NSG 4100 EXAM 3: Adult Health III (GALEN
COLLEGE OF NURSING) ACTUAL
QUESTIONS AND ANSWERS LATEST
UPDATED 2026/2027 (GRADED A+)
NSG 4100 Exam 3
Unit 5: Complex Perfusion Problems (Part I)
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
, • Rationale: Rationale: Leads II, III, and aVF correspond to the inferior
portion of the heart, which is primarily supplied by the right coronary artery.
ST-segment elevation in these leads is a hallmark of an inferior wall
myocardial infarction. Recognizing the specific leads affected helps
localize the infarct and guide appropriate treatment.
Question 5
A nurse is preparing to administer adenosine to a patient in supraventricular
tachycardia (SVT). The patient's heart rate is 180 bpm and regular. Which
action is most critical for the nurse to take?
a) Administer the drug over 2 minutes to prevent side effects.
b) Have a defibrillator and crash cart at the bedside.
c) Instruct the patient to perform the Valsalva maneuver.
d)Administer the medication through an oral syringe.
• Correct Answer: b) Have a defibrillator and crash cart at the bedside.
• Rationale: Adenosine is a very short-acting drug that can cause a brief
period of asystole. Because of this risk, it is critical to have a
defibrillator and crash cart immediately available in case of a
sustained rhythm disturbance. The drug should be administered
rapidly via a large-bore IV.
Unit 6: Complex Perfusion Problems (Part II)
Question 6
A 55-year-old male with a history of uncontrolled hypertension presents with
severe, tearing back pain. He is diaphoretic, and his blood pressure is
210/110 mmHg. The nurse suspects an aortic dissection. What is the priority
nursing action?
a) Administer analgesics to relieve the pain.
b) Lower the head of the bed to a flat position.
c) Administer IV antihypertensives to lower the blood pressure.
d) Prepare the patient for an emergency abdominal aortic aneurysm repair.
• Correct Answer: c) Administer IV antihypertensives to lower the blood
pressure.
• Rationale: An aortic dissection is a medical emergency where the
inner layer of the aorta tears. The priority is to lower the blood
pressure to reduce the stress on the weakened aortic wall and
COLLEGE OF NURSING) ACTUAL
QUESTIONS AND ANSWERS LATEST
UPDATED 2026/2027 (GRADED A+)
NSG 4100 Exam 3
Unit 5: Complex Perfusion Problems (Part I)
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
, • Rationale: Rationale: Leads II, III, and aVF correspond to the inferior
portion of the heart, which is primarily supplied by the right coronary artery.
ST-segment elevation in these leads is a hallmark of an inferior wall
myocardial infarction. Recognizing the specific leads affected helps
localize the infarct and guide appropriate treatment.
Question 5
A nurse is preparing to administer adenosine to a patient in supraventricular
tachycardia (SVT). The patient's heart rate is 180 bpm and regular. Which
action is most critical for the nurse to take?
a) Administer the drug over 2 minutes to prevent side effects.
b) Have a defibrillator and crash cart at the bedside.
c) Instruct the patient to perform the Valsalva maneuver.
d)Administer the medication through an oral syringe.
• Correct Answer: b) Have a defibrillator and crash cart at the bedside.
• Rationale: Adenosine is a very short-acting drug that can cause a brief
period of asystole. Because of this risk, it is critical to have a
defibrillator and crash cart immediately available in case of a
sustained rhythm disturbance. The drug should be administered
rapidly via a large-bore IV.
Unit 6: Complex Perfusion Problems (Part II)
Question 6
A 55-year-old male with a history of uncontrolled hypertension presents with
severe, tearing back pain. He is diaphoretic, and his blood pressure is
210/110 mmHg. The nurse suspects an aortic dissection. What is the priority
nursing action?
a) Administer analgesics to relieve the pain.
b) Lower the head of the bed to a flat position.
c) Administer IV antihypertensives to lower the blood pressure.
d) Prepare the patient for an emergency abdominal aortic aneurysm repair.
• Correct Answer: c) Administer IV antihypertensives to lower the blood
pressure.
• Rationale: An aortic dissection is a medical emergency where the
inner layer of the aorta tears. The priority is to lower the blood
pressure to reduce the stress on the weakened aortic wall and
