NSG 4100 Exam 3: Cardiovascular & Respiratory
Nursing
Comprehensive Examination with ANSWER-s and
Rationales 2026!!!
Question 1: A patient presents with ventricular tachycardia and is hemodynamically unstable. What is
the priority intervention?
A) Administer amiodarone IV push
B) Perform synchronized cardioversion
C) Administer adenosine rapid IV push
D) Perform defibrillation
ANSWER✨✨✔-: B) Perform synchronized cardioversion
Rationale: Synchronized cardioversion is the treatment of choice for unstable ventricular tachycardia
with a pulse. The synchronizer delivers the shock on the R wave to avoid inducing ventricular fibrillation.
Amiodarone is used for stable VT. Adenosine is for supraventricular tachycardias. Defibrillation is for
pulseless VT/VF.
Question 2: A nurse is caring for a patient with a congenital heart defect. The physician orders a
procedure involving the right atrium and right foramen ovale. Which anatomical structure is being
accessed?
A) Patent ductus arteriosus
,B) Ventricular septal defect
C) Atrial septal defect
D) Coarctation of the aorta
ANSWER✨✨✔-: C) Atrial septal defect
Rationale: The foramen ovale is a fetal structure located in the atrial septum. When it fails to close after
birth, it creates an atrial septal defect. Access through the right atrium to the right foramen ovale is
typically for closing an ASD. The other options involve different anatomical locations.
Question 3: During a Functional Endoscopic Sinus Surgery (FESS), the surgical team uses chest x-ray to
guide the procedure. What cardiac rhythm might be identified on the x-ray?
A) Normal sinus rhythm
B) Ventricular tachycardia
C) Atrial fibrillation
D) Sinus bradycardia
ANSWER✨✨✔-: B) Ventricular tachycardia
Rationale: While chest x-rays do not directly visualize cardiac rhythms, the question indicates that during
FESS, the team monitors for ventricular tachycardia, which can be a complication during sinus surgery
due to vagal stimulation or anesthesia effects. The x-ray may show signs of hemodynamic compromise
from the dysrhythmia.
Question 4: A patient with sinus tachycardia requires atropine administration. What is the primary
indication for atropine in this context?
A) To decrease heart rate
B) To increase cardiac output
C) To treat symptomatic bradycardia
,D) To reverse cholinergic effects
ANSWER✨✨✔-: C) To treat symptomatic bradycardia
Rationale: Atropine is a parasympatholytic agent that blocks the vagus nerve, increasing heart rate. It is
indicated for symptomatic bradycardia, not sinus tachycardia. In sinus tachycardia, the underlying cause
should be treated. Atropine would worsen tachycardia and should be avoided.
Question 5: A patient presents with cardiogenic pulmonary edema and hypovolemia. The provider
orders a nitroglycerine (clonidine) loading dose. What is the primary action of this medication
combination?
A) Increase cardiac contractility
B) Reduce preload and afterload
C) Increase systemic vascular resistance
D) Stimulate alpha-adrenergic receptors
ANSWER✨✨✔-: B) Reduce preload and afterload
Rationale: Nitroglycerine is a potent vasodilator that reduces preload and afterload, decreasing the
workload of the heart. Clonidine is a centrally acting alpha-2 agonist that reduces sympathetic outflow.
In cardiogenic pulmonary edema, reducing preload decreases pulmonary congestion while reducing
afterload improves cardiac output.
Question 6: A patient with severe chest pulmonary congestion is receiving bronchodilators. What is the
primary purpose of this therapy?
A) To reduce pulmonary artery pressure
B) To dilate bronchioles and improve airflow
C) To decrease pulmonary capillary permeability
D) To increase surfactant production
, ANSWER✨✨✔-: B) To dilate bronchioles and improve airflow
Rationale: Bronchodilators such as albuterol work by relaxing bronchial smooth muscle, increasing
airway diameter, and improving airflow. While they may have secondary effects on pulmonary
pressures, their primary indication is for bronchospasm and airway obstruction, not directly for
pulmonary congestion.
Question 7: A patient is experiencing diaphoresis and an elevated temperature. The nurse notes
"sweating being temp" in the chart. Which intervention is most appropriate?
A) Administer antipyretics and provide cooling measures
B) Increase room temperature and apply warm blankets
C) Administer IV fluids at room temperature
D) Apply ice packs to the groin and axillae
ANSWER✨✨✔-: A) Administer antipyretics and provide cooling measures
Rationale: The phrase "sweating being temp" suggests the patient is diaphoretic with fever. The priority
is to reduce the fever through antipyretic administration (acetaminophen or ibuprofen) and external
cooling measures. Sweating is the body's compensatory mechanism to cool down during fever.
Question 8: A patient's laboratory results show low red blood cell hemoglobin levels. The nurse
recognizes this as:
A) Hypervolemia
B) Anemia
C) Polycythemia
D) Dehydration
ANSWER✨✨✔-: B) Anemia
Nursing
Comprehensive Examination with ANSWER-s and
Rationales 2026!!!
Question 1: A patient presents with ventricular tachycardia and is hemodynamically unstable. What is
the priority intervention?
A) Administer amiodarone IV push
B) Perform synchronized cardioversion
C) Administer adenosine rapid IV push
D) Perform defibrillation
ANSWER✨✨✔-: B) Perform synchronized cardioversion
Rationale: Synchronized cardioversion is the treatment of choice for unstable ventricular tachycardia
with a pulse. The synchronizer delivers the shock on the R wave to avoid inducing ventricular fibrillation.
Amiodarone is used for stable VT. Adenosine is for supraventricular tachycardias. Defibrillation is for
pulseless VT/VF.
Question 2: A nurse is caring for a patient with a congenital heart defect. The physician orders a
procedure involving the right atrium and right foramen ovale. Which anatomical structure is being
accessed?
A) Patent ductus arteriosus
,B) Ventricular septal defect
C) Atrial septal defect
D) Coarctation of the aorta
ANSWER✨✨✔-: C) Atrial septal defect
Rationale: The foramen ovale is a fetal structure located in the atrial septum. When it fails to close after
birth, it creates an atrial septal defect. Access through the right atrium to the right foramen ovale is
typically for closing an ASD. The other options involve different anatomical locations.
Question 3: During a Functional Endoscopic Sinus Surgery (FESS), the surgical team uses chest x-ray to
guide the procedure. What cardiac rhythm might be identified on the x-ray?
A) Normal sinus rhythm
B) Ventricular tachycardia
C) Atrial fibrillation
D) Sinus bradycardia
ANSWER✨✨✔-: B) Ventricular tachycardia
Rationale: While chest x-rays do not directly visualize cardiac rhythms, the question indicates that during
FESS, the team monitors for ventricular tachycardia, which can be a complication during sinus surgery
due to vagal stimulation or anesthesia effects. The x-ray may show signs of hemodynamic compromise
from the dysrhythmia.
Question 4: A patient with sinus tachycardia requires atropine administration. What is the primary
indication for atropine in this context?
A) To decrease heart rate
B) To increase cardiac output
C) To treat symptomatic bradycardia
,D) To reverse cholinergic effects
ANSWER✨✨✔-: C) To treat symptomatic bradycardia
Rationale: Atropine is a parasympatholytic agent that blocks the vagus nerve, increasing heart rate. It is
indicated for symptomatic bradycardia, not sinus tachycardia. In sinus tachycardia, the underlying cause
should be treated. Atropine would worsen tachycardia and should be avoided.
Question 5: A patient presents with cardiogenic pulmonary edema and hypovolemia. The provider
orders a nitroglycerine (clonidine) loading dose. What is the primary action of this medication
combination?
A) Increase cardiac contractility
B) Reduce preload and afterload
C) Increase systemic vascular resistance
D) Stimulate alpha-adrenergic receptors
ANSWER✨✨✔-: B) Reduce preload and afterload
Rationale: Nitroglycerine is a potent vasodilator that reduces preload and afterload, decreasing the
workload of the heart. Clonidine is a centrally acting alpha-2 agonist that reduces sympathetic outflow.
In cardiogenic pulmonary edema, reducing preload decreases pulmonary congestion while reducing
afterload improves cardiac output.
Question 6: A patient with severe chest pulmonary congestion is receiving bronchodilators. What is the
primary purpose of this therapy?
A) To reduce pulmonary artery pressure
B) To dilate bronchioles and improve airflow
C) To decrease pulmonary capillary permeability
D) To increase surfactant production
, ANSWER✨✨✔-: B) To dilate bronchioles and improve airflow
Rationale: Bronchodilators such as albuterol work by relaxing bronchial smooth muscle, increasing
airway diameter, and improving airflow. While they may have secondary effects on pulmonary
pressures, their primary indication is for bronchospasm and airway obstruction, not directly for
pulmonary congestion.
Question 7: A patient is experiencing diaphoresis and an elevated temperature. The nurse notes
"sweating being temp" in the chart. Which intervention is most appropriate?
A) Administer antipyretics and provide cooling measures
B) Increase room temperature and apply warm blankets
C) Administer IV fluids at room temperature
D) Apply ice packs to the groin and axillae
ANSWER✨✨✔-: A) Administer antipyretics and provide cooling measures
Rationale: The phrase "sweating being temp" suggests the patient is diaphoretic with fever. The priority
is to reduce the fever through antipyretic administration (acetaminophen or ibuprofen) and external
cooling measures. Sweating is the body's compensatory mechanism to cool down during fever.
Question 8: A patient's laboratory results show low red blood cell hemoglobin levels. The nurse
recognizes this as:
A) Hypervolemia
B) Anemia
C) Polycythemia
D) Dehydration
ANSWER✨✨✔-: B) Anemia
