Galen NUR 242 Exam 2 () Med-
Surg Nursing (A+ Guarantee)
GALEN NUR 242 EXAM 2 ()
MEDICAL-SURGICAL NURSING CONCEPTS
COMPREHENSIVE PRACTICE EXAMINATION
200+ QUESTIONS WITH VERIFIED ANSWERS AND DETAILED RATIONALES
A+ GUARANTEE | 100% CORRECT
SECTION 1: CARDIOVASCULAR DISORDERS – ATRIAL FIBRILLATION
(Questions 1-30)
Question 1
Which action by the nurse is most important when preparing for cardioversion
of a client with atrial fibrillation?
A) Ensure the defibrillator is in "sync" mode
B) Apply defibrillator pads to the chest
C) Administer a sedative to the client
D) Set the defibrillator to 200 joules
Answer: A
Rationale: The synchronizer switch on the defibrillator must be set to the "on"
(sync) position to ensure the shock is delivered on the R wave, avoiding the
vulnerable T wave period which could induce ventricular fibrillation
[citation:1][citation:7].
Question 2
1
,Which assessment finding by the nurse caring for a client with new-onset atrial
fibrillation would be most important to communicate to the health care
provider?
A) Heart rate of 110 beats per minute
B) Sudden vision change
C) Complaints of mild fatigue
D) Blood pressure of 130/80 mmHg
Answer: B
Rationale: Sudden vision change may indicate an embolic event to the cerebral
circulation, suggesting a stroke is occurring. This requires immediate medical
intervention [citation:1][citation:7].
Question 3
A client who has atrial fibrillation with rapid ventricular response is started on a
continuous heparin infusion. Which clinical finding enables the nurse to
conclude that the heparin therapy is effective?
A) Platelet count is within normal range
B) Activated partial thromboplastin time (aPTT) is twice the usual value
C) International normalized ratio (INR) is 1.0
D) Blood pressure is stable at 120/80 mmHg
Answer: B
Rationale: The therapeutic goal for heparin therapy is to achieve an aPTT that is
1.5 to 2.5 times the normal control value (approximately twice the usual value),
indicating adequate anticoagulation without excessive bleeding risk
[citation:1][citation:7].
Question 4
When treating clients for osteoporosis, which medication has a side effect of
atrial fibrillation when infused too quickly?
A) Alendronate (Fosamax)
B) Raloxifene (Evista)
2
,C) Zoledronic acid (Reclast)
D) Teriparatide (Forteo)
Answer: C
Rationale: Zoledronic acid, a bisphosphonate given intravenously for
osteoporosis, can cause atrial fibrillation as a potential adverse effect if infused
too rapidly. It should be administered over at least 15 minutes
[citation:1][citation:7].
Question 5
After the home health nurse obtains a radial pulse rate of 136 beats/minute in a
client with chronic atrial fibrillation, which action would the nurse take next?
A) Notify the health care provider immediately
B) Take the client's apical pulse for a full minute
C) Administer an as-needed dose of digoxin
D) Document the finding as expected for atrial fibrillation
Answer: B
Rationale: In atrial fibrillation, the radial pulse is often unreliable due to pulse
deficit (difference between apical and radial rates). The nurse should assess
the apical pulse for a full minute to obtain an accurate heart rate before any
further intervention [citation:1][citation:7].
Question 6
Which finding for a client who has a diagnosis of paroxysmal atrial fibrillation is
most important to report quickly to the health care provider?
A) Palpitations lasting 30 minutes
B) Right arm weakness
C) Complaints of chest pressure
D) Fatigue after mild activity
Answer: B
3
, Rationale: Right arm weakness suggests a neurological event, indicating
possible embolic stroke. Patients with atrial fibrillation are at high risk for
thromboembolism, and new neurologic deficits require immediate evaluation
[citation:1][citation:7].
Question 7
When teaching a client with atrial fibrillation about a new prescription for
warfarin (Coumadin), the nurse will include information about which vitamin?
A) Vitamin A
B) Vitamin C
C) Vitamin D
D) Vitamin K
Answer: D
Rationale: Vitamin K is the antagonist of warfarin and can reverse its
anticoagulant effects. Clients should maintain a consistent intake of vitamin K-
rich foods (green leafy vegetables) to keep INR levels stable
[citation:1][citation:7].
Question 8
Which action is essential for the nurse to include in the plan of care for a client
with atrial fibrillation?
A) Monitor blood pressure every shift
B) Take pulse apically for a full minute
C) Restrict fluid intake to 1500 mL daily
D) Encourage ambulation four times daily
Answer: B
Rationale: Apical pulse assessment for a full minute is essential because atrial
fibrillation causes an irregularly irregular rhythm, making peripheral pulse
measurements unreliable. Pulse deficits must be identified
[citation:1][citation:7].
4
Surg Nursing (A+ Guarantee)
GALEN NUR 242 EXAM 2 ()
MEDICAL-SURGICAL NURSING CONCEPTS
COMPREHENSIVE PRACTICE EXAMINATION
200+ QUESTIONS WITH VERIFIED ANSWERS AND DETAILED RATIONALES
A+ GUARANTEE | 100% CORRECT
SECTION 1: CARDIOVASCULAR DISORDERS – ATRIAL FIBRILLATION
(Questions 1-30)
Question 1
Which action by the nurse is most important when preparing for cardioversion
of a client with atrial fibrillation?
A) Ensure the defibrillator is in "sync" mode
B) Apply defibrillator pads to the chest
C) Administer a sedative to the client
D) Set the defibrillator to 200 joules
Answer: A
Rationale: The synchronizer switch on the defibrillator must be set to the "on"
(sync) position to ensure the shock is delivered on the R wave, avoiding the
vulnerable T wave period which could induce ventricular fibrillation
[citation:1][citation:7].
Question 2
1
,Which assessment finding by the nurse caring for a client with new-onset atrial
fibrillation would be most important to communicate to the health care
provider?
A) Heart rate of 110 beats per minute
B) Sudden vision change
C) Complaints of mild fatigue
D) Blood pressure of 130/80 mmHg
Answer: B
Rationale: Sudden vision change may indicate an embolic event to the cerebral
circulation, suggesting a stroke is occurring. This requires immediate medical
intervention [citation:1][citation:7].
Question 3
A client who has atrial fibrillation with rapid ventricular response is started on a
continuous heparin infusion. Which clinical finding enables the nurse to
conclude that the heparin therapy is effective?
A) Platelet count is within normal range
B) Activated partial thromboplastin time (aPTT) is twice the usual value
C) International normalized ratio (INR) is 1.0
D) Blood pressure is stable at 120/80 mmHg
Answer: B
Rationale: The therapeutic goal for heparin therapy is to achieve an aPTT that is
1.5 to 2.5 times the normal control value (approximately twice the usual value),
indicating adequate anticoagulation without excessive bleeding risk
[citation:1][citation:7].
Question 4
When treating clients for osteoporosis, which medication has a side effect of
atrial fibrillation when infused too quickly?
A) Alendronate (Fosamax)
B) Raloxifene (Evista)
2
,C) Zoledronic acid (Reclast)
D) Teriparatide (Forteo)
Answer: C
Rationale: Zoledronic acid, a bisphosphonate given intravenously for
osteoporosis, can cause atrial fibrillation as a potential adverse effect if infused
too rapidly. It should be administered over at least 15 minutes
[citation:1][citation:7].
Question 5
After the home health nurse obtains a radial pulse rate of 136 beats/minute in a
client with chronic atrial fibrillation, which action would the nurse take next?
A) Notify the health care provider immediately
B) Take the client's apical pulse for a full minute
C) Administer an as-needed dose of digoxin
D) Document the finding as expected for atrial fibrillation
Answer: B
Rationale: In atrial fibrillation, the radial pulse is often unreliable due to pulse
deficit (difference between apical and radial rates). The nurse should assess
the apical pulse for a full minute to obtain an accurate heart rate before any
further intervention [citation:1][citation:7].
Question 6
Which finding for a client who has a diagnosis of paroxysmal atrial fibrillation is
most important to report quickly to the health care provider?
A) Palpitations lasting 30 minutes
B) Right arm weakness
C) Complaints of chest pressure
D) Fatigue after mild activity
Answer: B
3
, Rationale: Right arm weakness suggests a neurological event, indicating
possible embolic stroke. Patients with atrial fibrillation are at high risk for
thromboembolism, and new neurologic deficits require immediate evaluation
[citation:1][citation:7].
Question 7
When teaching a client with atrial fibrillation about a new prescription for
warfarin (Coumadin), the nurse will include information about which vitamin?
A) Vitamin A
B) Vitamin C
C) Vitamin D
D) Vitamin K
Answer: D
Rationale: Vitamin K is the antagonist of warfarin and can reverse its
anticoagulant effects. Clients should maintain a consistent intake of vitamin K-
rich foods (green leafy vegetables) to keep INR levels stable
[citation:1][citation:7].
Question 8
Which action is essential for the nurse to include in the plan of care for a client
with atrial fibrillation?
A) Monitor blood pressure every shift
B) Take pulse apically for a full minute
C) Restrict fluid intake to 1500 mL daily
D) Encourage ambulation four times daily
Answer: B
Rationale: Apical pulse assessment for a full minute is essential because atrial
fibrillation causes an irregularly irregular rhythm, making peripheral pulse
measurements unreliable. Pulse deficits must be identified
[citation:1][citation:7].
4
