Basic Arrhythmia Interpretation
Textbook Exam Questions
Course Introduction
This course introduces students to the fundamental concepts of cardiac arrhythmias, focusing on the identification and interpretation of basic heart rhythm irregularities through electrocardiogram (ECG) analysis. Learners will gain the skills necessary to recognize normal versus abnormal cardiac rhythms, understand the underlying physiological mechanisms, and differentiate among common arrhythmias such as atrial fibrillation, ventricular tachycardia, and heart blocks. Through interactive lectures and hands-on practice, students will develop competencies essential for safe patient care in various healthcare settings, preparing them for advanced cardiac life support and clinical decision-making.
Recommended Textbook
EKG Plain and Simple 4th Edition by Karen Ellis
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Chapter 1: Cardiac Anatomy and Physiology
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Q1) The parasympathetic nervous system causes
A)slowed digestion.
B)decrease in heart rate.
C)pupillary dilation.
D)increase in blood pressure.
Answer: B
Q2) The ________ is the chamber that receives blood from the superior and inferior venae cavae.
Answer: right atrium
Q3) The vessel that delivers oxygenated blood to the anterior wall of the left ventricle is the
A)left main coronary artery.
B)coronary vein.
C)right coronary artery.
D)left anterior descending coronary artery.
Answer: D
Q4) The heart has three layers: the endocardium,myocardium,and epicardium.
A)True
B)False
Answer: True
Page 3
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Chapter 2: Electrophysiology
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Sample Questions
Q1) Arrhythmias are ________ heart rhythms. Answer: Abnormal
Q2) Depolarization is a(n)
A)electrical event that should result in muscle relaxation.
B)mechanical event that should result in depolarization.
C)electrical event that should result in muscle contraction.
D)mechanical event that should result in repolarization.
Answer: C
Q3) If the sinus node and atria both fail,the ________ will be absent on the rhythm strip.
A)P wave
B)QRS complex
C)R wave
D)T wave
Answer: A
Q4) Normal conduction begins with the pacemaker of the heart,the ________. Answer: Sinus node
Q5) The pacemaker with the slowest inherent rate is the ________. Answer: Ventricle
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Chapter 3: Lead Morphology and Placement
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Sample Questions
Q1) AVL has its positive pole on the
A)left arm.
B)right leg.
C)right arm.
D)left leg.
Answer: A
Q2) The bipolar lead formed by joining the right arm and right leg is
A)Lead I.
B)Lead II.
C)Lead III.
D)There is no such lead.
Answer: D
Q3) In which lead should the tallest QRS complex be seen?
A)Lead I
B)Lead II
C)Lead III
D)aVF
Answer: B
Q4) A ________ is an arrow that depicts the general direction of current flow.
Answer: vector
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Chapter 4: Technical Aspects of the EKG
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Sample Questions
Q1) Macroshock and microshock are LEAST likely to be caused by which of the following?
A)Frayed electrical cord on the EKG machine
B)Broken grounding prong on the electrical cord
C)Properly maintained EKG machine
D)Ungrounded hospital bed on which the patient is lying
Q2) Artifact in Leads I,III,and aVL is caused by a loose or detached electrode patch or wire on the left arm.
A)True
B)False
Q3) Microshock is different from macroshock in that microshock is
A)a higher-voltage electrical shock.
B)a lower-voltage electrical shock.
C)caused by inadequate grounding of electrical equipment.
D)incapable of causing death.
Q4) Sometimes,the presence of artifact can be verified by changing the lead.
A)True
B)False
Q5) Baseline sway is caused by lotion or sweat on the skin interfering with the ________ reaching the EKG machine.
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Chapter 5: Calculating Heart Rate
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Sample Questions
Q1) The type of regularity in which the R-R intervals are 22-24-23-29-33-47-27 is
A)regular.
B)regular but interrupted by premature beats.
C)regular but interrupted by pauses.
D)irregular.
Q2) Regardless of the method used,what are you doing when you calculate heart rate?
A)Counting the number of P waves in a minute-long rhythm strip
B)Counting the number of QRS complexes in a minute-long rhythm strip
C)Counting the number of premature beats or pauses in a minute-long rhythm strip
D)Counting the number of irregular blocks in a minute-long rhythm strip
Q3) The mean rate in Figure 1 is
A)50.
B)60.
C)70.
D)100.
Q4) If the QRS complexes are all 15 little blocks apart,the heart rate is ________.
Q5) Regularity is concerned with the constancy of QRS complexes.
A)True
B)False
Q6) A regular rhythm is one in which ________.
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Chapter 6: How to Interpret a Rhythm Strip
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Sample Questions
Q1) An arrhythmia is a(n)________ heart rhythm.
Q2) If the patient's rhythm changes,you should FIRST
A)assess your patient for signs of decreased cardiac output.
B)calculate the heart rate,rhythm,and intervals.
C)change the lead to see if the rhythm is real or if it's artifact.
D)look for P waves.
Q3) A rhythm originating in the sinus node should NOT have which of the following?
A)Narrow QRS complexes of uniform shape
B)Regularly spaced QRS complexes
C)Absent QRS complexes
D)Heart rate of 60-100
Q4) Sinus rhythm is an irregular rhythm interrupted by premature beats and pauses.
A)True
B)False
Q5) The normal PR interval in sinus rhythm should be ________.
Q6) What are the five steps in rhythm interpretation?
Q7) The normal rhythm of the heart is called ________.
Q8) A rhythm with a heart rate less than 60 is a tachycardia.
A)True
B)False
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Chapter 7: Rhythms Originating in the Sinus Node
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Sample Questions
Q1) In sinus rhythm,the heart rate is
A)60-100.
B)greater than 100.
C)less than 60.
D)greater than 170.
Q2) Sinus arrest can occur at any heart rate.
A)True
B)False
Q3) The heart rate during sinus tachycardia is less than 60.
A)True
B)False
Q4) Which of the following is an irregular rhythm originating in the sinus node?
A)Sinus arrhythmia
B)Sinus rhythm
C)Sinus tachycardia
D)Sinus bradycardia
Q5) A condition in which the thyroid gland overproduces thyroid hormones and causes the heart rate,temperature,and blood pressure to rise to dangerous levels is called
Page 9
Q6) In a sinus arrest,the sinus node________ firing for a time.
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Chapter 8: Rhythms Originating in the Atria
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Sample Questions
Q1) Both atrial fibrillation and multifocal atrial tachycardia have at least three different shapes of P waves.
A)True
B)False
Q2) Atrial tachycardia is characterized by
A)abnormal P waves preceding the regular QRS complexes.
B)sawtooth waves between the QRS complexes.
C)undulating,fibrillatory baseline between the irregular QRS complexes.
D)a heart rate of 250-350.
Q3) The P wave of a PAC is shaped _____from sinus P waves.
Q4) Multifocal atrial tachycardia is an irregular rhythm with a heart rate greater than 100.
A)True
B)False
Q5) In order to diagnose PAT,the ________ that initiates it must be seen.
Q6) Atrial fibrillation can cause a drop in cardiac output because it causes
A)a loss of the atrial kick.
B)the ventricles to contract more forcefully.
C)the AV valves to remain open too long.
D)the sinus node to fire more often.
Page 10
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Chapter 9: Rhythms Originating in the AV Junction
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Sample Questions
Q1) Mid-junctional rhythms originate midway between the sinus node and the atria.
A)True
B)False
Q2) Conduction to the ventricle is said to be ________ in junctional rhythms.
Q3) Junctional bradycardia is usually the result of usurpation.
A)True
B)False
Q4) Low junctional rhythms originate low down in the ventricle.
A)True
B)False
Q5) Junctional bradycardia must have a heart rate less than 20.
A)True
B)False
Q6) Electrical shock is used to treat frequent PJCs.
A)True
B)False
Q7) How do the P waves of junctional rhythms differ from the P waves of sinus rhythms?
Q8) PJCs are ________ beats from the AV junction.
Q9) Junctional tachycardia is best called SVT if there are no ________ P waves.
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Chapter 10: Rhythms Originating in the Ventricles
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Sample Questions
Q1) Multifocal PVCs are those that
A)have different shaped P waves preceding them.
B)have different shaped QRS complexes.
C)come from the same focus.
D)resemble each other.
Q2) Ventricular tachycardia is usually a result of escape.
A)True
B)False
Q3) Torsades de pointes is a form of ventricular tachycardia that ________ around an axis.
Q4) PVC stands for ________.
Q5) The treatment of choice for ventricular fibrillation is ________.
Q6) For which of the following rhythms is electrical shock to the heart appropriate?
A)Ventricular tachycardia
B)Ventricular fibrillation
C)Asystole
D)All except C
Q7) PVCs are usually followed by an incomplete compensatory pause.
A)True
B)False
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Chapter 11: AV Blocks
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Sample Questions
Q1) In third-degree AV block,if the block is at the AV node
A)the QRS will be wide and bizarre.
B)the P waves will be tall and pointy.
C)the QRS will be narrow.
D)there will be no P waves.
Q2) 2:1 AV block is characterized by one P wave to every other QRS.
A)True
B)False
Q3) Wenckebach is also known as ________.
Q4) In AV blocks,the underlying rhythm is ________.
Q5) Treatment for third-degree AV block usually includes A)digitalis.
B)lidocaine.
C)amiodarone. D)pacemaker.
Q6) Which strip is consistent with Mobitz I second-degree AV block (Wenckebach)? A)A
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Chapter 13: How to Interpret a 12-Lead EKG
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Sample Questions
Q1) A QS pattern in V is characteristic of A)complete heart block.
B)Mobitz II second-degree AV block.
C)LBBB.
D)RBBB.
Q2) Hypertrophy can stress the heart.
A)True
B)False
Q3) An axis of +120 degrees is ________ deviation.
Q4) In severe hyperkalemia,the QRS can widen out significantly.
A)True
B)False
Q5) If both Lead I and aVF's QRS complexes are positive,the axis is ________.
Q6) Hyperkalemia is a potassium deficit in the bloodstream. A)True
B)False
Q7) The normal axis is between 0 and -90 degrees.
A)True
B)False
Q8) If Lead I and aVF both have negative QRS complexes,the axis is ________.
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Chapter 14: Myocardial Infarction
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Sample Questions
Q1) An inverted T wave is indicative of
A)myocardial necrosis.
B)myocardial ischemia.
C)myocardial injury.
D)abnormal ventricular depolarization.
Q2) Which of the following BEST describes the progression of electrical conductivity in an EKG with normal transition?
A)V and V are mostly positive,V and V are isoelectric,and V and V are mostly negative.
B)V through V are isoelectric,V is mostly negative,and V and V are mostly positive.
C)V through V are mostly negative,V is isoelectric,and V and V are mostly positive.
D)V through V are mostly negative,V through V are mostly positive,and V is isoelectric.
Q3) The normal T wave is tall and pointy.
A)True
B)False
Q4) A ________ MI is seen as a mirror image of an anterior MI.
Q5) Name the three Is of infarction.
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Chapter 16: Medications and Electrical Therapy
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Sample Questions
Q1) Beta-blockers have what effect on heart rate and contractility?
A)Increased heart rate and contractility
B)Decreased heart rate and contractility
C)Increased heart rate and decreased contractility
D)Decreased heart rate and increased contractility
Q2) Which of the following would NOT be an indication for a pacemaker?
A)Idioventricular rhythm
B)Sinus rhythm
C)Third-degree AV block
D)Mobitz II second-degree AV block
Q3) Which of the following medications blocks vagus nerve effects on the heart?
A)Digitalis
B)Epinephrine
C)Atropine
D)Verapamil
Q4) The first letter of the pacemaker code tells the
A)chamber sensed.
B)chamber paced.
C)pacemaker's response to sensed events.
D)programmability of the pacemaker.
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Chapter 17: Diagnostic Electrocardiography
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Sample Questions
Q1) For submaximal testing,what percentage of the target heart rate must be attained?
A)65%
B)85%
C)70%
D)100%
Q2) Mr.Jackson has periods of sudden,unexpected syncope.What kind of Holter monitoring system would be best?
A)Patient-activated event monitor
B)Either an arrhythmia-activated event monitor with a memory loop recorder or a continuous recorder
C)Continuous recorder
D)Any type of system would be adequate.
Q3) A MET is a measurement of oxygen consumption.
A)True
B)False
Q4) The most commonly used device for exercise stress testing is the arm ergometer.
A)True
B)False
Q5) Bayes' theorem is concerned with the ________ of stress test results.
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