Introduction to ECG Interpretation Final Exam
Course Introduction
This course provides a foundational understanding of electrocardiogram (ECG) principles and techniques, essential for students pursuing careers in healthcare. Learners will explore cardiac anatomy and physiology, the electrical conduction system of the heart, and the fundamental components of ECG waveforms. Through hands-on practice and case-based scenarios, students will develop skills in recording, reading, and systematically interpreting ECG tracings. The course covers normal ECG patterns as well as the recognition of common arrhythmias, ischemic changes, and conduction abnormalities, preparing students to apply their knowledge in clinical settings.
Recommended Textbook
EKG Plain and Simple 3rd Edition by Karen Ellis RN
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2
Chapter 1: Coronary Anatomy and Physiology
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Q1) The superior vena cava returns blood to the right atrium from the _____.
Answer: Head;chest;upper arms
Q2) The layer of the heart that does the work of contracting is the endocardium.
A)True
B)False
Answer: False
Q3) Pulmonary veins deliver blood to the
A)Right atrium.
B)Left atrium.
C)Right ventricle.
D)Left ventricle.
Answer: B
Q4) 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
Q5) The term _____ means half-moon.
Answer: Semilunar
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Chapter 2: Electrophysiology
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Sample Questions
Q1) A negative deflection that occurs before a positive one is labeled a _____ wave. Answer: Q
Q2) The PR segment is a flat line located between the QRS complex and the T wave.
A)True
B)False
Answer: False
Q3) For purposes of determining the presence of ST segment changes,the baseline is considered to be the
A)PT segment.
B)PR segment.
C)TP segment.
D)QT segment.
Answer: B
Q4) The T wave represents
A)Atrial depolarization.
B)Atrial repolarization.
C)Ventricular depolarization.
D)Ventricular repolarization.
Answer: D
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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) AVL has its positive pole on the A)Left arm.
B)Right leg.
C)Right arm.
D)Left leg.
Answer: A
Q3) In the precordial leads,we look at current flow in the _____ plane.
Answer: Horizontal
Q4) AVF
A)Is a bipolar lead.
B)Is a precordial lead.
C)Is an augmented lead.
D)Has its positive pole on the left arm.
Answer: C
Page 5
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Chapter 4: Technical Aspects of the Ekg
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Q1) A digital converter on the EKG machine
A)Controls the amount of artifact.
B)Controls the calibration of the machine.
C)Is the pen that prints out the EKG tracing.
D)Converts the analog signal to a digital one.
Q2) The word "somatic" means _____.
Q3) Troubleshooting involves determining and alleviating the cause of _____.
Q4) It is possible to have artifact in the midst of a dangerous rhythm.
A)True
B)False
Q5) Artifact in Leads I,III,and AVL is caused by a loose or detached electrode patch or wire on the left arm.
A)True
B)False
Q6) Some modern EKG machines are Bluetooth-capable,allowing EMS workers to
A)Listen to their favorite music station while on the job.
B)Control the artifact on the EKG.
C)Hear the EKG's interpretation via special headphones.
D)Transmit the EKG to the nearest hospital so workers can prepare for the patient's arrival.
Page 6
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Chapter 5: Calculating Heart Rate
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Sample Questions
Q1) The type of regularity in which the QRS complexes vary wildly throughout the rhythm strip is
A)Regular.
B)Regular but interrupted by premature beats.
C)Regular but interrupted by pauses.
D)Irregular.
Q2) Atrial rate can be calculated by counting
A)QRS complexes.
B)P waves.
C)PR intervals.
D)R-R intervals.
Q3) Which of the following is NOT a method of calculating heart rate?
A)The six-second strip method.
B)The little block method.
C)The memory method.
D)The P-P interval method.
Q4) Heart rate is the same as _____ rate.
Q5) Calculating heart rate involves counting the number of P waves on the strip.
A)True
B)False
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Chapter 6: How to Interpret a Rhythm Strip
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Q1) The normal PR interval in sinus rhythm should be _____.
Q2) Sinus rhythms should have narrow QRS complexes of uniform shape.
A)True
B)False
Q3) Normal QRS complexes should have a QRS complex
A)Less than 0.20 seconds wide.
B)Less than 0.12 seconds wide.
C)Between 0.12 and 0.20 seconds wide.
D)That is alternately narrow and wide.
Q4) Multiple P waves preceding the QRS complexes are typical of sinus rhythm.
A)True
B)False
Q5) Dysrhythmias are
A)Normal heart rhythms.
B)Abnormal heart rhythms.
C)Rhythms originating in the sinus node.
D)Rhythms that cause no symptoms.
Q6) Sinus rhythm is an irregular rhythm interrupted by premature beats and pauses.
A)True
B)False
8
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Chapter 7: Rhythms Originating in the Sinus Node
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Q1) Patients with a heart rate of 45 always show symptoms of decreased cardiac output.
A)True
B)False
Q2) A pacemaker is usually needed to treat sinus bradycardia.
A)True
B)False
Q3) In sinus rhythm,the heart rate is
A)60-100.
B)Greater than 100.
C)Less than 60.
D)Greater than 170.
Q4) The PR interval in sinus rhythms should be _____ from beat to beat.
Q5) Sinus arrest can occur at any heart rate.
A)True
B)False
Q6) In a sinus arrest,the sinus node_____ firing for a time.
Q7) Sinus arrest is best treated by anti-anxiety medication.
A)True
B)False
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Chapter 8: Rhythms Originating in the Atria
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Sample Questions
Q1) Treatment of atrial fibrillation could include such medications as A)Digitalis.
B)Calcium channel blockers.
C)Amiodarone.
D)All the above.
Q2) A run of three or more PACs in a row that usurps the underlying rhythm is called _____.
Q3) The atrial rate in atrial tachycardia is _____.
Q4) Flutter waves are often described as sawtooth- or picket-fence-shaped waves.
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) Multifocal atrial tachycardia is an irregular rhythm with a heart rate greater than 100.
A)True
B)False
Page 10
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Chapter 9: Rhythms Originating in the Av Junction
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Q1) Which junctional rhythm WOULD NOT be treated with atropine?
A)Junctional bradycardia
B)Juctional rhythm
C)Accelerated junctional rhythm
D)Junctional tachycardia
Q2) Junctional bradycardia must have a heart rate less than 20.
A)True
B)False
Q3) Junctional tachycardia without visible P waves is best called A)Sinus tachycardia.
B)SVT.
C)Atrial tachycardia.
D)PJCs.
Q4) Junctional rhythm has a heart rate _____.
Q5) Junctional rhythms originate in the A)Sinoatrial junction.
B)Atrioventricular junction.
C)Sinoventricular junction.
D)Sinus node junction.
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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Q1) Multifocal couplets are
A)Long runs of ventricular tachycardia.
B)A pair of PVCs that look the same.
C)A pair of PVCs that look different.
D)Reason to start CPR.
Q2) Ventricular bigeminy is a term that means the PVCs occur every _____ beat.
Q3) PVCs are usually followed by an incomplete compensatory pause.
A)True
B)False
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) 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
Q6) QRS complexes in ventricular rhythms should be _____ seconds wide.
Page 12
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Chapter 11: Av Blocks
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Q1) In third-degree AV block,_____ sinus impulses get through to the ventricles.
Q2) Wenckebach is a type of
A)First-degree AV block.
B)Second-degree AV block.
C)Third-degree AV block.
D)Fourth-degree AV block.
Q3) First-degree AV block is characterized by a prolonged QRS interval.
A)True
B)False
Q4) 2:1 AV block is characterized by two P waves to every QRS.
A)True
B)False
Q5) All AV blocks involve a disturbance in conduction somewhere between the atria and the ventricles.
A)True
B)False
Q6) Mobitz II second-degree AV block involves a block at either the AV node or the _____.
Q7) In a second-degree AV block,some impulses from the sinus node _____ to the ventricles;others don't.
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Chapter 12: How to Interpret a 12-Lead Ekg
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Sample Questions
Q1) Bundle branch blocks are a sign of imminent cardiac arrest.
A)True
B)False
Q2) If the QRS in I is negative and the QRS in AVF is positive,the axis is
A)Normal.
B)Right axis deviation.
C)Left axis deviation.
D)Indeterminate axis.
Q3) In LVH,the S wave in V1 added to the R wave in V5 or V6 should be
A)Greater than 20 mms
B)Less than 30 mms
C)Greater than 35 mms
D)Less than 35 mms
Q4) If the QRS in I and AVF are both negative,the axis is A)Normal.
B)Right axis deviation.
C)Left axis deviation.
D)Indeterminate axis.
Q5) If lead I and AVF both have negative QRS complexes,the axis is _____.
Q6) A rate-related BBB is one which _____.
Page 14
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Chapter 13: Myocardial Infarction
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Q1) Hyperacute changes of an MI are those seen in the MI's earliest stages.
A)True
B)False
Q2) An acute inferior wall STEMI has ST elevation in leads
A)I,AVL,V5-6.
B)V1-4.
C)II,III,AVF.
D)V1-2.
Q3) Which of the following is indicative of myocardial necrosis?
A)ST elevation
B)ST depression
C)Significant Q wave
D)Inverted T wave
Q4) Which kind of MI usually damages only the innermost layer of the myocardium?
A)NSTEMI
B)Transmural
C)Posterior
D)Anteroseptal
Q5) Pericarditis is _____ of the pericardium.
Q6) Explain where the leads are placed for a right-sided EKG.
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Chapter 14: Medications and Electrical Therapy
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Sample Questions
Q1) What is epinephrine's effect on blood pressure?
A)No effect
B)Increases blood pressure
C)Decreases blood pressure
D)Causes a sudden increase in BP,then a profound drop in BP
Q2) Which medication used to treat SVT can cause several seconds of asystole before the rhythm converts? _____.
Q3) VVI pacemakers are inserted into which chamber of the heart?
A)Right atrium
B)Left atrium
C)Right ventricle
D)Left ventricle
Q4) The pacemaker's generation of an electrical impulse is called A)Capture.
B)Firing.
C)Sensing.
D)Conductivity.
Q5) One action that can correct failure to fire is to change the battery.
A)True
B)False
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Chapter 15: Diagnostic Electrocardiography
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Q1) If the stress test is negative but the angiogram reveals coronary artery disease,the stress test is said to have been a
A)True positive.
B)False positive.
C)True negative.
D)False negative.
Q2) A true positive stress test is one in which the stress test is _____ and the angiogram is _____.
Q3) If your patient develops a first-degree AV block during her stress test,you should
A)Stop the test immediately.
B)Continue,but watch the rhythm cautiously.
C)Stop the test and send the patient for a permanent pacemaker.
D)Back the stage to the previous level.
Q4) The stress test should be terminated only if the patient passes out.
A)True B)False
Q5) The most commonly used device for exercise stress testing is the arm ergometer. A)True B)False
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