NURS 5354 EKG EXAM LATEST 2026 UPDATED QUESTIONS AND
VERIFIED 100% SOLUTIONS (2026/2027) GRADE: A+|STATUS:
GUARANTEED PASS
Primary axis - Answers -QRS complex, located in frontal plane, the six limb leads are used to
determine the axis.
Mean QRS axis is determined by - Answers -anatomic position of the heart and direction of
ventricular depolarization.
Axis - Answers -ECG Major direction of the electrical activity of the heart. Axis may be normal,
leftward deviation, rightward deviation, or be indeterminate:
Mean QRS axis - Answers -General direction of electrical activity in the frontal plane toward
which the QRS complex is predominately pointing
QRS axis adults - Answers -between -30 and +90 degrees. Remember the left ventricle is
normally electronically predominant, so the normal axis is downward and to the left
Left axis deviation is defined as - Answers -QRS axis falling between -30 and -90 degrees
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,Right axis deviation is defined as - Answers -QRS axis falls between +90 and +180 degrees
Indeterminate axis - Answers -between +/- 180 and -90 degrees
Fastest but nonspecific method for determining the QRS axis - Answers -locate the direction of
the QRS complex in Leads I & aVF. If using Lead I and aVF there is possibility it may still be a
normal axis the investigate Lead II. If Lead II is negative as well, then there is a true left axis
deviation
In the right axis deviation - Answers -the QRS complex is negative in Lead I & positive in Lead
aVF
L axis deviation causes - Answers -Inferior wall myocardial infarction, left ventricular
hypertrophy, left bundle branch block, and ventricular ectopy/rhythms
R axis deviation causes - Answers -Lateral wall myocardial infarction, right bundle branch block,
right ventricular hypertrophy, dextrocardia, ventricular ectopy/rhythms, and acute right heart
strain (seen with PE)
Bundle branch block (BBB) - Answers -a problem with the electrical conduction system
associated with either the left or right bundle branch
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, BBB - Answers -leads to inefficient ejection of blood from the ventricle
LBBB - Answers -QRS complex greater than 0.12, deep S wave in leads V1 V2 V3,
Broad/notchedR wave is leads V5 & V6
RBBB - Answers -QRS complex greater than 0.12, large/notched R wave in leads V1 & V2 also
slurred S wave lateral leads , I, V5& V6
BBB A priority for the provider - Answers -determine if any symptoms associated with the BBB
and if the block is new
New onset BBB concerning for - Answers -myocardial infarction
LBBB causes - Answers -myocardial infarction, coronary artery disease, valvular disease such as
aortic stenosis, cardiomyopathies, myocarditis, hyperkalemia, and digoxin toxicity
RBBB causes - Answers -heart disease secondary to hypertension, myocardial infarction,
myocarditis, cardiomyopathies, COPD, cor pulmonale or right sided heart failure, & PE
3|Page
VERIFIED 100% SOLUTIONS (2026/2027) GRADE: A+|STATUS:
GUARANTEED PASS
Primary axis - Answers -QRS complex, located in frontal plane, the six limb leads are used to
determine the axis.
Mean QRS axis is determined by - Answers -anatomic position of the heart and direction of
ventricular depolarization.
Axis - Answers -ECG Major direction of the electrical activity of the heart. Axis may be normal,
leftward deviation, rightward deviation, or be indeterminate:
Mean QRS axis - Answers -General direction of electrical activity in the frontal plane toward
which the QRS complex is predominately pointing
QRS axis adults - Answers -between -30 and +90 degrees. Remember the left ventricle is
normally electronically predominant, so the normal axis is downward and to the left
Left axis deviation is defined as - Answers -QRS axis falling between -30 and -90 degrees
1|Page
,Right axis deviation is defined as - Answers -QRS axis falls between +90 and +180 degrees
Indeterminate axis - Answers -between +/- 180 and -90 degrees
Fastest but nonspecific method for determining the QRS axis - Answers -locate the direction of
the QRS complex in Leads I & aVF. If using Lead I and aVF there is possibility it may still be a
normal axis the investigate Lead II. If Lead II is negative as well, then there is a true left axis
deviation
In the right axis deviation - Answers -the QRS complex is negative in Lead I & positive in Lead
aVF
L axis deviation causes - Answers -Inferior wall myocardial infarction, left ventricular
hypertrophy, left bundle branch block, and ventricular ectopy/rhythms
R axis deviation causes - Answers -Lateral wall myocardial infarction, right bundle branch block,
right ventricular hypertrophy, dextrocardia, ventricular ectopy/rhythms, and acute right heart
strain (seen with PE)
Bundle branch block (BBB) - Answers -a problem with the electrical conduction system
associated with either the left or right bundle branch
2|Page
, BBB - Answers -leads to inefficient ejection of blood from the ventricle
LBBB - Answers -QRS complex greater than 0.12, deep S wave in leads V1 V2 V3,
Broad/notchedR wave is leads V5 & V6
RBBB - Answers -QRS complex greater than 0.12, large/notched R wave in leads V1 & V2 also
slurred S wave lateral leads , I, V5& V6
BBB A priority for the provider - Answers -determine if any symptoms associated with the BBB
and if the block is new
New onset BBB concerning for - Answers -myocardial infarction
LBBB causes - Answers -myocardial infarction, coronary artery disease, valvular disease such as
aortic stenosis, cardiomyopathies, myocarditis, hyperkalemia, and digoxin toxicity
RBBB causes - Answers -heart disease secondary to hypertension, myocardial infarction,
myocarditis, cardiomyopathies, COPD, cor pulmonale or right sided heart failure, & PE
3|Page
