Cardiac Rhythm Interpretation and Management Flashcards
7 cards from real CCRN practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Cardiac Rhythm Interpretation and Management flashcards as text
A patient with a permanent pacemaker shows pacer spikes on the monitor that are not followed by QRS complexes. What pacemaker malfunction does this represent?
Answer: Failure to capture
Failure to capture occurs when the pacemaker spike is delivered but fails to depolarize the myocardium, meaning the spike appears without a following P wave or QRS complex.
Which ECG change is most consistent with an acute anterior ST-elevation myocardial infarction (STEMI)?
Answer: ST elevation in leads V1 through V4
The left anterior descending artery supplies the anterior wall; its occlusion causes ST elevation in the precordial leads V1–V4, the territory those leads overlie.
Long QT syndrome predisposes a patient to which potentially fatal dysrhythmia?
Answer: Torsades de pointes
A prolonged QT interval represents delayed ventricular repolarization, creating a vulnerable window during which a premature beat can trigger torsades de pointes.
A 12-lead ECG demonstrates a short PR interval, a slurring at the beginning of the QRS (delta wave), and a wide QRS complex. This pattern is characteristic of:
Answer: Wolff-Parkinson-White (WPW) syndrome
WPW is identified by the triad of a short PR interval, delta wave (pre-excitation slurring), and widened QRS caused by an accessory pathway bypassing the AV node.
A junctional escape rhythm in a post-cardiac surgery patient is best identified by which ECG finding?
Answer: Absent or retrograde P waves with narrow QRS complexes at 40–60 bpm
Junctional escape rhythms originate in the AV node/junction, producing narrow QRS complexes at 40–60 bpm; P waves are absent, inverted, or retrograde depending on where conduction spreads.
During continuous monitoring, a patient's rhythm suddenly changes to a wide-complex tachycardia at 220 bpm. The patient is unresponsive and pulseless. What is the nurse's immediate priority?
Answer: Initiate unsynchronized defibrillation immediately
A pulseless wide-complex tachycardia should be treated as VF/pulseless VT; immediate unsynchronized defibrillation followed by CPR is the ACLS-recommended response.
A critically ill patient's 12-lead ECG shows ST depression in leads I, aVL, V5, and V6. This pattern is most consistent with ischemia in which territory?
Answer: Lateral wall (circumflex territory)
Leads I, aVL, V5, and V6 face the lateral wall of the left ventricle, which is supplied predominantly by the left circumflex artery; ST depression in these leads indicates lateral wall ischemia.