GALEN COLLEGE OF NURSING
NUR 242 — Exam 2
Cardiac Nursing —
Complete Question Bank
NCLEX-Style Practice Questions with Detailed Rationales
Topic: Cardiac Medications, Dysrhythmias, ACS, Angina — 125 Questions
Edition 1 · September 2026
Table of Contents
1. Instructions for Use 2
2. Practice Questions with Answers & Rationales — Cardiac Nursing (125 Questions) 2
NUR 242 · Galen College of Nursing Page 1
,NUR 242 EXAM 2 PRACTICE GUIDE INSTRUCTIONS & PRACTICE QUESTIONS
How to Use This Guide
Read each stem, choose your answer, then check the rationale directly below it. The correct
option is marked, and each wrong option is explained so you understand why it's wrong — not
just that it is. All questions are based on the Galen College of Nursing NUR 242 Medical-
Surgical Nursing Concepts curriculum.
Category: Cardiac Nursing — Comprehensive Review (125 Questions)
1. A nurse is preparing for cardioversion of a client with atrial fibrillation. Which
action is most important for the nurse to take?
A. Set synchronizer switch on defibrillator to the "on" position
B. Set the defibrillator to 200 joules
C. Apply defibrillator pads to the chest
D. Administer sedation to the client
Correct Answer: A
Rationale: When preparing for cardioversion, the nurse must set the synchronizer
switch to the "on" position to ensure the shock is delivered on the R wave of the
cardiac cycle. This prevents the shock from being delivered on the T wave, which could
cause ventricular fibrillation.
Tested Concept: Cardioversion preparation
Source Concept: "Set synchronizer switch on defibrillator to the 'on' position."
Difficult
,2. A nurse is caring for a client with new-onset atrial fibrillation. Which
assessment finding is most important to communicate to the healthcare
provider?
A. Sudden vision change
B. Heart rate of 110 beats/minute
C. Blood pressure of 140/88 mmHg
D. Mild shortness of breath
Correct Answer: A
Rationale: Sudden vision change in a client with atrial fibrillation may indicate a
thromboembolic event such as a stroke or transient ischemic attack. This requires
immediate communication to the healthcare provider for urgent intervention.
Tested Concept: Atrial fibrillation — complications
Source Concept: "Sudden vision change."
Difficult
, 3. A client with atrial fibrillation with rapid ventricular response is started on a
continuous heparin infusion. Which clinical finding enables the nurse to
conclude that the heparin therapy is effective?
A. An activated partial thromboplastin time (aPTT) is twice the usual value
B. The client's heart rate has decreased to 80 beats/minute
C. The client's blood pressure is stable
D. The client reports no chest pain
Correct Answer: A
Rationale: Heparin therapy is effective when the aPTT is 1.5 to 2.5 times the normal
value (approximately twice the usual value). This indicates adequate anticoagulation to
prevent thrombus formation in atrial fibrillation.
Tested Concept: Heparin therapy effectiveness
Source Concept: "An activated partial thromboplastin time (aPTT) is twice the usual value."
Moderate
NUR 242 — Exam 2
Cardiac Nursing —
Complete Question Bank
NCLEX-Style Practice Questions with Detailed Rationales
Topic: Cardiac Medications, Dysrhythmias, ACS, Angina — 125 Questions
Edition 1 · September 2026
Table of Contents
1. Instructions for Use 2
2. Practice Questions with Answers & Rationales — Cardiac Nursing (125 Questions) 2
NUR 242 · Galen College of Nursing Page 1
,NUR 242 EXAM 2 PRACTICE GUIDE INSTRUCTIONS & PRACTICE QUESTIONS
How to Use This Guide
Read each stem, choose your answer, then check the rationale directly below it. The correct
option is marked, and each wrong option is explained so you understand why it's wrong — not
just that it is. All questions are based on the Galen College of Nursing NUR 242 Medical-
Surgical Nursing Concepts curriculum.
Category: Cardiac Nursing — Comprehensive Review (125 Questions)
1. A nurse is preparing for cardioversion of a client with atrial fibrillation. Which
action is most important for the nurse to take?
A. Set synchronizer switch on defibrillator to the "on" position
B. Set the defibrillator to 200 joules
C. Apply defibrillator pads to the chest
D. Administer sedation to the client
Correct Answer: A
Rationale: When preparing for cardioversion, the nurse must set the synchronizer
switch to the "on" position to ensure the shock is delivered on the R wave of the
cardiac cycle. This prevents the shock from being delivered on the T wave, which could
cause ventricular fibrillation.
Tested Concept: Cardioversion preparation
Source Concept: "Set synchronizer switch on defibrillator to the 'on' position."
Difficult
,2. A nurse is caring for a client with new-onset atrial fibrillation. Which
assessment finding is most important to communicate to the healthcare
provider?
A. Sudden vision change
B. Heart rate of 110 beats/minute
C. Blood pressure of 140/88 mmHg
D. Mild shortness of breath
Correct Answer: A
Rationale: Sudden vision change in a client with atrial fibrillation may indicate a
thromboembolic event such as a stroke or transient ischemic attack. This requires
immediate communication to the healthcare provider for urgent intervention.
Tested Concept: Atrial fibrillation — complications
Source Concept: "Sudden vision change."
Difficult
, 3. A client with atrial fibrillation with rapid ventricular response is started on a
continuous heparin infusion. Which clinical finding enables the nurse to
conclude that the heparin therapy is effective?
A. An activated partial thromboplastin time (aPTT) is twice the usual value
B. The client's heart rate has decreased to 80 beats/minute
C. The client's blood pressure is stable
D. The client reports no chest pain
Correct Answer: A
Rationale: Heparin therapy is effective when the aPTT is 1.5 to 2.5 times the normal
value (approximately twice the usual value). This indicates adequate anticoagulation to
prevent thrombus formation in atrial fibrillation.
Tested Concept: Heparin therapy effectiveness
Source Concept: "An activated partial thromboplastin time (aPTT) is twice the usual value."
Moderate
