ECG WORKOUT
EXERCISES IN ARRHYTHMIA
INTERPRETATION
8TH EDITION
• AUTHOR(S)JANE HUFF
TEST BANK
1
Reference
Ch. 1 — Description and Location of the Heart — Surface
relationships and lead correlations
Question Stem (2–3 sentences)
A telemetry strip shows ST-segment elevation greatest in leads
II, III, and aVF with reciprocal ST depression in lead I. Rate is 88
,bpm, rhythm is sinus. Based on the ECG pattern and heart
surface anatomy, where is the acute injury most likely located?
Options
A. Anterior wall (ventricular anterior surface)
B. Inferior (diaphragmatic) surface of the heart
C. Lateral wall (left ventricular free wall)
D. Septal wall
Correct Answer
B
Rationales
• Correct (B): ST elevation in II, III, and aVF localizes to the
inferior (diaphragmatic) surface of the heart; anatomically
this region is supplied most often by the right coronary
artery. The pattern of reciprocal changes in lead I supports
an inferior injury.
• Incorrect (A): An anterior wall infarct would show ST
elevation primarily in V1–V4; II/III/aVF changes are not
typical.
• Incorrect (C): Lateral injury produces ST changes in leads I,
aVL, V5–V6, not isolated inferior leads.
• Incorrect (D): Septal infarction primarily affects V1–V2;
inferior lead ST elevation is inconsistent with an isolated
septal lesion.
,Teaching Point
ST elevation in II, III, aVF = inferior (diaphragmatic) wall; think
RCA supply.
Citation
Huff, J. (2022). ECG Workout: Exercises in Arrhythmia
Interpretation (8th ed.). Ch. 1.
2
Reference
Ch. 1 — Function of the Heart — Cardiac output compensatory
rhythms
Question Stem (2–3 sentences)
A postoperative patient’s monitor shows sinus tachycardia at
120 bpm with normal P waves and narrow QRS complexes.
Blood pressure is borderline low and urine output is decreased.
Which physiologic function explains the observed rhythm as a
compensatory response?
Options
A. Increased stroke volume via enhanced diastolic filling
B. Increased heart rate to maintain cardiac output in response
to decreased stroke volume
C. Decreased systemic vascular resistance causing reflex
bradycardia
D. Increased afterload reducing myocardial oxygen demand
, Correct Answer
B
Rationales
• Correct (B): Sinus tachycardia with normal P waves and
narrow QRS is a physiologic response to decreased stroke
volume or low blood pressure; increasing heart rate helps
preserve cardiac output (CO = HR × SV).
• Incorrect (A): Stroke volume typically falls with
hypotension/hypovolemia; tachycardia, not increased
stroke volume, is the immediate compensatory
mechanism.
• Incorrect (C): Decreased SVR often causes reflex
tachycardia, not bradycardia; the strip shows tachycardia.
• Incorrect (D): Increased afterload would increase
myocardial work; it does not explain sinus tachycardia as
an initial compensatory response.
Teaching Point
CO = HR × SV; tachycardia commonly compensates for
diminished stroke volume.
Citation
Huff, J. (2022). ECG Workout: Exercises in Arrhythmia
Interpretation (8th ed.). Ch. 1.
3
EXERCISES IN ARRHYTHMIA
INTERPRETATION
8TH EDITION
• AUTHOR(S)JANE HUFF
TEST BANK
1
Reference
Ch. 1 — Description and Location of the Heart — Surface
relationships and lead correlations
Question Stem (2–3 sentences)
A telemetry strip shows ST-segment elevation greatest in leads
II, III, and aVF with reciprocal ST depression in lead I. Rate is 88
,bpm, rhythm is sinus. Based on the ECG pattern and heart
surface anatomy, where is the acute injury most likely located?
Options
A. Anterior wall (ventricular anterior surface)
B. Inferior (diaphragmatic) surface of the heart
C. Lateral wall (left ventricular free wall)
D. Septal wall
Correct Answer
B
Rationales
• Correct (B): ST elevation in II, III, and aVF localizes to the
inferior (diaphragmatic) surface of the heart; anatomically
this region is supplied most often by the right coronary
artery. The pattern of reciprocal changes in lead I supports
an inferior injury.
• Incorrect (A): An anterior wall infarct would show ST
elevation primarily in V1–V4; II/III/aVF changes are not
typical.
• Incorrect (C): Lateral injury produces ST changes in leads I,
aVL, V5–V6, not isolated inferior leads.
• Incorrect (D): Septal infarction primarily affects V1–V2;
inferior lead ST elevation is inconsistent with an isolated
septal lesion.
,Teaching Point
ST elevation in II, III, aVF = inferior (diaphragmatic) wall; think
RCA supply.
Citation
Huff, J. (2022). ECG Workout: Exercises in Arrhythmia
Interpretation (8th ed.). Ch. 1.
2
Reference
Ch. 1 — Function of the Heart — Cardiac output compensatory
rhythms
Question Stem (2–3 sentences)
A postoperative patient’s monitor shows sinus tachycardia at
120 bpm with normal P waves and narrow QRS complexes.
Blood pressure is borderline low and urine output is decreased.
Which physiologic function explains the observed rhythm as a
compensatory response?
Options
A. Increased stroke volume via enhanced diastolic filling
B. Increased heart rate to maintain cardiac output in response
to decreased stroke volume
C. Decreased systemic vascular resistance causing reflex
bradycardia
D. Increased afterload reducing myocardial oxygen demand
, Correct Answer
B
Rationales
• Correct (B): Sinus tachycardia with normal P waves and
narrow QRS is a physiologic response to decreased stroke
volume or low blood pressure; increasing heart rate helps
preserve cardiac output (CO = HR × SV).
• Incorrect (A): Stroke volume typically falls with
hypotension/hypovolemia; tachycardia, not increased
stroke volume, is the immediate compensatory
mechanism.
• Incorrect (C): Decreased SVR often causes reflex
tachycardia, not bradycardia; the strip shows tachycardia.
• Incorrect (D): Increased afterload would increase
myocardial work; it does not explain sinus tachycardia as
an initial compensatory response.
Teaching Point
CO = HR × SV; tachycardia commonly compensates for
diminished stroke volume.
Citation
Huff, J. (2022). ECG Workout: Exercises in Arrhythmia
Interpretation (8th ed.). Ch. 1.
3
