EKG Rhythm Strip Quiz 40

Identify the following rhythms.

1.

a.  Normal sinus rhythm with 1st degree AV block
b. Atrial fibrillation with rapid ventricular response

c.  Accelerated junctional rhythm

d.  Idioventricular rhythm

2.

a. Normal sinus rhythm with 1st degree block

b.  Sinus bradycardia

c.  Atrial flutter 

d.  2nd degree heart block type II with a 3:1 block

3.

a.  3rd degree heart block

b.  Atrial flutter with slow ventricular response

c.  Atrial fibrillation

d.  2nd degree heart block type II

4.

a. Sinus bradycardia with atrial ectopy

b. Normal sinus rhythm with an unifocal PVCs

c.  Sinus tachycardia with frequent multifocal PACs

d.  Sinus rhythm with premature junctional contractions

5.

a. Normal sinus rhythm
b.  Sinus bradycardia

c.  Sinus tachycardia

d.  1st degree AV block

6.

a.  Normal sinus rhythm
b. Sinus bradycardia

c.  Sinus tachycardia

d.  1st degree AV block

7.

a.  Normal sinus rhythm with sinus pauses
b. Sinus arrhythmia

c.  Atrial fibrillation

d.  Junctional rhythm

8.

a.  Normal sinus rhythm

b.  Sinus arrhythmia

c.  Atrial fibrillation

d.  Junctional rhythm with retrograde P waves

9.

a.  Atrial paced

b.  Ventricular paced

c.  AV pacing

d.  Biventricular pacing 

10.

a.  Polymorphic ventricular tachycardia

b.  Idioventricular rhythm

c.  Ventricular fibrillation

d.  Atrial fibrillation 

Answers

1.

c. Accelerated junctional rhythm. The P waves are absent. The rate is 83 bpm. A junctional rhythm with a rate between 60-100 bpm is called an accelerated junctional rhythm.

2.

c. Atrial flutter. There is a 3:1 ratio of flutter waves to QRS complexes. The rhythm is fairly regular.

3.

a. 3rd degree heart block. The ventricles and the atria are beating asynchronously so there is not a 1:1 relationship between the P waves and QRS complexes.

4.

b. Normal sinus rhythm with an unifocal PVCs.  A compensatory pause follows each PVC.

5.

b. Sinus bradycardia

6.

d.  1st degree AV block.  The PR interval is .28 sec.  

7.

c. Atrial fibrillation.   The low voltage in this lead may make it difficult to interpret this rhythm.  The absence of P waves and the irregular rhythm all point to an atrial fibrillation.

8.

a. Normal sinus rhythm

9.

b. Ventricular paced. A ventricular pacer spike is present before each QRS complex.

10.

c. Ventricular fibrillation. The rhythm is completely irregular and there are no organized complexes present.


Reviewed 6/4/13