Galen NUR 242 Exam 2 - MED SURG: (Latest 2026/2027
Update)
Atrial Fibrillation, Digoxin, Myocardial Infarction, Angina,
Pacemakers
Q&A | Grade A | 100% Correct (Verified Answers) – Galen College of Nursing
SUBJECT COURSE FORMAT
Medical-Surgical Nursing - NUR 242 Exam 2 Q&A Guide with Rationale
Cardiology, Dysrhythmias,
Pharmacology
Question 1
Which action by the nurse is most important when preparing for cardioversion of a client with atrial
fibrillation?
A. Set synchronizer switch on defibrillator to the "on" position
B. Remove oxygen from the patient
C. Apply conductive gel to paddles
D. Administer sedation
CORRECT ANSWER
A. Set synchronizer switch on defibrillator to the "on" position
CLINICAL RATIONALE
• Synchronized cardioversion delivers shock on the R wave to avoid inducing ventricular fibrillation.
• Failure to synchronize can cause the shock to fall on the T wave, triggering VFib.
,Question 2
Which assessment finding by the nurse caring for a client with new-onset atrial fibrillation would be
most important to communicate to the health care provider?
A. Sudden vision change
B. Heart rate 120 beats/minute
C. Blood pressure 130/80 mmHg
D. Fatigue
CORRECT ANSWER
A. Sudden vision change
CLINICAL RATIONALE
• Sudden vision change may indicate embolic stroke from atrial thrombus.
• Atrial fibrillation increases risk of thromboembolism; neurologic changes require immediate evaluation.
Question 3
A client who has 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. Heart rate decreases to 80 beats/minute
C. Blood pressure increases
D. Patient denies chest pain
CORRECT ANSWER
A. An activated partial thromboplastin time (aPTT) is twice the usual value
CLINICAL RATIONALE
• Therapeutic heparin range is aPTT 1.5-2.5 times normal (usually 60-80 seconds).
• Goal is to prevent thrombus formation and embolization.
, Question 4
Which assessment finding for a client with heart failure who is taking digoxin will be most important
to communicate to the health care provider?
A. Premature ventricular contractions (PVCs)
B. Heart rate 68 beats/minute
C. Blood pressure 110/70 mmHg
D. Urine output 1200 mL in 8 hours
CORRECT ANSWER
A. Premature ventricular contractions (PVCs)
CLINICAL RATIONALE
• PVCs are a sign of digoxin toxicity, especially if frequent or multifocal.
• Other signs include nausea, vomiting, yellow vision, and bradycardia.
Question 5
When teaching a client about digoxin, which symptom will the nurse include as a reason to withhold
the digoxin?
A. Yellow vision
B. Headache
C. Dizziness
D. Fatigue
CORRECT ANSWER
A. Yellow vision
CLINICAL RATIONALE
• Yellow-green halos around lights (xanthopsia) is a classic sign of digoxin toxicity.
• Other signs: nausea, vomiting, anorexia, and cardiac dysrhythmias.
Update)
Atrial Fibrillation, Digoxin, Myocardial Infarction, Angina,
Pacemakers
Q&A | Grade A | 100% Correct (Verified Answers) – Galen College of Nursing
SUBJECT COURSE FORMAT
Medical-Surgical Nursing - NUR 242 Exam 2 Q&A Guide with Rationale
Cardiology, Dysrhythmias,
Pharmacology
Question 1
Which action by the nurse is most important when preparing for cardioversion of a client with atrial
fibrillation?
A. Set synchronizer switch on defibrillator to the "on" position
B. Remove oxygen from the patient
C. Apply conductive gel to paddles
D. Administer sedation
CORRECT ANSWER
A. Set synchronizer switch on defibrillator to the "on" position
CLINICAL RATIONALE
• Synchronized cardioversion delivers shock on the R wave to avoid inducing ventricular fibrillation.
• Failure to synchronize can cause the shock to fall on the T wave, triggering VFib.
,Question 2
Which assessment finding by the nurse caring for a client with new-onset atrial fibrillation would be
most important to communicate to the health care provider?
A. Sudden vision change
B. Heart rate 120 beats/minute
C. Blood pressure 130/80 mmHg
D. Fatigue
CORRECT ANSWER
A. Sudden vision change
CLINICAL RATIONALE
• Sudden vision change may indicate embolic stroke from atrial thrombus.
• Atrial fibrillation increases risk of thromboembolism; neurologic changes require immediate evaluation.
Question 3
A client who has 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. Heart rate decreases to 80 beats/minute
C. Blood pressure increases
D. Patient denies chest pain
CORRECT ANSWER
A. An activated partial thromboplastin time (aPTT) is twice the usual value
CLINICAL RATIONALE
• Therapeutic heparin range is aPTT 1.5-2.5 times normal (usually 60-80 seconds).
• Goal is to prevent thrombus formation and embolization.
, Question 4
Which assessment finding for a client with heart failure who is taking digoxin will be most important
to communicate to the health care provider?
A. Premature ventricular contractions (PVCs)
B. Heart rate 68 beats/minute
C. Blood pressure 110/70 mmHg
D. Urine output 1200 mL in 8 hours
CORRECT ANSWER
A. Premature ventricular contractions (PVCs)
CLINICAL RATIONALE
• PVCs are a sign of digoxin toxicity, especially if frequent or multifocal.
• Other signs include nausea, vomiting, yellow vision, and bradycardia.
Question 5
When teaching a client about digoxin, which symptom will the nurse include as a reason to withhold
the digoxin?
A. Yellow vision
B. Headache
C. Dizziness
D. Fatigue
CORRECT ANSWER
A. Yellow vision
CLINICAL RATIONALE
• Yellow-green halos around lights (xanthopsia) is a classic sign of digoxin toxicity.
• Other signs: nausea, vomiting, anorexia, and cardiac dysrhythmias.
