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| 1 | Which of the following is true regarding hypertrophy? |
 | A) | It is a condition in which the chamber becomes enlarged as the result of volume overload |
| B) | It results from the ventricle having to pump against increased resistance within the cardiovascular system. |
| C) | It is most often seen with certain types of valvular disease. |
| D) | Hypertrophy is common associated with the atria. |
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| 2 | Changes seen on the ECG that may indicate the presence of enlargement or hypertrophy include: |
| A) | an increase in duration of the waveform |
| B) | an increase in the amplitude of the waveform |
| C) | axis deviation |
| D) | all of the above |
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| 3 | Normal characteristics of the P wave include: |
| A) | a duration of 0.10 to 0.20 seconds |
| B) | its amplitude, whether a positive or negative deflection, does not exceed 3.5 mm |
| C) | each is followed by a QRS complex |
| D) | a biphasic waveform that is wider at the beginning than the end |
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| 4 | Leads ___ and ___ provide the necessary information to assess atrial enlargement. |
| A) | I, aVF |
| B) | II, V1 |
| C) | III, V6 |
| D) | I, V3 |
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| 5 | With right atrial enlargement: |
| A) | the P wave is wider than normal |
| B) | the latter part of the P wave is larger in amplitude than the first part |
| C) | the P wave is 2.0 to 2.5 mm in amplitude |
| D) | if the P wave is biphasic, the initial part of taller than the terminal component |
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| 6 | With left atrial enlargement: |
| A) | the terminal portion of the P wave is wider than normal |
| B) | the terminal (left atrial) portion of the P wave drops at least 1 mm below the isoelectric line (in lead V1) |
| C) | the amplitude of the terminal portion of the P wave may increase in V1 |
| D) | all of the above |
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| 7 | Normally, in lead V1 the: |
| A) | QRS complex is wide |
| B) | R wave is usually very short, while the S wave is much larger than the R wave |
| C) | S wave is usually very short, while the R wave is much larger than the S wave |
| D) | S wave and the R wave are the same amplitude |
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| 8 | The most common characteristic seen with right ventricular hypertrophy is: |
| A) | the S wave is larger than the R wave in lead V1 |
| B) | increased R wave amplitude over the precordial leads overlying the left ventricle |
| C) | right axis deviation |
| D) | widening of the QRS complex |
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| 9 | Left ventricular hypertrophy is identified by: |
| A) | increased R wave amplitude in the precordial leads overlying the left ventricle and S waves that are smaller in the leads overlying the left ventricle (lead V6) but larger in the leads (lead V1) overlying the right ventricle |
| B) | right axis deviation |
| C) | a widened QRS complex and the R, R' configuration in the precordial leads |
| D) | PR interval less than 0.12 seconds, wide QRS complexes, and a delta wave seen in some leads |
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| 10 | The limb lead criteria for left ventricular hypertrophy include the R wave amplitude in: |
| A) | lead aVR exceeds 13 mm |
| B) | lead II exceeds 21 mm |
| C) | lead III exceeds 14 mm |
| D) | lead I plus the S wave amplitude in lead III exceeds 25 mm |
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| 11 | In bundle branch block you see: |
| A) | axis deviation |
| B) | the R waves are larger than the S waves in lead V1 |
| C) | widened QRS complexes and an R, R' configuration in the precordial leads |
| D) | widened P waves with two peaks |
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| 12 | To diagnose right bundle branch block check for an R, R' in leads: |
| A) | I and II |
| B) | V5 or V6 |
| C) | V1 or V2 |
| D) | aVF, aVR |
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| 13 | To diagnose left bundle branch block check for an R, R' in leads: |
| A) | V5 or V6 |
| B) | V3 or V4 |
| C) | I and III |
| D) | aVF, aVR |
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| 14 | Left anterior hemiblock results in: |
| A) | left axis deviation |
| B) | extreme right axis deviation |
| C) | QRS complexes with an R, R' configuration in leads V1 and V2 |
| D) | wide QRS complexes |
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| 15 | Left posterior hemiblock results in: |
| A) | QRS complexes with an R, R' configuration in leads V5 and V6 |
| B) | right axis deviation |
| C) | increased R wave amplitude over the precordial leads overlying the left ventricle |
| D) | tall positive R waves in the left lateral leads and deep S waves inferiorly |
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| 16 | Preexcitation is diagnosed by looking for: |
| A) | wide QRS complexes |
| B) | notched P waves |
| C) | a short PR interval |
| D) | tall R waves in leads V1 and V2 |
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| 17 | You are assessing the ECG of a patient who is being admitted to the hospital. You see a regular rhythm with heart rate of 86 beats per minute and each tall P wave is followed by a narrow QRS complex. The QRS complexes have R waves that are larger than the S waves in lead V1 and the S waves are larger than the R waves in lead V6. The PR intervals are 0.08 seconds in duration. This condition is: |
| A) | right atrial enlargement |
| B) | left ventricular hypertrophy |
| C) | right bundle branch block |
| D) | right ventricular hypertrophy |
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| 18 | You are assessing the ECG of a patient who has been ill for several days. You see a regular rhythm with a heart rate of 96 beats per minute. The P waves are round and upright. In leads V1 and V 2 the QRS complexes are wider than normal and notched (look like the letter M). Also, you note late broad S waves in leads I, aVL, V5, and V6. The PR intervals are 0.12 seconds in duration. This condition is: |
| A) | right atrial enlargement |
| B) | left ventricular hypertrophy |
| C) | right bundle branch block |
| D) | right ventricular hypertrophy |
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| 19 | Your 58-year-old patient has been suffering from episodes of paroxysmal supraventricular tachycardia. You attach her to an ECG and see a regular rhythm that has a heart rate of 84 beats per minute. There are upright P waves that are each followed by a wider than normal QRS complex. There appears to be delta waves. The duration of the PR intervals is 0.08 seconds in duration. This condition is: |
| A) | right atrial enlargement |
| B) | Wolff-Parkinson-White (WPW) syndrome |
| C) | right bundle branch block |
| D) | Lown-Ganong-Levine (LGL) syndrome |
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| 20 | An enlarged chamber is bigger and can hold more blood than normal but does not necessarily have a thicker muscular wall in contrast to a hypertrophied ventricle which has a thick muscular wall. |
| A) | True |
| B) | False |
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| 21 | Lead II is nearly parallel to the flow of current through the atria. Because of this it records the largest deflections and is more likely to reveal abnormalities in atrial depolarization. |
| A) | True |
| B) | False |
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| 22 | The first part of the P wave represents depolarization of the left atrium. |
| A) | True |
| B) | False |
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| 23 | Right ventricular hypertrophy is more common than left ventricular hypertrophy. |
| A) | True |
| B) | False |
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| 24 | The duration of the QRS complex is significantly prolonged in both right and left ventricular hypertrophy. |
| A) | True |
| B) | False |
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| 25 | Bundle branch block occurs when accessory conduction pathways exist between the atria and ventricles that bypass the AV node and bundle of His and allow the atria to depolarize the ventricles earlier than usual. |
| A) | True |
| B) | False |