Deck 12: Origin and Clinical Aspects of Atrial Dysrhythmias

Question 1

Atrial dysrhythmias:

A) can lead to decreased cardiac output.
B) produce an increase in the strength of the atrial "kick."
C) seldom have a heart rate of greater than 160 beats per minute.
D) are often caused by excessive parasympathetic stimulation.

Answer 1

can lead to decreased cardiac output.

Question 2

Characteristics of atrial dysrhythmias include:

A) wide, bizarre-looking QRS complexes.
B) longer than normal QT intervals.
C) T waves that take an opposite direction to the R wave.
D) P waves which appear different than sinus P waves.

Answer 2

P waves which appear different than sinus P waves.

Question 3

Atrial rhythms include all of the following except:

A) atrial flutter.
B) sick sinus syndrome.
C) atrial tachycardia.
D) wandering atrial pacemaker.

Answer 3

sick sinus syndrome.

Question 4

In wandering atrial pacemaker, the pacemaker site shifts between the:

A) SA node, atria, and/or AV junction.
B) atrial conduction pathways and AV junction.
C) AV junction, Bundle of His and right and left bundle branch.
D) bundle branches and His-Purkinje system.

Question 5

Which of the following is the most distinguishing characteristic that helps identify wandering atrial pacemaker?

A) Narrow QRS complexes.
B) A heart rate of between 120 and 150 beats per minute.
C) P waves that continually change in appearance.
D) PR intervals that are between 0.12 and 0.20 seconds in duration.

Question 6

Wandering atrial pacemaker typically has a rate of _______ beats per minute.

A) less than 80
B) 20 to 40
C) 40 to 60
D) 60 to 100

Question 7

Wandering atrial pacemaker:

A) can produce a life-threatening reduction in cardiac output.
B) is an ominous finding in children, older adults, and well-conditioned athletes.
C) represents the presence of excessive sympathetic nervous system stimulation.
D) is generally caused by the inhibitory vagal effect of respiration on the SA node and AV junction.

Question 8

Premature atrial complexes originate from the:

A) SA node
B) atria
C) AV junction
D) Bundle of His

Question 9

Premature atrial complexes:

A) are preceded by a P' wave that differs from the sinus P waves of the underlying rhythm
B) are typically followed by a compensatory pause
C) have a wide and bizarre QRS complex
D) have inverted T waves

Question 10

When premature atrial complexes occur the first thing you see as you look across the ECG tracing is/are:

A) wide, bizarre shaped QRS complexes
B) inverted P' waves
C) compensatory pauses.
D) an irregular rhythm.

Question 11

When every other beat is a PAC, it is called ______ PACs.

A) unifocal
B) bigeminal
C) trigeminal
D) quadrigeminal

Question 12

The characteristic heart rate associated with atrial tachycardia is ________ beats per minute.

A) 60 to 100
B) 100 to 150
C) 150 to 250
D) 300 to 350

Question 13

When the onset of atrial tachycardia is sudden and typically witnessed it is called:

A) paroxysmal.
B) sustained.
C) multifocal.
D) supraventricular

Question 14

Supraventricular tachycardia includes all of the following except:

A) Atrial tachycardia.
B) Junctional tachycardia.
C) Ventricular tachycardia.
D) Multifocal atrial tachycardia.

Question 15

The heart rate associated with multifocal atrial tachycardia is ____, ____ beats per minute.

A) 60 to 100
B) 300 to 350
C) 100 to 250
D) 60 to 150

Question 16

Which of the following is the most distinguishing characteristic that helps identify multifocal atrial tachycardia?

A) Narrow QRS complexes.
B) Shortened PR intervals.
C) A totally irregular rhythm.
D) P waves that continually change in appearance.

Question 17

Which of the following rhythms has a characteristic "saw tooth pattern?"

A) Atrial fibrillation.
B) Wandering atrial pacemaker.
C) Atrial flutter.
D) Atrial tachycardia.

Question 18

Which of the following dysrhythmias is "totally irregular?"

A) Sinus bradycardia
B) Wandering atrial pacemaker
C) Atrial flutter
D) Atrial fibrillation

Question 19

Atrial fibrillation has an atrial rate of ______ beats per minute.

A) between 40 and 60
B) between 100 and 150
C) greater than 350
D) between 250 and 350

Question 20

Atrial fibrillation has:

A) a regular rhythm.
B) QRS complexes which appear wide and bizarre in configuration.
C) PR intervals of greater than 0.20 seconds.
D) an absence of discernible P waves.

Question 21

In which of the following dysrhythmias are "f" waves seen?

A) Atrial fibrillation
B) Wandering atrial pacemaker
C) Atrial flutter
D) Atrial tachycardia

Question 22

Patients experiencing ___________ may develop intra-atrial emboli predisposing the patient to systemic emboli-particularly stroke.

A) multifocal atrial tachycardia
B) atrial flutter
C) atrial fibrillation
D) premature atrial complexes

Question 23

Atrial dysrhythmias originate from the AV junction or His-Purkinje system.

Question 24

Dysrhythmias that originate above the ventricles are called supraventricular dysrhythmias.

Question 25

PACs can occur in patients with healthy hearts when there is the use of caffeine, tobacco, or alcohol, or with anxiety, fatigue, or fever.

Question 26

Short bursts of the atrial tachycardia often result in severe cardiac output in normally healthy people.

Question 27

While in atrial tachycardia there is one P wave preceding each QRS complex, it is typically buried in the T wave of the preceding beat.

Question 28

In atrial flutter the atrial to ventricular conduction ratio remains constant at a 2:1, 3:1, or 4:1 ratio.

Question 29

Atrial flutter results from circus reentry, a condition during which the impulse from the SA node circles back through the atria, returning to the SA node region and repeatedly restimulates the AV node over and over.