Course Introduction
Medical-Surgical Nursing Pre-Test Questions
Medical-Surgical Nursing is a comprehensive course designed to equip students with the foundational knowledge and clinical skills necessary for caring for adult patients experiencing common acute and chronic health problems. The course covers pathophysiology, assessment, and evidence-based management of various medical and surgical conditions, such as cardiovascular, respiratory, gastrointestinal, renal, musculoskeletal, and endocrine disorders. Emphasis is placed on the nursing process, patient safety, interdisciplinary collaboration, pharmacological interventions, perioperative care, and patient education. Students will also explore critical thinking, clinical judgment, and holistic care approaches to promote optimal patient outcomes in diverse healthcare settings.
Recommended Textbook
ECGs Made Easy 6th Edition by Barbara J Aehlert
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Page 2
Chapter 1: Anatomy and Physiology
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Sample Questions
Q1) The right atrium receives blood low in oxygen from three vessels. Name them. Answer: Superior vena cava, inferior vena cava, and coronary sinus.
Q2) The base of the heart is found at approximately the level of the _____ rib(s).
A) first
B) second
C) fourth
D) fifth and sixth
Answer: B
Q3) Which side of the heart is a low-pressure system that pumps venous blood to the lungs?
A) Left
B) Right Answer: B
Q4) What effects can be expected from sympathetic stimulation of the heart?
Answer: Sympathetic stimulation of the heart results in increased heart rate, force of contraction, conduction velocity, blood pressure, and cardiac output.
Q5) The inferior outer surface of the heart is also called the _____ surface. Answer: diaphragmatic
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Chapter 2: Basic Electrophysiology
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Sample Questions
Q1) Which of the following correctly reflects examples of ectopic (latent) pacemakers?
A) The SA node and AV junction
B) The AV junction and ventricles
C) The SA node and right bundle branch
D) The AV junction and left bundle branch
Answer: B
Q2) List three causes of artifact on an ECG tracing.
Answer: Artifacts may be due to loose electrodes, broken wires or ECG cables, muscle tremor, patient movement, external chest compressions, or 60-cycle interference.
Q3) The point where the QRS complex and the ST segment meet is called the ST junction or J-point.
A)True
B)False
Answer: TRUE
Q4) List four major electrolytes that influence cardiac function. Answer: Sodium, potassium, calcium, and chloride.
Q5) A line between waveforms is called a(n) _____. Answer: segment
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Chapter 3: Sinus Mechanisms
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Sample Questions
Q1) List three significant signs and/or symptoms that, if observed with a sinus bradycardia, would require management of this dysrhythmia.
Answer: Clinical signs and symptoms of hemodynamic compromise can include acute changes in mental status; chest pain or discomfort; cold, clammy skin; fall in urine output; heart failure; low blood pressure; pulmonary congestion; shock; and shortness of breath.
Q2) Which of the following are possible causes of sinus bradycardia?
A) Elevated temperature, pain
B) Increased intracranial pressure, beta-blocker overdose
C) Hypoxia, fright, caffeine-containing beverages
D) Hypovolemia, administration of sympathomimetics
Answer: B
Q3) 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 second
Answer: B
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5
Chapter 4: Atrial Rhythms
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Sample Questions
Q1) To determine whether the ventricular rhythm on an ECG tracing is regular or irregular, compare _____ intervals.
A) PR
B) R-R
C) TP
D) P to P
Q2) What is meant by the term controlled atrial fibrillation?
A) The overall ventricular rate is less than 100 beats/min.
B) The atrial rate is less than 100 beats/min.
C) The overall ventricular rate is greater than 100 beats/min.
D) The atrial rate is greater than 100 beats/min.
Q3) The presence of an accessory pathway should be considered in atrial fibrillation with a ventricular rate faster than 180 beats/min.
A)True
B)False
Q4) Upon conversion of atrial fibrillation to sinus rhythm, the patient should be observed for signs of a possible stroke.
A)True
B)False
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Chapter 5: Junctional Rhythms
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Sample Questions
Q1) A beat originating from the AV junction that appears later than the next expected sinus beat is called a(n) _______________.
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) If the AV junction paces the heart, the electrical impulse must travel in a backward direction to activate the atria. This is called _____ conduction.
Q4) A(n) _____ pause often follows a PJC and represents the delay during which the SA node resets its rhythm for the next beat.
Q5) In a junctional rhythm viewed in lead II, where is the location of the P wave on the ECG if atrial and ventricular depolarization occur simultaneously?
A) Before the QRS complex
B) During the QRS complex
C) After the QRS complex
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Chapter 6: Ventricular Rhythms
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Sample Questions
Q1) What is the name given to polymorphic VT that occurs in the presence of a long QT interval?
Q2) Transcutaneous pacing is the treatment of choice for pulseless ventricular tachycardia or ventricular fibrillation.
A)True
B)False
Q3) 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
Q4) 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
Q5) List four reasons when the ventricles may assume responsibility for pacing the heart.
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Chapter 7: Atrioventricular Blocks
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Sample Questions
Q1) The ventricular rhythm is regular in second-degree AV block type I.
A)True
B)False
Q2) The PR interval of a first-degree AV block _____.
A) is constant and less than 0.12 second in duration
B) is constant and more than 0.20 second in duration
C) is generally progressive until a P wave appears without a QRS complex
D) gradually decreases in duration until a P wave appears without a QRS complex
Q3) 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
Q4) The QRS complex associated with a third-degree AV block is always wide.
A)True
B)False
Q5) A _____ bundle branch block produces a RSR pattern in lead V<sub>1</sub>.
Q6) Most of the bundle branch tissue is supplied by the _____ coronary artery.
A) right
B) left
Page 9
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Chapter 8: Pacemaker Rhythms
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Sample Questions
Q1) The first letter of the pacemaker identification code represents _____.
A) the chamber sensed
B) the chamber paced
C) the mode of response
D) programmable functions
Q2) In pacing, sensitivity refers to _____.
A) the ability of a pacemaker to recognize and respond to intrinsic electrical activity
B) a pacing lead with a single electrical pole at the distal tip of the pacing lead through which the stimulating pulse is delivered
C) the successful conduction of an artificial pacemaker's impulse through the myocardium, resulting in depolarization
D) the length of time between an atrial sensed or atrial paced event and the delivery of a ventricular pacing stimulus
Q3) Your patient has a DDD pacemaker. Briefly explain the meaning of each of these letters.
Q4) Describe what is meant by the term overdrive pacing.
Q5) Your patient has a VVI pacemaker. Briefly explain the meaning of each of these letters.
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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) Where should the positive electrode for leadd V<sub>5</sub> be positioned?
A) Right side of the sternum, fourth intercostal space
B) Left midaxillary line at the same level as V4
C) Left side of the sternum, fourth intercostal space
D) Left anterior axillary line at the same level as V4
Q3) When reviewing a 12-lead ECG, intervals and duration are usually expressed in
Q4) Patients who experience a(n) _____ myocardial infarction have a greater incidence of heart failure and cardiogenic shock than those who have myocardial infarctions affecting other areas of the left ventricle.
A) lateral
B) posterior
C) inferior
D) anterior
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Chapter 10: Posttest
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Sample Questions
Q1) When reviewing a 12-lead ECG, intervals and duration are usually expressed in _____.
Q2) 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.
Q3) In an adult, the normal duration of the QRS complex is _____ seconds.
A) 0.12 to 0.20
B) 0.06 to 0.11
C) 0.04 to 0.14
D) 0.20 to 0.38
Q4) V<sub>4</sub>R, V<sub>5</sub>R, and V<sub>6</sub>R are used to view the posterior wall of the left ventricle.
A)True
B)False
Q5) A QRS measuring 0.10 to 0.12 second is called a(n) _____ right or left bundle branch block.
Q6) List five signs or symptoms of decreased cardiac output.
Q7) What is a biphasic waveform?
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