NR 325 Adult Health III - Week 2 Study Guide 2026 |Chamberlain
College
1. A nurse is monitoring a client’s EKG strip and notes a PR interval of 0.28
seconds. How should the nurse interpret this finding?
A. First-degree AV block
B. Normal sinus rhythm
C. Second-degree AV block Type I
D. Third-degree heart block
Answer: A
Rationale: A PR interval greater than 0.20 seconds indicates a first-degree AV block, which
represents a delay in conduction from the atria to the ventricles.
2. The nurse sees a sawtooth pattern on the EKG monitor with an atrial rate of
300 bpm. Which rhythm is this?
A. Atrial fibrillation
B. Atrial flutter
C. Ventricular tachycardia
D. Sinus tachycardia
Answer: B
Rationale: Atrial flutter is characterized by ‘sawtooth’ F-waves and typically has a very
fast, regular atrial rate.
,3. Which medication is the first-line treatment for a patient experiencing
symptomatic sinus bradycardia?
A. Amiodarone
B. Adenosine
C. Atropine
D. Digoxin
Answer: C
Rationale: Atropine is an anticholinergic used to increase the heart rate in symptomatic
bradycardia.
4. A patient’s EKG shows a sudden absence of P-waves and a totally irregular
QRS rhythm. What is the priority nursing intervention?
A. Perform a carotid massage
B. Prepare for immediate defibrillation
C. Administer 1mg of Epinephrine
D. Assess for signs of a stroke and check apical pulse
Answer: D
Rationale: Atrial fibrillation increases the risk of thrombus formation in the atria, which
can lead to an embolic stroke.
5. When performing synchronized cardioversion, why is it critical that the ‘sync’
button is engaged?
A. To allow for higher energy levels than defibrillation
B. To prevent the machine from charging too high
C. To ensure the shock hits the T-wave
D. To deliver the shock during the QRS complex
Answer: D
Rationale: Synchronized cardioversion must occur on the R-wave of the QRS complex to
avoid hitting the T-wave, which could cause ventricular fibrillation (R-on-T phenomenon).
, 6. A patient is in Ventricular Fibrillation. What is the priority action?
A. Administer IV Lidocaine
B. Perform synchronized cardioversion
C. Check for a pulse for 60 seconds
D. Defibrillate immediately
Answer: D
Rationale: V-fib is a pulseless, lethal rhythm; immediate defibrillation is the most effective
treatment to restore a rhythm.
7. Which EKG finding is characteristic of a Premature Ventricular Contraction
(PVC)?
A. A narrow QRS complex less than 0.10 seconds
B. A wide and bizarre QRS complex
C. An inverted P-wave before the QRS
D. A PR interval of exactly 0.12 seconds
Answer: B
Rationale: PVCs originate in the ventricles, resulting in a wide (greater than 0.12s) and
distorted QRS shape.
8. A nurse identifies ‘failure to capture’ on a patient’s pacemaker monitor. What
does this mean?
A. The pacemaker is not sensing the patient’s own beats
B. The pacemaker spikes are not followed by a QRS complex
C. The battery is dead
D. The patient is having a myocardial infarction
Answer: B
Rationale: Failure to capture occurs when the pacemaker sends an electrical impulse
(spike) but the heart muscle does not depolarize (no QRS).
College
1. A nurse is monitoring a client’s EKG strip and notes a PR interval of 0.28
seconds. How should the nurse interpret this finding?
A. First-degree AV block
B. Normal sinus rhythm
C. Second-degree AV block Type I
D. Third-degree heart block
Answer: A
Rationale: A PR interval greater than 0.20 seconds indicates a first-degree AV block, which
represents a delay in conduction from the atria to the ventricles.
2. The nurse sees a sawtooth pattern on the EKG monitor with an atrial rate of
300 bpm. Which rhythm is this?
A. Atrial fibrillation
B. Atrial flutter
C. Ventricular tachycardia
D. Sinus tachycardia
Answer: B
Rationale: Atrial flutter is characterized by ‘sawtooth’ F-waves and typically has a very
fast, regular atrial rate.
,3. Which medication is the first-line treatment for a patient experiencing
symptomatic sinus bradycardia?
A. Amiodarone
B. Adenosine
C. Atropine
D. Digoxin
Answer: C
Rationale: Atropine is an anticholinergic used to increase the heart rate in symptomatic
bradycardia.
4. A patient’s EKG shows a sudden absence of P-waves and a totally irregular
QRS rhythm. What is the priority nursing intervention?
A. Perform a carotid massage
B. Prepare for immediate defibrillation
C. Administer 1mg of Epinephrine
D. Assess for signs of a stroke and check apical pulse
Answer: D
Rationale: Atrial fibrillation increases the risk of thrombus formation in the atria, which
can lead to an embolic stroke.
5. When performing synchronized cardioversion, why is it critical that the ‘sync’
button is engaged?
A. To allow for higher energy levels than defibrillation
B. To prevent the machine from charging too high
C. To ensure the shock hits the T-wave
D. To deliver the shock during the QRS complex
Answer: D
Rationale: Synchronized cardioversion must occur on the R-wave of the QRS complex to
avoid hitting the T-wave, which could cause ventricular fibrillation (R-on-T phenomenon).
, 6. A patient is in Ventricular Fibrillation. What is the priority action?
A. Administer IV Lidocaine
B. Perform synchronized cardioversion
C. Check for a pulse for 60 seconds
D. Defibrillate immediately
Answer: D
Rationale: V-fib is a pulseless, lethal rhythm; immediate defibrillation is the most effective
treatment to restore a rhythm.
7. Which EKG finding is characteristic of a Premature Ventricular Contraction
(PVC)?
A. A narrow QRS complex less than 0.10 seconds
B. A wide and bizarre QRS complex
C. An inverted P-wave before the QRS
D. A PR interval of exactly 0.12 seconds
Answer: B
Rationale: PVCs originate in the ventricles, resulting in a wide (greater than 0.12s) and
distorted QRS shape.
8. A nurse identifies ‘failure to capture’ on a patient’s pacemaker monitor. What
does this mean?
A. The pacemaker is not sensing the patient’s own beats
B. The pacemaker spikes are not followed by a QRS complex
C. The battery is dead
D. The patient is having a myocardial infarction
Answer: B
Rationale: Failure to capture occurs when the pacemaker sends an electrical impulse
(spike) but the heart muscle does not depolarize (no QRS).
