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NUR 283 Comp 2 Galen Exam – 200
Q&A with Rationales | Cardiac, Neuro,
Endocrine, Pharm, Delegation | Next
Gen NCLEX | Pass Guaranteed
This comprehensive NUR 283 Comp 2 Exam Study Guide
contains 200+ multiple-choice questions with correct answers
and detailed rationales in Galen format. Covers all key content
areas: Cardiac & Perfusion (Atrial Fibrillation, Cardiac Output,
VTach, Torsades, Cardioversion, Digoxin Toxicity,
Heparin/Warfarin), Neurological & Stroke (BE FAST, tPA Door-
to-Needle 60 min, Hemorrhagic vs Ischemic, Increased ICP,
Pupil Changes), Endocrine (Hepatic Encephalopathy, Lactulose,
Cushing's, Addison's, DKA, HHS, Thyroid Disorders, Adrenal
Crisis), Hematology (Blood Transfusions, Transfusion Reactions,
Central Lines, TPN, Enteral Feedings), Spinal Cord Injury
(Autonomic Dysreflexia, Neurogenic Bladder), Pharmacology
(Digoxin, Heparin, Warfarin, Furosemide, Lisinopril, Metoprolol,
Insulin, Glipizide, Lithium, Antipsychotics), Oncology
(Chemotherapy, Radiation, Tumor Lysis, Neutropenia,
Mucositis), Pediatrics (Milestones, Pincer Grasp, Fontanelle,
Erikson), Legal/Ethical (Living Will, Abuse Reporting, Mandatory
Reporting), Delegation & Scope (RN vs LPN vs UAP), and
Palliative/Hospice Care. Includes high-yield NCLEX-style
questions with priority nursing interventions. Perfect for Galen
College of Nursing students preparing for Comp 2. Pass with
confidence!
,2|Page
1. A nurse is caring for a client with atrial fibrillation. Which assessment finding
is most concerning and requires immediate intervention?
A) Heart rate of 110 bpm
B) Irregularly irregular heart rhythm
C) Absence of P waves on ECG
D) Sudden onset of severe headache and confusion
*D) Sudden onset of severe headache and confusion
Rationale: Atrial fibrillation increases the risk of clot formation, which can lead
to embolic stroke. Sudden severe headache and confusion are signs of a
potential cerebrovascular accident (CVA). This requires immediate intervention.
The other findings are expected with atrial fibrillation.
2. A client with atrial fibrillation is prescribed digoxin. Which finding indicates
digoxin toxicity?
A) Heart rate 72 bpm
B) Serum digoxin level 1.2 ng/mL
C) Nausea, vomiting, and yellow halos around lights
D) Blood pressure 130/80 mm Hg
*C) Nausea, vomiting, and yellow halos around lights
Rationale: Nausea, vomiting, and visual disturbances (yellow/green halos) are
classic signs of digoxin toxicity. The therapeutic range is 0.5–2.0 ng/mL; a level
of 1.2 is within therapeutic range. Heart rate and blood pressure do not
specifically indicate toxicity.
3. A nurse is calculating cardiac output for a client. Which formula is correct?
A) CO = HR × SV
B) CO = HR × BP
C) CO = SV × BP
D) CO = HR + SV
*A) CO = HR × SV
Rationale: Cardiac output (CO) is calculated by multiplying heart rate (HR) by
stroke volume (SV). Normal CO is 4–6 L/min. The other formulas are incorrect.
,3|Page
4. A client has a cardiac output of 3.2 L/min. Which finding would the nurse
expect?
A) Warm, pink skin
B) Capillary refill < 2 seconds
C) Urine output of 20 mL/hr
D) Alert and oriented
*C) Urine output of 20 mL/hr
Rationale: A cardiac output of 3.2 L/min is below normal (4–6 L/min).
Decreased cardiac output leads to poor perfusion, resulting in decreased urine
output (< 30 mL/hr). Warm skin, normal cap refill, and alert mental status
indicate good perfusion.
5. The nurse is evaluating a client's hemodynamic status. Which finding
indicates adequate perfusion?
A) MAP 58 mm Hg
B) CVP 8 mm Hg
C) Urine output 25 mL/hr
D) Warm, dry skin with cap refill < 2 seconds
*D) Warm, dry skin with cap refill < 2 seconds
Rationale: Signs of good perfusion include warm, pink, dry skin; urine output ≥
30 mL/hr; mental status alert and oriented; cap refill < 2 seconds; MAP ≥ 60;
CVP 2–6 mmHg. Warm skin with normal cap refill is the most direct indicator of
adequate peripheral perfusion.
6. The nurse is caring for a client with low cardiac output. Which action should
the nurse take first?
A) Administer a vasodilator
B) Assess heart rate and rhythm
C) Increase IV fluid rate
D) Notify the healthcare provider
*B) Assess heart rate and rhythm
Rationale: When troubleshooting low cardiac output, the nurse should first
assess heart rate and rhythm. Tachycardia or dysrhythmias can significantly
, 4|Page
reduce cardiac output. Assessment precedes intervention. After assessment, the
nurse can evaluate preload (CVP), afterload (BP), and contractility.
7. A client is in ventricular tachycardia. Which action should the nurse
implement first?
A) Defibrillate the client immediately
B) Prepare to administer amiodarone
C) Assess the client for a pulse
D) Call a code blue
*C) Assess the client for a pulse
Rationale: The immediate priority is to determine if the client is stable
(pulsatile) or unstable (pulseless). Ventricular tachycardia without a pulse is a
shockable rhythm requiring defibrillation; with a pulse, treatment like
amiodarone may be considered. Always assess first.
8. A client is in torsades de pointes. The nurse understands this dysrhythmia can
occur when:
A) The client is shocked mid-repolarization
B) The client has a serum potassium of 4.0 mEq/L
C) The client has a serum magnesium of 2.0 mEq/L
D) The client has a normal QT interval
*A) The client is shocked mid-repolarization
Rationale: Torsades de pointes can occur if a client is shocked during the
vulnerable period (mid-repolarization, S-T segment). It is associated with
prolonged QT interval, hypokalemia, and hypomagnesemia. Shocking during
repolarization can precipitate this life-threatening dysrhythmia.
9. The nurse is preparing to cardiovert a client with atrial fibrillation. Which
action is essential?
A) Administer IV adenosine prior to cardioversion
B) Ensure the client has been anticoagulated per protocol
C) Place the defibrillator pads in the anteroposterior position
D) Sedate the client with oral benzodiazepines
NUR 283 Comp 2 Galen Exam – 200
Q&A with Rationales | Cardiac, Neuro,
Endocrine, Pharm, Delegation | Next
Gen NCLEX | Pass Guaranteed
This comprehensive NUR 283 Comp 2 Exam Study Guide
contains 200+ multiple-choice questions with correct answers
and detailed rationales in Galen format. Covers all key content
areas: Cardiac & Perfusion (Atrial Fibrillation, Cardiac Output,
VTach, Torsades, Cardioversion, Digoxin Toxicity,
Heparin/Warfarin), Neurological & Stroke (BE FAST, tPA Door-
to-Needle 60 min, Hemorrhagic vs Ischemic, Increased ICP,
Pupil Changes), Endocrine (Hepatic Encephalopathy, Lactulose,
Cushing's, Addison's, DKA, HHS, Thyroid Disorders, Adrenal
Crisis), Hematology (Blood Transfusions, Transfusion Reactions,
Central Lines, TPN, Enteral Feedings), Spinal Cord Injury
(Autonomic Dysreflexia, Neurogenic Bladder), Pharmacology
(Digoxin, Heparin, Warfarin, Furosemide, Lisinopril, Metoprolol,
Insulin, Glipizide, Lithium, Antipsychotics), Oncology
(Chemotherapy, Radiation, Tumor Lysis, Neutropenia,
Mucositis), Pediatrics (Milestones, Pincer Grasp, Fontanelle,
Erikson), Legal/Ethical (Living Will, Abuse Reporting, Mandatory
Reporting), Delegation & Scope (RN vs LPN vs UAP), and
Palliative/Hospice Care. Includes high-yield NCLEX-style
questions with priority nursing interventions. Perfect for Galen
College of Nursing students preparing for Comp 2. Pass with
confidence!
,2|Page
1. A nurse is caring for a client with atrial fibrillation. Which assessment finding
is most concerning and requires immediate intervention?
A) Heart rate of 110 bpm
B) Irregularly irregular heart rhythm
C) Absence of P waves on ECG
D) Sudden onset of severe headache and confusion
*D) Sudden onset of severe headache and confusion
Rationale: Atrial fibrillation increases the risk of clot formation, which can lead
to embolic stroke. Sudden severe headache and confusion are signs of a
potential cerebrovascular accident (CVA). This requires immediate intervention.
The other findings are expected with atrial fibrillation.
2. A client with atrial fibrillation is prescribed digoxin. Which finding indicates
digoxin toxicity?
A) Heart rate 72 bpm
B) Serum digoxin level 1.2 ng/mL
C) Nausea, vomiting, and yellow halos around lights
D) Blood pressure 130/80 mm Hg
*C) Nausea, vomiting, and yellow halos around lights
Rationale: Nausea, vomiting, and visual disturbances (yellow/green halos) are
classic signs of digoxin toxicity. The therapeutic range is 0.5–2.0 ng/mL; a level
of 1.2 is within therapeutic range. Heart rate and blood pressure do not
specifically indicate toxicity.
3. A nurse is calculating cardiac output for a client. Which formula is correct?
A) CO = HR × SV
B) CO = HR × BP
C) CO = SV × BP
D) CO = HR + SV
*A) CO = HR × SV
Rationale: Cardiac output (CO) is calculated by multiplying heart rate (HR) by
stroke volume (SV). Normal CO is 4–6 L/min. The other formulas are incorrect.
,3|Page
4. A client has a cardiac output of 3.2 L/min. Which finding would the nurse
expect?
A) Warm, pink skin
B) Capillary refill < 2 seconds
C) Urine output of 20 mL/hr
D) Alert and oriented
*C) Urine output of 20 mL/hr
Rationale: A cardiac output of 3.2 L/min is below normal (4–6 L/min).
Decreased cardiac output leads to poor perfusion, resulting in decreased urine
output (< 30 mL/hr). Warm skin, normal cap refill, and alert mental status
indicate good perfusion.
5. The nurse is evaluating a client's hemodynamic status. Which finding
indicates adequate perfusion?
A) MAP 58 mm Hg
B) CVP 8 mm Hg
C) Urine output 25 mL/hr
D) Warm, dry skin with cap refill < 2 seconds
*D) Warm, dry skin with cap refill < 2 seconds
Rationale: Signs of good perfusion include warm, pink, dry skin; urine output ≥
30 mL/hr; mental status alert and oriented; cap refill < 2 seconds; MAP ≥ 60;
CVP 2–6 mmHg. Warm skin with normal cap refill is the most direct indicator of
adequate peripheral perfusion.
6. The nurse is caring for a client with low cardiac output. Which action should
the nurse take first?
A) Administer a vasodilator
B) Assess heart rate and rhythm
C) Increase IV fluid rate
D) Notify the healthcare provider
*B) Assess heart rate and rhythm
Rationale: When troubleshooting low cardiac output, the nurse should first
assess heart rate and rhythm. Tachycardia or dysrhythmias can significantly
, 4|Page
reduce cardiac output. Assessment precedes intervention. After assessment, the
nurse can evaluate preload (CVP), afterload (BP), and contractility.
7. A client is in ventricular tachycardia. Which action should the nurse
implement first?
A) Defibrillate the client immediately
B) Prepare to administer amiodarone
C) Assess the client for a pulse
D) Call a code blue
*C) Assess the client for a pulse
Rationale: The immediate priority is to determine if the client is stable
(pulsatile) or unstable (pulseless). Ventricular tachycardia without a pulse is a
shockable rhythm requiring defibrillation; with a pulse, treatment like
amiodarone may be considered. Always assess first.
8. A client is in torsades de pointes. The nurse understands this dysrhythmia can
occur when:
A) The client is shocked mid-repolarization
B) The client has a serum potassium of 4.0 mEq/L
C) The client has a serum magnesium of 2.0 mEq/L
D) The client has a normal QT interval
*A) The client is shocked mid-repolarization
Rationale: Torsades de pointes can occur if a client is shocked during the
vulnerable period (mid-repolarization, S-T segment). It is associated with
prolonged QT interval, hypokalemia, and hypomagnesemia. Shocking during
repolarization can precipitate this life-threatening dysrhythmia.
9. The nurse is preparing to cardiovert a client with atrial fibrillation. Which
action is essential?
A) Administer IV adenosine prior to cardioversion
B) Ensure the client has been anticoagulated per protocol
C) Place the defibrillator pads in the anteroposterior position
D) Sedate the client with oral benzodiazepines
