Academic Year 2026–2027 RELIAS Medical-Surgical Telemetry Updated
2026 | 190+ Questions and Answers | Medical-Surgical Telemetry Exam
Prep, Comprehensive Study Guide, Practice Exam, Test Bank, ECG Rhythm
Interpretation, Cardiac Monitoring, Dysrhythmias, Hemodynamic
Assessment, Cardiovascular Nursing, Respiratory Care, Clinical
Judgment, Patient Safety, Detailed Rationales and Complete Revision
Material
Question 1: A patient on a telemetry unit is exhibiting sinus tachycardia at a rate of
130 bpm. Which of the following assessment findings would be MOST consistent
with this dysrhythmia?
A. Bounding peripheral pulses and a widened pulse pressure
B. Cold, clammy skin and prolonged capillary refill
C. A history of hyperthyroidism and recent administration of albuterol
D. Jugular venous distention and peripheral edema
CORRECT ANSWER: C. A history of hyperthyroidism and recent administration of
albuterol
Rationale: Sinus tachycardia is often a physiologic response to increased metabolic
demand or sympathetic stimulation. Hyperthyroidism and beta-agonists like albuterol
are common causes. Bounding pulses are more associated with aortic regurgitation or
sepsis, while cold, clammy skin and prolonged cap refill suggest shock or poor
perfusion. JVD and edema are signs of right-sided heart failure.
Question 2: A patient’s cardiac monitor shows a regular rhythm with a rate of 42
bpm and normal P waves preceding each QRS complex. What is the MOST
appropriate initial nursing action?
A. Prepare for transcutaneous pacing
B. Administer atropine 0.5 mg IV push
C. Assess the patient's level of consciousness and blood pressure
D. Prepare an infusion of dopamine
CORRECT ANSWER: C. Assess the patient's level of consciousness and blood
pressure
Rationale: The rhythm described is sinus bradycardia. Treatment is guided by
symptoms. The first step is to assess the patient's hemodynamic stability (LOC, BP,
signs of shock). Atropine and pacing are indicated if the patient is symptomatic and
unstable. Dopamine is a second-line agent for symptomatic bradycardia.
Question 3: When caring for a patient post-cardiac catheterization via the femoral
artery, which finding requires IMMEDIATE notification of the healthcare provider?
,A. A small amount of serosanguineous drainage at the insertion site
B. Bruising of the groin site measuring 3 cm in diameter
C. Loss of the palpable pedal pulse on the affected extremity
D. The patient reports a pain level of 3 out of 10 at the insertion site
CORRECT ANSWER: C. Loss of the palpable pedal pulse on the affected extremity
Rationale: Loss of distal pulses indicates a potential arterial occlusion or thrombus
formation, which is a critical complication requiring immediate intervention to prevent
limb ischemia. A small amount of drainage or bruising is common. A pain level of 3 is
expected and manageable.
Question 4: A nurse is preparing to administer an IV push of Adenosine for a patient
with supraventricular tachycardia. How should this medication be administered?
A. As a slow IV push over 2 to 5 minutes
B. As a rapid IV push followed immediately by a 20 mL saline flush
C. As an infusion piggybacked into a primary line over 30 minutes
D. As a bolus through the intramuscular route for rapid onset
CORRECT ANSWER: B. As a rapid IV push followed immediately by a 20 mL saline
flush
Rationale: Adenosine has an extremely short half-life (seconds). It must be
administered as a rapid IV push followed by a rapid saline flush to ensure the entire
dose reaches the heart as a bolus to effectively cause a brief AV block.
Question 5: A patient is ordered a continuous heparin infusion for a pulmonary
embolism. Which laboratory value is the PRIORITY to monitor to assess the
therapeutic effect of this medication?
A. Prothrombin time (PT)
B. Activated Partial Thromboplastin Time (aPTT)
C. International Normalized Ratio (INR)
D. Platelet count
CORRECT ANSWER: B. Activated Partial Thromboplastin Time (aPTT)
Rationale: Heparin affects the intrinsic pathway of the coagulation cascade, which is
monitored by the aPTT. PT/INR is used to monitor warfarin therapy. Platelet count is
monitored to assess for Heparin-Induced Thrombocytopenia (HIT), but aPTT is the
primary indicator of therapeutic dosing efficacy.
Question 6: On a cardiac rhythm strip, the PR interval is measured at 0.24 seconds.
This finding indicates which of the following?
,A. Delayed ventricular depolarization
B. Prolonged conduction time through the AV node
C. Early repolarization of the atria
D. Complete absence of atrial activity
CORRECT ANSWER: B. Prolonged conduction time through the AV node
Rationale: The normal PR interval is 0.12 to 0.20 seconds. A prolonged PR interval
(>0.20) indicates a delay in conduction from the SA node through the AV node (first-
degree AV block). It does not represent ventricular depolarization (QRS complex) or
atrial activity itself.
Question 7: The nurse is caring for a patient with acute decompensated heart
failure who is receiving continuous IV furosemide. Which assessment finding
indicates the medication is having the desired therapeutic effect?
A. A decrease in urine output to 20 mL/hr
B. A decrease in the patient's weight by 2 kg in 24 hours
C. An increase in the patient's heart rate from 80 to 96 bpm
D. An increase in the patient's blood pressure from 140/90 to 160/100
CORRECT ANSWER: B. A decrease in the patient's weight by 2 kg in 24 hours
Rationale: Furosemide is a diuretic used to reduce fluid volume overload in heart
failure. A significant weight loss reflects the loss of fluid (diuresis). Decreased urine
output is a sign of worsening renal function or failure of the medication. Tachycardia and
hypertension could indicate worsening failure or other complications.
Question 8: A patient with chest pain is prescribed nitroglycerin sublingually. The
patient asks the nurse how this medication works. What is the MOST accurate
response?
A. It increases cardiac contractility to improve coronary blood flow
B. It dilates coronary arteries and reduces preload and afterload
C. It causes platelet aggregation to seal the site of a rupture
D. It dissolves the existing thrombus blocking the coronary artery
CORRECT ANSWER: B. It dilates coronary arteries and reduces preload and
afterload
Rationale: Nitroglycerin is a potent vasodilator. It dilates veins (reducing preload) and
arteries (reducing afterload and dilating coronary vessels). This reduces myocardial
oxygen demand and increases oxygen supply to ischemic tissue. It does not affect
contractility or dissolve clots (that is the role of thrombolytics).
, Question 9: While interpreting a telemetry strip, the nurse notes that the QRS
complex is 0.14 seconds wide. This is MOST indicative of a rhythm originating from
where?
A. The sinoatrial node
B. The atrioventricular node
C. The bundle of His
D. The ventricles
CORRECT ANSWER: D. The ventricles
Rationale: A normal QRS duration is less than 0.12 seconds. A wide QRS complex
(≥0.12 seconds) indicates a delay in ventricular depolarization, which occurs when the
impulse originates in the ventricles (ventricular rhythm) or has an aberrant conduction
pathway. Sinus, AV nodal, and bundle of His rhythms typically have narrow QRS
complexes.
Question 10: A patient is 2 hours post-operative from a total knee replacement and
has a patient-controlled analgesia (PCA) pump of morphine. The patient is
somnolent and has a respiratory rate of 8 breaths per minute. Which medication
should the nurse anticipate administering?
A. Naloxone
B. Flumazenil
C. Epinephrine
D. Atropine
CORRECT ANSWER: A. Naloxone
Rationale: The patient is showing signs of opioid toxicity: somnolence and respiratory
depression. Naloxone is a specific opioid antagonist that reverses these effects.
Flumazenil is for benzodiazepine reversal. Epinephrine is for anaphylaxis. Atropine is for
bradycardia.
Question 11: A nurse is caring for a patient on a telemetry unit. The patient's
monitor shows a rhythm of atrial fibrillation with a rapid ventricular response.
Which of the following is the PRIMARY goal for this patient's immediate
management?
A. Chemical cardioversion to sinus rhythm
B. Electrical cardioversion to sinus rhythm
C. Rate control to prevent hemodynamic compromise
D. Initiation of aspirin to prevent stroke
CORRECT ANSWER: C. Rate control to prevent hemodynamic compromise
2026 | 190+ Questions and Answers | Medical-Surgical Telemetry Exam
Prep, Comprehensive Study Guide, Practice Exam, Test Bank, ECG Rhythm
Interpretation, Cardiac Monitoring, Dysrhythmias, Hemodynamic
Assessment, Cardiovascular Nursing, Respiratory Care, Clinical
Judgment, Patient Safety, Detailed Rationales and Complete Revision
Material
Question 1: A patient on a telemetry unit is exhibiting sinus tachycardia at a rate of
130 bpm. Which of the following assessment findings would be MOST consistent
with this dysrhythmia?
A. Bounding peripheral pulses and a widened pulse pressure
B. Cold, clammy skin and prolonged capillary refill
C. A history of hyperthyroidism and recent administration of albuterol
D. Jugular venous distention and peripheral edema
CORRECT ANSWER: C. A history of hyperthyroidism and recent administration of
albuterol
Rationale: Sinus tachycardia is often a physiologic response to increased metabolic
demand or sympathetic stimulation. Hyperthyroidism and beta-agonists like albuterol
are common causes. Bounding pulses are more associated with aortic regurgitation or
sepsis, while cold, clammy skin and prolonged cap refill suggest shock or poor
perfusion. JVD and edema are signs of right-sided heart failure.
Question 2: A patient’s cardiac monitor shows a regular rhythm with a rate of 42
bpm and normal P waves preceding each QRS complex. What is the MOST
appropriate initial nursing action?
A. Prepare for transcutaneous pacing
B. Administer atropine 0.5 mg IV push
C. Assess the patient's level of consciousness and blood pressure
D. Prepare an infusion of dopamine
CORRECT ANSWER: C. Assess the patient's level of consciousness and blood
pressure
Rationale: The rhythm described is sinus bradycardia. Treatment is guided by
symptoms. The first step is to assess the patient's hemodynamic stability (LOC, BP,
signs of shock). Atropine and pacing are indicated if the patient is symptomatic and
unstable. Dopamine is a second-line agent for symptomatic bradycardia.
Question 3: When caring for a patient post-cardiac catheterization via the femoral
artery, which finding requires IMMEDIATE notification of the healthcare provider?
,A. A small amount of serosanguineous drainage at the insertion site
B. Bruising of the groin site measuring 3 cm in diameter
C. Loss of the palpable pedal pulse on the affected extremity
D. The patient reports a pain level of 3 out of 10 at the insertion site
CORRECT ANSWER: C. Loss of the palpable pedal pulse on the affected extremity
Rationale: Loss of distal pulses indicates a potential arterial occlusion or thrombus
formation, which is a critical complication requiring immediate intervention to prevent
limb ischemia. A small amount of drainage or bruising is common. A pain level of 3 is
expected and manageable.
Question 4: A nurse is preparing to administer an IV push of Adenosine for a patient
with supraventricular tachycardia. How should this medication be administered?
A. As a slow IV push over 2 to 5 minutes
B. As a rapid IV push followed immediately by a 20 mL saline flush
C. As an infusion piggybacked into a primary line over 30 minutes
D. As a bolus through the intramuscular route for rapid onset
CORRECT ANSWER: B. As a rapid IV push followed immediately by a 20 mL saline
flush
Rationale: Adenosine has an extremely short half-life (seconds). It must be
administered as a rapid IV push followed by a rapid saline flush to ensure the entire
dose reaches the heart as a bolus to effectively cause a brief AV block.
Question 5: A patient is ordered a continuous heparin infusion for a pulmonary
embolism. Which laboratory value is the PRIORITY to monitor to assess the
therapeutic effect of this medication?
A. Prothrombin time (PT)
B. Activated Partial Thromboplastin Time (aPTT)
C. International Normalized Ratio (INR)
D. Platelet count
CORRECT ANSWER: B. Activated Partial Thromboplastin Time (aPTT)
Rationale: Heparin affects the intrinsic pathway of the coagulation cascade, which is
monitored by the aPTT. PT/INR is used to monitor warfarin therapy. Platelet count is
monitored to assess for Heparin-Induced Thrombocytopenia (HIT), but aPTT is the
primary indicator of therapeutic dosing efficacy.
Question 6: On a cardiac rhythm strip, the PR interval is measured at 0.24 seconds.
This finding indicates which of the following?
,A. Delayed ventricular depolarization
B. Prolonged conduction time through the AV node
C. Early repolarization of the atria
D. Complete absence of atrial activity
CORRECT ANSWER: B. Prolonged conduction time through the AV node
Rationale: The normal PR interval is 0.12 to 0.20 seconds. A prolonged PR interval
(>0.20) indicates a delay in conduction from the SA node through the AV node (first-
degree AV block). It does not represent ventricular depolarization (QRS complex) or
atrial activity itself.
Question 7: The nurse is caring for a patient with acute decompensated heart
failure who is receiving continuous IV furosemide. Which assessment finding
indicates the medication is having the desired therapeutic effect?
A. A decrease in urine output to 20 mL/hr
B. A decrease in the patient's weight by 2 kg in 24 hours
C. An increase in the patient's heart rate from 80 to 96 bpm
D. An increase in the patient's blood pressure from 140/90 to 160/100
CORRECT ANSWER: B. A decrease in the patient's weight by 2 kg in 24 hours
Rationale: Furosemide is a diuretic used to reduce fluid volume overload in heart
failure. A significant weight loss reflects the loss of fluid (diuresis). Decreased urine
output is a sign of worsening renal function or failure of the medication. Tachycardia and
hypertension could indicate worsening failure or other complications.
Question 8: A patient with chest pain is prescribed nitroglycerin sublingually. The
patient asks the nurse how this medication works. What is the MOST accurate
response?
A. It increases cardiac contractility to improve coronary blood flow
B. It dilates coronary arteries and reduces preload and afterload
C. It causes platelet aggregation to seal the site of a rupture
D. It dissolves the existing thrombus blocking the coronary artery
CORRECT ANSWER: B. It dilates coronary arteries and reduces preload and
afterload
Rationale: Nitroglycerin is a potent vasodilator. It dilates veins (reducing preload) and
arteries (reducing afterload and dilating coronary vessels). This reduces myocardial
oxygen demand and increases oxygen supply to ischemic tissue. It does not affect
contractility or dissolve clots (that is the role of thrombolytics).
, Question 9: While interpreting a telemetry strip, the nurse notes that the QRS
complex is 0.14 seconds wide. This is MOST indicative of a rhythm originating from
where?
A. The sinoatrial node
B. The atrioventricular node
C. The bundle of His
D. The ventricles
CORRECT ANSWER: D. The ventricles
Rationale: A normal QRS duration is less than 0.12 seconds. A wide QRS complex
(≥0.12 seconds) indicates a delay in ventricular depolarization, which occurs when the
impulse originates in the ventricles (ventricular rhythm) or has an aberrant conduction
pathway. Sinus, AV nodal, and bundle of His rhythms typically have narrow QRS
complexes.
Question 10: A patient is 2 hours post-operative from a total knee replacement and
has a patient-controlled analgesia (PCA) pump of morphine. The patient is
somnolent and has a respiratory rate of 8 breaths per minute. Which medication
should the nurse anticipate administering?
A. Naloxone
B. Flumazenil
C. Epinephrine
D. Atropine
CORRECT ANSWER: A. Naloxone
Rationale: The patient is showing signs of opioid toxicity: somnolence and respiratory
depression. Naloxone is a specific opioid antagonist that reverses these effects.
Flumazenil is for benzodiazepine reversal. Epinephrine is for anaphylaxis. Atropine is for
bradycardia.
Question 11: A nurse is caring for a patient on a telemetry unit. The patient's
monitor shows a rhythm of atrial fibrillation with a rapid ventricular response.
Which of the following is the PRIMARY goal for this patient's immediate
management?
A. Chemical cardioversion to sinus rhythm
B. Electrical cardioversion to sinus rhythm
C. Rate control to prevent hemodynamic compromise
D. Initiation of aspirin to prevent stroke
CORRECT ANSWER: C. Rate control to prevent hemodynamic compromise
