ECG & Cardiac Rhythm Essentials

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Test your ECG and rhythm basics knowledge.

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Maurice Kendricks

Estados Unidos

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ECG & Cardiac Rhythm Essentials


ECG & Cardiac Rhythm EssentialsVersión en línea Test your ECG and rhythm basics knowledge. por Maurice Kendricks 1 Which ECG interval reflects AV nodal conduction time (SA to AV)? a ST segment b QT interval c PR interval d QRS interval 2 On standard ECG paper, one large box equals? a 0.20 sec b 0.40 sec c 0.02 sec d 1.0 sec 3 QT interval > 0.45 sec increases risk for? a Atrial fibrillation b Sinus bradycardia c Lethal ventricular dysrhythmias d AV block 4 Sinus bradycardia best describes? a Ventricular focus fires early b Normal sinus impulse < 60/min c SA node firing >100/min d AV node pacemaker 40–60/min 5 Likely cause of newly symptomatic sinus bradycardia? a Dehydration and fever b Thyrotoxicosis c Beta-blocker or digoxin therapy d Acute blood loss 6 Unstable sinus bradycardia first-line medication/dose? a Dopamine 10 mcg/kg/min b Atropine 1 mg IV, repeat q3–5 min (max 3 mg) c Adenosine 6 mg push d Amiodarone 150 mg IV 7 Sinus tachycardia in post-op patient with fever is most likely due to? a Thyroid crisis b Third-degree block c Fever increasing metabolic demand d Sick sinus syndrome 8 Priority action for stable narrow-complex SVT before meds? a Start amiodarone infusion b Give epinephrine c Prepare for defibrillation d Coach Valsalva maneuver 9 Persistent SVT after vagal maneuvers: best sequence? a Diltiazem → verapamil → BB b Adenosine 6 mg → 12 mg IV rapid push c Lidocaine → procainamide d Amiodarone → adenosine 10 Premature atrial contractions (PACs) are typically? a Present only with MI b Lethal; require defibrillation c Benign; may need reassurance or low-dose beta blocker if frequent d Caused by caffeine in all cases 11 Most important labs for frequent PVCs initially? a K+, Mg2+ b Na+, Cl- c Ca2+, phosphate d AST, ALT 12 Assessment finding most expected with frequent PVCs? a Bounding pulses b Apical-radial pulse deficit c Bradycardia with regular rhythm d Fixed split S2 13 Defining ECG feature of atrial fibrillation? a Irregularly irregular rhythm with absent P waves b PR > 0.20 sec c Sawtooth P waves d Regular rhythm with wide QRS 14 Highest priority risk in uncontrolled A-fib? a Thromboembolism/stroke b Pleural effusion c Myocardial rupture d Torsades de pointes 15 Which order requires bleeding precautions? a Amiodarone 400 mg PO BID b Apixaban 5 mg PO BID c Metoprolol 50 mg PO daily d Diltiazem infusion 16 For A-fib >48 hours, elective cardioversion needs? a NPO for 24 hours only b Adequate anticoagulation or TEE to rule out thrombus c No pre-procedure testing d Lidocaine bolus 17 Atrial flutter key ECG pattern? a Marked ST depression b Flat baseline between QRS c Tall peaked T waves d Regular flutter (sawtooth) waves 18 Aortic stenosis pathophysiology? a RV→RA retrograde flow b Regurgitant flow LV→LA c Narrowed aortic valve obstructing LV outflow d LA outflow obstruction to LV 19 Classic triad of symptomatic severe AS? a Fever, friction rub, chest pain b Cough, crackles, cyanosis c Syncope, Angina, Dyspnea (SAD) d Edema, ascites, JVD 20 Which finding is most consistent with aortic regurgitation? a Bounding water-hammer pulses and wide pulse pressure b Narrow pulse pressure, carotid radiation murmur c Holosystolic murmur to axilla d Opening snap with diastolic rumble 21 Mitral stenosis hallmark auscultation? a Early diastolic blowing murmur b Harsh crescendo-decrescendo systolic murmur c Fixed split S2 d Opening snap followed by low diastolic rumble at apex 22 Mitral regurgitation typical manifestation? a Pleuritic chest pain b Holosystolic murmur at apex radiating to axilla; possible S3 c Pulsus paradoxus d Electrical alternans 23 Tricuspid regurgitation assessment you'd expect? a Opening snap and malar flush b Holosystolic murmur that increases with inspiration, JVD, hepatomegaly, edema c Murmur louder with expiration d Wide fixed split S2 24 First-line diagnostic to grade valvular disease severity? a Echocardiogram (valve area/gradients/EF) b D-dimer c CT angiography d BNP 25 Priority nursing management for symptomatic valvular HF exacerbation? a Position upright, oxygen PRN, diuretics, daily weights, low-sodium b Large fluid bolus c Encourage isometric exercise d Restrict oxygen 26 Typical presentation of acute pericarditis? a Crushing chest pain b Sharp chest pain worse leaning forward with friction rub c Sharp pain worse supine d Silent ischemia 27 ECG change typical in acute pericarditis? a Tall T waves in lateral leads only b New LBBB c Diffuse ST elevation with PR depression d ST depression in V1-V3 28 Pharmacologic mainstays for uncomplicated pericarditis? a Heparin + nitroglycerin b NSAIDs + colchicine; taper per response c Beta-blocker + ACE inhibitor d Thrombolytics 29 Pericardial effusion ECG hallmark with large effusions? a Low-voltage QRS and electrical alternans b Prolonged PR interval c Peaked T waves d Delta waves 30 Hemodynamically significant effusion priority intervention? a Start warfarin b Begin strenuous exercise c High-dose diuretics only d Prepare for pericardiocentesis; monitor; report hypotension/tachycardia Feedback 1 PR reflects AV nodal conduction; QRS is ventricular, QT is repolarization, ST is isoelectric. 2 One large box is 0.20 s; small box is 0.04 s. 3 Prolonged QT raises risk of torsades and other malignant rhythms. 4 Bradycardia is a slow sinus rate; atrial/AV or ventricular origins are not correct here. 5 Negative chronotropes slow AV/SA conduction, causing bradycardia. 6 First-line is atropine; if ineffective, pacing or other agents considered. 7 Fever commonly drives sinus tachycardia; other options are less likely here. 8 Vagal maneuvers are first-line for stable SVT to terminate rhythm. 9 Adenosine is first-line acute termination for many SVTs after vagal attempts. 10 PACs are usually benign; consider rate control if frequent. 11 Electrolyte abnormalities, especially potassium and magnesium, predispose to PVCs. 12 PVCs can cause irregular beats; frequent PVCs may show compensatory patterns, not deficit. 13 AF has irregular rhythm and no discrete P waves. 14 Embolic stroke risk drives urgent anticoagulation decisions. 15 Direct oral anticoagulants require bleeding precautions. 16 To reduce embolic risk, anticoagulate or exclude atrial thrombus with TEE. 17 Atrial flutter shows sawtooth atrial activity. 18 AS is an outflow obstruction at the aortic valve. 19 SAD represents exertional symptoms of severe AS. 20 AR causes wide pulse pressure and bounding pulses. 21 OS followed by diastolic rumble is classic MS. 22 MR presents with holosystolic murmur to axilla and may have S3. 23 TR intensity increases with inspiration (Carvallo sign) and systemic signs present. 24 Echocardiography assesses structure and function of valves. 25 HF management focuses on symptoms and fluid balance. 26 Pain improves leaning forward; friction rub is common. 27 Diffuse ST elevation with PR depression is characteristic. 28 NSAIDs and colchicine are first-line; taper as symptoms improve. 29 Low voltage and beat-to-beat QRS changes (electrical alternans) seen with large effusions. 30 Significant effusion requires drainage and monitoring for tamponade signs.

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ECG & Cardiac Rhythm EssentialsVersión en línea

por Maurice Kendricks

Which ECG interval reflects AV nodal conduction time (SA to AV)?

On standard ECG paper, one large box equals?

QT interval > 0.45 sec increases risk for?

Sinus bradycardia best describes?

Likely cause of newly symptomatic sinus bradycardia?

Unstable sinus bradycardia first-line medication/dose?

Sinus tachycardia in post-op patient with fever is most likely due to?

Priority action for stable narrow-complex SVT before meds?

Persistent SVT after vagal maneuvers: best sequence?

Premature atrial contractions (PACs) are typically?

Most important labs for frequent PVCs initially?

Assessment finding most expected with frequent PVCs?

Defining ECG feature of atrial fibrillation?

Highest priority risk in uncontrolled A-fib?

Which order requires bleeding precautions?

For A-fib >48 hours, elective cardioversion needs?

Atrial flutter key ECG pattern?

Aortic stenosis pathophysiology?

Classic triad of symptomatic severe AS?

Which finding is most consistent with aortic regurgitation?

Mitral stenosis hallmark auscultation?

Mitral regurgitation typical manifestation?

Tricuspid regurgitation assessment you'd expect?

First-line diagnostic to grade valvular disease severity?

Priority nursing management for symptomatic valvular HF exacerbation?

Typical presentation of acute pericarditis?

ECG change typical in acute pericarditis?

Pharmacologic mainstays for uncomplicated pericarditis?

Pericardial effusion ECG hallmark with large effusions?

Hemodynamically significant effusion priority intervention?