NURS 280 Midterm Exam:
Comprehensive Study
Guide with Questions and
Answers 2026/2027
SECTION 1: CARDIOVASCULAR AND RESPIRATORY
CONDITIONS
Cardiac Arrest and Dysrhythmias
Q: A nurse is analyzing a client's electrocardiogram (ECG) strip and
identifies the following: Heart rate 92/min, Rhythm: Irregular, P
wave: Unable to identify, PR interval: Unable to measure, QRS
duration: 0.10 seconds. What rhythm does this represent?
A: Atrial Fibrillation. This rhythm is characterized by an irregularly
irregular rhythm with absent identifiable P waves .
Q: A nurse in a coronary care unit is admitting a client who has had
CPR following a cardiac arrest. The client is receiving lidocaine IV at
2 mg/min. When the client asks why he is receiving this medication,
what should the nurse explain?
A: Lidocaine prevents dysrhythmias. It is an antiarrhythmic medication
used to suppress ventricular dysrhythmias following cardiac arrest .
Q: A nurse is providing teaching to a client about recognizing
manifestations of an impending cardiac arrest. Which manifestation
should the nurse include?
,A: Profound fatigue. Other warning signs may include chest pain,
palpitations, and shortness of breath .
Q: Which alterations are causes of pulseless electrical activity (PEA)?
A: Hypovolemia, Hypoxia, and Hyperkalemia. These conditions can lead
to PEA by impairing cardiac output or electrical conduction.
Hypertension, hypernatremia, and hyperthermia are not typically causes .
Q: A nurse is planning care for a client who has atrial fibrillation and
reports heart palpitations, lightheadedness, and shortness of breath.
Which procedure should the nurse anticipate?
A: Synchronized electrical cardioversion. This procedure delivers a timed
electrical shock to restore normal sinus rhythm in symptomatic atrial
fibrillation .
Q: What does the nurse understand is the cause of dizziness and
palpitations in a client with atrial fibrillation?
A: The heart's electrical signals are rapid, chaotic, and irregular. This
results in ineffective atrial contraction and reduced cardiac output .
Q: Which client is at highest risk for developing atrial flutter?
A: The client who had a myocardial infarction and required stent
placement. Coronary artery disease is a significant risk factor for atrial
flutter .
Q: A nurse is teaching a newly licensed nurse about the
epidemiology of sudden cardiac arrest. What should the nurse
include?
A: Sudden cardiac arrest is considered a public health burden worldwide.
It accounts for a significant number of cardiovascular deaths globally .
Q: Following cardiac arrest, which manifestation should alert the
nurse to the development of post-cardiac arrest syndrome (PCAS)?
,A: Decreased circulation to the kidneys. PCAS involves systemic
ischemia-reperfusion injury affecting multiple organs, including the
kidneys .
Acute Respiratory Distress Syndrome (ARDS)
Q: A nurse is assessing a client who has suspected acute respiratory
distress syndrome (ARDS). What is the most common presenting
manifestation?
A: Dyspnea. This is typically the earliest and most prominent symptom of
ARDS .
Q: Which condition is the most common cause of ARDS?
A: Sepsis. Systemic infection leading to widespread inflammation is the
leading cause of ARDS .
Q: A client with ARDS requires mechanical ventilation and receives a
prescription for pancuronium. The nurse recognizes this medication
is for which purpose?
A: Suppress respiratory effort. Pancuronium is a neuromuscular blocking
agent used to facilitate mechanical ventilation in severe ARDS .
Q: Which finding should the nurse expect when assessing a client
with ARDS?
A: Decreased pulmonary compliance due to stiffness. ARDS causes lung
stiffness from alveolar edema and inflammation, reducing compliance .
Pulmonary Embolism and Asthma
Q: A nurse is educating a client who presents with a pulmonary
embolism. Which information should the nurse provide?
, A: Treatment is needed for all clients who have a pulmonary embolism.
Even asymptomatic or hemodynamically stable patients require
anticoagulation to prevent recurrence .
Q: A nurse is educating a client who has a pulmonary embolism.
Which information should the nurse include?
A: There is an increased risk of bleeding. Anticoagulation therapy carries
a significant bleeding risk that requires monitoring .
Q: A nurse is caring for a client with asthma. What happens
physiologically when bronchospasm occurs?
A: Bronchospasm occurs when there is inflammation, edema, and excess
mucus. These factors combine to narrow the airways and obstruct
airflow .
Q: Which risk factor is associated with a client having a higher risk
of experiencing status asthmaticus?
A: Previous intubation due to a status asthmaticus episode. A history of
severe exacerbations requiring intubation is a strong predictor of future
life-threatening episodes .
SECTION 2: PHARMACOLOGY AND MEDICATION
MANAGEMENT
Q: A nurse is teaching a client who has been taking prednisone to
treat asthma and has a new prescription to discontinue the
medication. The nurse should explain to reduce the dose gradually
to prevent which adverse effect?
A: Adrenocortical insufficiency. Abrupt cessation of corticosteroids
suppresses the hypothalamic-pituitary-adrenal axis, leading to adrenal
insufficiency .
Comprehensive Study
Guide with Questions and
Answers 2026/2027
SECTION 1: CARDIOVASCULAR AND RESPIRATORY
CONDITIONS
Cardiac Arrest and Dysrhythmias
Q: A nurse is analyzing a client's electrocardiogram (ECG) strip and
identifies the following: Heart rate 92/min, Rhythm: Irregular, P
wave: Unable to identify, PR interval: Unable to measure, QRS
duration: 0.10 seconds. What rhythm does this represent?
A: Atrial Fibrillation. This rhythm is characterized by an irregularly
irregular rhythm with absent identifiable P waves .
Q: A nurse in a coronary care unit is admitting a client who has had
CPR following a cardiac arrest. The client is receiving lidocaine IV at
2 mg/min. When the client asks why he is receiving this medication,
what should the nurse explain?
A: Lidocaine prevents dysrhythmias. It is an antiarrhythmic medication
used to suppress ventricular dysrhythmias following cardiac arrest .
Q: A nurse is providing teaching to a client about recognizing
manifestations of an impending cardiac arrest. Which manifestation
should the nurse include?
,A: Profound fatigue. Other warning signs may include chest pain,
palpitations, and shortness of breath .
Q: Which alterations are causes of pulseless electrical activity (PEA)?
A: Hypovolemia, Hypoxia, and Hyperkalemia. These conditions can lead
to PEA by impairing cardiac output or electrical conduction.
Hypertension, hypernatremia, and hyperthermia are not typically causes .
Q: A nurse is planning care for a client who has atrial fibrillation and
reports heart palpitations, lightheadedness, and shortness of breath.
Which procedure should the nurse anticipate?
A: Synchronized electrical cardioversion. This procedure delivers a timed
electrical shock to restore normal sinus rhythm in symptomatic atrial
fibrillation .
Q: What does the nurse understand is the cause of dizziness and
palpitations in a client with atrial fibrillation?
A: The heart's electrical signals are rapid, chaotic, and irregular. This
results in ineffective atrial contraction and reduced cardiac output .
Q: Which client is at highest risk for developing atrial flutter?
A: The client who had a myocardial infarction and required stent
placement. Coronary artery disease is a significant risk factor for atrial
flutter .
Q: A nurse is teaching a newly licensed nurse about the
epidemiology of sudden cardiac arrest. What should the nurse
include?
A: Sudden cardiac arrest is considered a public health burden worldwide.
It accounts for a significant number of cardiovascular deaths globally .
Q: Following cardiac arrest, which manifestation should alert the
nurse to the development of post-cardiac arrest syndrome (PCAS)?
,A: Decreased circulation to the kidneys. PCAS involves systemic
ischemia-reperfusion injury affecting multiple organs, including the
kidneys .
Acute Respiratory Distress Syndrome (ARDS)
Q: A nurse is assessing a client who has suspected acute respiratory
distress syndrome (ARDS). What is the most common presenting
manifestation?
A: Dyspnea. This is typically the earliest and most prominent symptom of
ARDS .
Q: Which condition is the most common cause of ARDS?
A: Sepsis. Systemic infection leading to widespread inflammation is the
leading cause of ARDS .
Q: A client with ARDS requires mechanical ventilation and receives a
prescription for pancuronium. The nurse recognizes this medication
is for which purpose?
A: Suppress respiratory effort. Pancuronium is a neuromuscular blocking
agent used to facilitate mechanical ventilation in severe ARDS .
Q: Which finding should the nurse expect when assessing a client
with ARDS?
A: Decreased pulmonary compliance due to stiffness. ARDS causes lung
stiffness from alveolar edema and inflammation, reducing compliance .
Pulmonary Embolism and Asthma
Q: A nurse is educating a client who presents with a pulmonary
embolism. Which information should the nurse provide?
, A: Treatment is needed for all clients who have a pulmonary embolism.
Even asymptomatic or hemodynamically stable patients require
anticoagulation to prevent recurrence .
Q: A nurse is educating a client who has a pulmonary embolism.
Which information should the nurse include?
A: There is an increased risk of bleeding. Anticoagulation therapy carries
a significant bleeding risk that requires monitoring .
Q: A nurse is caring for a client with asthma. What happens
physiologically when bronchospasm occurs?
A: Bronchospasm occurs when there is inflammation, edema, and excess
mucus. These factors combine to narrow the airways and obstruct
airflow .
Q: Which risk factor is associated with a client having a higher risk
of experiencing status asthmaticus?
A: Previous intubation due to a status asthmaticus episode. A history of
severe exacerbations requiring intubation is a strong predictor of future
life-threatening episodes .
SECTION 2: PHARMACOLOGY AND MEDICATION
MANAGEMENT
Q: A nurse is teaching a client who has been taking prednisone to
treat asthma and has a new prescription to discontinue the
medication. The nurse should explain to reduce the dose gradually
to prevent which adverse effect?
A: Adrenocortical insufficiency. Abrupt cessation of corticosteroids
suppresses the hypothalamic-pituitary-adrenal axis, leading to adrenal
insufficiency .
