,Jersey College NUR 201 Exam 2 | Medical-Surgical Nursing I
(2026) Q&A
1. A nurse is analyzing a patient's ECG strip. Which finding is most characteristic of
atrial fibrillation?
A) Absent P waves with an irregularly irregular ventricular rhythm
B) Presence of a sawtooth pattern between QRS complexes
C) A prolonged PR interval
D) Tall, peaked T waves
Correct Answer: Absent P waves with an irregularly irregular ventricular rhythm
Rationale: Atrial fibrillation is characterized by an irregularly irregular rhythm with no
discernible P waves because the atria are quivering rather than contracting
effectively. A sawtooth pattern is typical of atrial flutter, a prolonged PR interval
indicates first-degree AV block, and tall, peaked T waves are associated with
hyperkalemia.
2. A patient's ECG shows a heart rate of 48 beats/min with regular R-R intervals and
normal P waves preceding each QRS complex. The patient is asymptomatic. What is
the nurse's priority action?
A) Prepare for immediate defibrillation
B) Administer atropine as prescribed
C) Start a continuous heparin infusion
D) Continue to monitor the patient
Correct Answer: Continue to monitor the patient
,Rationale: Sinus bradycardia is defined as a heart rate less than 60 bpm with a
regular rhythm and normal P waves. Treatment with atropine is indicated only if the
patient is symptomatic (hypotension, chest pain, dizziness). Asymptomatic
bradycardia does not require immediate intervention.
3. A patient with a history of coronary artery disease is experiencing premature
ventricular contractions (PVCs) that are increasing in frequency. Which electrolyte
imbalance is most likely contributing to this finding?
A) Hyperkalemia
B) Hypokalemia
C) Hypercalcemia
D) Hypermagnesemia
Correct Answer: Hypokalemia
Rationale: PVCs can be triggered by electrolyte imbalances, especially hypokalemia
(low potassium), which increases myocardial irritability. Other causes include cardiac
ischemia, hypoxia, acidosis, digitalis toxicity, and stimulants such as caffeine, nicotine,
and alcohol.
4. A patient with ventricular tachycardia is pulseless and unresponsive. What is the
priority treatment the nurse should anticipate?
A) Administration of intravenous amiodarone
B) Synchronized cardioversion
C) Immediate defibrillation
D) Administration of atropine
Correct Answer: Immediate defibrillation
, Rationale: For pulseless ventricular tachycardia, the treatment of choice is immediate
defibrillation. Synchronized cardioversion is used for unstable tachyarrhythmias with
a pulse, amiodarone may be given after defibrillation, and atropine is used for
symptomatic bradycardia.
5. A nurse is reviewing the laboratory results of a patient with chronic renal failure.
Which serum potassium level is most indicative of hyperkalemia?
A) 5.3 mEq/L
B) 3.8 mEq/L
C) 4.2 mEq/L
D) 2.9 mEq/L
Correct Answer: 5.3 mEq/L
Rationale: Hyperkalemia is defined as a serum potassium level greater than 5.0
mEq/L. Renal failure is the most common cause. Levels below 3.5 indicate
hypokalemia, and 3.8–4.2 are within normal range.
6. A patient is taking furosemide, a potassium-wasting diuretic. Which manifestation
of hypokalemia should the nurse assess for?
A) Facial muscle spasm
B) Generalized weakness and muscle cramps
C) Tetany and Chvostek's sign
D) Bone pain and excessive urination
Correct Answer: Generalized weakness and muscle cramps
Rationale: Hypokalemia (K+ <3.5 mEq/L) commonly presents with muscle weakness,
fatigue, and cramps due to altered neuromuscular function. Facial spasm and
(2026) Q&A
1. A nurse is analyzing a patient's ECG strip. Which finding is most characteristic of
atrial fibrillation?
A) Absent P waves with an irregularly irregular ventricular rhythm
B) Presence of a sawtooth pattern between QRS complexes
C) A prolonged PR interval
D) Tall, peaked T waves
Correct Answer: Absent P waves with an irregularly irregular ventricular rhythm
Rationale: Atrial fibrillation is characterized by an irregularly irregular rhythm with no
discernible P waves because the atria are quivering rather than contracting
effectively. A sawtooth pattern is typical of atrial flutter, a prolonged PR interval
indicates first-degree AV block, and tall, peaked T waves are associated with
hyperkalemia.
2. A patient's ECG shows a heart rate of 48 beats/min with regular R-R intervals and
normal P waves preceding each QRS complex. The patient is asymptomatic. What is
the nurse's priority action?
A) Prepare for immediate defibrillation
B) Administer atropine as prescribed
C) Start a continuous heparin infusion
D) Continue to monitor the patient
Correct Answer: Continue to monitor the patient
,Rationale: Sinus bradycardia is defined as a heart rate less than 60 bpm with a
regular rhythm and normal P waves. Treatment with atropine is indicated only if the
patient is symptomatic (hypotension, chest pain, dizziness). Asymptomatic
bradycardia does not require immediate intervention.
3. A patient with a history of coronary artery disease is experiencing premature
ventricular contractions (PVCs) that are increasing in frequency. Which electrolyte
imbalance is most likely contributing to this finding?
A) Hyperkalemia
B) Hypokalemia
C) Hypercalcemia
D) Hypermagnesemia
Correct Answer: Hypokalemia
Rationale: PVCs can be triggered by electrolyte imbalances, especially hypokalemia
(low potassium), which increases myocardial irritability. Other causes include cardiac
ischemia, hypoxia, acidosis, digitalis toxicity, and stimulants such as caffeine, nicotine,
and alcohol.
4. A patient with ventricular tachycardia is pulseless and unresponsive. What is the
priority treatment the nurse should anticipate?
A) Administration of intravenous amiodarone
B) Synchronized cardioversion
C) Immediate defibrillation
D) Administration of atropine
Correct Answer: Immediate defibrillation
, Rationale: For pulseless ventricular tachycardia, the treatment of choice is immediate
defibrillation. Synchronized cardioversion is used for unstable tachyarrhythmias with
a pulse, amiodarone may be given after defibrillation, and atropine is used for
symptomatic bradycardia.
5. A nurse is reviewing the laboratory results of a patient with chronic renal failure.
Which serum potassium level is most indicative of hyperkalemia?
A) 5.3 mEq/L
B) 3.8 mEq/L
C) 4.2 mEq/L
D) 2.9 mEq/L
Correct Answer: 5.3 mEq/L
Rationale: Hyperkalemia is defined as a serum potassium level greater than 5.0
mEq/L. Renal failure is the most common cause. Levels below 3.5 indicate
hypokalemia, and 3.8–4.2 are within normal range.
6. A patient is taking furosemide, a potassium-wasting diuretic. Which manifestation
of hypokalemia should the nurse assess for?
A) Facial muscle spasm
B) Generalized weakness and muscle cramps
C) Tetany and Chvostek's sign
D) Bone pain and excessive urination
Correct Answer: Generalized weakness and muscle cramps
Rationale: Hypokalemia (K+ <3.5 mEq/L) commonly presents with muscle weakness,
fatigue, and cramps due to altered neuromuscular function. Facial spasm and
