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semester test review

Total questions: 100

Worksheet time: 50mins

Name
Class
Date
1.

What must the EKG tech always check before starting

a)

calculate the rate first

b)

check the patient

c)

read the rhythm strips from right to left

d)

evaluate the QRS duration

2.

PR interval measurement is not the same each time is called:

a)

variable

b)

absent

c)

unmeasurable

d)

indeterminable

3.

athletes typically exhibit

a)

normal sinus rhythm

b)

sinus arrhythmia

c)

sinus bradycardia

d)

sinus pause

4.

most accurate technique to determine heart rate

a)

300

b)

1500

c)

6 six second

d)

1 EKG strip

5.

sinus tachycardia may accompany:

a)

palpitations

b)

numbness in fingers

c)

apnea

d)

syncope

6.

SA node stops firing and causes a pause in electrical activity

a)

NSR

b)

sinus arrest

c)

sinus bradycardia

d)

idioventricular rhythm

7.

rhythm that is influenced by the respiratory cycle and variations of vagal tone

a)

sinus arrhythmia

b)

sinus arrest

c)

sinus bradycardia

d)

sinus tachycardia

8.

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?

a)

sinus arrest

b)

sinus bradycardia

c)

sinus tachycardia

d)

sinus arrhythmia

9.

persistent tachycardia may lead to heart failure due to

a)

increased time spent in diastole

b)

decreased cardiac output

c)

increased stroke volume

d)

decreased heart rate

10.

p wave represents

a)

atrial depolarization

b)

atrial repolarization

c)

ventricular depolarization

d)

ventricular repolarization

11.

QRS represents

a)

atrial depolarization

b)

atrial repolarization

c)

ventricular repolarization

d)

ventricular depolarization

12.

t wave represents

a)

atrial depolarization

b)

atrial repolarization

c)

ventricular depolarization

d)

ventricular repolarization

13.

an arrhythmia is identified according to _______ of the ectopic pacemaker.

a)

size of U wave

b)

the location

c)

the AV node

d)

the amplitude

14.

a major characteristic of identifying atrial arrhythmias is to closely examine the size, shape, and direction of the:

a)

T wave

b)

S wave

c)

P wave

d)

R wave

15.

what is the result of rapid ventricular rates (greater than 100 bpm) with atrial arrhythmias that can be life threatening?

a)

prolonged diastole

b)

decreased heart rate

c)

decreased cardiac output

d)

prolonged coronary artery perfusion

16.

characterized by V-shaped waveforms, sometimes called flutter waves.

a)

A-fib

b)

A-fluter

c)

ventricular fibrillation

d)

torsades de pointe

17.

has a pacemaker that shifts back and forth between sinus node and the ectopic atrial site

a)

sinus tachycardia

b)

wandering atrial pacemaker

c)

atrial fibrillation

d)

atrial flutter

18.

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)

a fib

b)

a flutter

c)

wandering atrial pacemaker

d)

paroxysmal atrial tachycardia

19.

premature atrial contractions that are infrequent require

a)

close medical monitoring

b)

compressions

c)

oxygen therapy

d)

no treatment

20.

special wave type that is formed with atrial tachycardia

a)

s-t wave

b)

"f" wave

c)

"F" wave

d)

t-p wave

21.

SVT is

a)

regular

b)

irregular

22.

cardiac output is defined as

a)

tension on a coronary artery

b)

the amount of blood in the coronary arteries

c)

the amount of blood pumped per minute by the heart

d)

the volume of blood ejected form the right ventricles

23.

patient with symptomatic sinus bradycardia at a rate of 40 beats per minute typically experiences

a)

high blood pressure

b)

facial flushing and apnea

c)

hypotension and dyspnea

d)

calf pain and dry cough

24.

major complication of atrial fibrillation

a)

thrombi formation

b)

widened QRS complexes

c)

increased cardiac output

d)

premature atrial complexes

25.

similar to NSR but AV node is delayed, resulting in longer PR inverval

a)

PAC

b)

first degree AV block

c)

second degree AV block type 1

d)

PJC

26.

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.

a)

PR interval

b)

P wave

c)

QRS complex

d)

ST segment

27.

atria and ventricles beating independently from each other

a)

third degree AV block

b)

second degree AV block type 2

c)

ventricular fibrillation

d)

second degree AV block type 1

28.

typically presents with wide QRS with slurred upstroke also known as delta wave

a)

wolff parkison white

b)

a fib

c)

ventricular tachycardia

d)

bundle branch block

29.

AV block also called Wencheback

a)

second degree AV block type 1

b)

second degree AV block type 2

c)

third degree AV block

d)

first degree AV block

30.

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

a)

NSR

b)

first degree AV block

c)

idioventricular rhythm

d)

accelerated junctional

31.

constant PR interval that exceeds 0.20 sec

a)

third degree AV block

b)

first degree AV block

c)

idioventricular rhythm

d)

second degree AV block type 1

32.

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

a)

first degree AV block

b)

second degree AV block type 1

c)

second degree AV block type 2

d)

third degree AV block

33.

rhythm that progresses quickly to third degree AV block

a)

second degree AV block type 1

b)

second degree AV block type 2

c)

first degree AV block

d)

third degree AV block

34.

frequent non-conducted QRS complexes are likely to cause signs of

a)

low cardiac output

b)

hyperkalemia

c)

kidney failure

d)

congestive heart failure

35.

main component of treatment for third degree heart block

a)

pacemaker

b)

calcium channel blockers

c)

oxygen and antiarrhythmias

d)

cardioversion

36.

treatment isn't required if patient has

a)

first degree AV block

b)

second degree AV block type 2

c)

third degree AV block

d)

complete AV dissociation

37.

second degree AV block type 1, PR inteval

a)

according to the ventricular response rate

b)

progressively lengthens until a QRS is dropped

c)

remains constant despite an irregular ventricular rhythm

d)

is unmeasureable

38.

syncope

a)

fainting

b)

coughing

c)

shortness of breath

d)

difficulty breathing

39.

ventricles are depolarized first in junctional rhythm, p wave will occur

a)

before QRS

b)

after QRS

c)

during QRS

d)

doesn't appear

40.

atrial are depolarized first in junctional rhythm, p wave will occur

a)

before QRS

b)

after QRS

c)

during QRS

d)

doesn't appear

41.

atrial and ventricles are depolarized first in junctional rhythm, p wave will occur

a)

before QRS

b)

after QRS

c)

during QRS

d)

doesn't appear

42.

junctional rhythm PR interval

a)

less than 0.10 sec

b)

greater than 0.12 sec

c)

0.12 - 0.20 sec

d)

variable

43.

junctional escape rhythm, p wave can occur

a)

before, during, or after QRS

b)

within t wave

c)

with every third QRS complex

d)

earlier than expected

44.

patient presents a burst of V-tach, the EKG tech recognizes this by

a)

every 4th complex in PVC

b)

the patient's cardiac output has decreased by half

c)

couplet PVCs

d)

triplet or more PVCs

45.

signs and symptoms of accelerated junctional rhythm include

a)

low cardiac output

b)

high blood pressure

c)

dyspnea

d)

altered mental status

46.

major characteristic of identifying atrial arrhythmias is to closely examine the size, shape, and direction of

a)

p wave

b)

t wave

c)

s wave

d)

r wave

47.

idioventricular rhythm has absence of

a)

p wave

b)

t wave

c)

s wave

d)

ST segment

48.

monitor shows irregular rhythm and a rate that increases and decreases in consistent cycle

a)

sinus arrest

b)

sinus arrhythmia

c)

sinus bradycardia

d)

NSR

49.

which interval should be used to determine regularity of ventricular depolarization

a)

P-P

b)

QT

c)

PR

d)

R-R

50.

undeterminable R-R and P-P interval

a)

ventricular fibrillation

b)

accelerated idioventricular

c)

agonal

d)

ventricular tachycardia

51.

pulseless electrical activity refers to a condition in which there is

a)

a bradycardic rate

b)

asystole on a monitor or rhythm strip

c)

electrical activity in the heart but no actual contraction

d)

asystole and a palpable pulse and blood pressure

52.

characteristic of bundle branch block are all of the following except:

a)

absent p wave

b)

seen with a notched r wave

c)

wide QRS complex

d)

presents with an underlying rhythm

53.

which portion of the cardiac cycle is absent in a ventricular arrhythmia

a)

P wave

b)

ST segment

c)

T wave

d)

R wave

54.

ventricular ectopic beats and rhythm occur in a pacemaker site anywhere

a)

below the bundle of his

b)

above the AV nde

c)

below the SA node

d)

above the atrial pacemaker site

55.

all rhythms are associated with wide QRS except

a)

accelerated idioventricular rhythm

b)

idioventricular rhythm

c)

accelerated junctional rhythm

d)

ventricular tachycardia

56.

ventricular tachycardia degenerates into deadlier rhythm

a)

idioventricular rhythm

b)

accelerated idioventricular rhythm

c)

heart block

d)

ventricular fibrillation

57.

accelerated idioventricular rhythm degenerates into a deadlier rhythm

a)

idioventricular rhythm

b)

ventricular fibrillation

c)

ventricular tachycardia

d)

heart block

58.

absence of all cardiac electrical activity is known as

a)

agonal

b)

asystole

c)

pulseless electrical activity

d)

bundle branch block

59.

most dangerous rhythm

a)

ventricular fibrillation

b)

atrial fibrillation

c)

premature ventricular contraction

d)

premature atrial contraction

60.

when a patient with a pacemaker has an EKG performed, the strip with contain

a)

small spikes where a p wave may not be seen

b)

an introverted t wave

c)

large spikes where a QRS complex is absent

d)

an elevated ST segment

61.

rhythm has p wave and wide QRS

a)

torsades de pointe

b)

juncitonal tachycardia

c)

accelerated idioventricular rhythm

d)

bundle branch block

62.

when ventricular rhythm or ectopic beat originate in the ventricles, QRS measures

a)

less than 0.10 sec

b)

less than 0.12 sec

c)

greater than 0.12 sec

d)

equal to 0.10 sec

63.

patient is in atrial fibrillation and begins to develop severe shortness of breath. suspect the patient may have

a)

infection

b)

CVA

c)

PE

d)

fever

64.

characteristic feature of Wolf-Parkinson-White (WPW) syndrome

a)

prolonged PR interval

b)

delta wave

c)

third degree AV block

d)

narrow QRS complex

65.

primary indication for dual-chamber pacemaker implantation

a)

atrial fibrillation

b)

complete heart block

c)

isolated sinus arrhythmia

d)

premature ventricular contraction

66.

first action that should be taken when PEA is identified

a)

administer ephinephrine

b)

begin chest compressions

c)

intubate the patient

d)

check blood glucose

67.

which heart block conditions most strongly indicates the need for permanent pacemaker placement

a)

first degree AV block

b)

second degree AV type 2

c)

a fib

d)

sinus tachycardia

68.

which of the following is not typically an indication for pacemaker placement

a)

first degree AV block

b)

symptomatic sinus bradycardia

c)

third degree AV block

d)

second degree AV block type 2

69.

in atrial flutter, a major point for consideration is if the patient can tolerate

a)

T-P wave

b)

configuration of the flutter waves

c)

QT interval

d)

the ventricular rate

70.

syncope, diaphoresis, shortness of breath, lightheadedness, and dizziness are all signs of

a)

brain damage

b)

hyperkalemia

c)

heart failure

d)

hypokalemia

71.

the main goal in treating atrial fibrillation would be to

a)

increase the patient's blood pressure

b)

increase the patient's fluid intake

c)

prepare for cardioversion

d)

slowing down the ventricular response with medication

72.

what is the main way to diagnose an atrioventricular block

a)

determine the number of the P waves to corresponding ectopic sites in the atria

b)

identify the deflection of the p wave

c)

determine the relationship of the p wave to the QRS complex

d)

recognizing the failure of the atria to depolarize

73.

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

a)

PR interval

b)

P wave

c)

QRS complex

d)

ST segment

74.

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

a)

first degree AV block

b)

second degree AV block type 1

c)

second degree AV block type 2

d)

third degree AV block

75.

second degree AV block type 2 is generally more serious than type 1 because

a)

cardiac output is diminished

b)

ventricular rate rises above 100 beats/minute

c)

peripheral vascular system shuts down almost as soon as the arrhythmia begins

d)

atrial rates rises above 100 beats/minute

76.

rhythm that will most likely not show any symptoms of low cardiac output would be

a)

paroxysmal junctional tachycardia

b)

premature junctional complexes (5 ectopic beats in a minute)

c)

accelerated junctional rhythm

d)

junctional escape rhythm

77.

ventricular pacemaker cells are found at the

a)

purkinje fibers

b)

AV node

c)

SA node

d)

right bundle branch

78.

which pacemaker rhythm has a pacing spike before the p wave

a)

atrial pacemaker rhythm

b)

ventricular pacemaker

c)

atrioventricular pacemaker

d)

wandering atrial pacemaker

79.

which pacemaker has a pacing spike before p waves and before QRS complexes

a)

atrial pacemaker rhythm

b)

ventricular pacemaker

c)

atrioventricular pacemaker

d)

wandering atrial pacemaker

80.

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

a)

sinus arrhythmia

b)

ventricular fibrillation

c)

asystole

d)

agonal

81.

standard duration of normal ekg

a)

PR segment 0.12 - 0.20 sec

b)

PR interval 0.12 - 0.20 sec

c)

PR segment 0.10 - 0.12 sec

d)

PR interval 0.10 - 0.12 sec

82.

sinus bradycardia is present, patient's heart rhythm is

a)

higher than 110 bpm and all measurements are abnormal

b)

less than 60 bpm and all other measurements are abnormal

c)

less than 60 bpm and all other measurements are normal

d)

higher than 110 bpm and all other measurements are normal

83.

approximate time for QRS complex

a)

0.08 - 0.14 sec

b)

0.06 - 0.12 sec

c)

0.12 - 0.20 sec

d)

0.04 - 0.08 sec

84.

calculating ventricular rate, a quick method would be to multiply 10 by

a)

number of P waves

b)

number of T waves

c)

number of R waves

d)

number of U waves

85.

patients that are experiencing sinus tachycardia typically have a heart rate that is

a)

regular and above 100 bpm

b)

irregular and below 60 bpm

c)

regular and 60 - 100 bpm

d)

irregular and above 100 bpm

86.

typical characteristic of a premature atrial contraction (PAC)

a)

premature, abnormal p wave or hidden in the preceding t wave with normal QRS complex

b)

p wave are the same shape and configuration

c)

atrial and ventricular rates are different

d)

t waves are inverted in lead ll

87.

rate of wandering atrial pacemaker

a)

60-100 bpm

b)

50-90 bpm

c)

101-150 bpm

d)

60-80 bpm

88.

accelerated junctional rhythm, QRS complex appears

a)

narrow

b)

wide

c)

absent

d)

normal

89.

6 squares in R-R interval, calculated heart rate is

a)

40 bpm

b)

50 bpm

c)

30 bpm

d)

60 bpm

90.

rate for accelerated junctional rhythm

a)

40-60 bpm

b)

60-100 bpm

c)

>100 bpm

d)

20-40 bpm

91.

4 large squares between 2 consecutive QRS complex, rate is

a)

75

b)

66

c)

150

d)

112

92.

rate for paroxysmal junctional tachycardia

a)

40-60 bpm

b)

60-100 bpm

c)

>100 bpm

d)

variable

93.

inherent rate of AV junction is

a)

20-60 bpm

b)

40-60 bpm

c)

60-100 bpm

d)

80-100 bpm

94.

rate for junctional escape rhythm or junctional rhythm is

a)

20-40 bpm

b)

60-100 bpm

c)

40-60 bpm

d)

80-100 bpm

95.

3 large boxes from R-R interval, heart rate is

a)

100 bpm

b)

50 bpm

c)

75 bpm

d)

200 bpm

96.

10 small squares between R-R wave, heart rate is

a)

136 bpm

b)

150 bpm

c)

148 bpm

d)

166 bpm

97.

20 small squares between R-R waves, heart rate is

a)

36 bpm

b)

50 bpm

c)

75 bpm

d)

150 bpm

98.

12 small squares between R-R waves, heart rate is

a)

125 bpm

b)

150 bpm

c)

148 bpm

d)

166 bpm

99.

17 small squares between R-R waves, heart rate is

a)

136 bpm

b)

150 bpm

c)

88 bpm

d)

66 bpm

100.

a patient is in multifocal atrial tachycardia, what would be the best response by the EKG tech

a)

instruct the patient to bear down to elicit the vasovagal effect

b)

notify the patient’s physician

c)

check the patient’s leads

d)

prep for cardioversion