Deck 6: Errors of Conduction: Bradycardia

Question 1

Unlike type I dropped beats, type II second degree block, also known as a classic block, gives no indication of an impending dropped beat.

Answer 1

True

Question 2

Approximately 75% of all pacemakers placed in the United States are rate responsive pacemakers.

Answer 2

False

Question 3

Vasculo-occlusive events in the right coronary artery, involving the inferior wall and the AV node, can lead to ____ heart blocks.

A) type II
B) type I
C) sinus rhythm type I first degree
D) sinus rhythm type I second degree

Answer 3

type I

Question 4

In the past, a second degree block meant added delay at the AV junction shown by an elongated PR interval.

Question 5

The pattern of lengthening PR intervals and then a dropped beat is called a type I second degree block or ____.

A) A/V block
B) cellular hypoxia
C) Wenckebach's phenomena
D) infranodal block

Question 6

The brief sudden loss of consciousness and postural tone is called ____.

A) convulsions
B) hypotension
C) syncope
D) orthostatic syndrome

Question 7

A ____ pacemaker is effective when the heart is in asystole but can be dangerous if the patient still has a native underlying rhythm.

A) random mode
B) fixed mode
C) standard
D) type I

Question 8

Currently the majority of internal pacemakers use biological batteries because they have a predictable power curve.

Question 9

Many medications, particularly those in the ____ classification, can cause bradycardia.

A) Vaughn-Williams
B) hyperthyroid
C) ACE inhibitor
D) calcium channel inhibitor

Question 10

Current ICD models cannot be placed in the same location as a pacemaker.

Question 11

The key to effective cough CPR is that it must begin immediately when the patient starts to lose consciousness.

Question 12

____ syndrome is syncope caused by an exaggerated reflex response to carotid sinus stimulation.

A) Neurocardiogenic
B) Sick sinus
C) Vasovagal
D) Shaver's

Question 13

Pacemaker syndrome is thought to occur in as many as 28% of patients with a pacemaker.

Question 14

The division of the heart between the atria and the ventricles is at the ____ of the heart.

A) crux
B) mid-atrial level
C) lower right side
D) upper left side

Question 15

A principal cause of cardiogenic syncope is ____.

A) dysrhythmia
B) orthostatic syndrome
C) hypotension
D) outflow obstruction

Question 16

Syncope is one of the more frequent reasons for an EMS call.

Question 17

The sympathetic nervous system maintains peripheral vascular tone and a loss of sympathetic stimulation causes vasodilation, significant venous pooling, and subsequent hypotension. This effect is called the ____.

A) orthostatic relaxation
B) syncope
C) pulse effect
D) vasodepressor effect

Question 18

Neurocardiogenic syncope (i.e., vasovagal syncope) is caused by cardioinhibitory and vasodepressor effects on the body.

Question 19

There are many causes of syncope, from the benign to the potentially lethal.

Question 20

The most common procedure for transplantation is to remove the native heart at the ____ level and replace it with the donor heart.

A) SA node
B) common bundle of His
C) mid-ventricular
D) mid-atrial

Question 21

____ is when the pacemaker fails to sense the underlying or native rhythm.

A) Pacemaker syndrome
B) Oversensing
C) Undersensing
D) Twiddler syndrome

Question 22

The drug of choice of Paramedics for sedation when pacing is ____________________, with a dose of 5 to 10 mg administered approximately one to five minutes before the pacing begins.

Question 23

____________________ disorders are conditions that prevent ventricular filling during diastole and include tension pneumothorax and cardiac tamponade.

Question 24

The ____________________ switch is a magnet switch that turns certain functions of a pacemaker on or off.

Question 25

____ occurs when the pacemaker picks up artifact (termed noise) and the inhibition prevents the pacemaker from pacing.

A) Oversensing
B) Pacemaker syndrome
C) Undersensing
D) Twiddler syndrome

Question 26

Once the decision has been made to pace a patient, the preparation can be remembered using a(n) ____ approach.

A) TEP
B) TCP
C) SMART
D) ABCDE

Question 27

____ is performed by applying sharp blows to the chest, in the same manner as a precordial thump but with one-quarter the force.

A) Electrical pacing
B) Chemical pacing
C) EMI
D) Percussion pacing

Question 28

____________________ is when a pacemaker patient with dementia manipulates the pulse generator buried just under the skin, which causes coiling of the leads in the process.

Question 29

____ occurs when the pacer spike, a sharp vertical line on the ECG, is immediately followed by a QRS.

A) Mechanical capture
B) Technical capture
C) Electrical capture
D) Biological capture

Question 30

The ____ pacemaker most closely replicates the natural conduction of the heart through pacing and sensing both chambers.

A) LI
B) DDD
C) VVI
D) VOO

Question 31

When the ICD senses a ventricular tachycardia, or supraventricular tachycardia, the ICD delivers a series of stacked countershocks, ranging from 0.1 joules to ____ joules, to the heart until the tachydysrhythmia resolves.

A) 20
B) 30
C) 40
D) 50

Question 32

____ are pulsations in the neck and chest as the atria contract against the closed AV valves and pulsations flow backward.

A) Cannon A waves
B) Cannon V waves
C) Pacemaker waves
D) Sympathetic waves

Question 33

Patients with ____ will present with signs of shock, varying pulse pressures on palpation (the rhythm remains regular), and jugular venous distention with visible cannon waves from retrograde blood flow.

A) twiddler syndrome
B) pacemaker malfunction
C) pacemaker syndrome
D) undersensing syndrome

Question 34

A(n) ____ detects and terminates potentially lethal tachydysrhythmia.

A) EMI
B) ICD
C) TCP
D) TEP

Question 35

Type II A/V heart blocks, or ____________________ heart blocks, tend to be more problematic and patients with them tend to be more symptomatic.