Telemetry Exam 138 Questions with Verified Answers,100% CORRECT

Telemetry Exam 138 Questions with Verified Answers An AV sequential pacemaker paces which chambers of the heart - CORRECT ANSWER Right atrium and right ventricle A DDD pacemaker paces which chambers of the heart ? ...

Telemetry Exam 138 Questions with Verified Answers An AV sequential pacemaker paces which chambers of the heart - CORRECT ANSWER Right atrium and right ventricle A DDD pacemaker paces which chambers of the heart ? - CORRECT ANSWER Right atrium and right ventricle The first letter of the pacemaker code tells the - CORRECT ANSWER Chamber paced When a pacemaker fires, it creates what sign on the EKG - CORRECT ANSWER A spike If a pacemaker fails to fire, what is shown on the EKG? - CORRECT ANSWER Lack of a pacemaker spike where there should be one Capture is evidenced on the EKG by the following presence of - CORRECT ANSWER P waves or QRS complexes following the pacemaker spikes The second letter of the pacemaker code tells the - CORRECT ANSWER Chamber sensed A transcutaneous pacemaker paces the heart - CORRECT ANSWER through the skin Which of the following would NOT be an indication for a pacemaker ? - CORRECT ANSWER Junctional tachycardia A VOO pacemaker would pace the - CORRECT ANSWER Ventricle, sense nothing and have response to sensed events since it cannot sense The pacemaker's generation of an electrical impulse is called - CORRECT ANSWER Firing A fixed rate pacemaker - CORRECT ANSWER Fires at its present rate regardless of intrinsic beats Which of the following is NOT true about asynchronous pacemakers ? - CORRECT ANSWER They are the same as demand pacemakers DDD pacemaker - CORRECT ANSWER Pace the atrium and the ventricle in succession Your patient has his own P waves but no QRS complexes. His DDD pacemaker should - CORRECT ANSWER Sense the intrinsic P waves and deliver QRS complexes to follow those P waves within a present rate range The most common pacemaker malfunctions include all but which of the following ? - CORRECT ANSWER Failure to repolarize Which of the following describes over-sensing? - CORRECT ANSWER The pacemaker incorrectly interprets something as a depolarization and is inhibited from firing If lead I's QRS is positive and AVF's QRS is also positive, the axis is - CORRECT ANSWER Normal If lead I's QRS is positive and AVF's QRS is negative, the axis is - CORRECT ANSWER Left axis deviation If lead I and AVF both have negative QRS complexes the axis is - CORRECT ANSWER Indeterminate If lead I's QRS is negative and AVF's QRS is positive, the axis is - CORRECT ANSWER Right axis deviation Normal axis is in the range of - CORRECT ANSWER 0 to +90 degrees Atrial enlargement would produce an abnormal - CORRECT ANSWER P wave Ventricular hypertrophy would produce an abnormal - CORRECT ANSWER QRS complex Right atrial enlargement ( right and atrial hypertrophy) is evidenced by - CORRECT ANSWER P waves greater than or equal to 2.5mms fall in leads 2, 3 and AVF Which of the following indicates left ventricular hypertrophy? - CORRECT ANSWER S wave in V1 plus R in V5 equal or greater than 35mms If in V1 the S wave of the QRS is 20mm deep, and in V5 the R wave is 28mm tall, by voltage criteria there is - CORRECT ANSWER Left ventricular hypertrophy Your patient has mitral stenosis. You are therefore not surprised to see what abnormality on his EKG? - CORRECT ANSWER Left atrial enlargement Left ventricular strain is evidenced by - CORRECT ANSWER Asymmetric ST depression and T wave inversion Which of the following is indicative of myocardial injury? - CORRECT ANSWER ST elevation Which of the following is indicative of myocardial necrosis? - CORRECT ANSWER Significant Q wave An inferior wall MI has ST elevation in leads - CORRECT ANSWER 2, 3, AVF Which of the following is a reciprocal change seen in the area opposite an infract? - CORRECT ANSWER ST depression An inverted T wave is indicative of - CORRECT ANSWER Myocardial ischemia ST segment elevation is indicative of - CORRECT ANSWER myocardial injury A posterior infraction is caused by an occlusion to which two coronary artery? - CORRECT ANSWER Right or circumflex An inferior MI is most often caused by an occlusion of which coronary artery? - CORRECT ANSWER Right An anterior MI is caused by occlusion of which coronary artery ? - CORRECT ANSWER Left anterior descending Mr. Johnson came to the hospital within the hour after his heart attack started. You would expect to see what indications of acute MI on his EKG? - CORRECT ANSWER ST segment elevation in the leads over the damaged areas The _________ of an old transmittal MI typically remains on the EKG forever - CORRECT ANSWER Significant Q wave A transmural MI - CORRECT ANSWER is a MI that damages the full thickness of the myocardium in a certain area. Most MIs are caused by a - CORRECT ANSWER Blood clot in a coronary artery In an anterior MI, which coronary artery is occluded ? - CORRECT ANSWER Left anterior descending Tall pointy T waves are a sign of what electrolyte disturbance? - CORRECT ANSWER Hyperkalemia Extremely widened QRS complexes are a sign of what electrolyte disturbance? - CORRECT ANSWER Hyperkalemia Digitalis effect causes - CORRECT ANSWER ST segment depression Hypercalcemia causes - CORRECT ANSWER Shortened ST segments Hypocalcemia causes - CORRECT ANSWER Prolonged ST segments Mr. Davis rhythm has uniform-shaped up-right P waves, each followed by a QRS complex. PR interval was 0.26 seconds and QRS interval was 0.14 seconds. Heart rate was 61. His vital signs were stable. This is consistent with what rhythm ? - CORRECT ANSWER Sinus rhythm with first degree AV block and bundle branch block Mr. Mallory presented to the ER with a heart rate of 150. The rhythm was regular QRS complexes were narrow and P waves could not be identified. Which of the following rhythms is consistent with that description? - CORRECT ANSWER Supraventricular tachycardia Mr. Jacob had a permanent DDD pacemaker implanted a few days ago. Today he cardiac arrested and died. What happens to the pacemaker when the patient is deceased? - CORRECT ANSWER The pacemaker battery continues to fire at its programmed rate until the battery runs out Mr. Chilton has a VV1 pacemaker set at a rate of 70. Which of the following rhythms should be pacemaker prevent from happening? - CORRECT ANSWER Junctional bradycardia Mr. Gorp has a pacemaker that sense atrial and ventricular depolarizations and paces atrium and ventricle. It can be inhibited or triggered by sensed events. What kind of pacemaker is this? - CORRECT ANSWER DDD Your patient's pacemaker lost capture when he turned form his back into his side. What action is most likely to restore capture ? - CORRECT ANSWER Turn the patient back onto his back Mrs. McShelton has a VV1 pacemaker. She is having pacemaker spikes in he T waves, QRS complexes and ST segments of her intrinsic beats. This is indicative of - CORRECT ANSWER Undersensing Mr. Caputto has a wide QRS of 0.14 seconds. The QRS configuration in V1 is a deep QS wave and in V6 is a monophasic R wave. The heart rate is 90 and there uniform- shaped upright P waves preceding each QRS. This describes - CORRECT ANSWER Sinus rhythm with left bundle branch block Mr. Calhoun overheard the CCU nurses saying in report that he was "having a lot of ectopy" what did they mean by ectopy ? - CORRECT ANSWER PVC's You're doing a 12 lead EKG on a patient with Parkinson's disease tremors. What kind of artifact will you be LEAST surprised to see? - CORRECT ANSWER Somatic tremors Mr. Pulitzer was admired to the CCU with slight concave ST segment elevations in all leads. He had a a heat pain that worsened on inspiration and was lessened with sitting up and leaning forward. This description is consistent with - CORRECT ANSWER Pericarditis Mac Jacob was a 21 year old black man who'd complained of shortness of breath and come to the ER. His cardiac enzymes were normal, but his EKG did show some slight ST segment elevations with a "fish-hook" at the end of the QRS complexes in v2-4. This is consistent with - CORRECT ANSWER Early repolarization Mr. Henry has ST segment elevations in 2,3 and AVF along with reciprocal ST depression in 1 and AVL and V1-4. Right sided EKG showed ST elevation in V3-4R. His blood pressure was quite low, 84/48. Mr. Henry was normally hypertensive. This description is consistent with - CORRECT ANSWER Inferior MI complicated by a right ventricular infraction Mr. Karene had a new right bundle branch block along with a left anterior hemiblock. He also had an MI. What kind of MI is. consistent with these conduction abnormalities? - CORRECT ANSWER Anterior MI Mr. Campho has a previous inferior MI about 20 year ago. What would you expect to see on her EKG that would be consistent with her old inferior MI? - CORRECT ANSWER Significant Q wave in 2, 3 and AVF Lidocaine is used to treat arrhythmias originating in the - CORRECT ANSWER Ventricle Atropine has what effect on the sinus node? - CORRECT ANSWER It increases its automaticity Isoproterenol would NOT be appropriate in the treatment of - CORRECT ANSWER Supraventricular tachycardia with heart rate of 167 Beta blockers have what effect on heart rate and contractility ? - CORRECT ANSWER Decreased heart rate and contractility Blocking beta-1 receptors - CORRECT ANSWER Decreased contractility is Propanolol (Inderol) is a - CORRECT ANSWER Beta blocker Digitalis is a - CORRECT ANSWER cardiac glycoside Epinephrine has what effect on heat rate and contractility ? - CORRECT ANSWER Increased heart rate and contractility Which of the following medications will cause a decrease in the R-R interval? - CORRECT ANSWER Atropine Which of the following is implicated as a potential cause of torsades des pointes ? - CORRECT ANSWER Quinine Beta blockers are contraindicated for patients with - CORRECT ANSWER Asthma or chronic lung disease Which of the following is NOT used in the treatment or rapid ventricular arrhythmias? - CORRECT ANSWER Digitalis Quinine can induce torsades de pointes by its increase of the - CORRECT ANSWER QT interval In a cardiac arrest emergency, epinephrine should be given in which of the following ways? - CORRECT ANSWER Intravenously Isoproterenol is a - CORRECT ANSWER Beta stimulant Isoproterenol must be used with caution because it has what adverse effects? - CORRECT ANSWER It causes an increase in myocardial oxygen consumption Digitalis is NOT indicated in the treatment of - CORRECT ANSWER Ventricular tachycardia Which of the following medications would be indicated in the treatment of sinus bradycardia, heart rate 35, with frequent PVCs? - CORRECT ANSWER Atropine Which combination of medications would be appropriate to use for the patient in asystole? - CORRECT ANSWER Atropine and epinephrine Verapamil is most commonly used in the treatment of - CORRECT ANSWER Tachycardia Verapamil is a - CORRECT ANSWER calcium channel blocker Which of the following medications blocks parasympathetic effects on the heart? - CORRECT ANSWER Atropine Atropine has what effect on the sinus node and AV node? - CORRECT ANSWER It speeds both sinus node firing and AV conduction Hypoxia is treated with the administration of - CORRECT ANSWER Oxygen Which of the following medications can cause ST segment depression mimicking ischemia? - CORRECT ANSWER Digitalis Digitalis is CONTRAINDICATED in patient with - CORRECT ANSWER Third degree AV block Verapamil is CONTRAINDICATED in patients with - CORRECT ANSWER Hypotension Digitalis cause an increase in the - CORRECT ANSWER PR interval Which of the following would be CONTRAINDICATED in the treatment of agonal rhythm? - CORRECT ANSWER Lidocaine Which of the following interferes with the movement of calcium ions through the cardiac cell membranes? - CORRECT ANSWER Nifedipine Which of the following is also commonly used as a local anesthetic? - CORRECT ANSWER Lidocaine Administration of calcium is indicated in an overdose of which of the following medications? - CORRECT ANSWER Verapamil Which of the following is CONTRAINDICATED in the treatment of ventricular fibrillation? - CORRECT ANSWER Isoproterenol Beta blockers might interfere with a stress test in what way? - CORRECT ANSWER They prevent the heart rate form reaching target levels What is epinephrine's effect in blood pressure? - CORRECT ANSWER Increases blood pressure Which of the following directly causes increased tissue oxygenation? - CORRECT ANSWER Oxygen Atropine, when given to increase the heart rate on a symptomatic individual, is given by what route? - CORRECT ANSWER Intravenously The fastest route of medication administration is - CORRECT ANSWER Intravenous route The difference in atropine and digitals's effect on AV conduction is - CORRECT ANSWER Atropine speeds up AV conduction, digitalis slows AV conduction Which of the following is used primarily to treat supraventricular tachyarrhythmias? - CORRECT ANSWER Adenosine Which of the following is used primarily to treat ventricular tachyarrhythmias? - CORRECT ANSWER Lidocaine An accidental overdose of verapamil can be corrected by giving - CORRECT ANSWER Calcium A prolonged QT interval caused by quinidine toxicity can lead to what arrhythmia? - CORRECT ANSWER Torsades des pointes Which of the following causes slowed conduction through the AV node? - CORRECT ANSWER Digitalis Adenosine is used to treat - CORRECT ANSWER Supraventricular tachycardias Class 1 Antiarrhythmics medications include ALL BUT which of the following ? - CORRECT ANSWER Digitalis Calcium channel blockers belong to which category of anti arrhythmic medications? - CORRECT ANSWER Class IV Beta blockers belong to which category of antiarrhythmic medications? - CORRECT ANSWER Class 2 Which of the following is NOT a class 1 antiarrhythmic medications? - CORRECT ANSWER Verapamil Class 1 antiarrhythmic medications afffect what phase of the action potential? - CORRECT ANSWER Phase 0 Class 2 antiarrhythmic affect which phase of the action potential? - CORRECT ANSWER Phase 4 You're 46 year old patient, Mr. Joseph is brought by ambulance to the ER. There are no P waves or QRS complexes at all on his rhythm strip only a flat line. Which of the following medications is INAPPROPRIATE for treating this rhythm? - CORRECT ANSWER Propranolol When Mrs. Hoffstetter passed out at the mall, paramedics found her heart rate to be 34. Which of the following medications would be appropriate to give to cause the heart rate to increase? - CORRECT ANSWER Atropine Mr. Herbert passes out in the bathroom. He was pulseless with the rhythm seen. Appropriate intervention would be immediate - CORRECT ANSWER CPR, atropine, epinephrine Sam Colbert felt lousy, so he doubled up on his digitalis dose, thinking his malaise was due to his long lasting atrial fibrillation. After three days of this double-dosing, he felt worse, so he came to the ER with a heart rate of 32 and a blood pressure of 76/48. Which of the following would be appropriate INTIAL treatment for Mr. Colbert? - CORRECT ANSWER Atropine intravenously to increase his heart rate Your patient is in junctional rhythm with a heart rate of 54. His blood pressure is good, and he denies any symptoms. Appropriate treatment for this patient at this time is - CORRECT ANSWER Careful observation, with treatment if symptoms develop The rhythm belongs to Mr. Horning, who has a long history of emphysema. He has been unusually short of breath today and has just noticed a fluttering sensation in his chest. Due to Mr. Horning's history, you suspect that his arrhythmia might be successfully treated with - CORRECT ANSWER Supplemental oxygen administration at a low flow rate The rhythm below belongs to a 34 Year old female with a long history of hypertension. She has been taking beta blockers to control her blood pressure and has been feeling tired the past few days. She went to go physician. Which of the following medications would be appropriate for treating this rhythm? - CORRECT ANSWER Atropine Ms. Calhoun was found unconscious and pulseless with the rhythm as seen in Figure 4-4. Which of the following is INAPPROPRIATE for treating this rhythm? - CORRECT ANSWER Synchronized electrical cardioversion at 200 joules Appropriate electrical therapy for and. Calhoun's rhythm in Figure 4-4 would be which of the following? - CORRECT ANSWER Defibrillation at 200, then 300, then 360 joules sequentially if the rhythm persists Mrs. Samuel's permanent pacemaker's battery had completely run down, and her underlying rhythm was third degree AV block with a heart rate of 42. Her blood pressure was 150/88, and her skin was warm and dry. She denies distress. Given her condition, appropriate treatment would be - CORRECT ANSWER Immediate preparation for a pacemaker battery change At 1:30 PM Sam Stalone was in sinus rhythm with a heart rate of 86. At 1:35 PM to develop substernal chest tightness and his heart rate was noted to be 138. The ST segment in leads 2,3 and AVF on his 12- lead EKG rose to 2 mm above the baseline. His physician determined Mr. Stalone was having an inferior wall MI. Which of the following is NOT TRUE about Mr. Stalone's tachycardia? - CORRECT ANSWER The tachycardia is unrelated to the MI, as the heart rate decrease during an MI Mrs. Hollowell had a long history of renal failure and has been on hemodialysis for three years. She didn't show up for her dialysis yesterday and has now presented to the ER in idioventricular rhythm with a heart rate of 36 and a QRS interval of 0.32 seconds. The most likely cause of her widened QRS interval is - CORRECT ANSWER Hyperkalemia Appropriate treatment to restore Mrs. Hollowell's QRS interval to normal could include ALL BUT which of the following? - CORRECT ANSWER Intravenous potassium boluses Your patient is in pulseless ventricular tachycardia. According to ACLS protocol, your first intervention should be - CORRECT ANSWER Defibrillation Ms. Selwe is in SVT with a heart rate of 220. She feels fatigue but is tolerating the rhythm well. You ask her to take a deep breath and bear down as if straining at stool. She does, and the tachycardia covers back to sinus rhythm with a heart rate of 84. What is this trick called? - CORRECT ANSWER Vagal maneuver Ms. Kawasaki's QT inteval at a heart rate of 80 is 0.52 seconds. You know this predisposes her to what ventricular rhythm? - CORRECT ANSWER Torsades des pointes Mr. Sinclair has a temporary transvenous pacemaker instead yesterday for third degre AV block. He had been pacing almost 100%. Today he is having a short runs of ventricular tachycardia with a negative QRS configuration in V. Given the QRS configuration in V1, it is likely his ventricular tachycardia is caused by - CORRECT ANSWER Mechanical irritation from the pacemaker wire in his right ventricle Paramedics respond to an emergency call on a hot summer night to find a man, lying face down in an alley. He is not breathing and has no pulse. The monitor shows asystole. A bystander tells paramedics the man has been down for "at least an hour or two". No bystander CPR was started, and rigor mortis has set in. What is the correct action for the paramedics to take at this point? - CORRECT ANSWER Notify the authorities of a patient found dead at the scene. Mrs. Cohen is in Type 2 second degree AV block with a heart rate of 35. Her QRS interval is 0.14 seconds, and the physician indicated her block is at the bundle branch level. She is asymptomatic. Given her condition, the most appropriate INTIAL treatment of her arrhythmia would be - CORRECT ANSWER Cautious observation. Carlos Palyok has severe substernal chest pain radiating to his left arm and his jaw. His heart rate was 132 and his blood pressure was 240/130. ST segments were elevated in leads 1, AVL, and V1-6 and depressed in 2, 3 and AVF. There were significant Q waves developing in 1, AVL and V1-6. Appropriate treatment for Mr. palyok might include ALL BUT which of the following? - CORRECT ANSWER Infusion of clotting factors Max coburn has been diagnosed with an inferior MI and is receiving a TPA infusion. He is now having short runs of accelerated idioventricular rhythm. You know it's rhythm PROBABALY indicates that - CORRECT ANSWER The myocardium is reperfusing Ms. Jackson presents to the ER in new onset atria fibrillation with a heart rate of 180. Her skin is very pale, pulse is thready, she is cold and clammy and going into shock. Appropriate treatment would be to - CORRECT ANSWER Perform electrical cardioversion Mikhail Gornikov is in acute pulmonary edema. Blood pressure is 260/148 and heart rate is 122. Which of the following is NOT INDICATED in his treatment? - CORRECT ANSWER Large volume infusion of IV fluids Caleb Thinodeaux was at a concert when he felt palpations. He ignored them until he started felling faint. When he arrived at the ER, Mr. Thinodeaux was noted to be having short but frequent runs of torsades des pointes. In between, he was in sinus rhythm with a heart rate of 92. What electrolyte imbalance is most often suspected with this rhythm ? - CORRECT ANSWER Hypomagensemia