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Interpreting 12-Lead ECGs: A Piece by Piece Analysis

doi: 10.1097/01.NPR.0000337198.15435.86
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INSTRUCTIONS Interpreting 12-Lead ECGs: A Piece by Piece Analysis

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Interpreting 12-Lead Electrocardiograms: A Piece by Piece Analysis

General Purpose: To provide NPs with a systematic approach to interpreting ECGs. Learning Objectives: After reading the preceding article and taking the following test, you will be able to: 1. Discuss ECG leads and waveforms. 2. Describe the pathophysiology and clinical significance of axis deviation, BBBs, and ST-T wave changes.

1. Leads that view the transverse plane of the heart are

a. I, II, and III.

b. aVR, aVL, and aVF.

c. I, II, III, aVR, aVL, and aVF.

d. V1–V6.

2. Waveforms (P, QRS, T) can be seen best in lead

a. I.

b. II.

c. III.

d. V1.

3. R wave progression is seen in leads

a. I, II, and III.

b. aVR, aVL, and aVF.

c. I, II, III, aVR, aVL, and aVF.

d. V1–V6.

4. The P wave represents

a. atrial depolarization.

b. atrial repolarization.

c. ventricular depolarization.

d. ventricular repolarization.

5. The duration of the QRS complex should not exceed

a. 0.04 second.

b. 0.12 second.

c. 0.25 second.

d. 0.32 second.

6. A left anterior hemi-block causes

a. early repolarization.

b. right axis deviation.

c. left axis deviation.

d. widened QRS.

7. Which of the following can be a cause of left axis deviation?

a. pulmonary hypertension

b. RBBB

c. right ventricular hypertrophy

d. inferior wall MI

8. Right ventricular infarct may occur in conjunction with

a. left ventricular anterior wall infarction.

b. septal wall infarction.

c. left ventricular inferior wall infarction.

d. transmural MI.

9. ST segment depression or T wave inversion is indicative of

a. a normal ECG.

b. myocardial ischemia.

c. myocardial injury.

d. MI.

10. Diffuse ST segment elevation in most leads can be indicative of

a. right atrial hypertrophy.

b. left atrial hypertrophy.

c. pericarditis.

d. late repolarization.

11. Left ventricular hypertrophy is most commonly seen as ST-T wave abnormalities in the

a. inferior leads.

b. septal leads.

c. lateral leads.

d. anterolateral leads.

12. Which leads are used to differentiate RBBBs from LBBBs?

a. I, II, and III

b. V1, V2, and V3

c. I, V1, and V6

d. aVR, aVL, and aVF

13. In LBBB, the first QRS deflection in V1 will be

a. negative.

b. positive.

c. biphasic.

d. isoelectric.

14. A positive QRS in leads I and aVF is indicative of

a. normal axis.

b. right axis deviation.

c. left axis deviation.

d. extreme axis deviation.

15. Leads that view the inferior wall of the left ventricle are

a. I, aVL, V5, and V6.

b. II, III, and aVF.

c. V1 and V2.

d. V7, V8, and V9.

16. The lateral wall of the left ventricle can be viewed in leads

a. I, aVL, V5, and V6.

b. II, III, and aVF.

c. V1 and V2.

d. V7, V8, and V9.

17. In lead V1, the QRS in a RBBB would

a. be negative and notched.

b. be negative.

c. have an absent R wave.

d. be upright and have a rabbit ears shape.

Figure

Figure

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