CET Rhythm Interpretation & Patient Care 2 — Questions and Answers
Question 1: A patient's ECG shows a regular rhythm with a rate of 150 bpm, narrow QRS complexes, and no visible P waves. What is the most likely rhythm?
- Sinus tachycardia
- Atrial flutter with 2:1 block
- Supraventricular tachycardia (SVT) (Correct answer)
- Ventricular tachycardia
Correct answer: Supraventricular tachycardia (SVT)
SVT typically presents with a regular rate of 150-250 bpm, narrow QRS complexes, and absent or hidden P waves.
Question 2: On a rhythm strip, you observe a P wave followed by a progressively lengthening PR interval until a QRS is dropped, then the cycle repeats. What is this rhythm?
- First-degree AV block
- Mobitz Type I (Wenckebach) block (Correct answer)
- Mobitz Type II block
- Third-degree AV block
Correct answer: Mobitz Type I (Wenckebach) block
Mobitz Type I (Wenckebach) is characterized by progressive PR interval prolongation followed by a dropped QRS beat.
Question 3: A patient with a known pacemaker has a rhythm strip showing pacemaker spikes not followed by QRS complexes. This finding most likely indicates:
- Normal pacemaker function
- Pacemaker failure to capture (Correct answer)
- Pacemaker oversensing
- Pacemaker-mediated tachycardia
Correct answer: Pacemaker failure to capture
Failure to capture occurs when the pacemaker fires but the impulse does not depolarize the myocardium, resulting in spikes without QRS complexes.
Question 4: While performing an ECG on an anxious patient, you notice artifact that mimics atrial fibrillation. What is the most appropriate first action?
- Call a code immediately
- Ask the patient to relax and hold still, then repeat the tracing (Correct answer)
- Document the rhythm as atrial fibrillation
- Administer supplemental oxygen
Correct answer: Ask the patient to relax and hold still, then repeat the tracing
Muscle tremor artifact from an anxious or trembling patient can mimic AF; calming the patient and retaking the tracing is the correct first step.
Question 5: Which finding on a rhythm strip is most consistent with hyperkalemia?
- Prolonged QT interval
- Delta waves
- Tall, peaked T waves with widened QRS (Correct answer)
- Shortened PR interval
Correct answer: Tall, peaked T waves with widened QRS
Hyperkalemia classically produces tall, peaked (tent-shaped) T waves and, at higher levels, widening of the QRS complex.
Question 6: A patient's ECG shows a regular ventricular rate of 40 bpm with P waves occurring at a different, regular rate with no relationship to QRS complexes. What rhythm is present?
- Second-degree AV block, Mobitz II
- Junctional rhythm
- Complete (third-degree) AV block (Correct answer)
- Accelerated idioventricular rhythm
Correct answer: Complete (third-degree) AV block
Third-degree AV block features independent atrial and ventricular rhythms with no relationship between P waves and QRS complexes (AV dissociation).
Question 7: During an ECG procedure, the patient reports sudden chest pain and becomes diaphoretic. What is the MOST appropriate action by the ECG technician?
- Complete the ECG recording before calling for help
- Immediately stop the procedure and alert the nurse or physician (Correct answer)
- Administer aspirin from the crash cart
- Apply the remaining leads and continue monitoring
Correct answer: Immediately stop the procedure and alert the nurse or physician
A patient experiencing acute symptoms like chest pain and diaphoresis requires immediate notification of nursing or medical staff; the technician should not delay by completing the test.
CET Rhythm Interpretation & Patient Care 2
A patient's ECG shows a regular rhythm with a rate of 150 bpm, narrow QRS complexes, and no visible P waves.
What is the most likely rhythm?