Deck 3: Analyzing the Electrocardiogram

Question 1

Which of the following are characteristics of the normal ECG?

A) Waveforms and intervals that appear at regular intervals at a rate of 60 to 90 beats per minute (in the adult).
B) Upright and slightly asymmetrical P waves, each followed by a QRS complex of normal upright contour, duration, and configuration
C) A PR interval (PRI) with a duration of 0.12 to 0.24 seconds that precedes each QRS complex.
D) A flat ST segment followed by an inverted, symmetrical T wave.

Answer 1

Upright and slightly asymmetrical P waves, each followed by a QRS complex of normal upright contour, duration, and configuration

Question 2

When we analyze an ECG tracing what rhythm do we compare our findings against to determine if there are any abnormalities?

A) Sinus bradycardia
B) Normal sinus rhythm
C) Atrial fibrillation
D) a & b

Answer 2

Normal sinus rhythm

Question 3

To analyze an ECG tracing you should:

A) approach it in a logical and systematic manner.
B) examine the P waves and QRS complexes first.
C) first view it on the oscilloscope and then print out a six second tracing.
D) scan the tracing from right to left.

Answer 3

approach it in a logical and systematic manner.

Question 4

The Nine-Step Process is used to assess ECG tracings. It includes all of the following EXCEPT:

A) determining the heart rate.
B) determining the regularity.
C) checking for a pulse.
D) examining the P waves.

Question 5

You are in the emergency department and hear one of the ED physicians referring to the morphology of the P waves in an ECG tracing. When she says this, she means the ______ of the P wave

A) duration
B) appearance
C) amplitude
D) origin

Question 6

The flat line seen on the ECG tracing:

A) is called artifact.
B) occurs any time electrical activity is occurring in the upper chambers of the heart.
C) can be used as a baseline or reference point to identify the changing electrical movement.
D) represents the movement of electrical activity away from a positive electrode.

Question 7

The first step of analyzing the ECG tracing is to:

A) examine the QRS complexes.
B) examine the T waves.
C) identify the regularity.
D) determine the heart rate.

Question 8

You are assessing the heart rate in a 48-year old male who is short of breath. The first thing you should do is to categorize it as:

A) regular or irregular.
B) slow, normal or fast.
C) supraventricular or ventricular.
D) usual or unusual.

Question 9

The 48-year old male who is short of breath has a heart rate of 130 BPM. This heart rate is:

A) tachycardic.
B) normal.
C) bradycardic.
D) irregular

Question 10

The regularity of an ECG tracing is determined by:

A) assessing the heart rate.
B) counting the number of P waves each minute.
C) counting the number of QRS complexes minute.
D) examining the distances between consecutive QRS complexes and consecutive P waves.

Question 11

The 48-year old male who is short of breath has R-R intervals that are occasionally different. He has a/an _______ rhythm.

A) irregular
B) regular
C) normal
D) supraventricular

Question 12

The initiation of the impulse in the SA node and its movement through the atria produces a:

A) P wave.
B) PR interval.
C) QRS complex.
D) T wave.

Question 13

Which of the following are characteristics of sinus P waves?

A) They are inverted and round waveforms.
B) There is one P wave preceding each QRS complex.
C) Their amplitude is 0.5 to 3.5 mm.
D) Their duration is 0.08 to 0.12 seconds.

Question 14

The QRS complex:

A) is larger in appearance than the P wave and consists of three parts.
B) is generally wide and sharply pointed.
C) normally has a duration of 0.12 to 0.20 second and an amplitude of 5 to 30 mm.
D) represents movement of the electrical impulse through the atria causing their contraction.

Question 15

The PR interval:

A) is normally 0.12 to 0.20 seconds in duration.
B) represents ventricular depolarization.
C) is the distance from the beginning of the P wave to the beginning of the S wave.
D) extends across 5 to 10 small squares.

Question 16

The pause that follows the QRS complex is referred to as the:

A) QT interval.
B) PR interval.
C) U wave.
D) ST segment.

Question 17

The J point is the:

A) point at which the QRS meets the ST segment.
B) first negative deflection following the PR segment.
C) peak of the R wave.
D) area that connects the ST segment to the T wave.

Question 18

The ST segment is seen as a:

A) small, asymmetrical upright waveform.
B) large, triangular-shaped waveform.
C) flat line.
D) large, asymmetrical upright waveform.

Question 19

Repolarization of the ventricles is represented by the:

A) P wave.
B) QRS complex.
C) T wave.
D) R wave.

Question 20

The T wave:

A) is larger than the P wave and completely symmetrical.
B) has a peak which is closer to the end than the beginning.
C) is normally 15-20 mm in height in the limb leads.
D) is normally oriented in the same direction as the preceding QRS complex.

Question 21

The QT interval:

A) is the distance from the onset of the QRS complex until the end of the T wave.
B) measures the duration of ventricular depolarization.
C) is typically the same irrespective of the age, sex, or heart rate.
D) normally has a duration of 0.20 to 0.36 second.

Question 22

The U wave:

A) is a small upright waveform.
B) precedes the T wave.
C) is always present.
D) is a small upright waveform and precedes the T wave.

Question 23

The 12-lead ECG printout reveals __ views of the heart.

A) 6
B) 8
C) 10
D) 12

Question 24

The average heart rate in the adult is 60 to 100 BPM.

Question 25

The first five steps of the Nine-Step Process are better suited for identifying cardiac conditions.

Question 26

A quick analysis of an ECG can be done by looking at the tracing as it moves from left to right horizontally across ECG oscilloscope.

Question 27

An ECG printout is also called a dynamic tracing and represents what occurred in the heart at the time the tracing was recorded.

Question 28

Each dysrhythmia and cardiac condition has characteristics that are unique to it, making it identifiable to anyone who knows for what to look for.

Question 29

To analyze a 12-lead ECG tracing, move from left to right horizontally along the first row, then proceed to the second row and then the third row using the same technique.