NSG 322 PRACTICE EXAM QUESTIONS AND
DETAILED SOLUTIONS 2026
▶ Sinus Bradycardia. Answer: All normal, except rate <60 bpm
NSG: check pt. Symptomatic? incr HR via meds (atropine to block PNS),
pacemaker if not effective. Asymptomatic? monitor, hold b-blocker?
▶ Sinus Tachycardia. Answer: All normal, except rate 101-150
NSG: check pt. Symptomatic? decr HR via meds (b-blocker or adenosine
push by MD to reset heart), vagal manoeuvre (innervates PNS),
cardioversion if not effective
▶ Sinus Arrythmia. Answer: All normal, except slight irregular rhythm with
breathing
NSG: none, non-concerning pattern of HR speeding/slowing
▶ Atrial Fibrillation. Answer: Many sites within atria fire repetitively and
incoherently, causing ineffective atrial depolarization. AV node blocks most
impulses so ventricular rate is usually slower than atrial.
Atrial >350bpm, slow ventricular rate.
No discernable P wave, atrial is "f" waves (fibrillatory)
QRS: <0.12 sec
NSG: no good contraction, blood stagnates = incr risk of clots/stroke.
Watch for low BP
▶ Idioventricular Rhythm. Answer: Impulse starts at ventricles. Has to
double back around to get through entire heart, which takes longer.
Regular
20-40 bpm
no P wave, wide and bizarre QRS
, NSG: check pt. Probable resus.
▶ Ventricular Tachycardia. Answer: Unreliably regular
No P, PR
Wide and Bizarre QRS
NSG: check pt, prep for defib or cardioversion as it can turn into vfib
▶ Ventricular Fibrillation. Answer: Unorganized and irregular with no
discernable P, QRS, T
No pulse, resus required
▶ Groups of ECG Lead Placement. Answer: Inferior (II, III, aVF): left leg, rt
coronary artery
Lateral (I, aVL, V5, V6): lt arm and chest, Rt and Circumflex coronary
arteries
Septal (V1, V2) and Anterior (V3, V4): Lt anterior descending coronary
artery
▶ 12 Leads ECG Findings:
ST Depression. Answer: Indicates ischemia
▶ 12 Leads ECG Findings:
ST Elevation. Answer: Indicates injury
▶ 12 Leads ECG Findings:
Q Waves and T Wave Inversions. Answer: Indicates infarction
▶ Heart Failure. Answer: Inability of the heart to pump enough blood to
meet the oxygen demands of the body
▶ Systolic vs. Diastolic of Heart Failure. Answer: Systolic: pumping
problem, inability to contract and provide blood flow forward
Diastolic: filling/relaxation problem; inability of the left ventricle to relax
normally, resulting in fluid build up into lungs
DETAILED SOLUTIONS 2026
▶ Sinus Bradycardia. Answer: All normal, except rate <60 bpm
NSG: check pt. Symptomatic? incr HR via meds (atropine to block PNS),
pacemaker if not effective. Asymptomatic? monitor, hold b-blocker?
▶ Sinus Tachycardia. Answer: All normal, except rate 101-150
NSG: check pt. Symptomatic? decr HR via meds (b-blocker or adenosine
push by MD to reset heart), vagal manoeuvre (innervates PNS),
cardioversion if not effective
▶ Sinus Arrythmia. Answer: All normal, except slight irregular rhythm with
breathing
NSG: none, non-concerning pattern of HR speeding/slowing
▶ Atrial Fibrillation. Answer: Many sites within atria fire repetitively and
incoherently, causing ineffective atrial depolarization. AV node blocks most
impulses so ventricular rate is usually slower than atrial.
Atrial >350bpm, slow ventricular rate.
No discernable P wave, atrial is "f" waves (fibrillatory)
QRS: <0.12 sec
NSG: no good contraction, blood stagnates = incr risk of clots/stroke.
Watch for low BP
▶ Idioventricular Rhythm. Answer: Impulse starts at ventricles. Has to
double back around to get through entire heart, which takes longer.
Regular
20-40 bpm
no P wave, wide and bizarre QRS
, NSG: check pt. Probable resus.
▶ Ventricular Tachycardia. Answer: Unreliably regular
No P, PR
Wide and Bizarre QRS
NSG: check pt, prep for defib or cardioversion as it can turn into vfib
▶ Ventricular Fibrillation. Answer: Unorganized and irregular with no
discernable P, QRS, T
No pulse, resus required
▶ Groups of ECG Lead Placement. Answer: Inferior (II, III, aVF): left leg, rt
coronary artery
Lateral (I, aVL, V5, V6): lt arm and chest, Rt and Circumflex coronary
arteries
Septal (V1, V2) and Anterior (V3, V4): Lt anterior descending coronary
artery
▶ 12 Leads ECG Findings:
ST Depression. Answer: Indicates ischemia
▶ 12 Leads ECG Findings:
ST Elevation. Answer: Indicates injury
▶ 12 Leads ECG Findings:
Q Waves and T Wave Inversions. Answer: Indicates infarction
▶ Heart Failure. Answer: Inability of the heart to pump enough blood to
meet the oxygen demands of the body
▶ Systolic vs. Diastolic of Heart Failure. Answer: Systolic: pumping
problem, inability to contract and provide blood flow forward
Diastolic: filling/relaxation problem; inability of the left ventricle to relax
normally, resulting in fluid build up into lungs
