Clinical Electrocardiography
Mock Exam
Course Introduction
Clinical Electrocardiography focuses on the principles and practical applications of electrocardiogram (ECG) interpretation in clinical settings. The course covers the physiological basis of cardiac electrical activity, the standard twelve-lead ECG, and systematic analysis of waveforms, intervals, and segments. Students learn to identify normal and abnormal ECG patterns, including arrhythmias, myocardial ischemia and infarction, conduction disturbances, and electrolyte imbalances. Emphasis is placed on correlating ECG findings with underlying cardiac pathophysiology, integrating clinical case studies, and developing skills necessary for accurate, timely diagnosis and decision-making in patient care.
Recommended Textbook
EKG Plain and Simple 3rd Edition by Karen Ellis RN
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15 Chapters
790 Verified Questions
790 Flashcards
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Chapter 1: Coronary Anatomy and Physiology
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Sample Questions
Q1) The semilunar valves open when the
A)Atrial pressure exceeds the ventricular pressure.
B)Atrial and ventricular pressures are equal.
C)Ventricular pressure exceeds the aortic and pulmonary arterial pressures.
D)Impulse arrives at the AV node.
Answer: C
Q2) The second heart sound (S2)is associated with closure of which heart valves?
A)Mitral and aortic
B)Tricuspid and pulmonic
C)Tricuspid and mitral
D)Aortic and pulmonic
Answer: D
Q3) The heart chamber that has the greatest workload is the right atrium,as it pumps blood out to the entire body.
A)True
B)False
Answer: False
Q4) The function of the heart is to _____.
Answer: Pump enough blood to meet the body's metabolic needs
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Chapter 2: Electrophysiology
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Sample Questions
Q1) The cardiac cell at rest has what kind of electrical charge?
A)Positive charge
B)Negative charge
C)Neutral charge
D)No charge at all
Answer: B
Q2) Depolarization is a(n)
A)Electrical event that should result in muscle relaxation.
B)Mechanical event that should result in depolarization.
C)Electrical event that should result in muscle contraction.
D)Mechanical event that should result in repolarization.
Answer: C
Q3) Phase 0 of the action potential corresponds with what wave or complex on the EKG?
A)T wave
B)QRS complex
C)U wave
D)ST segment
Answer: B
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Chapter 3: Lead Morphology and Placement
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Sample Questions
Q1) The precordial leads are placed on the arms and legs.
A)True
B)False
Answer: False
Q2) V1 through V6 are the
A)Bipolar leads.
B)Frontal leads.
C)Augmented leads.
D)Precordial leads.
Answer: D
Q3) Which of the following is NOT a bipolar lead?
A)Lead II
B)AVF
C)Lead I
D)Lead III
Answer: B
Q4) A lead is an electrocardiographic _____.
Answer: Picture of the heart
Q5) Lead AVR's positive electrode is located on the _____.
Answer: Right arm
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Chapter 4: Technical Aspects of the Ekg
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Sample Questions
Q1) A patient is short of breath and his nurse tells you he must have the head of bed (HOB)at 90 degrees for his 12-lead EKG.You
A)Leave,telling the nurse to call you when the HOB can be lowered flat.
B)Roll the HOB flat and do the EKG,then roll the HOB back up.
C)Call the physician and ask why the HOB can't be lowered.
D)Do the EKG at 90 degrees and document this position on the EKG.
Q2) CPR artifact is caused by chest compressions obscuring the real _______.
Q3) Using an EKG machine with frayed wires is not dangerous if the wires are taped together.
A)True
B)False
Q4) 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
Q5) Artifact is a sign that the patient is in distress.
A)True
B)False
Q6) The word "somatic" means _____.
Page 6
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Chapter 5: Calculating Heart Rate
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Sample Questions
Q1) Which of the following is a method of calculating heart rate?
A)Six-second strip method
B)The QT interval method
C)The P-P interval method
D)All of the above
Q2) An irregular rhythm is one in which
A)The R-R intervals vary "all over the place."
B)The R-R intervals vary by only one or two little blocks.
C)There are premature beats or pauses that interrupt the otherwise regular rhythm.
D)The QRS complexes do not look alike.
Q3) If the QRS complexes are all 50 little blocks apart,the heart rate is _____.
Q4) A regular rhythm is one in which the R-R intervals
A)Vary by only one or two little blocks.
B)Do not vary at all.
C)Are the same as the P-P intervals.
D)Are interrupted by premature beats.
Q5) If the QRS complexes are all 15 little blocks apart,the heart rate is _____.
Q6) A regular rhythm is one in which _____.
Q7) Heart rate is the same as _____ rate.
Page 7
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Chapter 6: How to Interpret a Rhythm Strip
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Sample Questions
Q1) An abnormal rhythm is called a dysrhythmia.
A)True
B)False
Q2) The normal rhythm originating in the sinus node should have a heart rate
A)Greater than 100.
B)Less than 60.
C)Between 40 and 60.
D)Between 60 and 100.
Q3) Multiple P waves preceding the QRS complexes are typical of sinus rhythm.
A)True
B)False
Q4) The normal PR interval in sinus rhythm should be _____.
Q5) 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
Q6) A rhythm with a heart rate less than 60 is a tachycardia.
A)True
B)False
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Chapter 7: Rhythms Originating in the Sinus Node
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Sample Questions
Q1) Sinus arrest can occur at any heart rate.
A)True
B)False
Q2) The heart rate during sinus tachycardia is less than 60.
A)True
B)False
Q3) In sinus rhythms,the QRS complexes should have an interval of _____.
Q4) The sinus rhythm that has a heart rate greater than 100 is
A)Sinus rhythm.
B)Sinus bradycardia.
C)Sinus tachycardia.
D)Sinus arrhythmia.
Q5) A pause that occurs when the sinus node's impulse is not conducted out of the sinus node itself is
A)Sinus arrest.
B)Sinus arrhythmia.
C)Sinus bradycardia.
D)Sinus block.
Q6) The primary treatment of sinus tachycardia is _____.
Q7) In sinus rhythms,P waves are found _____ the QRS complexes.
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Chapter 8: Rhythms Originating in the Atria
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Sample Questions
Q1) An ectopic rhythm is one which originates in a location other than the sinus node.
A)True
B)False
Q2) The atrial rate in atrial flutter is _____.
Q3) Atrial flutter is almost always seen in patients with A)Thyrotoxicosis.
B)Acute heart attacks.
C)Heart disease.
D)Cardiac arrest.
Q4) Multifocal atrial tachycardia is an irregular rhythm with a heart rate greater than 100.
A)True
B)False
Q5) Which statement is true regarding P waves in atrial flutter?
A)There are no P waves-they're called flutter waves.
B)The P waves are all tall and pointy.
C)P waves change shape constantly.
D)P waves have an atrial rate of about 100.
Q6) Wandering atrial pacemaker has at least _____ different shapes of P waves.
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Chapter 9: Rhythms Originating in the Av Junction
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Sample Questions
Q1) Junctional tachycardia is best called SVT if there are no _____ P waves.
Q2) A junctional rhythm with a heart rate of 125 is called
A)Junctional bradycardia.
B)Junctional rhythm.
C)Accelerated junctional rhythm.
D)Junctional tachycardia.
Q3) Atropine should be given for junctional bradycardia if the patient is _____.
Q4) P waves hidden inside the QRS are a hallmark of junctional rhythms originating _____ in the AV junction.
Q5) Mid-junctional rhythms originate midway between the sinus node and the atria. A)True B)False
Q6) A premature beat arising from the AV junction is called a A)PAC.
B)Junctional escape beat.
C)PJC. D)PVC.
Q7) Junctional bradycardia must have a heart rate less than 20. A)True B)False
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Chapter 10: Rhythms Originating in the Ventricles
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Sample Questions
Q1) PVCs are premature beats from the ventricle.
A)True
B)False
Q2) All the following are appropriate treatment for asystole EXCEPT
A)Electrical shock to the heart.
B)CPR.
C)Oxygen.
D)Pacemaker.
Q3) Ventricular fibrillation has what effect on the cardiac output?
A)No effect
B)Causes an increase
C)Causes a decrease
D)Causes cardiac output to stop completely
Q4) In asystole,the cardiac output is
A)Zero.
B)Greater than in ventricular fibrillation.
C)Enhanced by electrical shock to the heart.
D)Not affected.
Q5) Accelerated idioventricular rhythm has a heart rate between _____.
Q6) Ventricular bigeminy is a term that means the PVCs occur every _____ beat.
Page 12
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Chapter 11: Av Blocks
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Sample Questions
Q1) In third-degree AV block,none of the sinus impulses get through to the ventricles.
A)True
B)False
Q2) All AV blocks are caused by a block at the bundle branches.
A)True
B)False
Q3) In first-degree AV block,all sinus impulses do get through to the ventricles.
A)True
B)False
Q4) In AV blocks,the site of the block is either the AV node or the bundle branches.
A)True
B)False
Q5) The type of AV block characterized by two P waves to each QRS and a constant PR interval is
A)First-degree AV block.
B)Third-degree AV block.
C)Wenckebach.
D)2:1 AV block.
Q6) What kind of symptoms does first-degree AV block cause? _____.
Page 13
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Chapter 12: How to Interpret a 12-Lead Ekg
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Sample Questions
Q1) A rate-related BBB is one which _____.
Q2) If the heart's current originates in the left ventricle and travels upward to the right,there would be right axis deviation.
A)True
B)False
Q3) RSR' is the characteristic pattern seen in V1 in patients with A)Complete heart block.
B)Mobitz II second-degree AV block.
C)LBBB.
D)RBBB.
Q4) Right ventricular hypertrophy is commonly caused by chronic lung disease.
A)True B)False
Q5) A disorder in which there is too much potassium in the bloodstream is called A)Hyperkalemia. B)Hypokalemia.
C)Hypercalcemia.
D)Hypocalcemia.
Q6) If lead I and AVF both have negative QRS complexes,the axis is _____.
Q7) An axis of +120 degrees is _____ deviation.
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Chapter 13: Myocardial Infarction
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Sample Questions
Q1) Mr.Johnson came to the hospital within the hour after his heart attack started.You would expect to see what indication of acute STEMI on his EKG?
A)ST segment elevation in the leads over the damaged area
B)ST segment depression in the leads over the damaged area
C)Significant Q waves in the leads over the damaged area
D)Tall,pointy P waves greater than 2.5 mms in lead II or V1
Q2) If the transition zone is between V1 and V2,the EKG is said to have A)Malrotation.
B)Clockwise rotation.
C)Counterclockwise rotation.
D)Normal R wave progression.
Q3) Anterior MI has indicative changes in leads _____.
Q4) Subendocardial MI is an old term for
A)Inferior MI.
B)NSTEMI.
C)STEMI.
D)Transmural MI.
Q5) A _____ MI is seen as a mirror image of an anterior MI.
Q6) Inferior-lateral MI has indicative changes in leads _____.
Q7) The leads one looks at to find an inferior MI are _____.
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Chapter 14: Medications and Electrical Therapy
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Sample Questions
Q1) When Mrs.Hoffstetter passed out at the mall,paramedics found her heart rate to be
34.Which of the following medications would be appropriate to give to cause the heart rate to increase?
A)Digitalis
B)Propranolol
C)Adenosine
D)Atropine
Q2) Newer pacemakers are well-insulated against microwaves.
A)True
B)False
Q3) A common cause of failure to fire is undersensing.
A)True
B)False
Q4) Capture is evidenced on the EKG by the presence of A)P waves or QRS complexes following the pacemaker spikes.
B)Pacemaker spikes at regular intervals.
C)Paced beats on top of intrinsic beats.
D)An appropriate distance between intrinsic beats and paced beats.
Q5) Which medication used to treat SVT can cause several seconds of asystole before the rhythm converts? _____.
Page 16
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Chapter 15: Diagnostic Electrocardiography
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Sample Questions
Q1) The stress test should be terminated only if the patient passes out.
A)True
B)False
Q2) The most widely known exercise protocol using a treadmill is the A)Kattus protocol.
B)Naughton protocol.
C)Bruce protocol.
D)Cornell protocol.
Q3) The point at which the QRS complex and ST segment join together is called the A)Q wave.
B)R-point.
C)S wave.
D)J-point.
Q4) A relative contraindication is one that means
A)Don't do the test under any circumstances.
B)Don't do the test unless the benefits outweigh the risks.
C)Do the test as soon as possible.
D)Do the test only if the patient's other relatives have had the same problem also.
Q5) Bayes' Theorem is concerned with the _____ of stress test results.
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