Quiz 5 Review

Quiz 5 Review : 

Quiz 5 Review Galveston College Paramedic Program 2010

Slide 2: 

“Treat the patient not the monitor!”

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1. It is MOST important to evaluate a cardiac dysrhythmia in the context of the:   A) patient's heart rate. B) patient's medical history. C) patient's overall condition. D) width of the QRS complex.

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2. Damage to the cardiac electrical conduction system caused by an acute myocardial infarction MOST commonly results in: A) severe tachycardia. B) ventricular arrhythmias. C) acute bundle branch block. D) bradycardia or heart block.

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3. A decreased cardiac output secondary to a heart rate greater than 150 beats/min is caused by: A) myocardial stretching due to increased preload. B) decreases in stroke volume and ventricular filling. C) increased automaticity of the cardiac pacemaker. D) ectopic pacemaker sites in the atria or ventricles.

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4. 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: A) fusion. B) reentry. C) ectopy. D) excitability.

Artifact: Loose Electrode : 

Artifact: Loose Electrode

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5. If a patient's ECG rhythm shows any artifact, you should:   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.

Rule of Electrical Flow : 

Electricity flowing toward positive electrode produces an upright pattern. Rule of Electrical Flow

Slide 10: 

6. When using limb leads, any impulse moving toward a positive electrode will:  cause a positive deflection on the ECG. produce a significant amount of artifact. C) cause a negative deflection on the ECG. D) manifest with narrow QRS complexes.

Electrode Placement for Monitoring Lead II : 

Electrode Placement for Monitoring Lead II

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7. When assessing lead II via the limb leads, the negative lead should be placed on the:  left arm. left leg. right arm. right leg.

The Electrocardiogram (1 of 19) : 

13/121 The Electrocardiogram (1 of 19) ECG Leads Bipolar (Limb) Einthoven’s Triangle Leads I, II, III Augmented (Unipolar) aVR, aVL, aVF Precordial V1 – V6

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8. According to the Einthoven triangle, lead II is assessed by placing the:  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.

The Electrocardiogram (2 of 19) : 

15/121 The Electrocardiogram (2 of 19) Height is measured in millimeters Width is measured in milliseconds

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9. On the ECG graph paper, height is measured in _____________ and width is measure in ____________. A) centimeters, seconds B) milliseconds, millimeters C) seconds, centimeters D) millimeters, milliseconds

The Electrocardiogram (3 of 19) : 

17/121 The Electrocardiogram (3 of 19) ECG Paper Speed Amplitude and Deflection Calibration

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10. How many large boxes on the ECG graph paper represent 6 seconds? 20 30 40 50

Graph Paper : 

Graph Paper } Time

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11. If a particular interval on the ECG graph paper is 1.5 small boxes in width, the interval would be measured as: A) 0.06 seconds. B) 2 millimeters. C) 45 milliseconds. D) 60 milliseconds.

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12. If a QRS complex is not preceded by a P wave: A) the rhythm is likely ventricular in origin. B) atrial fibrillation is the likely underlying rhythm. C) the pacemaker for the heart is not the SA node. D) there are at least three ectopic atrial pacemakers.

The Electrocardiogram (12 of 19) : 

22/121 The Electrocardiogram (12 of 19) Time Intervals PR Interval (PRI) or PQ Interval (PQI) 0.12–0.20 seconds QRS Interval 0.08–0.12 seconds ST Segment QT Interval 0.33–0.42 seconds

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13. A prolonged P-R interval: A) is greater than 0.12 seconds. B) suggests damage to the SA node. C) may indicate a diseased AV node. D) indicates that the AV node was bypassed.

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14. The duration of the QRS complex should be less than: 0.10 seconds. B) 0.12 seconds. C) 0.14 seconds. D) 0.16 seconds.

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15. A wide QRS complex that is preceded by a normal P wave indicates: 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.

Q Waves : 

Q Waves Chapter 3

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16. Q waves are considered abnormal or pathologic if they are:  A) greater than 0.02 seconds wide and consistently precede the R wave. B) deeper than one third the total 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.

The ST Segment : 

The ST Segment From the end of the QRS complex to the beginning of the T wave Should be at the baseline Chapter 3

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17. The __________ represents the end of ventricular depolarization and the beginning of repolarization. A) J point B) T wave C) ST segment D) T-P interval

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Gail Walraven, Basic Arrhythmias, Sixth Edition©2006 by Pearson Education, Inc., Upper Saddle River, NJ

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Gail Walraven, Basic Arrhythmias, Sixth Edition©2006 by Pearson Education, Inc., Upper Saddle River, NJ

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18. The downslope of the T wave: 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 dysrhythmia.

Slide 33: 

ST elevation of more than 1 mm should be substantiated in a 12-Lead EKG.

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19. An ST segment that is more than 1 mm above the isoelectric line: A) indicates myocardial ischemia. B) is clinically insignificant in lead II. C) must be substantiated by a 12-lead ECG. D) is a definitive sign of myocardial injury.

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20. The 6-second method for calculating the rate of a cardiac rhythm: 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.