NSG 4100 Exam 3 – Hemodynamics &
Cardiac Rhythms ACTUAL EXAM
LATEST 2026!!! REAL
1. The nurse is caring for a client with a central venous pressure (CVP)
catheter. The nurse understands that the catheter tip for CVP monitoring is
located in which of the following locations?
A. Left ventricle
B. Pulmonary artery
C. Vena cava or right atrium
D. Aortic arch
ANSWER: C. Vena cava or right atrium
Rationale:
A. Left ventricle – Incorrect. CVP measures right atrial pressure, not left
ventricular pressure.
B. Pulmonary artery – Incorrect. This is the location for a pulmonary artery
catheter (Swan-Ganz), not CVP.
C. Vena cava or right atrium – Correct. CVP reflects right atrial pressure
and preload.
,D. Aortic arch – Incorrect. This measures arterial pressure, not central
venous pressure.
2. A client has a central line for hemodynamic monitoring. Which action by
a newly hired nurse requires immediate intervention by the preceptor?
A. Refusing to use topical antibiotic ointment at the insertion site
B. Using alcohol-based hand rub before and after catheter contact
C. Replacing transducer tubing and flush solution every 96 hours
D. Allowing the client to take a full bath and shower with the catheter in
place
ANSWER: D. Allowing the client to take a full bath and shower with the
catheter in place
Rationale:
A. No intervention needed – Antibiotic ointment is not routinely
recommended due to fungal resistance risk.
B. Correct technique – Hand hygiene is appropriate.
C. Appropriate – Changing every 96 hours follows CDC guidelines.
D. Requires immediate intervention – Central lines must be kept dry;
submerging increases infection risk.
3. The nurse is interpreting a CVP reading of 2 mm Hg. This indicates:
A. Hypervolemia
B. Increased preload
,C. Hypovolemia
D. Left heart failure
ANSWER: C. Hypovolemia
Rationale:
A. Hypervolemia – Incorrect. Hypervolemia increases CVP (typically >8-12
mm Hg).
B. Increased preload – Incorrect. Low CVP suggests low preload.
C. Hypovolemia – Correct. Normal CVP is 2–8 mm Hg; 2 mm Hg is low-
normal, trending toward hypovolemia.
D. Left heart failure – Incorrect. Left heart failure may increase CVP if right
heart also affected, but CVP is not specific to left failure.
4. Which EKG rhythm is most commonly associated with lower metabolic
needs and physiological rest?
A. Atrial fibrillation
B. Sinus bradycardia
C. Ventricular tachycardia
D. Sinus tachycardia
ANSWER: B. Sinus bradycardia
Rationale:
A. Atrial fibrillation – Incorrect. Can be irregular and fast, not restful.
, B. Sinus bradycardia – Correct. Rate <60, often in athletes or during sleep;
lowers myocardial oxygen demand.
C. Ventricular tachycardia – Incorrect. Life-threatening, high metabolic
demand.
D. Sinus tachycardia – Incorrect. Increases metabolic demand.
5. A client with sinus tachycardia has a new prescription. Which medication
requires immediate follow-up with the provider?
A. Amiodarone
B. Procainamide
C. Atropine
D. Sotalol
ANSWER: C. Atropine
Rationale:
A. Amiodarone – Used for tachyarrhythmias, not inappropriate.
B. Procainamide – Antiarrhythmic for tachycardia.
C. Atropine – Increases heart rate; contraindicated in sinus tachycardia
because it worsens tachycardia.
D. Sotalol – Beta-blocker used to slow rate in sinus tachycardia.
6. The nurse notes a heart rate of 42 bpm with regular R-R intervals on the
monitor. The client is asymptomatic. The nurse should first:
A. Prepare for transcutaneous pacing
Cardiac Rhythms ACTUAL EXAM
LATEST 2026!!! REAL
1. The nurse is caring for a client with a central venous pressure (CVP)
catheter. The nurse understands that the catheter tip for CVP monitoring is
located in which of the following locations?
A. Left ventricle
B. Pulmonary artery
C. Vena cava or right atrium
D. Aortic arch
ANSWER: C. Vena cava or right atrium
Rationale:
A. Left ventricle – Incorrect. CVP measures right atrial pressure, not left
ventricular pressure.
B. Pulmonary artery – Incorrect. This is the location for a pulmonary artery
catheter (Swan-Ganz), not CVP.
C. Vena cava or right atrium – Correct. CVP reflects right atrial pressure
and preload.
,D. Aortic arch – Incorrect. This measures arterial pressure, not central
venous pressure.
2. A client has a central line for hemodynamic monitoring. Which action by
a newly hired nurse requires immediate intervention by the preceptor?
A. Refusing to use topical antibiotic ointment at the insertion site
B. Using alcohol-based hand rub before and after catheter contact
C. Replacing transducer tubing and flush solution every 96 hours
D. Allowing the client to take a full bath and shower with the catheter in
place
ANSWER: D. Allowing the client to take a full bath and shower with the
catheter in place
Rationale:
A. No intervention needed – Antibiotic ointment is not routinely
recommended due to fungal resistance risk.
B. Correct technique – Hand hygiene is appropriate.
C. Appropriate – Changing every 96 hours follows CDC guidelines.
D. Requires immediate intervention – Central lines must be kept dry;
submerging increases infection risk.
3. The nurse is interpreting a CVP reading of 2 mm Hg. This indicates:
A. Hypervolemia
B. Increased preload
,C. Hypovolemia
D. Left heart failure
ANSWER: C. Hypovolemia
Rationale:
A. Hypervolemia – Incorrect. Hypervolemia increases CVP (typically >8-12
mm Hg).
B. Increased preload – Incorrect. Low CVP suggests low preload.
C. Hypovolemia – Correct. Normal CVP is 2–8 mm Hg; 2 mm Hg is low-
normal, trending toward hypovolemia.
D. Left heart failure – Incorrect. Left heart failure may increase CVP if right
heart also affected, but CVP is not specific to left failure.
4. Which EKG rhythm is most commonly associated with lower metabolic
needs and physiological rest?
A. Atrial fibrillation
B. Sinus bradycardia
C. Ventricular tachycardia
D. Sinus tachycardia
ANSWER: B. Sinus bradycardia
Rationale:
A. Atrial fibrillation – Incorrect. Can be irregular and fast, not restful.
, B. Sinus bradycardia – Correct. Rate <60, often in athletes or during sleep;
lowers myocardial oxygen demand.
C. Ventricular tachycardia – Incorrect. Life-threatening, high metabolic
demand.
D. Sinus tachycardia – Incorrect. Increases metabolic demand.
5. A client with sinus tachycardia has a new prescription. Which medication
requires immediate follow-up with the provider?
A. Amiodarone
B. Procainamide
C. Atropine
D. Sotalol
ANSWER: C. Atropine
Rationale:
A. Amiodarone – Used for tachyarrhythmias, not inappropriate.
B. Procainamide – Antiarrhythmic for tachycardia.
C. Atropine – Increases heart rate; contraindicated in sinus tachycardia
because it worsens tachycardia.
D. Sotalol – Beta-blocker used to slow rate in sinus tachycardia.
6. The nurse notes a heart rate of 42 bpm with regular R-R intervals on the
monitor. The client is asymptomatic. The nurse should first:
A. Prepare for transcutaneous pacing
