Page 1 of 184
“NSG 4100 NCLEX EXAM 1 - 4” EXAM 2025 – 2026 SOLVED QUESTIONS &
ANSWERS VERIFIED 100% GRADED A+ (LATEST VERSION) WELL REVISED
AND HIGHLY RECOMMENDALE 100% GUARANTEE PASS
Nclex questions 4100 exam
The nurse is watching the cardiac monitor and notices that the rhythm
suddenly changes. There are no P waves, the QRS complexes are wide, and
the ventricular rate is regular but more than 140 beats/minute. The nurse
determines that the client is experiencing which dysrhythmia?
1.Sinus tachycardia
2.Ventricular fibrillation
3.Ventricular tachycardia
4.Premature ventricular contractions
3
Rationale:Ventricular tachycardia is characterized by the absence of P waves, wide
QRS complexes (longer than 0.12 seconds), and typically a rate between 140 and
180 impulses/minute. The rhythm is regular.
A client has frequent bursts of ventricular tachycardia on the cardiac monitor.
What should the nurse be most concerned about with this dysrhythmia?
1.It can develop into ventricular fibrillation at any time.
2.It is almost impossible to convert to a normal rhythm.
3.It is uncomfortable for the client, giving a sense of impending doom.
4.It produces a high cardiac output that quickly leads to cerebral and
myocardial ischemia.
1
Rationale:Ventricular tachycardia is a life-threatening dysrhythmia that results from
an irritable ectopic focus that takes over as the pacemaker for the heart. The low
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cardiac output that results can lead quickly to cerebral and myocardial ischemia.
Clients frequently experience a feeling of impending doom. Ventricular tachycardia is
treated with antidysrhythmic medications, cardioversion (if the client is awake), or
defibrillation (loss of consciousness). Ventricular tachycardia can deteriorate into
ventricular fibrillation at any time.
A client is having frequent premature ventricular contractions. The nurse
should place priority on assessment of which item?
1.Sensation of palpitations
2.Causative factors, such as caffeine
3.Blood pressure and oxygen saturation
4.Precipitating factors, such as infection
3
Rationale:Premature ventricular contractions can cause hemodynamic compromise.
Therefore, the priority is to monitor the blood pressure and oxygen saturation. The
shortened ventricular filling time can lead to decreased cardiac output. The client
may be asymptomatic or may feel palpitations. Premature ventricular contractions
can be caused by cardiac disorders; states of hypoxemia; any number of
physiological stressors, such as infection, illness, surgery, or trauma; and intake of
caffeine, nicotine, or alcohol.
The client has developed atrial fibrillation, with a ventricular rate of 150
beats/minute. The nurse should assess the client for which associated signs
and/or symptoms?
1.Flat neck veins
2.Nausea and vomiting
3.Hypotension and dizziness
4.Hypertension and headache
3
Rationale:The client with uncontrolled atrial fibrillation with a ventricular rate more
than 100 beats/minute is at risk for low cardiac output because of loss of atrial kick.
The nurse assesses the client for palpitations, chest pain or discomfort, hypotension,
pulse deficit, fatigue, weakness, dizziness, syncope, shortness of breath, and
distended neck veins.
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The nurse is watching the cardiac monitor, and a client's rhythm suddenly
changes. There are no P waves; instead, there are fibrillatory waves before
each QRS complex. How should the nurse correctly interpret the client's heart
rhythm?
1.Atrial fibrillation
2.Sinus tachycardia
3.Ventricular fibrillation
4.Ventricular tachycardia
1
Rationale:Atrial fibrillation is characterized by a loss of P waves and fibrillatory waves
before each QRS complex. The atria quiver, which can lead to thrombus formation.
The nurse is assisting to defibrillate a client in ventricular fibrillation. After
placing the pad on the client's chest and before discharge, which intervention
is a priority?
1.Ensure that the client has been intubated.
2.Set the defibrillator to the "synchronize" mode.
3.Administer an amiodarone bolus intravenously.
4.Confirm that the rhythm is actually ventricular fibrillation.
4
Rationale:Until the defibrillator is attached and charged, the client is resuscitated by
using cardiopulmonary resuscitation. Once the defibrillator has been attached, the
electrocardiogram is checked to verify that the rhythm is ventricular fibrillation or
pulseless ventricular tachycardia. Leads also are checked for any loose connections.
A nitroglycerin patch, if present, is removed. The client does not have to be intubated
to be defibrillated. The machine is not set to the synchronous mode because there is
no underlying rhythm with which to synchronize. Amiodarone may be given
subsequently but is not required before defibrillation.
The nurse should evaluate that defibrillation of a client was most successful if
which observation was made?
1.Arousable, sinus rhythm, blood pressure (BP) 116/72 mm Hg
2.Nonarousable, sinus rhythm, BP 88/60 mm Hg
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3.Arousable, marked bradycardia, BP 86/54 mm Hg
4.Nonarousable, supraventricular tachycardia, BP 122/60 mm Hg
1
Rationale:After defibrillation, the client requires continuous monitoring of
electrocardiographic rhythm, hemodynamic status, and neurological status.
Respiratory and metabolic acidosis develop during ventricular fibrillation because of
lack of respiration and cardiac output. These can cause cerebral and
cardiopulmonary complications. Arousable status, adequate BP, and a sinus rhythm
indicate successful response to defibrillation.
The nurse is evaluating a client's response to cardioversion. Which
assessment would be the priority?
1.Blood pressure
2.Status of airway
3.Oxygen flow rate
4.Level of consciousness
2
Rationale:Nursing responsibilities after cardioversion include maintenance first of a
patent airway, and then oxygen administration, assessment of vital signs and level of
consciousness, and dysrhythmia detection.
The nurse is caring for a client who has just had implantation of an automatic
internal cardioverter-defibrillator. The nurse should assess which item based
on priority?
1.Anxiety level of the client and family
2.Presence of a MedicAlert card for the client to carry
3.Knowledge of restrictions on postdischarge physical activity
4.Activation status of the device, heart rate cutoff, and number of shocks it is
programmed to deliver
4
Rationale:The nurse who is caring for the client after insertion of an automatic
internal cardioverter-defibrillator needs to assess device settings, similar to after
insertion of a permanent pacemaker. Specifically, the nurse needs to know whether
the device is activated, the heart rate cutoff above which it will fire, and the number
“NSG 4100 NCLEX EXAM 1 - 4” EXAM 2025 – 2026 SOLVED QUESTIONS &
ANSWERS VERIFIED 100% GRADED A+ (LATEST VERSION) WELL REVISED
AND HIGHLY RECOMMENDALE 100% GUARANTEE PASS
Nclex questions 4100 exam
The nurse is watching the cardiac monitor and notices that the rhythm
suddenly changes. There are no P waves, the QRS complexes are wide, and
the ventricular rate is regular but more than 140 beats/minute. The nurse
determines that the client is experiencing which dysrhythmia?
1.Sinus tachycardia
2.Ventricular fibrillation
3.Ventricular tachycardia
4.Premature ventricular contractions
3
Rationale:Ventricular tachycardia is characterized by the absence of P waves, wide
QRS complexes (longer than 0.12 seconds), and typically a rate between 140 and
180 impulses/minute. The rhythm is regular.
A client has frequent bursts of ventricular tachycardia on the cardiac monitor.
What should the nurse be most concerned about with this dysrhythmia?
1.It can develop into ventricular fibrillation at any time.
2.It is almost impossible to convert to a normal rhythm.
3.It is uncomfortable for the client, giving a sense of impending doom.
4.It produces a high cardiac output that quickly leads to cerebral and
myocardial ischemia.
1
Rationale:Ventricular tachycardia is a life-threatening dysrhythmia that results from
an irritable ectopic focus that takes over as the pacemaker for the heart. The low
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cardiac output that results can lead quickly to cerebral and myocardial ischemia.
Clients frequently experience a feeling of impending doom. Ventricular tachycardia is
treated with antidysrhythmic medications, cardioversion (if the client is awake), or
defibrillation (loss of consciousness). Ventricular tachycardia can deteriorate into
ventricular fibrillation at any time.
A client is having frequent premature ventricular contractions. The nurse
should place priority on assessment of which item?
1.Sensation of palpitations
2.Causative factors, such as caffeine
3.Blood pressure and oxygen saturation
4.Precipitating factors, such as infection
3
Rationale:Premature ventricular contractions can cause hemodynamic compromise.
Therefore, the priority is to monitor the blood pressure and oxygen saturation. The
shortened ventricular filling time can lead to decreased cardiac output. The client
may be asymptomatic or may feel palpitations. Premature ventricular contractions
can be caused by cardiac disorders; states of hypoxemia; any number of
physiological stressors, such as infection, illness, surgery, or trauma; and intake of
caffeine, nicotine, or alcohol.
The client has developed atrial fibrillation, with a ventricular rate of 150
beats/minute. The nurse should assess the client for which associated signs
and/or symptoms?
1.Flat neck veins
2.Nausea and vomiting
3.Hypotension and dizziness
4.Hypertension and headache
3
Rationale:The client with uncontrolled atrial fibrillation with a ventricular rate more
than 100 beats/minute is at risk for low cardiac output because of loss of atrial kick.
The nurse assesses the client for palpitations, chest pain or discomfort, hypotension,
pulse deficit, fatigue, weakness, dizziness, syncope, shortness of breath, and
distended neck veins.
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The nurse is watching the cardiac monitor, and a client's rhythm suddenly
changes. There are no P waves; instead, there are fibrillatory waves before
each QRS complex. How should the nurse correctly interpret the client's heart
rhythm?
1.Atrial fibrillation
2.Sinus tachycardia
3.Ventricular fibrillation
4.Ventricular tachycardia
1
Rationale:Atrial fibrillation is characterized by a loss of P waves and fibrillatory waves
before each QRS complex. The atria quiver, which can lead to thrombus formation.
The nurse is assisting to defibrillate a client in ventricular fibrillation. After
placing the pad on the client's chest and before discharge, which intervention
is a priority?
1.Ensure that the client has been intubated.
2.Set the defibrillator to the "synchronize" mode.
3.Administer an amiodarone bolus intravenously.
4.Confirm that the rhythm is actually ventricular fibrillation.
4
Rationale:Until the defibrillator is attached and charged, the client is resuscitated by
using cardiopulmonary resuscitation. Once the defibrillator has been attached, the
electrocardiogram is checked to verify that the rhythm is ventricular fibrillation or
pulseless ventricular tachycardia. Leads also are checked for any loose connections.
A nitroglycerin patch, if present, is removed. The client does not have to be intubated
to be defibrillated. The machine is not set to the synchronous mode because there is
no underlying rhythm with which to synchronize. Amiodarone may be given
subsequently but is not required before defibrillation.
The nurse should evaluate that defibrillation of a client was most successful if
which observation was made?
1.Arousable, sinus rhythm, blood pressure (BP) 116/72 mm Hg
2.Nonarousable, sinus rhythm, BP 88/60 mm Hg
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3.Arousable, marked bradycardia, BP 86/54 mm Hg
4.Nonarousable, supraventricular tachycardia, BP 122/60 mm Hg
1
Rationale:After defibrillation, the client requires continuous monitoring of
electrocardiographic rhythm, hemodynamic status, and neurological status.
Respiratory and metabolic acidosis develop during ventricular fibrillation because of
lack of respiration and cardiac output. These can cause cerebral and
cardiopulmonary complications. Arousable status, adequate BP, and a sinus rhythm
indicate successful response to defibrillation.
The nurse is evaluating a client's response to cardioversion. Which
assessment would be the priority?
1.Blood pressure
2.Status of airway
3.Oxygen flow rate
4.Level of consciousness
2
Rationale:Nursing responsibilities after cardioversion include maintenance first of a
patent airway, and then oxygen administration, assessment of vital signs and level of
consciousness, and dysrhythmia detection.
The nurse is caring for a client who has just had implantation of an automatic
internal cardioverter-defibrillator. The nurse should assess which item based
on priority?
1.Anxiety level of the client and family
2.Presence of a MedicAlert card for the client to carry
3.Knowledge of restrictions on postdischarge physical activity
4.Activation status of the device, heart rate cutoff, and number of shocks it is
programmed to deliver
4
Rationale:The nurse who is caring for the client after insertion of an automatic
internal cardioverter-defibrillator needs to assess device settings, similar to after
insertion of a permanent pacemaker. Specifically, the nurse needs to know whether
the device is activated, the heart rate cutoff above which it will fire, and the number
