with rapid ventricular response. The
patient is stable. Why would the nurse avoid performing unsynchronized defibrillation?
A) It can cause the patient to go into asystole
B) It can dislodge a clot from the atria, causing a stroke
C) It is not effective for atrial fibrillation
D) It can cause ventricular tachycardia
Correct Answer: B) It can dislodge a clot from the atria, causing a stroke
Rationale: In atrial fibrillation, clots can form in the atrial appendages. Unsynchronized
defibrillation could dislodge these clots, leading to a stroke or pulmonary embolism.
Synchronized cardioversion is the preferred treatment for unstable AFib RVR after a
transesophageal echocardiogram (TEE) or with appropriate anticoagulation .
10. A patient with atrial fibrillation has lost their "atrial kick." Approximately what percent
of cardiac output can be lost due to this?
A) 10%
B) 20%
C) 30%
D) 50%
Correct Answer: C) 30%
Rationale: The "atrial kick" refers to the contribution of atrial contraction to ventricular filling.
With atrial fibrillation, this kick is lost, potentially reducing cardiac output by up to 30% .
11. Which medication is the antidote for heparin?
A) Vitamin K
B) Protamine sulfate
C) Naloxone
D) Flumazenil
Correct Answer: B) Protamine sulfate
EXAM QUESTIONS AND ANSWERS + RATIONALES | STUDY
GUIDE | 100% CORRECT
1. A patient presents with a regular, wide-complex tachycardia at a rate of 180 bpm. The
patient is pulseless and unresponsive. What is the priority intervention?
A) Synchronized cardioversion
B) Defibrillation
C) Administration of amiodarone
D) Administration of adenosine
Correct Answer: B) Defibrillation
Rationale: Ventricular tachycardia (VT) without a pulse is treated as a pulseless arrest.
Immediate defibrillation is the priority intervention. Synchronized cardioversion is for unstable
VT with a pulse, and amiodarone and adenosine are not the initial treatment for this rhythm .
2. The nurse is assessing a patient who is experiencing ventricular tachycardia with a
palpable pulse and is now unstable. What is the most appropriate initial intervention?
A) Immediate defibrillation
B) Synchronized cardioversion
C) Administration of amiodarone
D) Administration of lidocaine
Correct Answer: B) Synchronized cardioversion
Rationale: For a patient in ventricular tachycardia who is unstable but has a pulse, synchronized
cardioversion is the treatment of choice. Defibrillation is used for pulseless rhythms, and
medications like amiodarone are used after cardioversion or in stable patients .
3. The nurse is caring for a patient with new-onset atrial fibrillation. The patient is stable but
is experiencing rapid ventricular response (RVR). Which medication combination is most
appropriate to manage this rhythm?
A) Lidocaine and epinephrine
B) Amiodarone and Cardizem (diltiazem)
C) Heparin and amiodarone
D) Defibrillation and oxygen
Correct Answer: B) Amiodarone and Cardizem (diltiazem)
Rationale: For stable atrial fibrillation with RVR, treatment includes an antidysrhythmic like
amiodarone and a calcium channel blocker like Cardizem (diltiazem) to control the ventricular
rate. Anticoagulation is also indicated, but amiodarone and Cardizem directly manage the rate .
4. The nurse is assessing a patient who is experiencing atrial fibrillation and is unstable with
a rapid ventricular response. What is the appropriate intervention?
A) Defibrillation
, B) Synchronized cardioversion
C) Administration of atropine
D) Administration of diltiazem
Correct Answer: B) Synchronized cardioversion
Rationale: Unstable atrial fibrillation with RVR requires synchronized cardioversion to restore a
normal sinus rhythm. Defibrillation is used for pulseless rhythms, and atropine is for
bradycardia. Diltiazem is used for rate control in stable patients .
5. Which of the following rhythms is characterized by no electrical activity on the cardiac
monitor?
A) Ventricular fibrillation
B) Asystole
C) Pulseless electrical activity (PEA)
D) Ventricular tachycardia
Correct Answer: B) Asystole
Rationale: Asystole is the absence of any cardiac electrical activity, also known as a "flat line."
Ventricular fibrillation (VF) is a chaotic rhythm, PEA has organized electrical activity without a
pulse, and VT is a rapid, wide-complex rhythm .
6. In treating asystole, which two interventions are most critical?
A) Defibrillation and epinephrine
B) CPR and epinephrine
C) CPR and amiodarone
D) Defibrillation and amiodarone
Correct Answer: B) CPR and epinephrine
Rationale: The treatment for asystole is high-quality CPR and the administration of epinephrine.
Defibrillation is not indicated for asystole, as it has no electrical activity to defibrillate.
Amiodarone is used for shockable rhythms .
7. The nurse is observing a premature ventricular contraction (PVC) on the cardiac monitor.
What is the priority nursing action?
A) Immediately defibrillate the patient
B) Treat the underlying cause, such as hypoxia or electrolyte imbalance
C) Administer atropine
D) Prepare for transcutaneous pacing
Correct Answer: B) Treat the underlying cause, such as hypoxia or electrolyte imbalance
Rationale: While PVCs can be concerning, treatment focuses on addressing the underlying cause,
such as correcting hypoxia or electrolyte imbalances. Atropine is for bradycardia, and
defibrillation is not indicated .
, 8. A patient with atrial fibrillation is at risk for a stroke. What is the most important
intervention to prevent this complication?
A) Administering a calcium channel blocker
B) Administering an antidysrhythmic
C) Anticoagulation
D) Synchronized cardioversion
Correct Answer: C) Anticoagulation
Rationale: Patients with atrial fibrillation are at risk for blood clot formation in the atria due to
stasis. Anticoagulation is essential to prevent these clots from traveling to the brain and causing
an embolic stroke. "Control the rate and anticoagulate" is a key principle .
9. The nurse is assessing a patient in atrial fibrillation with rapid ventricular response. The
patient is stable. Why would the nurse avoid performing unsynchronized defibrillation?
A) It can cause the patient to go into asystole
B) It can dislodge a clot from the atria, causing a stroke
C) It is not effective for atrial fibrillation
D) It can cause ventricular tachycardia
Correct Answer: B) It can dislodge a clot from the atria, causing a stroke
Rationale: In atrial fibrillation, clots can form in the atrial appendages. Unsynchronized
defibrillation could dislodge these clots, leading to a stroke or pulmonary embolism.
Synchronized cardioversion is the preferred treatment for unstable AFib RVR after a
transesophageal echocardiogram (TEE) or with appropriate anticoagulation .
10. A patient with atrial fibrillation has lost their "atrial kick." Approximately what percent
of cardiac output can be lost due to this?
A) 10%
B) 20%
C) 30%
D) 50%
Correct Answer: C) 30%
Rationale: The "atrial kick" refers to the contribution of atrial contraction to ventricular filling.
With atrial fibrillation, this kick is lost, potentially reducing cardiac output by up to 30% .
11. Which medication is the antidote for heparin?
A) Vitamin K
B) Protamine sulfate
C) Naloxone
D) Flumazenil
Correct Answer: B) Protamine sulfate
