Deck 8: Recognizing Arrhythmias Pacemakers and Emergencies

Question 1

When the heartbeat originates outside of the SA node, it is called a(n)__________.

A) skipping beat
B) ectopic beat
C) escape beat
D) junctional beat

Answer 1

ectopic beat

Question 2

Which of the following presents on the ECG as chaotic indistinguishable waves caused by multiple ectopic and reentry paths originating from many different areas in the ventricle walls, yet has no recognizable rhythm or pattern?

A) Ventricular tachycardia
B) Premature ventricular complex
C) Idioventricular rhythm
D) Ventricular fibrillation

Answer 2

Ventricular fibrillation

Question 3

What heart condition do the waves in the ECG tracing below represent?

A) Junctional arrhythmia
B) Atrial flutter
C) Atrial tachycardia
D) Atrial fibrillation

Answer 3

Atrial flutter

Question 4

When medication no longer controls tachycardia, which of the following may be implanted into the patient to control these life-threatening arrhythmias?

A) Synchronous pacemaker
B) Implantable cardioverter defibrillator
C) Transcutaneous pacemaker
D) Asynchronous pacemaker

Question 5

What is the largest cause of natural deaths in the United States?

A) Diabetes
B) Recreational drug abuse
C) Sudden cardiac arrest
D) Myocardial infarction

Question 6

In a pacemaker ECG, if a spike appears by itself with no P wave and no QRS complex, it is called a(n) ____________.

A) Over sensing
B) Loss of capture
C) Failure to pace
D) Under sensing

Question 7

The primary difference between the sinus tachycardia and atrial tachycardia is found in the appearance of which of the following ECG tracings?

A) ST segment
B) P wave
C) R wave
D) T wave

Question 8

Blockage of one or more coronary arteries that supply blood to the left ventricle is usually the cause of which of the following?

A) Ventricular fibrillation
B) Aneurysm
C) Acute myocardial infarction
D) Sudden cardiac arrest

Question 9

What type of pacemaker ECG reading does the tracing below represent?

A) Loss of capture
B) Atrial pacemaker rhythm
C) Ventricular pacemaker rhythm
D) Dual chamber pacemaker rhythm

Question 10

____________ is defined as a decrease in oxygenated blood flow to the heart muscle.

A) Atrial arrhythmia
B) Myocardial infarction
C) Necrosis
D) Ischemia

Question 11

In atrial arrhythmias, the atrioventricular (AV) node overrides the SA node impulses and the AV node becomes the heart's____________.

A) pacemaker
B) battery
C) defibrillator
D) generator

Question 12

Which of the following conditions is where the heart muscle cannot contract even though electrical activity appears on the ECG?

A) Pulseless electrical activity
B) Idioventricular rhythm
C) Ventricular fibrillation
D) Premature ventricular complex

Question 13

Left untreated, some atrial arrhythmias can cause _________ to form in the heart.

A) electrolyte imbalances
B) coronary artery disease
C) blood clots
D) aneurysms

Question 14

The ECG tracing below shows how an abnormal ST segment may appear with which of the following?

A) Acute ischemia or injury in leads V1-V4 with an anterior wall injury
B) The location of damage with an MI
C) Acute ischemia or injury in Leads II, III, and aVF with an inferior wall injury
D) An old inferior infarction

Question 15

What heart condition does this tracing indicate is evolving?

A) Junctional tachycardia
B) Supraventricular arrhythmia
C) Acute myocardial infarction
D) Atrial tachycardia

Question 16

Junctional tachycardia occurs when the junctional rate is how many beats per minute?

A) 40-60
B) 250-350
C) 60-100
D) 100-180

Question 17

Which of the following is the absence of any ventricular activity, no depolarization, no pulse, no blood is flowing through the heart, no cardiac output?

A) Ventricular asystole
B) Ventricular tachycardia
C) Ventricular fibrillation
D) Ventricular arrhythmia

Question 18

Classify the rhythm of the ECG tracing below.

A) Atrial fibrillation
B) Atrial flutter
C) Normal sinus rhythm
D) Premature atrial complex

Question 19

Which of the following cardiac medications would be given if the indication is bradycardia?

A) Nitroglycerin
B) Adenosine
C) Atropine
D) Amiodarone

Question 20

Which of the following cardiac medications would be given if the indication is an acute coronary syndrome?

A) Dopamine
B) Lidocaine
C) Vasopressin
D) Nitroglycerin

Question 21

Over sensing or under sensing pacemakers can be detected on an ECG when the pacemaker fails to sense intrinsic _____________.

A) T waves
B) QRS complexes
C) P or R waves
D) R-R intervals

Question 22

A noticeable apical or peripheral pulse rate is usually the only outward sign that a patient has which of the following?

A) Ventricular tachycardia
B) Atrial tachycardia
C) Atrial flutter
D) Atrial fibrillation

Question 23

What type of heart rates occur more commonly in infants, children, and young adults who are anxious or extremely fatigued?

A) Ventricular asystole
B) Supraventricular tachycardia
C) Ventricular fibrillation
D) Idioventricular rhythm

Question 24

Which of the following weakens an arterial wall and can cause the vessel to rupture?

A) Coronary artery disease
B) Aneurysm
C) Blood clot
D) Blunt force trauma

Question 25

Except for ______________, in the other ventricular arrhythmias, the P wave is non-existent, so there is no atrial depolarization, no atrial contraction, and no atrial kick.

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

Question 26

The ECG tracings in Figure 8-18 are very short vertical straight lines which can be as small as 2 ms. What do these tracings represent?
 

A) Loss of capture
B) Dual chamber pacing
C) Atrial paced rhythm
D) Pacemaker spikes

Question 27

Embolic strokes often form in the heart due to _____________.

A) bradycardia
B) a blockage
C) tachycardia
D) loss of heart function

Question 28

What type of pacemaker rhythm is shown in the ECG tracing below?

A) Loss of capture
B) Dual chamber pacing rhythm
C) Ventricular pacing rhythm
D) Atrial pacing rhythm

Question 29

Failure of the heart to pump oxygenated blood efficiently causing cardiopulmonary arrest, is an example of what type of cardiac compromise?

A) Mechanical malfunction
B) Coronary artery disease
C) Electrical malfunction
D) Injury

Question 30

The ECG tracing below identifies the sinus P wave and possible P prime (P') wave presentations for what type of rhythm?

A) Normal sinus rhythm
B) Junctional tachycardia rhythm
C) Junctional rhythm
D) Accelerated junctional rhythm

Question 31

A patient in asystole is not defibrillated as this is what type of condition?

A) Terminal
B) Emergency
C) Underlying health
D) Intrinsic health

Question 32

When the malfunction is ________________, the ECG will show no pacemaker spikes on the ECG tracing.

A) over sensing
B) failure to pace
C) fail to capture
D) under sensing

Question 33

In what type of rhythm will ventricular pacemaker spikes be seen before each QRS complex and normally, no atrial spikes are visible, and   P waves may not be visible, except possibly in precordial lead V1?

A) Ventricular pacing rhythm
B) Atrial pacing rhythm
C) Loss of capture
D) Dual chamber pacing rhythm

Question 34

Untreated ischemia causes injury to what part of the heart?

A) Myocardium
B) Atrium
C) Ventricles
D) Arteries

Question 35

An ECG tracing from a patient with a pacemaker may have wide or bizarre __________ if the pacemaker captures the chamber it is pacing.

A) P waves
B) T waves
C) QRS complexes
D) R-R intervals

Question 36

The difference between a pacemaker and the ICD is that the ICD can deliver two levels of electrical__________.

A) impulses
B) activity
C) conduction
D) stimulus

Question 37

The treatment for controlling atrial arrhythmias is to first control the heart rate, then use of ______________ to return the atria to a sinus rhythm.

A) ventricular reconstruction
B) antiarrhythmic therapy
C) high electrical energy
D) anticoagulation therapy

Question 38

Which of the following does not allow the heart to rest between contractions (depolarization)?

A) Ventricular tachycardia
B) Ventricular asystole
C) Pulseless electrical activity
D) Ventricular fibrillation

Question 39

Which of the following is the use of high electrical energy to destroy abnormal electrical pathways?

A) Implanting an ICD
B) Ablation
C) Implanting a pacemaker
D) Ventricular reconstruction

Question 40

Which of the following is considered a very unstable rhythm that is usually a precursor to ventricular fibrillation or sudden cardiac death?

A) Ventricular asystole
B) Idioventricular rhythm
C) Ventricular tachycardia
D) Premature ventricular complex