Question 1

Completion
-An accessory pathway that has one end attached to normal conductive tissue is called a(n) __________.

Accepted Answer

bypass tract

Question 2

Identify the following rhythm (lead II). 
A) Sinus arrhythmia
B) Atrial tachycardia
C) Multifocal atrial tachycardia with a PAC
D) Sinus rhythm with a PAC, a run of PSVT, back to a sinus rhythm

Accepted Answer

The rhythm strip shows a sinus rhythm with a PAC, a run of PSVT, and then a change in the rhythm back to a sinus rhythm.

Question 3

Atrial fibrillation is characterized by _____.
A) one P wave before each QRS and a regular ventricular rate of 60 to 100 beats/min
B) an erratic, wavy baseline and irregular ventricular rhythm
C) "saw-tooth"- or "picket-fence"-shaped waveforms preceding each QRS
D) P waves occurring before, during, or after the QRS complex; when seen, they are inverted

Accepted Answer

Characteristics of atrial fibrillation:
Rhythm-Ventricular rhythm usually irregularly irregular.
Rate-Atrial rate usually 400 to 600 beats/min; ventricular rate variable.
P waves-No identifiable P waves, fibrillatory waves present; erratic, wavy baseline.
PR interval-Not measurable.
QRS duration-0.11 second or less unless abnormally conducted.

Question 4

Which of the following correctly describes multifocal atrial tachycardia?
A) Atrial rhythm is regular.
B) Ventricular rhythm is irregular.
C) Atrial and ventricular rhythms are regular.
D) Atrial and ventricular rhythms are irregular.

Accepted Answer

Characteristics of multifocal atrial tachycardia:
Rhythm-Usually irregular as the pacemaker site shifts from the SA node to ectopic atrial locations or AV junction.
Rate-Faster than 100 beats/min.
P waves-Size, shape, and direction may change from beat to beat; it may be upright, inverted, biphasic, rounded, flat, pointed, notched, or buried in the QRS complex.
PR interval-Varies as the pacemaker site shifts from the SA node to ectopic atrial locations or AV junction.
QRS duration-0.11 second or less unless abnormally conducted.

Question 5

P waves in this rhythm strip _____. 
A) are upright before every QRS complex
B) are inverted before every QRS complex
C) vary in size and shape
D) are not identifiable

Accepted Answer

P waves are not identifiable in the rhythm strip provided.

Question 6

Identify the following rhythm (lead II). 
A) Atrial flutter
B) Atrial fibrillation
C) Wolff-Parkinson-White syndrome
D) AV nodal reentrant tachycardia (AVNRT)

Accepted Answer

This rhythm strip shows atrial flutter.

Question 7

P waves in this rhythm strip _____. 
A) are upright before every QRS complex
B) are inverted before every QRS complex
C) vary in size and shape
D) are not identifiable

Accepted Answer

This rhythm strip shows multifocal atrial tachycardia in which the P waves vary in size and shape.

Question 8

P waves in this rhythm strip _____. 
A) occur regularly
B) are not identifiable; fibrillatory waves are present
C) are upright before every QRS complex
D) are not identifiable; flutter waves are present

Accepted Answer

This rhythm strip shows atrial flutter. P waves are not identifiable; flutter waves are present.

Question 9

Complete the following ECG criteria for atrial tachycardia:

Accepted Answer

The answer of Complete the following ECG criteria for atrial...

Question 10

To determine whether the ventricular rhythm on an ECG tracing is regular or irregular, compare _____ intervals.
A) PR
B) R-R
C) TP
D) P to P

Accepted Answer

To evaluate the rhythmicity of the ventricular rhythm on a rhythm strip, the interval between two consecutive R waves is measured. The distance between succeeding R-R intervals is measured and compared. If the ventricular rhythm is regular, the R-R intervals will measure the same.

Question 11

Identify the following rhythm (lead II). 
A) Atrial fibrillation
B) Sinus arrhythmia
C) Multifocal atrial tachycardia
D) Sinus tachycardia with premature atrial complexes (PACs)

Accepted Answer

The rhythm shown is a sinus tachycardia with premature atrial complexes (PACs).

Question 12

A wandering atrial pacemaker rhythm with a ventricular rate of 60 to 100/min may also be referred to as _____.
A) atrial flutter
B) atrial fibrillation
C) multifocal atrial tachycardia
D) multiformed atrial rhythm

Accepted Answer

Multiformed atrial rhythm is an updated term for the rhythm formerly known as wandering atrial pacemaker. When a wandering atrial pacemaker rhythm is associated with a ventricular rate of more than 100 beats/min, the dysrhythmia is called multifocal atrial tachycardia (MAT) or chaotic atrial tachycardia.

Question 13

Completion
-PACs associated with a wide QRS complex are called __________ PACs, indicating that conduction through the ventricles is abnormal.

Accepted Answer

The answer of Completion
-PACs associated with a wide QRS complex...

Question 14

Completion
-Sometimes, when a premature atrial complex (PAC) occurs very prematurely and close to the T wave of the preceding beat, only a P wave may be seen with no QRS after it (appearing as a pause). This type of PAC is termed a _____ PAC.

Accepted Answer

The answer of Completion
-Sometimes, when a premature atrial complex (PAC)...

Question 15

Identify the following rhythm (lead II). 
A) Sinus arrhythmia
B) Sinus tachycardia
C) Sinus rhythm with a PAC
D) Sinus tachycardia with a PAC

Accepted Answer

This rhythm strip shows a sinus tachycardia with a premature atrial complex.

Question 16

Completion
-Delivery of an electrical current timed for delivery during the QRS complex is called _____.

Accepted Answer

The answer of Completion
-Delivery of an electrical current timed for...

Question 17

A 77-year-old woman is complaining of a sudden onset of palpitations. The cardiac monitor reveals atrial fibrillation with a ventricular response of 144 to 210 beats/min while the patient is at rest. In this situation, the ventricular rate associated with this rhythm is considered to be _____.
A) controlled
B) uncontrolled

Accepted Answer

Atrial flutter or atrial fibrillation that has a ventricular rate of less than 100 beats/min is described as controlled. A controlled ventricular rate may be the result of a healthy AV node protecting the ventricles from very fast atrial impulses or medications used to control (block) conduction through the AV node, decreasing the number of impulses reaching the ventricles.

Question 18

What is meant by the term controlled atrial fibrillation?
A) The overall ventricular rate is less than 100 beats/min.
B) The atrial rate is less than 100 beats/min.
C) The overall ventricular rate is greater than 100 beats/min.
D) The atrial rate is greater than 100 beats/min.

Accepted Answer

Atrial flutter or atrial fibrillation that has a ventricular rate of less than 100 beats/min is described as controlled. A controlled ventricular rate may be the result of a healthy atrioventricular (AV) node protecting the ventricles from very fast atrial impulses or medications used to control (block) conduction through the AV node, decreasing the number of impulses reaching the ventricles.

Question 19

The most common type of supraventricular tachycardia (SVT) is _____.
A) atrial tachycardia
B) atrial flutter
C) AV reentrant tachycardia (AVRT)
D) AV nodal reentrant tachycardia (AVNRT)

Accepted Answer

AVNRT is the most common type of SVT. It is caused by reentry in the area of the AV node.

Question 20

How are frequent PACs usually managed?
A) Defibrillation
B) Synchronized cardioversion
C) Correcting the underlying cause
D) Administration of medications such as atropine or epinephrine

Accepted Answer

PACs usually do not require treatment if they are infrequent. The patient may complain of a "skipped beat" or occasional "palpitations" if PACs are frequent or may be unaware of their occurrence. In susceptible individuals, frequent PACs may induce episodes of atrial fibrillation or paroxysmal supraventricular tachycardia (PSVT). Frequent PACs are treated by correcting the underlying cause (e.g., correcting electrolyte imbalances, reducing stress, reducing or eliminating stimulants, treating heart failure). If the patient is symptomatic, frequent PACs may be treated with beta-blockers, such as atenolol or metoprolol.

Quiz 4: Atrial Rhythms

Completion -An accessory pathway that has one end attached to normal conductive tissue is called a(n) __________.

Identify the following rhythm (lead II) .

Atrial fibrillation is characterized by _____.

Which of the following correctly describes multifocal atrial tachycardia?

P waves in this rhythm strip _____.

Identify the following rhythm (lead II) .

P waves in this rhythm strip _____.

P waves in this rhythm strip _____.

Complete the following ECG criteria for atrial tachycardia:

To determine whether the ventricular rhythm on an ECG tracing is regular or irregular, compare _____ intervals.

Identify the following rhythm (lead II) .

A wandering atrial pacemaker rhythm with a ventricular rate of 60 to 100/min may also be referred to as _____.

Completion -PACs associated with a wide QRS complex are called __________ PACs, indicating that conduction through the ventricles is abnormal.

Completion -Sometimes, when a premature atrial complex (PAC) occurs very prematurely and close to the T wave of the preceding beat, only a P wave may be seen with no QRS after it (appearing as a pause). This type of PAC is termed a _____ PAC.

Identify the following rhythm (lead II) .

Completion -Delivery of an electrical current timed for delivery during the QRS complex is called _____.

A 77-year-old woman is complaining of a sudden onset of palpitations. The cardiac monitor reveals atrial fibrillation with a ventricular response of 144 to 210 beats/min while the patient is at rest. In this situation, the ventricular rate associated with this rhythm is considered to be _____.

What is meant by the term controlled atrial fibrillation?

The most common type of supraventricular tachycardia (SVT) is _____.

How are frequent PACs usually managed?