NSG 4100 EXAM 3 Practice Questions with Correct Answers Graded A+ 2026

Question 1 A 68-year-old male presents to the emergency department with complaints of dizziness and shortness of breath. The ECG shows a heart rate of 35 bpm with a consistent P wave before each QRS complex. The patient is alert but his blood pressure is 88/50 mmHg. What is the priority nursing intervention? a) Administer atropine as prescribed. b) Prepare for transcutaneous pacing. c) Obtain an order for a 12-lead ECG. d) Elevate the head of the bed to improve breathing. • Correct Answer: b) Prepare for transcutaneous pacing. • Rationale: The patient is experiencing symptomatic sinus bradycardia (HR 60 bpm with signs of poor perfusion like dizziness and hypotension). While atropine is a first-line medication, a heart rate of 35 bpm is severely low, and the patient is hypotensive. Preparing for transcutaneous pacing is the priority as it can immediately increase the heart rate and improve cardiac output, while waiting for atropine to take effect or if atropine is ineffective. Question 2 A nurse is caring for a patient who is post-cardiac catheterization. The patient's telemetry monitor suddenly shows a rapid, irregular rhythm with a heart rate of 150 bpm and no discernible P waves. The patient reports feeling lightheaded. What is the most likely rhythm? a) Sinus tachycardia b) Atrial fibrillation c) Ventricular tachycardia d) Atrial flutter • Correct Answer: b) Atrial fibrillation • Rationale: Atrial fibrillation is characterized by a rapid and irregular heart rhythm with no identifiable P waves. The loss of atrial kick and rapid ventricular response can lead to a decrease in cardiac output, causing symptoms like lightheadedness. Question 3 A 75-year-old patient with a history of heart failure and recurrent ventricular tachycardia is being discharged with a newly implanted cardioverter-defibrillator (ICD). Which statement by the patient indicates a need for further teaching? a) "I need to avoid lifting heavy objects for a few weeks." b) "If I feel a shock, I should call my doctor immediately." c) "My family needs to learn CPR in case the device doesn't work." d) "I can use my cell phone and microwave without any problems." • Correct Answer: b) "If I feel a shock, I should call my doctor immediately." • Rationale: The patient should be taught to call their doctor after receiving a shock. If they receive multiple shocks or feel unwell, they should seek emergency medical attention. Feeling a single shock indicates the device is working as intended to correct a life-threatening arrhythmia. Question 4 A patient with a history of coronary artery disease is admitted with chest pain. The ECG shows ST elevation in leads II, III, and aVF. The nurse knows this finding is indicative of an infarction in which area of the heart? a) Anterior wall b) Lateral wall c) Inferior wall d) Septal wall • Correct Answer: c) Inferior wall