coursekey final exam

When applying chest leads, V6 is placed:

Responses

• A

  fifth ICS, left midclavicular line

• B

  fifth ICS, midaxillary line

• C

  fourth ICS, right sternal border

• D

  fourth ICS, left sternal border.

B

fifth ICS, midaxillary line

How are bigeminy PVCs described 

Responses

• A

  a PVC occurring every second beat 

• B

  a PVC occurring every third beat 

• C

  a PVC occurring every beat 

• D

  a PVC occurring every fourth beat 

A

a PVC occurring every second beat 

How many big boxes equal a 6-second strip

Responses

• A

  ten

• B

  fifteen

• C

  thirty

  thirt

• D

  twenty

C

thirty

Which of the following dysrhythmias has a characteristic feature of a sawtooth appearance 

Responses

• A

  Premature Atrial Contraction

• B

  Atrial Flutter

• C

  Atrial Fibrillation

• D

  Atrial Tachycardia

B

Atrial Flutter

Your patient’s heart rate changed from 85 to 58 bpm. You note regular, upright, matching P waves. The rhythm has changed from

Responses

• A

  sinus Bradycardia to normal sinus rhythm

• B

  normal sinus rhythm to sinus arrhythmia

• C

  normal sinus rhythm to sinus tachycardia

• D

  normal sinus rhythm to sinus bradycardia

D

normal sinus rhythm to sinus bradycardia

What are the characteristic features of a first-degree heart block 

Responses

• A

  Prolonged PR interval, without dropping a QRS complex 

• B

  Prolonged PR interval, with a dropped QRS complex 

• C

  Normal PR interval, without dropping a QRS complex 

• D

  Prolonged PR interval, with a wide QRS complex 

A

Prolonged PR interval, without dropping a QRS complex 

How many leads applied to obtain a 12-lead EKG

Responses

• A

  12

• B

  8

  C.

  10

• D

  3

CC.

10

The ECG complexes are determined to occur in a regular pattern. What method do you use to calculate the the most accurate heart rate? 

Responses

• A

  300 method

• B

  6-second method

• C

  1500 method

• D

  Any of these method

• 
  

  C

  1500 method

One cardiac cycle = 

Responses

• A

  valvular function of the heart 

• B

  contraction + relaxation of the heart 

• C

  contraction only of the heart 

• D

  relaxation only of the heart 

• 
  

  B

  contraction + relaxation of the heart 

Three big boxes between two R waves, what is the heart rate 

Responses

• A

  150 bpm

• B

  75 bpm

• C

  300 bpm

• D

  100 bpm

D

100 bpm

What is the lead color of the left leg

Responses

• A

  Red

• B

  Black

• C

  White

• D

  Green

A

Red

Which of the following describes Multifocal Atrial Tachycardia 

Responses

• A

  three different P waves and a heart rate greater than 150 bpm

• B

  three different T waves and a heart rate of 101 to 150 bpm

  C

  three different QRS complexes and a heart rate of 101 to 150 bpm

• D

  three different P waves and a heart rate of 101 to 150 bpm

D

three different P waves and a heart rate of 101 to 150 bpm

What is the default paper speed of an EKG paper 

Responses

• A

  25 mm per second

• B

  2.5 mm per minute

• C

  0.25 mm per Second

• D

  25 mm per minute

A

25 mm per second

Which artifacts can be corrected by having the patient relax and stay still?

Responses

• A

  AC interference

• B

  Somatic tremor

• C

  Wandering baseline

• D

  Interrupted baseline

• 
  

  B

  Somatic tremor

How are multifocal premature ventricular complexes described 

Responses

• A

  PVCs with regular R-R measurements 

• B

  PVCs that occur in different shapes and forms 

• C

  PVCs that occur in the same shapes and forms 

• D

  EKG with three consecutive PVCs 

• 
  

  B

  PVCs that occur in different shapes and forms 

Sinus rhythm with a rate more than 100 bpm is

Responses

• A

  sinus Bradycardia

• B

  sinus Tachycardia

• C

  normal sinus rhythm

• D

  sinus dysrhythmia

B

sinus Tachycardia

The correct sequence for the conducting system is:

Responses

• A

  SA node, bundle branches,  Purkinje fibers, AV bundle, AV node

• B

  SA node, AV bundle, Purkinje fibers, bundle branches, bundle of His

• C

  SA node, AV node, bundle of His, bundle branches, Purkinje fibers

• D

  SA node, bundle branches, bundle of His, AV bundle, Purkinje fibers

C

SA node, AV node, bundle of His, bundle branches, Purkinje fibers

Which of the following EKG changes is a sign of cardiac ischemia?

Responses

• A

  Long PR interval

• B

  ST segment elevation

• C

  ST segment depression

• D

  Wide QRS duration

C

ST segment depression

Which of the following atrial dysrhythmias has at least 3 changing P waves and a rate of 60 to 100 bpm

Responses

• A

  wandering atrial pacemaker 

• B

  multifocal atrial tachycardia 

• C

  atrial flutter 

• D

  premature atrial complexes 

A

wandering atrial pacemaker 

Deoxygenated blood returning from the superior vena cava and inferior vena cava enters which heart chamber?

Responses

• A

  right ventricle

• B

  right atrium

• C

  left atrium

• D

  left ventricle

B

right atrium

Which of the following rhythms are caused by premature beat from ventricular tissue 

Responses

• A

  PVC

• B

  PAC

  PAC - no response given

• C

  WAP 

  WAP  - no response given

• D

  MAT

• 
  

  A

  PVC

During the normal cardiac cycle, the electrical impulses representing Atrial depolarization are recorded on the EKG paper as 

Responses

• A

  U wave

• B

  T wave

• C

  P wave

• D

  QRS complex

C

P wave

What is the rate of accelerated idioventricular rhythm

Responses

• A

  100 - 150

• B

  40 - 100

• C

  20 - 40

• D

  60 - 100

B

40 - 100

The Einthoven triangle is formed by which of the following leads 

Responses

• A

  precordial leads 

• B

  chest leads 

• C

  unipolar leads 

  D

  bipolar leads 

D

bipolar leads 

\Note: another name of Bipolar ( Standard limb leads)

• Lead I: Right arm to left arm.

• Lead II: Right arm to left leg.

• Lead III: Left arm to left leg. 

Which of the following are ways to prevent AC inteference artifacts 

Responses

• A

  replace loose electrodes and have the patient turn slightly to the side.

• B

  apply electrodes securely, remove tension from lead wires

• C

  have patient place hands under his or her buttocks, remind patient not to move

• D

  unplug electrical equipments, move bed away from the wall

D

unplug electrical equipments, move bed away from the wall

The innermost layer of the heart is called the:

Responses

• A

  epicardium

• B

  endocardium

• C

  Pericardium

• D

  visceral pericardium

• 
  

  B

  endocardium

Which of the following EKG settings requires the patient’s informed consent?

Responses

• A

  Telemetry monitor

• B

  Holter monitor

• C

  Posterior 12 lead EKG

• D

  Stress test

D

Stress test

The three types of leads that make up a 12-lead ECG consist of: 

Responses

• A

  6 standard bipolar, 3 augmented limb, and 3 chest leads

• B

  3 standard bipolar, 3 augmented limb, and 6 chest leads

• C

  4 augmented limb, 4 standard bipolar, and 4 chest leads

• D

   augmented limb, 3 standard bipolar, and 3 chest leads

B

3 standard bipolar, 3 augmented limb, and 6 chest leads

Leads V1 – V2 – V3 – V4 – V5 – V6 are known as:

Responses

• A

  Precordial leads

• B

  Bipolar leads

• C

  Standard leads

• D

  Augmented limb leads

• 
  

  A

  Precordial leads

Measurement of PR interval is 

Responses

• A

  end of P wave to the end of QRS complex

• B

  beginning of P wave to beginning of QRS complex

• C

  beginning of P wave to end of QRS complex

• D

  beginning of P wave to the end of P wave

B

beginning of P wave to beginning of QRS complex

The heart’s ability to initiate its own electrical impulse is known as:

Responses

• A

  Contractility

• B

  Automaticity

• C

  Conductivity

• D

  Excitability

B

Automaticity

Depolarization of the cells causes the heart muscle to 

Responses

• A

  contract 

• B

  relax 

• C

  open the valves 

• D

  fill the chambers of the heart

A

contract 

The heart block dysrhythmia, which is characterized by PR intervals becoming progressively longer until a missing QRS complex 

Responses

• A

  Second degree AV block, type II

• B

  Third degree AV block

• C

  Second degree AV block, type I

• D

  First degree heart block

C

Second degree AV block, type I

The superior vena cava carries:

Responses

A

oxygen-rich blood to the right atrium

B

oxygen-rich blood to the left atrium

C

oxygen-poor blood to the left atrium 

D oxygen-poor blood to the right atrium

D

oxygen-poor blood to the right atrium

When the EKG paper is read in a horizontal way, it gives the information related to

Responses

• A

  voltage

• B

  height

• C

  time

• D amplitude

C time (duration)

Which of the following statements made by the patient indicates understanding of cardiac event monitor?

Responses

• A

  “ I should press on the button once I feel any symptom" - not selected,

• B

  “ I should resume my daily activities including my swimming lessons”

• C

  “ I should remove the monitor when I go to bed”

• D

  “ I should stop my heart medications before using the monitor” -

A  I should press on the button once I feel any symptom"

During sinus rhythm, the primary pacemaker is 

Responses

• A

  Bundle of HIS

• B

  AV junction

• C

  SA node

• D

  AV node

C

SA node

One “small square” when measured on the horizontal axis for duration is equal to:

Responses

• A

  0.08 sec

• B

  0.04 sec

• C

  0.4 sec

• D

  0.2 sec

B

0.04 sec

aVR – aVL – aVF are known as:

Responses

• A

  Unipolar leads  

• B

  Bipolar leads

• C

  Precordial leads

  Precordial leads 

D Standard leads

A Unipolar leads (augmented) aVR – aVL – aVF

Which of the following leads explores the lateral wall of the left ventricle?

Responses

• A

  V1, V2

• B

  V3, V4

• C

  II, III

• D

  V5, V6

D

V5, V6

Normal QRS complex duration is __________ seconds.

Responses

• A

  0.22 to 0.26

• B

  0.06 to 0.10

• C

  0.12 to 0.20

• D

  0.28 to 0.32

B

0.06 to 0.10

What adjustment is needed for recording an EKG on a patient with orthopnea?

Responses

• A

  Put the patient on the left side

• B

  Put the patient in a semi-Fowler position 

• C

  Put the patient in Sim's position 

• D

  Put the leg electrodes on the abdomen

• 
  

  B

  Put the patient in a semi-Fowler position 

In a normal ECG tracing, the T wave represents the:

Responses

• A

  depolarization of the ventricles

• B

  repolarization of the ventricles

• C

  repolarization of the atria

• D

  depolarization of the atria

B

repolarization of the ventricles

Normal PR Interval is __________ second.

Responses

• A

  0.06 to 0.10 

• B

  0.22 to 0.26

• C

  0.28 to 0.32 

• D

  0.12 to 0.20

D

0.12 to 0.20

Which of the following leads explore the anterior wall of the heart?

Responses

• A

  Leads V3, V4

• B

  Leads I, II, III

• C

  Leads V5, V6

• D

  Leads aVF, aVL

A

Leads V3, V4

Which of the following EKG changes may indicate the patient suffers from a Myocardial infarction?

Responses

• A

  Absent P wave

• B

  ST segment elevation

• C

  Wide QRS duration

• D

  Short PR interval

B

ST segment elevation

The tricuspid valve is located between the:

Responses

• A

  right atrium and right ventricle

  B

  left ventricle and the aorta

• C

  right ventricle and the pulmonary artery

• D

  left atrium and left ventricle

• 
  

  A

  right atrium and right ventricle

With junctional rhythms P waves may be:

Responses

• A

  Multiple shapes

• B

•   Absent or inverted

  • C

    Having variable PR intervals

  • D

    Upright and peake

B 

Absent or Inverted 

The valve located between the left atrium and left ventricle is the:  

Responses

• A

  Bicuspid valve

• B

  Pulmonary valve

• C

  Tricuspid valve

D

Aortic

• 
  

  A

  Bicuspid valve

The term dyspnea means

A

Not breathing 

B

  Slow breathing 

C

  Fast breathing

D-Difficult Breathing   

D-Difficult Breathing   

Which of the following EKG devices is used as real time monitor in hospital?

A

Holter Monitor

B.

Loop Memory event monitor

C.

Telemetry monitor

D

12 lead EKG

C.

Telemetry monitor

Two PVCs back to back are referred to as a 

Responses

A

trigeminy PVCs

B

multifocal PVCs

C

  coupling PVCs - correct

• D

  bigeminy PVCs

C

  coupling PVCs - correct

Leads I – II – III are known as:

Responses

A

Augmented limb leads

B

Unipolar limb leads

C

Bipolar leads 

D

Precordial leads

C

Bipolar leads 

Diastole is the _________________ phase of the heart

Responses

A

blood moving through the heart

B

ventricular squeezing

C

contraction

D

relaxation

D

relaxation

The right side of the heart_____________ Responses

A Pumps deoxygenated blood to the lungs

B pumps Oxygenated blood to the lungs pumps C pumps oxygenated blood to the body

D pumps deoxygenated blood to the body

A

Pumps deoxygenated blood to the lungs

A single beat that originates earlier from an ectopic focus from atria, other than the SA node is called

A

premature ventricular complex

B

Premature sinus complexPremature sinus complex

C

premature Junctional complex

D Premature Atrial complex

• 
  

  D

  Premature Atrial complex

During an exercise stress test, what will the patient be asked to do? Responses

A

Decrease the level of exertion as the test progresses

Maintain same level of exertion throughout the test

C

Increase the level of exertion as the test progresses

D

The patient will not be asked to do anything during the test

C

Increase the level of exertion as the test progresses

In pediatric population, which electrode is displaced to right chest?

A

V3

B V4

C V5

D V2

A

V3

Which of the following chest leads is placed on the 5th ICS, midclavicular line 

Responses

• A

  V1

• B

  V2

• C

  V5

• D

  V3

• E

  V4

• F

  V6

E

V4

What is the correct anatomical placement of the posterior lead V9

Responses

• A

  anterior axillary line 

  B

  left paraspinal border 

  l

• C

  mid-subscapular line 

• D

  posterior axillary line 

B

left paraspinal border 

What is the lead color of chest lead V5

Responses

• A

  orange 

• B

  white 

• C

  black 

• D

  green 

A

orange 

Which of the following conduction system structure has a rate of 20-40 bpm

Responses

• A

  Bundle branches 

  B

  SA node 

• C

  AV node 

• D

  Purkinje fibers 

D

Purkinje fibers 

Which of the following represents Lead II

Responses

• A

  right arm to left arm 

• B

  Right arm to left leg 

• C

  left arm to left leg 

• D

  left arm to right leg 

• 
  

  B

  Right arm to left leg 

Which of the following leads make up the Einthoven triangle 

Responses

• A

  precordial leads 

• B

  augmented leads 

• C

  bipolar leads 

• D

  unipolar leads 

C

bipolar leads 

All of the following causes somatic tremor artifacts except

Responses

• A

  talking 

• B

  Parkinson's disease 

• C

  chewing gum 

• D

  electrical wiring 

D

electrical wiring 

Where are leads placed on a patient with whole arm amputation 

Responses

• A

  clavicle 

• B

  aortic sternal notch 

• C

  manubrium 

• D

  deltoid 

A

clavicle 

What is the time duration of the PR interval 

Responses

• A

  0.04 to 0.10 second 

• B

  0.12 to 0.20 second 

• C

  0.012 to 0.020 second 

• D

  0.4 to 0.010 second 

B

0.12 to 0.20 second 

Identify the following dysrhythmia on the following criteria: 

• Rhythm = Irregular 

• Rate = 60-100 bpm

• P wave = changes in appearance with at least three different shaped P waves 

• PR inteval = varies 

• QRS = 0.06 to 0.10 seconds 

Responses

• A

  atrial flutter 

• B

  prematue atrial complexes 

• C

  multifocal atrial tachycardia 

• D

  wandering atrial pacemaker 

D

wandering atrial pacemaker 

All of the following leads will show the inferior wall of the left ventricle except 

Responses

• A

  aVL

• B

  III

• C

  aVF

• D

  II

A

aVL

Right bundle branch block is 

Responses

• A

  negatively polarized 

• B

  postively polarized 

• C

  positively deflected 

• D

  negatively deflected 

C

positively deflected 

What are the layers of the blood vessels from the outermost to the innermost 

Responses

• A

  tunica adventitia, tunica intima, tunica media 

• B

  tunica intima, tunica media, tunica adventitia 

• C

  tunica adventitia, tunica media, tunica intima 

• D

  tunica media, tunica intima, tunica adventitia

C

tunica adventitia, tunica media, tunica intima 

When are pathologic Q waves seen after a heart attack 

Responses

• A

  two minutes after 

• B

  several hours 

• C

  instant 

• D

  does not show 

B

several hours 

Which of the following conditions can be a cause of pulmonary edema 

Responses

• A

  atrial only failure 

• B

  right-sided heart failure 

• C

  left-sided heart failure 

• D

  pericarditis 

C

left-sided heart failure 

How long does a Holter monitor record for 

Responses

• A

  72-148 hours

• B

  24-48 hours 

• C

  24-36 hours 

• D

  24-72 hours 

B

24-48 hours 

Identify the following tracing:

Responses

• A

  atrial dysrhythmia 

• B

  atrial flutter

• C

  atrial fibrillation

• D

  tachycardia

C

atrial fibrillation

Identify the following tracing:

Responses

• A

  agonal

• B

  asystole

• C

  sinus arrest 

• D

  sinus block

A

agonal

Identify the following:

Responses

• A

  WAP

• B

  Wandering baseline

• C

  somatic tremor

• D

  interrupted baseline

• 
  

  B

  Wandering baseline

Identify the following tracing:

 

Responses

• A

  LBBB

  B

  first degree heart block

• C

  RBBB

• D

  sinus arrest

A

LBBB

Identify the following tracing:

Responses

• A

  sinus exit blook

• B

  sinus tachycardia

  C

  tachycardia

• D

  sinus arrest

D

sinus arrest

Identify the following tracing:

Responses

• A

  Junctional escape rhythm

  answer

• B

  first degree heart block

• C

  Accelerated Junctional Rhythm

• D

  2nd degree heart block

Junctional escape rhythm

Identify the following tracing:

Responses

• A

  atrial fibrillation

• B

  ventricular fibrillation

• C

  atrial flutter

• D

  ventricular tachycardia

C

atrial flutter

Identify the following tracing:

Responses

• A

  accelerated idioventricular rhythm

• B

  Junctional rhythm

• C

  accelerated ventricular pacemaker

• D

  multifocal atrial tachycardia

D

multifocal atrial tachycardia

Identify the following tracing:

Responses

• A

  accelerated idioventricular rhythm

• B

  premature ventricular complex

• C

  accelerated junctional rhythm

• D

  tachycardia

  tachycardia - no response given

A

accelerated idioventricular rhythm

Identify the following tracing:

Responses

• A

  PAC with a bradycardia 

  answer

• B

  PVC

• C

  PAC with a tachycardia

• D

  PVC with bradycardia

• 
  

  A

  PAC with a bradycardia 

identify the following tracing:

Responses

• A

  sinus dysrhythmia

• B

  normal sinus rhythm

• C

  premature sinus dysrhythmia

• D

  ventricular dysrhythmia

A

sinus dysrhythmia

Identify the following tracing:

Responses

• A

  SVT

• B

  ventricular tachycardia

• C

  sinus tachycardia

• 
  

  A

  SVT

Identify the following tracing:

Responses

• A

  2nd degree heart block

• B

  1st degree heart blocks

• C

  2nd degree heart block, type 1

B

1st degree heart blocks

Identify the following tracing:

Responses

• A

  3rd degree HB

• B

  1st degree HB

• C

  WAP

• D

  2nd degree HB, Type II

A

3rd degree HB

Identify the following tracing:

Responses

• A

  PVC with trigeminy

• B

  PVC with a bigeminy

• C

  frequent PVC

• D

  Occasional PVC

• 
  

  B

  PVC with a bigeminy

Identify the following tracing:

Responses

• A

  PVC bigeminy

• B

  PVC Run of ventricular tachycardia

• C

  PVC coupling

• D

  PVC occasional 

C

PVC coupling

Identify the following tracing:

Responses

• A

  Paroxysmal event

• B

  PVC tachycardia

• C

  Ventricular tachycardia

• D

  Torsades de Pointes

A

Paroxysmal event

Identify the following tracing:

Responses

• A

  Ventricular tachycardia

• B

  ventricular fibrillation

• C

  Torsades de Pointes

• D

  SVT

• 
  

  C

  Torsades de Pointes

Identify the following tracing:

Responses

• A

  atrial pacemaker

• B

  atrial fibrillation

  C

  atrial flutter

• D

  atrial premature complex

A

atrial pacemaker

Identify the following tracing:

Responses

• A

  Vfib

• B

  PVC

• C

  ventricular pacemaker

• D

  normal sinus rythm

C

ventricular pacemaker