1
NSG 4100 Notes w Annotations COMPLETE
QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) |ALREADY GRADED
A+||BRAND NEW VERSION!!
Section 1: Complex Perfusion Problems (Cardiovascular) – Questions 1–35
Hemodynamic Concepts
Q1. The heart contracts to pump blood out. This phase of the cardiac cycle is called:
A. Diastole
B. Systole
C. Preload
D. Afterload
Answer: B. Systole
Rationale: Systole is the contraction phase when the heart pumps blood out (depolarization). Diastole is
the relaxation phase when the heart fills with blood.
Q2. The amount of ventricular stretch at the end of diastole is called:
A. Afterload
B. Cardiac output
C. Stroke volume
D. Preload
Answer: D. Preload
Rationale: Preload is the initial stretching of the ventricles prior to contraction—the heart "loading up"
for the next squeeze. Fluids can be given to increase preload.
Q3. A patient's CVP reading is 2 mm Hg. The nurse interprets this as:
A. Elevated right ventricular preload (hypervolemia)
B. Reduced right ventricular preload (hypovolemia)
C. Normal right ventricular pressure
D. Increased pulmonary artery pressure
Answer: B. Reduced right ventricular preload (hypovolemia)
Rationale: CVP < 2 mm Hg indicates reduced right ventricular preload (hypovolemic). CVP > 6 mm Hg
indicates elevated right ventricular preload (hypervolemic).
,2
Q4. Systemic vascular resistance (SVR) is the amount of resistance the heart must overcome to open the
aortic valve. This is called:
A. Preload
B. Stroke volume
C. Afterload
D. Cardiac output
Answer: C. Afterload
Rationale: Afterload is the resistance the heart must overcome to open the aortic valve and push blood
into systemic circulation. Vasoconstriction increases afterload.
Q5. The nurse is caring for a patient with hemodynamic monitoring. What solution should NOT be
infused into the monitoring systems?
A. Normal saline
B. Dextrose
C. Lactated Ringer's
D. Heparinized saline
Answer: B. Dextrose
Rationale: Dextrose solutions should not be infused into hemodynamic monitoring systems. Normal
saline (with or without heparin) is used.
Q6. A patient with a central venous pressure catheter asks about bathing. The nurse's best response is:
A. "You may take a bath but keep the site dry."
B. "Do not submerge the catheter site in water; showering is permitted with an impermeable cover."
C. "You must take sponge baths only until the catheter is removed."
D. "You may shower without any special precautions."
Answer: B. "Do not submerge the catheter site in water; showering is permitted with an
impermeable cover."
Rationale: The catheter site must not be submerged in water. Showering is permitted only if the
catheter and tubing are in an impermeable cover.
Cardiac Rhythms & ECG Interpretation
Q7. A patient's ECG shows a heart rate of 35 bpm with consistent P waves before each QRS complex. BP
is 88/50 mmHg and the patient reports dizziness. What is the priority nursing intervention?
A. Administer atropine as prescribed
B. Prepare for transcutaneous pacing
C. Obtain a 12-lead ECG
D. Elevate the head of the bed
Answer: B. Prepare for transcutaneous pacing
Rationale: The patient has symptomatic sinus bradycardia with severe hypotension. While atropine is
first-line medication, a rate of 35 bpm is severely low. Transcutaneous pacing can immediately increase
heart rate and improve cardiac output while waiting for atropine to take effect.
, 3
Q8. A nurse notes a rapid, irregular rhythm with a heart rate of 150 bpm and no discernible P waves on
the telemetry monitor. The patient reports lightheadedness. What rhythm is most likely?
A. Sinus tachycardia
B. Atrial fibrillation
C. Ventricular tachycardia
D. Atrial flutter
Answer: B. Atrial fibrillation
Rationale: Atrial fibrillation is characterized by a rapid, irregular rhythm with no identifiable P waves.
The loss of atrial kick and rapid ventricular response decreases cardiac output, causing lightheadedness.
Q9. Which of the following is a cause of sinus tachycardia? (Select all that apply)
A. Fever
B. Hypothyroidism
C. Pain
D. Hypoxia
E. Increased intracranial pressure
Answer: A, C, D
Rationale: Sinus tachycardia (>100 bpm) is caused by fever, hyperthyroidism (not hypothyroidism), pain,
increased metabolism, hypotension, and hypoxia.
Q10. What medication should NOT be given for sinus tachycardia?
A. Beta-blockers
B. Calcium channel blockers
C. Atropine
D. Adenosine
Answer: C. Atropine
Rationale: Atropine increases heart rate and is used for bradycardia, not tachycardia. Beta-blockers and
calcium channel blockers are appropriate for sinus tachycardia.
Q11. A patient's ECG strip shows ventricular tachycardia. What is the appropriate intervention?
A. Defibrillation
B. Synchronized cardioversion
C. Atropine IV push
D. Adenosine rapid IV push
Answer: B. Synchronized cardioversion
Rationale: Ventricular tachycardia with a pulse is treated with synchronized cardioversion. Pulseless VT
requires defibrillation.
Q12. A patient develops Torsades de Pointes. The nurse anticipates administering:
A. Amiodarone
B. Magnesium sulfate
C. Atropine
D. Epinephrine
NSG 4100 Notes w Annotations COMPLETE
QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) |ALREADY GRADED
A+||BRAND NEW VERSION!!
Section 1: Complex Perfusion Problems (Cardiovascular) – Questions 1–35
Hemodynamic Concepts
Q1. The heart contracts to pump blood out. This phase of the cardiac cycle is called:
A. Diastole
B. Systole
C. Preload
D. Afterload
Answer: B. Systole
Rationale: Systole is the contraction phase when the heart pumps blood out (depolarization). Diastole is
the relaxation phase when the heart fills with blood.
Q2. The amount of ventricular stretch at the end of diastole is called:
A. Afterload
B. Cardiac output
C. Stroke volume
D. Preload
Answer: D. Preload
Rationale: Preload is the initial stretching of the ventricles prior to contraction—the heart "loading up"
for the next squeeze. Fluids can be given to increase preload.
Q3. A patient's CVP reading is 2 mm Hg. The nurse interprets this as:
A. Elevated right ventricular preload (hypervolemia)
B. Reduced right ventricular preload (hypovolemia)
C. Normal right ventricular pressure
D. Increased pulmonary artery pressure
Answer: B. Reduced right ventricular preload (hypovolemia)
Rationale: CVP < 2 mm Hg indicates reduced right ventricular preload (hypovolemic). CVP > 6 mm Hg
indicates elevated right ventricular preload (hypervolemic).
,2
Q4. Systemic vascular resistance (SVR) is the amount of resistance the heart must overcome to open the
aortic valve. This is called:
A. Preload
B. Stroke volume
C. Afterload
D. Cardiac output
Answer: C. Afterload
Rationale: Afterload is the resistance the heart must overcome to open the aortic valve and push blood
into systemic circulation. Vasoconstriction increases afterload.
Q5. The nurse is caring for a patient with hemodynamic monitoring. What solution should NOT be
infused into the monitoring systems?
A. Normal saline
B. Dextrose
C. Lactated Ringer's
D. Heparinized saline
Answer: B. Dextrose
Rationale: Dextrose solutions should not be infused into hemodynamic monitoring systems. Normal
saline (with or without heparin) is used.
Q6. A patient with a central venous pressure catheter asks about bathing. The nurse's best response is:
A. "You may take a bath but keep the site dry."
B. "Do not submerge the catheter site in water; showering is permitted with an impermeable cover."
C. "You must take sponge baths only until the catheter is removed."
D. "You may shower without any special precautions."
Answer: B. "Do not submerge the catheter site in water; showering is permitted with an
impermeable cover."
Rationale: The catheter site must not be submerged in water. Showering is permitted only if the
catheter and tubing are in an impermeable cover.
Cardiac Rhythms & ECG Interpretation
Q7. A patient's ECG shows a heart rate of 35 bpm with consistent P waves before each QRS complex. BP
is 88/50 mmHg and the patient reports dizziness. What is the priority nursing intervention?
A. Administer atropine as prescribed
B. Prepare for transcutaneous pacing
C. Obtain a 12-lead ECG
D. Elevate the head of the bed
Answer: B. Prepare for transcutaneous pacing
Rationale: The patient has symptomatic sinus bradycardia with severe hypotension. While atropine is
first-line medication, a rate of 35 bpm is severely low. Transcutaneous pacing can immediately increase
heart rate and improve cardiac output while waiting for atropine to take effect.
, 3
Q8. A nurse notes a rapid, irregular rhythm with a heart rate of 150 bpm and no discernible P waves on
the telemetry monitor. The patient reports lightheadedness. What rhythm is most likely?
A. Sinus tachycardia
B. Atrial fibrillation
C. Ventricular tachycardia
D. Atrial flutter
Answer: B. Atrial fibrillation
Rationale: Atrial fibrillation is characterized by a rapid, irregular rhythm with no identifiable P waves.
The loss of atrial kick and rapid ventricular response decreases cardiac output, causing lightheadedness.
Q9. Which of the following is a cause of sinus tachycardia? (Select all that apply)
A. Fever
B. Hypothyroidism
C. Pain
D. Hypoxia
E. Increased intracranial pressure
Answer: A, C, D
Rationale: Sinus tachycardia (>100 bpm) is caused by fever, hyperthyroidism (not hypothyroidism), pain,
increased metabolism, hypotension, and hypoxia.
Q10. What medication should NOT be given for sinus tachycardia?
A. Beta-blockers
B. Calcium channel blockers
C. Atropine
D. Adenosine
Answer: C. Atropine
Rationale: Atropine increases heart rate and is used for bradycardia, not tachycardia. Beta-blockers and
calcium channel blockers are appropriate for sinus tachycardia.
Q11. A patient's ECG strip shows ventricular tachycardia. What is the appropriate intervention?
A. Defibrillation
B. Synchronized cardioversion
C. Atropine IV push
D. Adenosine rapid IV push
Answer: B. Synchronized cardioversion
Rationale: Ventricular tachycardia with a pulse is treated with synchronized cardioversion. Pulseless VT
requires defibrillation.
Q12. A patient develops Torsades de Pointes. The nurse anticipates administering:
A. Amiodarone
B. Magnesium sulfate
C. Atropine
D. Epinephrine
