Test Bank for EKG Plain and Simple, 4th Edition

EKG Plain and Simple, 4e (Ellis) Chapter 2 Electrophysiology 2.1 Multiple Choice Questions 1) What electrical event must occur for atrial contraction to occur? A) Atrial depolarization B) Ventricular depolarization C) Atrial repolarization D) Ventricular repolarization Answer: A LO: 2.1: Define the terms polarized, depolarization, and repolarization and relate them to contraction and relaxation. 2) The cardiac cell at rest has what kind of electrical charge? A) Positive charge B) Negative charge C) Neutral charge D) No charge at all Answer: B LO: 2.1: Define the terms polarized, depolarization, and repolarization and relate them to contraction and relaxation. 3) The term repolarization refers to the A) heart’s mechanical activity. B) brain’s electrical activity. C) heart’s electrical activity. D) heart’s electrical and mechanical activity. Answer: C LO: 2.1: Define the terms polarized, depolarization, and repolarization and relate them to contraction and relaxation. 4) Depolarization is a(n) A) electrical event that should result in muscle relaxation. B) mechanical event that should result in depolarization. C) electrical event that should result in muscle contraction. D) mechanical event that should result in repolarization. Answer: C LO: 2.1: Define the terms polarized, depolarization, and repolarization and relate them to contraction and relaxation. 1 Copyright © 2017 Pearson Education, Inc. 5) Which of the following is NOT true? A) Cardiac cells can contract without having been depolarized. B) Cardiac cells must be depolarized before they can contract. C) Cardiac contraction occurs as a result of phase 0 of the action potential. D) Cardiac contraction requires the presence of calcium ions. Answer: A LO: 2.1: Define the terms polarized, depolarization, and repolarization and relate them to contraction and relaxation. 6) Which of the following ions has a direct effect on ventricular muscle contraction? A) Sodium B) Potassium C) Magnesium D) Calcium Answer: D LO: 2.1: Define the terms polarized, depolarization, and repolarization and relate them to contraction and relaxation. 7) In the action potential, phase 0 is A) depolarization. B) plateau. C) rapid repolarization. D) rest. Answer: A LO: 2.2: Describe and label the phases of the action potential. 8) In the action potential, phase 3 is A) depolarization. B) rapid repolarization. C) plateau. D) rest. Answer: B LO: 2.2: Describe and label the phases of the action potential. 9) Phase 0 of the action potential corresponds with what wave or complex on the EKG? A) T wave B) QRS complex C) U wave D) ST segment Answer: B LO: 2.2: Describe and label the phases of the action potential. 2.4: Draw and explain the P wave, QRS complex, T wave, and U wave. 2 Copyright © 2017 Pearson Education, Inc. 10) +20 mV is the A) resting transmembrane potential. B) transmembrane potential at the conclusion of phase 3 of the action potential. C) transmembrane potential at the conclusion of phase 0 of the action potential. D) transmembrane potential at the beginning of cardiac rest. Answer: C LO: 2.2: Describe and label the phases of the action potential. 2.3: Define transmembrane potential. 11) Which of the following correctly describes the relative refractory period? A) It is the period in which even a weak impulse can cause another depolarization. B) It is the period in which only a strong impulse can cause another depolarization. C) It is the period in which no impulses at all can cause another depolarization. D) It is the period in which the heart function stops temporarily to allow impulse transmission to occur. Answer: B LO: 2.6: Define the absolute and relative refractory periods and the implications of each. 12) The relative refractory period extends from the A) beginning of the T wave to the beginning of the next QRS complex. B) beginning of the P wave to the beginning of the QRS complex. C) beginning of the QRS complex to the upstroke of the T wave. D) upstroke of the T wave to the end of the T wave. Answer: D LO: 2.6: Define the absolute and relative refractory periods and the implications of each. 13) The P wave represents A) atrial depolarization. B) atrial repolarization. C) ventricular depolarization. D) ventricular repolarization. Answer: A LO: 2.4: Draw and explain the P wave, QRS complex, T wave, and U wave. 14) The QRS complex represents A) atrial depolarization. B) atrial repolarization. C) ventricular depolarization. D) ventricular repolarization. Answer: C LO: 2.4: Draw and explain the P wave, QRS complex, T wave, and U wave. 3 Copyright © 2017 Pearson Education, Inc. 15) The T wave represents A) atrial depolarization. B) atrial repolarization. C) ventricular depolarization. D) ventricular repolarization. Answer: D LO: 2.4: Draw and explain the P wave, QRS complex, T wave, and U wave. 16) The PR segment is located between the A) P wave and the QRS complex. B) QRS complex and the T wave. C) T wave and the next P wave. D) P wave and the T wave. Answer: A LO: 2.5: Explain where the PR and ST segments are located. 17) The ST segment is located between the A) P wave and the QRS complex. B) QRS complex and the T wave. C) T wave and the next P wave. D) P wave and the T wave. Answer: B LO: 2.5: Explain where the PR and ST segments are located. 18) The normal ST segment is A) at the isoelectric line. B) elevated above the isoelectric line. C) depressed below the isoelectric line. D) both above and below the isoelectric line. Answer: A LO: 2.5: Explain where the PR and ST segments are located. 19) The baseline on the EKG strip is considered to be the A) PT segment. B) PR segment. C) TP segment. D) QT segment. Answer: C LO: 2.5: Explain where the PR and ST segments are located. 20) The wave or complex that represents ventricular repolarization is the A) P wave. B) QRS complex. C) T wave. D) U wave. Answer: C LO: 2.4: Draw and explain the P wave, QRS complex, T wave, and U wave. 4 Copyright © 2017 Pearson Education, Inc. 21) An upward deflection of the QRS complex is called a(n) A) P wave. B) Q wave. C) R wave. D) T wave. Answer: C LO: 2.4: Draw and explain the P wave, QRS complex, T wave, and U wave. 22) Which of these statements about the sinus node is FALSE? A) It is the normal pacemaker of the heart. B) It has the fastest inherent rate of all the possible pacemaker sites. C) It is the slowest pacemaker of the heart. D) It fires at an inherent rate of 60—100 beats per minute. Answer: C LO: 2.12: List the different pacemakers of the heart and their inherent rates. 23) The job of the cardiac conduction system’s pacemaker is to A) propagate electrical impulses. B) conduct electrical impulses. C) cause depolarization of myocardial cells. D) all of the above. Answer: A LO: 2.11: Define pacemaker. 24) The normal pacemaker of the heart is the A) sinus node. B) AV node. C) Purkinje fibers. D) coronary sinus. Answer: A LO: 2.12: List the different pacemakers of the heart and their inherent rates. 25) The normal inherent rate of the sinus node as a pacemaker is A) 20—40 beats per minute. B) 40—60 beats per minute. C) 60—80 beats per minute. D) 60—100 beats per minute. Answer: D LO: 2.12: List the different pacemakers of the heart and their inherent rates. 5 Copyright © 2017 Pearson Education, Inc. 26) The ventricle’s inherent rate is A) 20—40 beats per minute. B) 40—60 beats per minute. C) 60—80 beats per minute. D) 60—100 beats per minute. Answer: A LO: 2.12: List the different pacemakers of the heart and their inherent rates. 27) After the sinus node initiates an impulse, where does the impulse go next? A) Interatrial tracts B) Purkinje fibers C) Ventricular tissue D) Bundle branches Answer: A LO: 2.13: Track the cardiac impulse from the sinus node through the conduction system. 28) Which of the following characteristics of heart cells is mechanical? A) Automaticity B) Contractility C) Excitability D) Conductivity Answer: B LO: 2.14: Define the four characteristics of cardiac cells. 29) Contractility is the ability of a cardiac cell to A) initiate an impulse without outside stimulus. B) pass an impulse along to neighboring cells. C) respond to a stimulus by depolarizing. D) contract. Answer: D LO: 2.14: Define the four characteristics of cardiac cells. 30) What is TRUE about the following intervals: PR 0.14, QRS 0.08? A) The QRS interval is prolonged. B) PR interval is shortened. C) PR interval is prolonged. D) Intervals are normal. Answer: D LO: 2.9: On a rhythm strip, determine if the PR, QRS, and QT intervals are normal or abnormal. 31) On a rhythm strip, the P wave is normally A) spiked. B) small. C) inverted. D) last. Answer: B LO: 2.7: Be able to label, on a rhythm strip, all the waves and complexes. 6 Copyright © 2017 Pearson Education, Inc. 32) On EKG paper, one big block represents A) 0.04 sec. B) 0.10 sec. C) 0.20 sec. D) 1 sec. Answer: C LO: 2.8: Explain the delineations of EKG paper. 33) The PR interval would be considered abnormal if it measured ________ small blocks on the EKG paper. A) 3 B) 4 C) 5 D) 6 Answer: D LO: 2.9: On a rhythm strip, determine if the PR, QRS, and QT intervals are normal or abnormal. 34) A QRS complex with one positive deflection followed by one negative deflection would be labeled A) RS. B) QS. C) QR. D) RR’. Answer: A LO: 2.10: Name the waves in a variety of QRS complexes. 35) A QRS complex that has both an R and an R’ wave will have A) one positive deflection. B) two positive deflections. C) one negative deflection. D) two negative deflections. Answer: B LO: 2.10: Name the waves in a variety of QRS complexes. 36) The area of the conduction system that initiates the impulse is called the A) internodal tract. B) pacemaker. C) bundle of His. D) lead. Answer: B LO: 2.11: Define pacemaker. 7 Copyright © 2017 Pearson Education, Inc. 37) The pacemaker is the ________ of the conduction system of the heart. A) beginning B) pump C) highway D) end Answer: A LO: 2.11: Define pacemaker. 38) The electrical impulse travels through the ________ to get from the atrium to the AV node. A) interatrial tracts B) bundle of His C) Purkinje fibers D) internodal tracts Answer: D LO: 2.13: Track the cardiac impulse from the sinus node through the conduction system. 39) A beat that appears on the rhythm strip after a long pause and causes a slower rhythm than the normal rhythm is called a(n) A) usurpation beat. B) irritable beat. C) escape beat. D) pacemaker beat. Answer: C LO: 2.15: Describe the difference between escape and usurpation. 40) If a pacemaker becomes irritable and fires at a faster than normal rate, ________ will occur. A) escape B) usurpation C) cardiac block D) refraction Answer: B LO: 2.15: Describe the difference between escape and usurpation. 41) If a heart rhythm is slower than normal, it is called a(n) A) arrhythmia. B) plateau. C) complex. D) deflection. Answer: A LO: 2.16: Define arrhythmia. 8 Copyright © 2017 Pearson Education, Inc. 42) If the sinus node and atria both fail, the ________ will be absent on the rhythm strip. A) P wave B) QRS complex C) R wave D) T wave Answer: A LO: 2.17: Tell what happens: When the sinus node fails, when the sinus node and atria both fail, and when the sinus node, atria, and AV node all fail. 43) If the sinus node, atria, and AV node all fail, the heart rate will be between A) 40 to 60 beats per minute. B) 20 to 40 beats per minute. C) 10 to 20 beats per minute. D) 60 to 100 beats per minute. Answer: B LO: 2.17: Tell what happens: When the sinus node fails, when the sinus node and atria both fail, and when the sinus node, atria, and AV node all fail. 44) The EKG is a recording of the A) heart’s mechanical activity. B) brain’s electrical activity. C) heart’s electrical activity. D) heart’s electrical and mechanical activity. Answer: C 45) The job of the cardiac conduction system is to A) propagate electrical impulses. B) conduct electrical impulses. C) cause depolarization of myocardial cells. D) all of the above. Answer: D 46) The PR interval measures the time it takes for the impulse to travel from the A) AV node to the bundle branches. B) bundle of His to the ventricular myocardium. C) sinus node to the internodal tracts. D) atria to the ventricle. Answer: D 2.2 True/False Questions 1) The polarized cardiac cell is electrically negative. Answer: TRUE LO: 2.1: Define the terms polarized, depolarization, and repolarization and relate them to contraction and relaxation. 9 Copyright © 2017 Pearson Education, Inc. 2) The cardiac cell, at rest, has a transmembrane potential of +20 mV. Answer: FALSE LO: 2.3: Define transmembrane potential. 3) During the absolute refractory period, only a strong stimulus can result in depolarization. Answer: FALSE LO: 2.6: Define the absolute and relative refractory periods and the implications of each. 4) Cardiac cell stimulus during the absolute refractory period often results in very fast, dangerous rhythms. Answer: FALSE LO: 2.6: Define the absolute and relative refractory periods and the implications of each. 5) The P wave represents atrial depolarization. Answer: TRUE LO: 2.4: Draw and explain the P wave, QRS complex, T wave, and U wave. 6) The PR segment is a flat line located between the QRS complex and the T wave. Answer: FALSE LO: 2.5: Explain where the PR and ST segments are located. 7) The ST segment is a flat line from which the waves and complexes take off. Answer: FALSE LO: 2.5: Explain where the PR and ST segments are located. 8) The normal pacemaker of the heart is the AV node. Answer: FALSE LO: 2.12: List the different pacemakers of the heart and their inherent rates. 9) The normal rate of the sinus node is 60—100 beats per minute. Answer: TRUE LO: 2.12: List the different pacemakers of the heart and their inherent rates. 10) If the PR interval is 0.10 secs, the time it takes for the impulse to travel from the atrium down to the ventricle is abnormal. Answer: FALSE LO: 2.9: On a rhythm strip, determine if the PR, QRS, and QT intervals are normal or abnormal. 11) The baseline is a flat line from which the waves and complexes take off. Answer: TRUE 12) The PR interval measures the time it takes for the impulse to travel from the atrium down to the ventricle. Answer: TRUE 10 Copyright © 2017 Pearson Education, Inc. 2.3 Short Answer Questions 1) Atrial depolarization is represented on the EKG as a ________. Answer: P wave LO: 2.4: Draw and explain the P wave, QRS complex, T wave, and U wave. 2) Depolarization is the changing of the cardiac cell to an electrically ________ charge. Answer: positive LO: 2.1: Define the terms polarized, depolarization, and repolarization and relate them to contraction and relaxation. 3) Transmembrane potential is the electrical charge at the ________. Answer: cell membrane LO: 2.3: Define transmembrane potential. 4) Refractory means ________ to. Answer: Resistant LO: 2.6: Define the absolute and relative refractory periods and the implications of each. 5) One small block on the EKG paper measures ________ seconds. Answer: 0.04 LO: 2.8: Explain the delineations of EKG paper. 6) Normal QRS interval is ________ seconds or less than three small blocks. Answer: <0.12 LO: 2.4: Draw and explain the P wave, QRS complex, T wave, and U wave. 2.9: On a rhythm strip, determine if the PR, QRS, and QT intervals are normal or abnormal. 7) A negative deflection that occurs before a positive one is labeled a ________ wave. Answer: Q LO: 2.4: Draw and explain the P wave, QRS complex, T wave, and U wave. 2.7: Be able to label, on a rhythm strip, all the waves and complexes. 8) Normal conduction begins with the pacemaker of the heart, the ________. Answer: Sinus node LO: 2.12: List the different pacemakers of the heart and their inherent rates. 9) The pacemaker with the slowest inherent rate is the ________. Answer: Ventricle LO: 2.12: List the different pacemakers of the heart and their inherent rates. 10) Arrhythmias are ________ heart rhythms. Answer: Abnormal LO: 2.16: Define arrhythmia. 11 Copyright © 2017 Pearson Education, Inc.