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EKG CMA

Total questions: 108

Worksheet time: 2hrs 36mins

Name
Class
Date
1.
What is also known as the pacemaker of the heart?
a)
AV Node
b)
SA Node
c)
Bundle of His
d)
Purkinje Fibers
2.
The valve between the right atrium and right ventricle is known as the ___ valve.
a)
bicuspid/mitral
b)
tricuspid
c)
pulmonary
d)
aortic
3.
Travel the electrical conduction of the heart starting with the SA node.
a)
AV node, Purkinje fibers, bundle of His, left and right bundle branches
b)
Bundle of His, left and right bundle branches, AV node
c)
AV node, Bundle of His, Purkinje fibers, left and right bundle branches
d)
AV node, Bundle of His, left and right bundle branches, Purkinje fibers
4.
Which 2 chambers pump oxygenated blood?
a)
right atrium, left ventricle
b)
right atrium, right ventricle
c)
left atrium, right ventricle
d)
left atrium, left ventricle
5.

An atrial pacemaker site that changes from location to location has

a)

P waves that continually change in appearance

b)

One pacemaker site from which the impulse arise

c)

Inverted P’ waves

d)

A chaotic baseline preceding each QRS complex

6.

Which of the following has more P waves than QRS complexes?

a)

A dysrhythmia where the pacemaker changes from site to site with each beat

b)

Early beats that arise from the atria

c)

AV heart block

d)

Dysrhythmias that arise from the AV junction

7.

The ___________ represents the end of ventricular depolarization and beginning of ventricular repolarization.

a)

T wave

b)

U wave

c)

QT interval

d)

ST segment

8.

The ___________ represents ventricular repolarization.

a)

T wave

b)

U wave

c)

QT interval

d)

ST segment

9.

1. Prominent U waves are seen in:

a)

Hypokalemia

b)

myocardial infarction.

c)

digitalis toxicity.

d)

All of these

10.

The point at which the QRS complex meets the ST segment is called the:

a)

QT junction.

b)

ST interval.

c)

J point.

d)

RS point.

11.

Impulses that arise from the ventricles produce QRS complexes that:

a)

look the same as the QRS complexes which are produced by impulses originating from the SA node.

b)

are called R prime or R' waves.

c)

are typically notched and biphasic.

d)

appear wide and bizarre-looking.

12.
The lead most commonly used for continuous cardiac monitoring is lead _____.
a)
I
b)
MCL1
c)
V1
d)
II
13.

The PR intervals are not measurable in:

a)

wandering atrial pacemaker.

b)

atrial flutter

c)

2nd - degree AV heart block, Type I.

d)

premature atrial complexes.

14.

The PR interval denotes depolarization of the heart from the

a)

Bundle of His through the ventricles

b)

SA node through the atria, AV node, and His-Purkinje system

c)

AV node through the bundle of His

d)

SA node through the atria and AV node

15.
Artifact is
a)
a normal part of each EKG tracing
b)
an indication of decreased cardiac output
c)
sometimes caused by muscle tremors or extra patient movement
d)
consistently the same across the EKG tracing
16.

ST segment depression suggests:

a)

Myocardial ischemia

b)

Myocardial injury/infarction

c)

Pericarditis

d)

A healthy heart

17.

The QT interval:

a)

represents the time needed for ventricular repolarization.

b)

is prolonged when ventricular repolarization is accelerated.

c)

extends from the beginning of the P wave to the end of the T wave.

d)

is usually between 0.36 and 0.44 seconds in duration.

18.
The electrocardiograph can be used to do all the following EXCEPT
a)
detect cardiac dysrhythmias
b)
determine cardiac output
c)
identify the presence of myocardial ischemia and/or infarction
d)
evaluate the function of artificial impanted pacemakers
19.

Blood enters the heart from the _______?

a)

Superior and inferior vena cava

b)

Bicuspid and Tricuspid

c)

aorta

d)

pulmonary artery

20.

From the pulmonary valve blood enters the _______?

a)

aortic artery

b)

pulmonary valve

c)

pulmonary artery

d)

aortic valve

21.

After the blood returns from the lungs, it is now____?

a)

deoxygenated

b)

oxygenated

c)

purple

22.

Once blood passes through the mitral/ bicuspid valve, it enters the________?

a)

Right atrium

b)

Left atrium

c)

Right ventricle

d)

Left ventricle

23.

Blood is forced from the left ventricle up through the_______?

a)

pulmonary valve

b)

bicuspid valve

c)

tricuspid valve

d)

aortic valve

24.

Normal heart rate for an adult is?

a)

20 to 100/min

b)

40 to 120/min

c)

60 to 100/min

d)

20 to 60/min

25.

The normal hear rhythm is called?

a)

Sinus brady

b)

ventricle fibrillation

c)

Normal sinus rhythm

d)

Junctional Rhytms

26.

deoxygenated blood coming from____?

a)

body to lungs

b)

head to body

c)

lungs to body

d)

lungs to head

27.

oxygenated blood returning from ___?

a)

Lungs to body

b)

Body to lungs

c)

head to body

d)

lungs to head

28.

The SA Node is known as?

a)

Pacemaker

b)

gatekeeper

c)

ventricle

d)

cardiac muscle

29.

The AV Node is known as?

a)

pacemaker

b)

gatekeeper

c)

ventricle

d)

cardiac muscle

30.

The SA Node generates impulses at?

a)

60-100 times per minute

b)

60-40 times per minute

c)

40-20 time per minute

d)

20-100 times per minutes

31.

AV Node can fire at a rate of?

a)

60-100 times per minute

b)

40-60 times per minute

c)

40-20 times per minute

d)

60-20 times per minute

32.

which is the correct order?

a)

SA Node, AV Node, Bundle of His, Lt and Rt Bundle Branches, Purkinje Fibers

b)

AV Node, SA Node, Lt and Rt Bundle Branches, Bundle of His, Purkinje Fibers

c)

Bundle of His, Lt and Rt Bundle Branches, Bundles of His, Purkinje Fibers, AV Node, SA Node

d)

Purkinje Fibers, Bundle of His, AV Node, Lt and Rt Bundle Branches

33.

Define Depolarization

a)

Contraction

b)

Relaxation

34.

Define repolarization

a)

Contraction

b)

Relaxation

35.

The QRS complex is normally __________ seconds in duration

a)

0.06 to 0.10

b)

0.04 to 0.10

c)

0.08 to 0.12

d)

0.10 to 0.12

36.

P waves contract the __________

a)

ventricles

b)

atria

c)

AV junction

d)

SA node

37.

PR interval is the same at _________ seconds

a)

0.06 to 0.10

b)

0.10 to 0.12

c)

0.12 to 0.20

d)

0.20 to 0.25

38.

What is cardiac output?

a)

The amount of O2 carries through the veins per minute

b)

Heart rate speeding up

c)

The amount of blood pump through the heart per minute

d)

The amount blood pump through the lungs per minute

39.

Rhythm that is slow or fast is considered

a)

Tachycardia

b)

Bradycardia

c)

Irregular

d)

Abnormal

40.

Four the 4 methods of the determining the pulse on an EKG tracing

a)

adding, subtracting, multiplying, dividing

b)

6 seconds X 10, 300 150 100 75 60 50, 1500, rate calculators

c)

seconds, minutes, hours, days

d)

6 seconds X 10, 300 200 150 100 75 60 50, 1500, rate rulers

41.

Adult systolic blood pressure

a)

> 70

b)

70 + 2* age

c)

90 to 120 mm Hg

d)

60 to 90 mm Hg

42.

Adult Diastolic blood pressure

a)

60 to 90 mm Hg

b)

70 + 2* age

c)

90 to 120 mm Hg

d)

N/A

43.

In a lifetime, how much blood will your heart pump?

a)

1.5 million

b)

A thousand

c)

2.4 million

d)

10,000

44.

Why is the SA node known as the pacemaker of the heart?

a)

Because when impulses come too quickly, it slows or allows only select impulses through.

b)

Initiates and maintains the rhythm of the heart and maintains the pace of the heart beat.

c)

Because it splits into two and impulses travel much faster.

d)

Because they conduct impulses rapidly through the muscles to assist in it's contractions

45.

Can tell us if the impulse that initiated arose from the SA node and traveled through the atria and AV junction at a normal fashion:

a)

QRS Complexes

b)

PR Intervals

c)

T waves

d)

P waves

46.

P waves, QRS complexes, and T waves are:

a)

Depolarization

b)

A type of measurement

c)

Repolarization

d)

The path of the electrical activity through the heart

47.

They are so small that they sometimes are not seen on the ECG

a)

ST segments

b)

T wave

c)

U waves

d)

Q wave

48.

The advantages of the 300, 150 method is all of the following except

a)

Quick

b)

Fairly accurate

c)

Can be used only when rhythm is regular

d)

More precise

49.

How do you determine the 1500 method

a)

Count the number of small squares between two consecutive R waves

b)

Find a R wave located on a bold line and then find the next consecutive R wave. If it is on a bold line then the heart rate is the value of that line

c)

Identify two successive 3-second marks. Count the number of QRS complexes in that 6 second section. Multiply by 10

d)

Position the start mark on an R wave, then find the next consecutive R wave. Where the next R wave lines up is the approximate heart rate.

50.

Identify the 4 chambers of the heart

a)

Tricuspid valve, Bicuspid valve, Right atrium, and Left ventricle

b)

Right atrium, Right ventricle, Left atrium, and Left ventricle

c)

Left ventricle, Right atrium, Right ventricle, tricuspid valve

d)

Left ventricle, Left atrium, bicuspid valve

51.

Which of the following isn't apart of the nine main elements of the ECG tracing

a)

T waves

b)

QRS complexes

c)

1500 method

d)

PR intervals

52.

P waves can tell us..

a)

If the heart will beat in a consecutive, rhythmic fashion

b)

If the impulse that initiated arose from the SA node and traveled through the atria and AV junction at a normal fashion

c)

That there's sometimes the presence of a U wave

d)

About movement of the electrical impulse through the ventricles, causing their contraction.

53.

What has more oxygen than the veins?

a)

Arteries

b)

Heart

c)

Lungs

d)

Organs

54.

The heart pumps around how many liters of blood?

a)

3-4

b)

4-8

c)

5-6

d)

8-9

55.

What to not forget to hand to patient before leaving the room

a)

Sticker

b)

EKG machine

c)

Call light

d)

Gloves

56.

Where is V1 located

a)

Nipple line

b)

Axillary line

c)

5th intercostal space

d)

4th intercostal space

57.

Where is V6 located

a)

Between V3 and V4

b)

Axillary line

c)

4th intercostal space

d)

Nipple line

58.

What do you do if the EKG comes out messed up

a)

Leave the patient to figure it out themselves

b)

Get a doctor or whose in charge to help you

c)

Ignore it

d)

Let the patient leave

59.

Where is V4 located

a)

4th intercostal space

b)

inbetween V2 and V3

c)

Axillary line

d)

Nipple line

60.

Where is V2 located

a)

Across from V1

b)

Right below V1

c)

In between V3 and V4

d)

Axillary line

61.

Where is V3 located

a)

Nipple line

b)

In between V2 and V4

c)

Below V1

d)

Axillary line

62.

Where is V5 located

a)

Below V2

b)

Nipple line

c)

Beside V3

d)

In between V4 and V6

63.

What do you do when you first walk in the room

a)

Knock on the door

b)

Wash your hands

c)

Introduce yourself

d)

Provide privacy

e)

Explain procedure

64.
Which letter(s) indicates the health of the ventricles?
a)
T-wave  
b)
S-T waves
c)
R wave 
d)
QRS
65.
Which letter(s) indicates the health of the atria?
a)
QRS
b)
P-Q wave
c)
P wave only 
d)
T wave
66.
If there is a flat P wave which structures int he heart are damaged? 
a)
SA/AV node
b)
Bicuspid valve
c)
Bundle of His
d)
Purkinje fibers
67.
If the p-wave is high/irregular. What is happening to the atria chamber? 
a)
Blood is traveling too fast
b)
Blood is remaining in the chamber 
c)
SA node is damaged
d)
Heart is not getting enough Oxygen
68.
The place where the electrical current starts and is considered the heart's pacemaker:
a)
Sino-atrial node 
b)
right atrium
c)
atria-ventricular node 
d)
left ventricle
69.
The p-wave correlates with which event?
a)
atrium contraction /signals moving from SA node to AV node
b)
ventricle contraction
c)
ventricle repolarization
d)
both atrial and ventricle contraction
70.
The AV node is located at...
a)
A
b)
B
c)
C
d)
D
71.
The Purkinje fibers are located at...
a)
F
b)
G
c)
H
d)
I
72.
The components that indicate the QRS complex is...
a)
a,b,c
b)
b,c,d
c)
c,d,e
d)
b,d,e
73.
The QRS-wave correlates with which event?
a)
atrium contraction /signals moving from SA node to AV node
b)
ventricle contraction
c)
ventricle repolarization
d)
both atrial and ventricle contraction
74.
A patient that has swelling in the legs, on a fluid restriction, and possible low sodium diet would have the diagnosis of:
a)
CHF
b)
COPD
c)
MI
d)
Diabetes
75.

A patient complaining about left sided arm pain, nausea, and diaphoresis should be evaluated for:

a)

Congestive Heart Failure (CHF)

b)

Diabetes

c)

Myocardial Infarction (MI)

d)

Chronic Obstructive Pulmonary Disease (COPD)

76.

Which would be on a chemistry panel?

a)

Liver functions, kidney function, and electrolytes

b)

Cholesterol, tryiglycerides, LDL, HDL

c)

WBC, RBC, HGB, HCT

d)

PT,PTT, INR

77.
Each small box on EKG paper measures:
a)
0.04 sec
b)
0.2 sec
c)
25 mm/sec
d)
10 mm
78.
Each large box on the EKG paper measures:
a)
0.04 sec.
b)
0.20 sec.
c)
25 mm/sec
d)
10 mm
79.
What is the normal speed of EKG paper?
a)
0.04 sec.
b)
0.20 sec.
c)
25 mm/sec
d)
10 mm
80.

What is the measurement of the standardization mark?

a)

10mm high and 5mm across

b)

5mm high and 10mm across

c)

5mm high and 5mm across

d)

None of the above

81.
What is the normal measurement for the PR interval?
a)
0.04  to 0.10 sec
b)
0.12 to 0.2 sec
82.

How would you correct artifact from somatic (muscle) tremor?

a)

Turn their cell phone off

b)

Check the leads

c)

Give the patient a blanket

d)

Push the "AC Interference" button on the machine

83.
How would you correct Electric (AC) artifact?
a)
Make sure the room is warm
b)
Check the leads
c)
Push the "Somatic Tremor" button on the machine
d)
Unplug nearby machines
84.
Einthoven's Triangle is made up of:
a)
Precordial Leads
b)
avR,  avL, avF
c)
Leads I, II, III
d)
Three lead telemetry
85.

The lead on 5th intercostal space, mid-axillary is:

a)

V4

b)

V6

c)

V1

d)

V5

86.

The lead that is on the right side at the 4th intercostal space/sternal border is:

a)

V2

b)

V1

c)

V3

d)

V4

87.
V1-V6 are referred to as:
a)
Einthoven's Triangle
b)
Leads I,II,III
c)
Precordial Leads
d)
Augmented Leads
88.
Which of the following could prevent a good EKG?
a)
Using tincture of benzoin
b)
Shaving hair
c)
Using alcohol to clean skin
d)
Using electrodes with dry gel
89.

Who would be a candidate for a right sided EKG on?

a)

A patient with Dextrocardia

b)

A patient with Situs Inversus

c)

A patient that needs nuclear testing

d)

A patient with a L. lower extremity amputation

90.
what is the name of the arrhythmia in the EKG tracing ?
a)
sinus arrhythmia
b)
ventricular fibrillation
c)
wandering atrial pacemaker
d)
atrial fibrillation
91.
An electrocardiogram measures what?
a)
The amount of pressure exerted on blood vessels.
b)
The electrical activity of the heart.
c)
How many times the heart contracts over time.
d)
The body's temperature caused by friction of blood in vessel.
92.
What do the letters EKG stand for?
a)
Electrocardiograph
b)
Electromagneticgraph
c)
Electrocardiogram 
d)
Electrolytes
93.
An EKG is actually
a)
A ratio
b)
An equation
c)
A time frame
d)
A graph 
94.
What letters are used to label the parts of an EKG?
a)
PQRST 
b)
ABCDE
c)
ACDC
d)
DNAI
95.
Which of the following is not a direct indicator of a person's cardiac health?
a)
Heart Rate
b)
Blood Pressure
c)
EKG
d)
Temperature 
96.
The p-wave correlates with which event?
a)
atrium contraction /signals moving from SA node to AV node
b)
ventricle contraction
c)
ventricle repolarization
d)
both atrial and ventricle contraction
97.
The place where the electrical current starts and is considered the heart's pacemaker:
a)
Sino-atrial node 
b)
right atrium
c)
atria-ventricular node 
d)
left ventricle
98.
The t-wave correlates with which event?
a)
atrium contraction /signals moving from SA node to AV node
b)
ventricle contraction
c)
ventricle repolarization
d)
both atrial and ventricle contraction
99.
The nurse analyzing EKGs recognizes that which finding is abnormal?
a)
PR = 0.24
b)
QRS =0.10
c)
HR = 68
d)
Rhythm = regular
100.
The nurse notes that an alert patient has a stat order to initiate an amiodarone (Cordorone®) IV infusion.  In reviewing data about the patient, the nurse recognizes that the patient is most likely currently experiencing which rhythm? 
a)
Atrial fibrillation
b)
Sinus bradycardia
c)
Unifocal infrequent PVCs     
d)
First degree AV Block
101.
When analyzing an EKG  rhythm strip, the nurse notes the following: Ventricular HR = 120 Rhythm = regular PR = 0.20 QRS = 0.16 QT = .32 Which rhythm interpretation by the nurse is correct?
a)
Atrial flutter with rapid ventricular response
b)
Atrial fibrillation with rapid ventricular response
c)
Sinus tachycardia with bundle branch block
d)
Sinus rhythm with first degree AV block
102.

The nurse is reviewing a patient’s electrocardiogram. Which wave should the nurse recognize as being the first positive wave in a normal cardiac cycle?

a)

P wave

b)

Q wave

c)

R wave

d)

S wave

103.

The nurse is assessing the client’s electrocardiography (ECG). What does the P wave on the ECG tracing represent?

a)

Contraction of the atria

b)

Contraction of the ventricles

c)

Depolarization of the atria

d)

Depolarization of the ventricles

104.

The nurse is reviewing cardiac anatomy with a patient scheduled for pacemaker insertion. Where should the nurse identify the location of the sinus node for the patient?

a)

Left atrium

b)

Right atrium

c)

Left ventricle

d)

Right ventricle

105.

A patient has a normal heartbeat of 72 beats per minute. What area of the conduction system should the nurse consider as functioning normally in this patient?

a)

Bundle of His

b)

Sinoatrial node

c)

Purkinje’s fibers

d)

Atrioventricular node

106.

The nurse is determining the functioning of a patient’s sinoatrial node. How many times per minute should the nurse expect the node to normally fire?

a)

20 to 40

b)

25 to 55

c)

40 to 85

d)

60 to 100

107.

The nurse determines that a patient’s electrocardiogram is demonstrating normal sinus rhythm. What did the nurse observe to come to this conclusion? (Select all that apply.)

a)

Regular rhythm

b)

P wave before each QRS complex

c)

Wide QRS intervals

d)

Heart rate 88 beats per minute

108.

The nurse is analyzing a client’s electrocardiogram tracing. Which of the following complexes is not normally seen on an electrocardiogram tracing?

a)

P wave

b)

QRS complex

c)

T wave

d)

U wave

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