Advanced Med/Surg Exam
Study Guide – Practice
Questions with Answers.
Updated 2026
domains of nursing practice - Ans✔✔-where you practice nursing
nursing practice - Ans✔✔--the protection, promotion, and optimization of
health
-preventing illness and injury
-alleviation of suffering
nursing process - Ans✔✔--assessment
-diagnosis
-planning
-implementation
-evaluation
QSEN competencies - Ans✔✔--Patient - Centered Care
-Teamwork and Collaboration
-Safety
,-Quality Improvement
-Informatics
-Evidence - Based Practice
5 rights of delegation - Ans✔✔-1. Right Task
2. Right Circumstance
3. Right Person
4. Right Directions / Communication
5. Right Supervision / Evaluation
properties of cardiac cells - Ans✔✔--Automaticity - Ability to initiate an impulse
spontaneously and continuously
-Excitability - Ability to be electrically stimulated
-Conductivity - Ability to transmit an impulse along a membrane in an orderly
manner
-Contractility - Ability to respond mechanically to an impulse
SA node - Ans✔✔--pacemaker of the heart
-located in Rt atrium
-produces heart rate
-beats at *60-100 bpm*
,parasympathetic nervous system - Ans✔✔-(vagal response)
-decreases rate of SA node
-*decreases heart rate*
-slows impulse conduction of AV node
sympathetic nervous system - Ans✔✔-(fight or flight)
-increases rate of SA node
-*increases heart rate*
-increases impulse conduction of AV node
-increases cardiac contractility
Electrocardiogram monitoring - Ans✔✔--Graphic tracing of electrical impulses
produced by heart
-Waveforms of ECG represent activity of charged ions across membranes of
myocardial cells
depolarization - Ans✔✔-contraction
repolarization - Ans✔✔-Return of the cell to resting state
secondary pacemakers of the heart - Ans✔✔--AV Node: beats at 40-60 bpm
-His-Purkinje Fibers: 20-40 bpm
reading ECG - Ans✔✔--small / little boxes = 0.04 seconds
-bolded box lines = 0.2 seconds
, isoelectric line - Ans✔✔-The baseline of the ECG
PR interval (PRI) - Ans✔✔--from onset of P wave to onset of QRS
-Normal duration = *0.12-0.20 sec*
-represents atria to ventricular conduction time
prolonged PR interval - Ans✔✔-may indicate first degree heart block
QT interval - Ans✔✔--total ventricular activity
-*0.34-0.43*
-measured from beginning of QRS to the end of the T wave
-varies with heart rate
-less than half of the R to R interval
P wave - Ans✔✔-caused by atrial depolarization
QRS complex - Ans✔✔--ventricular depolarization
-*less than 0.12 seconds*
-Q wave greater than 1/3 the height of the R wave, greater than 0.04 seconds
are abnormal and may represent an MI (if Q wave is wider or taller than a box
it can be a pathological Q)
T wave - Ans✔✔-results from ventricular repolarization
Study Guide – Practice
Questions with Answers.
Updated 2026
domains of nursing practice - Ans✔✔-where you practice nursing
nursing practice - Ans✔✔--the protection, promotion, and optimization of
health
-preventing illness and injury
-alleviation of suffering
nursing process - Ans✔✔--assessment
-diagnosis
-planning
-implementation
-evaluation
QSEN competencies - Ans✔✔--Patient - Centered Care
-Teamwork and Collaboration
-Safety
,-Quality Improvement
-Informatics
-Evidence - Based Practice
5 rights of delegation - Ans✔✔-1. Right Task
2. Right Circumstance
3. Right Person
4. Right Directions / Communication
5. Right Supervision / Evaluation
properties of cardiac cells - Ans✔✔--Automaticity - Ability to initiate an impulse
spontaneously and continuously
-Excitability - Ability to be electrically stimulated
-Conductivity - Ability to transmit an impulse along a membrane in an orderly
manner
-Contractility - Ability to respond mechanically to an impulse
SA node - Ans✔✔--pacemaker of the heart
-located in Rt atrium
-produces heart rate
-beats at *60-100 bpm*
,parasympathetic nervous system - Ans✔✔-(vagal response)
-decreases rate of SA node
-*decreases heart rate*
-slows impulse conduction of AV node
sympathetic nervous system - Ans✔✔-(fight or flight)
-increases rate of SA node
-*increases heart rate*
-increases impulse conduction of AV node
-increases cardiac contractility
Electrocardiogram monitoring - Ans✔✔--Graphic tracing of electrical impulses
produced by heart
-Waveforms of ECG represent activity of charged ions across membranes of
myocardial cells
depolarization - Ans✔✔-contraction
repolarization - Ans✔✔-Return of the cell to resting state
secondary pacemakers of the heart - Ans✔✔--AV Node: beats at 40-60 bpm
-His-Purkinje Fibers: 20-40 bpm
reading ECG - Ans✔✔--small / little boxes = 0.04 seconds
-bolded box lines = 0.2 seconds
, isoelectric line - Ans✔✔-The baseline of the ECG
PR interval (PRI) - Ans✔✔--from onset of P wave to onset of QRS
-Normal duration = *0.12-0.20 sec*
-represents atria to ventricular conduction time
prolonged PR interval - Ans✔✔-may indicate first degree heart block
QT interval - Ans✔✔--total ventricular activity
-*0.34-0.43*
-measured from beginning of QRS to the end of the T wave
-varies with heart rate
-less than half of the R to R interval
P wave - Ans✔✔-caused by atrial depolarization
QRS complex - Ans✔✔--ventricular depolarization
-*less than 0.12 seconds*
-Q wave greater than 1/3 the height of the R wave, greater than 0.04 seconds
are abnormal and may represent an MI (if Q wave is wider or taller than a box
it can be a pathological Q)
T wave - Ans✔✔-results from ventricular repolarization
