Kaiser post test rhythms & heart blocks
When evaluating a patient with sinus arrest, count the number of boxes between the P waves, and multiply that number by 0.01 0.02 0.04 0.05
0.04
A patient is identified as having an uncontrolled ventricular rate when atrial flutter is accompanied by a ventricular rate of greater than _____. 60 beats per minute 100 beats per minute 150 beats per minute 250 beats per minute
100 beats per minute
All junctional rhythms originate from which pacemaker site? AV node AV junction Bundle branches SA node
AV junction
From what pacemaker site do junctional rhythms originate? AV node AV junction SA node Bundle branches
AV junction
What is the heart's secondary pacemaker? AV junction Bundle of His Purkinje fibers SA node
AV junction
A dysrhythmia is defined as a(n) Abnormal cardiac rhythm Abnormal electrical rhythm Cardiac recovery phase Cardiac ready state
Abnormal cardiac rhythm
The phrase "Hs and Ts" is a reminder to look for the underlying causes of which of the following rhythm? (Select all that apply.) Asystole Bigeminal premature ventricular complexes (PVC) Idioventricular rhythm (IVR) Pulseless electrical activity (PEA)
Asystole Bigeminal premature ventricular complexes (PVC) Idioventricular rhythm (IVR) Pulseless electrical activity (PEA)
Which of the following lethal rhythms is associated with the poorest prognosis? (Select all that apply.) Asystole Pulseless electrical activity (PEA) Pulseless ventricular tachycardia (PVT) Ventricular fibrillation (Vfib)
Asystole Pulseless electrical activity (PEA)
An antiarrhythmic drug should not be administered with which of the following rhythms? (Select all that apply) Asystole or PEA Idioventricular rhythm (IVR) Pulseless ventricular tachycardia Ventricular fibrillation
Asystole or PEA Idioventricular rhythm (IVR)
Which of the following is an accurate statement about sinus bradycardia? Atrial and ventricular rhythm is irregular Atrial and ventricular rate is 40-60 beats per minute The duration of the QRS is greater than 1.10 seconds Ventricular rate is 60-100 beats per minute
Atrial and ventricular rate is 40-60 beats per minute
Which three (3) are examples of supraventricular tachycardia (SVT)? Accelerated junctional Atrial fibrillation Atrial flutter Junctional tachycardia
Atrial fibrillation Atrial flutter Junctional tachycardia
_____, _____, and _____ are examples of supraventricular tachycardia (SVT)? Accelerated junctional Atrial fibrillation Atrial flutter Junctional tachycardia
Atrial fibrillation Atrial flutter Junctional tachycardia
Caffeine, alcohol, and fatigue can be likely causes for (Select all that apply.) Atrial flutter Sinus pause Atrial fibrillation Ventricular tachycardia
Atrial flutter Atrial fibrillation Ventricular tachycardia
What is the name of the rhythm with an atrial rate greater than 250 beats per minute, a non-measurable PR interval, and a ventricular rate of 120? Atrial fibrillation with controlled ventricular rate Atrial fibrillation with uncontrolled ventricular rate Atrial flutter with uncontrolled ventricular rate Atrial flutter with controlled ventricular rate
Atrial flutter with uncontrolled ventricular rate
Any ectopy should be cause for concern in healthy people. True False
False
Which of the following ECG strip descriptions would indicate the most significant blockage? Normal atrial/ventricular rates; constant, prolonged PRI; no dropped QRS complexes Variable PRI with dropped QRS; atrial rate greater than ventricular rate No PRI; more Ps than QRSs; ventricular rate of 20-40 bpm; QRS > 0.10 seconds Constant PRI and wide QRS, with more P waves than QRS complexes
No PRI; more Ps than QRSs; ventricular rate of 20-40 bpm; QRS > 0.10 seconds
You would not see a _____ on an ECG strip with supraventricular tachycardia. Normal PR Interval QRS between 0.04-0.10 seconds Regular rhythm Ventricular rate > 150 beats per minute
Normal PR Interval
Which heart block is considered normal in some individuals? Normal sinus rhythm (NSR) with bundle branch block 2nd degree block Type I Normal sinus rhythm (NSR) with 1st degree block 2nd degree block Type II
Normal sinus rhythm (NSR) with 1st degree block
Why is the R-on-T premature ventricular complex (PVC) of major concern? The ventricles are depolarizing early during the repolarization phase The ventricles are repolarizing The atria are being stimulated during the repolarizing phase The ventricles are being stimulated during the relative refractory period
The ventricles are being stimulated during the relative refractory period
What is the initial treatment for 3rd degree heart block? Amiodarone Digoxin Synchronized cardioversion Transcutaneous pacer
Transcutaneous pacer
When atropine is ineffective for symptomatic sinus bradycardia your next intervention would be what? Adenosine Procainamide Transcutaneous pacing Synchronized cardioversion
Transcutaneous pacing
When atropine is ineffective for symptomatic sinus bradycardia, what would be your next intervention? Adenosine Procainamide Transcutaneous pacing Synchronized cardioversion
Transcutaneous pacing
The initial step in treating stable sinus tachycardia is Administer adenosine Synchronized cardioversion Treat the underlying cause Vagal maneuvers
Treat the underlying cause
What is the initial step in treating stable sinus tachycardia? Administer adenosine Synchronized cardioversion Treat the underlying cause Vagal maneuvers
Treat the underlying cause
A sustained ventricular tachycardia lasts longer than 30 seconds. True False
True
Atrial fibrillation can be a chronic condition and well tolerated. True False
True
Dysrhythmias do not follow the normal path of conduction and can be caused by drugs, electrolyte disturbances, or medical procedures. True False
True
Heart blocks occur when there is a partial or complete interruption in the cardiac conduction system. True False
True
The purpose of cardioversion is to shock the heart and get it back to a stable rhythm. True False
True
A patient whose ECG shows a rapid, chaotic rhythm and no discernible P waves or QRS complexes is probably in what dysrhythmia? Junctional rhythm Idioventricular rhythm Ventricular fibrillation Ventricular tachycardia
Ventricular fibrillation
Sinus tachycardia is defined as a sinus rhythm at a rate of _____. 40-65 beats per minute 60-100 beats per minute 80-100 beats per minute 100-150 beats per minute
100-150 beats per minute
What rhythm is delayed in the AV node causing a prolonged PR interval? 2nd degree heart block type I 1st degree heart block Junctional rhythm Sinus arrhythmia
1st degree heart block
Atrial flutter is caused by rapidly firing circuits in the atria that are depolarizing at a rate greater than _____. 100 beats per minute 150 beats per minute 200 beats per minute 250 beats per minute
250 beats per minute
An ECG strip that shows a regular atrial rhythm, an atrial rate greater than the ventricular rate (some QRS complexes are dropped), and a constant PR interval when the atrial and ventricular complexes appear together would most likely be identifited as what rhythm? 2nd degree block Type II Sinus rhythm with bundle branch block 2nd degree block Type I Sinus rhythm with 1st degree AVB
2nd degree block Type II
An ECG strip that showed a regular rhythm, an atrial rate greater than the ventricular rate, a constant PRI and two P waves for each QRS complex, and the a QRS is 0.04-0.10 seconds; what rhythm would be identified? 2nd degree block type I Sinus rhythm with bundle branch block 2nd degree block type II Sinus rhythm with 1st degree AVB
2nd degree block type II
The P wave is never hidden in which one of the following rhythms? 2nd degree heart block type II 3rd degree heart block Junctional Supraventricular tachycardia (SVT)
2nd degree heart block type II
What rhythm is characterized by a conduction block between the atria and ventricles resulting in some nonconducted P waves (QRS complex drops) but fixed PR intervals when the P wave and QRS complex appear together? Bundle branch block (BBB) 2nd degree heart block type II 3rd degree heart block at bundle branch block level Idioventricular rhythm (IVR)
2nd degree heart block type II
What period of time defines a sustained ventricular tachycardia? 2 seconds 30 seconds 120 seconds 300 minutes
30 seconds
When applying electrodes to a patient, to view MCL1, where is the chest lead placed? 4th intercostal space to the left of the sternum On the left just below the patient's rib cage 4th intercostal space to the right of the sternum 2nd intercostal space at the angle of Louis
4th intercostal space to the right of the sternum
A normal sinus rhythm has a rate of _____. 35-50 beats per minute 40-60 beats per minute 50-80 beats per minute 60-100 beats per minute
60-100 beats per minute
To be identified as accelerated junctional rhythm, the ventricular rate must reach _____. 60-100 beats per minute 100-150 beats per minute 150-200 beats per minute 200-250 beats per minute
60-100 beats per minute
After reperfusion therapy it is not unusual to see which rhythm? Accelerated idioventricular rhythm (IVR) Junctional rhythm Sinus bradycardia Supraventricular tachycardia (SVT)
Accelerated idioventricular rhythm (IVR)
A patient with 3 or more consecutive ventricular escape beats at a rate of 40-100 beats per minute has which of the following rhythms? Accelerated idoventricular rhythm (IVR) Idioventricular rhythm Junctional rhythm Sinus rhythm
Accelerated idoventricular rhythm (IVR)
Which of the following is NOT an example of a narrow complex supraventricular tachycardia? Accelerated junctional rhythm Atrial fibrillation AV nodal re-entry tachycardia Atrial flutter
Accelerated junctional rhythm
If the patient with supraventricular tachycardia is stable, vagal maneuvers may be used to stimulate the vagus nerve which releases _____. Acetylcholine Blood albumin Dopamine Oxygen
Acetylcholine
Which medication is first-line to treat asymptomatic supraventricular tachycardia (SVT)? Amiodarone Adenosine Digoxin Procainamide
Adenosine
Which medication therapy is first-line treatment for stable supraventricular tachycardia (SVT)? Amiodarone Adenosine Procainamide Digoxin
Adenosine
What is the appropriate treatment for a stable patient with atrial fibrillation and a controlled ventricular response? Administer anticoagulants and antiarrhythmics Administer atropine and amiodarone Administer beta blockers and epinephrine Administer digoxin and vasopressin
Administer anticoagulants and antiarrhythmics
Which antiarrhythmic is given for pulseless ventricular tachycardia (VT) and ventricular fibrillation (Vfib) that is unresponsive to CPR, defibrillation, and a vasopressor? Adenosine Amiodarone Epinephrine Procainamide
Amiodarone
A premature beat that originates in the atria in an area other than the Sinus Node followed by a normal ventricular response is sometimes referred to as? An aberrantly conducted premature atrial complex (PAC) A non-conducted premature atrial complex (PAC) A premature junctional complex (PJC) A premature ventricular complex (PVC)
An aberrantly conducted premature atrial complex (PAC)
Which is the appropriate sequence when initiating CPR? Assess the patient; check for pulse; activate EMS Assess the patient; give 2 breaths; check for pulse Assess the patient; activate EMS; check for pulse Assess the patient; do 2 minutes of CPR; activate EMS
Assess the patient; activate EMS; check for pulse
Which is the correct intervention sequence for asystole? Assess the patient; initiate CPR; defibrillate ASAP Assess the patient; confirm rhythm in another lead; initiate CPR Assess the patient; confirm rhythm in another lead; synchronize cardiovert Confirm rhythm in another lead; assess the patient; initiate CPR
Assess the patient; confirm rhythm in another lead; initiate CPR
Which is the correct intervention sequence for ventricular fibrillation? Assess the patient; initiate CPR; administer epinephrine Assess the patient; initiate CPR; defibrillate ASAP Assess the patient; defibrillate; intubate Assess the patient; synchronize cardioversion; CPR
Assess the patient; initiate CPR; defibrillate ASAP
Which rhythm is demonstrated if the heart has lost all electrical activity? Asystole Idioventricular Pulseless electrical activity (PEA) Ventricular fibrillation
Asystole
Which of the following drugs should be administered quickly to effectively treat sinus bradycardia? Amiodarone Atropine Dopamine Epinephrine
Atropine
What property is the ability of a cardiac cell to initiate an electrical impulse? Automaticity Excitability Conductivity Contractility
Automaticity
Which of the following conditions may cause sinus tachycardia? Dehydration Heart block Hypothermia Hypothyroidism
Dehydration
Which of the following drugs may cause sinus bradycardia? Atropine Digoxin Dopamine Ephinephrine
Digoxin
Which of the following drugs slow or inhibit AV node conduction? Epinephrine, digoxin, dopamine Digoxin, adenosine, verapamil Epinephrine, verapamil, atropine Atropine, dopamine, adenosine
Digoxin, adenosine, verapamil
What is the key identifier for a premature atrial complex (PAC)? Early P wave Early QRS interval Early ST segment Early T wave
Early P wave
On the patient's rhythm strip, you note there are pacemaker spikes that are not followed by a P wave or a QRS. What type of pacemaker malfunction is this called? Failure to sense Failure to capture Oversensing 60 cycle interference
Failure to capture
In 3rd degree heart block, the QRS is always 0.12 or greater. True False
False
Premature ventricular complexes that occur 2 in a row are referred to as bigeminal. True False
False
When deciding if or how to intervene when a patient is experiencing sinus bradycardia, it is critical to focus primarily on readings from the ECG monitor. True False
False
Which of the following conditions/situations may cause bradycardia? Anxiety Hypoxia Hyperthermia Hyperthyroidism
Hypoxia
When a patient experiences three or more consecutive ventricular escape beats at 20 to 40 beats per minute, the patient is experiencing which of the following rhythms? Idioventricular rhythm Sinus rhythm Ventricular fibrillation Ventricular tachycardia
Idioventricular rhythm
What are premature ventricular complexes (PVCs) that arise from several irritable sites called? Unifocal premature ventricular complexes Multifocal premature ventricular complexes Premature ventricular complex couplet Trigeminal premature ventricular complexes
Multifocal premature ventricular complexes
Which of the following is a possible cause for ventricular fibrillation (V-fib)? Anxiety Hypothermia Hyperthyroidism Myocardial ischemia
Myocardial ischemia
A way to determine if you are looking at a junctional or atrial arrhythmia is to look at the ECG characteristics of the _____. Heart rate PR interval P wave QRS complex
PR interval
In sinus arrhythmia, which of the following intervals remains regular? P-to-P interval R-to-R interval PR interval QRS complex
PR interval
Which is a key to differentiating 2nd degree block type I from type II? PR intervals P waves Rate Rhythm
PR intervals
The sudden onset or cessation of a dysrhythmia is called? Atrial flutter Multiformed atrial rhythm Paroxysmal Wolff-Parkinson-White Syndrome
Paroxysmal
What is the most common type of rhythm in supraventricular tachycardia (SVT)? Atrial fibrillation Atrial tachycardia Junctional tachycardia Paroxysmal supraventricular tachycardia
Paroxysmal supraventricular tachycardia
What is a single ectopic beat that occurs as the result of an irritable focus in the atria called? Premature atrial complex (PAC) Premature junctional complex (PJC) Premature ventricular complex (PVC) Ventricular fibrillation (VF)
Premature atrial complex (PAC)
What is the initial treatment response for a patient in either pulseless ventricular tachycardia or ventricular fibrillation? Provide quality CPR and defibrillate Monitor the rhythm in another lead Administer adenosine with rapid IV or IO Call the physician for expert consultation
Provide quality CPR and defibrillate
The ECG monitor displays a normal-appearing rhythm but when you assess the patient they are unresponsive and pulseless. What rhythm would this be? Asystole Idioventricular Pulseless electrical activity (PEA) Ventricular fibrillation
Pulseless electrical activity (PEA)
What does the information found in the last 0.04 seconds from the J point back into the QRS complex differentiate? Degree of heart block Origin of heart block Right bundle branch block from left bundle branch block Root cause of bundle branch block
Right bundle branch block from left bundle branch block
What is the heart's electrical activity dominated by? AV junction Bundle of His Purkinje fibers SA node
SA node
Select the possible treatment option(s) for a stable, symptomatic patient with junctional tachycardia. (Select all that apply.) Administer adenosine Administer digitalis Administer oxygen Obtain IV access
Select the possible treatment option(s) for a stable, symptomatic patient with junctional tachycardia. (Select all that apply.) Administer adenosine Administer digitalis Administer oxygen Obtain IV access
What rhythm is initiated by the SA node and transmitted through the atria, AV junction, bundle branches, and Purkinje fibers? Atrial Junctional Sinus Ventricular
Sinus
The term for a sinus rhythm with a rate less than 60 beats per minute is Atrial Sinus Bradycardia Dysrhythmia Tachycardia
Sinus Bradycardia
What rhythm shows a normal rate, normal QRS and PRI durations, and an absent beat or beats? Ectopic beat Junctional Sinus pause Sinus arrhythmia
Sinus pause
An ECG strip that showed a regular atrial and ventricular rate, normal QRS and normal P waves with a PR interval greater than 0.20 seconds would be identified as a _____. 2nd degree block Type II Sinus rhythm with bundle branch block 2nd degree block Type I Sinus rhythm with 1st degree block
Sinus rhythm with 1st degree block
When you have a regular atrial and ventricular rhythm with a normal QRS and PRI, and the atrial and ventricular rate is between 100-150 bpm, this rhythm would be identified as a Normal sinus rhythm Sinus arrhythmia Sinus bradycardia Sinus tachycardia
Sinus tachycardia
Which of the following statements is incorrect about premature atrial complexes (PACs)? A PAC is not a rhythm; it is a beat. The PAC needs to be counted in the underlying rhythm. PACs are not uncommon. Infrequent occurrence of PACs may not require treatment intervention.
The PAC needs to be counted in the underlying rhythm.
Which of the following statements is inaccurate about idioventricular rhythms? Occurs when the supraventricular pacemaker fails to fire an impulse The rate of this rhythm is not adequate to sustain life The PR interval in this rhythm is within normal range This rhythm generates wide, bizarre QRS complexes
The PR interval in this rhythm is within normal range
A sinus pause occurs with which of the following? The SA node fails to discharge an impulse The impulse is delivered by a secondary pacemaker The cardiac rhythm decreases below 60 beats per minute Cardiac arrest occurs
The SA node fails to discharge an impulse
What is the one ECG characteristic where sinus arrhythmia differs from normal sinus rhythm? The atrial and ventricular rate The distance between the Ps and Rs The duration of the PR interval The duration of the QRS complex
The distance between the Ps and Rs
Ventricular fibrillation is generally present with cardiac arrest and is most often brought on by myocardial ischemia. True False
True
Ventricular tachycardia is a potentially life-threatening rhythm. True False
True
What wave might not be visible if the patient presents with sinus tachycardia (ST)? P wave QRS complex T wave U wave
U wave
Ventricular rhythms have a QRS of 0.10 or greater due to which of the following? Atypical ventricular repolarization Ventricles are stimulated asynchronously Ventricles depolarize early Ventricular irritability
Ventricles are stimulated asynchronously
Three or more consecutive premature ventricular complexes (PVC) at a rate greater than 100 is called: Accelerated idioventricular rhythm (IVR) Idioventricular Supraventricular tachycardia (SVT) Ventricular tachycardia (VT)
Ventricular tachycardia (VT)
Each of the following medications is used for ventricular dysrhythmias EXCEPT Lidocaine Amiodarone Verapamil Procainamide
Verapamil
The criteria for identifying a rhythm problem as being a supraventricular tachycardia (SVT) include which of the following? QRS complex within normal limits PRI within normal limits; wide QRS Very rapid ventricular rate; wide QRS Very rapid ventricular rate; QRS complex within normal limits
Very rapid ventricular rate; QRS complex within normal limits
