DC Dysrhythmia ECG Monitoring & Analysis 4

Question 1

A patient in the ICU has a rhythm strip showing P waves occurring independently of QRS complexes, with a ventricular rate of 38 bpm and an atrial rate of 82 bpm. This represents:

Accepted Answer

Third-degree (complete) AV block

Answer

Complete AV dissociation with independent atrial and ventricular rates defines third-degree (complete) heart block.

Question 2

Which lead is considered BEST for continuous bedside cardiac monitoring to detect ischemia and most dysrhythmias?

Accepted Answer

Lead II

Answer

Lead II provides the best visualization of P waves and is the standard lead for continuous dysrhythmia monitoring.

Question 3

On a rhythm strip, a delta wave indicates:

Accepted Answer

Pre-excitation via an accessory pathway (WPW syndrome)

Answer

A delta wave is the slurred upstroke at the beginning of the QRS caused by ventricular pre-excitation through an accessory pathway, as seen in Wolff-Parkinson-White syndrome.

Question 4

A patient has a rhythm with regularly occurring P waves at 72 bpm, but every third P wave is followed by two closely spaced QRS complexes. What is this pattern called?

Accepted Answer

Trigeminy

Answer

PVC trigeminy is the pattern where every third beat is a premature ventricular contraction, creating groups of two normal beats followed by one PVC.

Question 5

A prolonged QRS duration greater than 0.12 seconds indicates:

Accepted Answer

Intraventricular conduction delay or bundle branch block

Answer

QRS duration exceeding 0.12 seconds (120 ms) signals abnormal ventricular conduction, such as a bundle branch block or intraventricular conduction delay.

(DC) Dysrhythmia Certification Practice Test

(DC) Dysrhythmia Certification Practice Test

DC Dysrhythmia ECG Monitoring & Analysis 4