BASIC DYSRHYTHMIAS EXAM
QUESTIONS WITH CORRECT ANSWERS
EKG paper is divided into small squares and larger squares - Answer-Large squares
are defined by a dark line. They are 5 squares high and 5 squares long (0.20 seconds)
Small squares may be lines or may be dots within the dark lines. They are 0.04 seconds
every mark below EKG grid is 3sec
Artifact - Answer-EKG waveforms from sources outside the heart
Interference seen on a monitor or EKG strip
4 causes
Patient movement (i.e. pt. with tremors)
Loose or defective electrodes (fuzzy baseline)
Improper grounding (60 cycle interference)
Faulty EKG apparatus
Normal PR and QRS interval lengths - Answer-PR Interval: .12-.20 seconds
QRS Interval: < .12 seconds
Origin of Rhythms - Answer-They are named for the structure of the heart where the foci
(a cell sending off an electrical impulse) is located that is producing the abnormal
rhythm
Sinus (Sinus node)
Junctional (Area between the atria & ventricles)
Ventricular (any cell in the ventricles)
Atrial (any cell in the atria)
AV Blocks (AV node blocking some or all of the passage of electricity through it)
Sinus Arrhythmia (SA) - Answer-Normal except irregular
The difference between the fastest two heart beats (from 1 QRS to the next QRS) and
the slowest two heart beats is greater than .12 sec
Asystole - Answer-No electrical activity
CODE BLUE
but it does arise from the SA node??
Pulseless Electrical Activity (PEA) - Answer-Normal rhythm, but...No Pulse*
Electrical activity is present but there is no pulse, so the heart is not beating! Something
has happened to prevent the muscular tissue from responding to the electrical activity
(i.e. ↓↑ K+, hypothermia, Pneumothorax, cardiac tampanode, hypovolemia, drug
overdose, pulmonary or coronary thrombosis)
, Rhythms arising from the SA Node - Answer-Sinus Rhythm
Sinus Tachycardia
Sinus Bradycardia
Sinus Arrhythmia
Asystole
Pulseless Electrical Activity
Junctional rhythm - Answer-Initiates somewhere between atria and ventricle.
PR interval will be less than normal or there will be no P wave
Ventricular rhythm - Answer-wide QRS (often inverted?)
Premature Beats - Answer-Not a rhythm, just a single early beat
Three Options:
-If it arises from the Atria, it will have a normal PR Interval
This is a Premature Atrial Contraction or PAC
-If it arises from the Junctional area, it will have a PR Interval which is less than normal
or no P wave at all
This is a Premature Junctional Contraction or PJC
-If it arises from the Ventricular area, it will be a QRS which is wide and bizarre shaped
This is a Premature Ventricular Contraction or PVC
When are PVCs a Problem? - Answer-Increase from the patient's normal amount
Multiple PVCs in a row
PVC falls on the T wave of previous beat
Multifocal (they arise from different cells, therefore they are different shapes)
PVC Troubles - Answer-Bigeminy = every other beat is a PVC
Trigeminy = every 3rd beat is a PVC
Multiple PVCs right after each other: couplet or triplet
Ventricular Tachycardia (VT) - Answer-4 or more ventricular beats in a row
Rate > 150 bpm
Sustained VTach - Answer-Pt stays in VTach & needs our help to switch (defibrillate or
cardiovert)
Code BLUE !
Idioventricular Rhythm - Answer-Ventricular beats, but....
slow rate
Torsades de Pointes - Answer-A form of VTach which looks like the rhythm strip is
twisting
Code BLUE !
Ventricular Fibrillation (VF) - Answer-Squiggly line
QUESTIONS WITH CORRECT ANSWERS
EKG paper is divided into small squares and larger squares - Answer-Large squares
are defined by a dark line. They are 5 squares high and 5 squares long (0.20 seconds)
Small squares may be lines or may be dots within the dark lines. They are 0.04 seconds
every mark below EKG grid is 3sec
Artifact - Answer-EKG waveforms from sources outside the heart
Interference seen on a monitor or EKG strip
4 causes
Patient movement (i.e. pt. with tremors)
Loose or defective electrodes (fuzzy baseline)
Improper grounding (60 cycle interference)
Faulty EKG apparatus
Normal PR and QRS interval lengths - Answer-PR Interval: .12-.20 seconds
QRS Interval: < .12 seconds
Origin of Rhythms - Answer-They are named for the structure of the heart where the foci
(a cell sending off an electrical impulse) is located that is producing the abnormal
rhythm
Sinus (Sinus node)
Junctional (Area between the atria & ventricles)
Ventricular (any cell in the ventricles)
Atrial (any cell in the atria)
AV Blocks (AV node blocking some or all of the passage of electricity through it)
Sinus Arrhythmia (SA) - Answer-Normal except irregular
The difference between the fastest two heart beats (from 1 QRS to the next QRS) and
the slowest two heart beats is greater than .12 sec
Asystole - Answer-No electrical activity
CODE BLUE
but it does arise from the SA node??
Pulseless Electrical Activity (PEA) - Answer-Normal rhythm, but...No Pulse*
Electrical activity is present but there is no pulse, so the heart is not beating! Something
has happened to prevent the muscular tissue from responding to the electrical activity
(i.e. ↓↑ K+, hypothermia, Pneumothorax, cardiac tampanode, hypovolemia, drug
overdose, pulmonary or coronary thrombosis)
, Rhythms arising from the SA Node - Answer-Sinus Rhythm
Sinus Tachycardia
Sinus Bradycardia
Sinus Arrhythmia
Asystole
Pulseless Electrical Activity
Junctional rhythm - Answer-Initiates somewhere between atria and ventricle.
PR interval will be less than normal or there will be no P wave
Ventricular rhythm - Answer-wide QRS (often inverted?)
Premature Beats - Answer-Not a rhythm, just a single early beat
Three Options:
-If it arises from the Atria, it will have a normal PR Interval
This is a Premature Atrial Contraction or PAC
-If it arises from the Junctional area, it will have a PR Interval which is less than normal
or no P wave at all
This is a Premature Junctional Contraction or PJC
-If it arises from the Ventricular area, it will be a QRS which is wide and bizarre shaped
This is a Premature Ventricular Contraction or PVC
When are PVCs a Problem? - Answer-Increase from the patient's normal amount
Multiple PVCs in a row
PVC falls on the T wave of previous beat
Multifocal (they arise from different cells, therefore they are different shapes)
PVC Troubles - Answer-Bigeminy = every other beat is a PVC
Trigeminy = every 3rd beat is a PVC
Multiple PVCs right after each other: couplet or triplet
Ventricular Tachycardia (VT) - Answer-4 or more ventricular beats in a row
Rate > 150 bpm
Sustained VTach - Answer-Pt stays in VTach & needs our help to switch (defibrillate or
cardiovert)
Code BLUE !
Idioventricular Rhythm - Answer-Ventricular beats, but....
slow rate
Torsades de Pointes - Answer-A form of VTach which looks like the rhythm strip is
twisting
Code BLUE !
Ventricular Fibrillation (VF) - Answer-Squiggly line
