Deck 5: Rhythm Strip Interpretation and Sinus Rhythms
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Deck 5: Rhythm Strip Interpretation and Sinus Rhythms
1
The shape of the P wave is analyzed to determine whether:
A)the atrial impulses caused the ventricular contraction.
B)atrial depolarization occurred.
C)all of the atrial current is moving in the same pathway.
D)the atria and ventricles are contracting together.
A)the atrial impulses caused the ventricular contraction.
B)atrial depolarization occurred.
C)all of the atrial current is moving in the same pathway.
D)the atria and ventricles are contracting together.
all of the atrial current is moving in the same pathway.
2
Which sinus rhythm has a rate of less than 60 beats per minute?
A)Sinus tachycardia
B)Sinus bradycardia
C)Sinus dysrhythmia
D)Normal sinus rhythm
A)Sinus tachycardia
B)Sinus bradycardia
C)Sinus dysrhythmia
D)Normal sinus rhythm
Sinus bradycardia
3
The ECG tracing is considered a legal document and needs to be included in the patient's medical record. What four items must be on each ECG tracing?
A)Patient's date of birth, today's date and time, physician's name
B)Patient's Social Security number, diagnosis, today's date and time
C)Patient's name, today's date and time, initials of the ECG technician
D)Patient's name, patient's date of birth, diagnosis, type of insurance the patient has
A)Patient's date of birth, today's date and time, physician's name
B)Patient's Social Security number, diagnosis, today's date and time
C)Patient's name, today's date and time, initials of the ECG technician
D)Patient's name, patient's date of birth, diagnosis, type of insurance the patient has
Patient's name, today's date and time, initials of the ECG technician
4
Which of the following are common symptoms of low cardiac output?
A)Nausea, vomiting
B)Headache, diarrhea
C)Shortness of breath, hypotension
D)Muscle aches, low back pain
A)Nausea, vomiting
B)Headache, diarrhea
C)Shortness of breath, hypotension
D)Muscle aches, low back pain
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5
Sinus tachycardia may be a normal finding in people as a result of:
A)cardiac arrest.
B)exercise.
C)low cardiac output.
D)hypertension.
A)cardiac arrest.
B)exercise.
C)low cardiac output.
D)hypertension.
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6
QRS duration measurement is essential to determine the time it takes for:
A)atrial depolarization.
B)ventricular depolarization.
C)ventricular relaxation.
D)atrial relaxation.
A)atrial depolarization.
B)ventricular depolarization.
C)ventricular relaxation.
D)atrial relaxation.
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7
What is evaluated and classified when determining dysrhythmias?
A)Rate, artifact, and complexes on the ECG tracing
B)Artifact, complexes, and patient symptoms
C)Waves, segments, and intervals on the ECG tracing
D)Patient condition and symptoms
A)Rate, artifact, and complexes on the ECG tracing
B)Artifact, complexes, and patient symptoms
C)Waves, segments, and intervals on the ECG tracing
D)Patient condition and symptoms
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8
The normal range for the QRS complex duration is:
A)0)12 to 0.20 second.
B)greater than 0.12 second.
C)0)06 to 0.10 second.
D)less than 0.06 second.
A)0)12 to 0.20 second.
B)greater than 0.12 second.
C)0)06 to 0.10 second.
D)less than 0.06 second.
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9
Sinus tachycardia is considered serious or life-threatening in patients who have had a recent:
A)stress test.
B)loss of consciousness.
C)viral infection.
D)myocardial infarction.
A)stress test.
B)loss of consciousness.
C)viral infection.
D)myocardial infarction.
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10
The QRS complex represents the time it takes for:
A)the ventricles to depolarize or contract.
B)repolarization to take place.
C)the electrical current to be initiated at the SA node.
D)the current to move through the atria.
A)the ventricles to depolarize or contract.
B)repolarization to take place.
C)the electrical current to be initiated at the SA node.
D)the current to move through the atria.
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11
What is the rate of a normal sinus rhythm?
A)60 to 100 bpm
B)40 to 60 bpm
C)100 to 150 bpm
D)Greater than 150 bpm
A)60 to 100 bpm
B)40 to 60 bpm
C)100 to 150 bpm
D)Greater than 150 bpm
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12
A patient with sinus bradycardia may require what type of treatment?
A)Medication or a pacemaker
B)Physical therapy and a stress test
C)IV fluids and oxygen
D)Open-heart surgery
A)Medication or a pacemaker
B)Physical therapy and a stress test
C)IV fluids and oxygen
D)Open-heart surgery
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13
The normal PR interval measurement is:
A)0)06 to 0.12 second.
B)0)20 to 0.24 second.
C)0)12 to 0.20 second.
D)0)10 to 0.16 second.
A)0)06 to 0.12 second.
B)0)20 to 0.24 second.
C)0)12 to 0.20 second.
D)0)10 to 0.16 second.
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14
Which of the following serves as the pacemaker in a normal heart?
A)AV node
B)Bundle of His
C)SA node
D)Bundle branches
A)AV node
B)Bundle of His
C)SA node
D)Bundle branches
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15
Identify the following rhythm: 
A)Sinus bradycardia
B)Sinus tachycardia
C)Sinus dysrhythmia
D)Normal sinus rhythm

A)Sinus bradycardia
B)Sinus tachycardia
C)Sinus dysrhythmia
D)Normal sinus rhythm
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16
Which sinus rhythm has a rate of more than 100 beats per minute?
A)Sinus bradycardia
B)Sinus tachycardia
C)Normal sinus rhythm
D)Sinus dysrhythmia
A)Sinus bradycardia
B)Sinus tachycardia
C)Normal sinus rhythm
D)Sinus dysrhythmia
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17
If you can't identify an R wave on the ECG tracing, which of the following wave(s)can you use to determine the regularity of the ventricles?
A)Q and S wave junction
B)P and R wave junction
C)T wave
D)P wave
A)Q and S wave junction
B)P and R wave junction
C)T wave
D)P wave
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18
Which of the following questions is necessary to analyze a P wave on an ECG tracing?
A)Does each P wave have a QRS complex following it?
B)Is the interval between the P wave and the QRS complex constant?
C)Are the atrial and ventricular rates the same?
D)Is the ST segment at the isoelectric line?
A)Does each P wave have a QRS complex following it?
B)Is the interval between the P wave and the QRS complex constant?
C)Are the atrial and ventricular rates the same?
D)Is the ST segment at the isoelectric line?
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19
Identify a rhythm using these criteria: regular rhythm, ventricular and atrial rates are 74 beats/minute, P wave precedes each QRS, PR interval and QRS duration within normal limits.
A)Sinus bradycardia
B)Sinus tachycardia
C)Normal sinus rhythm
D)Sinus dysrhythmia
A)Sinus bradycardia
B)Sinus tachycardia
C)Normal sinus rhythm
D)Sinus dysrhythmia
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20
Measuring the PR interval requires the ECG technician to measure from the:
A)beginning of the Q wave to the J point.
B)beginning of the Q wave to the beginning to the T wave.
C)beginning of the P wave to the end of the R wave.
D)beginning of the P wave to the beginning of the QRS complex.
A)beginning of the Q wave to the J point.
B)beginning of the Q wave to the beginning to the T wave.
C)beginning of the P wave to the end of the R wave.
D)beginning of the P wave to the beginning of the QRS complex.
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21
What must occur if sinus arrest exceeds 6 seconds?
A)Medical emergency procedures must be initiated.
B)Repeat ECGs must be done.
C)Oxygen must be given.
D)A licensed practitioner must be notified.
A)Medical emergency procedures must be initiated.
B)Repeat ECGs must be done.
C)Oxygen must be given.
D)A licensed practitioner must be notified.
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22
In which dysrhythmia do the P-P and R-R intervals progressively widen, and then narrow, following the patient's breathing pattern?
A)Sinus tachycardia
B)Sinus dysrhythmia
C)Sinus bradycardia
D)Normal sinus rhythm
A)Sinus tachycardia
B)Sinus dysrhythmia
C)Sinus bradycardia
D)Normal sinus rhythm
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23
Lack of blood supply to an area of tissue due to a blockage in the circulation to that area is known as:
A)infarct.
B)interval.
C)ischemia.
D)dysrhythmia.
A)infarct.
B)interval.
C)ischemia.
D)dysrhythmia.
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24
On the ECG tracing, what precedes and follows the sinus arrest period?
A)Complete cardiac complexes
B)Junctional escape beats
C)Premature atrial contractions
D)Changing P waves
A)Complete cardiac complexes
B)Junctional escape beats
C)Premature atrial contractions
D)Changing P waves
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25
To determine the actual rhythm on an ECG tracing, the ECG technician:
A)views the computerized interpretation from the ECG machine.
B)analyzes the characteristics of the rhythm and matches them to specific rhythm criteria.
C)asks the physician to interpret the ECG tracing.
D)estimates the distance between QRS complexes.
A)views the computerized interpretation from the ECG machine.
B)analyzes the characteristics of the rhythm and matches them to specific rhythm criteria.
C)asks the physician to interpret the ECG tracing.
D)estimates the distance between QRS complexes.
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26
You have performed an ECG on a patient, resulting in the following ECG tracing. How would you classify the patient's rhythm? 
A)Sinus bradycardia
B)Sinus tachycardia
C)Sinus dysrhythmia
D)Normal sinus rhythm

A)Sinus bradycardia
B)Sinus tachycardia
C)Sinus dysrhythmia
D)Normal sinus rhythm
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27
If a QRS complex measures 0.12 second or wider, it most likely indicates:
A)normal ventricular conduction.
B)delayed ventricular conduction.
C)increased delay at the AV node.
D)myocardial infarction.
A)normal ventricular conduction.
B)delayed ventricular conduction.
C)increased delay at the AV node.
D)myocardial infarction.
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28
The part of the ECG tracing below that is circled in blue is the: 
A)QRS complex.
B)P wave.
C)PR interval.
D)ST segment.

A)QRS complex.
B)P wave.
C)PR interval.
D)ST segment.
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29
A condition in which no rhythm or electrical current travels through the cardiac conduction system is known as:
A)atrial kick.
B)apnea.
C)syncope.
D)asystole.
A)atrial kick.
B)apnea.
C)syncope.
D)asystole.
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30
You have performed an ECG on a patient, resulting in the following ECG tracing. How would you classify the patient's rhythm? 
A)Sinus bradycardia
B)Sinus tachycardia
C)Sinus dysrhythmia
D)Normal sinus rhythm

A)Sinus bradycardia
B)Sinus tachycardia
C)Sinus dysrhythmia
D)Normal sinus rhythm
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31
What symptom do patients with sinus tachycardia often complain of?
A)Hypotension
B)Palpitations
C)Decreased urinary output
D)Headache
A)Hypotension
B)Palpitations
C)Decreased urinary output
D)Headache
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32
Which rhythm shows an irregularity during inspiration and expiration?
A)Sinus tachycardia
B)Sinus bradycardia
C)Sinus dysrhythmia
D)Normal sinus rhythm
A)Sinus tachycardia
B)Sinus bradycardia
C)Sinus dysrhythmia
D)Normal sinus rhythm
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33
A condition in which the patient loses consciousness or faints is known as:
A)seizure.
B)syncope.
C)asystole.
D)apnea.
A)seizure.
B)syncope.
C)asystole.
D)apnea.
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34
The condition in which stimulation of the vagus nerve causes changes in heart rate is known as:
A)vagal tone.
B)ventricular tone.
C)vascular tone.
D)valvular tone.
A)vagal tone.
B)ventricular tone.
C)vascular tone.
D)valvular tone.
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35
Sinus bradycardia has almost the same criteria as normal sinus rhythm; the only difference is that the:
A)P-P intervals are irregular.
B)PR interval measurement is greater than 0.12 second.
C)heart rate is slower.
D)QRS duration is within normal limits.
A)P-P intervals are irregular.
B)PR interval measurement is greater than 0.12 second.
C)heart rate is slower.
D)QRS duration is within normal limits.
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36
In sinus dysrhythmia, if the heart rate decreases to 40 to 50 beats per minute, the patient may complain of:
A)decreased urinary output.
B)lung congestion, cough.
C)hypertension, pale skin.
D)palpitations, dizziness.
A)decreased urinary output.
B)lung congestion, cough.
C)hypertension, pale skin.
D)palpitations, dizziness.
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37
Which dysrhythmia occurs when the SA node stops firing, causing a pause in electrical activity?
A)Sinus bradycardia
B)Sinus tachycardia
C)Sinus arrest
D)Normal sinus rhythm
A)Sinus bradycardia
B)Sinus tachycardia
C)Sinus arrest
D)Normal sinus rhythm
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38
In determining the type of ECG rhythm the patient has, the ECG technician evaluates the components of the ECG rhythm strip, including all of the following except:
A)regularity.
B)U wave.
C)rate.
D)PR interval.
A)regularity.
B)U wave.
C)rate.
D)PR interval.
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39
Signs and symptoms of adequate cardiac output include:
A)an alert and oriented patient.
B)difficulty breathing.
C)chest pain or pressure.
D)hypotension.
A)an alert and oriented patient.
B)difficulty breathing.
C)chest pain or pressure.
D)hypotension.
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40
What should you do if the patient you are monitoring is very pale and breathing very fast, yet his monitor indicates he is in normal sinus rhythm?
A)Report his condition to a licensed practitioner immediately.
B)Perform another ECG tracing to see if the rhythm changes.
C)Call a Code Blue medical emergency.
D)Tell the patient to take deep breaths.
A)Report his condition to a licensed practitioner immediately.
B)Perform another ECG tracing to see if the rhythm changes.
C)Call a Code Blue medical emergency.
D)Tell the patient to take deep breaths.
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41
You have performed an ECG on a patient, resulting in the following ECG tracing. How would you classify the patient's rhythm? 
A)Sinus bradycardia
B)Sinus tachycardia
C)Sinus dysrhythmia
D)Normal sinus rhythm

A)Sinus bradycardia
B)Sinus tachycardia
C)Sinus dysrhythmia
D)Normal sinus rhythm
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42
You have performed an ECG on a patient, resulting in the following ECG tracing. How would you classify the patient's rhythm? 
A)Sinus bradycardia
B)Sinus tachycardia
C)Sinus dysrhythmia
D)Sinus arrest

A)Sinus bradycardia
B)Sinus tachycardia
C)Sinus dysrhythmia
D)Sinus arrest
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43
In which rhythm does the SA node initiate an electrical impulse, but the impulse is not conducted to the atria?
A)Sinus arrest
B)Sinus dysrhythmia
C)Sinus exit block
D)Sinus bradycardia
A)Sinus arrest
B)Sinus dysrhythmia
C)Sinus exit block
D)Sinus bradycardia
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44
The PR interval is measured from the:
A)end of the P wave to the end of the T waves
B)end of the P wave to the end of the QRS complex
C)beginning of the P wave to the beginning of the QRS complex
D)beginning of the P wave to the beginning of the T wave
A)end of the P wave to the end of the T waves
B)end of the P wave to the end of the QRS complex
C)beginning of the P wave to the beginning of the QRS complex
D)beginning of the P wave to the beginning of the T wave
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45
Sinus exit block and sinus arrest result in similar ECG tracings. The distinguishing factor is that in sinus exit block, the:
A)QRS is slightly wider than normal.
B)P waves are inverted or entirely absent.
C)pause duration is usually greater than 6 seconds.
D)pause duration is a multiple of the R-R or P-P interval.
A)QRS is slightly wider than normal.
B)P waves are inverted or entirely absent.
C)pause duration is usually greater than 6 seconds.
D)pause duration is a multiple of the R-R or P-P interval.
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46
What treatment may be needed for patients who have frequent episodes of sinus exit block with bradycardia?
A)Physical therapy
B)Temporary or permanent pacemaker
C)Medication such as digitalis or quinidine
D)Coronary bypass
A)Physical therapy
B)Temporary or permanent pacemaker
C)Medication such as digitalis or quinidine
D)Coronary bypass
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47
Which of the following is a characteristic of sinus bradycardia?
A)The QRS duration is between 0.10 and 0.16 second.
B)The heart rate is less than 60 beats per minute.
C)The shape of the P waves varies from one beat to the next.
D)The PR interval is between 0.06 and 0.10 second.
A)The QRS duration is between 0.10 and 0.16 second.
B)The heart rate is less than 60 beats per minute.
C)The shape of the P waves varies from one beat to the next.
D)The PR interval is between 0.06 and 0.10 second.
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48
You have performed an ECG on a patient, resulting in the following ECG tracing. How would you classify the patient's rhythm? 
A)Sinus arrest
B)Sinus tachycardia
C)Sinus dysrhythmia
D)Normal sinus rhythm

A)Sinus arrest
B)Sinus tachycardia
C)Sinus dysrhythmia
D)Normal sinus rhythm
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49
You have performed an ECG on a patient, resulting in the following ECG tracing. How would you classify the patient's rhythm? 
A)Sinus bradycardia
B)Sinus dysrhythmia
C)Sinus tachycardia
D)Normal sinus rhythm

A)Sinus bradycardia
B)Sinus dysrhythmia
C)Sinus tachycardia
D)Normal sinus rhythm
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50
Which of the following statements about sinus dysrhythmia is true?
A)The PR interval varies along with the heart rate.
B)The QRS duration varies along with the heart rate.
C)The intervals between the P-P and R-R waves vary.
D)The P waves are usually inverted in deflection.
A)The PR interval varies along with the heart rate.
B)The QRS duration varies along with the heart rate.
C)The intervals between the P-P and R-R waves vary.
D)The P waves are usually inverted in deflection.
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51
Which of the following conditions may result in sinus exit block?
A)Acute myocardial infarction
B)Congestive heart failure
C)Sinus tachycardia
D)Chronic bronchitis
A)Acute myocardial infarction
B)Congestive heart failure
C)Sinus tachycardia
D)Chronic bronchitis
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52
Which of the following patients is most likely to exhibit signs and symptoms of low cardiac output?
A)A 55-year-old female athlete with a resting heart rate of 56 beats per minute
B)A 60-year-old male with a heart rate of 74, whose tracing shows infrequent periods of sinus arrest lasting 1 second
C)A 43-year-old female who has been walking on a treadmill and has a heart rate of 110 beats per minute
D)A 48-year-old male with a heart rate of 52, whose tracing shows frequent periods of sinus arrest lasting 2.5 seconds
A)A 55-year-old female athlete with a resting heart rate of 56 beats per minute
B)A 60-year-old male with a heart rate of 74, whose tracing shows infrequent periods of sinus arrest lasting 1 second
C)A 43-year-old female who has been walking on a treadmill and has a heart rate of 110 beats per minute
D)A 48-year-old male with a heart rate of 52, whose tracing shows frequent periods of sinus arrest lasting 2.5 seconds
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53
You have performed an ECG on a patient, resulting in the following ECG tracing. How would you classify the patient's rhythm? 
A)Sinus bradycardia
B)Sinus tachycardia
C)Sinus dysrhythmia
D)Sinus arrest

A)Sinus bradycardia
B)Sinus tachycardia
C)Sinus dysrhythmia
D)Sinus arrest
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54
Which of the following is not characteristic of sinus tachycardia?
A)The R-R intervals and the P-P intervals are equal and constant.
B)The heart rate is between 100 and 150 beats per minute.
C)The PR interval is between 0.12 and 0.20 second.
D)The QRS duration is between 0.10 and 0.16 second.
A)The R-R intervals and the P-P intervals are equal and constant.
B)The heart rate is between 100 and 150 beats per minute.
C)The PR interval is between 0.12 and 0.20 second.
D)The QRS duration is between 0.10 and 0.16 second.
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55
Which of the following is a characteristic of sinus arrest?
A)The cardiac complexes before and after the sinus pause are usually regular.
B)The PR interval is affected by the pause during a sinus arrest episode.
C)The atrial and ventricular rates are different.
D)The QRS morphology varies during periods of sinus arrest.
A)The cardiac complexes before and after the sinus pause are usually regular.
B)The PR interval is affected by the pause during a sinus arrest episode.
C)The atrial and ventricular rates are different.
D)The QRS morphology varies during periods of sinus arrest.
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