NUR 265 Week 4 Study Guide: Advanced Medical-Surgical Nursing
2026 |Galen College
1. A patient with new-onset Atrial Fibrillation is at high risk for which
complication?
A. Pulmonary Edema
B. Cardiac Tamponade
C. Ventricular Fibrillation
D. Ischemic Stroke
Answer: D
Rationale: In Atrial Fibrillation, the atria quiver rather than contract effectively, which can
lead to blood stasis and clot formation, potentially causing an embolic stroke.
2. When treating a patient in pulseless Ventricular Tachycardia, what is the
priority action?
A. Synchronized Cardioversion
B. Administration of Epinephrine
C. Amiodarone bolus
D. Defibrillation
Answer: D
Rationale: For pulseless VT or Ventricular Fibrillation, immediate defibrillation is the
priority treatment to attempt to restore a perfusing rhythm.
,3. A patient presents with Sinus Bradycardia and a heart rate of 38 bpm, feeling
dizzy and hypotensive. Which medication should the nurse anticipate first?
A. Lidocaine
B. Atropine
C. Dopamine
D. Amiodarone
Answer: B
Rationale: Atropine is the first-line medication for symptomatic bradycardia to increase
the heart rate.
4. Which ECG characteristic is most definitive for a Third-Degree Heart Block?
A. A PR interval greater than 0.20 seconds
B. Progressive lengthening of the PR interval until a QRS is dropped
C. No relationship between P waves and QRS complexes
D. A consistent PR interval followed by a dropped QRS
Answer: C
Rationale: In third-degree (complete) heart block, the atria and ventricles beat
independently, showing no correlation between P waves and QRS complexes.
5. During the administration of Adenosine for SVT, what should the nurse warn
the patient about?
A. Excessive urination
B. A brief period of asystole or chest pressure
C. Long-term visual changes
D. Severe back pain
Answer: B
Rationale: Adenosine slows conduction through the AV node and often causes a short
period of asystole and feelings of impending doom or chest pressure.
, 6. Which hemodynamic parameter best reflects the patient’s fluid volume status
(preload) in the right side of the heart?
A. Central Venous Pressure (CVP)
B. Pulmonary Artery Wedge Pressure (PAWP)
C. Systemic Vascular Resistance (SVR)
D. Cardiac Output (CO)
Answer: A
Rationale: CVP measures the pressure in the right atrium and is an indicator of right-sided
preload and fluid status.
7. In the Oliguric phase of Acute Kidney Injury, which electrolyte imbalance is
the nurse most likely to observe?
A. Hypokalemia
B. Hypercalcemia
C. Hypophosphatemia
D. Hyperkalemia
Answer: D
Rationale: In AKI, the kidneys cannot excrete potassium effectively, leading to potentially
life-threatening hyperkalemia.
8. A patient in Septic Shock has a persistent low blood pressure despite fluid
resuscitation. Which vasopressor is typically the first-line choice?
A. Vasopressin
B. Nitroprusside
C. Dobutamine
D. Norepinephrine
Answer: D
Rationale: Norepinephrine (Levophed) is the first-line vasopressor recommended in the
Surviving Sepsis guidelines for refractory hypotension.
2026 |Galen College
1. A patient with new-onset Atrial Fibrillation is at high risk for which
complication?
A. Pulmonary Edema
B. Cardiac Tamponade
C. Ventricular Fibrillation
D. Ischemic Stroke
Answer: D
Rationale: In Atrial Fibrillation, the atria quiver rather than contract effectively, which can
lead to blood stasis and clot formation, potentially causing an embolic stroke.
2. When treating a patient in pulseless Ventricular Tachycardia, what is the
priority action?
A. Synchronized Cardioversion
B. Administration of Epinephrine
C. Amiodarone bolus
D. Defibrillation
Answer: D
Rationale: For pulseless VT or Ventricular Fibrillation, immediate defibrillation is the
priority treatment to attempt to restore a perfusing rhythm.
,3. A patient presents with Sinus Bradycardia and a heart rate of 38 bpm, feeling
dizzy and hypotensive. Which medication should the nurse anticipate first?
A. Lidocaine
B. Atropine
C. Dopamine
D. Amiodarone
Answer: B
Rationale: Atropine is the first-line medication for symptomatic bradycardia to increase
the heart rate.
4. Which ECG characteristic is most definitive for a Third-Degree Heart Block?
A. A PR interval greater than 0.20 seconds
B. Progressive lengthening of the PR interval until a QRS is dropped
C. No relationship between P waves and QRS complexes
D. A consistent PR interval followed by a dropped QRS
Answer: C
Rationale: In third-degree (complete) heart block, the atria and ventricles beat
independently, showing no correlation between P waves and QRS complexes.
5. During the administration of Adenosine for SVT, what should the nurse warn
the patient about?
A. Excessive urination
B. A brief period of asystole or chest pressure
C. Long-term visual changes
D. Severe back pain
Answer: B
Rationale: Adenosine slows conduction through the AV node and often causes a short
period of asystole and feelings of impending doom or chest pressure.
, 6. Which hemodynamic parameter best reflects the patient’s fluid volume status
(preload) in the right side of the heart?
A. Central Venous Pressure (CVP)
B. Pulmonary Artery Wedge Pressure (PAWP)
C. Systemic Vascular Resistance (SVR)
D. Cardiac Output (CO)
Answer: A
Rationale: CVP measures the pressure in the right atrium and is an indicator of right-sided
preload and fluid status.
7. In the Oliguric phase of Acute Kidney Injury, which electrolyte imbalance is
the nurse most likely to observe?
A. Hypokalemia
B. Hypercalcemia
C. Hypophosphatemia
D. Hyperkalemia
Answer: D
Rationale: In AKI, the kidneys cannot excrete potassium effectively, leading to potentially
life-threatening hyperkalemia.
8. A patient in Septic Shock has a persistent low blood pressure despite fluid
resuscitation. Which vasopressor is typically the first-line choice?
A. Vasopressin
B. Nitroprusside
C. Dobutamine
D. Norepinephrine
Answer: D
Rationale: Norepinephrine (Levophed) is the first-line vasopressor recommended in the
Surviving Sepsis guidelines for refractory hypotension.
