NSG 4100 TEST BANK EXAM Actual Updated 2026 With Detailed Answers
SECTION 1: CARDIOVASCULAR AND HEMODYNAMIC MONITORING (Questions 1-150)
Question 1
The nurse is attending to a client who has orders for central venous pressure
monitoring. The nurse understands the catheter attached to a pressure
monitoring system will be placed in the:
A) Left to right ventricle
B) Vena cava or left atrium
C) Vena cava or right atrium
D) Pulmonary artery or vein
Answer: C) Vena cava or right atrium
Rationale: Central venous pressure (CVP) monitoring measures pressure in
the vena cava or right atrium, reflecting right ventricular preload and fluid
status. The catheter is typically placed in the superior vena cava or right
atrium via the internal jugular or subclavian vein.
Question 2
The nurse preceptor is observing a newly hired nurse care for a client who has
hemodynamic monitoring catheter in place. Which of the following actions by
the newly hired nurse requires immediate intervention by the nurse preceptor?
A) Refusing to use topical antibiotic ointment and creams on the insertion sites
B) Using alcohol-based hand rub before and after each contact with the
catheter
C) Replacing transducer tubing, continuous flush devices and solution every 96
hours
D) Informing the client that this type of catheter allows for total freedom in the
bath and shower
,Answer: D) Informing the client that this type of catheter allows for total
freedom in the bath and shower
Rationale: Hemodynamic monitoring catheters must be kept dry; the insertion
site should not be submerged in water. Clients should be taught to cover the
site with a waterproof dressing during showers and avoid baths. The other
actions are correct: avoiding antibiotic ointments (can promote fungal growth),
hand hygiene, and changing equipment per protocol (typically every 96 hours)
are appropriate.
Question 3
The nurse is caring for a client who developed a cardiac rhythm of sinus
bradycardia. Which of the following findings are commonly associated with this
rhythm?
A) Lower metabolic needs
B) Side effects of atropine
C) High metabolic demand
D) Physiological stress
Answer: A) Lower metabolic needs
Rationale: Sinus bradycardia (heart rate <60 bpm) can be normal in well-
conditioned athletes due to lower metabolic needs. It may also occur during
sleep. It is not caused by atropine (atropine increases heart rate), high
metabolic demand, or physiological stress (which typically causes
tachycardia).
Question 4
The nurse is reviewing newly written prescriptions for a client admitted with
sinus tachycardia. Which of the following prescriptions requires immediate
follow up with a primary health care provider?
,A) Amiodarone
B) Procainamide
C) Atropine
D) Sotalol
Answer: C) Atropine
Rationale: Atropine is used to treat bradycardia, not tachycardia.
Administering atropine to a patient with sinus tachycardia could worsen the
condition by further increasing heart rate. The other medications are
antiarrhythmics that may be used to treat certain tachyarrhythmias.
Question 5
The nurse is caring for a client with a history of cardiomyopathy and valvular
heart disease. The client is being treated for proarrhythmic medications that
have a cardiac rhythm as seen below (ventricular fibrillation). Which of the
following actions should the nurse take?
A) Have the client perform the vagal maneuver
B) Administer the prescribed cardiac medication
C) Begin CPR and prepare for early defibrillation
D) Elevate the client's head of the bed
Answer: C) Begin CPR and prepare for early defibrillation
Rationale: Ventricular fibrillation is a life-threatening emergency requiring
immediate CPR and defibrillation. Vagal maneuvers are for stable
supraventricular tachycardia. Medications may be given after defibrillation
attempts.
Question 6
The nurse is caring for a client who has developed torsades de pointes,
focusing on correcting underlying electrolyte imbalances. Which of the
, following IV medications should the nurse expect to also be ordered for this
client?
A) IV Isoproterenol
B) IV Ciprofloxacin
C) IV bolus of epinephrine
D) IV bolus of adenosine
Answer: A) IV Isoproterenol
Rationale: Torsades de pointes is often associated with prolonged QT interval
and can be treated with IV magnesium sulfate. Isoproterenol may be used to
increase heart rate and shorten the QT interval in some cases. Antibiotics,
epinephrine, and adenosine are not first-line treatments for torsades.
Question 7
The nurse is caring for a client who develops a cardiac rhythm of ventricular
tachycardia. The nurse should identify this rhythm as:
A) A ventricular tachycardia requiring an emergent response
B) A stable sinus tachycardia requiring monitoring
C) A stable ventricular fibrillation requiring monitoring
D) A supraventricular tachycardia requiring a non-emergency response
Answer: A) A ventricular tachycardia requiring an emergent response
Rationale: Ventricular tachycardia is a life-threatening dysrhythmia that
requires immediate intervention. It can deteriorate into ventricular fibrillation
and cardiac arrest. Treatment depends on stability and may include
medications, cardioversion, or defibrillation.
Question 8
The nurse is caring for a client with atrial fibrillation. Which of the following is a
priority assessment?
SECTION 1: CARDIOVASCULAR AND HEMODYNAMIC MONITORING (Questions 1-150)
Question 1
The nurse is attending to a client who has orders for central venous pressure
monitoring. The nurse understands the catheter attached to a pressure
monitoring system will be placed in the:
A) Left to right ventricle
B) Vena cava or left atrium
C) Vena cava or right atrium
D) Pulmonary artery or vein
Answer: C) Vena cava or right atrium
Rationale: Central venous pressure (CVP) monitoring measures pressure in
the vena cava or right atrium, reflecting right ventricular preload and fluid
status. The catheter is typically placed in the superior vena cava or right
atrium via the internal jugular or subclavian vein.
Question 2
The nurse preceptor is observing a newly hired nurse care for a client who has
hemodynamic monitoring catheter in place. Which of the following actions by
the newly hired nurse requires immediate intervention by the nurse preceptor?
A) Refusing to use topical antibiotic ointment and creams on the insertion sites
B) Using alcohol-based hand rub before and after each contact with the
catheter
C) Replacing transducer tubing, continuous flush devices and solution every 96
hours
D) Informing the client that this type of catheter allows for total freedom in the
bath and shower
,Answer: D) Informing the client that this type of catheter allows for total
freedom in the bath and shower
Rationale: Hemodynamic monitoring catheters must be kept dry; the insertion
site should not be submerged in water. Clients should be taught to cover the
site with a waterproof dressing during showers and avoid baths. The other
actions are correct: avoiding antibiotic ointments (can promote fungal growth),
hand hygiene, and changing equipment per protocol (typically every 96 hours)
are appropriate.
Question 3
The nurse is caring for a client who developed a cardiac rhythm of sinus
bradycardia. Which of the following findings are commonly associated with this
rhythm?
A) Lower metabolic needs
B) Side effects of atropine
C) High metabolic demand
D) Physiological stress
Answer: A) Lower metabolic needs
Rationale: Sinus bradycardia (heart rate <60 bpm) can be normal in well-
conditioned athletes due to lower metabolic needs. It may also occur during
sleep. It is not caused by atropine (atropine increases heart rate), high
metabolic demand, or physiological stress (which typically causes
tachycardia).
Question 4
The nurse is reviewing newly written prescriptions for a client admitted with
sinus tachycardia. Which of the following prescriptions requires immediate
follow up with a primary health care provider?
,A) Amiodarone
B) Procainamide
C) Atropine
D) Sotalol
Answer: C) Atropine
Rationale: Atropine is used to treat bradycardia, not tachycardia.
Administering atropine to a patient with sinus tachycardia could worsen the
condition by further increasing heart rate. The other medications are
antiarrhythmics that may be used to treat certain tachyarrhythmias.
Question 5
The nurse is caring for a client with a history of cardiomyopathy and valvular
heart disease. The client is being treated for proarrhythmic medications that
have a cardiac rhythm as seen below (ventricular fibrillation). Which of the
following actions should the nurse take?
A) Have the client perform the vagal maneuver
B) Administer the prescribed cardiac medication
C) Begin CPR and prepare for early defibrillation
D) Elevate the client's head of the bed
Answer: C) Begin CPR and prepare for early defibrillation
Rationale: Ventricular fibrillation is a life-threatening emergency requiring
immediate CPR and defibrillation. Vagal maneuvers are for stable
supraventricular tachycardia. Medications may be given after defibrillation
attempts.
Question 6
The nurse is caring for a client who has developed torsades de pointes,
focusing on correcting underlying electrolyte imbalances. Which of the
, following IV medications should the nurse expect to also be ordered for this
client?
A) IV Isoproterenol
B) IV Ciprofloxacin
C) IV bolus of epinephrine
D) IV bolus of adenosine
Answer: A) IV Isoproterenol
Rationale: Torsades de pointes is often associated with prolonged QT interval
and can be treated with IV magnesium sulfate. Isoproterenol may be used to
increase heart rate and shorten the QT interval in some cases. Antibiotics,
epinephrine, and adenosine are not first-line treatments for torsades.
Question 7
The nurse is caring for a client who develops a cardiac rhythm of ventricular
tachycardia. The nurse should identify this rhythm as:
A) A ventricular tachycardia requiring an emergent response
B) A stable sinus tachycardia requiring monitoring
C) A stable ventricular fibrillation requiring monitoring
D) A supraventricular tachycardia requiring a non-emergency response
Answer: A) A ventricular tachycardia requiring an emergent response
Rationale: Ventricular tachycardia is a life-threatening dysrhythmia that
requires immediate intervention. It can deteriorate into ventricular fibrillation
and cardiac arrest. Treatment depends on stability and may include
medications, cardioversion, or defibrillation.
Question 8
The nurse is caring for a client with atrial fibrillation. Which of the following is a
priority assessment?
