Deck 14: Origin and Clinical Aspects of Ventricular Dysrhythmias

Question 1

The Purkinje fibers:

A) have an inherent rate of 20 to 40 beats per minute.
B) slow the conduction of the impulse to allow the atria to finish filling the ventricles.
C) are the primary pacemaker site of the heart.
D) spread the conduction impulse throughout the atria.

Answer 1

have an inherent rate of 20 to 40 beats per minute.

Question 2

Features common to ventricular dysrhythmias are:

A) PR intervals which are greater than 0.20 seconds in duration.
B) upright, elevated T waves.
C) inverted P waves that immediately precede or follow the QRS complexes.
D) wide, bizarre-looking QRS complexes.

Answer 2

wide, bizarre-looking QRS complexes.

Question 3

Premature ventricular complexes (PVCs):

A) occur in the cardiac cycle later than the next expected sinus beat.
B) most often occur for no apparent reason in individuals who have healthy hearts.
C) are early ectopic beats that originate from an irritable focus in the ventricular conduction system or muscle tissue.
D) produce increased ventricular contraction because the impulse spreads from cell to cell across the ventricles.

Answer 3

are early ectopic beats that originate from an irritable focus in the ventricular conduction system or muscle tissue.

Question 4

Characteristics of premature ventricular complexes include that they:

A) are preceded by an inverted P wave.
B) are followed by a noncompensatory pause.
C) have a wide and bizarre-looking QRS complex.
D) have normal PR intervals.

Question 5

When every fourth beat is a PVC, it is called ______ PVCs.

A) unifocal
B) bigeminal
C) trigeminal
D) quadrigeminal

Question 6

Two PVCs in a row is called a ______ of PVCs.

A) double
B) couplet
C) deuce
D) bigeminy

Question 7

Three PVCs in a row is called a:

A) salvo.
B) triplet.
C) blast.
D) couplet.

Question 8

An interpolated PVC is one that:

A) occurs near the T wave of the preceding beat.
B) produces a wide, biphasic QRS complex.
C) arises from the bundle of His or higher.
D) does not disrupt the normal cardiac cycle.

Question 9

An R-on-T PVC:

A) occurs on or near the T wave of the previous beat.
B) appears as a PVC squeezed between two regular complexes.
C) may precipitate ventricular asystole.
D) produces a non-compensatory pause.

Question 10

When a PVC occurs the first thing you see as you look across the ECG tracing is:

A) a fast rate.
B) a wide, bizarre looking QRS complex that is preceded by an inverted P' wave.
C) an irregular rhythm.
D) an early beat which has a tall, biphasic QRS complex and is followed by an inverted T wave.

Question 11

Your 48-year-old patient is complaining of chest pain and palpitations. You attach the ECG monitor to reveal tachycardia at a rate of 110 beats per minute with frequent early beats. The early beats appear wide and bizarre, have a T wave that takes an opposite direction to the QRS complex and are not preceded by a P wave. As you watch the ECG monitor you note the beats are occurring "every other beat." This patient is experiencing:

A) wandering atrial pacemaker
B) atrial fibrillation
C) bigeminal PVCs
D) couplets of PVCs

Question 12

With an idioventricular rhythm the pacemaker site is in the:

A) SA node
B) atrial conduction pathways
C) AV junction
D) Purkinje fibers

Question 13

Characteristics of idioventricular rhythm include:

A) narrow QRS complexes.
B) a heart rate of between 20 and 40 beats per minute.
C) P waves that follow the QRS complexes.
D) T waves that take the same direction as the R waves.

Question 14

Idioventricular rhythm:

A) is a fast dysrhythmia that arises from the bundle of His or ventricles.
B) is caused by increased catecholamine and sympathetic tone, ingestion of stimulants, and drug toxicity.
C) may be either monomorphic or polymorphic.
D) typically causes decreased cardiac output which leads to the patient becoming symptomatic.

Question 15

Characteristics of ventricular tachycardia include:

A) wide, bizarre-looking QRS complexes.
B) a heart rate of between 60 and 120 beats per minute.
C) inverted P waves that precede the QRS complex.
D) PR intervals that are between 0.12 and 0.20 seconds in duration.

Question 16

A 51-year-old male was working out at the gym when he suddenly experienced lightheadedness. The ECG monitor reveals a regular rhythm of wide and bizarre-looking QRS complexes at a rate of 90 beats per minute. The QRS complexes are followed by a T wave that takes an opposite direction to the R wave. Also, there are no P waves. This patient is experiencing:

A) ventricular tachycardia
B) supraventricular tachycardia
C) wandering atrial pacemaker
D) accelerated idioventricular rhythm

Question 17

Ventricular tachycardia:

A) produces a sufficient enough cardiac output to meet the body's needs.
B) often precedes ventricular fibrillation and sudden death.
C) seldom occurs in the presence of myocardial ischemia or significant cardiac disease.
D) occurs in bursts of 6 to 10 complexes in a row but is seldom seen as a sustained fast rate.

Question 18

Ventricular tachycardia is said to be present when there are ___ or more PVCs in a row.

A) 5
B) 2
C) 3
D) 6

Question 19

Ventricular tachycardia has:

A) P waves preceding each QRS complex.
B) a rate of between 100 and 250 beats per minute.
C) an irregular rhythm.
D) wide, biphasic QRS complexes.

Question 20

Torsades de pointes is:

A) a unique variant of monomorphic ventricular tachycardia.
B) responsive to standard antidysrhythmic drugs.
C) characterized by QRS complexes that alternate between upright deflections and downward deflections.
D) a slow idioventricular rhythm.

Question 21

The most common cause of prehospital cardiac arrest in the adult patient is:

A) asystole
B) pulseless electrical activity (PEA)
C) ventricular fibrillation
D) a run of sustained ventricular tachycardia

Question 22

Ventricular fibrillation is seen on the ECG monitor as:

A) an overall pattern that appears irregularly shaped, chaotic, and lacks any regular repeating features.
B) electrical signals that are the same height and width.
C) a sustained run of wide, bizarre looking QRS complexes.
D) a rhythm that has a changing distance between the peaks of the R waves.

Question 23

The true definitive treatment for ventricular fibrillation is:

A) the rapid administration of antidysrhythmic medications.
B) pacing.
C) CPR, intubation, IV.
D) defibrillation.

Question 24

Asystole:

A) is defined as the presence of chaotic cardiac activity.
B) produces a complete cessation of cardiac output.
C) appears as a chaotic line on the ECG monitor.
D) is the most common primary event in cardiac arrest in the adult.

Question 25

Which of the following has an organized electrical rhythm but no pulse?

A) ventricular fibrillation
B) asystole
C) PEA
D) idioventricular rhythm

Question 26

Ventricular dysrhythmias can be life threatening because the ventricles are ultimately responsible for cardiac output.

Question 27

Uniformed PVCs arise from different sites in the ventricles and tend to look different from one another.

Question 28

When a PVC occurs and no pulse is felt is it is called a nonperfusing PVC.

Question 29

Idioventricular rhythm is often the first organized rhythm following defibrillation.