NU 623 Arrhythmias and Valvular Dx Ch 36 Questions with Correct Answ
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1. What risk assessment tool is recommended in patients with nonvalvular AF
for assessment of stroke risk?: The CHA2DS2-VASc-This scoring includes the addition of having vascular
disease and being a female.
2. What are common causes of PAC's (Premature Atrial Contractions)?: This ar-
rhythmia is commonly seen in young, healthy individuals. Cardiac stimulants such as caffeine, nicotine, alcohol, or
over-the-counter medications sometimes induce PACs. They may also occur in patients with right atrial dilation caused
by obstructive lung disease and heart failure.
3. A CHADS2 risk score of 2 or greater indicates what?: Anticoagulation therapy is recom-
mended for a CHADS2 risk score of 2 or greater.
4. What does the Acronym CHADS stand for?: C- Congestive Heart Failure - 1 pt
H-Hypertension or treated hypertension - 1pt
A- Age >75- 1 pt
D-Diabetes- 1 pt
S-Prior stroke of TIA- 2 pts
5. How is atrial tachycardia differentiated from atrial flutter?: The atrial rate differentiates
atrial tachycardia from atrial flutter. This rate difference is particularly pertinent when the clinician is attempting to
discern whether the arrhythmia is an atrial tachycardia with a heart block (as seen in digitalis toxicity) or an atrial flutter.
Both rhythms can present with more than one observable P wave before the QRS. An atrial tachycardia rate (P-wave
rate of 140-250 per minute) is slower than an atrial flutter rate (P-wave rate of 250-350 per minute). It is important for
the clinician to remember that the P-wave rate needs to be counted separately from the QRS rate.
6. What block is observed with a regular rhythm and only a prolonged P-R
interval?: 1st degree
7. What block occurs in the AV nodal area with progressive lengthening of the
P-R interval until a QRS complex (ventricular contraction) is dropped?: 2nd degree-
Mobitz type I
8. What block occurs within or below the bundle of His, with a P-R interval that
remains fixed. The conduction ratio (P waves to QRS complexes) is commonly
2:1, 3:1, or 4:1.?: 2nd degree- Mobitz type II
9. What block occurs when the atria beat regularly and at a normal rate but
no excitation is transmitted from the atria to the ventricles. In turn, the atria
1/6
, NU 623 Arrhythmias and Valvular Dx Ch 36 Questions with Correct Answ
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and ventricles contract independently at their own intrinsic rates?: 3rd degree, further
classified as 3rd degree at the junctional level or 3rd degree at the ventricular level
10. A patient presents with a normal digitalis level but complains of new-onset
of an atrial tachydysrhythmia and noncardiac subjective symptoms including
altered visual color perception. What would you suspect?: Digitalis toxicity- The serum
digitalis level may not reflect the amount of digitalis bound to the myocardial membrane, where it cannot be measured.
Thus, a normal digitalis level should not be the determining factor in assessing digitalis toxicity.
11. A pt's EKG reveals a notched pattern in a classic rsR (little r, s wave, larger R
prime) upright qrs complex that is greater than 0.12 in lead V1. What does this
indicate?: Right BBB
12. How is a Right BBB differentiated from a Left BBB?: In a Left BBB - V1 will retain the
original formation (showing a small upright r wave with negative remaining complex) that is .12 or greater. LBBB can
be confirmed in either V5 or V6 also by a notched appearance but does not have a set pattern to the qrs as found in
the rsR of a RBBB.
13. What is the "frog sign"?: During PSVT, the atria contract against closed AV valves, resulting in a rapid,
regular expansion of the neck veins (the same mechanism as cannon waves). This physical finding has been called the
"frog sign" because the rapid, regular expansion of the neck veins resembles the puffing motion of a frog, which may
be noted by the patient's family members.
14. The ECG shows a regular rhythm with a rate of 150- 250 per minute. The
P waves are ectopic and distorted. The P-R interval is shortened, the QRS is
normal. What do you suspect?: SVT
15. The ECG shows a regular atrial rate of 250 to 350 beats per minute, and a
regular ventricular rate. The P waves are discernible and "march out" (i.e., can
be mapped out with a caliper) consistently throughout the strip. P-R intervals
cannot be calculated, and the QRS complexes have variable conduction. What
do you suspect?: A-flutter
16. How long does it take coumadin to achieve a therapeutic effect and how
often should labs be monitored for a patient receiving coumadin for AFIB?: -
Warfarin (Coumadin), takes approximately 5 days to achieve its full anticoagulant effect. A prothrombin time (PT) with
international normalized ratio (INR) is drawn and the patient is started on warfarin with the dose adjusted according to
the patient's INR. The target INR in atrial fibrillation is between 2 and 3. The PT should be checked at regular intervals
2/6
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1. What risk assessment tool is recommended in patients with nonvalvular AF
for assessment of stroke risk?: The CHA2DS2-VASc-This scoring includes the addition of having vascular
disease and being a female.
2. What are common causes of PAC's (Premature Atrial Contractions)?: This ar-
rhythmia is commonly seen in young, healthy individuals. Cardiac stimulants such as caffeine, nicotine, alcohol, or
over-the-counter medications sometimes induce PACs. They may also occur in patients with right atrial dilation caused
by obstructive lung disease and heart failure.
3. A CHADS2 risk score of 2 or greater indicates what?: Anticoagulation therapy is recom-
mended for a CHADS2 risk score of 2 or greater.
4. What does the Acronym CHADS stand for?: C- Congestive Heart Failure - 1 pt
H-Hypertension or treated hypertension - 1pt
A- Age >75- 1 pt
D-Diabetes- 1 pt
S-Prior stroke of TIA- 2 pts
5. How is atrial tachycardia differentiated from atrial flutter?: The atrial rate differentiates
atrial tachycardia from atrial flutter. This rate difference is particularly pertinent when the clinician is attempting to
discern whether the arrhythmia is an atrial tachycardia with a heart block (as seen in digitalis toxicity) or an atrial flutter.
Both rhythms can present with more than one observable P wave before the QRS. An atrial tachycardia rate (P-wave
rate of 140-250 per minute) is slower than an atrial flutter rate (P-wave rate of 250-350 per minute). It is important for
the clinician to remember that the P-wave rate needs to be counted separately from the QRS rate.
6. What block is observed with a regular rhythm and only a prolonged P-R
interval?: 1st degree
7. What block occurs in the AV nodal area with progressive lengthening of the
P-R interval until a QRS complex (ventricular contraction) is dropped?: 2nd degree-
Mobitz type I
8. What block occurs within or below the bundle of His, with a P-R interval that
remains fixed. The conduction ratio (P waves to QRS complexes) is commonly
2:1, 3:1, or 4:1.?: 2nd degree- Mobitz type II
9. What block occurs when the atria beat regularly and at a normal rate but
no excitation is transmitted from the atria to the ventricles. In turn, the atria
1/6
, NU 623 Arrhythmias and Valvular Dx Ch 36 Questions with Correct Answ
100% Solved
Study online at https://quizlet.com/_i392qq
and ventricles contract independently at their own intrinsic rates?: 3rd degree, further
classified as 3rd degree at the junctional level or 3rd degree at the ventricular level
10. A patient presents with a normal digitalis level but complains of new-onset
of an atrial tachydysrhythmia and noncardiac subjective symptoms including
altered visual color perception. What would you suspect?: Digitalis toxicity- The serum
digitalis level may not reflect the amount of digitalis bound to the myocardial membrane, where it cannot be measured.
Thus, a normal digitalis level should not be the determining factor in assessing digitalis toxicity.
11. A pt's EKG reveals a notched pattern in a classic rsR (little r, s wave, larger R
prime) upright qrs complex that is greater than 0.12 in lead V1. What does this
indicate?: Right BBB
12. How is a Right BBB differentiated from a Left BBB?: In a Left BBB - V1 will retain the
original formation (showing a small upright r wave with negative remaining complex) that is .12 or greater. LBBB can
be confirmed in either V5 or V6 also by a notched appearance but does not have a set pattern to the qrs as found in
the rsR of a RBBB.
13. What is the "frog sign"?: During PSVT, the atria contract against closed AV valves, resulting in a rapid,
regular expansion of the neck veins (the same mechanism as cannon waves). This physical finding has been called the
"frog sign" because the rapid, regular expansion of the neck veins resembles the puffing motion of a frog, which may
be noted by the patient's family members.
14. The ECG shows a regular rhythm with a rate of 150- 250 per minute. The
P waves are ectopic and distorted. The P-R interval is shortened, the QRS is
normal. What do you suspect?: SVT
15. The ECG shows a regular atrial rate of 250 to 350 beats per minute, and a
regular ventricular rate. The P waves are discernible and "march out" (i.e., can
be mapped out with a caliper) consistently throughout the strip. P-R intervals
cannot be calculated, and the QRS complexes have variable conduction. What
do you suspect?: A-flutter
16. How long does it take coumadin to achieve a therapeutic effect and how
often should labs be monitored for a patient receiving coumadin for AFIB?: -
Warfarin (Coumadin), takes approximately 5 days to achieve its full anticoagulant effect. A prothrombin time (PT) with
international normalized ratio (INR) is drawn and the patient is started on warfarin with the dose adjusted according to
the patient's INR. The target INR in atrial fibrillation is between 2 and 3. The PT should be checked at regular intervals
2/6
