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Worksheetssemester test review
Total questions: 100
Worksheet time: 50mins
What must the EKG tech always check before starting
calculate the rate first
check the patient
read the rhythm strips from right to left
evaluate the QRS duration
PR interval measurement is not the same each time is called:
variable
absent
unmeasurable
indeterminable
athletes typically exhibit
normal sinus rhythm
sinus arrhythmia
sinus bradycardia
sinus pause
most accurate technique to determine heart rate
300
1500
6 six second
1 EKG strip
sinus tachycardia may accompany:
palpitations
numbness in fingers
apnea
syncope
SA node stops firing and causes a pause in electrical activity
NSR
sinus arrest
sinus bradycardia
idioventricular rhythm
rhythm that is influenced by the respiratory cycle and variations of vagal tone
sinus arrhythmia
sinus arrest
sinus bradycardia
sinus tachycardia
which rhythm is a normal response of the heart of the body's demand for increased blood flow as a result of exercise and exertion?
sinus arrest
sinus bradycardia
sinus tachycardia
sinus arrhythmia
persistent tachycardia may lead to heart failure due to
increased time spent in diastole
decreased cardiac output
increased stroke volume
decreased heart rate
p wave represents
atrial depolarization
atrial repolarization
ventricular depolarization
ventricular repolarization
QRS represents
atrial depolarization
atrial repolarization
ventricular repolarization
ventricular depolarization
t wave represents
atrial depolarization
atrial repolarization
ventricular depolarization
ventricular repolarization
an arrhythmia is identified according to _______ of the ectopic pacemaker.
size of U wave
the location
the AV node
the amplitude
a major characteristic of identifying atrial arrhythmias is to closely examine the size, shape, and direction of the:
T wave
S wave
P wave
R wave
what is the result of rapid ventricular rates (greater than 100 bpm) with atrial arrhythmias that can be life threatening?
prolonged diastole
decreased heart rate
decreased cardiac output
prolonged coronary artery perfusion
characterized by V-shaped waveforms, sometimes called flutter waves.
A-fib
A-fluter
ventricular fibrillation
torsades de pointe
has a pacemaker that shifts back and forth between sinus node and the ectopic atrial site
sinus tachycardia
wandering atrial pacemaker
atrial fibrillation
atrial flutter
has chaotic electrical impulses that arise from multiple ectopic atrial sites that cause the atria to quiver and produce wavy and irregular p waves
a fib
a flutter
wandering atrial pacemaker
paroxysmal atrial tachycardia
premature atrial contractions that are infrequent require
close medical monitoring
compressions
oxygen therapy
no treatment
special wave type that is formed with atrial tachycardia
s-t wave
"f" wave
"F" wave
t-p wave
SVT is
regular
irregular
cardiac output is defined as
tension on a coronary artery
the amount of blood in the coronary arteries
the amount of blood pumped per minute by the heart
the volume of blood ejected form the right ventricles
patient with symptomatic sinus bradycardia at a rate of 40 beats per minute typically experiences
high blood pressure
facial flushing and apnea
hypotension and dyspnea
calf pain and dry cough
major complication of atrial fibrillation
thrombi formation
widened QRS complexes
increased cardiac output
premature atrial complexes
similar to NSR but AV node is delayed, resulting in longer PR inverval
PAC
first degree AV block
second degree AV block type 1
PJC
patient is being tested by EKG for possible delay in electrical conduction from the SA node to the AV node. Technician should look at ____ to diagnosis.
PR interval
P wave
QRS complex
ST segment
atria and ventricles beating independently from each other
third degree AV block
second degree AV block type 2
ventricular fibrillation
second degree AV block type 1
typically presents with wide QRS with slurred upstroke also known as delta wave
wolff parkison white
a fib
ventricular tachycardia
bundle branch block
AV block also called Wencheback
second degree AV block type 1
second degree AV block type 2
third degree AV block
first degree AV block
EKG technician obtains EKG with: upright P wave, PR interval of 0.24 sec, QRS complex of 0.08 sec, T wave upright at 5mm, heart rate is 68 bpm. The rhythm is
NSR
first degree AV block
idioventricular rhythm
accelerated junctional
constant PR interval that exceeds 0.20 sec
third degree AV block
first degree AV block
idioventricular rhythm
second degree AV block type 1
type of atrioventricular block with each successive impulse has increasing difficulty passing through the AV node until an impulse doesn't pass through and a QRS is blocked or dropped is
first degree AV block
second degree AV block type 1
second degree AV block type 2
third degree AV block
rhythm that progresses quickly to third degree AV block
second degree AV block type 1
second degree AV block type 2
first degree AV block
third degree AV block
frequent non-conducted QRS complexes are likely to cause signs of
low cardiac output
hyperkalemia
kidney failure
congestive heart failure
main component of treatment for third degree heart block
pacemaker
calcium channel blockers
oxygen and antiarrhythmias
cardioversion
treatment isn't required if patient has
first degree AV block
second degree AV block type 2
third degree AV block
complete AV dissociation
second degree AV block type 1, PR inteval
according to the ventricular response rate
progressively lengthens until a QRS is dropped
remains constant despite an irregular ventricular rhythm
is unmeasureable
syncope
fainting
coughing
shortness of breath
difficulty breathing
ventricles are depolarized first in junctional rhythm, p wave will occur
before QRS
after QRS
during QRS
doesn't appear
atrial are depolarized first in junctional rhythm, p wave will occur
before QRS
after QRS
during QRS
doesn't appear
atrial and ventricles are depolarized first in junctional rhythm, p wave will occur
before QRS
after QRS
during QRS
doesn't appear
junctional rhythm PR interval
less than 0.10 sec
greater than 0.12 sec
0.12 - 0.20 sec
variable
junctional escape rhythm, p wave can occur
before, during, or after QRS
within t wave
with every third QRS complex
earlier than expected
patient presents a burst of V-tach, the EKG tech recognizes this by
every 4th complex in PVC
the patient's cardiac output has decreased by half
couplet PVCs
triplet or more PVCs
signs and symptoms of accelerated junctional rhythm include
low cardiac output
high blood pressure
dyspnea
altered mental status
major characteristic of identifying atrial arrhythmias is to closely examine the size, shape, and direction of
p wave
t wave
s wave
r wave
idioventricular rhythm has absence of
p wave
t wave
s wave
ST segment
monitor shows irregular rhythm and a rate that increases and decreases in consistent cycle
sinus arrest
sinus arrhythmia
sinus bradycardia
NSR
which interval should be used to determine regularity of ventricular depolarization
P-P
QT
PR
R-R
undeterminable R-R and P-P interval
ventricular fibrillation
accelerated idioventricular
agonal
ventricular tachycardia
pulseless electrical activity refers to a condition in which there is
a bradycardic rate
asystole on a monitor or rhythm strip
electrical activity in the heart but no actual contraction
asystole and a palpable pulse and blood pressure
characteristic of bundle branch block are all of the following except:
absent p wave
seen with a notched r wave
wide QRS complex
presents with an underlying rhythm
which portion of the cardiac cycle is absent in a ventricular arrhythmia
P wave
ST segment
T wave
R wave
ventricular ectopic beats and rhythm occur in a pacemaker site anywhere
below the bundle of his
above the AV nde
below the SA node
above the atrial pacemaker site
all rhythms are associated with wide QRS except
accelerated idioventricular rhythm
idioventricular rhythm
accelerated junctional rhythm
ventricular tachycardia
ventricular tachycardia degenerates into deadlier rhythm
idioventricular rhythm
accelerated idioventricular rhythm
heart block
ventricular fibrillation
accelerated idioventricular rhythm degenerates into a deadlier rhythm
idioventricular rhythm
ventricular fibrillation
ventricular tachycardia
heart block
absence of all cardiac electrical activity is known as
agonal
asystole
pulseless electrical activity
bundle branch block
most dangerous rhythm
ventricular fibrillation
atrial fibrillation
premature ventricular contraction
premature atrial contraction
when a patient with a pacemaker has an EKG performed, the strip with contain
small spikes where a p wave may not be seen
an introverted t wave
large spikes where a QRS complex is absent
an elevated ST segment
rhythm has p wave and wide QRS
torsades de pointe
juncitonal tachycardia
accelerated idioventricular rhythm
bundle branch block
when ventricular rhythm or ectopic beat originate in the ventricles, QRS measures
less than 0.10 sec
less than 0.12 sec
greater than 0.12 sec
equal to 0.10 sec
patient is in atrial fibrillation and begins to develop severe shortness of breath. suspect the patient may have
infection
CVA
PE
fever
characteristic feature of Wolf-Parkinson-White (WPW) syndrome
prolonged PR interval
delta wave
third degree AV block
narrow QRS complex
primary indication for dual-chamber pacemaker implantation
atrial fibrillation
complete heart block
isolated sinus arrhythmia
premature ventricular contraction
first action that should be taken when PEA is identified
administer ephinephrine
begin chest compressions
intubate the patient
check blood glucose
which heart block conditions most strongly indicates the need for permanent pacemaker placement
first degree AV block
second degree AV type 2
a fib
sinus tachycardia
which of the following is not typically an indication for pacemaker placement
first degree AV block
symptomatic sinus bradycardia
third degree AV block
second degree AV block type 2
in atrial flutter, a major point for consideration is if the patient can tolerate
T-P wave
configuration of the flutter waves
QT interval
the ventricular rate
syncope, diaphoresis, shortness of breath, lightheadedness, and dizziness are all signs of
brain damage
hyperkalemia
heart failure
hypokalemia
the main goal in treating atrial fibrillation would be to
increase the patient's blood pressure
increase the patient's fluid intake
prepare for cardioversion
slowing down the ventricular response with medication
what is the main way to diagnose an atrioventricular block
determine the number of the P waves to corresponding ectopic sites in the atria
identify the deflection of the p wave
determine the relationship of the p wave to the QRS complex
recognizing the failure of the atria to depolarize
a patient is being tested by way of ekg for a possible delay in electrical conduction from the SA node to the AV node. the technician should look at which part to confirm diagnosis
PR interval
P wave
QRS complex
ST segment
rhythm best describes QRS complexes that are periodically dropped causing the ventricular rhythm to be irregular, however, the PR interval is constant on conducted beats
first degree AV block
second degree AV block type 1
second degree AV block type 2
third degree AV block
second degree AV block type 2 is generally more serious than type 1 because
cardiac output is diminished
ventricular rate rises above 100 beats/minute
peripheral vascular system shuts down almost as soon as the arrhythmia begins
atrial rates rises above 100 beats/minute
rhythm that will most likely not show any symptoms of low cardiac output would be
paroxysmal junctional tachycardia
premature junctional complexes (5 ectopic beats in a minute)
accelerated junctional rhythm
junctional escape rhythm
ventricular pacemaker cells are found at the
purkinje fibers
AV node
SA node
right bundle branch
which pacemaker rhythm has a pacing spike before the p wave
atrial pacemaker rhythm
ventricular pacemaker
atrioventricular pacemaker
wandering atrial pacemaker
which pacemaker has a pacing spike before p waves and before QRS complexes
atrial pacemaker rhythm
ventricular pacemaker
atrioventricular pacemaker
wandering atrial pacemaker
an 80 year old man experienced one episode of syncope. while performing the EKG on the patient, you discover a chaotic rhythm that is absent in p waves and QRS complexes. the rhythm is
sinus arrhythmia
ventricular fibrillation
asystole
agonal
standard duration of normal ekg
PR segment 0.12 - 0.20 sec
PR interval 0.12 - 0.20 sec
PR segment 0.10 - 0.12 sec
PR interval 0.10 - 0.12 sec
sinus bradycardia is present, patient's heart rhythm is
higher than 110 bpm and all measurements are abnormal
less than 60 bpm and all other measurements are abnormal
less than 60 bpm and all other measurements are normal
higher than 110 bpm and all other measurements are normal
approximate time for QRS complex
0.08 - 0.14 sec
0.06 - 0.12 sec
0.12 - 0.20 sec
0.04 - 0.08 sec
calculating ventricular rate, a quick method would be to multiply 10 by
number of P waves
number of T waves
number of R waves
number of U waves
patients that are experiencing sinus tachycardia typically have a heart rate that is
regular and above 100 bpm
irregular and below 60 bpm
regular and 60 - 100 bpm
irregular and above 100 bpm
typical characteristic of a premature atrial contraction (PAC)
premature, abnormal p wave or hidden in the preceding t wave with normal QRS complex
p wave are the same shape and configuration
atrial and ventricular rates are different
t waves are inverted in lead ll
rate of wandering atrial pacemaker
60-100 bpm
50-90 bpm
101-150 bpm
60-80 bpm
accelerated junctional rhythm, QRS complex appears
narrow
wide
absent
normal
6 squares in R-R interval, calculated heart rate is
40 bpm
50 bpm
30 bpm
60 bpm
rate for accelerated junctional rhythm
40-60 bpm
60-100 bpm
>100 bpm
20-40 bpm
4 large squares between 2 consecutive QRS complex, rate is
75
66
150
112
rate for paroxysmal junctional tachycardia
40-60 bpm
60-100 bpm
>100 bpm
variable
inherent rate of AV junction is
20-60 bpm
40-60 bpm
60-100 bpm
80-100 bpm
rate for junctional escape rhythm or junctional rhythm is
20-40 bpm
60-100 bpm
40-60 bpm
80-100 bpm
3 large boxes from R-R interval, heart rate is
100 bpm
50 bpm
75 bpm
200 bpm
10 small squares between R-R wave, heart rate is
136 bpm
150 bpm
148 bpm
166 bpm
20 small squares between R-R waves, heart rate is
36 bpm
50 bpm
75 bpm
150 bpm
12 small squares between R-R waves, heart rate is
125 bpm
150 bpm
148 bpm
166 bpm
17 small squares between R-R waves, heart rate is
136 bpm
150 bpm
88 bpm
66 bpm
a patient is in multifocal atrial tachycardia, what would be the best response by the EKG tech
instruct the patient to bear down to elicit the vasovagal effect
notify the patient’s physician
check the patient’s leads
prep for cardioversion
