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NR 341 Complex Adult Health Exam 1
Questions with Rationalized
Answers | Advanced Medical-
Surgical & NCLEX-RN® Prep
Exam Structure:
Subject: Complex Adult Health (NR 341) - Cardiac & Respiratory
Source: NR 341 Complex Adult Health Exam 1
Format: Questions and Verified Answers with Rationales
1. The QT interval is the total time taken for ventricular
depolarization and repolarization. Prolongation of the QT interval:
A. decreases the risk of lethal dysrhythmias.
B. usually occurs when heart rate increases.
C. increases the risk of lethal dysrhythmias.
D. can only be measured with irregular rhythms.
Answer: C. increases the risk of lethal dysrhythmias.
Rationale:
1. A prolonged QT interval indicates delayed ventricular repolarization.
2. This delay creates a vulnerable period (R-on-T phenomenon) where
premature beats can trigger torsades de pointes or ventricular
fibrillation.
3. Prolonged QT is a known risk factor for sudden cardiac death.
2. The patient has an irregular heart rhythm. To determine an
accurate heart rate, the nurse first:
A. identifies the markers on the ECG paper that indicate a 6-second strip.
B. counts the number of large boxes between two consecutive P waves.
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C. counts the number of small boxes between two consecutive QRS
complexes.
D. divides the number of complexes in a 6-second strip by 10.
Answer: A. identifies the markers on the ECG paper that indicate a 6-
second strip.
Rationale:
1. For irregular rhythms, the 6-second method is most accurate.
2. The nurse counts the number of QRS complexes in a 6-second strip
(30 large boxes).
3. Multiplying by 10 gives the approximate heart rate.
3. The patient is admitted with a fever and rapid heart rate. The
patient's temperature is 103°F (39.4°C). The nurse places the patient
on a cardiac monitor and finds the patient's atrial and ventricular
rates are above 105 beats per minute. P waves are clearly seen and
appear normal in configuration. QRS complexes are normal in
appearance and 0.08 seconds wide. The rhythm is regular, and blood
pressure is normal. The nurse should focus on providing:
A. medications to lower heart rate.
B. treatment to lower temperature.
C. treatment to lower cardiac output.
D. treatment to reduce heart rate.
Answer: B. treatment to lower temperature.
Rationale:
1. The rhythm is sinus tachycardia, which is appropriate for fever.
2. Treating the underlying cause (fever) will normalize the heart rate.
3. Lowering the heart rate directly could be harmful if the tachycardia is
compensatory.
4. The nurse is working on the night shift when she notices sinus
bradycardia on the patient's cardiac monitor. The nurse should:
A. give atropine to increase heart rate.
B. begin transcutaneous pacing of the patient.
C. start a dopamine infusion to stimulate heart function.
D. assess for hemodynamic instability.
Answer: D. assess for hemodynamic instability.
Rationale:
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1. Sinus bradycardia is common in healthy individuals, especially during
sleep.
2. Treatment is only indicated if the patient is symptomatic
(hypotension, chest pain, altered mental status).
3. The nurse should first assess the patient, not treat the monitor.
5. The patient is admitted with sinus pauses causing periods of loss of
consciousness. The patient is asymptomatic, awake and alert, but
fatigued. He Answers questions appropriately. When admitting this
patient, the nurse should first:
A. prepare the patient for temporary pacemaker insertion.
B. prepare the patient for permanent pacemaker insertion.
C. assess the patient's medication profile.
D. apply transcutaneous pacemaker paddles.
Answer: C. assess the patient's medication profile.
Rationale:
1. Sinus pauses can be caused by medications (beta-blockers, calcium
channel blockers, digoxin).
2. The nurse should first assess for reversible causes.
3. Pacemaker insertion may be needed later, but medication review
comes first.
6. The patient's heart rate is 165 beats per minute. His cardiac
monitor shows a rapid rate with narrow QRS complexes. The P waves
cannot be seen, but the rhythm is regular. The patient's blood
pressure has dropped from 124/62 to 78/30. His skin is cold and
diaphoretic and he is complaining of nausea. The nurse prepares the
patient for:
A. administration of beta-blockers.
B. administration of atropine.
C. transcutaneous pacemaker insertion.
D. emergent cardioversion.
Answer: D. emergent cardioversion.
Rationale:
1. The rhythm is likely supraventricular tachycardia (SVT) with
hemodynamic instability.
NR 341 Complex Adult Health Exam 1
Questions with Rationalized
Answers | Advanced Medical-
Surgical & NCLEX-RN® Prep
Exam Structure:
Subject: Complex Adult Health (NR 341) - Cardiac & Respiratory
Source: NR 341 Complex Adult Health Exam 1
Format: Questions and Verified Answers with Rationales
1. The QT interval is the total time taken for ventricular
depolarization and repolarization. Prolongation of the QT interval:
A. decreases the risk of lethal dysrhythmias.
B. usually occurs when heart rate increases.
C. increases the risk of lethal dysrhythmias.
D. can only be measured with irregular rhythms.
Answer: C. increases the risk of lethal dysrhythmias.
Rationale:
1. A prolonged QT interval indicates delayed ventricular repolarization.
2. This delay creates a vulnerable period (R-on-T phenomenon) where
premature beats can trigger torsades de pointes or ventricular
fibrillation.
3. Prolonged QT is a known risk factor for sudden cardiac death.
2. The patient has an irregular heart rhythm. To determine an
accurate heart rate, the nurse first:
A. identifies the markers on the ECG paper that indicate a 6-second strip.
B. counts the number of large boxes between two consecutive P waves.
, 2|Page
C. counts the number of small boxes between two consecutive QRS
complexes.
D. divides the number of complexes in a 6-second strip by 10.
Answer: A. identifies the markers on the ECG paper that indicate a 6-
second strip.
Rationale:
1. For irregular rhythms, the 6-second method is most accurate.
2. The nurse counts the number of QRS complexes in a 6-second strip
(30 large boxes).
3. Multiplying by 10 gives the approximate heart rate.
3. The patient is admitted with a fever and rapid heart rate. The
patient's temperature is 103°F (39.4°C). The nurse places the patient
on a cardiac monitor and finds the patient's atrial and ventricular
rates are above 105 beats per minute. P waves are clearly seen and
appear normal in configuration. QRS complexes are normal in
appearance and 0.08 seconds wide. The rhythm is regular, and blood
pressure is normal. The nurse should focus on providing:
A. medications to lower heart rate.
B. treatment to lower temperature.
C. treatment to lower cardiac output.
D. treatment to reduce heart rate.
Answer: B. treatment to lower temperature.
Rationale:
1. The rhythm is sinus tachycardia, which is appropriate for fever.
2. Treating the underlying cause (fever) will normalize the heart rate.
3. Lowering the heart rate directly could be harmful if the tachycardia is
compensatory.
4. The nurse is working on the night shift when she notices sinus
bradycardia on the patient's cardiac monitor. The nurse should:
A. give atropine to increase heart rate.
B. begin transcutaneous pacing of the patient.
C. start a dopamine infusion to stimulate heart function.
D. assess for hemodynamic instability.
Answer: D. assess for hemodynamic instability.
Rationale:
, 3|Page
1. Sinus bradycardia is common in healthy individuals, especially during
sleep.
2. Treatment is only indicated if the patient is symptomatic
(hypotension, chest pain, altered mental status).
3. The nurse should first assess the patient, not treat the monitor.
5. The patient is admitted with sinus pauses causing periods of loss of
consciousness. The patient is asymptomatic, awake and alert, but
fatigued. He Answers questions appropriately. When admitting this
patient, the nurse should first:
A. prepare the patient for temporary pacemaker insertion.
B. prepare the patient for permanent pacemaker insertion.
C. assess the patient's medication profile.
D. apply transcutaneous pacemaker paddles.
Answer: C. assess the patient's medication profile.
Rationale:
1. Sinus pauses can be caused by medications (beta-blockers, calcium
channel blockers, digoxin).
2. The nurse should first assess for reversible causes.
3. Pacemaker insertion may be needed later, but medication review
comes first.
6. The patient's heart rate is 165 beats per minute. His cardiac
monitor shows a rapid rate with narrow QRS complexes. The P waves
cannot be seen, but the rhythm is regular. The patient's blood
pressure has dropped from 124/62 to 78/30. His skin is cold and
diaphoretic and he is complaining of nausea. The nurse prepares the
patient for:
A. administration of beta-blockers.
B. administration of atropine.
C. transcutaneous pacemaker insertion.
D. emergent cardioversion.
Answer: D. emergent cardioversion.
Rationale:
1. The rhythm is likely supraventricular tachycardia (SVT) with
hemodynamic instability.
