basic ECG Rhythm recognition

Question 1

what is the accurate conduction system of the heart?

Answer 1

SA Node, AV Node, Bundle of His, Right and Left Bundle Branch, Ventricles

Question 2

The SA Node, also known as the “primary pacemaker” beats how many times per minute?

Answer 2

60 - 100 bpm

Question 3

The back up to the SA Node, the AV Node, also known as the “escape pacemaker” beats how many times per minute?

Answer 3

40 - 60 bpm

Question 4

The back up to back up of the pacemakers, the ventricles, beats how many times per minute?

Answer 4

20 - 40 bpm

Question 5

what two areas make up the AV Junction?

Answer 5

The AV Node to the Bundle of His

Question 6

what two areas make up the ventricles?

Answer 6

The Bundle Branches and the Purkinjie network

Question 7

What are the electrophysiologic properties of the myocardial cells?

Answer 7

To make the heart contract and regulate the heart rate.

Question 8

The ability to initiate an adequate impulse:

a. automaticity
b. excitability
c. conductivity
d. contractility

Answer 8

a. automaticity

Question 9

The ability to transmit an impulse:

a. automaticity
b. excitability
c. conductivity
d. contractility

Answer 9

c. conductivity

Question 10

The ability to respond to an electrical impulse:

a. automaticity
b. excitability
c. conductivity
d. contractility

Answer 10

b. excitability

Question 11

The ability to respond with pumping action:

a. automaticity
b. excitability
c. conductivity
d. contractility

Answer 11

d. contractility

Question 12

Dysrhythmias are mostly seed when there is a problem with what property of the myocardial cell?

Answer 12

Automaticity

Question 13

what occurs during eletrical events as shifts of electrons from the inside to the outside of the cell occur, thus stimulating the cells to respond leading to contraction?

Answer 13

cell changes

Question 14

A cell change occuring during eletrical events when potassium (K+) is inside the cell and sodium (Na+) and calcium (Ca+) are outside is known as:

a. polarized (resting)
b. depolarized (stimulated)
c. repolarized (recovery)

Answer 14

a. polarized (resting)

Question 15

A cell change occuring during eletrical events when potassium (K+) is outside and move back inside the cell and sodium (Na+) and calcium (Ca+) inside move back outside of the cell is known as:

a. polarized (resting)
b. depolarized (stimulated)
c. repolarized (recovery)

Answer 15

c. repolarized (recovery)

Question 16

A cell change occuring during eletrical events when potassium (K+) inside the cell moves outside and sodium (Na+) and calcium (Ca+) outside moves inside the cell is known as:

a. polarized (resting)
b. depolarized (stimulated)
c. repolarized (recovery)

Answer 16

b. depolarized (stimulated)

Question 17

Cardiac effects of the sympathetic nervous system is known as rest and digest. True or false.

Answer 17

False.

The cardiac effects of the SNS is known as fight or flight.

Question 18

Cardiac effects of the parasympathetic nervous system is known as fight or flight. True or false.

Answer 18

False.

The cardiac effects of the PSNS is known as rest and digest.

Question 19

what activates cardiac B1 adrenergic receptors?
a. sympathetic nervous system
b. parasympathetic nervous system

Answer 19

a. sympathetic nervous system

Question 20

what activates cholinergic receptors?
a. sympathetic nervous system
b. parasympathetic nervous system

Answer 20

b. parasympathetic nervous system

Question 21

A nurses is assesing a patient and finds that his pupils are dialated, his HR and BP have increased, and upon ausculation his bronchis are open. What kind of effects is this patient experiencing?

a. caffine
b. smoothie
c. inhibitory
d. excitatory

Answer 21

d. excitatory

Question 22

During fight or flight the SNS displays:

• Increased rate of SA Node pacing
• Increased rae of conduction
• Increased rate of contraction
• Increased irritability of foci

and are known as…

Answer 22

**Cardiac Excitatory Effects

Question 23

During rest and digest the pSNS displays:

• decreased Increased rate of SA Node pacing
• decreased rae of conduction
• decreased rate of contraction
• decreased irritability of atrial and junctional foci

and are known as…

Answer 23

Cardiac Inhibitory Effects

Question 24

Eletrical stimulation proceeds pumping. True or false.

Answer 24

False.

Eletrical is first!

Eletrical stimulation precedes pumping.

Question 25

What wave is normally first in the cardiac cycle?

Answer 25

P wave

Question 26

when both atria contract/relax together they push blood where?

Answer 26

into the ventricles

Question 27

when both venticles contract/relax together they push blood where?

Answer 27

into the pulmonary artery and aorta

Question 28

The ECG is an important clinical indicator of the heart's function. True or False.

Answer 28

True. ## Footnote Helps determine what part of the patients heart is damaged.

Question 29

The correct way to apply electodes is?

Answer 29

- white on right - clouds over grass - smoke over fire - shit in my heart

Question 30

The nurse is monitoring a patient on an ECG monitor and notices artifact. What could be causing this? | I.e. distortion, inaccurate image

Answer 30

- Muscle tremors - Patient movement - Loose electrode - Broken lead wire

Question 31

The nurse is monitoring a patient on an ECG monitor and notices artifact. What should the do first? a. call the HCP b. asses the patient c. lay the patient supine d. admister 100 mL NS | I.e. distortion, inaccurate image

Answer 31

b. asses the patient | REMEMBER treat the **patient** instead of the cardiac monitor

Question 32

ECG leads attach to what kind of transmitter?

Answer 32

battery operated

Question 33

# telemetry what is located on the unit that transmit ECG signals to the monitor?

Answer 33

An antennae

Question 34

The telemetry unit allows the patient to be a. fertile b. mobile c. in a coma

Answer 34

b. mobile

Question 35

The telemerty unit is appropriate for all patients. True or False.

Answer 35

False. ## Footnote The telemetry unit is NOT APPROPRIATE for all patients.

Question 36

On an ECG paper, what is measured horizontally?

Answer 36

Time

Question 37

On an ECG paper, what is measured vertically?

Answer 37

amplitude | Millivolts

Question 38

A nurse is reaading an ECG strip and is assesing the PQRST. She is evaluating what kind or response? a. palpatations b. eletrical c. mechanical d. racial

Answer 38

b. eletrical

Question 39

A nurse is taking a patients pulse to determine if the patient is stable or unstable. She is evaluating what kind of response? a. palpatations b. eletrical c. mechanical d. racial

Answer 39

c. mechanical

Question 40

A nurse is reading an ECG strip and is assesing the PQRST. She is evaluating what kind of response? a. palpatations b. eletrical c. mechanical d. racial

Answer 40

b. eletrical

Question 41

What is **not** a sign that the heart is effective? a. stable hemodynamis status b. disorientation c. capillary refill less than 2 seconds d. urinary output greater than or equal to 30mL/hour

Answer 41

b. disorientation

Question 42

The nurse is trying to apply electrodes to the patient and they are not sticking. What may be the problem? Select ALL that Apply: a. sweat b. hair c. water

Answer 42

a. sweat b. hair c. water

Question 43

1 small square measures how many seconds? a. 0.04 seconds b. 0.06 seconds c. 0.08 seconds d. 1.0 second | (1 mm)

Answer 43

a. 0.04 seconds

Question 44

1 large square measures how many seconds? a. 0.40 seconds b. 0.80 seconds c. 0.20 seconds d. 0.70 seconds

Answer 44

c. 0.20 seconds

Question 45

5 large squares measures how many seconds? a. 8 seconds b. 7 seconds c. 2 seconds d. 1 second

Answer 45

d. 1 seconds ## Footnote 0.20 x 5 = 1 second

Question 46

300 large squares measures how many seconds? a. 80 seconds b. 70 seconds c. 60 seconds d. 10 second

Answer 46

c. 60 seconds | 1 minute

Question 47

what is the baseline of the PQRST wave aka? a. axis line b. isoeletric line c. wave base d. flat line

Answer 47

b. isoeletric line

Question 48

the P wave represents? a. atrium depolarization b. atrium repolarization c. ventricle depolarization d. ventricle repolarization

Answer 48

a. atrium depolarization ## Footnote slows down

Question 49

the QRS complex represents? a. atrium depolarization b. atrium repolarization c. ventricle depolarization d. ventricle repolarization

Answer 49

c. ventricle depolarization

Question 50

the plateau phase and the T wave represents? a. atrium depolarization b. atrium repolarization c. ventricle depolarization d. ventricle repolarization

Answer 50

d. ventricle repolarization

Question 51

each large square represents how many seconds? a. 0.40 b. 0.20 c 0.10

Answer 51

b. 0.20

Question 52

how many large squares represent 1 second? a. 5 large squares b. 6 large squares c. 3 large squares

Answer 52

a. 5 large squares

Question 53

how many large squares represent a full minute? a. 30 large squares b. 300 large squares c. 3,000 large squares

Answer 53

b. 300 large squares

Question 54

how many large squares represent a 6-second strip?

Answer 54

30 large squares

Question 55

how does the nurse determine if the patient is stable or unstable?

Answer 55

pulse quality | HR 60 - 100 bpm

Question 56

a BP such as 90/64 shows the nurse the patient is?

Answer 56

showing instability

Question 57

the BEGINNING of the P wave to the BEGINNING of the QRS complex is called?

Answer 57

The PR interval

Question 58

the BEGINNING of the Q to the ENDINNING of the S is called? | when it leaves isoeletric and returns to the the isoeletric line

Answer 58

The QRS interval | the ENTIRE QRS COMPLEX

Question 59

The PR interval should measure between what?

Answer 59

0.12 - 0.20 ## Footnote - three - five small boxes

Question 60

The QRS interval should measure between what? | when it leaves isoeletric and returns to the the isoeletric line

Answer 60

0.04 - 0.12 | the ENTIRE QRS COMPLEX ## Footnote normal: - one - three small boxes

Question 61

A high T wave could mean?

Answer 61

electolyte imbalance; hyperkalemia

Question 62

A high T wave could mean?

Answer 62

electolyte imbalance; hyperkalemia

Question 63

two large squares vertically measures?

Answer 63

1 mV

Question 64

The eletrical composition of a heart beat can be seen as?

Answer 64

PQRST | ONE HEART BEAT

Question 65

During what wave does depolarization begin in the SA node and spreads to the AV followed by the right then left? | Atrial contraction ## Footnote SA - sinoatrial AV - atrioventricular

Answer 65

P wave

Question 66

slowed conduction through the AV Node

Answer 66

PR Segment

Question 67

the eletrical impulse from the atria to the ventricles ## Footnote P wave to the beginning of QRS (P wave & PR segment)

Answer 67

Time lag: 0.12 - 0.20 seconds (normal duration)

Question 68

the depolarization (contraction) of both ventricles ## Footnote From beginning of Q (or R) wave to end of S wave

Answer 68

Time lag: 0.04 - 0.12 seconds (normal duration)

Question 69

From the end of ventricular depolarization to the start of ventricular repolarization, normally found on the isoeletric line

Answer 69

ST segment ## Footnote isoeletric ST Segment

Question 70

From the end of QRS/ J point to the beginning of T wave

Answer 70

ST Segment

Question 71

ST Segment elevated more than 1mm vertically

Answer 71

ST Elevation

Question 72

ST Segment depressed more than 0.50 mm vertically

Answer 72

ST Depression ## Footnote ischemia normal in older people

Question 73

The repolarization of both ventricles is represented by what positive, rounded wave?

Answer 73

T wave ## Footnote Ventricular repolarization

Question 74

A tall peaked T wave could mean?

Answer 74

hyperkalemia

Question 75

An inverted, flat T wave could mean?

Answer 75

hypokalemia, myocardial ischemia ## Footnote MI Ischemia - occurs when blood flow to your heart is reduced, preventing the heart muscle from receiving enough oxygen therefor the muscle dies.

Question 76

Measured from beginning of QRS to end of T wave

Answer 76

Time lag: less than or equal to 0.44 seconds (normal duration)

Question 77

Increased risk for sudden cardiac death | (life - threatening ventricular rhythms)

Answer 77

prolongation of a QT Interval

Question 78

The total time required for ventricular depolarization and repolarization is represented on the ECG by the: A. PR interval. B. QRS complex. C. ST segment. D. QT interval.

Answer 78

D. QT interval.

Question 79

ECG waveforms are measured in which of the following? A. Pressure and cardiac output B. Seconds and minutes C. Beats per minute D. Amplitude (voltage) and duration (time)

Answer 79

D. Amplitude (voltage) and duration (time)

Question 80

The P wave represents: A. Atrial depolarization B. Atrial repolarization C. Ventricular depolarization D. Ventricular repolarization

Answer 80

A. Atrial depolarization

Question 81

The normal measurement of the PR interval is: A. Less than 0.11 second. B. 0.06 to 0.10 second. C. 0.12 to 0.20 second. D. 0.16 to 0.26 second.

Answer 81

C. 0.12 to 0.20 second.

Question 82

The QRS complex normally measures: A. Less than or equal to 0.12 second. B. 0.10 to 0.16 second. C. 0.12 to 0.20 second. D. 0.16 to 0.24 second.

Answer 82

A. Less than or equal to 0.12 second.

Question 83

The ST segment is normally: A. Isoelectric. B. Elevated. C. Depressed. D. Biphasic.

Answer 83

A. Isoelectric.