Advanced Skill- Exam 3
True or False: In a first-degree heart block, the atrial rhythm is regular and the QRS complex will
measure less than 0.12 seconds.
True
Your patient is found to have a first-degree heart block after obtaining an ECG. The patient is
asymptomatic. The nurse prepares to? Select all that apply:
A. Activate the emergency response team
B. Obtain atropine and temporary pacing pads
C. Continue to monitor
D. Start CPR
E. Assess the patient's current medications
C, E
(Patients with first-degree heart blocks rarely have symptoms. It is the least severe of all the heart
blocks. This patient is having no symptoms and should continue to be monitored. In addition, the nurse
should review the patient's current medication to make sure no medication the patient is taking could
slow down AV conduction leading to this heart block (such as calcium channel blockers like diltiazem,
digoxin, or beta blockers.)
What medication below could cause a first-degree heart block?
A. Lisinopril
B. Diltiazem
C. Furosemide
D. Clopidogrel
B
(Diltiazem is a calcium channel blocker, which can slow conduction through the AV node and lead to a
heart block. Other medications that could cause a first-degree heart block included digoxin, beta-
adrenergic blockers, quinidine, procainamide, and amiodarone.)
A hallmark finding in a first-degree heart block is?
A. A gradually lengthening PR interval with a randomly dropped QRS complex
B. A PR interval >0.20 seconds
C. A constant PR interval with randomly dropped QRS complexes
D. Independent P-waves and QRS complexes
B
Which statement below best describes why a first-degree heart block occurs?
, A. The SA node is firing too rapidly to the AV node.
B. The signal traveling from the AV node to the Purkinje fibers is blocked in the right and left bundle
branches.
C. The electrical signal is moving slowly through the AV node.
D. The AV node is completely unable to fire during the electrical conduction cycle which create a delay
in ventricular contraction.
C
Which of the following occurs with a first-degree heart block? Select all that apply.
A. Regular P-waves
B. PR interval <0.20 seconds
C. Regular ventricular rhythm
D. PR interval >0.20 seconds
A, C, D
Select all the options below that describe a second degree type 1 heart block:
A. PR Interval <0.20 seconds throughout the rhythm
B. Atrial and ventricular rhythm regular
C. Atrial rate is faster than the ventricular rate
D. Normal p waves
E. Gradually lengthening PR Intervals
F. Dropped QRS complexes
G. QRS <0.12 seconds
C, D, E, F, G
True or False: A hallmark finding of second-degree type 1 heart block is the constant PR interval
throughout the rhythm, with intermittent dropping of QRS complexes following P-waves.
False
(This describes a second-degree type 2 heart block. In a second-degree type 1 heart block, the PR
interval progressively lengthens with each beat until a P-wave occurs without a subsequent QRS
complex. The progressive lengthening occurs due to the P-waves getting further and further away from
the QRS complex. This cycle then repeats itself.)
In second-degree type 1 heart blocks, why is the ventricular rate slower than the atrial rate?
A. The atrial rate is faster than the ventricular rate because of the shorten PR intervals.
B. The constant PR intervals decrease the rate of conduction to the AV node which slows down the
ventricular rate.
C. The ventricular rate is slower than the atrial rate because at times the electrical signal isn't able to
travel down from the atria to the ventricles, which leads to a dropped QRS complex.
D. The SA node is firing too slow and this affects how the AV node stimulates the ventricles to
contract.
C
True or False: In a first-degree heart block, the atrial rhythm is regular and the QRS complex will
measure less than 0.12 seconds.
True
Your patient is found to have a first-degree heart block after obtaining an ECG. The patient is
asymptomatic. The nurse prepares to? Select all that apply:
A. Activate the emergency response team
B. Obtain atropine and temporary pacing pads
C. Continue to monitor
D. Start CPR
E. Assess the patient's current medications
C, E
(Patients with first-degree heart blocks rarely have symptoms. It is the least severe of all the heart
blocks. This patient is having no symptoms and should continue to be monitored. In addition, the nurse
should review the patient's current medication to make sure no medication the patient is taking could
slow down AV conduction leading to this heart block (such as calcium channel blockers like diltiazem,
digoxin, or beta blockers.)
What medication below could cause a first-degree heart block?
A. Lisinopril
B. Diltiazem
C. Furosemide
D. Clopidogrel
B
(Diltiazem is a calcium channel blocker, which can slow conduction through the AV node and lead to a
heart block. Other medications that could cause a first-degree heart block included digoxin, beta-
adrenergic blockers, quinidine, procainamide, and amiodarone.)
A hallmark finding in a first-degree heart block is?
A. A gradually lengthening PR interval with a randomly dropped QRS complex
B. A PR interval >0.20 seconds
C. A constant PR interval with randomly dropped QRS complexes
D. Independent P-waves and QRS complexes
B
Which statement below best describes why a first-degree heart block occurs?
, A. The SA node is firing too rapidly to the AV node.
B. The signal traveling from the AV node to the Purkinje fibers is blocked in the right and left bundle
branches.
C. The electrical signal is moving slowly through the AV node.
D. The AV node is completely unable to fire during the electrical conduction cycle which create a delay
in ventricular contraction.
C
Which of the following occurs with a first-degree heart block? Select all that apply.
A. Regular P-waves
B. PR interval <0.20 seconds
C. Regular ventricular rhythm
D. PR interval >0.20 seconds
A, C, D
Select all the options below that describe a second degree type 1 heart block:
A. PR Interval <0.20 seconds throughout the rhythm
B. Atrial and ventricular rhythm regular
C. Atrial rate is faster than the ventricular rate
D. Normal p waves
E. Gradually lengthening PR Intervals
F. Dropped QRS complexes
G. QRS <0.12 seconds
C, D, E, F, G
True or False: A hallmark finding of second-degree type 1 heart block is the constant PR interval
throughout the rhythm, with intermittent dropping of QRS complexes following P-waves.
False
(This describes a second-degree type 2 heart block. In a second-degree type 1 heart block, the PR
interval progressively lengthens with each beat until a P-wave occurs without a subsequent QRS
complex. The progressive lengthening occurs due to the P-waves getting further and further away from
the QRS complex. This cycle then repeats itself.)
In second-degree type 1 heart blocks, why is the ventricular rate slower than the atrial rate?
A. The atrial rate is faster than the ventricular rate because of the shorten PR intervals.
B. The constant PR intervals decrease the rate of conduction to the AV node which slows down the
ventricular rate.
C. The ventricular rate is slower than the atrial rate because at times the electrical signal isn't able to
travel down from the atria to the ventricles, which leads to a dropped QRS complex.
D. The SA node is firing too slow and this affects how the AV node stimulates the ventricles to
contract.
C
