Deck 11: Pacemaker Rhythms

Question 1

What pacemaker complication occurs when the pacemaker does not sense the patient's inherent cardiac electrical activity?

A)Malfunctioning
B)Malsensing
C)Loss of capture
D)Oversensing

Answer 1

Malsensing

Question 2

What factor on an AV pacemaker tracing is similar to the measurement of the PR interval on a normal rhythm tracing?

A)Atrial kick
B)Inherent rhythm
C)AV delay
D)Pacing spike

Answer 2

AV delay

Question 3

When is an atrial pacemaker used alone?

A)When the conduction system from the AV node through the ventricles is intact and functioning
B)When both ventricles need to be stimulated to contract
C)When the atria need to contract completely before the ventricles to allow for an atrial kick
D)When conduction in the ventricles is not working properly

Answer 3

When the conduction system from the AV node through the ventricles is intact and functioning

Question 4

If a patient is experiencing hypotension, lightheadedness, blackouts, and bradycardia, what pacemaker complication may be occurring?

A)Malfunctioning
B)Malsensing
C)Loss of capture
D)Oversensing

Question 5

In which pacemaker complication does the tracing show a pacing spike but no waveform immediately after it?

A)Malsensing
B)Malfunctioning
C)Loss of capture
D)Oversensing

Question 6

What type of pacemaker is used for patients with heart failure?

A)AV pacemaker
B)Atriobiventricular pacemaker
C)Ventricular pacemaker
D)Atrial pacemaker

Question 7

In which pacemaker complication does the pacemaker perceive electrical current from sources other than the heart?

A)Malfunctioning
B)Malsensing
C)Loss of capture
D)Oversensing

Question 8

Which of the following is not one of the components to be evaluated on a pacemaker tracing?

A)The chamber depolarization characteristics
B)The AV delay
C)The QT interval
D)The presence of atrial and/or ventricular spikes

Question 9

What provides the extra blood supply needed for 10% to 30% of the clinically normal cardiac output?

A)AV delay
B)Atrial kick
C)Atrial pacemaker
D)Ventricular pacemaker

Question 10

What is the patient's own heart rhythm called?

A)Inherent rhythm
B)Inherited rhythm
C)Irregular rhythm
D)Input rhythm

Question 11

Which pacemaker rhythm has a pacing spike before the QRS complexes but no pacing spike before the P waves?

A)Ventricular pacemaker rhythm
B)Atrial pacemaker rhythm
C)Atriobiventricular pacemaker rhythm
D)AV pacemaker rhythm

Question 12

When malsensing occurs, a pacemaker may send impulses to the heart during the relaxation phase. What condition may the patient experience if malsensing occurs in a ventricular pacemaker?

A)Ventricular fibrillation
B)SV tachycardia
C)Premature junctional complexes
D)Idioventricular rhythm

Question 13

Which of the following is not one of the questions to ask when evaluating a pacemaker ECG tracing?

A)What are the regularity and rate of the paced rhythm?
B)Is atrial capture present?
C)Is appropriate ventricular sensing occurring?
D)What is the ratio of paced beats to inherent beats within 1 minute?

Question 14

Which term indicates the mark on an ECG tracing that represents the stimulation of electrical current from the pacemaker generator?

A)Oversensing
B)Atrial capture
C)Triggering
D)Pacing spike

Question 15

AV pacing is similar to what characteristic of the heart?

A)Normal conduction pathway
B)Normal valvular function
C)Normal blood flow of the heart
D)Normal capacity of the heart chambers

Question 16

Which pacemaker rhythm does not have a pacing spike before P waves?

A)Ventricular pacemaker rhythm
B)Atrial pacemaker rhythm
C)Atriobiventricular pacemaker rhythm
D)AV pacemaker rhythm

Question 17

If the electronic pacemaker is set to 72 bpm and the AV node is firing at 58 bpm, what is the patient's heart rate?

A)130 bpm
B)72 bpm
C)65 bpm
D)58 bpm

Question 18

Which of the following statements best describes an atrioventricular pacemaker?

A)It stimulates the atria when the conduction system from the AV node through the ventricles is intact and functioning.
B)It mimics the normal cardiac conduction system and allows the atria to contract completely before the ventricles to allow for an atrial kick.
C)It stimulates both ventricles to contract, in contrast to ventricular pacing, in which only the lower portion of the right ventricle is stimulated.
D)It delivers direct stimulation to the ventricles to produce both atrial and ventricular contraction.

Question 19

On what basic principle do electronic pacemakers work?

A)The impulse with the highest voltage controls the heartbeat.
B)The heartbeat is more readily controlled by electronic impulses than by the heart's inherent impulses.
C)The fastest pacemaker, whether inherent or artificial (electronic), controls the heartbeat.
D)The impulse with the longest duration controls the heartbeat.

Question 20

When is a ventricular pacemaker used alone?

A)When both the atria and the ventricles need to be stimulated to contract
B)When the atria need to contract completely before the ventricles to allow for an atrial kick
C)When the conduction system from the AV node through the ventricles is intact and functioning
D)When conduction in the ventricles is not working properly, so the ventricles must be stimulated to contract

Question 21

Under which of these conditions might a pacemaker rhythm be irregular?

A)The patient's heart generates impulses at a rate that is slower than the pacemaker rate.
B)The patient's heart does not generate any inherent impulses.
C)The patient's heart generates impulses at a rate that is faster than the pacemaker rate.
D)The patient's underlying heart rhythm is irregular.

Question 22

The electrical current generated by a pacemaker has which of the following characteristics?

A)It has a high voltage and must be handled with caution.
B)It is not dangerous to the patient or the technician.
C)It is easily transmitted from the patient to other people.
D)It is strongly conducted along the patient's skin.

Question 23

Appearance of a QRS complex after a pacing spike indicates that what has occurred?

A)Atrial capture
B)AV delay
C)Ventricular capture
D)Atrial kick

Question 24

What type of pacemaker is evident in this ECG tracing?

A)Atrial pacemaker
B)Ventricular pacemaker
C)AV pacemaker
D)Atriobiventricular pacemaker

Question 25

Which of the following terms indicates that something caused electrical impulses to occur?

A)Capture
B)Trigger
C)Firing rate
D)AV delay

Question 26

Pacemaker generators use what type of batteries to create the electrical impulses?

A)Alkaline
B)Nickel-cadmium
C)Lithium
D)Solar

Question 27

Before you perform an ECG on your patient, he informs you that he has a pacemaker but isn't sure what kind. A portion of the ECG tracing is shown here. What type of pacemaker does this patient have?

A)Atrial pacemaker
B)Ventricular pacemaker
C)AV pacemaker
D)Atriobiventricular pacemaker

Question 28

What type of pacemaker is evident in this ECG tracing?

A)Atrial pacemaker
B)Ventricular pacemaker
C)AV pacemaker
D)Atriobiventricular pacemaker

Question 29

Which of the following pacemaker complications may be due to a battery that needs to be replaced?

A)Oversensing
B)Loss of capture
C)Undersensing
D)Failure to depolarize

Question 30

A patient known to have an AV pacemaker has been brought to the emergency department of the hospital where you work. The patient is pale, is having difficulty breathing, and is barely conscious. At the physician's request, you perform an immediate ECG. A portion of the tracing is shown here. What may be causing the patient's signs and symptoms?

A)The pacemaker is sending too many impulses, and the patient's heart cannot respond quickly enough.
B)The pacemaker is functioning, but the patient's heart is not depolarizing after every impulse, leading to low cardiac output.
C)The pacemaker has stopped functioning, and the patient is in cardiac arrest.
D)The pacemaker is oversensing, so it is generating impulses at a slower rate than it should, resulting in a slow heart rate and low cardiac output.

Question 31

What is another term for pacemaker competition?

A)Malfunctioning
B)Malsensing
C)Loss of capture
D)Oversensing

Question 32

Which of the following terms describes what happens when a pacemaker does not detect any cardiac electrical activity and never turns off?

A)Oversensing
B)Undersensing
C)Triggering
D)Malsensing

Question 33

What is the function of a pacemaker?

A)To stimulate the heart to contract
B)To improve the heart's contractility
C)To increase the heart's stroke volume
D)To increase the force of cardiac contractions

Question 34

Which of the following is not a typical pacemaker complication?

A)Slower firing rates than set
B)Less effective sensing capabilities
C)Lower electrical current than predetermined
D)Depolarization after pacing spikes

Question 35

A cardiac tracing obtained has a total of eight complexes in the six-second strip and four of them have pacing spikes. What percentage of pacing would be reported in addition to the rhythm interpretation?

A)100
B)75
C)50
D)25

Question 36

You have performed an ECG on a patient who has a pacemaker. A portion of the ECG tracing is shown here. What type of pacemaker is indicated, and at what rate is the pacemaker set?

A)Atrial pacemaker set at 64 bpm
B)Atrial pacemaker set at 71 bpm
C)Ventricular pacemaker set at 78 bpm
D)Ventricular pacemaker set at 83 bpm

Question 37

When the pacemaker delivers ventricular pacing, the pacing spike is followed by a wide QRS complex, which looks similar to which of the following?

A)Left bundle branch block
B)Right bundle branch block
C)Atrial fibrillation
D)First-degree AV block

Question 38

Which of the following most accurately describes evidence of mechanical capture?

A)Wide QRS complex preceded by a pacing spike
B)Pacing spikes present before the P wand QRS complex.
C)Presence of pulse and blood pressure.
D)Asystolic tracing.