Which of the following chest leads are placed on the chest using specific anatomical landmarks?
V1, V2, V4, V5, V6
Which of the following can cause extreme right axis deviation?
Dextrocardia
Which of the following is a characteristic of P-P intervals in all heart block dysrhythmias?
Regular
What is recorded on the ECG strip?
The electrical activity of the heart
To locate the intercostal space (ICS), the ECG technician feels for the bony part of the rib cage for…..
False
In a RBBB, the QRS is:
Positively deflected
Electrical safety is maintained while performing an ECG by all of the following EXCEPT
Removing the plug from the electrical outlet by pulling it out by the prong connection
Which of the following is NOT implied consent?
Pt signing a consent form for a treadmill stress test
Atrial fibrillation shows chaotic disorganized activity between QRS complexes
True
About how many inches of complexes should you run for leads I, II and III?
About 8 to 10 inches
The LCD display is an area on the 12 lead ECG machine where the following information is available to view
All of the above
Which layer is prone to disruption when atherosclerotic plaque is ruptured and peels away?
Tunica intima
The echocardiogram uses sound waves to create an image of the walls and chambers of the heart and is.. valves
False
When the pacemaker delivers ventricular pacing, the pacing spike will be followed by a wide QRS complex, which looks similar …
LBBB
The indicators of myocardial ischemia are
ST segment depression, T wave inversion
Which one of the following is NOT a reason to use an ambulatory monitor?
To evaluate oxygen utilization by the myocardium
What device enables lay rescuers to help a pt with sudden cardiac arrest?
Automatic external defibrillator (AED)
The first electrocardiograph was invented by
Wilhelm Einthoven
A BBB must be considered when the QRS complex measures:
0.12 seconds or greater
What is the heart’s response to stimulation of the Vagus nerve?
Slows down
Fast, irregular heartbeat sensations felt by the pt, which may or may not be associated with complaints of chest pain
Palpitations?
What should you do if you recognize ventricular tachycardia on the ECG monitor?
All of the above
What factor on a pacemaker tracing is similar to the measurement of the PR interval on a nl rhythm tracing
Atrioventricular delay
The function of the heart is to pump blood to and from all the tissues of the body
True
One of the primary branches of the R main coronary artery providing blood to the posterior wall of the heart is the
Posterior descending artery
Occlusion of the circumflex artery leads to cardiogenic shock and sudden death and is often referred to as the “widow maker”
False
The V5 lead is placed midway between V4 and V6 on the L anterior axillary line
True
____ Causes the inverted P wave morphology found with junctional rhythms?
Electrical impulses are coming from the AV node instead of the SA node, causing depolarization of the atria to f….
What is the origination point of a supraventricular tachycardia?
Above the ventricles
If the pt’s normal heart rate is 60 and it now 140, the pt probably will not experience any sx’s of just…
False
What measurement on the ECG tracing represents how long it takes for the current to travel through the ventricular myocardium
QRS duration
What medical conditions place pressure on the atria, causing atrial dysrhythmias to occur?
Myocardial infarction, valvular problems, neurological influences.
The QRS measurement in all junctional dysrhythmias is within normal limits, between 0.06 and 0.10 seconds.
True
Following an exercise stress test, the pt will have a cooling off period. How long will this last and what should you do
10-15
Pts may experience chest pain due to what condition that is not cardiac in origin?
All of the above: Gallbladder pain, inflammation of the lungs, and gastric or esophageal irritation
How many people in the United States suffer form angina
10 million
An impulse that occurs too soon after the preceding impulse, causing a period when no other impulses can occur in the …
Blocked or non-conducted impulse
The two most common types of ambulatory monitoring are:
Continuous and intermittent
PVC’s that occur during the normal R-R internal without interrupting the normal cycle are known as:
Interpolated
What is the most common;y used stress test protocol?
Bruce protocol
Which heart block dysrhythmia has regular P-P and R-R intervals that both occur at the same rate?
First degree heart block
Which leads view the septal wall?
V1 and V2
Junctional rhythms are suggestive of more serious conditions with the electrical conduction system in the heart
True
Telemetry monitoring is the transmission of an electrical signal to a monitoring station, similar to a transmitter radio
True
Which landmark is an imaginary line on the chest that runs vertically through the enter of the clavicle?
Midclavicular line
Which atrial dysrhythmia has a clearly changing P wave and a heart rate of 101 to 150 bpm
Multifocal atrial tachycardia (MAT)
When the pt has a LBBB, the L conduction pathway is blocked. The current travels down the L then R ventricle to contract
False
What would you tell a pt who asked you how long a thallium stress test would last?
4-5 hours
An ectopic focus originating above the ventricles in the atria or junctional region of the heart is:
Supraventricular
Which type of ambulatory monitoring is performed in a hospital
Telemetry
The usual setting for the artifact filter is
40 Hz
Every atrial spike should have a P wave after it to indicate that the electrical current is causing the cells to depolarize
True
In sinus dysrhythmia, if the heart rate decreases to 40 to 50 bpm, the pt may complain of
Palpitations, dizziness
What sx’s would you observe in a pt with first degree AV block
The pt should have a nl cardiac output and no sx’s
Which so the following is not considered a bipolar lead?
AVR
When is an atrial pacemaker used alone?
When the conduction system from the AV node through the ventricles is intact and functioning
Which heart block dysrhythmia has a PR interval that gets progressively longer until the QRS is dropped, and after…
Second degree AV block, type I
Which of the following sx’s are signs of unstable angina
All of these: chest pain is more frequent or severe, chest pain occurs with less exertion or lasts longer than usual, chest pain does not respond to medications as it did before
The abnormal thickening of the ventricular wall due to chronic pressure overload that is often caused by hypertension is known as
Hypertrophy
A strong bleach solution and stiff bristle brush to clean the equipment case, cover and control panel of the ECG machine
False
The tricuspid and mitral valves are known as ___ because they separate the atria from the ventricles.
Atrioventricular valves
How would frequent premature atrial complexes affect a pt with coronary artery disease?
Low cardiac output
Which pacemaker complication shows a pacing spike, but no waveform immediately following it?
Loss of capture
What is the difference between ventricular tachycardia and ventricular fibrillation
Ventricular fibrillation is chaotic in appearance
Together, the contraction and relaxation of the heart make up:
The cardiac cycle
You will be able to determine the atrial rate in atrial fibrillation
False
Uncontrolled atrial fibrillation has a heart rate between 60 -100 bpm
False
The ability of the heart cells to receive and transmit an electrical impulse is known as:
Conductivity
Which ventricular dysrhythmia is often called “the straight or flat line” of rhythms?
Asystole
Which of the following conditions would NOT prevent a pt form participating in exercise electrocardiography
Diabetes
When the paper is 25mm/sec, there are how many boxes per minute
150 boxes per minute
Idioventricular rhythms occur when the sinoatrial and junctional pacemakers fail to initiate an impulse
True
A normal QRS complex is 0.12 to 0.20 seconds in length
False
How are agonal rhythm and asystole the same
All of the above: In both rhythms the pt will be unconscious, both rhythms have an absence of P waves, both rhythms are life threatening and require basic and advanced life support
First degree heart block can lead to decreased cardiac output
False
You observe a wide QRS complex in lead II. Which lead should you check to evaluate the location of the bundle branch block
Lead V1
Why is it unlikely that a pt would have sx’s of low cardiac output with accelerated junctional rhythm?
The heart rate is the same as normal sinus rhythm
Which of the following is not a possible cause of left axis deviation?
Anterolateral wall MI
Which of the following medications would most likely be stopped prior to a treadmill stress test
Beta blocker
With second degree AV block, type I
Not all of the P waves are followed by a QRS complex
___ rhythm occurs when the SA node fails to initiate the electrical activity and one of the backup pacemakers sites takes over
Escape rhythm
What changes occur in the eCG tracing with a STEMI
All of the above
First degree heart block is not a true block; there is delay around the AV node, but each impulse is eventually conducted
True
WAP is a normal finding in children, older adults, and well conditioned athletes. It may also be found in pts with
Organic heart disease and drug toxicity
The advantage of continuous monitoring over intermittent monitoring
Continuous monitoring provides a complete tracing and records before, during, and after the pt activates…
A normal PR interval is 0.06-0.10 seconds in length
False
If disposable electrodes are left on a pt’s sin for more than two readings, inaccurate ECG tracings may result
True
Rhythm? or regularity of atrial contraction is evaluated by assessing the regularity or irregularity of the R waves
False
Which three groups of pts present with complaints or problems that are atypical?
Women, elderly, diabetics
Steps in evaluating a pacemaker ECG tracing include all of the following except
What is the ration of paced beats to own beats within 1 minute
Name the two semilunar valves
Aortic, pulmonary
Which of these pts would have Persantine thallium stress test?
68 year old pt confined to his bed after cardiac surgery
With junctional rhythms, the electrical current is initiated form the
AV junction
BBB can be seen in the
Precordial leads
The effect of junctional tachycardia on the pt depends on
The rate of the rhythm
The ECG waveform is indicative of
How the heart is functioning electrically
The pt with junctional escape rhythm has a faster than normal heart rate
False
The advantage of atrioventricular pacing?
It mimics the normal cardiac conduction system and allows the atria to contract completely prior to the ventricles to …
How do you determine how many pretest recordings of BP and 12 lead ECG’s you obtain
Check with the physicians orders
Frequently, second degree AV block, type I, will progress to third degree AV block
False
Atrial dysrhythmia has a cardiac complex that occurs too soon, has a positively deflected P wave, …
Premature atrial complexes (PAC)
… Instruct the pt when the appointment is made in preparation for an exercise electrocardiography. Which of the ….
Check the order and instruct pts regarding medications they should or should not take prior to the procedure
When estimating the heart rate with the 6 second method, you must locate 6 seconds on rhythm strip, …
10
What is the normal, inherent rate of the AV node?
40-60 bpm
BBB
Is diagnosed by analyzing only the width of the QRS complexes
Identify the rhythm using these criteria: Regular rhythm, ventricular and atrial rates are 60-100 bpm, P wave precede….
NSR
….P-P interval is irregular with all heart blocks
False
….unction of the BBB is to
Distribute the electrical impulse through the myocardium
Which additional test is not likely to be ordered if the ambulatory monitor results are abnormal
Pulmonary function test
The outermost layer of the heart is the
Epicardium
In which of the heart block dysrhythmias are there more P waves than QRS complexes
All of these: third degree AV block, second degree AV block, type I, second degree AV block, type II
Every instance of ST segment elevation is indicative of myocardial injury
True
QRS duration measurement represents the time it takes for:
The ventricles to depolarize or contract
Name one of the questions necessary to analyze a P wave of the ECG tracing
Does each P wave have a QRS complex following it?
ECG waveform provide basic information about a pts’s condition
True
Which heart rate method is the most accurate with regular rhythm
1500 method
The function of the bundle branch system is to
Purkinje fibers
What term means the ability of the heart to initiate an electrical impulse without being stimulated by another or independent source
Automaticity
The period of time between ventricular depolarization and the beginning of ventricular depolarization
False
For women, the hormones produced during child bearing years increase the risk of cardiac problem
False
If a pt has a L ventricular hypertrophy, the axis deviation will be
Left
With third degree AV block , there is complete block at a or below
True
What sx’s would you observe in a pt with first degree AV block
The pt should have nl cardiac output and no sx’s
V1 and V2 view
Left coronary, septal branch