NSG 4100 Exam 3 ANSWERs
Comprehensive Cardiovascular and Respiratory
Nursing Examination 2026
1. A patient with ventricular tachycardia and a pulse is unstable. Which intervention should the nurse
prepare for first?
A. Administer adenosine IV push
B. Prepare for synchronized cardioversion
C. Begin unsynchronized defibrillation
D. Administer amiodarone infusion
ANSWER: B
Rationale:
A (Incorrect): Adenosine is used for stable supraventricular tachycardia (SVT), not ventricular
tachycardia. It works by briefly blocking AV node conduction.
B (Correct): Synchronized cardioversion is the treatment of choice for unstable ventricular tachycardia
with a pulse. The synchronization prevents delivery during the vulnerable period of the T wave, which
could cause ventricular fibrillation.
nursingcecentral.com
C (Incorrect): Unsynchronized defibrillation is used for pulseless ventricular tachycardia or ventricular
fibrillation, not when the patient has a pulse.
D (Incorrect): Amiodarone may be used for stable ventricular tachycardia or as an adjunct, but unstable
patients require immediate cardioversion first.
2. The nurse is caring for a patient who requires CPR but has suspected neck trauma. What is the priority
modification to standard CPR technique?
A. Use jaw-thrust maneuver instead of head-tilt chin-lift
B. Avoid chest compressions to prevent further injury
,C. Hyperextend the neck to open the airway
D. Place a pillow under the shoulders
ANSWER: A
Rationale:
A (Correct): The jaw-thrust maneuver opens the airway without extending the neck, which is critical
when cervical spine injury is suspected. This prevents further spinal cord damage.
B (Incorrect): Chest compressions should never be withheld due to neck trauma. Circulation is the
priority in cardiac arrest.
C (Incorrect): Hyperextending the neck is contraindicated with suspected cervical spine injury as it can
cause further damage to the spinal cord.
D (Incorrect): Placing a pillow under the shoulders would extend the neck, which is contraindicated with
suspected cervical spine trauma.
3. A patient presents with sinus tachycardia. Which underlying cause should the nurse assess for first?
A. Primary cardiac dysrhythmia requiring immediate cardioversion
B. Hypovolemia, pain, fever, or anxiety
C. Need for beta-blocker administration
D. Imminent cardiac arrest
ANSWER: B
Rationale:
A (Incorrect): Sinus tachycardia is typically a normal physiological response, not a primary dysrhythmia
requiring cardioversion.
B (Correct): Sinus tachycardia is usually a compensatory response to underlying conditions such as
hypovolemia, pain, fever, anxiety, hypoxia, or anemia. The nurse must identify and treat the underlying
cause.
C (Incorrect): Beta-blockers may be considered, but only after identifying the cause. Treating sinus
tachycardia without addressing the underlying cause can be harmful.
D (Incorrect): While sinus tachycardia can occur before cardiac arrest, it is not itself a sign of imminent
arrest. It's usually a compensatory mechanism.
4. A patient with acute cardiogenic pulmonary edema is experiencing severe dyspnea. The physician
orders morphine sulfate IV. What is the primary rationale for this medication?
A. To provide pain relief for chest discomfort
B. To reduce preload and anxiety, decreasing work of breathing
,C. To increase cardiac contractility
D. To prevent respiratory arrest
ANSWER: B
Rationale:
A (Incorrect): While morphine does provide pain relief, this is not the primary rationale in pulmonary
edema unless the patient is experiencing pain.
B (Correct): Morphine reduces preload through venodilation, decreases anxiety, and reduces the work
of breathing in pulmonary edema. It helps relieve dyspnea by reducing pulmonary capillary pressure.
pmc.ncbi.nlm.nih.gov
simplenursing.com
C (Incorrect): Morphine does not increase cardiac contractility; it may actually decrease it slightly.
D (Incorrect): Morphine can depress respiration and is used cautiously. It does not prevent respiratory
arrest.
5. The nurse is administering bronchodilators to a patient with COPD. Which assessment finding
indicates the medication is effective?
A. Decreased heart rate
B. Improved breath sounds and decreased wheezing
C. Increased sputum production
D. Decreased respiratory rate to 8 breaths/min
ANSWER: B
Rationale:
A (Incorrect): Bronchodilators, especially beta-agonists, typically increase heart rate as a side effect, not
decrease it.
B (Correct): Improved breath sounds and decreased wheezing indicate bronchodilation and improved
airway patency, showing the medication is working effectively.
C (Incorrect): While sputum may become easier to expectorate, increased production is not the goal and
may indicate infection.
D (Incorrect): A respiratory rate of 8 is too low and may indicate respiratory depression. Normal
respiratory rate is 12-20 breaths/min.
6. A patient with COPD is experiencing an acute exacerbation. Which nursing intervention is the priority?
A. Administer high-flow oxygen at 100%
B. Position in high Fowler's position
, C. Encourage coughing and deep breathing
D. Administer sedatives to reduce anxiety
ANSWER: B
Rationale:
A (Incorrect): High-flow oxygen can suppress the hypoxic drive in COPD patients. Oxygen should be
titrated carefully, typically starting at 24-28% via Venturi mask.
www.myamericannurse.com
B (Correct): High Fowler's position maximizes lung expansion and decreases the work of breathing. This
is the immediate priority for respiratory distress.
C (Incorrect): While important, coughing and deep breathing are not the priority during acute
respiratory distress. Stabilization comes first.
D (Incorrect): Sedatives can depress respiratory drive and are contraindicated in acute COPD
exacerbation.
7. The nurse hears crackles (rales) in a patient's lung bases. This finding is most consistent with which
condition?
A. Pneumothorax
B. Pulmonary edema or pneumonia
C. COPD exacerbation
D. Asthma
ANSWER: B
Rationale:
A (Incorrect): Pneumothorax typically presents with decreased or absent breath sounds on the affected
side, not crackles.
B (Correct): Crackles (rales) are caused by fluid in the alveoli and are characteristic of pulmonary edema
or pneumonia. They sound like hair rubbing together or Velcro being pulled apart.
C (Incorrect): COPD typically presents with wheezes, rhonchi, or decreased breath sounds, not crackles.
D (Incorrect): Asthma is characterized by wheezing, not crackles.
8. A child is diagnosed with epiglottitis. Which nursing intervention is contraindicated?
A. Keeping the child in an upright position
B. Attempting to visualize the throat with a tongue depressor
C. Allowing the child to remain with the parent
Comprehensive Cardiovascular and Respiratory
Nursing Examination 2026
1. A patient with ventricular tachycardia and a pulse is unstable. Which intervention should the nurse
prepare for first?
A. Administer adenosine IV push
B. Prepare for synchronized cardioversion
C. Begin unsynchronized defibrillation
D. Administer amiodarone infusion
ANSWER: B
Rationale:
A (Incorrect): Adenosine is used for stable supraventricular tachycardia (SVT), not ventricular
tachycardia. It works by briefly blocking AV node conduction.
B (Correct): Synchronized cardioversion is the treatment of choice for unstable ventricular tachycardia
with a pulse. The synchronization prevents delivery during the vulnerable period of the T wave, which
could cause ventricular fibrillation.
nursingcecentral.com
C (Incorrect): Unsynchronized defibrillation is used for pulseless ventricular tachycardia or ventricular
fibrillation, not when the patient has a pulse.
D (Incorrect): Amiodarone may be used for stable ventricular tachycardia or as an adjunct, but unstable
patients require immediate cardioversion first.
2. The nurse is caring for a patient who requires CPR but has suspected neck trauma. What is the priority
modification to standard CPR technique?
A. Use jaw-thrust maneuver instead of head-tilt chin-lift
B. Avoid chest compressions to prevent further injury
,C. Hyperextend the neck to open the airway
D. Place a pillow under the shoulders
ANSWER: A
Rationale:
A (Correct): The jaw-thrust maneuver opens the airway without extending the neck, which is critical
when cervical spine injury is suspected. This prevents further spinal cord damage.
B (Incorrect): Chest compressions should never be withheld due to neck trauma. Circulation is the
priority in cardiac arrest.
C (Incorrect): Hyperextending the neck is contraindicated with suspected cervical spine injury as it can
cause further damage to the spinal cord.
D (Incorrect): Placing a pillow under the shoulders would extend the neck, which is contraindicated with
suspected cervical spine trauma.
3. A patient presents with sinus tachycardia. Which underlying cause should the nurse assess for first?
A. Primary cardiac dysrhythmia requiring immediate cardioversion
B. Hypovolemia, pain, fever, or anxiety
C. Need for beta-blocker administration
D. Imminent cardiac arrest
ANSWER: B
Rationale:
A (Incorrect): Sinus tachycardia is typically a normal physiological response, not a primary dysrhythmia
requiring cardioversion.
B (Correct): Sinus tachycardia is usually a compensatory response to underlying conditions such as
hypovolemia, pain, fever, anxiety, hypoxia, or anemia. The nurse must identify and treat the underlying
cause.
C (Incorrect): Beta-blockers may be considered, but only after identifying the cause. Treating sinus
tachycardia without addressing the underlying cause can be harmful.
D (Incorrect): While sinus tachycardia can occur before cardiac arrest, it is not itself a sign of imminent
arrest. It's usually a compensatory mechanism.
4. A patient with acute cardiogenic pulmonary edema is experiencing severe dyspnea. The physician
orders morphine sulfate IV. What is the primary rationale for this medication?
A. To provide pain relief for chest discomfort
B. To reduce preload and anxiety, decreasing work of breathing
,C. To increase cardiac contractility
D. To prevent respiratory arrest
ANSWER: B
Rationale:
A (Incorrect): While morphine does provide pain relief, this is not the primary rationale in pulmonary
edema unless the patient is experiencing pain.
B (Correct): Morphine reduces preload through venodilation, decreases anxiety, and reduces the work
of breathing in pulmonary edema. It helps relieve dyspnea by reducing pulmonary capillary pressure.
pmc.ncbi.nlm.nih.gov
simplenursing.com
C (Incorrect): Morphine does not increase cardiac contractility; it may actually decrease it slightly.
D (Incorrect): Morphine can depress respiration and is used cautiously. It does not prevent respiratory
arrest.
5. The nurse is administering bronchodilators to a patient with COPD. Which assessment finding
indicates the medication is effective?
A. Decreased heart rate
B. Improved breath sounds and decreased wheezing
C. Increased sputum production
D. Decreased respiratory rate to 8 breaths/min
ANSWER: B
Rationale:
A (Incorrect): Bronchodilators, especially beta-agonists, typically increase heart rate as a side effect, not
decrease it.
B (Correct): Improved breath sounds and decreased wheezing indicate bronchodilation and improved
airway patency, showing the medication is working effectively.
C (Incorrect): While sputum may become easier to expectorate, increased production is not the goal and
may indicate infection.
D (Incorrect): A respiratory rate of 8 is too low and may indicate respiratory depression. Normal
respiratory rate is 12-20 breaths/min.
6. A patient with COPD is experiencing an acute exacerbation. Which nursing intervention is the priority?
A. Administer high-flow oxygen at 100%
B. Position in high Fowler's position
, C. Encourage coughing and deep breathing
D. Administer sedatives to reduce anxiety
ANSWER: B
Rationale:
A (Incorrect): High-flow oxygen can suppress the hypoxic drive in COPD patients. Oxygen should be
titrated carefully, typically starting at 24-28% via Venturi mask.
www.myamericannurse.com
B (Correct): High Fowler's position maximizes lung expansion and decreases the work of breathing. This
is the immediate priority for respiratory distress.
C (Incorrect): While important, coughing and deep breathing are not the priority during acute
respiratory distress. Stabilization comes first.
D (Incorrect): Sedatives can depress respiratory drive and are contraindicated in acute COPD
exacerbation.
7. The nurse hears crackles (rales) in a patient's lung bases. This finding is most consistent with which
condition?
A. Pneumothorax
B. Pulmonary edema or pneumonia
C. COPD exacerbation
D. Asthma
ANSWER: B
Rationale:
A (Incorrect): Pneumothorax typically presents with decreased or absent breath sounds on the affected
side, not crackles.
B (Correct): Crackles (rales) are caused by fluid in the alveoli and are characteristic of pulmonary edema
or pneumonia. They sound like hair rubbing together or Velcro being pulled apart.
C (Incorrect): COPD typically presents with wheezes, rhonchi, or decreased breath sounds, not crackles.
D (Incorrect): Asthma is characterized by wheezing, not crackles.
8. A child is diagnosed with epiglottitis. Which nursing intervention is contraindicated?
A. Keeping the child in an upright position
B. Attempting to visualize the throat with a tongue depressor
C. Allowing the child to remain with the parent
