CCRN Practice – Cardiac Conduction and EKG Interpretation Part 1
This flashcard set focuses on interpreting EKG findings and understanding coronary artery involvement in cardiac conduction. It reinforces knowledge of lead placement, ST segment changes, and their correlation to affected conduction system structures.
A patient in the ED with complaints of chest pain. The 12-lead EKG shows ST elevation in leads V3 and V4. Occlusion of the affected coronary artery most likely would affect perfusion to which portion of the conduction system?
A. Sinoatrial (SA) node
B. Bachmann's bundle
C. Atrioventricular (AV) node
D. Bundle of His
LAD so D. bundle of his
Key Terms
A patient in the ED with complaints of chest pain. The 12-lead EKG shows ST elevation in leads V3 and V4. Occlusion of the affected coronary artery most likely would affect perfusion to which portion of the conduction system?
A. Sinoatrial (SA) node
B. Bachmann's bundle
C. Atrioventricular (AV) node
D. Bundle of His
LAD so D. bundle of his
Which of the following is the preferred lead for ST segment monitoring for a patient with a suspected RCA occlusion?
A.I
B. aVR
C. III
D. V1
c. III
Which of the following is not a manifestation of hypertrophic cardiomyopathy?
A. Syncope
B. Murmur that increases with squatting
C. Chest pain
D. Sudden cardiac death
*B
Classic manifestations of hypertrophic cardiomyopathy are chest pain, syncope, and an aortic stenosis type of murmur that decreases when the ...
In which quadrant is the mean QRS complex axis located if the QRS complex is predominantly positive in lead I and negative in lead aVF?
A. Normal quadrant
B. Left axis deviation quadrant
C. Right axis deviation quadrant
D. Indeterminant quadrant
*B
Because the positive of lead I is the left arm, if the QRS complex is upright in lead I, the mean QRS axis is to the left. Because the positi...
A patient becomes apneic and pulseless. CPR has been initiated, and the monitor shows asystole in two leads. Which of the following drugs would be used initially?
A. Calcium gluconate
B. Atropine
C. Epinephrine
D. Amiodarone (Cordarone)
C
After CPR is initiated and an intravenous access is established, epinephrine should be given. Calcium was used in the past in asystole but is ...
What is associated w/ Mitral Stenosis
A. Pinkish discoloration of the cheeks
B. Systolic murmur
C. Widened pulse pressure
D. Narrow pulse pressure
A
Patients with mitral stenosis may exhibit a pinkish discoloration of the cheeks (i.e., malar blush). Mitral stenosis causes a diastolic murmur...
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| Term | Definition |
|---|---|
A patient in the ED with complaints of chest pain. The 12-lead EKG shows ST elevation in leads V3 and V4. Occlusion of the affected coronary artery most likely would affect perfusion to which portion of the conduction system? | LAD so D. bundle of his |
Which of the following is the preferred lead for ST segment monitoring for a patient with a suspected RCA occlusion? | c. III |
Which of the following is not a manifestation of hypertrophic cardiomyopathy? | *B |
In which quadrant is the mean QRS complex axis located if the QRS complex is predominantly positive in lead I and negative in lead aVF? | *B |
A patient becomes apneic and pulseless. CPR has been initiated, and the monitor shows asystole in two leads. Which of the following drugs would be used initially? | C |
What is associated w/ Mitral Stenosis | A |
Four days after a mitral valve replacement, the patient develops atrial fibrillation. The nurse initially would: | B |
A patient has just returned from the cath lab. She had an angioplasty for occlusion of her RCA. She still has femoral artery and vein sheaths in place. The patient complains of chest pain that she rates 9/10 about an hour after she returns from the cath lab. Which of the following is indicated? | D |
A 35-year-old woman underwent a mitral valve replacement. Her chest tube output has been approximately 125 mL/hr for the last 3 hours, and now the drainage has ceased suddenly. The immediate assessment reveals a significant decrease in BP, RAP 12, PAP 30/15 , PAOP 13. What other data would indicate the development of cardiac tamponade? | C |
A patient has had an inferior MI. He now has a new holosystolic murmur at apex, acute severe dyspnea, decreased cardiac index, and a normal cardiac silhouette on x-ray. Which of the following complications most likely is occurring in this patient? | A |
A patient with HF caused by diastolic dysfunction is prescribed carvedilol (Coreg). What type of drug is carvedilol? | C. Alpha- and noncardioselective beta-blocker |
A 52-year-old man is admitted to the critical care unit with a diagnosis of an acute MI. EKG shows ST elevation and T wave inversion in leads V2, V3, and V4. His history includes HTN, 80 pack-years of smoking, COPD, and HLD. | B. Absence of creatine kinase (CK) enzyme elevation |
Substernal chest pain, low-grade fever, and pericardial friction rub are clinical indications of which of the following? | A. Pericarditis |
A patient sustains a myocardial contusion as a result of a MVC. Which of the following signs and symptoms would be most likely? | A. Jugular venous distention |
A patient is admitted to the coronary care unit with third-degree AV heart block, and a transvenous temporary ventricular pacemaker is inserted. Four hours later the patient complains of dizziness while lying in bed. The monitor shows third-degree AV block with a ventricular rate of 52 and no pacing spikes. This indicates which of the following? | B. Failure to pace |
Which one of the following structures is at greatest risk for trauma in myocardial contusion? | B. RV |
Leads V8 and V9 are used to evaluate which of the following? | B. posterior MI |
Which of the following is the major advantage of minimally invasive direct coronary artery bypass grafting (MIDCABG)? | C. avoidance of cardiopulmonary bypass |
A patient arrives to the ED with a knife sticking out of his chest. He is stable at this time but complaining of pain at the knife insertion site. The physician is busy resuscitating another patient. What should be done? | C. Leave the knife in but stabilize it with adhesive tape. |
A 57-year-old man was admitted to the critical care unit with a diagnosis of anteroseptal MI. A PA catheter was inserted, and initial readings were within normal limits. BP 140/92, HR 110 and regular, RR 24. Breath sounds equal and clear. 3 hrs after admission, the pt becomes restless with cool, pale skin. Now BP 110/72, HR 120, RR 28 and labored. Crackles are audible at the lung bases BL. The patient is given furosemide (Lasix) at 8 am. At 9 am, the PAOP drops to 8, with a drop in BP. Which of the following would be the most appropriate intervention at this time? | A. Administer saline bolus. |
What type of AV block is characterized by a progressive prolongation of the PR interval followed by a nonconducted P wave? | B. Second-degree AV block, type I |
A premature P wave buried in the T wave before a run of wide QRS complex tachycardia indicates that the wide QRS complex tachycardia is most likely which of the following? | A. Supraventricular tachycardia with aberrancy |
Which of the following drugs are used for first-line therapy for chronic management of hypertension? | C. Diuretics and beta-blockers |
A 61-year-old man is admitted to the critical care unit from the cath lab. He has just had a PCI and stent insertion to the RCA. His leg is immobilized, and the HOB 30 degrees. Six hours later the patient is restless and complaining of back pain. The femoral sheath is intact in the right femoral area, and there is no evidence of bleeding or hematoma. Neck veins are flat with the HOB 30 degrees, and heart sounds are normal. Vital signs are BP 80/50, HR 120, and RR 24. Which of the following is the priority issue for patient education for this patient? | C. The need for taking a platelet aggregation inhibitor daily |
Unstable angina that presents as pain at rest is likely to be due to progression of CAD or which of the following? | C. Coronary artery spasm |
Which of the following is the major disadvantage of the use of serum myoglobin for the diagnosis of an acute MI? | C. High sensitivity and false-positive results |
Which of the following is the most likely mechanism for atrial tachycardias? | A. re-entry |
Which of the following would be a contraindication to the use of fibrinolytic drugs, such as recombinant tissue plasminogen activator? | C. uncontrolled hypertension |
A patient returns to the critical care unit after insertion of a transvenous pacemaker. There are pacing spikes not followed by a QRS. Which of the following is a method to facilitate capture during pacing? | B. Increase the milliamperage. |
eduction in peripheral circulation and shifting of the oxyhemoglobin dissociation curve can affect the accuracy of which of the following? | D. Pulse oximetry |
Which of the following would not be recommended for diastolic dysfunction? | C. inotropes |
Why does nitroprusside (Nipride) cause tachycardia? | C. Stimulation of baroreceptors |
Aortic stenosis would elevate which of the following? | A. Left ventricular systolic pressure |
Which of the following does not predispose the patient to digitalis toxicity? | D. Hyponatremia |
Which of the following types of drugs can cause hypotension, hyperkalemia, angioedema, proteinuria, and cough? | D. Angiotensin-converting enzyme (ACE) inhibitors |
Ashman's phenomenon is most likely to be evident in which of the following electrocardiogram changes? | B. A-fib |
Which of the following is a clinical indication of diastolic dysfunction? | B. S4 |
Which of the following type of drug would be prescribed after a MI to aid in prevention of remodeling? | C. ACE inhibitors |
Which of the following are clinical indications of bacterial endocarditis? | A. fever and new murmur |
While monitoring the patient's PAP, a damped waveform is noted. Which of the following would not be an appropriate action? | C. Fast flush the distal lumen. |
Which of the following is not characteristic of the clinical presentation of dissecting thoracic aortic aneurysm? | A. Crushing substernal chest pain |
Which of the following is an important group of drugs used to block a maladaptive compensatory mechanism in HF? | B. Angiotensin-converting enzyme (ACE) inhibitors |
A 55-year-old man with a long history of alcoholism continues to drink alcohol and now has alcoholic cardiomyopathy, a form of dilated cardiomyopathy. Which of the following would this patient not be expected to receive? | B. Cardiac transplant referral |
The reciprocal changes of a posterior MI are evident in which leads? | B. V1, V2 |
A 52-year-old woman arrives in the ED. started having fluttering in her chest about 1 hour ago and now is having chest pain. She has a history of HTN. The EKG monitor shows paroxysmal atrial tachycardia with HR 150, BP 130/88. Verapamil 5 mg is given via slow IV push. What would be a desirable therapeutic outcome? | B. Decrease in heart rate |
Which of the following is the most common cause of death associated with an acute MI? | B. Ventricular dysrhythmias |