Clinical Skills in Nursing Review Questions
Course Introduction
Clinical Skills in Nursing is a foundational course designed to equip students with the essential hands-on skills and competencies needed for effective patient care in a variety of healthcare settings. Through a combination of theoretical instruction, simulation, and supervised practical experience, students learn key clinical procedures such as vital sign measurement, medication administration, wound care, patient hygiene, and infection control. Emphasis is placed on the development of critical thinking, communication, and teamwork abilities, as well as adherence to professional ethical standards and patient safety protocols. By the end of the course, students are prepared to confidently perform fundamental nursing tasks and contribute as capable members of the healthcare team.
Recommended Textbook
ECGs Made Easy 6th Edition by Barbara J Aehlert
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Chapter 1: Anatomy and Physiology
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Sample Questions
Q1) Complete occlusion of the _____ coronary artery, also referred to as the widow maker, usually results in sudden death.
A) right
B) left main
C) circumflex
D) left anterior descending
Answer: B
Q2) Blood pressure is the result of cardiac output and peripheral vascular resistance.
A)True
B)False
Answer: TRUE
Q3) Which of the following are semilunar valves?
A) Aortic and pulmonic
B) Aortic and tricuspid
C) Pulmonic and mitral
D) Tricuspid and mitral
Answer: A
Q4) The right atrium receives blood low in oxygen from three vessels. Name them. Answer: Superior vena cava, inferior vena cava, and coronary sinus.
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Chapter 2: Basic Electrophysiology
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Sample Questions
Q1) In an adult, the normal duration of the QRS complex is _____.
A) 0.12 to 0.20 second
B) 0.10 second or less
C) 0.04 to 0.14 second
D) 0.20 second or less
Answer: B
Q2) Tall, peaked T waves observed on the ECG are most commonly seen in patients with _____.
A) hypokalemia
B) hyperkalemia
C) hyponatremia
D) hypernatremia
Answer: B
Q3) List four major electrolytes that influence cardiac function.
Answer: Sodium, potassium, calcium, and chloride.
Q4) The appearance of coved ("frowny face") ST-segment elevation is called a(n)
Answer: acute injury pattern
Q5) A line between waveforms is called a(n) _____.
Answer: segment
4
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Chapter 3: Sinus Mechanisms
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Sample Questions
Q1) Management of a patient with a sinus tachycardia might include _____.
A) identification and treatment of the underlying cause
B) administration of atropine
C) use of a pacemaker
D) vagal maneuvers, such as carotid sinus pressure
Answer: A
Q2) In sinus arrhythmia, a gradual increasing of the heart rate is usually associated with _____.
A) expiration
B) inspiration
C) excessive caffeine intake
D) early signs of heart failure
Answer: B
Q3) The rate of a sinus rhythm is ____ beats/min.
A) slower than 60
B) 60 to 100
C) 80 to 120
D) faster than 100
Answer: B
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Page 5
Chapter 4: Atrial Rhythms
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Sample Questions
Q1) Which of the following correctly describes multifocal atrial tachycardia?
A) Atrial rhythm is regular.
B) Ventricular rhythm is irregular.
C) Atrial and ventricular rhythms are regular.
D) Atrial and ventricular rhythms are irregular.
Q2) A 77-year-old woman is complaining of a sudden onset of palpitations. The cardiac monitor reveals atrial fibrillation with a ventricular response of 144 to 210 beats/min while the patient is at rest. In this situation, the ventricular rate associated with this rhythm is considered to be _____.
A) controlled
B) uncontrolled
Q3) A macroreentrant circuit is one that involves a small area of heart tissue, usually a few centimeters or less.
A)True
B)False
Q4) Multifocal atrial tachycardia is another name for atrial fibrillation.
A)True
B)False
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Chapter 5: Junctional Rhythms
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Sample Questions
Q1) The atrioventricular (AV) junction consists of the _____.
A) SA and AV nodes
B) AV node and the Purkinje fibers
C) AV node and nonbranching portion of the bundle of His
D) AV node, bundle of His, and the right and left bundle branches
Q2) If seen, the P wave of a rhythm originating in the AV junction will appear _____ in lead II.
A) upright
B) inverted
C) tall and peaked
D) wide and notched
Q3) The pacemaker cells in the AV junction are located near the nonbranching portion of the bundle of His.
A)True
B)False
Q4) If the AV junction paces the heart, the electrical impulse must travel in a backward direction to activate the atria. This is called _____ conduction.
Q5) A(n) _____ pause often follows a PJC and represents the delay during which the SA node resets its rhythm for the next beat.
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Chapter 6: Ventricular Rhythms
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Sample Questions
Q1) Transcutaneous pacing is the treatment of choice for pulseless ventricular tachycardia or ventricular fibrillation.
A)True
B)False
Q2) An idioventricular (ventricular escape) rhythm has an intrinsic rate of 40 to 60 beats/min.
A)True
B)False
Q3) List four common causes of premature ventricular complexes.
Q4) List three potential sites of origin of ectopic beats.
Q5) The term premature ventricular complex is technically more correct than premature ventricular contraction.
A)True
B)False
Q6) Sustained monomorphic VT is often associated with underlying heart disease, particularly myocardial ischemia, and rarely occurs in patients without underlying structural heart disease.
A)True
B)False
Page 8
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Chapter 7: Atrioventricular Blocks
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Sample Questions
Q1) Second-degree AV block type II is characterized by _____ intervals.
A) irregular P to P
B) irregular R to R
C) regular P to P intervals and regular R to R
D) irregular P to P intervals and irregular R to R
Q2) Indicate the ECG criteria for the following dysrhythmias: \(\begin{array}{|l|l|l} & \begin{array}{l}
\text { Third-Degree AV } \\
\text { Block }
\end{array} & 2: 1 \text { AV Block } \\
\hline \text { Ventricular } & & \\
\hline \text { Rhythm } & & \\
\hline \text { PR interval } & & \\
\hline \text { QRS width } & & \end{array}\)
Q3) A _____ bundle branch block produces a QS pattern in lead V<sub>1</sub>.
Q4) The QRS complex associated with a third-degree AV block is always wide.
A)True
B)False
Page 9
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Chapter 8: Pacemaker Rhythms
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Sample Questions
Q1) In pacing, threshold refers to _____.
A) the ability of a pacemaker to recognize and respond to intrinsic electrical activity
B) the minimum level of electrical current needed to consistently depolarize the myocardium
C) a pacing lead with a single electrical pole at the distal tip of the pacing lead through which the stimulating pulse is delivered
D) the ability of a pacemaker to increase the pacing rate in response to physical activity or metabolic demand
Q2) In pacing, rate modulation refers to _____.
A) the ability of a pacemaker to recognize and respond to intrinsic electrical activity
B) the minimum level of electrical current needed to consistently depolarize the myocardium
C) the ability of a pacemaker to increase the pacing rate in response to physical activity or metabolic demand
D) a pacing lead with a single electrical pole at the distal tip of the pacing lead through which the stimulating pulse is delivered.
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Chapter 9: Introduction to the 12-Lead Electrocardiogram
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Sample Questions
Q1) Hypertrophy refers to a(n) _____.
A) delay in impulse conduction through the SA node
B) disturbance in impulse conduction through the AV junction
C) increase in the diameter of a chamber of the heart caused by volume overload
D) increase in the thickness of a heart chamber because of chronic pressure overload
Q2) Which leads look at adjoining tissue in the inferior region of the left ventricle?
A) I, aVL
B) V1, V2
C) V3, V4, V5
D) II, III, aVF
Q3) Which of the following ECG changes is one of the earliest to occur during an ST elevation infarction, but may have resolved by the time the patient seeks medical assistance?
A) Pathologic Q waves
B) Hyperacute T waves
C) Horizontal ST segments
D) Lengthening of the QT interval
Q4) What two factors determine the portion of the heart that each lead "sees"?
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Page 11
Chapter 10: Posttest
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Sample Questions
Q1) In the limb leads, the ST segment is normally isoelectric.
A)True
B)False
Q2) The inferior surface of the left ventricle is supplied by the _____ coronary artery in most of the population.
A) left
B) right
Q3) Explain the benefits of a dual-chamber pacemaker.
Q4) Your patient has a VVI pacemaker. Briefly explain the meaning of each of these letters.
Q5) Anterior wall myocardial infarctions are most often a result of an occlusion of a branch of the _____ coronary artery.
A) left
B) right
Q6) When reviewing a 12-lead ECG, intervals and duration are usually expressed in _____.
Q7) A beat originating from the AV junction that appears later than the next expected sinus beat is called a(n) _______________.
Q8) A _____ bundle branch block produces a QS pattern in lead V<sub>1</sub>.
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