MED SURG CHAPTERS 36,37,38 & 40 | TRUSTED BY
STUDENTS ACROSS MULTIPLE DISCIPLINES! | QUALITY
CONTENT YOU CAN RELY ON!!
Course Code:
Course Title:
Programme:
Academic Year: 2026/2027.
Duration: 2 Hours.
Total Marks: 100.
Candidate Instructions:
1) Write your Registration Number on every answer booklet used.
2) Answer ALL questions in Section A and ANY TWO (2) questions in Section B.
3) Read each question carefully before answering.
4) Begin each question on a new page.
5) The marks for each question are indicated in brackets.
6) This paper consists of several printed pages, including this page.
7) Ensure your copy is complete before the examination begins.
8) Unauthorized materials and communication with other candidates are not permitted.
Turn Over.
APPHIA – Crafted with Care and Precision for Academic Excellence.
1
,A client's cardiac status is being observed by telemetry monitoring. The nurse observes a P wave
that changes shape in lead II. What conclusion does the nurse make about the P wave?
a. It originates from an ectopic focus.
b. The P wave was replaced by U waves.
c. It is from the sinoatrial (SA) node.
d. Multiple P waves are present. Answer: A
The nurse is assessing the client's electrocardiography (ECG). What does the P wave on the
ECG tracing represent?
a. Contraction of the atria
b. Contraction of the ventricles
c. Depolarization of the atria
d. Depolarization of the ventricles Answer: C
A nurse notes that the PR interval on a client's electrocardiograph (ECG) tracing is 0.14 second.
What action does the nurse take?
a. Assess serum cardiac enzymes.
b. Administer 1 mg epinephrine IV.
c. Administer oxygen via nasal cannula.
d. Document the finding in the client's chart. Answer: D
When analyzing a client's electrocardiograph (ECG) tracing, the nurse observes that not all QRS
complexes are preceded by a P wave. What is the nurse's interpretation of this observation?
a. The client has hyperkalemia causing irregular QRS complexes.
b. Ventricular tachycardia is overriding the normal atrial rhythm.
c. The client's chest leads are not making sufficient contact with the skin.
d. Ventricular and atrial depolarizations are initiated from different sites. Answer: D
The nurse observes a prominent U wave on the client's electrocardiograph (ECG) tracing. What
is the most appropriate action for the nurse to take?
a. Document the finding as a normal variant.
b. Review the client's daily electrolyte results.
c. Move the crash cart closer to the client's room.
d. Call for an immediate electrocardiogram. Answer: B
APPHIA – Crafted with Care and Precision for Academic Excellence.
2
, The client's heart rate increases slightly during inspiration and decreases slightly during
expiration. What action does the nurse take?
a. Evaluate for a respirator disorder.
b. Assess the client for chest pain.
c. Document the finding in the chart.
d. Administer antidysrhythmic drugs. Answer: C
A client with tachycardia is experiencing clinical manifestations. Which manifestation requires
immediate intervention by the nurse?
a. Mid-sternal chest pain
b. Increased urine output
c. Mild orthostatic hypotension
d. P wave touching the T wave Answer: A
A client is experiencing sinus bradycardia with hypotension and dizziness. What medication
does the nurse administer?
a. Atropine (Atropine)
b. Digoxin (Lanoxin)
c. Lidocaine (Xylocaine)
d. Metoprolol (Lopressor) Answer: A
A client experiences occasional premature atrial contractions (PACs) accompanied by
palpitations that resolve spontaneously without treatment. What instruction does the nurse
include in the client's teaching plan?
a. "Minimize or abstain from caffeine."
b. "Lie on your side until the attack subsides."
c. "Use your oxygen when you experience PACs."
d. "Take quinidine (Cardioquin) daily to prevent PACs." Answer: A
The nurse identifies a client's rhythm to be a sustained supraventricular tachycardia. What
medication does the nurse administer?
a. Atropine (Atropine)
b. Epinephrine (Adrenalin)
c. Lidocaine (Xylocaine)
d. Diltiazem (Cardizem) Answer: D
APPHIA – Crafted with Care and Precision for Academic Excellence.
3
STUDENTS ACROSS MULTIPLE DISCIPLINES! | QUALITY
CONTENT YOU CAN RELY ON!!
Course Code:
Course Title:
Programme:
Academic Year: 2026/2027.
Duration: 2 Hours.
Total Marks: 100.
Candidate Instructions:
1) Write your Registration Number on every answer booklet used.
2) Answer ALL questions in Section A and ANY TWO (2) questions in Section B.
3) Read each question carefully before answering.
4) Begin each question on a new page.
5) The marks for each question are indicated in brackets.
6) This paper consists of several printed pages, including this page.
7) Ensure your copy is complete before the examination begins.
8) Unauthorized materials and communication with other candidates are not permitted.
Turn Over.
APPHIA – Crafted with Care and Precision for Academic Excellence.
1
,A client's cardiac status is being observed by telemetry monitoring. The nurse observes a P wave
that changes shape in lead II. What conclusion does the nurse make about the P wave?
a. It originates from an ectopic focus.
b. The P wave was replaced by U waves.
c. It is from the sinoatrial (SA) node.
d. Multiple P waves are present. Answer: A
The nurse is assessing the client's electrocardiography (ECG). What does the P wave on the
ECG tracing represent?
a. Contraction of the atria
b. Contraction of the ventricles
c. Depolarization of the atria
d. Depolarization of the ventricles Answer: C
A nurse notes that the PR interval on a client's electrocardiograph (ECG) tracing is 0.14 second.
What action does the nurse take?
a. Assess serum cardiac enzymes.
b. Administer 1 mg epinephrine IV.
c. Administer oxygen via nasal cannula.
d. Document the finding in the client's chart. Answer: D
When analyzing a client's electrocardiograph (ECG) tracing, the nurse observes that not all QRS
complexes are preceded by a P wave. What is the nurse's interpretation of this observation?
a. The client has hyperkalemia causing irregular QRS complexes.
b. Ventricular tachycardia is overriding the normal atrial rhythm.
c. The client's chest leads are not making sufficient contact with the skin.
d. Ventricular and atrial depolarizations are initiated from different sites. Answer: D
The nurse observes a prominent U wave on the client's electrocardiograph (ECG) tracing. What
is the most appropriate action for the nurse to take?
a. Document the finding as a normal variant.
b. Review the client's daily electrolyte results.
c. Move the crash cart closer to the client's room.
d. Call for an immediate electrocardiogram. Answer: B
APPHIA – Crafted with Care and Precision for Academic Excellence.
2
, The client's heart rate increases slightly during inspiration and decreases slightly during
expiration. What action does the nurse take?
a. Evaluate for a respirator disorder.
b. Assess the client for chest pain.
c. Document the finding in the chart.
d. Administer antidysrhythmic drugs. Answer: C
A client with tachycardia is experiencing clinical manifestations. Which manifestation requires
immediate intervention by the nurse?
a. Mid-sternal chest pain
b. Increased urine output
c. Mild orthostatic hypotension
d. P wave touching the T wave Answer: A
A client is experiencing sinus bradycardia with hypotension and dizziness. What medication
does the nurse administer?
a. Atropine (Atropine)
b. Digoxin (Lanoxin)
c. Lidocaine (Xylocaine)
d. Metoprolol (Lopressor) Answer: A
A client experiences occasional premature atrial contractions (PACs) accompanied by
palpitations that resolve spontaneously without treatment. What instruction does the nurse
include in the client's teaching plan?
a. "Minimize or abstain from caffeine."
b. "Lie on your side until the attack subsides."
c. "Use your oxygen when you experience PACs."
d. "Take quinidine (Cardioquin) daily to prevent PACs." Answer: A
The nurse identifies a client's rhythm to be a sustained supraventricular tachycardia. What
medication does the nurse administer?
a. Atropine (Atropine)
b. Epinephrine (Adrenalin)
c. Lidocaine (Xylocaine)
d. Diltiazem (Cardizem) Answer: D
APPHIA – Crafted with Care and Precision for Academic Excellence.
3
