ECG WORKOUT
EXERCISES IN ARRHYTHMIA
INTERPRETATION
8TH EDITION
• AUTHOR(S)JANE HUFF
TEST BANK
1️⃣
Reference
Ch. 1 — Description & Location of the Heart — Conduction
origin and surface location
Question Stem
A telemetry strip obtained from a patient lying flat shows a
regular rhythm at ~75 bpm with upright P waves before every
narrow QRS and a consistent PR interval of 0.16 s. The nurse
notes chest pain localized to the left anterior chest. Using
,knowledge of the heart’s anatomical position, which statement
best links the ECG pattern and the location of ischemic pain?
A. The rhythm indicates atrial-origin tachycardia; left anterior
chest pain suggests mitral valve disease.
B. The rhythm is normal sinus; left anterior chest pain likely
reflects ischemia of structures on the heart’s anterior surface.
C. The rhythm indicates junctional escape rhythm; anterior
chest pain suggests pericarditis only.
D. The rhythm is sinus bradycardia; anterior chest pain indicates
inferior wall ischemia.
Correct Answer
B
Rationales
• Correct (B): The ECG shows normal sinus rhythm
(appropriate rate, P before each QRS, consistent PR). Pain
on the left anterior chest anatomically corresponds to the
heart’s anterior surface (right ventricle/left anterior wall),
where ischemia commonly produces anterior chest pain.
• Incorrect (A): The ECG does not show atrial tachycardia;
rate and morphology are normal. Mitral valve disease is
not specifically localized to left anterior chest pain.
• Incorrect (C): Junctional rhythm would have absent or
inverted P waves; this strip has upright P waves.
Pericarditis can cause anterior pain but the ECG pattern
here isn’t junctional.
, • Incorrect (D): The rhythm is not bradycardic (~75 bpm).
Inferior wall ischemia classically causes pain that may
radiate to the epigastrium/right shoulder, not specifically
left anterior.
Teaching Point
Normal sinus rhythm + left anterior chest pain often implicates
anterior cardiac structures (anterior wall).
Citation
Huff, J. (2022). ECG Workout: Exercises in Arrhythmia
Interpretation (8th ed.). Ch. 1.
2️⃣
Reference
Ch. 1 — Function of the Heart — Cardiac output and rate
relationship
Question Stem
A postoperative telemetry strip shows a regular rhythm at 130
bpm with narrow QRS complexes and distinct P waves
preceding each beat. The patient is hypotensive and pale.
Which physiologic explanation best connects the tachycardia to
decreased cardiac output?
A. Tachycardia always increases stroke volume so cardiac output
is elevated despite hypotension.
B. Increased heart rate may shorten diastolic filling time,
reducing stroke volume and worsening cardiac output.
, C. Sinus tachycardia directly causes valvular stenosis, producing
hypotension.
D. High rate causes permanent myocardial contractility
increase, improving cardiac output.
Correct Answer
B
Rationales
• Correct (B): At high heart rates, diastolic filling time
shortens, which can reduce stroke volume; with
insufficient compensatory increase in stroke volume,
cardiac output falls, producing hypotension.
• Incorrect (A): Tachycardia does not always increase stroke
volume; at very high rates stroke volume often falls.
• Incorrect (C): Sinus tachycardia does not directly cause
valvular stenosis.
• Incorrect (D): Acute high rates do not cause a sustained
increase in contractility that reliably improves cardiac
output; they can decrease efficiency.
Teaching Point
Excessive rate shortens diastole and can reduce stroke volume
and cardiac output.
Citation
Huff, J. (2022). ECG Workout: Exercises in Arrhythmia
Interpretation (8th ed.). Ch. 1.
EXERCISES IN ARRHYTHMIA
INTERPRETATION
8TH EDITION
• AUTHOR(S)JANE HUFF
TEST BANK
1️⃣
Reference
Ch. 1 — Description & Location of the Heart — Conduction
origin and surface location
Question Stem
A telemetry strip obtained from a patient lying flat shows a
regular rhythm at ~75 bpm with upright P waves before every
narrow QRS and a consistent PR interval of 0.16 s. The nurse
notes chest pain localized to the left anterior chest. Using
,knowledge of the heart’s anatomical position, which statement
best links the ECG pattern and the location of ischemic pain?
A. The rhythm indicates atrial-origin tachycardia; left anterior
chest pain suggests mitral valve disease.
B. The rhythm is normal sinus; left anterior chest pain likely
reflects ischemia of structures on the heart’s anterior surface.
C. The rhythm indicates junctional escape rhythm; anterior
chest pain suggests pericarditis only.
D. The rhythm is sinus bradycardia; anterior chest pain indicates
inferior wall ischemia.
Correct Answer
B
Rationales
• Correct (B): The ECG shows normal sinus rhythm
(appropriate rate, P before each QRS, consistent PR). Pain
on the left anterior chest anatomically corresponds to the
heart’s anterior surface (right ventricle/left anterior wall),
where ischemia commonly produces anterior chest pain.
• Incorrect (A): The ECG does not show atrial tachycardia;
rate and morphology are normal. Mitral valve disease is
not specifically localized to left anterior chest pain.
• Incorrect (C): Junctional rhythm would have absent or
inverted P waves; this strip has upright P waves.
Pericarditis can cause anterior pain but the ECG pattern
here isn’t junctional.
, • Incorrect (D): The rhythm is not bradycardic (~75 bpm).
Inferior wall ischemia classically causes pain that may
radiate to the epigastrium/right shoulder, not specifically
left anterior.
Teaching Point
Normal sinus rhythm + left anterior chest pain often implicates
anterior cardiac structures (anterior wall).
Citation
Huff, J. (2022). ECG Workout: Exercises in Arrhythmia
Interpretation (8th ed.). Ch. 1.
2️⃣
Reference
Ch. 1 — Function of the Heart — Cardiac output and rate
relationship
Question Stem
A postoperative telemetry strip shows a regular rhythm at 130
bpm with narrow QRS complexes and distinct P waves
preceding each beat. The patient is hypotensive and pale.
Which physiologic explanation best connects the tachycardia to
decreased cardiac output?
A. Tachycardia always increases stroke volume so cardiac output
is elevated despite hypotension.
B. Increased heart rate may shorten diastolic filling time,
reducing stroke volume and worsening cardiac output.
, C. Sinus tachycardia directly causes valvular stenosis, producing
hypotension.
D. High rate causes permanent myocardial contractility
increase, improving cardiac output.
Correct Answer
B
Rationales
• Correct (B): At high heart rates, diastolic filling time
shortens, which can reduce stroke volume; with
insufficient compensatory increase in stroke volume,
cardiac output falls, producing hypotension.
• Incorrect (A): Tachycardia does not always increase stroke
volume; at very high rates stroke volume often falls.
• Incorrect (C): Sinus tachycardia does not directly cause
valvular stenosis.
• Incorrect (D): Acute high rates do not cause a sustained
increase in contractility that reliably improves cardiac
output; they can decrease efficiency.
Teaching Point
Excessive rate shortens diastole and can reduce stroke volume
and cardiac output.
Citation
Huff, J. (2022). ECG Workout: Exercises in Arrhythmia
Interpretation (8th ed.). Ch. 1.
