APEX EKG FINAL EXAM ACTUAL QUESTIONS AND
ANSWERS RATED A+
✔✔Accelerated Junctional Rhythm - ✔✔Regularity: atrial and ventricular rate is regular
Rate: > 60 but less than 100
P wave: inverted or absent, may be before, within or after the QRS
PRI : less than 0.12 seconds if the P wave precedes the QRS complex
QRS: 0.06 to 0.10 seconds and usually normal
QTI: 0.36 to 0.46 seconds
T wave: usually normal, upright, smooth and round uniform shape
✔✔Junctional Tachycardia - ✔✔Regularity: atrial and ventricular rate is regular
Rate: >100 beats per minute
P wave: inverted or absent, may be before, within or after the QRS
PRI : less than 0.12 seconds if the P wave precedes the QRS complex
QRS: 0.06 to 0.10 seconds and usually normal
QTI: 0.36 to 0.46 seconds
T wave: usually normal, upright, smooth and round uniform shape
✔✔Premature Ventricular Contractions (PVCs) - ✔✔Regularity: atrial rate regular,
underlying ventricular rate is regular except for the interrupting early beat
Rate: determined by the underlying rhythm
P wave: upright, smooth, round and uniform shape, EXCEPT at the early beat it will be
absent
PRI : 0.12 to 0.20 seconds except for early beat
QRS: 0.06 to 0.10 seconds or normal, for the early beat its wide and bizarre
QTI: 0.36 to 0.46 seconds for normal beats
T wave: normal except for early beats
✔✔Ventricular Tachycardia (LETHAL) - ✔✔Regularity: usually regular
Rate: 140 to 250 beats per minute
P wave: Usually none seen, but dissociated from the QRS if present
PRI : none
QRS: > 0.12 seconds, wide and bizarre, tombstone like
QTI: unable to determine
T wave: absent, usually buried in the QRS
✔✔Torsades De Pointes (LETHAL) - ✔✔Big little big little, Twisting
✔✔Ventricular Fibrillation (LETHAL) - ✔✔Regularity: indeterminable
Rate: unable to measure, ventricles are beating in excess of 400 beats per minute
P wave: none
PRI : none
QRS: none
QTI: none
, T wave: none
There are NO waveforms only an irregular wavy chaotic baseline
✔✔Idioventricular Rhythm (LETHAL) - ✔✔Regularity: usually regular
Rate: 20 to 40 beats per minute
P wave: absent
PRI : none
QRS: wide and bizarre
QTI: unable to determine
T wave: absent, or may slopes off in the opposite direction of the QRS
✔✔Agonal Rhythm (LETHAL) - ✔✔Regularity: irregular
Rate: less than 20 beats per minute
P wave: absent
PRI : none
QRS: wide and bizarre, > 0.12 sec
QTI: unable to determine
T wave: slopes off in the opposite direction of the QRS
✔✔Asystole (LETHAL) - ✔✔Regularity: none
Rate: zero
P wave: none
PRI : none
QRS: none
QTI: none
T wave: none
✔✔Heart Block 1st Degree AVB - ✔✔Regularity: atrial and ventricular rate are regular
Rate: varies depends on underlying rhythm
P wave: upright, smooth, round and uniform shape, one for every QRS complex
PRI : greater than 0.20 seconds, prolonged but constant
QRS: 0.06 to 0.10 seconds
QTI: 0.36 to 0.46 seconds
T wave: upright, smooth and round uniform shape, normal
✔✔Heart Block 2nd Degree AVB Type I - ✔✔Regularity: usually irregular, but can look
regular but interrupted, a classic sign of Wenckebach is a pattern of grouped beats, with
a pause
Rate: atrial rate usually 60-100; ventricular rate less than the atrial rate due to the
nonconducted beats
P wave: upright, smooth, round and uniform shape, BUT not all are followed by a QRS
complex
PRI : progressively gets longer until you have a P wave without a QRS complex (or a
"dropped beat")
QRS: 0.06 to 0.10 seconds
QTI: 0.36 to 0.46 seconds
ANSWERS RATED A+
✔✔Accelerated Junctional Rhythm - ✔✔Regularity: atrial and ventricular rate is regular
Rate: > 60 but less than 100
P wave: inverted or absent, may be before, within or after the QRS
PRI : less than 0.12 seconds if the P wave precedes the QRS complex
QRS: 0.06 to 0.10 seconds and usually normal
QTI: 0.36 to 0.46 seconds
T wave: usually normal, upright, smooth and round uniform shape
✔✔Junctional Tachycardia - ✔✔Regularity: atrial and ventricular rate is regular
Rate: >100 beats per minute
P wave: inverted or absent, may be before, within or after the QRS
PRI : less than 0.12 seconds if the P wave precedes the QRS complex
QRS: 0.06 to 0.10 seconds and usually normal
QTI: 0.36 to 0.46 seconds
T wave: usually normal, upright, smooth and round uniform shape
✔✔Premature Ventricular Contractions (PVCs) - ✔✔Regularity: atrial rate regular,
underlying ventricular rate is regular except for the interrupting early beat
Rate: determined by the underlying rhythm
P wave: upright, smooth, round and uniform shape, EXCEPT at the early beat it will be
absent
PRI : 0.12 to 0.20 seconds except for early beat
QRS: 0.06 to 0.10 seconds or normal, for the early beat its wide and bizarre
QTI: 0.36 to 0.46 seconds for normal beats
T wave: normal except for early beats
✔✔Ventricular Tachycardia (LETHAL) - ✔✔Regularity: usually regular
Rate: 140 to 250 beats per minute
P wave: Usually none seen, but dissociated from the QRS if present
PRI : none
QRS: > 0.12 seconds, wide and bizarre, tombstone like
QTI: unable to determine
T wave: absent, usually buried in the QRS
✔✔Torsades De Pointes (LETHAL) - ✔✔Big little big little, Twisting
✔✔Ventricular Fibrillation (LETHAL) - ✔✔Regularity: indeterminable
Rate: unable to measure, ventricles are beating in excess of 400 beats per minute
P wave: none
PRI : none
QRS: none
QTI: none
, T wave: none
There are NO waveforms only an irregular wavy chaotic baseline
✔✔Idioventricular Rhythm (LETHAL) - ✔✔Regularity: usually regular
Rate: 20 to 40 beats per minute
P wave: absent
PRI : none
QRS: wide and bizarre
QTI: unable to determine
T wave: absent, or may slopes off in the opposite direction of the QRS
✔✔Agonal Rhythm (LETHAL) - ✔✔Regularity: irregular
Rate: less than 20 beats per minute
P wave: absent
PRI : none
QRS: wide and bizarre, > 0.12 sec
QTI: unable to determine
T wave: slopes off in the opposite direction of the QRS
✔✔Asystole (LETHAL) - ✔✔Regularity: none
Rate: zero
P wave: none
PRI : none
QRS: none
QTI: none
T wave: none
✔✔Heart Block 1st Degree AVB - ✔✔Regularity: atrial and ventricular rate are regular
Rate: varies depends on underlying rhythm
P wave: upright, smooth, round and uniform shape, one for every QRS complex
PRI : greater than 0.20 seconds, prolonged but constant
QRS: 0.06 to 0.10 seconds
QTI: 0.36 to 0.46 seconds
T wave: upright, smooth and round uniform shape, normal
✔✔Heart Block 2nd Degree AVB Type I - ✔✔Regularity: usually irregular, but can look
regular but interrupted, a classic sign of Wenckebach is a pattern of grouped beats, with
a pause
Rate: atrial rate usually 60-100; ventricular rate less than the atrial rate due to the
nonconducted beats
P wave: upright, smooth, round and uniform shape, BUT not all are followed by a QRS
complex
PRI : progressively gets longer until you have a P wave without a QRS complex (or a
"dropped beat")
QRS: 0.06 to 0.10 seconds
QTI: 0.36 to 0.46 seconds
