NUR 425 Exam 1 ACTUAL EXAM
NUR 425 EXAM 1 ACTUAL EXAM NEWEST 2025 ACTUAL EXAM
COMPLETE 150 QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) |ALREADY GRADED A+
When titrating an analgesic to manage pain, what is the priority goal?
A. Administer smallest dose that provides relief with the fewest side effects.
B. Titrate upward until the client is pain free.
C. Titrate downwards to prevent toxicity.
D. Ensure that the drug is adequate to meet the client's subjective needs. - ANSWER-A (The goal
is to control pain while minimizing side effects. For severe pain, the medication can be titrated
upward until pain is controlled. Downward titration occurs when the pain begins to subside.
Adequate dosing is important; however, the concept of controlled dosing applies more to
potent vasoactive drugs.)
For a cognitively impaired client who cannot accurately report pain, what is the first action that
you should take?
A. Closely assess for nonverbal signs such as grimacing or rocking.
B. Obtain baseline behavioral indicators from family members.
C. Look at the MAR and chart, to note the time of the last dose and response.
D. Give the maximum PRS dose within the minimum time frame for relief. - ANSWER-B
(Complete information from the family should be obtained during the initial comprehensive
history and assessment. If this information is not obtained, the nursing staff will have to rely on
observation of nonverbal behavior and careful documentation to determine pain and relief
patterns.)
A nurse is assessing an electrocardiogram rhythm strip. The P waves and QRS complexes are
regular. The PR interval is 0.16 second, and QRS complexes measure 0.06 second. The overall
heart rate is 64 beats per minute. The nurse assesses the cardiac rhythm as:
A. Normal sinus rhythm
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, NUR 425 Exam 1 ACTUAL EXAM
B. Sinus bradycardia
C. Atrial fibrillation
D. First-degree heart block. - ANSWER-A (This rhythm is NSR. The P waves and QRS complexes
are regular. The PR interval is less than 0.2 seconds. The QRS complex is less than 0.12 seconds.
The heart rate is between 60-100 BPM.)
A nurse notices frequent artifact on the ECG monitor for a client whose leads are connected by
cable to a console at the bedside. The nurse examines the client to determine the cause. Which
of the following items is *unlikely* to be responsible for the artifact?
A. Frequent movement of the client
B. Tightly secured cable connections
C. Leads applied over hairy areas
D. Leads applied to the limbs - ANSWER-B (Motion artifact, or "noise," can be caused by
frequent client movement, electrode placement on limbs, and insufficient adhesion to the skin,
such as placing electrodes over hairy areas of the skin. Electrode placement over bony
prominences also should be avoided. Signal interference can also occur with electrode removal
and cable disconnection.)
A nurse is watching the cardiac monitor and notices that the rhythm suddenly changes. There
are no P waves, the QRS complexes are wide, and the ventricular rate is regular but over 100.
The nurse determines that the client is experiencing:
A. Premature ventricular contractions
B. Ventricular tachycardia
C. Ventricular fibrillation
D. Sinus tachycardia - ANSWER-B (Ventricular tachycardia is characterized by the absence of P
waves, wide QRS complexes (usually greater than 0.14 second), and a rate between 100 and 250
impulses per minute. The rhythm is usually regular.)
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, NUR 425 Exam 1 ACTUAL EXAM
A nurse is viewing the cardiac monitor in a client's room and notes that the client has just gone
into ventricular tachycardia. The client is awake and alert and has good skin color. The nurse
would prepare to do which of the following?
A. Immediately defibrillate
B. Prepare for pacemaker insertion
C. Administer amiodarone (Cordarone) intravenously
D. Administer epinephrine (Adrenaline) intravenously - ANSWER-C (First-line treatment of
ventricular tachycardia in a client who is hemodynamically stable is the use of anti-dysrhythmics
such as amiodarone (Cordarone), lidocaine (Xylocaine), and procainamide (Pronestyl).
Cardioversion also may be needed to correct the rhythm (cardioversion is recommended for
stable ventricular tachycardia). Defibrillation is used with pulseless ventricular tachycardia.
Epinephrine would stimulate and already excitable ventricle and is contraindicated.)
A nurse is caring for a client with unstable ventricular tachycardia. The nurse instructs the client
to do which of the following, if prescribed, during an episode of ventricular tachycardia?
A. Breathe deeply, regularly, and easily
B. Inhale deeply and cough forcefully every 1 to 3 seconds
C. Lie down flat in bed
D. Remove any metal jewelry - ANSWER-B (Cough cardiopulmonary resuscitation (CPR)
sometimes is used in the client with unstable ventricular tachycardia. The nurse tells the client
to use cough CPR, if prescribed, by inhaling deeply and coughing forcefully every 1 to 3 seconds.
Cough CPR may terminate the dysrhythmia or sustain the cerebral and coronary circulation for a
short time until other measures can be implemented.)
A client is having frequent premature ventricular contractions. A nurse would place priority on
assessment of which of the following items?
A. Blood pressure and peripheral perfusion
B. Sensation of palpitations
C. Causative factors such as caffeine
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, NUR 425 Exam 1 ACTUAL EXAM
D. Precipitating factors such as infection - ANSWER-A (Premature ventricular contractions can
cause hemodynamic compromise. The shortened ventricular filling time with the ectopic beats
leads to decreased stroke volume and, if frequent enough, to decreased cardiac output. The
client may be asymptomatic or may feel palpitations. PVCs can be caused by cardiac disorders or
by any number of physiological stressors, such as infection, illness, surgery, or trauma, and by
the intake of caffeine, alcohol, or nicotine.)
A client has developed atrial fibrillation, with a ventricular rate of 150 beats per minute. A nurse
assesses the client for:
A. Hypotension and dizziness
B. Nausea and vomiting
C. Hypertension and headache
D. Flat neck veins - ANSWER-A (The client with uncontrolled atrial fibrillation with a ventricular
rate more than 150 beats a minute is at risk for low cardiac output because of loss of atrial kick.
The nurse assesses the client for palpitations, chest pain or discomfort, hypotension, pulse
deficit, fatigue, weakness, dizziness, syncope, shortness of breath, and distended neck veins.)
A nurse is watching the cardiac monitor, and a client's rhythm suddenly changes. There are no P
waves; instead there are wavy lines. The QRS complexes measure 0.08 second, but they are
irregular, with a rate of 120 beats a minute. The nurse interprets this rhythm as:
A. Sinus tachycardia
B. Atrial fibrillation
C. Ventricular tachycardia
D. Ventricular fibrillation - ANSWER-B (Atrial fibrillation is characterized by a loss of P waves; an
undulating, wavy baseline; QRS duration that is often within normal limits; and an irregular
ventricular rate, which can range from 60 to 100 beats per minute (when controlled with
medications) to 100 to 160 beats per minute (when uncontrolled).)
Which patient is most at risk for developing delirium?
a. A 50-yr-old woman with cholecystitis
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NUR 425 EXAM 1 ACTUAL EXAM NEWEST 2025 ACTUAL EXAM
COMPLETE 150 QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) |ALREADY GRADED A+
When titrating an analgesic to manage pain, what is the priority goal?
A. Administer smallest dose that provides relief with the fewest side effects.
B. Titrate upward until the client is pain free.
C. Titrate downwards to prevent toxicity.
D. Ensure that the drug is adequate to meet the client's subjective needs. - ANSWER-A (The goal
is to control pain while minimizing side effects. For severe pain, the medication can be titrated
upward until pain is controlled. Downward titration occurs when the pain begins to subside.
Adequate dosing is important; however, the concept of controlled dosing applies more to
potent vasoactive drugs.)
For a cognitively impaired client who cannot accurately report pain, what is the first action that
you should take?
A. Closely assess for nonverbal signs such as grimacing or rocking.
B. Obtain baseline behavioral indicators from family members.
C. Look at the MAR and chart, to note the time of the last dose and response.
D. Give the maximum PRS dose within the minimum time frame for relief. - ANSWER-B
(Complete information from the family should be obtained during the initial comprehensive
history and assessment. If this information is not obtained, the nursing staff will have to rely on
observation of nonverbal behavior and careful documentation to determine pain and relief
patterns.)
A nurse is assessing an electrocardiogram rhythm strip. The P waves and QRS complexes are
regular. The PR interval is 0.16 second, and QRS complexes measure 0.06 second. The overall
heart rate is 64 beats per minute. The nurse assesses the cardiac rhythm as:
A. Normal sinus rhythm
1|Page
, NUR 425 Exam 1 ACTUAL EXAM
B. Sinus bradycardia
C. Atrial fibrillation
D. First-degree heart block. - ANSWER-A (This rhythm is NSR. The P waves and QRS complexes
are regular. The PR interval is less than 0.2 seconds. The QRS complex is less than 0.12 seconds.
The heart rate is between 60-100 BPM.)
A nurse notices frequent artifact on the ECG monitor for a client whose leads are connected by
cable to a console at the bedside. The nurse examines the client to determine the cause. Which
of the following items is *unlikely* to be responsible for the artifact?
A. Frequent movement of the client
B. Tightly secured cable connections
C. Leads applied over hairy areas
D. Leads applied to the limbs - ANSWER-B (Motion artifact, or "noise," can be caused by
frequent client movement, electrode placement on limbs, and insufficient adhesion to the skin,
such as placing electrodes over hairy areas of the skin. Electrode placement over bony
prominences also should be avoided. Signal interference can also occur with electrode removal
and cable disconnection.)
A nurse is watching the cardiac monitor and notices that the rhythm suddenly changes. There
are no P waves, the QRS complexes are wide, and the ventricular rate is regular but over 100.
The nurse determines that the client is experiencing:
A. Premature ventricular contractions
B. Ventricular tachycardia
C. Ventricular fibrillation
D. Sinus tachycardia - ANSWER-B (Ventricular tachycardia is characterized by the absence of P
waves, wide QRS complexes (usually greater than 0.14 second), and a rate between 100 and 250
impulses per minute. The rhythm is usually regular.)
2|Page
, NUR 425 Exam 1 ACTUAL EXAM
A nurse is viewing the cardiac monitor in a client's room and notes that the client has just gone
into ventricular tachycardia. The client is awake and alert and has good skin color. The nurse
would prepare to do which of the following?
A. Immediately defibrillate
B. Prepare for pacemaker insertion
C. Administer amiodarone (Cordarone) intravenously
D. Administer epinephrine (Adrenaline) intravenously - ANSWER-C (First-line treatment of
ventricular tachycardia in a client who is hemodynamically stable is the use of anti-dysrhythmics
such as amiodarone (Cordarone), lidocaine (Xylocaine), and procainamide (Pronestyl).
Cardioversion also may be needed to correct the rhythm (cardioversion is recommended for
stable ventricular tachycardia). Defibrillation is used with pulseless ventricular tachycardia.
Epinephrine would stimulate and already excitable ventricle and is contraindicated.)
A nurse is caring for a client with unstable ventricular tachycardia. The nurse instructs the client
to do which of the following, if prescribed, during an episode of ventricular tachycardia?
A. Breathe deeply, regularly, and easily
B. Inhale deeply and cough forcefully every 1 to 3 seconds
C. Lie down flat in bed
D. Remove any metal jewelry - ANSWER-B (Cough cardiopulmonary resuscitation (CPR)
sometimes is used in the client with unstable ventricular tachycardia. The nurse tells the client
to use cough CPR, if prescribed, by inhaling deeply and coughing forcefully every 1 to 3 seconds.
Cough CPR may terminate the dysrhythmia or sustain the cerebral and coronary circulation for a
short time until other measures can be implemented.)
A client is having frequent premature ventricular contractions. A nurse would place priority on
assessment of which of the following items?
A. Blood pressure and peripheral perfusion
B. Sensation of palpitations
C. Causative factors such as caffeine
3|Page
, NUR 425 Exam 1 ACTUAL EXAM
D. Precipitating factors such as infection - ANSWER-A (Premature ventricular contractions can
cause hemodynamic compromise. The shortened ventricular filling time with the ectopic beats
leads to decreased stroke volume and, if frequent enough, to decreased cardiac output. The
client may be asymptomatic or may feel palpitations. PVCs can be caused by cardiac disorders or
by any number of physiological stressors, such as infection, illness, surgery, or trauma, and by
the intake of caffeine, alcohol, or nicotine.)
A client has developed atrial fibrillation, with a ventricular rate of 150 beats per minute. A nurse
assesses the client for:
A. Hypotension and dizziness
B. Nausea and vomiting
C. Hypertension and headache
D. Flat neck veins - ANSWER-A (The client with uncontrolled atrial fibrillation with a ventricular
rate more than 150 beats a minute is at risk for low cardiac output because of loss of atrial kick.
The nurse assesses the client for palpitations, chest pain or discomfort, hypotension, pulse
deficit, fatigue, weakness, dizziness, syncope, shortness of breath, and distended neck veins.)
A nurse is watching the cardiac monitor, and a client's rhythm suddenly changes. There are no P
waves; instead there are wavy lines. The QRS complexes measure 0.08 second, but they are
irregular, with a rate of 120 beats a minute. The nurse interprets this rhythm as:
A. Sinus tachycardia
B. Atrial fibrillation
C. Ventricular tachycardia
D. Ventricular fibrillation - ANSWER-B (Atrial fibrillation is characterized by a loss of P waves; an
undulating, wavy baseline; QRS duration that is often within normal limits; and an irregular
ventricular rate, which can range from 60 to 100 beats per minute (when controlled with
medications) to 100 to 160 beats per minute (when uncontrolled).)
Which patient is most at risk for developing delirium?
a. A 50-yr-old woman with cholecystitis
4|Page
