Free EKG Certification Question and Answers — Questions and Answers

Question 1: Following complaints of weakness and overall malaise, a patient is put on the heart monitor. What kind of rhythm is this?

ventricular fibrillation
sinus arrest
accelerated idioventricular rhythm (Correct answer)
atrial fibrillation

Correct answer: accelerated idioventricular rhythm

Accelerated idioventricular rhythm (AIVR) is characterized by a ventricular rate between 40-100 bpm, wide QRS complexes, and no consistent relationship between P waves and QRS complexes (or absent P waves). It often occurs in the setting of myocardial ischemia or reperfusion. The symptoms of weakness and malaise are consistent with a slower ventricular rhythm that may not adequately perfuse the body.

Question 2: This beat is called a .

atrial fibrillation (Correct answer)
normal sinus rhythm
atrial flutter
sinus bradycardia

Correct answer: atrial fibrillation

Atrial fibrillation is characterized by an irregularly irregular rhythm with no discernible P waves, replaced by chaotic fibrillatory waves. The ventricular response is typically rapid and irregular. This chaotic electrical activity in the atria prevents effective atrial contraction and leads to an erratic ventricular rhythm.

Question 3: A patient is visiting her cardiologist for a routine examination. What does the monitor's rhythm look like?

sinus tachycardia
atrial flutter
third-degree AV heart block
first-degree AV heart block (Correct answer)

Correct answer: first-degree AV heart block

First-degree AV heart block is identified by a consistently prolonged PR interval (greater than 0.20 seconds) on the EKG. Every P wave is followed by a QRS complex, indicating that all atrial impulses are eventually conducted to the ventricles, but with a delay. This condition is often asymptomatic and discovered during routine examinations.

Question 4: What would you call this rhythm?

sinus tachycardia
junctional tachycardia (Correct answer)
normal sinus rhythm
sinus arrest (Correct answer)

Correct answer: junctional tachycardia

Junctional tachycardia is characterized by a narrow QRS complex tachycardia with a heart rate typically between 100-180 bpm. P waves may be absent, inverted, or retrograde (appearing after the QRS) due to the impulse originating from the AV junction. This rhythm indicates increased automaticity of the AV junction.

Question 5: When your patient complains of chest pain, the cardiac monitor is activated. What would you say about this rhythm?

first-degree AV heart block
premature ventricular complex
sinus bradycardia
premature atrial complex (Correct answer)

Correct answer: premature atrial complex

A premature atrial complex (PAC) is an early beat originating from an ectopic focus in the atria, before the next expected sinus beat. It is characterized by an early P wave that often has a different morphology than the sinus P waves, followed by a QRS complex. PACs are common and often benign, though they can sometimes cause palpitations or chest discomfort.

Question 6: Your patient reports experiencing vomiting, nausea, and chest pain. You notice this rhythm after putting him on the monitor. What would you describe this rhythm as being?

idioventricular rhythm
premature atrial complex
premature ventricular complex bigeminy (Correct answer)
third-degree heart block

Correct answer: premature ventricular complex bigeminy

Premature ventricular complex (PVC) bigeminy occurs when every second beat is a PVC. A PVC is a wide, bizarre QRS complex that is not preceded by a P wave and occurs prematurely. In bigeminy, a normal beat is followed by a PVC, then another normal beat, then another PVC, creating a distinct alternating pattern.

Question 7: You observe this rhythm after placing your patient on the cardiac monitor. What kind of rhythm would you describe?

second-degree AV heart block type 1 (Correct answer)
normal sinus rhythm
second-degree AV heart block type II
sinus bradycardia

Correct answer: second-degree AV heart block type 1

Second-degree AV heart block type 1, also known as Wenckebach phenomenon, is characterized by a progressive lengthening of the PR interval until a P wave is completely blocked and not followed by a QRS complex. After the dropped beat, the cycle repeats. This pattern distinguishes it from other AV blocks.

Question 8: This beat is known as .

atrial flutter
normal sinus rhythm
sinus bradycardia (Correct answer)
sinus tachycardia

Correct answer: sinus bradycardia

Sinus bradycardia is a normal sinus rhythm with a heart rate below 60 beats per minute (bpm). The EKG shows regular P waves followed by QRS complexes, indicating that the impulse originates from the sinoatrial (SA) node, but the SA node is firing at a slower rate than normal. It can be physiological in athletes or pathological.

Question 9: A patient of yours is complaining of weariness, dizziness, and chest pain. What is the beat of their hearts?

third-degree AV heart block (Correct answer)
asystole
first-degree AV heart block
junctional escape rhythm

Correct answer: third-degree AV heart block

Third-degree AV heart block, or complete heart block, is characterized by a complete dissociation between atrial and ventricular activity. P waves occur regularly but independently of the QRS complexes, which also occur regularly but at a much slower rate, originating from an escape pacemaker in the AV junction or ventricles. This lack of coordination leads to symptoms like weariness, dizziness, and chest pain due to poor cardiac output.

Question 10: This tracing is an illustration of

Atrial flutter
Accelerated idioventricular
Junctional rhythm
Sinus rhythm with first-degree AVB (Correct answer)

Correct answer: Sinus rhythm with first-degree AVB

Sinus rhythm with first-degree AVB means that the heart's electrical activity originates normally from the sinus node (indicated by regular P waves followed by QRS complexes). However, there is a consistent delay in conduction through the AV node, resulting in a prolonged PR interval (greater than 0.20 seconds) for every beat. All atrial impulses are conducted, just slowly.

Question 11: This tracing is an illustration of

Mobitz II second-degree AVB (Correct answer)
Sinus arrest
Sinus pause
Mobitz I second-degree AVB

Correct answer: Mobitz II second-degree AVB

Mobitz II second-degree AVB is characterized by a constant PR interval for the conducted beats, but with intermittent, sudden drops of QRS complexes without prior PR lengthening. This means some P waves are not followed by a QRS, indicating a block below the AV node, often in the Bundle of His or bundle branches. It is considered more serious than Mobitz I due to its potential to progress to complete heart block.

Question 12: This tracing is an illustration of

Antidromic AVRT
Ventricular tachycardia
Accelerated junctional
Junctional tachycardia (Correct answer)

Correct answer: Junctional tachycardia

Junctional tachycardia is a rapid heart rhythm originating from the AV junction, typically with a rate between 100-180 bpm. On an EKG, it presents with narrow QRS complexes and often absent, inverted, or retrograde P waves (P waves appearing after the QRS or hidden within it). This occurs due to enhanced automaticity of the AV junction.

Question 13: The principal blood vessel responsible for carrying blood from the head and upper extremities to the heart is the:

Pulmonary artery
Inferior vena cava
Aorta
Superior vena cava (Correct answer)

Correct answer: Superior vena cava

The superior vena cava (SVC) is the large vein that collects deoxygenated blood from the head, neck, upper limbs, and chest. It then empties this blood into the right atrium of the heart. The inferior vena cava collects blood from the lower body, while the pulmonary artery carries deoxygenated blood from the heart to the lungs, and the aorta carries oxygenated blood from the heart to the body.

Question 14: Typically, the rate of paroxysmal tachycardia is:

250-350 bpm
150-300 bpm
150-250 bpm (Correct answer)
150-250 bpm 350+ bpm

Correct answer: 150-250 bpm

Paroxysmal tachycardia refers to a sudden onset and termination of a rapid heart rhythm. While the specific rate can vary depending on the type (e.g., SVT, VT), a general range for many forms of paroxysmal tachycardia is typically between 150-250 bpm. This rapid rate is often associated with symptoms like palpitations, dizziness, or chest pain.

Question 15: The heart pumps the following amount of blood into the aorta each minute:

Ejection fraction
Cardiac output (Correct answer)
Venous volume
Stroke volume

Correct answer: Cardiac output

Cardiac output is the volume of blood pumped by the heart into the aorta each minute. It is calculated by multiplying the heart rate (beats per minute) by the stroke volume (the amount of blood pumped out with each beat). This measurement is a key indicator of the heart's efficiency in delivering blood to the body's tissues.

Question 16: A continuously long PR interval defines this rhythm.

1st degree (Correct answer)
1st degree
2nd Degree type 2
2nd Degree type 1

Correct answer: 1st degree

A continuously long PR interval defines a first-degree AV block. In this condition, every atrial impulse is conducted to the ventricles, but the time it takes for the impulse to travel from the atria through the AV node to the ventricles is consistently prolonged beyond the normal 0.20 seconds. This is usually a benign condition.

Free EKG Certification Question and Answers

Following complaints of weakness and overall malaise, a patient is put on the heart monitor.
What kind of rhythm is this?