1. Which of the following is the most common cause of a ventricular fibrillation (VF) arrest?
A. Acute myocardial infarction
B. Hypothermia
C. Hyperkalemia
D. Drug overdose
Answer: A) Acute myocardial infarction
Rationale: Acute myocardial infarction is the most common cause of ventricular fibrillation,
particularly within the first few hours of the infarction, due to ischemic injury to the heart
muscle.
2. Which of the following is a common cause of torsades de pointes?
A. Hyperkalemia
B. Hypokalemia
C. Long QT syndrome
D. Hypoxia
Answer: C) Long QT syndrome
Rationale: Torsades de pointes is a form of polymorphic ventricular tachycardia often associated
with a prolonged QT interval, which can result from congenital or acquired long QT syndrome.
3. Which of the following is a characteristic feature of a premature ventricular contraction (PVC)
on an ECG?
A. A premature, wide QRS complex without a preceding P wave
B. A narrow QRS complex with a compensatory pause
C. An early P wave followed by a normal QRS complex
D. A prolonged PR interval with an absent QRS complex
Answer: A) A premature, wide QRS complex without a preceding P wave
,Rationale: PVCs are premature depolarizations originating from the ventricles. They are
characterized by wide, bizarre QRS complexes, which occur before the next expected sinus beat.
There is typically no preceding P wave.
4. Which of the following medications can cause a prolonged QT interval and potentially lead to
Torsades de Pointes?
A. Lidocaine
B. Amiodarone
C. Erythromycin
D. Atropine
Answer: C) Erythromycin
Rationale: Erythromycin, an antibiotic, can prolong the QT interval and increase the risk of
developing Torsades de Pointes, particularly when used in conjunction with other QT-prolonging
drugs.
5. What is the primary risk of untreated atrial fibrillation?
A. Stroke
B. Hypotension
C. Respiratory failure
D. Myocardial infarction
Answer: A) Stroke
Rationale: The chaotic atrial activity in atrial fibrillation can lead to the formation of blood clots
in the atria, particularly in the left atrial appendage. These clots can travel to the brain and cause
a stroke.
6. Which of the following ECG findings is most characteristic of a heart with a bundle branch
block?
A. Prolonged PR interval
B. Wide QRS complex with a distinct notch in the R wave
C. Absent P waves
, D. Tall, peaked T waves
Answer: B) Wide QRS complex with a distinct notch in the R wave
Rationale: A bundle branch block causes a delay in ventricular depolarization, leading to a
widened QRS complex. The characteristic notch or "rabbit ears" in the R wave are seen on the
ECG.
7. Which of the following arrhythmias is associated with a very rapid ventricular rate and is often
seen in patients with ischemic heart disease?
A. Ventricular fibrillation
B. Atrial flutter
C. Ventricular tachycardia
D. First-degree AV block
Answer: C) Ventricular tachycardia
Rationale: Ventricular tachycardia is characterized by a rapid heart rate originating from the
ventricles. It is commonly seen in patients with ischemic heart disease and can be life-
threatening if untreated.
8. Which of the following rhythms is typically associated with a “sawtooth” pattern of P waves
on an ECG?
A. Atrial fibrillation
B. Atrial flutter
C. Ventricular tachycardia
D. Sinus tachycardia
Answer: B) Atrial flutter
Rationale: Atrial flutter is characterized by a rapid, regular atrial rhythm with the appearance of
“sawtooth” P waves (flutter waves) on the ECG, due to rapid atrial depolarizations.
9. What is the most appropriate intervention for a patient with symptomatic, sustained ventricular
tachycardia?
A. Amiodarone infusion
A. Acute myocardial infarction
B. Hypothermia
C. Hyperkalemia
D. Drug overdose
Answer: A) Acute myocardial infarction
Rationale: Acute myocardial infarction is the most common cause of ventricular fibrillation,
particularly within the first few hours of the infarction, due to ischemic injury to the heart
muscle.
2. Which of the following is a common cause of torsades de pointes?
A. Hyperkalemia
B. Hypokalemia
C. Long QT syndrome
D. Hypoxia
Answer: C) Long QT syndrome
Rationale: Torsades de pointes is a form of polymorphic ventricular tachycardia often associated
with a prolonged QT interval, which can result from congenital or acquired long QT syndrome.
3. Which of the following is a characteristic feature of a premature ventricular contraction (PVC)
on an ECG?
A. A premature, wide QRS complex without a preceding P wave
B. A narrow QRS complex with a compensatory pause
C. An early P wave followed by a normal QRS complex
D. A prolonged PR interval with an absent QRS complex
Answer: A) A premature, wide QRS complex without a preceding P wave
,Rationale: PVCs are premature depolarizations originating from the ventricles. They are
characterized by wide, bizarre QRS complexes, which occur before the next expected sinus beat.
There is typically no preceding P wave.
4. Which of the following medications can cause a prolonged QT interval and potentially lead to
Torsades de Pointes?
A. Lidocaine
B. Amiodarone
C. Erythromycin
D. Atropine
Answer: C) Erythromycin
Rationale: Erythromycin, an antibiotic, can prolong the QT interval and increase the risk of
developing Torsades de Pointes, particularly when used in conjunction with other QT-prolonging
drugs.
5. What is the primary risk of untreated atrial fibrillation?
A. Stroke
B. Hypotension
C. Respiratory failure
D. Myocardial infarction
Answer: A) Stroke
Rationale: The chaotic atrial activity in atrial fibrillation can lead to the formation of blood clots
in the atria, particularly in the left atrial appendage. These clots can travel to the brain and cause
a stroke.
6. Which of the following ECG findings is most characteristic of a heart with a bundle branch
block?
A. Prolonged PR interval
B. Wide QRS complex with a distinct notch in the R wave
C. Absent P waves
, D. Tall, peaked T waves
Answer: B) Wide QRS complex with a distinct notch in the R wave
Rationale: A bundle branch block causes a delay in ventricular depolarization, leading to a
widened QRS complex. The characteristic notch or "rabbit ears" in the R wave are seen on the
ECG.
7. Which of the following arrhythmias is associated with a very rapid ventricular rate and is often
seen in patients with ischemic heart disease?
A. Ventricular fibrillation
B. Atrial flutter
C. Ventricular tachycardia
D. First-degree AV block
Answer: C) Ventricular tachycardia
Rationale: Ventricular tachycardia is characterized by a rapid heart rate originating from the
ventricles. It is commonly seen in patients with ischemic heart disease and can be life-
threatening if untreated.
8. Which of the following rhythms is typically associated with a “sawtooth” pattern of P waves
on an ECG?
A. Atrial fibrillation
B. Atrial flutter
C. Ventricular tachycardia
D. Sinus tachycardia
Answer: B) Atrial flutter
Rationale: Atrial flutter is characterized by a rapid, regular atrial rhythm with the appearance of
“sawtooth” P waves (flutter waves) on the ECG, due to rapid atrial depolarizations.
9. What is the most appropriate intervention for a patient with symptomatic, sustained ventricular
tachycardia?
A. Amiodarone infusion