1. Dysrhythmia Review By Don Frasco, RN

2. After the blood returns from the body it passes through the superior and inferior vena cava into what chamber? A.Left atrium B.Right ventricle C.Left ventricle D.Right atrium

3. What valve sits between the left atrium and the left ventricle? A.Tricuspid valve B.Valsalvic valve C.Bicuspid (Mitral) valve D.Pulmonic valve

4. Complete the sentence: “Pulmonary arteries carry _________ blood.” A.Type A B.Oxygenated C.Type B D.Deoxygenated

5. From the right atrium, the blood flows past the tricuspid valve into the _______ A.Left atrium B.Right ventricle C.Left ventricle D.Right atrium

6. True or False The Right Ventricle is the chamber that pumps blood into the lungs. Answer: True

7. The amount of fluid prior to contraction, best describes A.Cardiac Output B.Starlings Law C.Preload D.Stroke Volume

8. Heart Rate x Stroke Volume = ________ A.Cardiac Output B.Starlings Law C.Preload D.Stroke Volume

9. The ________ is the chamber that pumps blood to the body. A.Left atrium B.Right ventricle C.Left Ventricle D.Right Atrium

10. Name all the components of the conduction pathway in order. His-Purkinje system in Ventricles Internodal & Interatrial Pathways Left & Right Bundle Branches Bundle of His Atrioventricular (AV) Node Sinoatrial Node (SA) Node

11. Name all the components of the conduction pathway in order. Sinoatrial Node (SA) Node Internodal & Interatrial Pathways Atrioventricular (AV) Node Bundle of His Left & Right Bundle Branches His-Purkinje system in Ventricles

12. The electrical current generated by ventricular depolarization is recorded as the A.P wave B.QRS complex C.Atrial T wave D.T wave

13. The electrical current generated by ventricular repolarization is recorded as the A.P wave B.T wave C.QRS complex D.Atrial T wave

14. Causes of artifacts on an EKG tracing include: A.Muscle tremor B.Poor electrode contact with the skin C.External chest compression D.All of the above

15. The normal PR interval is between: A.0.8 and 0.24 seconds B.0.8 and 0.16 seconds C.0.12 and 0.20 seconds D.0.10 and 0.24 seconds

16. Myocardial Ischemia, Acute MI, and excess serum potassium can cause an abnormal __________ on the EKG A.P wave B.QRS complex C.T wave D.U wave

17. Identify this Rhythm Sinus Bradycardia with Peak P waves, ST Elevation, Tall and Peak T waves

18. The EKG change that may be noted after a completed acute STEMI myocardial infarction is A. Absence of “P” waves B.Tall, Peaked “T” waves C.Pathological Q wave D.Inverted “P” waves

19. In an acute MI, elevation of the ST segment represents: A.Ischemia B.Injury C.Necrosis D.Tissue regeneration

20. In the presence of an Acute MI, a “Q” wave of more than 25% the amplitude of the R wave and wider than 0.04 seconds indicates: A. Bundle branch block B.Improvement in condition C.Infarction (death of tissue) necrosis D.Injury

21. Identify the Abnormalities Bundle Branch Block, ST Depression, Inverted T waves

22. The heart rate can be determined by A.The six second strip method B.The large box method C.The small box method D.All of the above

23. An arrhythmia originating in an escape pacemaker in the AV junction with a rate of 61 to 100 beats per minute is called a(n): A.Agonal rhythm B.Junctional Escape Rhythm C.Accelerated Junctional Rhythm D.Junctional Tachycardia

24. Identify This Rhythm Junctional Bradycardia 1500 ÷ 38 = 39

25. If the QRS complexes are < 0.12 seconds in duration, the electrical impulses responsible for the QRS complexes most likely have originated in the: A.SA node B.Atrial sites C.AV junction D.All of the above

26. A PR interval of less than 0.12 seconds indicates that the pacemaker site of the P wave is in the: A.AV junction B.Lower right atrium near the AV node C.Upper right atrium with an accessory AV pathway present WPW D.All of the above

27. Identify This Rhythm Sinus Arrhythmia

28. If there are 20 small squares between the peaks of two consecutive R waves, in a regular rhythm, the heart rate is _________ beats per minute A.50 B.75 C.100 D.150 Formula: 1500 ÷ 20 = 75

29. Identify This Rhythm Sinus Rhythm

30. Two PVC’s in a row are called A.Trigeminy B.Couplet or a Pair C.Bigeminy D.Run or Burst

31. Identify This Rhythm Sinus Bradycardia With Bigeminal Unifocal PVCs

32. The QRS complex of a PAC usually resembles that of: A.The underlying rhythm B.A premature ventricular complex C.A right bundle branch block D.A left bundle branch block

33. Identify The Ectopic Premature Atrial Complex (PAC)

34. Atrial flutter is characterized by A.An atrial rate slower than the ventricular rate B.Waves with a saw tooth or picket fence pattern C.An atrial rate between 160 and 220 beats per minute D.All of the above

35. Identify This Rhythm Atrial Flutter with 4:1 block P PPP R

36. The reduction in cardiac output accompanying SVT can cause: A.Syncope B.Lightheadedness C.Dizziness D.All of the above

37. Identify This Rhythm Supraventricular Tachycardia (SVT)

38. A Non-conducted or Blocked PAC is A.Only found in bradycardic arrhythmias B.A premature P wave that is not followed by a QRS complex C.Never symptomatic in patients D.A P wave with a dropped or blocked QRS

39. Identify This Rhythm Sinus Bradycardia

40. Junctional type P waves are “_________” before, during or after the QRS. A.Notched/Flat B.Biphasic/Monophasic C.Inverted/retrograde D.Saw toothed/Picket Fence

41. An early beat that originates in an ectopic pacemaker, in the AV junction, occurring before the next expected beat of the underlying rhythm, is called: A.A premature atrial contraction B.A premature junctional contraction C.A premature ventricular contraction D.None of the above

42. The QRS complex of a PJC: A.Resembles a premature ventricular contraction B.Is usually wider than.12 C.Resembles that of the underlying rhythm D.All of the above

43. Identify The Ectopic Premature Junctional Complex (PJC)

44. Identical PVCs that originate from a single ectopic pacemaker site are called; A.Multifocal B.Unifocal C.Polymorphic D.Monomorphic

45. An early beat consisting of an abnormally wide and bizarre QRS complex, originating in an ectopic pacemaker in the ventricles is called a A.PAC B.PJC C.PVC D.QVC

46. A PVC may: A.Trigger ventricular fibrillation if it occurs on the “T” wave B.Often be a precursor to V-Tach C.All of the above D.None of the above

47. Groups of 3 PVCs are called: A.Triplets B.Trigeminy C.Short run of VT or Salvo D.All of the above

48. Identify The Ectopic Premature Ventricular Complex (PVC)

49. An arrhythmia characterized by multiple dissimilar, small atrial waves occurring at 400 or more beats per minute is: A.Multifocal Atrial Tachycardia B.Atrial Flutter C.Atrial Fibrillation D.Atrial tachycardia

50. An arrhythmia originating in pacemakers that shift back and forth between the SA node and an ectopic pacemaker in the atria or AV junction is call a(n): A.Multifocal Atrial Tachycardia B.Wandering Atrial Pacemaker C.Paroxysmal Supraventricular Tachycardia (PSVT) D.All of the above

51. Identify This Rhythm Wandering Atrial Pacemaker (WAP)

52. Absent “P” waves in a junctional arrhythmia indicate: A.Retrograde atrial depolarization occurs at the same time as antegrade ventricular depolarization B.Atrial depolarization has not occurred because a retrograde AV block C.Either of the above D.None of the above

53. Identify This Rhythm Accelerated Junctional Rhythm (AJR) P R T

54. The number of P waves is: A.The same as that of the number of QRS complexes B.Sometimes less than the number of the QRS complexes C.Sometimes greater than the number of QRS complexes D.All of the above

55. Identify This Rhythm 2 nd degree AV Block Type II, Mobitz II with 2:1 block P P P P PPP P RR R

56. An arrhythmia in which there is a progressive delay following each P wave in the conduction of electrical impulses through the AV node until the conduction of electrical impulses is completely blocked is called a: A.First degree AV block B.Second degree, Type I AV block (Wenckebach) C.Second degree, Type II AV block D.Third degree AV block

57. Identify This Rhythm 2 nd degree AV block Type I, Wenckebach, Mobitz I

58. Second degree, type two AV Block, should be monitored and observed because A.It can progress to a third degree, complete AV heart block B.It can progress to ventricular tachycardia C.It is symptomatic D.None of the above

59. Identify This Rhythm 3 rd degree AV block Complete Heart Block

60. An arrhythmia originating in the ventricular pacemaker with a rate of 20-40 bpm is call a(n) A.Ventricular escape rhythm (VER or IVR) B.Ventricular tachycardia C.Agonal ventricular rhythm D.Accelerated ventricular rhythm

61. Identify This Rhythm Accelerated Ventricular Rhythm (AVR) Accelerated Idioventricular Rhythm (AIVR)

62. Rhythm that originates in the ventricles, which may produce a pulse. A.Asystole B.Agonal C.Ventricular Tachycardia D.Ventricular Fibrillation

63. Identify This Rhythm Monomorphic Ventricular Tachycardia

64. Identify This Rhythm Polymorphic Ventricular Tachycardia Torsades de Pointes

65. Identify This Rhythm Ventricular Fibrillation

66. Identify This Rhythm 2 nd degree AV Block Type I

67. Identify This Rhythm 2 nd degree AV Block Type II

68. Identify This Rhythm 3 rd degree AV Block

69. Identify This Rhythm Ventricular Pacemaker

70. Identify This Rhythm Atrial and Ventricular (AV) Pacemaker

71. Identify This Rhythm Asystole

72. Which rhythm may have a pulse if palpated? A.) B.) C.) D.) None of the above Always check lead placement

73. Questions?