EKG (6-14)

Sinus tachycardia's heart rate is A) 60—100. B) greater than 100. C) less than 60. D) greater than 170.

b

The difference between wandering atrial pacemaker and multifocal atrial tachycardia is A) wandering atrial pacemaker has a faster heart rate. B) multifocal atrial tachycardia has a faster heart rate. C) wandering atrial pacemaker has uniform shape P waves; multifocal atrial tachycardia has P waves of at least three different shapes. D) wandering atrial pacemaker has only two different shape P waves; multifocal atrial tachycardia has at least five different shaped P waves.

b

A heart rate greater than 100 is said to be a A) tachycardia. B) bradycardia. C) myocardium. D) bundle branch block.

a

Frequent PACs can be a sign of impending A) heart failure. B) sinus arrest. C) respiratory failure. D) cardiac arrest.

a

A rhythm originating in the sinus node should NOT have which of the following? A) Narrow QRS complexes of uniform shape B) Regularly spaced QRS complexes C) Absent QRS complexes D) Heart rate of 60—100

c

In which rhythm is an escape beat sometimes seen? A) Sinus rhythm B) Sinus bradycardia C) Sinus arrhythmia D) Sinus arrest

d

Possible causes of sinus tachycardia include which of the following? A) Fever B) Anxiety C) Congestive heart failure D) All of the above

d

In sinus rhythm, the heart rate is A) 60—100. B) greater than 100. C) less than 60. D) greater than 170.

a

A PAC often deforms the shape of the A) QRS. B) preceding T wave. C) preceding U wave. D) following T wave.

b

Arrhythmias are A) normal heart rhythms. B) abnormal heart rhythms. C) rhythms originating in the sinus node. D) rhythms that cause no symptoms.

b

QRS interval in Figure 4 is closest to A) 0.42 seconds. B) 0.10 seconds. C) 0.28 seconds. D) 0.30 seconds.

b

Thyrotoxicosis is a condition associated with which rhythm? A) Sinus block B) Sinus arrest C) Sinus tachycardia D) Sinus bradycardia

c

Which of the following sinus rhythms would be expected with stimulation of the sympathetic nervous system? A) Sinus rhythm rate 68 B) Sinus bradycardia rate 45 C) Sinus arrhythmia rate 45—73 D) Sinus tachycardia rate 125

d

Wandering atrial pacemaker is a medical emergency.

false

An abnormal rhythm is called an arrhythmia.

true

An artificial pacemaker can be used to treat sinus bradycardia.

true

An ectopic rhythm is one which originates in a location other than the sinus node.

true

The heart rate during sinus rhythm is 60—100.

true

All sinus rhythms have A) upright, matching P waves. B) wide, bizarre QRS complexes. C) multiple P waves of varying configurations. D) heart rates between 40 and 100.

a

Atrial fibrillation can cause a drop in cardiac output because it causes A) a loss of the atrial kick. B) the ventricles to contract more forcefully. C) the AV valves to remain open too long. D) the sinus node to fire more often.

a

Atrial flutter is characterized by what kind of atrial waves? A) Zigzag or sawtooth-shaped waves between the QRS complexes B) P waves of uniform shape C) No atrial waves at all D) Tall, pointy P waves following the QRS complexes

a

Atrial tachycardia is characterized by A) abnormal P waves preceding the regular QRS complexes. B) sawtooth waves between the QRS complexes. C) undulating, fibrillatory baseline between the irregular QRS complexes. D) a heart rate of 250—350.

a

Atropine's mode of action is to A) speed up the rate of sinus node firing and speed conduction through the AV node. B) speed impulse conduction through the bundle branches and AV node. C) slow the rate of conduction through the AV node and slow sinus node firing. D) speed sinus node firing and slow AV node conduction.

a

If the patient's rhythm changes, you should FIRST A) assess your patient for signs of decreased cardiac output. B) calculate the heart rate, rhythm, and intervals. C) change the lead to see if the rhythm is real or if it's artifact. D) look for P waves.

a

In sinus block A) the pause is a multiple of the R-R intervals. B) there are P waves inside the pause. C) all R-R intervals are constant. D) the heart rate varies from 100 to 160.

a

PR interval in Figure 4 is closest to A) 0.12 seconds. B) 0.28 seconds. C) 0.04 seconds. D) 0.40 seconds.

a

Paroxysmal means A) starting and stopping suddenly. B) life-threatening. C) premature. D) prolonged

a

Sinus rhythms all have A) uniform shape P waves preceding the QRS complexes. B) multiple shapes of P waves preceding the QRS complexes. C) a wavy baseline without P waves or QRS complexes. D) inverted P waves in Lead II.

a

The most common cause of an unexplained pause is a(n) A) nonconducted PAC. B) sinus arrest. C) sinus block. D) atrial tachycardia.

a

The normal rhythm of the heart has P waves that are A) upright, matching, and precede the QRS complex. B) variable in shape and location. C) often hidden inside QRS complexes. D) multiple in number, preceding the QRS complex.

a

The rhythm in Figure 4 is A) sinus rhythm. B) sinus bradycardia. C) sinus rhythm with sinus arrest. D) sinus tachycardia.

a

Which of the following is an irregular rhythm originating in the sinus node? A) Sinus arrhythmia B) Sinus rhythm C) Sinus tachycardia D) Sinus bradycardia

a

Which of these statements about how sinus arrhythmia differs from wandering atrial pacemaker is TRUE? A) Sinus arrhythmia has uniform P wave shapes; wandering atrial pacemaker has at least three different shaped P waves. B) Sinus arrhythmia has a regular rhythm; wandering atrial pacemaker is irregular. C) Sinus arrhythmia has a heart rate of less than 100; wandering atrial pacemaker has a rate greater than 100. D) Sinus arrhythmia is lethal; wandering atrial pacemaker is benign.

a

Which statement is TRUE regarding P waves in atrial flutter? A) There are no P waves; flutter waves are present instead. B) The P waves are all tall and pointy. C) P waves change shape constantly. D) P waves have an atrial rate of about 100.

a

A heart rate less than 60 is said to be a A) tachycardia. B) bradycardia. C) tachyarrhythmia. D) bundle branch block.

b

A regular rhythm with narrow QRS complexes, indistinguishable P waves, and a heart rate of 155 would be consistent with A) atrial fibrillation. B) supraventricular tachycardia. C) sinus bradycardia. D) ventricular tachycardia.

b

Atrial fibrillation is A) regular. B) irregular. C) regular but interrupted by premature beats. D) regular but interrupted by pauses.

b

Atropine is a medication that would be appropriate for symptomatic A) sinus tachycardia. B) sinus bradycardia. C) sinus rhythm. D) none of the above.

b

In sinus arrhythmia, the heart rateA) speeds up during inspiration and expiration.B) speeds up during inspiration, slows during expiration.C) slows during inspiration and expiration.D) slows during inspiration, speeds up during expiration.

b

Junctional rhythms originate in the A) sinoatrial junction. B) atrioventricular junction. C) sinoventricular junction. D) sinus node junction.

b

Normal QRS intervals should be A) less than 0.20 seconds wide. B) less than 0.12 seconds wide. C) between 0.12 and 0.20 seconds wide. D) alternately narrow and wide.

b

Sinus arrhythmia has a pattern that often corresponds with the A) PR intervals. B) breathing pattern. C) P-P intervals. D) patient's age.

b

Sinus arrhythmia is A) a regular rhythm. B) an irregular rhythm. C) a rhythm that originates in the atria. D) a rhythm that originates in the AV junction.

b

The T wave in Figure 4 is A) inverted. B) upright. C) indicative of sinus control of the ventricles. D) indicative of ventricular depolarization.

b

Which is TRUE about sinus arrest and sinus exit block?A) Sinus exit block is an irregular rhythm; sinus arrest is regular. B) Sinus arrest always ends in an escape beat; sinus exit block doesn't. C) Sinus arrest and sinus exit block can both result in decreased cardiac output. D) The pause in both sinus exit block and sinus arrest is a multiple of the R-R intervals.

b

Which of the following has a heart rate less than 60? A) Sinus rhythm B) Sinus bradycardia C) Sinus tachycardia D) Atrial tachycardia

b

A PAC is a A) premature beat from the sinus node. B) late beat from the atria. C) premature beat from the ventricle. D) premature beat from the atrium.

d

A pause that occurs when the sinus node's impulse is not conducted out of the sinus node itself is A) sinus arrest. B) sinus arrhythmia. C) sinus bradycardia. D) sinus block.

d

Atrial flutter has an atrial rate A) between 60 and 100. B) greater than 100. C) between 40 and 60. D) between 250 and 350.

d

Blood clots collecting in the atria are a possible complication of what rhythm? A) Atrial tachycardia B) PACs C) Sinus tachycardia D) Atrial fibrillation

d

SVT stands for A) sinus ventricular tachycardia. B) supraventricular tension. C) sinus valvular tachycardia. D) supraventricular tachycardia.

d

The normal rhythm originating in the sinus node should have a heart rate that is A) greater than 100. B) less than 60. C) between 40 and 60. D) between 60 and 100.

d

The rhythm most often associated with chronic obstructive pulmonary disease is A) atrial fibrillation. B) SVT. C) sinus arrhythmia. D) multifocal atrial tachycardia.

d

Treatment of atrial fibrillation could include such medications as A) digitalis. B) calcium channel blockers. C) amiodarone. D) all the above.

d

In atrial fibrillation of less than 48 hours duration, anticoagulant therapy is indicated before attempting to convert the rhythm back to sinus rhythm.

false

Multiple P waves preceding the QRS complexes are typical of sinus rhythm.

false

PACs are premature beats from the sinus node.

false

Patients with a heart rate of 45 always show symptoms of decreased cardiac output.

false

Sinus arrest is best treated by anti-anxiety medication.

false

Sinus rhythm is an irregular rhythm interrupted by premature beats and pauses.

false

The heart rate during sinus bradycardia is greater than 100.

false

The heart rate during sinus tachycardia is less than 60.

false

The sinus rhythm has a heart rate of 60—80.

false

A rhythm with a heart rate greater than 100 is a tachycardia.

true

All sinus rhythms have a P-QRS-T configuration.

true

Atrial fibrillation is an ectopic rhythm.

true

Diaphoresis is a cold sweat.

true

Flutter waves are often described as sawtooth- or picket-fence-shaped waves.

true

High fever can cause sinus tachycardia.

true

In SVT, the QRS complexes are regular.

true

In atrial flutter, the flutter waves are regular.

true

Multifocal atrial tachycardia is an irregular rhythm with a heart rate greater than 100.

true

Nonconducted PACs do not conduct through to the ventricles.

true

Oxygen can help return an abnormal heart rhythm to normal.

true

Sinus arrest can occur at any heart rate.

true

Sinus block can occur at any heart rate.

true

Sinus bradycardia is common among well-conditioned athletes

true

Sinus rhythms should have narrow QRS complexes of uniform shape.

true

Some signs of decreased cardiac output are pallor, hypotension, and dizziness.

true

Atrial fibrillation is routinely a reason to begin CPR.

false

Atrial tachycardia is always accompanied by symptoms of decreased cardiac output.

false

Atropine is the drug of choice to treat sinus tachycardia.

false

Atropine speeds conduction through the bundle branches.

false

Blood clots in the atria are associated with multifocal atrial tachycardia.

false

Both atrial fibrillation and multifocal atrial tachycardia have at least three different shapes of P waves.

false

High fever is a common cause of sinus arrest.

false

In SVT, the heart rate must be greater than 180.

false

The most crucial criterion to identifying sinus rhythms is the upright matching P waves in Lead II.

true

The only difference in interpretation criteria between sinus rhythm, sinus bradycardia, and sinus tachycardia is the heart rate.

true

Atrial fibrillation causes the atria to A) contract forcefully. B) expel the blood backwards. C) wiggle instead of contract. D) depolarize as a unit.

c

Atrial fibrillation has A) P waves of multiple shapes. B) P waves with uniform shape. C) no P waves at all. D) sawtooth-shaped waves between the QRS complexes.

c

Atrial flutter is almost always seen in patients with A) thyrotoxicosis. B) acute heart attacks. C) heart disease. D) cardiac arrest.

c

Atrial flutter is characterized by A) P waves of varying shapes and regularly spaced QRS complexes. B) irregularly irregular pattern of QRS complexes. C) regularly spaced V-shaped waves. D) a run of six or more PACs in a row.

c

Sinus bradycardia's heart rate is A) 60—100. B) greater than 100. C) less than 60. D) greater than 170.

c

The sinus rhythm that has a heart rate greater than 100 is A) sinus rhythm. B) sinus bradycardia. C) sinus tachycardia. D) sinus arrhythmia.

c

Treatment for sinus tachycardia associated with a high fever would be to A) give atropine. B) start CPR. C) give acetaminophen or ibuprofen to get the temperature down. D) give beta-blockers.

c

Wandering atrial pacemaker has at least three different shapes of A) T waves. B) QRS complexes. C) P waves. D) U waves.

c

Which of the following is TRUE about sinus rhythm? A) It is regular. B) It has an irregularly irregular pattern of QRS complexes. C) It has multiple shapes of P waves. D) It has wide QRS complexes without preceding P waves.

c

A pacemaker is usually needed to treat sinus bradycardia.

false

A rhythm with a heart rate less than 60 is a tachycardia.

false