CCRN Cardiac Rhythm Interpretation and Management 3

Question 1

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?

Accepted Answer

Failure to capture

Answer

Failure to sense

Answer

Oversensing

Answer

Pacemaker-mediated tachycardia

Question 2

Which ECG change is most consistent with an acute anterior ST-elevation myocardial infarction (STEMI)?

Accepted Answer

ST elevation in leads V1 through V4

Answer

ST depression in leads II, III, and aVF

Answer

New right bundle branch block pattern

Answer

PR interval prolongation greater than 0.20 seconds

Question 3

Long QT syndrome predisposes a patient to which potentially fatal dysrhythmia?

Accepted Answer

Torsades de pointes

Answer

Paroxysmal atrial fibrillation

Answer

Complete heart block

Answer

Accelerated idioventricular rhythm

Question 4

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:

Accepted Answer

Wolff-Parkinson-White (WPW) syndrome

Answer

First-degree AV block with aberrant conduction

Answer

Regular sawtooth atrial flutter pattern

Answer

Multifocal atrial tachycardia

Question 5

A junctional escape rhythm in a post-cardiac surgery patient is best identified by which ECG finding?

Accepted Answer

Absent or retrograde P waves with narrow QRS complexes at 40–60 bpm

Answer

Wide QRS complexes with AV dissociation at 60–100 bpm

Answer

Sawtooth flutter waves between narrow QRS complexes

Answer

Irregularly irregular rhythm with fibrillatory baseline

Question 6

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?

Accepted Answer

Initiate unsynchronized defibrillation immediately

Answer

Administer adenosine 6 mg rapid IV push

Answer

Obtain a 12-lead ECG to confirm the rhythm before treating

Answer

Administer amiodarone 300 mg IV bolus

Question 7

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?

Accepted Answer

Lateral wall (circumflex territory)

Answer

Anterior wall (LAD territory)

Answer

Inferior wall (RCA territory)

Answer

Right ventricular wall