Advent Health EKG Exam Questions and Answers |
Newest Update 2026/2027 | Graded A+ | Assured Pass.
.
Afib
The .impulse .originates .in .the .Atria
• .The .Atrial .rate .is .> .300 .and .unable .to .measure .[N/A]
• .No .discernable .P .waves .- .PRI .& .Atrial .rhythm .cannot .be
.
measured .[N/A]
• .The .Ventricular .rhythm .is .irregular
• .QRS .within .normal .limits
• .If .the .Ventricular .rate .is .<100 .the .rhythm .is .controlled .A-fib; if .the
.
Ventricular .rate .is .> .100 .the .rhythm .is .uncontrolled .A-fib
• .This .is .a .chronic .rhythm .for .some .patients
Treatment: .controlled .patients: .anticoagulants .and .antiarrythmics;
.
uncontrolled .but .stable .patients: .Beta .blockers, .calcium .channel
.
blockers, .or .digoxin; .Unstable .patients: .cardioversion
Junctional .Rhythm
Impulse .starts .in .the .AV .junction
• .P .waves .are .absent, .short, .inverted .or .retrograde
• .Ventricular .Rhythm: .Regular
• .Ventricular .Rate: .40-60 .bpm
• .QRS .is .usually .within .normal .limits
,Idioventricular .Rhythm .(IVR)
Impulse .originates .in .the .ventricles ▪
.
Rhythm: .Ventricular .is .usually .regular
▪ .Rate: .Ventricular .between .20-40
▪ .QRS: .≥ .0.12
▪ .Atrial .rate, .rhythm, .and .PRI: .N/A
- .Treatment: .assess .pt, .check .for .DNR .in .chart, .transcutaneous
.
pacing, .atropine. .NEVER .GIVE .ANTI-ARRYTHMICS
.
MEDICATIONS
Accelerated .Idioventricular .Rhythm
Follows .the .same .criteria .as .IVR, .except .Ventricular .rate .is .40100.
• .If .no .intervention .happens, .the .patient .will .deteriorate.
- .Treatment: .assess .pt, .atropine, .transcutaneous .pacing. .NEVER
.
GIVE .ANTI-ARRHYTHMIC .MEDICATIONS
Ventricular .Pacing
• .The .pacemaker .lead .is .placed .in .to .right .ventricle.
• .The .pacemaker .generator .fires .an .impulse .Initiating .ventricular
.
activity.
• .The .right .ventricle .will .contract .first .followed .by .the .left .ventricle.
.
This .results .in .a .wide .QRS
• .Atrial .activity .is .typically .absent. .Therefore, .Atrial .rhythm, .rate,
, .
and .PRI .are .non- .measurable
• .Rhythm: .Ventricular .regular
• .Rate: .Ventricular .within .set .pacer .limits. .Measured .from .pacer
.
spike .to .pacer .spike
• .QRS: .Wide; .Pacer .spike .seen .before .each .QRS. .Measured .from
.
pacer .spike .to .end of .QRS
Failure .to .capture
A .pacer .spike .note .followed .by .the .appropriate .atrial .or .ventricular
.
response
• .Can .be .a .potentially .lethal .situation!
Failure .to .pace
Absence .of .pacer .activity .(spikes) .when .the .pacemaker .generator
.
should .have .fired .an .impulse.
• .Typically .seen .when .the .patient's .intrinsic .heart .rate .falls .less
.
than .the .pacemaker's .low .HR .limit .and the .pacer .fails .to .fire.
normal .sinus .rhythm .(NSR)
Impulse .starts .in .the .SA .Node
• .Rate: .Atrial .& .Ventricular .60-100 .[WNL]
• .Rhythm: .Atrial .and .Ventricular .are .regular
• .P .waves: .Normal; .each .followed .by .QRS
• .PRI: .0.12 .- .0.20 .[WNL]
Newest Update 2026/2027 | Graded A+ | Assured Pass.
.
Afib
The .impulse .originates .in .the .Atria
• .The .Atrial .rate .is .> .300 .and .unable .to .measure .[N/A]
• .No .discernable .P .waves .- .PRI .& .Atrial .rhythm .cannot .be
.
measured .[N/A]
• .The .Ventricular .rhythm .is .irregular
• .QRS .within .normal .limits
• .If .the .Ventricular .rate .is .<100 .the .rhythm .is .controlled .A-fib; if .the
.
Ventricular .rate .is .> .100 .the .rhythm .is .uncontrolled .A-fib
• .This .is .a .chronic .rhythm .for .some .patients
Treatment: .controlled .patients: .anticoagulants .and .antiarrythmics;
.
uncontrolled .but .stable .patients: .Beta .blockers, .calcium .channel
.
blockers, .or .digoxin; .Unstable .patients: .cardioversion
Junctional .Rhythm
Impulse .starts .in .the .AV .junction
• .P .waves .are .absent, .short, .inverted .or .retrograde
• .Ventricular .Rhythm: .Regular
• .Ventricular .Rate: .40-60 .bpm
• .QRS .is .usually .within .normal .limits
,Idioventricular .Rhythm .(IVR)
Impulse .originates .in .the .ventricles ▪
.
Rhythm: .Ventricular .is .usually .regular
▪ .Rate: .Ventricular .between .20-40
▪ .QRS: .≥ .0.12
▪ .Atrial .rate, .rhythm, .and .PRI: .N/A
- .Treatment: .assess .pt, .check .for .DNR .in .chart, .transcutaneous
.
pacing, .atropine. .NEVER .GIVE .ANTI-ARRYTHMICS
.
MEDICATIONS
Accelerated .Idioventricular .Rhythm
Follows .the .same .criteria .as .IVR, .except .Ventricular .rate .is .40100.
• .If .no .intervention .happens, .the .patient .will .deteriorate.
- .Treatment: .assess .pt, .atropine, .transcutaneous .pacing. .NEVER
.
GIVE .ANTI-ARRHYTHMIC .MEDICATIONS
Ventricular .Pacing
• .The .pacemaker .lead .is .placed .in .to .right .ventricle.
• .The .pacemaker .generator .fires .an .impulse .Initiating .ventricular
.
activity.
• .The .right .ventricle .will .contract .first .followed .by .the .left .ventricle.
.
This .results .in .a .wide .QRS
• .Atrial .activity .is .typically .absent. .Therefore, .Atrial .rhythm, .rate,
, .
and .PRI .are .non- .measurable
• .Rhythm: .Ventricular .regular
• .Rate: .Ventricular .within .set .pacer .limits. .Measured .from .pacer
.
spike .to .pacer .spike
• .QRS: .Wide; .Pacer .spike .seen .before .each .QRS. .Measured .from
.
pacer .spike .to .end of .QRS
Failure .to .capture
A .pacer .spike .note .followed .by .the .appropriate .atrial .or .ventricular
.
response
• .Can .be .a .potentially .lethal .situation!
Failure .to .pace
Absence .of .pacer .activity .(spikes) .when .the .pacemaker .generator
.
should .have .fired .an .impulse.
• .Typically .seen .when .the .patient's .intrinsic .heart .rate .falls .less
.
than .the .pacemaker's .low .HR .limit .and the .pacer .fails .to .fire.
normal .sinus .rhythm .(NSR)
Impulse .starts .in .the .SA .Node
• .Rate: .Atrial .& .Ventricular .60-100 .[WNL]
• .Rhythm: .Atrial .and .Ventricular .are .regular
• .P .waves: .Normal; .each .followed .by .QRS
• .PRI: .0.12 .- .0.20 .[WNL]
