Exam Prep Atrial Dysrhythmias Ch6

Electrocardiography for Healthcare Professionals, 5e (Booth)

Chapter 6 Atrial Dysrhythmias

1) What medical conditions place pressure on the atria, causing atrial dysrhythmias to occur?

A) Renal conditions, hypertension, thrombus

B) Myocardial infarction, valvular problems, neurological influences

C) Cerebrovascular accident, pulmonary embolism, neurological influences

D) Valvular problems, palpitations, angina

2) What kind of impulse causes atrial dysrhythmias?

A) Extrinsic

B) Augmented

C) Ectopic

D) Inferior

3) In a premature atrial complex (PAC), the P wave may be biphasic. This means that:

A) the waveform has both positive and negative deflections on the ECG tracing.

B) the P wave is hidden within the T wave.

C) every third complex is a premature beat.

D) a changing P wave configuration with at least three variations in one lead.

4) A pattern in which every third complex is a premature beat is referred to as:

A) bigeminy.

B) quadgeminy.

C) trigeminy.

D) triphasic.

5) Which atrial dysrhythmia has a cardiac complex that occurs too soon and may have abnormal P waves, but other than being ''early,'' has no other abnormal features?

A) Atrial flutter

B) Atrial fibrillation

C) Wandering atrial pacemaker (WAP)

D) Premature atrial complexes (PAC)

6) A cardiac cell or group of cells that produces an ectopic beat is known as a:

A) focus.

B) fusion.

C) flutter.

D) fascicle.

7) How many different P wave configurations in the same lead indicate a wandering atrial pacemaker (WAP)?

A) Two

B) Three

C) Four

D) None

8) WAP is a normal finding in children, older adults, and well-conditioned athletes. It may also be found in patients with:

A) congestive heart failure and hypertension.

B) cardiovascular disease and metabolic disorder.

C) neurological disorders and renal insufficiency.

D) organic heart disease and drug toxicity.

9) Identify the following rhythm:

A) Premature atrial complexes

B) Wandering atrial pacemaker

C) Multifocal atrial tachycardia

D) Atrial flutter

10) Multifocal atrial tachycardia (MAT) is sometimes confused with which of the following dysrhythmias?

A) Atrial fibrillation

B) Atrial flutter

C) Wandering atrial pacemaker (WAP)

D) Premature atrial complexes

11) What is the rate of wandering atrial pacemaker rhythm (WAP)?

A) 60 to 100 beats per minute

B) 100 to 150 beats per minute

C) 40 to 60 beats per minute

D) Greater than 150 beats per minute

12) Which statement correctly describes the P wave in multifocal atrial tachycardia?

A) It always has the same configuration and shape.

B) It has different configurations in the same lead.

C) It is positively deflected.

D) It changes from beat to beat.

13) What is the rate of multifocal atrial tachycardia (MAT)?

A) 60 to 100 beats per minute

B) 101 to 150 beats per minute

C) 150 to 300 beats per minute

D) Greater than 300 beats per minute

14) Multifocal atrial tachycardia (MAT) is usually triggered by congestive heart failure (CHF), acute mitral valve regurgitation, or an acute attack of:

A) indigestion.

B) coughing.

C) emphysema.

D) gout.

15) Identify the following rhythm:

A) Wandering atrial pacemaker (WAP)

B) Atrial flutter

C) Atrial fibrillation

D) Multifocal atrial tachycardia (MAT)

16) Which atrial dysrhythmia has capital F waves and a classic sawtooth or picket fence appearance?

A) Multifocal atrial tachycardia

B) Wandering atrial pacemaker

C) Atrial flutter

D) Atrial fibrillation

17) What is the atrial rate in atrial flutter?

A) 100 to 150 beats per minute

B) 250 to 350 beats per minute

C) 150 to 250 beats per minute

D) 60 to 100 beats per minute

18) What term describes the ability of the heart to initiate an electrical impulse without being stimulated by another or independent source?

A) Automaticity

B) Atrial kick

C) Augmented

D) Asystole

19) Identify the following rhythm:

A) Atrial fibrillation

B) Atrial flutter

C) Wandering atrial pacemaker

D) Multifocal atrial tachycardia

20) What occurs immediately prior to ventricular systole when blood is ejected from the atria into the ventricles?

A) Automaticity

B) Conductivity

C) Contractility

D) Atrial kick

21) The loss of atrial kick contributes to what percent decrease in cardiac output?

A) 40% to 50%

B) 5% to 10%

C) 10% to 30%

D) 50% to 75%

22) Which rhythm occurs when the atria quiver like a bowl of Jell-O?

A) Atrial flutter

B) Multifocal atrial tachycardia

C) Atrial fibrillation

D) PACs

23) What atrial dysrhythmia has lowercase "f" waves, chaotic atrial electrical activity, and irregular R-R intervals?

A) Atrial flutter

B) Atrial fibrillation

C) Wandering atrial pacemaker

D) Multifocal atrial tachycardia

24) Identify the following rhythm:

A) Atrial fibrillation

B) Atrial flutter

C) Multifocal atrial tachycardia

D) Wandering atrial pacemaker

25) What is the major health risk for patients with atrial fibrillation?

A) Hypertension

B) Bundle branch block

C) Congestive heart failure

D) Thrombus formation or embolism

26) What treatment is usually attempted for patients with atrial fibrillation?

A) Exercise stress test

B) Angiogram

C) Medication and/or electrical cardioversion

D) Echocardiogram

27) A traveling blood clot in the lungs is known as:

A) apnea.

B) cerebrovascular accident.

C) ischemia.

D) pulmonary embolism.

28) A stroke caused by a hemorrhage in the brain, or more often by a clot lodged in a cerebral artery, is known as a:

A) cerebrovascular accident (CVA).

B) renal infarction.

C) myocardial infarction.

D) pulmonary embolism.

29) Which of these health issues is not a possible complication of having a thrombus form in the atria as a result of atrial fibrillation?

A) Cerebral vascular accident

B) Myocardial infarction

C) Renal infarction

D) Congestive heart failure

30) Patients with new onset of atrial fibrillation often complain of:

A) coughing and chest congestion.

B) dizziness and nausea.

C) fever and chills.

D) edema and joint pain.

31) What treatment is usually indicated for patients with atrial flutter?

A) Oxygen therapy

B) Physical therapy

C) Exercise stress test

D) Angiogram

32) How would frequent premature atrial complexes (PACs) affect a patient with coronary artery disease?

A) Hypertension

B) Angina

C) Low cardiac output

D) Ischemia

33) What symptom might a patient with frequent PACs complain of?

A) Chest pain

B) Hypertension

C) Palpitations

D) Syncope

34) Which atrial dysrhythmia results from a reentry pathway that is similar to finding a shortcut to work or school, bypassing the normal traffic route to get to the destination faster?

A) Atrial fibrillation

B) Atrial flutter

C) Multifocal atrial tachycardia

D) Wandering atrial pacemaker

35) Which of the following terms describes electrical impulses that originate in the atria and initiate an early impulse that interrupts the inherent regular rhythm?

A) Atrial kick

B) Automaticity

C) Ectopic impulse

D) Premature atrial complexes (PACs)

36) Which atrial dysrhythmia has a changing P wave configuration with at least three variations in one lead and may also have an irregular rhythm?

A) Wandering atrial pacemaker (WAP)

B) Atrial flutter

C) Premature atrial complexes (PACs)

D) Atrial fibrillation

37) Which atrial dysrhythmia has a clearly changing P wave and a heart rate of 101 to 150 beats per minute?

A) Wandering atrial pacemaker (WAP)

B) Atrial flutter

C) Atrial fibrillation

D) Multifocal atrial tachycardia (MAT)

38) Which rhythm is often a transient dysrhythmia that will lead to a more serious atrial dysrhythmia if not treated?

A) Atrial fibrillation

B) Atrial flutter

C) Wandering atrial pacemaker (WAP)

D) Multifocal atrial tachycardia (MAT)

39) Which atrial dysrhythmia occurs when electrical impulses come from areas of reentry pathways or multiple ectopic foci?

A) Atrial fibrillation

B) Atrial flutter

C) Premature atrial complexes (PACs)

D) Multifocal atrial tachycardia (MAT)

40) Patients who have atrial fibrillation may have a loss of stroke volume of between:

A) 10% and 20%.

B) 20% and 30%.

C) 30% and 40%.

D) 40% and 50%.

41) Which atrial dysrhythmia shows chaotic, disorganized activity between normal, but irregular, QRS complexes?

A) Premature atrial complexes

B) Multifocal atrial tachycardia

C) Atrial flutter

D) Atrial fibrillation

42) In which of the atrial dysrhythmias is the atrial rate impossible to determine?

A) Atrial flutter

B) Wandering atrial pacemaker

C) Atrial fibrillation

D) Multifocal atrial tachycardia

43) Some patients can tolerate the loss of atrial kick if the heart rate remains between:

A) 40 and 60 beats per minute.

B) 60 and 100 beats per minute.

C) 100 and 150 beats per minute.

D) 150 and 250 beats per minute.

44) In which atrial dysrhythmia does the pacemaker site shift between the SA node, other sites in the atria, and/or the AV junction?

A) Wandering atrial pacemaker

B) Multifocal atrial tachycardia

C) Premature atrial complexes

D) Atrial fibrillation

45) When labeling an ECG tracing that shows PACs, what additional information should you document on the tracing?

A) The patient's estimated cardiac output and the type of PACs

B) The type of PACs and the frequency of normal QRS complexes

C) The frequency of normal QRS complexes and the underlying rhythm

D) The underlying rhythm and the type of PACs

46) If ectopic impulses are occurring in the heart at a rate that is faster than the SA node,

A) the rate at which the SA node fires controls the ectopic rate.

B) the ectopic beat overrides the SA node and causes the atria and ventricles to depolarize.

C) the ectopic and SA node impulses cancel each other, resulting in atrial fibrillation.

D) the SA node impulses control the atria, and the ectopic impulses control the ventricles.

47) Which portion of the ECG tracing is primarily affected by atrial dysrhythmias?

A) P waves

B) QRS complexes

C) ST segment

D) T waves

48) What causes the different P wave morphologies in an ECG tracing that shows wandering atrial pacemaker?

A) The variable strength of the atrial contraction caused by each impulse

B) The rate at which the ectopic impulses are generated

C) The varying sites of the ectopic impulses

D) The morphology of the resulting QRS complexes

49) Which of the following statements describes the PR interval in a wandering atrial pacemaker rhythm?

A) It depends on the rate of the atrial impulses.

B) It varies with the site of the atrial pacemaker.

C) It remains constant and within normal limits.

D) It depends on the force of ventricular contraction.

50) You have performed an ECG on a 68-year-old man and you quickly identify the rhythm as atrial fibrillation. The patient's heart rate is 192 and he appears pale and unresponsive. You inform the physician immediately because you know that the first treatment goal for this patient is to:

A) perform CPR.

B) attempt cardioversion.

C) slow the heart rate.

D) restore consciousness.

51) You are about to perform an ECG on a patient who has been hospitalized for acute congestive heart failure. Which of the following atrial dysrhythmias is this patient most likely to develop?

A) Wandering atrial pacemaker

B) Atrial flutter

C) Atrial fibrillation

D) Multifocal atrial tachycardia

52) You are asked to perform an ECG on a 7-year-old child. The child is active and appears to be in good health. When you check the ECG tracing, you notice that it shows a wandering atrial pacemaker rhythm. What should you do?

A) Notify the physician immediately so treatment can be started.

B) Note the condition on the tracing and notify your supervisor.

C) Tell the child's parents that she may need medication.

D) Follow your facility's usual procedure for ECG reporting.