NUR 201 Exam 2 Medsurge Review:
Cardiac Arrhythmias & Interventions
| Questions and Answers | 2026 Update
| 100% Correct -Jersey College.
1. A patient’s cardiac monitor shows a regular rhythm with a rate of 52
bpm, normal P waves, and a normal QRS. What is the priority nursing
action?
Answer: Assess the patient for symptoms (e.g., hypotension, chest pain,
altered mental status).
Rationale: Sinus bradycardia requires treatment only if symptomatic.
2. Which medication is first-line for a stable, symptomatic patient with
sinus bradycardia?
Answer: Atropine 0.5 mg IV push.
Rationale: Atropine increases heart rate by blocking vagal tone.
3. A patient has a heart rate of 180 bpm, regular rhythm, narrow QRS,
and no visible P waves. The patient is alert with BP 110/70. What is the
initial intervention?
,Answer: Vagal maneuvers (e.g., Valsalva, coughing).
Rationale: This is stable SVT; vagal maneuvers may terminate it.
4. If vagal maneuvers fail for stable SVT, which medication is given
next?
Answer: Adenosine 6 mg rapid IV push followed by saline flush.
Rationale: Adenosine transiently blocks the AV node to interrupt re-entry.
5. A patient in SVT becomes hypotensive with chest pain. What should
the nurse prepare for?
Answer: Synchronized cardioversion.
Rationale: Unstable tachycardia with a pulse requires synchronized
cardioversion.
6. What is the characteristic ECG finding of atrial flutter?
Answer: Sawtooth flutter waves (especially in leads II, III, aVF).
Rationale: Atrial rate 250-350 bpm with regular or irregular ventricular
response.
,7. A patient with chronic atrial fibrillation is at highest risk for which
complication?
Answer: Ischemic stroke from thromboembolism.
Rationale: Stasis of blood in the atria leads to clot formation.
8. Which class of medications is used for rate control in atrial
fibrillation?
Answer: Beta-blockers or calcium channel blockers (e.g., metoprolol,
diltiazem).
Rationale: They slow AV nodal conduction.
9. A patient in atrial fibrillation with rapid ventricular response (RVR)
has a BP of 80/50 and is confused. The nurse should anticipate:
Answer: Immediate synchronized cardioversion.
Rationale: Unstable patient with tachycardia requires prompt cardioversion.
10. What is the most common electrolyte disturbance that triggers
premature ventricular contractions (PVCs)?
Answer: Hypokalemia (low potassium).
Rationale: Low potassium increases myocardial irritability.
, 11. Which two rhythms are considered “shockable” in cardiac arrest?
Answer: Ventricular fibrillation (V-Fib) and pulseless ventricular tachycardia
(V-Tach).
Rationale: Defibrillation is indicated only for these two rhythms.
12. A patient is pulseless with a rhythm showing wide, regular QRS
complexes at 180 bpm with no P waves. What is the immediate action?
Answer: Defibrillate at 120-200 J (biphasic) followed by CPR.
Rationale: This is pulseless V-Tach – a shockable rhythm.
13. What rhythm appears as chaotic, irregular squiggles with no
identifiable complexes and no pulse?
Answer: Ventricular fibrillation (V-Fib).
Rationale: Immediate defibrillation and CPR are required.
14. A patient is found in asystole. Should the nurse defibrillate?
Answer: No. Defibrillation is not indicated for asystole.
Rationale: Asystole is a non-shockable rhythm; CPR and epinephrine are the
treatments.
Cardiac Arrhythmias & Interventions
| Questions and Answers | 2026 Update
| 100% Correct -Jersey College.
1. A patient’s cardiac monitor shows a regular rhythm with a rate of 52
bpm, normal P waves, and a normal QRS. What is the priority nursing
action?
Answer: Assess the patient for symptoms (e.g., hypotension, chest pain,
altered mental status).
Rationale: Sinus bradycardia requires treatment only if symptomatic.
2. Which medication is first-line for a stable, symptomatic patient with
sinus bradycardia?
Answer: Atropine 0.5 mg IV push.
Rationale: Atropine increases heart rate by blocking vagal tone.
3. A patient has a heart rate of 180 bpm, regular rhythm, narrow QRS,
and no visible P waves. The patient is alert with BP 110/70. What is the
initial intervention?
,Answer: Vagal maneuvers (e.g., Valsalva, coughing).
Rationale: This is stable SVT; vagal maneuvers may terminate it.
4. If vagal maneuvers fail for stable SVT, which medication is given
next?
Answer: Adenosine 6 mg rapid IV push followed by saline flush.
Rationale: Adenosine transiently blocks the AV node to interrupt re-entry.
5. A patient in SVT becomes hypotensive with chest pain. What should
the nurse prepare for?
Answer: Synchronized cardioversion.
Rationale: Unstable tachycardia with a pulse requires synchronized
cardioversion.
6. What is the characteristic ECG finding of atrial flutter?
Answer: Sawtooth flutter waves (especially in leads II, III, aVF).
Rationale: Atrial rate 250-350 bpm with regular or irregular ventricular
response.
,7. A patient with chronic atrial fibrillation is at highest risk for which
complication?
Answer: Ischemic stroke from thromboembolism.
Rationale: Stasis of blood in the atria leads to clot formation.
8. Which class of medications is used for rate control in atrial
fibrillation?
Answer: Beta-blockers or calcium channel blockers (e.g., metoprolol,
diltiazem).
Rationale: They slow AV nodal conduction.
9. A patient in atrial fibrillation with rapid ventricular response (RVR)
has a BP of 80/50 and is confused. The nurse should anticipate:
Answer: Immediate synchronized cardioversion.
Rationale: Unstable patient with tachycardia requires prompt cardioversion.
10. What is the most common electrolyte disturbance that triggers
premature ventricular contractions (PVCs)?
Answer: Hypokalemia (low potassium).
Rationale: Low potassium increases myocardial irritability.
, 11. Which two rhythms are considered “shockable” in cardiac arrest?
Answer: Ventricular fibrillation (V-Fib) and pulseless ventricular tachycardia
(V-Tach).
Rationale: Defibrillation is indicated only for these two rhythms.
12. A patient is pulseless with a rhythm showing wide, regular QRS
complexes at 180 bpm with no P waves. What is the immediate action?
Answer: Defibrillate at 120-200 J (biphasic) followed by CPR.
Rationale: This is pulseless V-Tach – a shockable rhythm.
13. What rhythm appears as chaotic, irregular squiggles with no
identifiable complexes and no pulse?
Answer: Ventricular fibrillation (V-Fib).
Rationale: Immediate defibrillation and CPR are required.
14. A patient is found in asystole. Should the nurse defibrillate?
Answer: No. Defibrillation is not indicated for asystole.
Rationale: Asystole is a non-shockable rhythm; CPR and epinephrine are the
treatments.
