ADVENT HEALTH EKG 2027 ADVANCED
COMPETENCY ASSESSMENT
QUESTIONS AND ANSWERS
1. A 65-year-old patient presents with chest pain and an EKG showing ST-segment elevation
in leads II, III, and aVF. Which coronary artery is most likely occluded?
A. Left Anterior Descending (LAD)
B. Left Main Coronary Artery
C. Left Circumflex (LCx)
D. Right Coronary Artery (RCA)
Answer: D
Conceptual Explanation: ST elevation in leads II, III, and aVF indicates an inferior wall
myocardial infarction, which is most commonly caused by occlusion of the Right Coronary
Artery (RCA).
2. What is the primary diagnostic EKG feature of Wellens’ Syndrome?
A. Persistent ST elevation in V1-V4 after an old MI
B. ST elevation in the AVR lead with widespread ST depression
C. Biphasic or deeply inverted T waves in leads V2 and V3
,D. Presence of a prominent U wave in the precordial leads
Answer: C
Conceptual Explanation: Wellens’ Syndrome is characterized by T-wave changes
(biphasic or deep inversions) in leads V2-V3, indicating critical stenosis of the proximal
LAD.
3. In the context of Left Bundle Branch Block (LBBB), which Sgarbossa criterion is most
specific for diagnosing an acute myocardial infarction?
A. Concordant ST-segment elevation >= 1 mm in any lead
B. ST-segment depression > 1 mm in leads V1, V2, or V3
C. Discordant ST-segment elevation >= 5 mm
D. PR interval prolongation > 200 ms
Answer: A
Conceptual Explanation: Concordant ST-segment elevation >= 1 mm in leads with a
positive QRS complex is the most specific Sgarbossa criterion for AMI in the presence of
LBBB.
4. Which of the following describes the EKG findings associated with Brugada Syndrome Type
1?
A. Saddle-back ST-segment elevation in V1-V2
B. Short PR interval with a Delta wave
, C. ST-segment depression in V5-V6 with tall R waves
D. Coved ST-segment elevation > 2 mm followed by a negative T-wave in V1-V2
Answer: D
Conceptual Explanation: Type 1 Brugada pattern is identified by a coved-type ST
elevation > 2 mm followed by an inverted T-wave in leads V1-V2.
5. A rhythm strip shows a regular narrow-complex tachycardia at 180 bpm with no visible P
waves. Vagal maneuvers are unsuccessful. What is the most likely diagnosis?
A. Atrial Fibrillation
B. Ventricular Tachycardia
C. Atrioventricular Nodal Reentrant Tachycardia (AVNRT)
D. Sinus Tachycardia
Answer: C
Conceptual Explanation: A regular, narrow-complex tachycardia without visible P waves
(often buried in the QRS) is most commonly AVNRT.
6. Which EKG finding is most suggestive of hyperkalemia?
A. Peaked T waves with a narrow base
B. Presence of U waves
C. Shortened QT interval
COMPETENCY ASSESSMENT
QUESTIONS AND ANSWERS
1. A 65-year-old patient presents with chest pain and an EKG showing ST-segment elevation
in leads II, III, and aVF. Which coronary artery is most likely occluded?
A. Left Anterior Descending (LAD)
B. Left Main Coronary Artery
C. Left Circumflex (LCx)
D. Right Coronary Artery (RCA)
Answer: D
Conceptual Explanation: ST elevation in leads II, III, and aVF indicates an inferior wall
myocardial infarction, which is most commonly caused by occlusion of the Right Coronary
Artery (RCA).
2. What is the primary diagnostic EKG feature of Wellens’ Syndrome?
A. Persistent ST elevation in V1-V4 after an old MI
B. ST elevation in the AVR lead with widespread ST depression
C. Biphasic or deeply inverted T waves in leads V2 and V3
,D. Presence of a prominent U wave in the precordial leads
Answer: C
Conceptual Explanation: Wellens’ Syndrome is characterized by T-wave changes
(biphasic or deep inversions) in leads V2-V3, indicating critical stenosis of the proximal
LAD.
3. In the context of Left Bundle Branch Block (LBBB), which Sgarbossa criterion is most
specific for diagnosing an acute myocardial infarction?
A. Concordant ST-segment elevation >= 1 mm in any lead
B. ST-segment depression > 1 mm in leads V1, V2, or V3
C. Discordant ST-segment elevation >= 5 mm
D. PR interval prolongation > 200 ms
Answer: A
Conceptual Explanation: Concordant ST-segment elevation >= 1 mm in leads with a
positive QRS complex is the most specific Sgarbossa criterion for AMI in the presence of
LBBB.
4. Which of the following describes the EKG findings associated with Brugada Syndrome Type
1?
A. Saddle-back ST-segment elevation in V1-V2
B. Short PR interval with a Delta wave
, C. ST-segment depression in V5-V6 with tall R waves
D. Coved ST-segment elevation > 2 mm followed by a negative T-wave in V1-V2
Answer: D
Conceptual Explanation: Type 1 Brugada pattern is identified by a coved-type ST
elevation > 2 mm followed by an inverted T-wave in leads V1-V2.
5. A rhythm strip shows a regular narrow-complex tachycardia at 180 bpm with no visible P
waves. Vagal maneuvers are unsuccessful. What is the most likely diagnosis?
A. Atrial Fibrillation
B. Ventricular Tachycardia
C. Atrioventricular Nodal Reentrant Tachycardia (AVNRT)
D. Sinus Tachycardia
Answer: C
Conceptual Explanation: A regular, narrow-complex tachycardia without visible P waves
(often buried in the QRS) is most commonly AVNRT.
6. Which EKG finding is most suggestive of hyperkalemia?
A. Peaked T waves with a narrow base
B. Presence of U waves
C. Shortened QT interval
