Rhythm Interpretation & Patient Care Flashcards

A junctional escape rhythm typically has a rate of:

Answer: 40–60 bpm

The AV junction acts as a secondary pacemaker with an intrinsic rate of 40–60 bpm when the SA node fails to fire.

ST-segment depression in leads V4–V6 and I, aVL during an ECG most likely indicates:

Answer: Lateral wall ischemia

ST depression in lateral leads (V4–V6, I, aVL) suggests ischemia in the lateral wall territory supplied by the circumflex artery.

What does a delta wave on an ECG indicate?

Answer: Pre-excitation via an accessory pathway (Wolff-Parkinson-White syndrome)

A delta wave is a slurred upstroke at the beginning of the QRS caused by early ventricular activation through an accessory pathway, as in WPW syndrome.

Which patient position is standard when recording a resting 12-lead ECG?

Answer: Supine with arms at sides

The standard position for a resting 12-lead ECG is supine with the patient's arms at their sides to minimize artifact and standardize lead vectors.

Diffuse ST-segment elevation in nearly all leads with reciprocal PR-segment depression is most characteristic of:

Answer: Acute pericarditis

Acute pericarditis classically produces diffuse (saddle-shaped) ST elevation in most leads with PR-segment depression, distinguishing it from the focal ST elevation of STEMI.

A patient's rhythm strip shows a regular rhythm at 38 bpm with wide QRS complexes (>0.12 sec) and no visible P waves. This rhythm is best described as:

Answer: Idioventricular (ventricular escape) rhythm

An idioventricular escape rhythm originates in the ventricles, producing wide QRS complexes at a rate of 20–40 bpm when higher pacemakers fail.

Right bundle branch block (RBBB) on an ECG is characterized by:

Answer: Wide QRS with RSR' (rabbit ear) pattern in V1 and deep, slurred S wave in V6

RBBB produces a QRS ≥0.12 sec with a classic RSR' (M-shaped) pattern in V1 and a wide, slurred S wave in lateral leads (I, V5, V6).