CJE MEDICAL-SURGICAL NURSING II
EXAMINATION COMPREHENSIVE
REVIEW QUESTIONS AND ANSWERS
WITH RATIONALES
CARDIAC DISORDERS (Questions 1-50)
1. A patient in bradycardia is cool and clammy. What is the next
expected intervention?
A) Epinephrine
B) Atropine
C) Lidocaine
D) Cardioversion
Correct Answer: B
Rationale: Atropine is the first-line medication for symptomatic
bradycardia with signs of low perfusion (pale, cool, clammy skin). It works
by blocking vagal influences on the SA node, increasing heart rate .
2. Where is anginal chest pain typically felt?
A) Right upper quadrant
B) Behind the sternum, may radiate to neck, jaw, shoulders, and left
arm
C) Epigastric region
, D) Left lower quadrant
Correct Answer: B
Rationale: Anginal pain is classically substernal (behind the sternum) and
may radiate to the neck, jaw, shoulders, and along the inner aspect of the
left arm. This radiation pattern is due to the shared nerve pathways
between the heart and these areas .
3. Which cardiac rhythms are shockable?
A) Asystole and PEA
B) Ventricular fibrillation and pulseless ventricular tachycardia
C) Atrial fibrillation and atrial flutter
D) Supraventricular tachycardia and bradycardia
Correct Answer: B
Rationale: Ventricular fibrillation and pulseless ventricular tachycardia are
shockable rhythms requiring defibrillation. Ventricular tachycardia with a
pulse is treated with synchronized cardioversion, not defibrillation .
4. An EKG shows tombstone-like heart rhythms, and the patient's pulse
is checked and none is observed. What is the priority intervention?
A) Cardioversion
B) Defibrillation
C) Administer amiodarone
, D) Start CPR
Correct Answer: B
Rationale: Tombstone-like EKG patterns indicate ventricular tachycardia. If
the patient has no pulse, defibrillation is the priority. If the patient has a
pulse, synchronized cardioversion is indicated .
5. A patient is in ventricular fibrillation. What is the first intervention?
A) Defibrillation
B) Administer lidocaine
C) Administer amiodarone
D) Administer procainamide
Correct Answer: A
Rationale: Ventricular fibrillation requires immediate defibrillation as the
first-line intervention. Medications (Lidocaine, Amiodarone, Procainamide)
are administered after defibrillation .
6. Which EKG finding is characteristic of atrial fibrillation?
A) Saw-tooth waves
B) Absent P waves with irregularly irregular rhythm
C) Tombstone ST elevation
D) Wide QRS complexes
Correct Answer: B
, Rationale: Atrial fibrillation is characterized by absent P waves and an
irregularly irregular ventricular response. The atria quiver instead of
contracting effectively, leading to this classic EKG pattern .
7. Which EKG finding is characteristic of atrial flutter?
A) Absent P waves
B) Saw-tooth flutter waves
C) Prolonged PR interval
D) ST depression
Correct Answer: B
Rationale: Atrial flutter produces classic "saw-tooth" flutter waves on EKG,
representing rapid, regular atrial depolarizations at a rate of 250-350 beats
per minute .
8. What is the first-line treatment for supraventricular tachycardia
(SVT)?
A) Adenosine
B) Vagal maneuvers
C) Amiodarone
D) Atropine
Correct Answer: B
EXAMINATION COMPREHENSIVE
REVIEW QUESTIONS AND ANSWERS
WITH RATIONALES
CARDIAC DISORDERS (Questions 1-50)
1. A patient in bradycardia is cool and clammy. What is the next
expected intervention?
A) Epinephrine
B) Atropine
C) Lidocaine
D) Cardioversion
Correct Answer: B
Rationale: Atropine is the first-line medication for symptomatic
bradycardia with signs of low perfusion (pale, cool, clammy skin). It works
by blocking vagal influences on the SA node, increasing heart rate .
2. Where is anginal chest pain typically felt?
A) Right upper quadrant
B) Behind the sternum, may radiate to neck, jaw, shoulders, and left
arm
C) Epigastric region
, D) Left lower quadrant
Correct Answer: B
Rationale: Anginal pain is classically substernal (behind the sternum) and
may radiate to the neck, jaw, shoulders, and along the inner aspect of the
left arm. This radiation pattern is due to the shared nerve pathways
between the heart and these areas .
3. Which cardiac rhythms are shockable?
A) Asystole and PEA
B) Ventricular fibrillation and pulseless ventricular tachycardia
C) Atrial fibrillation and atrial flutter
D) Supraventricular tachycardia and bradycardia
Correct Answer: B
Rationale: Ventricular fibrillation and pulseless ventricular tachycardia are
shockable rhythms requiring defibrillation. Ventricular tachycardia with a
pulse is treated with synchronized cardioversion, not defibrillation .
4. An EKG shows tombstone-like heart rhythms, and the patient's pulse
is checked and none is observed. What is the priority intervention?
A) Cardioversion
B) Defibrillation
C) Administer amiodarone
, D) Start CPR
Correct Answer: B
Rationale: Tombstone-like EKG patterns indicate ventricular tachycardia. If
the patient has no pulse, defibrillation is the priority. If the patient has a
pulse, synchronized cardioversion is indicated .
5. A patient is in ventricular fibrillation. What is the first intervention?
A) Defibrillation
B) Administer lidocaine
C) Administer amiodarone
D) Administer procainamide
Correct Answer: A
Rationale: Ventricular fibrillation requires immediate defibrillation as the
first-line intervention. Medications (Lidocaine, Amiodarone, Procainamide)
are administered after defibrillation .
6. Which EKG finding is characteristic of atrial fibrillation?
A) Saw-tooth waves
B) Absent P waves with irregularly irregular rhythm
C) Tombstone ST elevation
D) Wide QRS complexes
Correct Answer: B
, Rationale: Atrial fibrillation is characterized by absent P waves and an
irregularly irregular ventricular response. The atria quiver instead of
contracting effectively, leading to this classic EKG pattern .
7. Which EKG finding is characteristic of atrial flutter?
A) Absent P waves
B) Saw-tooth flutter waves
C) Prolonged PR interval
D) ST depression
Correct Answer: B
Rationale: Atrial flutter produces classic "saw-tooth" flutter waves on EKG,
representing rapid, regular atrial depolarizations at a rate of 250-350 beats
per minute .
8. What is the first-line treatment for supraventricular tachycardia
(SVT)?
A) Adenosine
B) Vagal maneuvers
C) Amiodarone
D) Atropine
Correct Answer: B
