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NR 341 Complex Adult Health – Exam 2 Comprehensive Practice Test
Bank Advanced/Hard Difficulty Level with Detailed Rationales for
Nursing Students Preparing for Chamberlain University NR 341
Complex Adult Health Exam 2
SECTION 1: CARDIAC DYSRHYTHMIAS AND ACUTE CORONARY SYNDROMES
(Questions 1–35)
1. The nurse is caring for a client with a dysrhythmia who has a heart rate of 38
beats/min, blood pressure of 88/52 mmHg, and reports lightheadedness. Which
intervention should the nurse implement first?
A) Prepare for transcutaneous pacing
B) Administer atropine 0.5 mg IV push
C) Administer normal saline 500 mL IV bolus
D) Apply oxygen via nasal cannula
Correct Answer: B
Rationale: Symptomatic bradycardia with hypotension and lightheadedness
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requires immediate treatment. Atropine 0.5 mg IV is the first-line medication for
symptomatic bradycardia. Transcutaneous pacing (A) is indicated if atropine is
ineffective. Fluid resuscitation (C) is not the priority for bradycardia. Oxygen (D) is
supportive but not the first intervention.
2. A client with a history of myocardial infarction is on telemetry and develops
ventricular tachycardia with a pulse. The client is alert and oriented. What is the
priority nursing action?
A) Prepare for defibrillation
B) Administer amiodarone 150 mg IV
C) Prepare for synchronized cardioversion
D) Assess the client's blood pressure and pulse
Correct Answer: D
Rationale: For stable ventricular tachycardia with a pulse, the nurse should first
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assess the client's hemodynamic status. If the client is stable (alert, oriented,
adequate blood pressure), synchronized cardioversion may be indicated.
Defibrillation (A) is for pulseless VT. Amiodarone (B) is administered after
cardioversion or for stable VT.
3. The nurse is interpreting a client's ECG and notes the absence of P waves, an
irregularly irregular rhythm, and a ventricular rate of 120 beats/min. Which
dysrhythmia is the client experiencing?
A) Atrial flutter
B) Atrial fibrillation
C) Ventricular tachycardia
D) Supraventricular tachycardia
Correct Answer: B
Rationale: Atrial fibrillation is characterized by the absence of discernible P waves,
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an irregularly irregular ventricular rhythm, and a variable ventricular rate. Atrial
flutter (A) has a "saw-tooth" appearance with regular rhythm. Ventricular
tachycardia (C) has wide QRS complexes. SVT (D) is regular and narrow-complex.
4. A client with atrial fibrillation is prescribed warfarin. Which laboratory value
should the nurse monitor to evaluate the effectiveness of this medication?
A) aPTT
B) INR
C) Platelet count
D) Serum potassium
Correct Answer: B
Rationale: Warfarin therapy is monitored using the International Normalized
Ratio (INR). The therapeutic INR range for atrial fibrillation is typically 2.0–3.0.
aPTT (A) is used to monitor heparin therapy. Platelet count (C) is monitored for
NR 341 Complex Adult Health – Exam 2 Comprehensive Practice Test
Bank Advanced/Hard Difficulty Level with Detailed Rationales for
Nursing Students Preparing for Chamberlain University NR 341
Complex Adult Health Exam 2
SECTION 1: CARDIAC DYSRHYTHMIAS AND ACUTE CORONARY SYNDROMES
(Questions 1–35)
1. The nurse is caring for a client with a dysrhythmia who has a heart rate of 38
beats/min, blood pressure of 88/52 mmHg, and reports lightheadedness. Which
intervention should the nurse implement first?
A) Prepare for transcutaneous pacing
B) Administer atropine 0.5 mg IV push
C) Administer normal saline 500 mL IV bolus
D) Apply oxygen via nasal cannula
Correct Answer: B
Rationale: Symptomatic bradycardia with hypotension and lightheadedness
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requires immediate treatment. Atropine 0.5 mg IV is the first-line medication for
symptomatic bradycardia. Transcutaneous pacing (A) is indicated if atropine is
ineffective. Fluid resuscitation (C) is not the priority for bradycardia. Oxygen (D) is
supportive but not the first intervention.
2. A client with a history of myocardial infarction is on telemetry and develops
ventricular tachycardia with a pulse. The client is alert and oriented. What is the
priority nursing action?
A) Prepare for defibrillation
B) Administer amiodarone 150 mg IV
C) Prepare for synchronized cardioversion
D) Assess the client's blood pressure and pulse
Correct Answer: D
Rationale: For stable ventricular tachycardia with a pulse, the nurse should first
,3
assess the client's hemodynamic status. If the client is stable (alert, oriented,
adequate blood pressure), synchronized cardioversion may be indicated.
Defibrillation (A) is for pulseless VT. Amiodarone (B) is administered after
cardioversion or for stable VT.
3. The nurse is interpreting a client's ECG and notes the absence of P waves, an
irregularly irregular rhythm, and a ventricular rate of 120 beats/min. Which
dysrhythmia is the client experiencing?
A) Atrial flutter
B) Atrial fibrillation
C) Ventricular tachycardia
D) Supraventricular tachycardia
Correct Answer: B
Rationale: Atrial fibrillation is characterized by the absence of discernible P waves,
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an irregularly irregular ventricular rhythm, and a variable ventricular rate. Atrial
flutter (A) has a "saw-tooth" appearance with regular rhythm. Ventricular
tachycardia (C) has wide QRS complexes. SVT (D) is regular and narrow-complex.
4. A client with atrial fibrillation is prescribed warfarin. Which laboratory value
should the nurse monitor to evaluate the effectiveness of this medication?
A) aPTT
B) INR
C) Platelet count
D) Serum potassium
Correct Answer: B
Rationale: Warfarin therapy is monitored using the International Normalized
Ratio (INR). The therapeutic INR range for atrial fibrillation is typically 2.0–3.0.
aPTT (A) is used to monitor heparin therapy. Platelet count (C) is monitored for
