Basic EKG Interpretation
Exam Solutions
Course Introduction
Basic EKG Interpretation introduces students to the fundamental principles and techniques for analyzing electrocardiograms (EKGs/ECGs). The course covers the electrical conduction system of the heart, waveform recognition, and the systematic approach to interpreting normal and abnormal rhythms. Emphasis is placed on identifying arrhythmias, ischemic changes, and other cardiac conditions through EKG tracings. Practical applications and case studies help students develop confidence in understanding EKGs, making this course valuable for those pursuing careers in healthcare, nursing, or emergency medical services.
Recommended Textbook
EKG Plain and Simple 4th Edition by Karen Ellis
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Chapter 1: Cardiac Anatomy and Physiology
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Sample Questions
Q1) The heart valve found at the opening of the pulmonary artery is the A)aortic valve.
B)tricuspid valve.
C)mitral valve.
D)pulmonic valve.
Answer: D
Q2) The inferior vena cava returns deoxygenated blood to the heart from A)the head and neck.
B)the coronary circulation.
C)the lower extremities and abdomen.
D)none of these-the vena cava carries oxygenated blood.
Answer: C
Q3) The vena cava is a large artery that carries blood from the right ventricle to the lungs.
A)True
B)False
Answer: False
Q4) The coronary artery that feeds blood to the right ventricle and the inferior wall of the left ventricle is the ________.
Answer: Right coronary artery (RCA)
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Chapter 2: Electrophysiology
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Sample Questions
Q1) The job of the cardiac conduction system is to
A)propagate electrical impulses.
B)conduct electrical impulses.
C)cause depolarization of myocardial cells.
D)all of the above.
Answer: D
Q2) A beat that appears on the rhythm strip after a long pause and causes a slower rhythm than the normal rhythm is called a(n)
A)usurpation beat.
B)irritable beat.
C)escape beat.
D)pacemaker beat.
Answer: C
Q3) The job of the cardiac conduction system's pacemaker is to A)propagate electrical impulses.
B)conduct electrical impulses.
C)cause depolarization of myocardial cells.
D)all of the above.
Answer: A
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Page 4
Chapter 3: Lead Morphology and Placement
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Sample Questions
Q1) AVR has its positive pole on the
A)left arm.
B)right leg.
C)right arm.
D)left leg.
Answer: C
Q2) Joining leads I,II,and III at their ends produces
A)the triaxial diagram.
B)the hexiaxial diagram.
C)Einthoven's triangle.
D)the precordial leads.
Answer: C
Q3) The QRS complex should be positive in which of the following leads?
A)AVR
B)V
C)V
D)V
Answer: C
Q4) Einthoven's law states that ________.
Answer: Lead I + Lead III = Lead II
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Chapter 4: Technical Aspects of the EKG
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Sample Questions
Q1) Your patient is having chills.What kind of artifact can this produce?
A)60-cycle interference
B)Baseline sway
C)Broken recording
D)Somatic tremors
Q2) Macroshock and microshock are two kinds of electrical shock the patient can sustain from faulty equipment.
A)True
B)False
Q3) The EKG machine's control feature that might reduce artifact is the ________.
Q4) Artifact does not cause symptoms of decreased cardiac output.
A)True
B)False
Q5) Chills can cause somatic tremor artifact.
A)True
B)False
Q6) If artifact is seen in leads I,III,and aVL,you should direct your corrective efforts to which limb or limbs?
Q7) The word "somatic" means ________.
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Q8) Troubleshooting involves determining and alleviating the cause of ________.
Chapter 5: Calculating Heart Rate
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Sample Questions
Q1) Atrial rate can be calculated by counting
A)QRS complexes.
B)P waves.
C)PR intervals.
D)R-R intervals.
Q2) What is the correct procedure for calculating a regular heart rate interrupted by premature beats?
A)Ignore the premature beats and calculate the heart rate using the six-second strip or memory methods.
B)Calculate the range slowest to fastest using the memory method and the mean rate using the six-second strip method.
C)Ignore the premature beats and calculate the heart rate using the little block or memory method.
D)Calculate the range fastest to slowest using the little block method and the mean rate using the six-second strip method.
Q3) Regularity is concerned with the constancy of QRS complexes.
A)True
B)False
Q4) If the QRS complexes are all 15 little blocks apart,the heart rate is ________.
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Chapter 6: How to Interpret a Rhythm Strip
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Sample Questions
Q1) A rhythm with a heart rate greater than 100 is a tachycardia.
A)True
B)False
Q2) The normal rhythm of the heart is called ________.
Q3) Sinus rhythms should have narrow QRS complexes of uniform shape.
A)True
B)False
Q4) The distance between consecutive P waves is called the ________.
Q5) Sinus rhythm is an irregular rhythm interrupted by premature beats and pauses.
A)True
B)False
Q6) A rhythm originating in the sinus node should NOT have which of the following?
A)Narrow QRS complexes of uniform shape
B)Regularly spaced QRS complexes
C)Absent QRS complexes
D)Heart rate of 60-100
Q7) The sinus rhythm has a heart rate of 60-80.
A)True
B)False
8
Q8) What are the five steps in rhythm interpretation?
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Chapter 7: Rhythms Originating in the Sinus Node
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Sample Questions
Q1) Treatment for sinus tachycardia associated with a high fever would be to
A)give atropine.
B)start CPR.
C)give acetaminophen or ibuprofen to get the temperature down.
D)give beta-blockers.
Q2) In which rhythm is an escape beat sometimes seen?
A)Sinus rhythm
B)Sinus bradycardia
C)Sinus arrhythmia
D)Sinus arrest
Q3) Atropine's mode of action is to
A)speed up the rate of sinus node firing and speed conduction through the AV node.
B)speed impulse conduction through the bundle branches and AV node.
C)slow the rate of conduction through the AV node and slow sinus node firing.
D)speed sinus node firing and slow AV node conduction.
Q4) A rhythm with a heart rate less than 60 is ________.
Q5) High fever can cause sinus tachycardia.
A)True
B)False
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Chapter 8: Rhythms Originating in the Atria
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Sample Questions
Q1) Atrial flutter is almost always seen in patients with A)thyrotoxicosis.
B)acute heart attacks.
C)heart disease.
D)cardiac arrest.
Q2) PACs are premature beats from the sinus node.
A)True
B)False
Q3) In atrial fibrillation of less than 48 hours duration,anticoagulant therapy is indicated before attempting to convert the rhythm back to sinus rhythm.
A)True
B)False
Q4) The atrial rate in paroxysmal atrial tachycardia is ________.
Q5) Atrial fibrillation is A)regular.
B)irregular.
C)regular but interrupted by premature beats.
D)regular but interrupted by pauses.
Q6) The P wave of a PAC is shaped _____from sinus P waves.
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Q7) Multifocal atrial tachycardia has at least ________ different shapes of P waves.
Chapter 9: Rhythms Originating in the AV Junction
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Sample Questions
Q1) Junctional tachycardia has a heart rate of
A)40-60.
B)60-100.
C)less than 40.
D)greater than 100.
Q2) In mid-junctional rhythms,the P wave is
A)upright,rounded,preceding the QRS.
B)inverted following the QRS.
C)inverted preceding the QRS.
D)hidden inside the QRS.
Q3) Junctional tachycardia is usually a result of escape.
A)True
B)False
Q4) Junctional tachycardia has a heart rate greater than 100.
A)True
B)False
Q5) Junctional rhythms have retrograde conduction to the ventricles.
A)True
B)False
Q6) Atropine should be given for junctional bradycardia if the patient is ________.
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Chapter 10: Rhythms Originating in the Ventricles
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Sample Questions
Q1) Two consecutive PVCs are called a ________.
Q2) PVC stands for ________.
Q3) The wide-QRS beat in Figure 10 is a(n)
A)junctional escape beat.
B)ventricular escape beat.
C)PVC.
D)compensatory pause.
Q4) The heart rate in Figure 12 is A)100.
B)20.
C)40.
D)zero.
Q5) Defibrillation is the treatment of choice for ventricular fibrillation.
A)True
B)False
Q6) For which of the following rhythms is electrical shock to the heart appropriate?
A)Ventricular tachycardia
B)Ventricular fibrillation
C)Asystole
D)All except C
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Chapter 11: AV Blocks
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Sample Questions
Q1) The rhythm in Figure 18 is A)Wenckebach.
B)Mobitz II second-degree AV block.
C)third-degree AV block.
D)junctional bradycardia.
Q2) 2:1 AV block can be caused by either
A)third-degree AV block or Wenckebach.
B)Wenckebach or Mobitz II second-degree AV block.
C)first-degree AV block or Wenckebach.
D)Mobitz II second-degree AV block or third-degree AV block.
Q3) The type of heart block that involves a prolonged PR interval and no dropped beats is Mobitz II second-degree AV block.
A)True
B)False
Q4) The type of AV block characterized by a prolonged PR interval is A)Wenckebach.
B)Mobitz II second-degree AV block.
C)third-degree AV block.
D)first-degree AV block.
Q5) Why does atropine not work when the block is at the bundle branches?
Page 13
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Chapter 13: How to Interpret a 12-Lead EKG
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Sample Questions
Q1) Bundle branch blocks do not cause symptoms.
A)True
B)False
Q2) Right axis deviation is between
A)0 and +90 degrees.
B)0 and -90 degrees.
C)+90 and 180 degrees.
D)-90 and 180 degrees.
Q3) A rate-related BBB is one which ________.
Q4) Hypercalcemia is a disorder in which there is too much ________ in the bloodstream.
A)cholesterol
B)calcium
C)calcitonin
D)potassium
Q5) Left axis deviation is between
A)0 and +90 degrees.
B)0 and -90 degrees.
C)+90 and 180 degrees.
D)-90 and 180 degrees.
14
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Chapter 14: Myocardial Infarction
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Sample Questions
Q1) Smiley-face ST elevation is concave and often seen in pericarditis.
A)True
B)False
Q2) Occlusion is
A)blockage.
B)an EKG finding seen in NSTEMIs.
C)an EKG finding consistent with ischemia.
D)the opening of a coronary artery.
Q3) Where is the V lead placed for a right-sided EKG?
A)The 5th intercostal space on the right mid-axillary line
B)The 4th intercostal space on the right sternal border
C)The 4th intercostal space on the left sternal border
D)The 5th intercostal space on the right midclavicular line
Q4) What kind of MI is indicated by significant Q waves in II,III,aVF,and V -6?
A)Anterior-lateral
B)Inferior-posterior
C)Inferior-lateral
D)Anteroseptal
Q5) Inferior-lateral MI has indicative changes in leads ________.
Q6) Name the three Is of infarction.
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Chapter 16: Medications and Electrical Therapy
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Sample Questions
Q1) Following cardiac arrest,use of therapeutic hypothermia reduces the risk of A)unconsciousness.
B)bradycardia.
C)ischemic brain damage.
D)ventricular arrhythmia.
Q2) The pacemaker's generation of an electrical impulse is called A)capture.
B)firing.
C)sensing.
D)conductivity.
Q3) A transcutaneous pacemaker paces the heart
A)through the skin.
B)by way of a wire threaded through a vein and into the heart.
C)by way of a wire attached to the surface of the heart.
D)permanently.
Q4) If a pacemaker fails to fire,what is shown on the EKG?
A)Lack of a P or QRS after the pacemaker spike
B)Lack of a pacemaker spike where there should be one
C)Paced beats on top of intrinsic beats
D)Tall,pointy T waves
Page 16
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Chapter 17: Diagnostic Electrocardiography
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Sample Questions
Q1) If the stress test is positive but an angiogram reveals normal coronary arteries,the stress test is said to have been a
A)true positive.
B)false positive.
C)true negative.
D)false negative.
Q2) All pharmacologic stress tests involve the use of A)a treadmill to induce stress.
B)medications to induce stress the way exercise would.
C)an arm ergometer to induce stress.
D)radioactive medications to determine tissue perfusion.
Q3) If the ST segment drops 3 mm during exercise,it is evidence of A)old MI.
B)myocardial ischemia.
C)J-point elevation.
D)ventricular tachycardia.
Q4) Chronotropic incompetence is the inability of the heart to increase its rate with exercise.
A)True
B)False
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