|
| 1 | You are assessing an ECG tracing of an 80 year old patient who is complaining of heaviness in their chest. You have determined the heart rate and regularity of the electrocardiogram. The next step of analyzing the electrocardiogram is to examine the: |
 | A) | P waves |
| B) | QRS complexes |
| C) | T waves |
| D) | PR intervals |
|
| 2 | Characteristic features of normal P waves include: |
| A) | one P wave precedes each QRS complex |
| B) | their amplitude is 0.2 to 3.5 mm |
| C) | their duration is 0.10 to 0.16 seconds |
| D) | they are usually rounded and inverted |
|
| 3 | In leads I, II, aVF, and V2 through V6, the deflection of the P wave is characteristically: |
| A) | biphasic |
| B) | negative or inverted |
| C) | positive or upright |
| D) | a & c |
|
| 4 | In leads III, and aVL, and V1, the P wave may be: |
| A) | biphasic |
| B) | negative or inverted |
| C) | positive or upright |
| D) | all of the above |
|
| 5 | In lead aVR, the P wave is: |
| A) | biphasic |
| B) | negative or inverted |
| C) | positive or upright |
| D) | a & c |
|
| 6 | _________ is the rhythm against which we compare all others. |
| A) | normal sinus rhythm |
| B) | atrial pacemaker |
| C) | sinus dysrhythmia |
| D) | junctional rhythm |
|
| 7 | Dysrhythmias that originate from the SA node: |
| A) | are characteristically upright or positive in lead aVR |
| B) | have P waves that look different than P waves seen with normal sinus rhythm |
| C) | include sinus bradycardia, sinus tachycardia, sinus dysrhythmia, and sinus arrest |
| D) | b & c |
|
| 8 | Tall and symmetrically peaked P waves may be seen with: |
| A) | impulses arising from an ectopic pacemaker at or below the AV junction |
| B) | increased right atrial pressure and right atrial dilation |
| C) | left atrial dilation |
| D) | premature ventricular complexes |
|
| 9 | Notched or wide (prolonged) P waves may be seen with: |
| A) | impulses arising from an ectopic pacemaker at or below the AV junction |
| B) | increased right atrial pressure and right atrial dilation |
| C) | increased left atrial pressure and left atrial dilation |
| D) | premature ventricular complexes |
|
| 10 | Impulses that arise from the atrial tissue or in the internodal pathways are referred to as: |
| A) | sinus dysrhythmias |
| B) | atrial dysrhythmias |
| C) | junctional dysrhythmias |
| D) | AV heart blocks |
|
| 11 | P waves produced by impulses that originate outside the SA node: |
| A) | appear wide and notched |
| B) | are called R prime |
| C) | are usually inverted |
| D) | look different than the sinus P waves |
|
| 12 | Which of the following originate from the atria? |
| A) | premature atrial complexes |
| B) | atrial tachycardia |
| C) | junctional escape rhythm |
| D) | a & b |
|
| 13 | If an ectopic pacemaker arises from the upper- or middle-right atrium the P' wave is ________ in lead II. |
| A) | inverted |
| B) | biphasic |
| C) | upright |
| D) | flat |
|
| 14 | If an ectopic impulse is initiated from the middle of the right atrium, the P' wave is _______ one that originates from the upper-right atrium. |
| A) | less positive than |
| B) | the same direction as |
| C) | the opposite direction as |
| D) | more positive than |
|
| 15 | If the impulse arises from the lower-right atrium near the AV node or in the left atrium, depolarization occurs in a _______ direction resulting in the P' wave being _______ in lead II. |
| A) | vertical, upright |
| B) | retrograde, inverted |
| C) | horizontal, biphasic |
| D) | retrograde, upright |
|
| 16 | Premature beats that arise from the atria or internodal pathways, before the SA node has a chance to fire, produce P' waves that: |
| A) | may be obscured or buried in the T wave of the preceding beat |
| B) | are typically inverted |
| C) | appear flat |
| D) | are initially elevated and then characteristically dip down below the isoelectric line |
|
| 17 | A change in P' wave morphology from beat to beat is characteristic of: |
| A) | atrial fibrillation |
| B) | atrial flutter |
| C) | sinus dysrhythmia |
| D) | wandering atrial pacemaker |
|
| 18 | A saw-toothed pattern of atrial waveforms are seen instead of normal P waves in: |
| A) | atrial fibrillation |
| B) | atrial tachycardia |
| C) | atrial flutter |
| D) | wandering atrial pacemaker |
|
| 19 | The P waves of an ECG tracing look the same no matter which lead is viewed. |
| A) | True |
| B) | False |
|
| 20 | In faster sinus tachycardias the P wave can sometimes be buried in the T wave of the preceding beat. |
| A) | True |
| B) | False |
|
| 21 | If the P wave originates in the SA node it will appear normal even if the atria are altered or damaged. |
| A) | True |
| B) | False |
|
| 22 | Abnormal P waves are those that look different, are inverted, absent, follow the QRS complex, or where there are P waves not followed by a QRS complex. |
| A) | True |
| B) | False |
|
| 23 | P waves appear the same even if the pacemaker site originates from a site other than the SA node. |
| A) | True |
| B) | False |
|
| 24 | The T wave preceding a premature atrial complex may look peaked, notched, or larger than normal suggesting that the P' wave is buried in the T wave. |
| A) | True |
| B) | False |
|
| 25 | An atrial P' wave which is not followed by a QRS complex is due to AV heart block. |
| A) | True |
| B) | False |