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Medical Emergencies EMS > homework week 3 quiz > Flashcards

homework week 3 quiz Flashcards

1
Q 
The duration of the QRS complex should be \_\_\_\_ milliseconds or less in a healthy adult.
Select one:
a. 100
b. 110 
c. 120
d. 130
A

b. 110

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2
Q 
If a particular interval on the ECG graph paper is 1.5 small boxes in width, the interval would be measured as:
Select one:
a. 0.06 seconds. 
b. 2 millimeters.
c. 45 milliseconds.
d. 600 milliseconds.
A

a. 0.06 seconds.

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3
Q

An electrical wave moving in the direction of a positive electrode will:
Select one:
a. cause a positive deflection on the ECG.
b. produce a significant amount of artifact.
c. cause a negative deflection on the ECG.
d. manifest with narrow QRS complexes.

A

a. cause a positive deflection on the ECG.

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4
Q

A prolonged PR interval:
Select one:
a. is greater than 120 milliseconds.
b. indicates that the AV node was bypassed.
c. indicates an abnormal delay at the AV node.
d. is a sign of rapid atrial depolarization.

A

c. indicates an abnormal delay at the AV node.

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5
Q 
Bombardment of the AV node by more than one impulse, potentially blocking the pathway for one impulse and allowing the other impulse to stimulate cardiac cells that have already depolarized, is called:
Select one:
a. fusion.
b. reentry.
c. ectopy.
d. excitability.
A

b. reentry.

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6
Q 
The QT interval would MOST likely be prolonged in patients:
Select one:
a. who take digitalis.
b. who are hypocalcemic. 
c. with a rapid heart rate.
d. who are hypercalcemic.
A

b. who are hypocalcemic.

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7
Q

The 6-second method for calculating the rate of a cardiac rhythm:
Select one:
a. involves counting the number of QRS complexes in a 6-second strip and multiplying that number by 10.
b. is an accurate method for calculating the heart rate if the cardiac rhythm is grossly irregular and very fast.
c. will yield an estimated heart rate that is typically within 2 to 3 beats per minute of the actual heart rate.
d. takes longer than other methods of calculating the rate and is thus impractical to use with critical patients.

A

a. involves counting the number of QRS complexes in a 6- second strip and multiplying that number by 10.

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8
Q 
In males, the QT interval is considered prolonged if it is \_\_\_\_\_\_ milliseconds or longer.
Select one:
a. 390
b. 400
c. 430
d. 450
A

d. 450

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9
Q

The point of maximal impulse usually can be felt on the:
Select one:
a. medial aspect of the chest, just below the third intercostal space.
b. left lateral chest, in the midaxillary line, at the fourth intercostal space.
c. left anterior chest, in the midaxillary line, at the fifth intercostal space.
d. left anterior chest, in the midclavicular line, at the fifth intercostal space.

A

d. left anterior chest, in the midclavicular line, at the fifth intercostal space.

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10
Q

A wide QRS complex that is preceded by a normal P wave indicates:
Select one:
a. that the rhythm is ventricular in origin.
b. rapid conduction through the ventricles.
c. a delay in conduction at the AV junction.
d. an abnormality in ventricular conduction.

A

d. an abnormality in ventricular conduction.

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11
Q 
On the ECG graph paper, amplitude is measured in \_\_\_\_\_\_\_\_\_\_\_\_\_ and width is measure in \_\_\_\_\_\_\_\_\_\_\_\_.
Select one:
a. centimeters, seconds
b. milliseconds, millimeters
c. seconds, centimeters
d. millimeters, milliseconds
A

d. millimeters, milliseconds

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12
Q 
When applying the limb leads, the negative lead should be placed on the:
Select one:
a. left arm.
b. left leg.
c. right arm.
d. right leg.
A

c. right arm.

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13
Q

Q waves are considered abnormal or pathologic if they are:
Select one:
a. greater than 0.02 seconds wide and consistently precede the R wave.
b. more than one-third the overall height of the QRS complex in lead II.
c. not visible in leads I or II when the QRS gain sensitivity is increased.
d. present in a patient who is experiencing chest pressure or discomfort.

A

b. more than one-third the overall height of the QRS complex in lead II.

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14
Q

According to the Einthoven triangle, lead II is assessed by placing the:
Select one:
a. negative lead on the left arm and the positive lead on the left leg.
b. positive lead on the left leg and the negative lead on the right arm.
c. positive lead on the left arm and the negative lead on the right arm.
d. negative lead on the right arm and the positive lead on the left leg.

A

d. negative lead on the right arm and the positive lead on the left leg.

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15
Q 
The normal P wave duration is less than \_\_\_ milliseconds and the amplitude is less than \_\_\_ millimeters tall.
Select one:
a. 110; 2.5 
b. 120; 3.0
c. 130; 3.5
d. 140; 4.0
A

a. 110; 2.5

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16
Q 
The area of conduction tissue in which electrical activity arises at any given time is called the:
Select one:
a. myocyte.
b. pacemaker. 
c. sinus node.
d. bundle of His.
A

b. pacemaker.

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17
Q

In contrast to the right side of the heart, the left side of the heart:
Select one:
a. drives blood out of the heart against the relatively high resistance of the systemic circulation.
b. is a high-pressure pump that sends blood through the pulmonary circulation and to the lungs.
c. is a relatively low-pressure pump that must stretch its walls in order to force blood through the aorta.
d. drives blood out of the heart against the relatively low resistance of the pulmonary circulation.

A

a. drives blood out of the heart against the relatively high resistance of the systemic circulation.

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18
Q 
On the ECG graph paper, 6 seconds is represented by how many large boxes?
Select one:
a. 20
b. 30 
c. 40
d. 50
A

b. 30

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19
Q 
Under normal conditions, the strength of cardiac contraction is regulated by:
Select one:
a. the heart rate.
b. the nervous system.
c. physical exertion.
d. the Frank-Starling mechanism.
A

b. the nervous system.

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20
Q

The second half of the T wave:
Select one:
a. is the point of ventricular repolarization to which a defibrillator is synchronized to deliver electrical energy.
b. is the strongest part of ventricular depolarization and is often the origin of dangerous ventricular arrhythmias.
c. represents a state of absolute ventricular refractoriness in which another impulse cannot cause depolarization.
d. represents a vulnerable period during which a strong impulse could cause depolarization, resulting in a lethal arrhythmia.

A

d. represents a vulnerable period during which a strong impulse could cause depolarization, resulting in a lethal arrhythmia.

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21
Q

If a patient’s ECG rhythm shows any artifact, you should:
Select one:
a. ensure the electrodes are applied firmly to the skin.
b. reverse the limb leads to obtain a clearer ECG tracing.
c. place the ground lead in a different anatomic location.
d. remove the negative lead and reassess the cardiac rhythm.

A

a. ensure the electrodes are applied firmly to the skin.

22
Q 
The \_\_\_\_\_\_\_\_\_\_ represents the end of ventricular depolarization and the beginning of repolarization.
Select one:
a. J point 
b. T wave
c. ST segment
d. T-P interval
A

a. J point

23
Q 
If the R-R interval spans more than \_\_\_\_ large boxes on the ECG graph paper, the heart rate is less than 60/min.
Select one:
a. 1.5
b. 2
c. 3.5
d. 5
A

d. 5

24
Q

A prolonged QT interval indicates that the heart:
Select one:
a. has a shorter-than-normal refractory period, increasing the likelihood of severe bradycardia.
b. is experiencing an extended refractory period, making the ventricles more vulnerable to dysrhythmias.
c. is depolarizing too quickly, which significantly increases the potential for reentry in the AV junction.
d. has a shortened refractory period and may be caused by factors such as hypocalcemia or pericarditis.

A

b. is experiencing an extended refractory period, making the ventricles more vulnerable to dysrhythmias.

25
Q 
If the R-R interval spans \_\_\_ large boxes or less, the heart rate is greater than 100/min.
Select one:
a. 3 
b. 4
c. 5
d. 6
A

a. 3

26
Q 
Which of the following would MOST likely cause bradycardia?
Select one:
a. Exercise
b. Hyperthermia
c. Amphetamines
d. Beta-blocker use
A

d. Beta-blocker use

27
Q

A classic sign of atrial flutter is:
Select one:
a. a constant 2:1 conduction ratio.
b. the presence of sawtooth F waves.
c. a ventricular rate less than 100 beats/min.
d. an irregular but consistent R-R interval.

A

b. the presence of sawtooth F waves

28
Q

Supraventricular tachycardia is MOST accurately defined as:
Select one:
a. any tachycardic rhythm with a heart rate greater than 130 beats/min and absent P waves.
b. a tachycardic rhythm originating from a pacemaker site above the level of the ventricles.
c. an irregular tachycardic rhythm that originates just below the AV junction.
d. a regular tachycardic rhythm between 150 and 180 beats/min with P waves buried in the QRS complexes.

A

b. a tachycardic rhythm originating from a pacemaker site above the level of the ventricles.

29
Q

If an impulse generated by the AV node begins moving upward through the atria before the other part of it enters the ventricles:
Select one:
a. the PR intervals will be greater than 0.20 seconds.
b. an upright P wave will appear after the QRS complex.
c. an inverted P wave will appear before the QRS complex.
d. a small inverted P wave will be buried in the QRS complex.

A

c. an inverted P wave will appear before the QRS complex.

30
Q

Which of the following statements regarding the SA node is correct?
Select one:
a. The SA node is the dominant cardiac pacemaker in healthy patients.
b. SA nodal ischemia occurs when the left coronary artery is occluded.
c. The SA node is located in the superior aspect of the right ventricle.
d. Impulses generated by the SA node travel through the right atrium only.

A

a. The SA node is the dominant cardiac pacemaker in healthy patients.

31
Q 
Which of the following differentiates an atrial rhythm from a sinus rhythm?
Select one:
a. Tachycardia
b. Profound bradycardia
c. Dissociated P waves
d. Varying shapes in P waves
A

d. Varying shapes in P waves

32
Q 
A wandering atrial pacemaker:
Select one:
a. has consistent P-wave shapes.
b. is generally faster than 100 beats/min.
c. may have variable PR intervals. 
d. is generally treated with atropine.
A

c. may have variable PR intervals.

33
Q

Atrial fibrillation can be interpreted by noting:
Select one:
a. PR intervals that vary from complex to complex.
b. an irregularly irregular rhythm and absent P waves.
c. a regularly irregular rhythm with abnormal P waves.
d. the presence of wide QRS complexes and a rapid rate.

A

b. an irregularly irregular rhythm and absent P waves.

34
Q 
Which of the following prescribed medications would a patient with chronic atrial fibrillation MOST likely take?
Select one:
a. Plavix and Vasotec
b. Lisinopril and aspirin
c. Digitalis and Coumadin 
d. Cordarone and furosemide
A

c. Digitalis and Coumadin

35
Q 
he treatment for sinus tachycardia should focus on:
Select one:
a. decreasing the heart rate.
b. correcting the underlying cause. 
c. administering IV fluid boluses.
d. relieving pain and anxiety.
A

b. correcting the underlying cause.

36
Q 
In contrast to treatment for supraventricular tachycardia, treatment for multifocal atrial tachycardia in the prehospital setting:
Select one:
a. is often more effective.
b. involves atropine sulfate.
c. is generally not effective. 
d. includes synchronized cardioversion.
A

c. is generally not effective.

37
Q

Which of the following is NOT characteristic of multifocal atrial tachycardia?
Select one:
a. Nonvisible P waves with a rapid ventricular rate
b. QRS complexes less than 0.11 seconds in duration
c. Variable PR intervals and P waves of differing size
d. Regular R-R intervals with a rate less than 150 beats/min

A

d. Regular R-R intervals with a rate less than 150 beats/min

38
Q

Junctional escape rhythms are characterized by:
Select one:
a. an absence of P waves.
b. QRS complexes greater than 0.12 seconds.
c. inverted P waves before the QRS complex.
d. a ventricular rate of 40 to 60 beats/min.

A

d. a ventricular rate of 40 to 60 beats/min.

39
Q

The AV junction:
Select one:
a. includes the AV node but not the bundle of His.
b. is the dominant and fastest pacemaker in the heart.
c. receives its blood supply from the circumflex artery.
d. is composed of the AV node and surrounding tissue.

A

d. is composed of the AV node and surrounding tissue.

40
Q

Normal sinus rhythm is characterized by all of the following, EXCEPT:
Select one:
a. minimal variation between the R-R intervals.
b. QRS complexes that are up to 140 milliseconds.
c. consistent PR intervals and upright P waves.
d. a consistent heart rate between 60 and 100 beats/min.

A

b. QRS complexes that are up to 140 milliseconds.

41
Q 
In sinus bradycardia, the:
Select one:
a. heart rate is less than 70 beats/min.
b. pacemaker site is the SA node. 
c. QRS complexes are often wide.
d. P waves are consistently upright.
A

b. pacemaker site is the SA node.

42
Q 
Patients with a heart rate greater than 150 beats/min usually become unstable because of:
Select one:
a. reduced ventricular filling. 
b. an increase in the atrial kick.
c. increased right atrial preload.
d. a significantly reduced afterload.
A

a. reduced ventricular filling.

43
Q 
When analyzing a cardiac rhythm strip in lead II, you should routinely evaluate all of the following components, EXCEPT the:
Select one:
a. QRS width.
b. PR interval.
c. ST segment.
d. R-R interval.
A

c. ST segment.

44
Q

n order to call a cardiac rhythm “paroxysmal” supraventricular tachycardia, you would have to:
Select one:
a. witness its onset and/or spontaneous termination. Correct
b. confirm the pacemaker origin with a 12-lead ECG.
c. observe a consistent heart rate greater than 150 beats/min.
d. ask the patient when he or she began feeling palpitations.

A

a. witness its onset and/or spontaneous termination.

45
Q 
Sinus dysrhythmia is:
Select one:
a. observed in all patients.
b. an irregular sinus rhythm.
c. a sign of myocardial ischemia.
d. most common in hypotensive patients.
A

b. an irregular sinus rhythm.

46
Q

Which of the following statements regarding sinus bradycardia is correct?
Select one:
a. Treatment focuses on the patient’s tolerance to the bradycardia.
b. Symptomatic bradycardia is often caused by a decreased atrial rate.
c. Sinus bradycardia often requires multiple doses of atropine to correct it.
d. Sinus bradycardia is caused by decreased vagal tone in most patients.

A

a. Treatment focuses on the patient’s tolerance to bradycardia.

47
Q 
An early complex that breaks the regularity of the underlying rhythm and that is characterized by a narrow QRS complex and an upright P wave that differs in shape and size from the P waves of the other complexes MOST accurately describes aNo:
Select one:
a. atrial escape complex.
b. wandering atrial pacemaker.
c. junctional escape complex.
d. premature atrial complex.
A

d. premature atrial complex.

48
Q

Sinus arrest is characterized by:
Select one:
a. a dropped PQRST complex.
b. an irregularly irregular rhythm.
c. PR intervals greater than 0.12 seconds.
d. irregularity during the inspiratory phase.

A

a. a dropped PQRST complex.

49
Q

A major complication associated with atrial fibrillation is:
Select one:
a. clot formation in the fibrillating atria.
b. a significant reduction in atrial filling.
c. pulmonary congestion and hypoxemia.
d. a profound increase in the atrial kick.

A

a. clot formation in the fibrillating atria.

50
Q 
A regular cardiac rhythm with a rate of 104 beats/min, upright P waves, a PR interval of 0.14 seconds, and QRS complexes that measure 0.10 seconds should be interpreted as:
Select one:
a. supraventricular tachycardia.
b. normal sinus rhythm.
c. sinus tachycardia. 
d. junctional tachycardia.
A

c. sinus tachycardia.

Medical Emergencies EMS (12 decks)

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