Kacmarek: Egan's Fundamentals of Respiratory Care, 10th 

Edition ​Chapter 17: Interpreting the Electrocardiogram  

Test Bank  

MULTIPLE CHOICE  

1. The electrocardiogram (ECG) is primarily used to evaluate the patient with symptoms 
suggestive of acute myocardial disease.  
a. True  
b. False  

2. Your patient has a normal ECG reading. What does this finding tell you about the patient’s 
likelihood of having a myocardial infarction in the immediate future?  
a. less than a 10% chance  
b. less than a 30 % chance  
c. less than 50% chance  
d. no predictive value  

3. Valvular defects in the heart can be detected with a 12-lead ECG.  

a. True  
b. False  
 
4. What term is used to define the ability of certain cardiac cells to depolarize without 
stimulation?  
a. automaticity  
b. polarization  
c. contraction  
d. Repolarization 
 
5. What structure normally paces the healthy heart?  
a. atrioventricular (AV) node  
b. sinoatrial (SA) node  
c. bundle of His  
d. Purkinje fibers  

6. What structure serves as the backup pacemaker for the heart?  

a. atrioventricular (AV) node  
b. sinoatrial (SA) node  
c. bundle of His  
d. Purkinje fibers  

7. Why is the electrical impulse temporarily delayed at the atrioventricular (AV) node? 
a. to allow complete emptying of the ventricles  
b. to allow more sodium buildup in the myocardial cells  
c. to allow better filling of the ventricles  
d. to allow complete filling of the atria  
 8. At what part of the cardiac conduction system does the electrical impulse travel most rapidly? 
a. bundle of His 
b. bundle branches  
c. interatrial pathways  
d. Purkinje fibers  

9. What is the normal maximum length of the P wave?  

a. 1 mm  
b. 3 mm  
c. 5 mm  
d. 7 mm  

10. Which of the following waves represents depolarization of the ventricles? 

a. P wave  
b. QRS wave  
c. T wave  
d. U wave  

11. What is the width of the normal QRS complex?  

a. not wider than 1 mm  
b. not wider than 3 mm  
c. not wider than 5 mm  
d. not wider than 7 mm  
12. Which of the following waves represents repolarization of the ventricles? 
a. P  
b. QRS  
c. T  
d. U  

13. What is the normal period of time for the PR interval?  

a. not longer than 0.20 second  
b. not longer than 0.30 second  
c. not longer than 0.45 second  
d. not longer than 0.50 second  

14. What is implied by an abnormally prolonged PR interval?  

a. atrioventricular block  
b. bundle-branch block  
c. myocardial infarction  
d. valvular detachment  

15. Which of the following ECG abnormalities is most life threatening?  

a. narrow QRS complex  
b. shortened PR interval  
c. elevated ST segment  
d. peak P waves  

 
16. Which of the following axis placements represents right-axis deviation? 

a. +60  
b. +90  
c. +120  
d. +190  

17. What condition is often associated with right-axis deviation?  

a. cor pulmonale  
b. congestive heart failure (CHF)  
c. mitral valve prolapse  
d. left ventricular hypertrophy  

18. What parameter is measured on the vertical axis of the ECG paper?  
a. time  
b. voltage  
c. cardiac contraction rate  
d. blood flow  

19. The QRS of an ECG falls on a dark vertical line of the ECG paper. Subsequent QRS 
complexes fall on every other dark line (10 mm apart). What is the ventricular rate? 
a. 300/min  
b. 200/min  
c. 150/min  
d. 100/min 

20. What is suggested by inverted T waves on the ECG?  

a. atrial enlargement  
b. myocardial ischemia  
c. ventricular hypertrophy  
d. dextrocardia  

21. Which of the following clinical conditions is not associated with tachycardia? 
a. anxiety  
b. hypoxemia  
c. pain  
d. hypothermia  
 
22. Which of the following medications is used to treat sinus bradycardia? 
a. atropine  
b. digitalis  
c. propranol  
d. lidocaine  

 
23. The ECG you are looking at has one P wave for every QRS complex and the PR interval is 
0.30 second. What is your interpretation?  
a. first-degree heart block  
b. right-axis deviation  
c. third-degree heart block  
d. atrial hypertrophy  

24. What type of medications may lead to first-degree heart block?  

a. bronchodilators  
b. corticosteroids  
c. ​β​-blockers  
d. xanthines  

25. Which of the following criteria applies to third-degree block?  

a. There is no relationship between the P waves and the QRS complexes.  
b. The PR interval becomes progressively longer.  
c. The ventricular rate is twice that of the atrial rate.  
d. The QRS complex is inverted compared to the P wave.  

26. For which of the following arrhythmias would an electronic pacemaker be indicated? 
a. first-degree block  
b. sinus tachycardia  
c. third-degree block  
d. ventricular fibrillation  

27. On inspection of an ECG rhythm strip from an adult patient, you notice the following: regular 
sawtooth like waves occurring at a rate of 280/min and a regular ventricular rhythm occurring 
at a rate of about 140/min. What is the most likely interpretation?  
a. atrial fibrillation  
b. atrial flutter  
c. ventricular tachycardia  
d. ventricular fibrillation 

28. Atrial flutter is considered to be a life-threatening arrhythmia.  

a. True  
b. False  

29. What is a possible serious complication associated with atrial fibrillation? 

a. pulmonary edema  
b. atrial thrombi  
c. cardiac tamponade  
d. cardiac standstill  
 
30. Sources for the electrical impulse that triggers cardiac contraction that lie outside the 
sinoatrial node are referred to as ectopic foci.  
a. True  
b. False  
31. Which of the following is NOT a common characteristic of a premature ventricular complex 
(PVC)?  
a. no P wave prior to the QRS complex  
b. widened QRS complex  
c. bizarre QRS complex  
d. narrow QRS  

32. An occasional premature ventricular complex (PVC) is not of major concern. 

a. True  
b. False  

33. What medication is most useful for the treatment of premature ventricular contractions? 
a. digoxin  
b. atropine  
c. lidocaine  
d. digitalis  

34. Which of the following is NOT a common cause of ventricular tachycardia? 

a. myocardial infarction  
b. coronary artery disease  
c. hypertensive heart disease  
d. pericarditis  

35. Sinus bradycardia is always a sign of an abnormality of the heart?  

a. True  
b. False  

36. While a patient is receiving an albuterol treatment, the nurse performs an ECG. The ECG 
shows the patient’s heart rate had increased from 98 to 120 beats/minute with narrow QRS 
complexes proceeded by a P wave. What is the appropriate course of treatment for this 
patient?  
a. atropine  
b. activate the rapid response team  
c. lidocaine  
d. discontinue the treatment  

37. A patient taking an ECG shows a regular sawtooth pattern with thirty P-waves within a six 
second interval (30 large boxes). What course of treatment should this patient receive for this 
arrhythmia?  
1. calcium channel blockers  
2. digoxin  
3. cardioversion  
4. defibrillation  
a. 1, 2, and 3  
b. 2 and 4  
c. 3 only  
d. 1, 2, 3, and 4  
 
38. An unconscious patient is bought in by EMS into an ER trauma room. Patient has no 
detectable pulse and the ECG baseline waveform shows grossly irregular fluctuations with a 
zigzag pattern. What is the course of action to treat this patient?  
1. rapid defibrillation  
2. cardiopulmonary resuscitation  
3. administration of oxygen  
4. administration of an antiarrhythmic medication  
a. 1, 2, and 3  
b. 2 and 4  
c. 3 only  
d. 1, 2, 3, and 4  

39. A patient who has been diagnosed with myocardial infarction is getting an ECG. The ECG 
trace shows a series of nonconducted P waves followed by a P wave that is conducted to the 
ventricles. The ratio of non-conducted to conducted P waves is fixed at 4:1. What plan for 
treatment should this patient receive?  
1. rapid defibrillation  
2. atropine  
3. cardioversion  
4. pacemaker  
a. 1, 2, and 3  
b. 2 and 4  
c. 3 only  
d. 1, 2, 3, and 4