Medical-Surgical Nursing Exam Questions
Course Introduction
Medical-Surgical Nursing is a comprehensive course designed to provide students with foundational and advanced knowledge necessary for caring for adult patients experiencing a wide variety of medical and surgical conditions. The course emphasizes the development of clinical reasoning, problem-solving skills, and evidence-based interventions across different body systems and disease processes. Students will learn to conduct thorough assessments, formulate nursing diagnoses, implement and evaluate care plans, and collaborate effectively with interdisciplinary teams. Additionally, the course covers patient education, perioperative care, pain management, and the ethical and professional responsibilities essential to quality patient-centered care in diverse healthcare settings.
Recommended Textbook
ECGs Made Easy 5th Edition by Barbara J Aehlert
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Chapter 1: Anatomy and Physiology
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Sample Questions
Q1) The tricuspid valve is _____.
A) a semilunar valve
B) located between the left ventricle and aorta
C) located between the right atrium and right ventricle
D) located between the right ventricle and pulmonary artery
Answer: C
Q2) The primary neurotransmitter of the parasympathetic division of the autonomic nervous system is _____.
A) dopamine
B) muscarine
C) acetylcholine
D) norepinephrine
Answer: C
Q3) Describe the function of the right atrium of the heart.
Answer: The right atrium receives deoxygenated blood from the superior vena cava (which carries blood from the head and upper extremities),the inferior vena cava (which carries blood from the lower body),and the coronary sinus (which receives blood from the intracardiac circulation).Blood passes through the tricuspid valve to the right ventricle.
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Page 3
Chapter 2: Basic Electrophysiology
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Sample Questions
Q1) On the ECG,the T wave represents _____.
A) atrial contraction
B) atrial repolarization
C) ventricular contraction
D) ventricular repolarization
Answer: D
Q2) If the wave of depolarization (electrical impulse)moves toward the positive electrode,the waveform recorded on ECG graph paper will be upright (positive deflection).
A)True
B)False
Answer: True
Q3) Lead II records the difference in electrical potential between the _____ leg and _____ arm.
A) left; left
B) left; right
C) right; left
D) right; right
Answer: B
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Page 4
Chapter 3: Sinus Mechanisms
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Sample Questions
Q1) Which of the following correctly reflects the ECG criteria for a sinus rhythm?
A) More P waves than QRS complexes
B) P waves that look alike and upright in lead II,one before each QRS complex
C) Irregular atrial and ventricular rhythm
D) PR interval exceeding 0.20 seconds
Answer: B
Q2) An ECG rhythm strip shows a ventricular rate of 46 bpm,a regular rhythm,a PR interval of 0.14 seconds,a QRS duration of 0.06 seconds,and one upright P wave before each QRS.This rhythm is _____.
A) sinus rhythm
B) sinus bradycardia
C) sinus arrest
D) sinoatrial block
Answer: B
Q3) The rate of sinus tachycardia is _____ beats/min.
A) slower than 60
B) 40 to 80
C) 60 to 100
D) faster than 100
Answer: D
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Chapter 4: Atrial Rhythms
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Sample Questions
Q1) PACs associated with a wide QRS complex are called _____ _____ PACs,indicating that conduction through the ventricles is abnormal.
Q2) Complete the following ECG criteria for Wolff-Parkinson-White (WPW)syndrome:
Q3) How are frequent PACs usually managed?
A) Defibrillation
B) Synchronized cardioversion
C) Correcting the underlying cause
D) Administration of medications such as atropine or epinephrine
Q4) Complete the following ECG criteria for atrial tachycardia:
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Chapter 5: Junctional Rhythms
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Sample Questions
Q1) A junctional escape rhythm occurs because of _____.
A) severe chronic obstructive pulmonary disease
B) multiple irritable sites firing within the AV junction
C) slowing of the rate of the heart's primary pacemaker
D) intrathoracic pressure changes associated with the normal respiratory cycle
Q2) Common causes of junctional dysrhythmias may include acute coronary syndromes and _____.
A) hyperthyroidism
B) hypovolemia
C) digitalis toxicity
D) hypoxia
Q3) List four reasons why the AV junction may assume responsibility for pacing the heart.
Q4) Depending on the severity of the patient's signs and symptoms,management of slow rhythms originating from the AV junction may require intervention including _____.
A) defibrillation
B) intravenous atropine
C) synchronized cardioversion
D) vagal maneuvers or adenosine,or both
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Chapter 6: Ventricular Rhythms
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Sample Questions
Q1) What is meant by the term pulseless electrical activity (PEA)?
A) A chaotic rhythm that is likely to degenerate into cardiac arrest
B) An organized rhythm on the cardiac monitor (other than VT),although a pulse is not present
C) A slow rhythm with a wide QRS complex
D) A flat line on the cardiac monitor
Q2) What is the name given to polymorphic VT that occurs in the presence of a long QT interval?
Q3) Complete the following ECG criteria for an accelerated idioventricular rhythm:
Q4) Complete the following ECG criteria for an idioventricular rhythm:
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Chapter 7: Heart Blocks
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Sample Questions
Q1) A 2:1 AV block 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 regular R to R
Q2) Indicate the ECG criteria for the following dysrhythmias.
\(\begin{array}{lccc}
& \text { Second-Degree AV Block Type I } & \text { Third-Degree AV Block } \\
\text { Ventricular } \\
\text { Rhythm } & ----------& ---------- \\
\text { PR interval } & ----------& ---------- \\
\text { QRS width } & ----------& ---------- \\
\end{array}\)
Q3) Complete the following ECG criteria for third-degree AV block:
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Chapter 8: Pacemaker Rhythms
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Sample Questions
Q1) Describe what is meant by the term overdrive pacing.
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.
Q3) Your patient has a VVI pacemaker.Briefly explain the meaning of each of these letters.
Q4) Explain the difference between electrical capture and mechanical capture.
Q5) A(n)_____ _____ is a vertical line on the ECG that indicates the artificial pacemaker has discharged.
Q6) Explain the benefits of a dual-chamber pacemaker.
Q7) Your patient has a DDD pacemaker.Briefly explain the meaning of each of these letters.
Q8) A demand pacemaker is also known as a _____ pacemaker.
Page 10
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Chapter 9: Introduction to the 12-Lead ECG
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Sample Questions
Q1) The chest leads are the only unipolar leads in the standard 12-lead ECG.
A)True
B)False
Q2) Lead I views the _____.
A) septum
B) inferior wall of the left ventricle
C) lateral wall of the left ventricle
D) anterior wall of the right ventricle
Q3) When you read a 12-lead ECG from left to right,the ECG tracing is continuous.
A)True
B)False
Q4) Lead aVL views the _____.
A) interatrial septum
B) lateral wall of the left ventricle
C) inferior wall of the left ventricle
D) anterior wall of the right ventricle
Q5) When reviewing a 12-lead ECG,intervals and duration are usually expressed in _____.
Q6) List six leads that view the heart in the frontal plane.
Q7) Describe the appearance of a pathologic Q wave.
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Chapter 10: Post-Test
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Sample Questions
Q1) Which of the following are chest leads?
A) Leads I and aVL
B) Leads I,II,and III
C) Leads
V<sub>1</sub>,V<sub>2</sub>,V<sub>3</sub>,V<sub>4</sub>,V<sub>5</sub>,V<sub>6</ sub>
D) Leads I,II,III,aVR,aVL,and aVF
Q2) If the AV junction paces the heart,the electrical impulse must travel in a backward direction to activate the atria.This is called _____ conduction.
Q3) Which of the following correctly describes multifocal atrial tachycardia?
A) The atrial rhythm is regular.
B) The ventricular rhythm is irregular.
C) The atrial and ventricular rhythms are regular.
D) The atrial and ventricular rhythms are irregular.
Q4) The right atrium receives deoxygenated blood from the _____ _____ _____ (which carries blood from the head and upper extremities),the _____ _____ _____ (which carries blood from the lower body),and the _____ _____ (which receives blood from the intracardiac circulation).
Q5) When reviewing a 12-lead ECG,intervals and duration are usually expressed in _____.
Page 12
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