WITH 35 ACCURATE QUESTIONS &
ANSWERS (VERIFIED ANSWERS) |
LATEST (2026/2027) UPDATED
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Section 1: Sinus & Atrial Rhythms (Questions 1–10)
1. A patient’s telemetry monitor shows a regular rhythm with a heart rate of 72 bpm,
upright P waves in Lead II that look identical, a PR interval of 0.16 seconds, and a
QRS duration of 0.08 seconds. Which rhythm is being displayed?
A) Sinus Bradycardia
B) Normal Sinus Rhythm
C) First-Degree AV Block
D) Atrial Flutter
E) Sinus Arrhythmia
Answer: B) Normal Sinus Rhythm
Expert Rationale: Normal Sinus Rhythm is characterized by a regular rate
between 60–100 bpm, matching upright P waves preceding every QRS complex,
a normal PR interval (0.12 to 0.20 seconds), and a narrow QRS complex (less
, than 0.12 seconds). All parameters provided fall within normal limits.
2. A patient recovering from an acute myocardial infarction becomes dizzy, diaphoretic,
and hypotensive. The cardiac monitor reveals sinus bradycardia at 42 bpm. What is
the priority nursing intervention?
A) Administer a 500 mL IV fluid bolus
B) Prepare for immediate synchronized cardioversion
C) Administer Adenosine 6 mg rapid IV push
D) Administer Atropine 1 mg IV push
E) Initiate transcutaneous pacing immediately
Answer: D) Administer Atropine 1 mg IV push
Expert Rationale: Per ACLS guidelines, the first-line medication for
symptomatic, unstable bradycardia is Atropine 1 mg IV push (which can be
repeated every 3–5 minutes up to a maximum of 3 mg). If Atropine is ineffective,
transcutaneous pacing or inotropic infusions (Dopamine/Epinephrine) should be
initiated.
3. A nurse notes a patient’s rhythm is regular at 135 bpm, with a normal PR interval and
a narrow QRS. The P waves are upright and uniform but occur very close to the
preceding T waves. The patient has a temperature of 102.1°F (38.9°C). What is the
primary treatment for this rhythm?
A) Administer Amiodarone 150 mg IV over 10 minutes
B) Perform immediate carotid sinus massage
C) Treat the underlying cause by administering antipyretics and IV fluids
D) Administer Diltiazem IV bolus
, E) Prepare the patient for urgent radiofrequency ablation
Answer: C) Treat the underlying cause by administering antipyretics and IV
fluids
Expert Rationale: The rhythm described is Sinus Tachycardia, which is a
physiological response to stress, fever, dehydration, hypoxia, or pain. Treatment
must be directed at resolving the underlying etiology (fever and dehydration in
this case) rather than directly slowing the heart rate with antiarrhythmic drugs.
4. While evaluating an EKG strip, the nurse notes that the rhythm is irregular, but all P
waves are identical, the PR interval remains constant at 0.14 seconds, and the QRS
complexes are normal. The heart rate increases slightly during inspiration and slows
during expiration. How should the nurse document this rhythm?
A) Premature Atrial Contractions
B) Wandering Atrial Pacemaker
C) Sinus Arrhythmia
D) Atrial Fibrillation
E) Sinus Arrest
Answer: C) Sinus Arrhythmia
Expert Rationale: Sinus Arrhythmia is a normal physiological variation
frequently seen in young adults and healthy individuals. It features an irregular
rhythm where the heart rate fluctuates with the respiratory cycle (speeding up
during inspiration, slowing down during expiration), while maintaining normal
sinus P wave morphology and PR intervals.
5. A patient on telemetry exhibits a predominantly regular sinus rhythm but experiences