NUR 430 EXAM 1 | COMPREHENSIVE NURSING STUDY GUIDE,
PRACTICE QUESTIONS & ANSWERS 2026/2027
Normal PR Interval - ANS ✔✔0.12-0.20 seconds
Normal QRS Duration - ANS ✔✔0.06 to 0.10 seconds
Sinus bradycardia originates in what part of the electrical conduction system?
a. AV node
b. SA node
c. Bundle Branches
d. Bundle of His - ANS ✔✔b. SA node
You're analyzing a patient's ECG reading. What should be found in the rhythm for it to be considered
Sinus Bradycardia (select all that apply):
a. One p wave present in front of every QRS complex
b. Atrial rate 60 and ventricular rate of 60
c. Regular atrial and ventricular rate
d. Atrial rate 40 and ventricular rate of 40
e. Regular atrial rate and irregular ventricular rate
f. PR interval 0.14 seconds
g. PR interval 0.36 seconds
h. QRS interval 0.08 seconds
i. QRS interval 0.16 seconds - ANS ✔✔a. One p wave present in front of every QRS complex
c. Regular atrial and ventricular rate
d. Atrial rate 40 and ventricular rate of 40
f. PR interval 0.14 seconds
h. QRS interval 0.08 seconds
You obtain an ECG on a patient and the rhythm is sinus bradycardia with a rate of 52 bpm. Your NEXT
nursing action is to?
a. Prepare to administer Atropine IV push
b. Set-up for transcutaneous pacing
c. Assess the patient
d. Call a rapid response - ANS ✔✔c. Assess the patient
Assess the patient. When discovering sinus bradycardia, the nurse should determine if the patient is
having symptoms. Not all cases of this rhythm require medical treatment.
Your patient is experiencing extreme fatigue, hypotension, palpations, and shortness of breath. You
obtain an ECG and discover a rhythm of sinus bradycardia with a rate of 40 bpm. What finding below
could be causing this condition?
,a. Potassium level of 3.9 meq/L
b. Lisinopril 10 mg BID PO
c. Blood glucose 84
d. Digoxin 0.125 mg PO daily - ANS ✔✔d. Digoxin 0.125 mg PO daily
Digoxin slows down the heart rate and can lead to bradycardia.
Which of the following is NOT a treatment for symptomatic sinus bradycardia?
a. Dopamine
b. Atropine
c. Synchronized cardioversion
d. Transcutaneous pacing - ANS ✔✔c. Synchronized cardioversion
A patient is experiencing sinus bradycardia with a rate of 34 bpm and blood pressure of 78/42. The
patient reports symptoms of chest pain, has cool and clammy skin, dyspnea, and feels like they may
faint. The nurse prepares to administer Atropine per a standing physician's order for the patient's
symptomatic bradycardia. How will the nurse administer this medication?
a. 3 mg IV push every 3-5 minutes, max dose of 5 mg
b. 2 mg IV push every 1-2 minutes, max dose of 3 mg
c. 3-5 mg IV push every 1 minute, max dose 10 mg
d. 1 mg IV push every 3-5 minutes, max dose of 3 mg - ANS ✔✔d. 1 mg IV push every 3-5 minutes, max
dose of 3 mg
Atropine for symptomatic bradycardia should be given as 0.5-1 mg IV push every 3-5 minutes, max dose
of 3 mg.
Referring back to the previous question (6), Atropine was ineffective for treating the bradycardia. The
patient is still symptomatic with a rate 35 bpm. What other options could be considered for the patient?
Select all that apply:
a. Transcutaneous pacing
b. Amiodarone Infusion
c. Dopamine Infusion
d. Epinephrine Infusion - ANS ✔✔a. Transcutaneous pacing
c. Dopamine Infusion
d. Epinephrine Infusion
Which medication below should not be used for the treatment of sinus bradycardia in a patient with a
transplanted heart?
a. Isoproterenol
b. Atropine
c. Epinephrine
d. Glucagon - ANS ✔✔b. Atropine
,A 20-year-old has a mandatory electrocardiogram (ECG) before participating on a college soccer team
and is found to have sinus bradycardia, rate 52. Blood pressure (BP) is 114/54, and the student denies
any health problems. What action by the nurse is most appropriate?
a. Allow the student to participate on the soccer team.
b. Refer the student to a cardiologist for further diagnostic testing.
c. Tell the student to stop playing immediately if any dyspnea occurs.
d. Obtain more detailed information about the students family health history. - ANS ✔✔a. Allow the
student to participate on the soccer team.
In an aerobically trained individual, sinus bradycardia is normal. The students normal BP and negative
health history indicate that there is no need for a cardiology referral or for more detailed information
about the family's health history. Dyspnea during an aerobic activity such as soccer is normal.
A patient develops sinus bradycardia at a rate of 32 beats/minute, has a blood pressure (BP) of 80/42
mmHg, and is complaining of feeling faint. Which actions should the nurse take next ?
a. Recheck the heart rhythm and BP in 5 minutes.
b. Have the patient perform the Valsalva maneuver.
c. Give the scheduled dose of diltiazem (Cardizem).
d. Apply the transcutaneous pacemaker (TCP) pad. - ANS ✔✔d. Apply the transcutaneous pacemaker
(TCP) pad.
The patient is experiencing symptomatic bradycardia, and treatment with TCP is appropriate. Continued
monitoring of the rhythm and BP is an inadequate response. Calcium channel blockers will further
decrease the heart rate, and the diltiazem should be held. The Valsalva maneuver will further decrease
the rate.
The client is exhibiting sinus bradycardia, is complaining of syncope and weakness, and has a BP of
98/60. Which collaborative treatment should the nurse anticipate being implemented?
a. Administer a thrombolytic medication.
b. Assess the client's cardiovascular status.
c. Prepare for insertion of a pacemaker.
d. Obtain a permit for synchronized cardioversion. - ANS ✔✔c. Prepare for insertion of a pacemaker.
Patient is symptomatic, prepare for pacemaker
A client's electrocardiogram strip shows atrial and ventricular rates of 80 complexes per minute. The PR
interval is 0.14 second, and the QRS complex measures 0.08 second. The nurse interprets this rhythm is:
a. Normal sinus rhythm
b. Sinus bradycardia
c. Sinus tachycardia
d. Sinus dysrhythmia - ANS ✔✔a. Normal sinus rhythm
A patient with symptomatic sinus bradycardia at a rate of 40 beats/min typically experiences:
, a. high blood pressure
b. hypotension & dyspnea
c. facial flushing & ataxia
d. calf pain & dry cough - ANS ✔✔b. hypotension & dyspnea
A patient with symptomatic bradycardia suffers from low cardiac output, which may produce
hypotension and dyspnea. The patient may also have chest pain, crackles, an S3 heart sound, and a
sudden onset of confusion.
For a patient with symptomatic sinus bradycardia, appropriate nursing interventions include establishing
IV access to administer:
a. atropine
b. anticoagulants
c. calcium channel blocker
d. beta-adrenergic blocker - ANS ✔✔a. atropine
Atropine or epinephrine are standard treatments for sinus bradycardia
What is the initial intervention in a patient with sinus tachycardia with the following vital signs: heart
rate, 136 beats/min; blood pressure, 102/60 mm Hg; respiratory rate, 24 breaths/min; temperature,
99.2° F; SpO2, 94% on oxygen 2 L/min by nasal cannula?
a. Administer adenosine IV push.
b. Identify the cause.
c. Administer nitroglycerine 0.4 mg sublingual.
d. Administer lidocaine 75 mg IV push. - ANS ✔✔b. Identify the cause.
Sinus tachycardia can be caused by a wide variety of factors, such as exercise, emotion, pain, fever,
hemorrhage, shock, heart failure, and thyrotoxicosis. Many medications used in critical care can also
cause sinus tachycardia; common culprits are aminophylline, dopamine, hydralazine, atropine, and
catecholamines such as epinephrine. This patient has a stable heart rate and SpO2; therefore, there is
time to identify the cause of the sinus tachycardia. Lidocaine is indicated for ventricular dysrhythmias.
Nitroglycerine is not indicated because the patient is not having chest pain at this time. Adenosine is
usually not indicated unless the heart rate is greater than 150 beats/min.
The client is exhibiting sinus bradycardia, is complaining of syncope and weakness,and has a BP of 98/60.
Which collaborative treatment should the nurse anticipatebeing implemented?
a. Administer a thrombolytic medication.
b. Assess the client's cardiovascular status.
c. Prepare for insertion of a pacemaker.
d. Obtain a permit for synchronized cardioversion. - ANS ✔✔c. Prepare for insertion of a pacemaker.
Patient is symptomatic, prepare for pacemaker
Persistent tachycardia in a patient who has had an MI may signal:
PRACTICE QUESTIONS & ANSWERS 2026/2027
Normal PR Interval - ANS ✔✔0.12-0.20 seconds
Normal QRS Duration - ANS ✔✔0.06 to 0.10 seconds
Sinus bradycardia originates in what part of the electrical conduction system?
a. AV node
b. SA node
c. Bundle Branches
d. Bundle of His - ANS ✔✔b. SA node
You're analyzing a patient's ECG reading. What should be found in the rhythm for it to be considered
Sinus Bradycardia (select all that apply):
a. One p wave present in front of every QRS complex
b. Atrial rate 60 and ventricular rate of 60
c. Regular atrial and ventricular rate
d. Atrial rate 40 and ventricular rate of 40
e. Regular atrial rate and irregular ventricular rate
f. PR interval 0.14 seconds
g. PR interval 0.36 seconds
h. QRS interval 0.08 seconds
i. QRS interval 0.16 seconds - ANS ✔✔a. One p wave present in front of every QRS complex
c. Regular atrial and ventricular rate
d. Atrial rate 40 and ventricular rate of 40
f. PR interval 0.14 seconds
h. QRS interval 0.08 seconds
You obtain an ECG on a patient and the rhythm is sinus bradycardia with a rate of 52 bpm. Your NEXT
nursing action is to?
a. Prepare to administer Atropine IV push
b. Set-up for transcutaneous pacing
c. Assess the patient
d. Call a rapid response - ANS ✔✔c. Assess the patient
Assess the patient. When discovering sinus bradycardia, the nurse should determine if the patient is
having symptoms. Not all cases of this rhythm require medical treatment.
Your patient is experiencing extreme fatigue, hypotension, palpations, and shortness of breath. You
obtain an ECG and discover a rhythm of sinus bradycardia with a rate of 40 bpm. What finding below
could be causing this condition?
,a. Potassium level of 3.9 meq/L
b. Lisinopril 10 mg BID PO
c. Blood glucose 84
d. Digoxin 0.125 mg PO daily - ANS ✔✔d. Digoxin 0.125 mg PO daily
Digoxin slows down the heart rate and can lead to bradycardia.
Which of the following is NOT a treatment for symptomatic sinus bradycardia?
a. Dopamine
b. Atropine
c. Synchronized cardioversion
d. Transcutaneous pacing - ANS ✔✔c. Synchronized cardioversion
A patient is experiencing sinus bradycardia with a rate of 34 bpm and blood pressure of 78/42. The
patient reports symptoms of chest pain, has cool and clammy skin, dyspnea, and feels like they may
faint. The nurse prepares to administer Atropine per a standing physician's order for the patient's
symptomatic bradycardia. How will the nurse administer this medication?
a. 3 mg IV push every 3-5 minutes, max dose of 5 mg
b. 2 mg IV push every 1-2 minutes, max dose of 3 mg
c. 3-5 mg IV push every 1 minute, max dose 10 mg
d. 1 mg IV push every 3-5 minutes, max dose of 3 mg - ANS ✔✔d. 1 mg IV push every 3-5 minutes, max
dose of 3 mg
Atropine for symptomatic bradycardia should be given as 0.5-1 mg IV push every 3-5 minutes, max dose
of 3 mg.
Referring back to the previous question (6), Atropine was ineffective for treating the bradycardia. The
patient is still symptomatic with a rate 35 bpm. What other options could be considered for the patient?
Select all that apply:
a. Transcutaneous pacing
b. Amiodarone Infusion
c. Dopamine Infusion
d. Epinephrine Infusion - ANS ✔✔a. Transcutaneous pacing
c. Dopamine Infusion
d. Epinephrine Infusion
Which medication below should not be used for the treatment of sinus bradycardia in a patient with a
transplanted heart?
a. Isoproterenol
b. Atropine
c. Epinephrine
d. Glucagon - ANS ✔✔b. Atropine
,A 20-year-old has a mandatory electrocardiogram (ECG) before participating on a college soccer team
and is found to have sinus bradycardia, rate 52. Blood pressure (BP) is 114/54, and the student denies
any health problems. What action by the nurse is most appropriate?
a. Allow the student to participate on the soccer team.
b. Refer the student to a cardiologist for further diagnostic testing.
c. Tell the student to stop playing immediately if any dyspnea occurs.
d. Obtain more detailed information about the students family health history. - ANS ✔✔a. Allow the
student to participate on the soccer team.
In an aerobically trained individual, sinus bradycardia is normal. The students normal BP and negative
health history indicate that there is no need for a cardiology referral or for more detailed information
about the family's health history. Dyspnea during an aerobic activity such as soccer is normal.
A patient develops sinus bradycardia at a rate of 32 beats/minute, has a blood pressure (BP) of 80/42
mmHg, and is complaining of feeling faint. Which actions should the nurse take next ?
a. Recheck the heart rhythm and BP in 5 minutes.
b. Have the patient perform the Valsalva maneuver.
c. Give the scheduled dose of diltiazem (Cardizem).
d. Apply the transcutaneous pacemaker (TCP) pad. - ANS ✔✔d. Apply the transcutaneous pacemaker
(TCP) pad.
The patient is experiencing symptomatic bradycardia, and treatment with TCP is appropriate. Continued
monitoring of the rhythm and BP is an inadequate response. Calcium channel blockers will further
decrease the heart rate, and the diltiazem should be held. The Valsalva maneuver will further decrease
the rate.
The client is exhibiting sinus bradycardia, is complaining of syncope and weakness, and has a BP of
98/60. Which collaborative treatment should the nurse anticipate being implemented?
a. Administer a thrombolytic medication.
b. Assess the client's cardiovascular status.
c. Prepare for insertion of a pacemaker.
d. Obtain a permit for synchronized cardioversion. - ANS ✔✔c. Prepare for insertion of a pacemaker.
Patient is symptomatic, prepare for pacemaker
A client's electrocardiogram strip shows atrial and ventricular rates of 80 complexes per minute. The PR
interval is 0.14 second, and the QRS complex measures 0.08 second. The nurse interprets this rhythm is:
a. Normal sinus rhythm
b. Sinus bradycardia
c. Sinus tachycardia
d. Sinus dysrhythmia - ANS ✔✔a. Normal sinus rhythm
A patient with symptomatic sinus bradycardia at a rate of 40 beats/min typically experiences:
, a. high blood pressure
b. hypotension & dyspnea
c. facial flushing & ataxia
d. calf pain & dry cough - ANS ✔✔b. hypotension & dyspnea
A patient with symptomatic bradycardia suffers from low cardiac output, which may produce
hypotension and dyspnea. The patient may also have chest pain, crackles, an S3 heart sound, and a
sudden onset of confusion.
For a patient with symptomatic sinus bradycardia, appropriate nursing interventions include establishing
IV access to administer:
a. atropine
b. anticoagulants
c. calcium channel blocker
d. beta-adrenergic blocker - ANS ✔✔a. atropine
Atropine or epinephrine are standard treatments for sinus bradycardia
What is the initial intervention in a patient with sinus tachycardia with the following vital signs: heart
rate, 136 beats/min; blood pressure, 102/60 mm Hg; respiratory rate, 24 breaths/min; temperature,
99.2° F; SpO2, 94% on oxygen 2 L/min by nasal cannula?
a. Administer adenosine IV push.
b. Identify the cause.
c. Administer nitroglycerine 0.4 mg sublingual.
d. Administer lidocaine 75 mg IV push. - ANS ✔✔b. Identify the cause.
Sinus tachycardia can be caused by a wide variety of factors, such as exercise, emotion, pain, fever,
hemorrhage, shock, heart failure, and thyrotoxicosis. Many medications used in critical care can also
cause sinus tachycardia; common culprits are aminophylline, dopamine, hydralazine, atropine, and
catecholamines such as epinephrine. This patient has a stable heart rate and SpO2; therefore, there is
time to identify the cause of the sinus tachycardia. Lidocaine is indicated for ventricular dysrhythmias.
Nitroglycerine is not indicated because the patient is not having chest pain at this time. Adenosine is
usually not indicated unless the heart rate is greater than 150 beats/min.
The client is exhibiting sinus bradycardia, is complaining of syncope and weakness,and has a BP of 98/60.
Which collaborative treatment should the nurse anticipatebeing implemented?
a. Administer a thrombolytic medication.
b. Assess the client's cardiovascular status.
c. Prepare for insertion of a pacemaker.
d. Obtain a permit for synchronized cardioversion. - ANS ✔✔c. Prepare for insertion of a pacemaker.
Patient is symptomatic, prepare for pacemaker
Persistent tachycardia in a patient who has had an MI may signal:
