PCCN CARDIAC MIDTERM EXAMS QUESTIONS AND
ANSWERS SET A+
✔✔Thomas has had an anterolateral MI. Where so you expect to see changes on the
12-lead EKG?
-V1, V2, I, AVL
-V2, V3, V4, I, AVL
-V2, V3, V4, II, III, AVF
-V1, V2, II, III, AVF - ✔✔V2, V3, V4, I, AVL
Changes in V2, V3, V4, I and AVL indicate an anterolateral MI. The MI could also be
detected in V5 and V6 which are also lateral leads.
✔✔What do abnormal Q waves signify on a 12-lead EKG?
-Nothing - They are of no significance
-Repolarization of the myocardium
-Complete- thickness infarction of the myocardium
-Partial- thickness death of myocardium - ✔✔Complete- thickness infarction of the
myocardium
When tissue dies as a result of MI, it becomes electrically dead, causing the opposing
energy to become the dominant feature.
Partial- thickness myocardial death would be classified as a non-Q wave MI.
✔✔Mary has had an inferior wall MI. Where do you expect to see the changes in her
12-lead EKG?
-II, III, AVF
-I, II, AVL
-I, III, AVF
-V1, V2 - ✔✔II, III, AVF
,✔✔Your patient has had an anteroseptal MI. Where do you expect to see the changes
on the 12-lead EKG?
-V1, V2, V3, V4
-V2, V3, V4, V5, V6
-V1, V2, II, III, AVF
-V1, V2, I, AVL - ✔✔V1, V2, V3, V4
✔✔Which parameter is measured by the vertical lines on the EKG paper?
-Velocity
-Time
-Voltage
-Intensity - ✔✔Time
The vertical lines on the EKG graph paper represent time. When conduction defects
occur, the tracings are wider because it takes more time to travel the same distance.
✔✔Which parameter is measured by the horizontal lines on the EKG paper?
-Velocity
-Time
-Voltage
-Intensity - ✔✔Voltage
Voltage is measured by the horizontal lines on the EKG graph paper. If a ventricle is
enlarged, a larger voltage will be apparent on the 12-lead EKG
✔✔V1 and V2 show which type of bundle branch block?
-Right
-Left
-Dual bundle
-V1 and V2 do not show BBBs - ✔✔Right
V1 and V2 show RBBBs
✔✔What are the most valuable pieces of information evaluated with a 12-lead EKG?
-Rate, arrhythmias, infarction
-Rate, rhythm, axis, hypertrophy, infarction
-Rate, BBB, hypertrophy
-Rate, rhythm, arrhythmias - ✔✔Rate, rhythm, axis, hypertrophy, infarction
, ✔✔Which of the following conditions are associated with ST/T wave abnormalities?
-Ventricular hypertrophy, pericarditis, COPD
-COPD, axis deviation
-Atrial hypertrophy, axis deviation
-Pericarditis, axis deviation - ✔✔Ventricular hypertrophy, pericarditis, COPD
✔✔Which 12-lead EKG changes would you expect to see in a patient with COPD?
-Low voltage P waves, tachycardia
-Tall P waves, left ventricular hypertrophy
-Tall, peaked P waves, right ventricular hypertrophy, low-voltage QRS
-Low-voltage QRS, left atrial hypertrophy - ✔✔Tall, peaked P waves, right ventricular
hypertrophy, low-voltage QRS
COPD causes changes in the 12-lead EKG due to the workload for the right side of the
heart. Changes commonly seen in patients with COPD include tall, peaked P waves,
right axis deviation, right ventricular hypertrophy and low-voltage QRS.
✔✔What are some common reasons for pacemaker insertion?
-Tachycardia, Wenckebach, bradycardia
-Symptomatic bradycardia, overdrive pacing, acute MI with sinus dysfunction
-Complete heart block, Wenckeback, tachycardia
-CCC, Wenckebach, tachycardia - ✔✔Symptomatic bradycardia, overdrive pacing,
acute MI with sinus dysfunction
There are multiple reasons for pacemaker insertion -- for example symptomatic
bradycardia, bradycardia with escape beats, overdrive pacing, bradycardia/ arrest,
acute MI with sinus dysfunction, 2nd heart block type 2 (Mobitz type 2), complete heart
block (3rd degree heart block), and development of a new bundle branch block.
✔✔Quinidine and hypomagnesemia can both lead to which condition?
-Torsades de Pointes
-Ventricular tachycardia
-Ventricular fibrillation
-Atrial tachycardia - ✔✔Torsades de Pointes
Quinindine and hypomagnesemia can lead to Torsades de Pointes -- a recurrent
ventricular tachycardia that turns on its axis every 6 to 8 beats, giving the EKG a
twisting or "turning on point" look. Hypomagnesemia can occur when the patient
recieves TPN (total parental nutrition).
✔✔Which condition is required for a diagnosis of HAP (hospital acquired pneumonia)?
ANSWERS SET A+
✔✔Thomas has had an anterolateral MI. Where so you expect to see changes on the
12-lead EKG?
-V1, V2, I, AVL
-V2, V3, V4, I, AVL
-V2, V3, V4, II, III, AVF
-V1, V2, II, III, AVF - ✔✔V2, V3, V4, I, AVL
Changes in V2, V3, V4, I and AVL indicate an anterolateral MI. The MI could also be
detected in V5 and V6 which are also lateral leads.
✔✔What do abnormal Q waves signify on a 12-lead EKG?
-Nothing - They are of no significance
-Repolarization of the myocardium
-Complete- thickness infarction of the myocardium
-Partial- thickness death of myocardium - ✔✔Complete- thickness infarction of the
myocardium
When tissue dies as a result of MI, it becomes electrically dead, causing the opposing
energy to become the dominant feature.
Partial- thickness myocardial death would be classified as a non-Q wave MI.
✔✔Mary has had an inferior wall MI. Where do you expect to see the changes in her
12-lead EKG?
-II, III, AVF
-I, II, AVL
-I, III, AVF
-V1, V2 - ✔✔II, III, AVF
,✔✔Your patient has had an anteroseptal MI. Where do you expect to see the changes
on the 12-lead EKG?
-V1, V2, V3, V4
-V2, V3, V4, V5, V6
-V1, V2, II, III, AVF
-V1, V2, I, AVL - ✔✔V1, V2, V3, V4
✔✔Which parameter is measured by the vertical lines on the EKG paper?
-Velocity
-Time
-Voltage
-Intensity - ✔✔Time
The vertical lines on the EKG graph paper represent time. When conduction defects
occur, the tracings are wider because it takes more time to travel the same distance.
✔✔Which parameter is measured by the horizontal lines on the EKG paper?
-Velocity
-Time
-Voltage
-Intensity - ✔✔Voltage
Voltage is measured by the horizontal lines on the EKG graph paper. If a ventricle is
enlarged, a larger voltage will be apparent on the 12-lead EKG
✔✔V1 and V2 show which type of bundle branch block?
-Right
-Left
-Dual bundle
-V1 and V2 do not show BBBs - ✔✔Right
V1 and V2 show RBBBs
✔✔What are the most valuable pieces of information evaluated with a 12-lead EKG?
-Rate, arrhythmias, infarction
-Rate, rhythm, axis, hypertrophy, infarction
-Rate, BBB, hypertrophy
-Rate, rhythm, arrhythmias - ✔✔Rate, rhythm, axis, hypertrophy, infarction
, ✔✔Which of the following conditions are associated with ST/T wave abnormalities?
-Ventricular hypertrophy, pericarditis, COPD
-COPD, axis deviation
-Atrial hypertrophy, axis deviation
-Pericarditis, axis deviation - ✔✔Ventricular hypertrophy, pericarditis, COPD
✔✔Which 12-lead EKG changes would you expect to see in a patient with COPD?
-Low voltage P waves, tachycardia
-Tall P waves, left ventricular hypertrophy
-Tall, peaked P waves, right ventricular hypertrophy, low-voltage QRS
-Low-voltage QRS, left atrial hypertrophy - ✔✔Tall, peaked P waves, right ventricular
hypertrophy, low-voltage QRS
COPD causes changes in the 12-lead EKG due to the workload for the right side of the
heart. Changes commonly seen in patients with COPD include tall, peaked P waves,
right axis deviation, right ventricular hypertrophy and low-voltage QRS.
✔✔What are some common reasons for pacemaker insertion?
-Tachycardia, Wenckebach, bradycardia
-Symptomatic bradycardia, overdrive pacing, acute MI with sinus dysfunction
-Complete heart block, Wenckeback, tachycardia
-CCC, Wenckebach, tachycardia - ✔✔Symptomatic bradycardia, overdrive pacing,
acute MI with sinus dysfunction
There are multiple reasons for pacemaker insertion -- for example symptomatic
bradycardia, bradycardia with escape beats, overdrive pacing, bradycardia/ arrest,
acute MI with sinus dysfunction, 2nd heart block type 2 (Mobitz type 2), complete heart
block (3rd degree heart block), and development of a new bundle branch block.
✔✔Quinidine and hypomagnesemia can both lead to which condition?
-Torsades de Pointes
-Ventricular tachycardia
-Ventricular fibrillation
-Atrial tachycardia - ✔✔Torsades de Pointes
Quinindine and hypomagnesemia can lead to Torsades de Pointes -- a recurrent
ventricular tachycardia that turns on its axis every 6 to 8 beats, giving the EKG a
twisting or "turning on point" look. Hypomagnesemia can occur when the patient
recieves TPN (total parental nutrition).
✔✔Which condition is required for a diagnosis of HAP (hospital acquired pneumonia)?
