NUR 425 FINAL EXAM QUESTIONS AND ANSWERS
(100% VERIFIED AND DETAILED ANSWERS) LATEST
UPDATE 2026/2027 | GRADED A+.
A nurse is assessing an electrocardiogram rhythm strip. The P waves and QRS complexes are
regular. The PR interval is 0.16 second, and QRS complexes measure 0.06 second. The overall
heart rate is 64 beats per minute. The nurse assesses the cardiac rhythm as:
A. Normal sinus rhythm
B. Sinus bradycardia
C. Atrial fibrillation
D. First-degree heart block. - CORRECT ANSWER- A (This rhythm is NSR. The P waves and
QRS complexes are regular. The PR interval is less than 0.2 seconds. The QRS complex is
less than 0.12 seconds. The heart rate is between 60-100 BPM.)
A nurse notices frequent artifact on the ECG monitor for a client whose leads are connected by
cable to a console at the bedside. The nurse examines the client to determine the cause. Which of
the following items is *unlikely* to be responsible for the artifact?
A. Frequent movement of the client
B. Tightly secured cable connections
C. Leads applied over hairy areas
D. Leads applied to the limbs - CORRECT ANSWER- B (Motion artifact, or "noise," can be
caused by frequent client movement, electrode placement on limbs, and insufficient adhesion
to the skin, such as placing electrodes over hairy areas of the skin. Electrode placement over
bony prominences also should be avoided. Signal interference can also occur with electrode
removal and cable disconnection.)
A 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 over 100. The
nurse determines that the client is experiencing:
A. Premature ventricular contractions
B. Ventricular tachycardia
,C. Ventricular fibrillation
D. Sinus tachycardia - CORRECT ANSWER- B (Ventricular tachycardia is characterized by the
absence of P waves, wide QRS complexes (usually greater than 0.14 second), and a rate
between 100 and 250 impulses per minute. The rhythm is usually regular.)
A nurse is viewing the cardiac monitor in a client's room and notes that the client has just gone
into ventricular tachycardia. The client is awake and alert and has good skin color. The nurse
would prepare to do which of the following?
A. Immediately defibrillate
B. Prepare for pacemaker insertion
C. Administer amiodarone (Cordarone) intravenously
D. Administer epinephrine (Adrenaline) intravenously - CORRECT ANSWER- C (First-line
treatment of ventricular tachycardia in a client who is hemodynamically stable is the use of
antidysrhythmics such as amiodarone (Cordarone), lidocaine (Xylocaine), and procainamide
(Pronestyl). Cardioversion also may be needed to correct the rhythm (cardioversion is
recommended for stable ventricular tachycardia). Defibrillation is used with pulseless
ventricular tachycardia. Epinephrine would stimulate and already excitable ventricle and is
contraindicated.)
A client is having frequent premature ventricular contractions. A nurse would place priority on
assessment of which of the following items?
A. Blood pressure and peripheral perfusion
B. Sensation of palpitations
C. Causative factors such as caffeine
D. Precipitating factors such as infection - CORRECT ANSWER- A (Premature ventricular
contractions can cause hemodynamic compromise. The shortened ventricular filling time with
the ectopic beats leads to decreased stroke volume and, if frequent enough, to decreased
cardiac output. The client may be asymptomatic or may feel palpitations. PVCs can be caused
by cardiac disorders or by any number of physiological stressors, such as infection, illness,
surgery, or trauma, and by the intake of caffeine, alcohol, or nicotine.)
,A client has developed atrial fibrillation, with a ventricular rate of 150 beats per minute. A nurse
assesses the client for:
A. Hypotension and dizziness
B. Nausea and vomiting
C. Hypertension and headache
D. Flat neck veins - CORRECT ANSWER- A (The client with uncontrolled atrial fibrillation
with a ventricular rate more than 150 beats a 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.)
A nurse is watching the cardiac monitor, and a client's rhythm suddenly changes. There are no P
waves; instead there are wavy lines. The QRS complexes measure 0.08 second, but they are
irregular, with a rate of 120 beats a minute. The nurse interprets this rhythm as:
A. Sinus tachycardia
B. Atrial fibrillation
C. Ventricular tachycardia
D. Ventricular fibrillation - CORRECT ANSWER- B (Atrial fibrillation is characterized by a
loss of P waves; an undulating, wavy baseline; QRS duration that is often within normal
limits; and an irregular ventricular rate, which can range from 60 to 100 beats per minute
(when controlled with medications) to 100 to 160 beats per minute (when uncontrolled).)
A nurse notes that a client with sinus rhythm has a premature ventricular contraction that falls on
the T wave of the preceding beat. The client's rhythm suddenly changes to one with no P waves
or definable QRS complexes. Instead there are coarse wavy lines of varying amplitude. The
nurse assesses this rhythm to be:
A. Ventricular tachycardia
B. Ventricular fibrillation
C. Atrial fibrillation
, D. Asystole - CORRECT ANSWER- B (Ventricular fibrillation is characterized by irregular,
chaotic undulations of varying amplitudes. Ventricular fibrillation has no measurable rate and
no visible
P waves or QRS complexes and results from electrical chaos in the ventricles.)
A nurse is caring for a client with unstable ventricular tachycardia. The nurse instructs the client
to do which of the following, if prescribed, during an episode of ventricular tachycardia?
A. Breathe deeply, regularly, and easily
B. Inhale deeply and cough forcefully every 1 to 3 seconds
C. Lie down flat in bed
D. Remove any metal jewelry - CORRECT ANSWER- B (Cough cardiopulmonary
resuscitation (CPR) sometimes is used in the client with unstable ventricular tachycardia. The
nurse tells the client to use cough CPR, if prescribed, by inhaling deeply and coughing
forcefully every 1 to 3 seconds. Cough CPR may terminate the dysrhythmia or sustain the
cerebral and coronary circulation for a short time until other measures can be implemented.)
Which patient is most at risk for developing delirium?
a. A 50-yr-old woman with cholecystitis
b. A 19-yr-old man with a fractured femur
c. A 42-yr-old woman having an elective hysterectomy
d. A 78-yr-old man admitted to the medical unit with complications related to heart failure -
CORRECT ANSWER- D
Which of the following ECG findings alerts the nurse that the client needs an antiarrhythmic?
A. Normal sinus rhythm
B. Sinus bradycardia
C. Sinus arrhythmia
D. Frequent ventricular ectopy - CORRECT ANSWER- D (Ventricular ectopy can be a
lifethreatening arrhythmia; therefore, the client needs an arrhythmic. Other choices are not
(100% VERIFIED AND DETAILED ANSWERS) LATEST
UPDATE 2026/2027 | GRADED A+.
A nurse is assessing an electrocardiogram rhythm strip. The P waves and QRS complexes are
regular. The PR interval is 0.16 second, and QRS complexes measure 0.06 second. The overall
heart rate is 64 beats per minute. The nurse assesses the cardiac rhythm as:
A. Normal sinus rhythm
B. Sinus bradycardia
C. Atrial fibrillation
D. First-degree heart block. - CORRECT ANSWER- A (This rhythm is NSR. The P waves and
QRS complexes are regular. The PR interval is less than 0.2 seconds. The QRS complex is
less than 0.12 seconds. The heart rate is between 60-100 BPM.)
A nurse notices frequent artifact on the ECG monitor for a client whose leads are connected by
cable to a console at the bedside. The nurse examines the client to determine the cause. Which of
the following items is *unlikely* to be responsible for the artifact?
A. Frequent movement of the client
B. Tightly secured cable connections
C. Leads applied over hairy areas
D. Leads applied to the limbs - CORRECT ANSWER- B (Motion artifact, or "noise," can be
caused by frequent client movement, electrode placement on limbs, and insufficient adhesion
to the skin, such as placing electrodes over hairy areas of the skin. Electrode placement over
bony prominences also should be avoided. Signal interference can also occur with electrode
removal and cable disconnection.)
A 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 over 100. The
nurse determines that the client is experiencing:
A. Premature ventricular contractions
B. Ventricular tachycardia
,C. Ventricular fibrillation
D. Sinus tachycardia - CORRECT ANSWER- B (Ventricular tachycardia is characterized by the
absence of P waves, wide QRS complexes (usually greater than 0.14 second), and a rate
between 100 and 250 impulses per minute. The rhythm is usually regular.)
A nurse is viewing the cardiac monitor in a client's room and notes that the client has just gone
into ventricular tachycardia. The client is awake and alert and has good skin color. The nurse
would prepare to do which of the following?
A. Immediately defibrillate
B. Prepare for pacemaker insertion
C. Administer amiodarone (Cordarone) intravenously
D. Administer epinephrine (Adrenaline) intravenously - CORRECT ANSWER- C (First-line
treatment of ventricular tachycardia in a client who is hemodynamically stable is the use of
antidysrhythmics such as amiodarone (Cordarone), lidocaine (Xylocaine), and procainamide
(Pronestyl). Cardioversion also may be needed to correct the rhythm (cardioversion is
recommended for stable ventricular tachycardia). Defibrillation is used with pulseless
ventricular tachycardia. Epinephrine would stimulate and already excitable ventricle and is
contraindicated.)
A client is having frequent premature ventricular contractions. A nurse would place priority on
assessment of which of the following items?
A. Blood pressure and peripheral perfusion
B. Sensation of palpitations
C. Causative factors such as caffeine
D. Precipitating factors such as infection - CORRECT ANSWER- A (Premature ventricular
contractions can cause hemodynamic compromise. The shortened ventricular filling time with
the ectopic beats leads to decreased stroke volume and, if frequent enough, to decreased
cardiac output. The client may be asymptomatic or may feel palpitations. PVCs can be caused
by cardiac disorders or by any number of physiological stressors, such as infection, illness,
surgery, or trauma, and by the intake of caffeine, alcohol, or nicotine.)
,A client has developed atrial fibrillation, with a ventricular rate of 150 beats per minute. A nurse
assesses the client for:
A. Hypotension and dizziness
B. Nausea and vomiting
C. Hypertension and headache
D. Flat neck veins - CORRECT ANSWER- A (The client with uncontrolled atrial fibrillation
with a ventricular rate more than 150 beats a 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.)
A nurse is watching the cardiac monitor, and a client's rhythm suddenly changes. There are no P
waves; instead there are wavy lines. The QRS complexes measure 0.08 second, but they are
irregular, with a rate of 120 beats a minute. The nurse interprets this rhythm as:
A. Sinus tachycardia
B. Atrial fibrillation
C. Ventricular tachycardia
D. Ventricular fibrillation - CORRECT ANSWER- B (Atrial fibrillation is characterized by a
loss of P waves; an undulating, wavy baseline; QRS duration that is often within normal
limits; and an irregular ventricular rate, which can range from 60 to 100 beats per minute
(when controlled with medications) to 100 to 160 beats per minute (when uncontrolled).)
A nurse notes that a client with sinus rhythm has a premature ventricular contraction that falls on
the T wave of the preceding beat. The client's rhythm suddenly changes to one with no P waves
or definable QRS complexes. Instead there are coarse wavy lines of varying amplitude. The
nurse assesses this rhythm to be:
A. Ventricular tachycardia
B. Ventricular fibrillation
C. Atrial fibrillation
, D. Asystole - CORRECT ANSWER- B (Ventricular fibrillation is characterized by irregular,
chaotic undulations of varying amplitudes. Ventricular fibrillation has no measurable rate and
no visible
P waves or QRS complexes and results from electrical chaos in the ventricles.)
A nurse is caring for a client with unstable ventricular tachycardia. The nurse instructs the client
to do which of the following, if prescribed, during an episode of ventricular tachycardia?
A. Breathe deeply, regularly, and easily
B. Inhale deeply and cough forcefully every 1 to 3 seconds
C. Lie down flat in bed
D. Remove any metal jewelry - CORRECT ANSWER- B (Cough cardiopulmonary
resuscitation (CPR) sometimes is used in the client with unstable ventricular tachycardia. The
nurse tells the client to use cough CPR, if prescribed, by inhaling deeply and coughing
forcefully every 1 to 3 seconds. Cough CPR may terminate the dysrhythmia or sustain the
cerebral and coronary circulation for a short time until other measures can be implemented.)
Which patient is most at risk for developing delirium?
a. A 50-yr-old woman with cholecystitis
b. A 19-yr-old man with a fractured femur
c. A 42-yr-old woman having an elective hysterectomy
d. A 78-yr-old man admitted to the medical unit with complications related to heart failure -
CORRECT ANSWER- D
Which of the following ECG findings alerts the nurse that the client needs an antiarrhythmic?
A. Normal sinus rhythm
B. Sinus bradycardia
C. Sinus arrhythmia
D. Frequent ventricular ectopy - CORRECT ANSWER- D (Ventricular ectopy can be a
lifethreatening arrhythmia; therefore, the client needs an arrhythmic. Other choices are not
