CRAT Test 5

Test 5 ... (https://onsloworg-my.sharepoint.com/:w:/r/personal/kiwheeler_onslow_org/Documents/ExamEdgeTest%205.docx?d=w4a8089ffe44841f58a75947027c16462&csf=1&web=1&e=sTqFp1)

10/T5

Which of the following might be considered predisposing factors for junctional rhythms?

1. Diabetes mellitus

2. Lupus erythematosus

3. Liver failure

4. All of the above

All of above

• Diabetes

  • SA node fails due to nerve or blood vessel damaged.

• Lupus erythematosus

  • Lupus myocarditis

• Liver Failure

  • Bile Acid Toxicity

1/T5

Which of the following artifacts results in a wide baseline consisting of a continuous series of even, fine, rapid spikes that can obscure the waveforms on the ECG tracing?

1. Electrical interference

2. Wandering baseline

3. Telemetry-related interference

4. False high-rate alarms

Electrical interference

11/T5

With an EKG, the voltage may be considered which of the following?

1. Deflected

2. Indirect

3. Negative

4. Posterior

Negative

X deflected(歪める、反らせる): it describes the physical movement of the wave line on the paper, not the voltage type itself.

15/T5

Alternating current interference can be caused by all of the following except?

1. Crossed lead wires

2. Improper grounding

3. Too little electrode gel

4. Other electrical equipment

Too little electrode gel

• “all of the following except”

• Alternating Current Interference = AC interference

19/T5

The major therapeutic goal in treating atrial fibrillation is which of the following?

1. Stop the erratic atrial impulses

2. Reduce ventricular rate below 80 bpm

3. Increase ventricular rate above 80 bpm

4. Reduce atrial impulse to below 100 bpm

Reduce Ventricular rate below 80 bpm

21/T5

Which of the following is the term that refers to a wide spectrum of SA node abnormalities that are caused by disturbances in the way impulses are generated or the inability to conduct impulses to the atrium?

1. Sinus arrest

2. Sinus pause

3. Sick sinus syndrome

4. Sinus arrhythmia

Sick sinus syndrome

22/T5

When there is no electrical activity occurring, or there is too little activity, the waveform resembles a straight line and is called which of the following?

1. Baseline

2. Intrinsic waveform

3. Straight line

4. Isoelectric waveform

Isoelectric waveform

28/T5

A pacemaker stimulation of the atria and then the lower portion of the right ventricle in a sequence is known as which of the following?

1. Atriobiventricular pacing

2. Inherent rhythm

3. Pacing spike

4. Atrioventricular sequential pacing

Atrioventricular sequential pacing

=AV Synchronous Pacing

=Dual-Chamber Pacing

DDD (Dual-chamber paced, sensed, response) is the most common and versatile mode used for this purpose.

32/T5

Which of the following pacemaker complications leads to competition between the intrinsic electronic pacemakers?

1. Malsensing

2. Loss of capture

3. Undersensing

4. Oversensing

Undersensing

Undersensing:

Intrinsic beats occur,

The pacer misfires,

The mis-timed pacing spike accidentally lands on the T wave

=> R-on-T phenomenon

33/T5

If the bundle of His becomes blocked, which of the following can be activated as a pacemaker?

1. Left bundle branch

2. Purkinje fibers

3. Fasciculi

4. Right bundle branch

Purkinje Fibers

[ Conduction Pathway ]

1. SA node

2. AV node

3. Bundle of His

4. Bundle branches

5. (Fasciculi :LBB only)

6. Purkinje Fibers

34/T5

Which of the following is similar to lead V1 on the 12 lead ECG?

1. MCL1

2. aVF

3. MCL6

4. aVR

MCL1

36/T5

Which of the following would be considered one of the grievance categories?

1. Expedited

2. Over extended

3. Irregular

4. Obtuse

Expedite

• The Grievance Categories

  • Standard

  • Extended

  • Expedite (most serious urgent case)

37/T5

If sinus arrhythmia suddenly develops in patients taking which of the following medications, the practitioner should be notified immediately?

1. Morphine sulfate

2. Aspirin

3. Digoxin

4. Lithium

Digoxin

Because of the narrow therapeutic index

Digoxin is used for Afib, Aflutter, and CHF.

39/T5

Atrial tachycardia can occur in patients with normal hearts and is generally related to which of the following?

1. Excessive exercise

2. Excessive use of alcohol

3. Excessive use of stimulants

4. Excessive insomnia

Excessive use of stimulants

Because stimulants are the direct effect on heart cellular mechanisms, especially in a normal heart.

41/T5

Which pacemaker malfunction causes the device to deliver a pacing stimulus during the heart’s relaxation (repolarization) phase, risking induction of dangerous arrhythmia?

1. Loss of capture

2. Undersensing

3. Oversensing

4. Battery depletion causing reduced device output

Undersensing

45/T5

The patient has spontaneous atrial activity leading the VVI pacemaker to not synchronize the ventricular activity with it. What can develop?

1. Myocardial infarction

2. Asystole

3. Bradycardia

4. Tricuspid regurgitation

Tricuspid regurgitation

=leaky heart valve condition, blood flow backward every beat.

48/T5

Which of the following is the outermost layer of the human heart?

1. Endocardium

2. Myocardium

3. Pericardium

4. Epicardium

Epicardium

50/T5

The stages of the cardiac cycle consists of all but which of the following?

1. Ventricular ejection

2. Ventricular systole

3. Atrial systole

4. Ventricular filling

Ventricular systole

1. Atrial Systole

2. Isovolumetric Contraction

3. Ventricular Ejection

4. Isovolumetric Relaxation

5. Ventricular Filling

54/T5

If there is waveform interference on an EKG, which of the following might be seen?

1. Bumpy pattern

2. Straight lines

3. No extra wave

4. None of the above

Bumpy pattern

“interference”

59/T5

On a standard ECG, a flattened baseline with missing or numerous erratic P wave most likely indicates which rhythm?

1. Atrial fibrillation

2. Multifocal atrial tachycardia

3. Ventricular flutter

4. Hyperkalemia

Atrial fibrillation

“missing or numerous erratic P wave”

61/T5

In a 12 lead ECG, which of the following is the number of limb leads there are?

1. 7

2. 6

3. 5

4. 3

6

Limb leads: I, II, III, aVR, aVL, aVF

63/T5

The right and left coronary arteries begin as a single branch off the ascending aorta from the area known as which of the following?

1. His Bundle

2. The triangle of Einthoven’s

3. The cardiac triangle

4. Sinuses of Valsalva

Sinuses of Valsalva

= at just above the aortic valve,

= three aortic sinuses,

= ensuring the openings into the coronary arteries are not obstructed by the open aortic valve

68/T5

Complication from failure to capture could include all of the following except?

1. Increased stimulation threshold because of such things as medications and/or electrolyte imbalance.

2. A fracture of the pacing lead wire

3. Liver failure

4. Perforation of the myocardium by a lead wire

Liver failure

“except”

79/T5

The ability of the heart muscle to contract after it receives the electrical impulse is which of the following?

1. Contractility

2. Excitability

3. Elasticity

4. conductivity

Contractility

• Excitability

  • The electrical response

  • “Flipping light switch”

  • The cell generates an action potential when stimulated.

• Contractility

  • The mechanical response

  • “The bulb ligting up“

  • The cell turns the electrical excitement into physical force.

  • a

80/T5

During which phase of the cardiac cycle do the aortic and pulmonic valves open to allow the ventricles to expel blood?

1. Isovolumetric ventricular depolarization

2. Ventricular filling

3. Atrial systole

4. Ventricular ejection

Ventricular ejection

• “Expel blood” and “ejection“

• Cardiac Cycle

  • P=Atrial Contraction

  • QRS=Isovolumetric Contraction

  • ST segment=Ventricular Ejection

  • T=Isovolumetric Relaxation

  • TP segment=Ventricular Filling

82/T5

Which of the following is not one of the causes of temporary atrioventricular blocks?

1. Myocardial infarction

2. Cardiomyopathy

3. Acute myocarditis

4. Cardiac Surgery

Cardiomyopathy

• Cardiomyopathy

  • The heart muscle can’t pump.

  • Myocardium gets stiffen, enlarge, thicken.

• Cause of AV block

  • Myocardial Infarction

  • Acute myocarditis

  • Cardiac Surgery

85/T5

Purkinje fibers end in minuscule filaments that directly depolarize which of the following?

1. Endocardium

2. Ventricular myocytes

3. Bundle branches

4. Epicardium

Ventricular myocytes

89/T5

Of the following, which would not be indicative of ventricular fibrillation?

1. No waves will be seen

2. Waves would be seen with every other complex

3. The QRS will be more than 120 ms

4. The rate will be 100-250

Waves would be seen with every other complex

“would not“

• No waves

• QRS is >0.12

• HR 100-250

94/T5

Of the following, which would not be considered potential causes of cardiac arrhythmias?

1. Injuries

2. Heart disease

3. Elevated glucose

4. Electrolyte imbalances

Elevated glucose