MED SURG RN EXIT EXAM NEWEST 2024
VERSION 2 ACTUAL EXAM QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS)
WITH RATIONALES ALREADY GRADED A+
Your patient's ECG shows atrial flutter. What complication can arise from this type of
rhythm?
A. Pericarditis
B. Stroke
C. Hypoglycemia
D. Endocarditis - answer- B. Stroke
Atrial flutter can increase the patient's risk of developing a blood clot which can lead to a
stroke. This is because the atria are not fully contracting but quivering. The quivering
leads blood to pool in the atria which can coagulate and form a clot. The clot can leave
the heart and travel to the brain or lungs and cause a stroke or pulmonary embolism.
Which statement is correct about atrial flutter?
A. The ventricular rate will always be irregular
B. P-waves will be present
C. This rhythm has a saw-tooth appearance
D. The PR interval will be >0.20 seconds - answer- C. This rhythm has a saw-tooth
appearance
A defining characteristic of atrial flutter is its saw-tooth appearance. This is formed by
the abnormal p-waves called flutter waves. This is a key point with discerning a-fib from
a-flutter. The ventricular rate can be regular or irregular with this rhythm.
,A patient's cardiac rhythm is sinus bradycardia with a heart rate of 34 beats/minute. If
the bradycardia is symptomatic, the nurse would expect the patient to exhibit:
1. Palpitations
2. Hypertension
3. Warm, flushed skin
4. Weakness and dizziness - answer- 4. Weakness and dizziness
A patient has a diagnosis of acute myocardial infarction, and his cardiac rhythm is sinus
bradycardia with six to eight premature ventricular contractions (PVCs) per minute. The
pattern that the nurse recognizes as the most characteristic of PVCs is:
1. An irregular rhythm
2. An inverted T wave
3. A wide, distorted QRS complex
4. An increasingly long PR interval - answer- 3. A wide, distorted QRS complex
Which of the following post implantation instructions must a nurse provide a patient with
a permanent pacemaker?
A. Delay activities such as swimming and bowling for at least 3 weeks
B. Avoid sources of electrical interference
C. Keep moving the arm on the side where the pacemaker is inserted
D. Keep the arm on the side of the pacemaker higher than the head - answer- B.
Avoid sources of electrical interference
The nurse must instruct the patient with a permanent pacemaker to avoid sources of
electrical interference. Also, instruct the patient to avoid strenuous movement, keep the
arm on the side of the pacemaker lower than the head except for brief moments when
,dressing or performing hygiene, and to delay for at least 8 weeks activities such as
swimming, bowling, tennis, mowing, etc.
Which of the following dysrhythmias are common in older patients?
A. Atrial fibrillation
B. Sinus tachycardia
C. Ventricular tachycardia
D. Sinus bradycardia - answer- D. Sinus bradycardia
The nurse is analyzing a rhythm strip. What component of the ECG corresponds to the
resting state of the patient’s heart?
A. P wave
B. T wave
C. U wave
D. QRS complex - answer- B. T wave
The T wave specifically represents ventricular muscle depolarization, also referred to as
the resting state. Ventricular muscle depolarization does not result in the P wave, U
wave, or QRS complex.
A patient has returned to the cardiac care unit after having a permanent pacemaker
implantation. For which potential complication should the nurse most closely assess this
patient?
A. Chest pain
B. Bleeding at the implantation site
C. Malignant hyperthermia
D. Bradycardia - answer- B. Bleeding at the implantation site
, Bleeding, hematomas, local infections, perforation of the myocardium, and tachycardia
are complications of pacemaker implantations
The nurse is caring for an adult patient who has gone into ventricular fibrillation. When
assisting with defibrillating the patient, what must the nurse do?
A. Maintain firm contact between paddles and patient skin
B. Apply a layer of water as a conducting agent
C. Call all clear once before discharging the defibrillator
D. Ensure the defibrillator is in the sync mode - answer- A. Maintain firm contact
between paddles and patient skin
The nurse should maintain good contact between the paddles and the patients skin to
prevent arcing, apply an appropriate conducting agent (not water) between the skin and
the paddles, and ensure the defibrillator is in the nonsync mode. Clear should be called
three times before discharging the paddles
A patient who is a candidate for an implantable cardioverter defibrillator (ICD) asks the
nurse about the purpose of this device. What would be the nurses best response?
A. To detect and treat dysrhythmias such as ventricular fibrillation and ventricular
tachycardia
B. To detect and treat bradycardia, which is an excessively slow heart rate
C. To detect and treat atrial fibrillation, in which your heart beats too quickly and
inefficiently
D. To shock your heart if you have a heart attack at home - answer- A. To detect
and treat dysrhythmias such as ventricular fibrillation and ventricular tachycardia
VERSION 2 ACTUAL EXAM QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS)
WITH RATIONALES ALREADY GRADED A+
Your patient's ECG shows atrial flutter. What complication can arise from this type of
rhythm?
A. Pericarditis
B. Stroke
C. Hypoglycemia
D. Endocarditis - answer- B. Stroke
Atrial flutter can increase the patient's risk of developing a blood clot which can lead to a
stroke. This is because the atria are not fully contracting but quivering. The quivering
leads blood to pool in the atria which can coagulate and form a clot. The clot can leave
the heart and travel to the brain or lungs and cause a stroke or pulmonary embolism.
Which statement is correct about atrial flutter?
A. The ventricular rate will always be irregular
B. P-waves will be present
C. This rhythm has a saw-tooth appearance
D. The PR interval will be >0.20 seconds - answer- C. This rhythm has a saw-tooth
appearance
A defining characteristic of atrial flutter is its saw-tooth appearance. This is formed by
the abnormal p-waves called flutter waves. This is a key point with discerning a-fib from
a-flutter. The ventricular rate can be regular or irregular with this rhythm.
,A patient's cardiac rhythm is sinus bradycardia with a heart rate of 34 beats/minute. If
the bradycardia is symptomatic, the nurse would expect the patient to exhibit:
1. Palpitations
2. Hypertension
3. Warm, flushed skin
4. Weakness and dizziness - answer- 4. Weakness and dizziness
A patient has a diagnosis of acute myocardial infarction, and his cardiac rhythm is sinus
bradycardia with six to eight premature ventricular contractions (PVCs) per minute. The
pattern that the nurse recognizes as the most characteristic of PVCs is:
1. An irregular rhythm
2. An inverted T wave
3. A wide, distorted QRS complex
4. An increasingly long PR interval - answer- 3. A wide, distorted QRS complex
Which of the following post implantation instructions must a nurse provide a patient with
a permanent pacemaker?
A. Delay activities such as swimming and bowling for at least 3 weeks
B. Avoid sources of electrical interference
C. Keep moving the arm on the side where the pacemaker is inserted
D. Keep the arm on the side of the pacemaker higher than the head - answer- B.
Avoid sources of electrical interference
The nurse must instruct the patient with a permanent pacemaker to avoid sources of
electrical interference. Also, instruct the patient to avoid strenuous movement, keep the
arm on the side of the pacemaker lower than the head except for brief moments when
,dressing or performing hygiene, and to delay for at least 8 weeks activities such as
swimming, bowling, tennis, mowing, etc.
Which of the following dysrhythmias are common in older patients?
A. Atrial fibrillation
B. Sinus tachycardia
C. Ventricular tachycardia
D. Sinus bradycardia - answer- D. Sinus bradycardia
The nurse is analyzing a rhythm strip. What component of the ECG corresponds to the
resting state of the patient’s heart?
A. P wave
B. T wave
C. U wave
D. QRS complex - answer- B. T wave
The T wave specifically represents ventricular muscle depolarization, also referred to as
the resting state. Ventricular muscle depolarization does not result in the P wave, U
wave, or QRS complex.
A patient has returned to the cardiac care unit after having a permanent pacemaker
implantation. For which potential complication should the nurse most closely assess this
patient?
A. Chest pain
B. Bleeding at the implantation site
C. Malignant hyperthermia
D. Bradycardia - answer- B. Bleeding at the implantation site
, Bleeding, hematomas, local infections, perforation of the myocardium, and tachycardia
are complications of pacemaker implantations
The nurse is caring for an adult patient who has gone into ventricular fibrillation. When
assisting with defibrillating the patient, what must the nurse do?
A. Maintain firm contact between paddles and patient skin
B. Apply a layer of water as a conducting agent
C. Call all clear once before discharging the defibrillator
D. Ensure the defibrillator is in the sync mode - answer- A. Maintain firm contact
between paddles and patient skin
The nurse should maintain good contact between the paddles and the patients skin to
prevent arcing, apply an appropriate conducting agent (not water) between the skin and
the paddles, and ensure the defibrillator is in the nonsync mode. Clear should be called
three times before discharging the paddles
A patient who is a candidate for an implantable cardioverter defibrillator (ICD) asks the
nurse about the purpose of this device. What would be the nurses best response?
A. To detect and treat dysrhythmias such as ventricular fibrillation and ventricular
tachycardia
B. To detect and treat bradycardia, which is an excessively slow heart rate
C. To detect and treat atrial fibrillation, in which your heart beats too quickly and
inefficiently
D. To shock your heart if you have a heart attack at home - answer- A. To detect
and treat dysrhythmias such as ventricular fibrillation and ventricular tachycardia
