NUR 453 EXAM 1 QUESTIONS AND ANSWERS | LATEST NUR 453
STUDY GUIDE & PRACTICE TEST 2026/2027
Which leads look at the inferior wall of the heart? - correct answer ✔✔Leads 2, 3, and AVF
Which leads look at the lateral aspect of the heart? - correct answer ✔✔Leads 1, AVL, V5, and V6
Which leads look at the interventricular septum? - correct answer ✔✔Leads V1 and V2
Which leads look at the anterior wall of the heart? - correct answer ✔✔Leads V3 and V4
Assessment of a patient in sinus bradycardia - correct answer ✔✔Bradycardia + no symptoms + no
hypoTN = just monitor (no interventions)
Bradycardia + symptoms (ex: syncope, hypoxemia, etc) but no hypoTN = give Atropine 0.5 mg IV
Bradycardia + symptoms + HypoTN (<70/40) = shock with Pacemaker! Call for help and give O2 while
waiting
Causes of sinus bradycardia - correct answer ✔✔Pain meds
Beta Blockers
Anemia
Exercise
Digoxin
Causes of sinus tachycardia - correct answer ✔✔Fever
Pain
Anxiety
Caffeine
Cocaine
Dehydration
PAC (Premature Atrial Contraction) - correct answer ✔✔Cardiac cell becomes irritable and fires an
impulse before the next sinus impulse is produced.
Caused by stress, fatigue, anxiety, caffeine, nicotine, infections
Remove substances and it is usually self-limiting
Atrial flutter - correct answer ✔✔No P wave
Sawtooth pattern
R to R is normal or fast
Normal QRS
Caused by pericarditis, hypoxia, and COPD
Treatment of Atrial Flutter - correct answer ✔✔Aflutter + HR > 100 + symptoms (palpitations, SOB,
dizziness, fatigue) = CCB & Digoxin to slow heart down
Aflutter + HR > 150 + BP 80/40 = Synchronized Cardioversion on R wave (unstable)
Atrial Fibrillation - correct answer ✔✔No P wave
, Most common dysrhythmia
Caused by ischemia, heart disease, age > 75
AFib Treatment - correct answer ✔✔Unstable/New onset: Cardioversion
Stable: rate or rhythm control (CCB or BB)
Risk of clot (can lead to stroke, give anticoagulants)
Junctional Rhythm - correct answer ✔✔The SA node is nonfunctional
P waves are absent
Heart is paced by the AV node at 40-60 beats/min
Occurs with hypoxemia and Digoxin toxicity
PVC - correct answer ✔✔Increased irritability of ventricles
No P wave
QRS wide & bizarre
Frequently occur in repetition
Can be asymptomatic or cause palpitations and decreased peripheral pulses
Caused by hypoxemia, hypokalemia, and hypomagnesemia
Ventricular Tachycardia - correct answer ✔✔Very rapid heartbeat that begins with the ventricles
3 or more PVCs in a row
> 140 - 250 BPM
Regular R to R rhythm
Wide & bizarre QRS
Unresponsive, pulseness, apneic
PVC Treatment - correct answer ✔✔Treat the cause (give K+ but NOT IV PUSH)
Pulse = cardiovert
No pulse = give CPR
VTach treatment - correct answer ✔✔Stable = amiodarone
Unstable w/pulse = cardiovert
Unstable w/o pulse = defibrillate
Clinical death - correct answer ✔✔Unresponsive
Lack of respirations
No pulse
Call a code blue & CPR is key to survival
Torsades de pointes - correct answer ✔✔Happens in alcoholics and pts w/diarrhea
Pulseless and polymorphic VTach (QRS starts small and then gets wide/bizarre/twisting)
Treatment: CPR and replace Mg2+
Ventricular Fibrillation - correct answer ✔✔No organized rhythm
Wavy lines of varying amplitude
Rapidly fatal
Tx = defibrillate
STUDY GUIDE & PRACTICE TEST 2026/2027
Which leads look at the inferior wall of the heart? - correct answer ✔✔Leads 2, 3, and AVF
Which leads look at the lateral aspect of the heart? - correct answer ✔✔Leads 1, AVL, V5, and V6
Which leads look at the interventricular septum? - correct answer ✔✔Leads V1 and V2
Which leads look at the anterior wall of the heart? - correct answer ✔✔Leads V3 and V4
Assessment of a patient in sinus bradycardia - correct answer ✔✔Bradycardia + no symptoms + no
hypoTN = just monitor (no interventions)
Bradycardia + symptoms (ex: syncope, hypoxemia, etc) but no hypoTN = give Atropine 0.5 mg IV
Bradycardia + symptoms + HypoTN (<70/40) = shock with Pacemaker! Call for help and give O2 while
waiting
Causes of sinus bradycardia - correct answer ✔✔Pain meds
Beta Blockers
Anemia
Exercise
Digoxin
Causes of sinus tachycardia - correct answer ✔✔Fever
Pain
Anxiety
Caffeine
Cocaine
Dehydration
PAC (Premature Atrial Contraction) - correct answer ✔✔Cardiac cell becomes irritable and fires an
impulse before the next sinus impulse is produced.
Caused by stress, fatigue, anxiety, caffeine, nicotine, infections
Remove substances and it is usually self-limiting
Atrial flutter - correct answer ✔✔No P wave
Sawtooth pattern
R to R is normal or fast
Normal QRS
Caused by pericarditis, hypoxia, and COPD
Treatment of Atrial Flutter - correct answer ✔✔Aflutter + HR > 100 + symptoms (palpitations, SOB,
dizziness, fatigue) = CCB & Digoxin to slow heart down
Aflutter + HR > 150 + BP 80/40 = Synchronized Cardioversion on R wave (unstable)
Atrial Fibrillation - correct answer ✔✔No P wave
, Most common dysrhythmia
Caused by ischemia, heart disease, age > 75
AFib Treatment - correct answer ✔✔Unstable/New onset: Cardioversion
Stable: rate or rhythm control (CCB or BB)
Risk of clot (can lead to stroke, give anticoagulants)
Junctional Rhythm - correct answer ✔✔The SA node is nonfunctional
P waves are absent
Heart is paced by the AV node at 40-60 beats/min
Occurs with hypoxemia and Digoxin toxicity
PVC - correct answer ✔✔Increased irritability of ventricles
No P wave
QRS wide & bizarre
Frequently occur in repetition
Can be asymptomatic or cause palpitations and decreased peripheral pulses
Caused by hypoxemia, hypokalemia, and hypomagnesemia
Ventricular Tachycardia - correct answer ✔✔Very rapid heartbeat that begins with the ventricles
3 or more PVCs in a row
> 140 - 250 BPM
Regular R to R rhythm
Wide & bizarre QRS
Unresponsive, pulseness, apneic
PVC Treatment - correct answer ✔✔Treat the cause (give K+ but NOT IV PUSH)
Pulse = cardiovert
No pulse = give CPR
VTach treatment - correct answer ✔✔Stable = amiodarone
Unstable w/pulse = cardiovert
Unstable w/o pulse = defibrillate
Clinical death - correct answer ✔✔Unresponsive
Lack of respirations
No pulse
Call a code blue & CPR is key to survival
Torsades de pointes - correct answer ✔✔Happens in alcoholics and pts w/diarrhea
Pulseless and polymorphic VTach (QRS starts small and then gets wide/bizarre/twisting)
Treatment: CPR and replace Mg2+
Ventricular Fibrillation - correct answer ✔✔No organized rhythm
Wavy lines of varying amplitude
Rapidly fatal
Tx = defibrillate
