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12-lead ECGs part II: Identifying common abnormalities

doi: 10.1097/01.NURSE.0000453838.38543.26
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INSTRUCTIONS 12-lead ECGs part II: Identifying common abnormalities


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12-lead ECGs part II: Identifying common abnormalities

GENERAL PURPOSE: To provide information about interpreting common ECG abnormalities. LEARNING OBJECTIVES: After reading this article and taking this test, you should be able to: 1. Describe bundle branch blocks. 2. Identify ECG changes accompanying an acute MI. 3. Identify common dysrhythmias.

  1. Ventricular synchrony is the result of
    1. ventricular depolarization beginning on the right side of the heart.
    2. a normally functioning right bundle branch and left bundle branch.
    3. ischemic heart disease.
    4. the action potential traveling from the SA to the AV node.
  2. Which ECG lead is recommended to best identify a RBBB?
    1. V1
    2. V4
    3. I
    4. aVR
  3. Which ECG finding(s) commonly indicates a LBBB?
    1. QRS duration of 0.10 second
    2. wide, downward S wave or rS wave in leads V1 and V2
    3. a “rabbit ears” QRS pattern
    4. a small R wave, downward S wave, and a second, larger R-wave pattern
  4. The cardiac action potential normally originates in the
    1. AV node.
    2. Bundle of His.
    3. SA node.
    4. Purkinje fibers.
  5. Which ECG change indicates reversible myocardial injury?
    1. flattened T waves
    2. elevated ST-segments
    3. inverted T waves
    4. depressed ST-segments
  6. The left circumflex artery supplies which area of the heart?
    1. inferior wall
    2. anterior wall
    3. lateral wall
    4. interventricular septum
  7. The inferior wall of the left ventricle is perfused by the
    1. right coronary artery.
    2. left circumflex artery.
    3. left anterior descending artery.
    4. left marginal artery.
  8. Which leads most accurately monitor the heart's interventricular septum?
    1. II, III, and aVF
    2. I, aVL, V5, and V6
    3. V3 and V4
    4. V1 and V2
  9. Which infarcted area of the heart would negatively impact cardiac output most significantly?
    1. anterior wall
    2. inferior wall
    3. interventricular septum
    4. lateral wall
  10. ST-segment elevation in leads I, aVL, V5, and V6 indicates which type of infarction?
    1. anterior wall
    2. inferior wall
    3. anteroseptal wall
    4. lateral wall
  11. Which zone of damage after an MI is characterized by tissue death?
    1. ischemic zone
    2. area of injury
    3. area of necrosis
    4. the penumbra
  12. Patients with AF lasting more than 48 hours are at high risk for
    1. retroperitoneal hemorrhage.
    2. thromboembolism.
    3. fever.
    4. infection.
  13. Which statement concerning sinus bradycardia is accurate?
    1. A heart rate less than 60 bpm is never normal.
    2. Sinus bradycardia is commonly caused by ischemic heart disease.
    3. Asymptomatic sinus bradycardia requires drug therapy.
    4. All patients with sinus bradycardia are candidates for a pacemaker.
  14. Compared with sinus tachycardia, AF is characterized by
    1. a faster ventricular response.
    2. loss of atrial kick.
    3. a regularly irregular rhythm.
    4. smaller P waves.
  15. Sinus tachycardia
    1. decreases myocardial oxygen demands.
    2. is characterized by nondiscernible P waves.
    3. is usually related to a physiologic cause.
    4. is associated with heart rates of 160-200 bpm.
  16. Your monitored and stable post-MI patient suddenly develops You first
    1. assess vital signs.
    2. prepare for transfer to ICU.
    3. administer oxygen.
    4. establish IV access.
  17. PVCs are
    1. caused by an action potential conducted through the His-Purkinje system.
    2. a sign of irritable ventricular tissue.
    3. characterized by a QRS duration of less than 0.12 second.
    4. unrelated to heart disease.
  18. The treatment for hemodynamically unstable VT with a pulse is
    1. I.epinephrine.
    2. defibrillation.
    3. I.amiodarone.
    4. immediate synchronized cardioversion.


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