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EKG1126

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Cardiology refers to a medical specialty which:   studies electrocardiograms, the heart, and treats diseases of the heart.  
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Electrocardiogram or ECG is:   a key test in diagnosing & identifying heart disease, records the electrical activity of the heart, & can be performed by a tech/nurse w/ proper training.  
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The machine used to obtain electrical information from the heart is called:   electrocardiograph or ECG machine  
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Job skills for the ECG technician include:   knowledge of anatomy & physiology of the heart; ability to prioritize tasks & activities by importance; responds to patients' emotional needs.  
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All healthcare workers must abide by certain rules which:   protect a patient's confidentiality & dignity; are established in the Patient's Bill of Rights.  
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Crises arise everyday in clinics and hospitals and require technicians to:   act quickly & prioritize activities; help the nurses & doctors w/in the limits of his/her training  
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When disagreements arise between healthcare workers:   each person should be allowed to explain his/her actions & the principles of conflict resolution and mediation applied.  
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If conflict resolution is used then:   communication will improve; patients will get better service  
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The ECG tech can provide a good quality service to patients and be an excellent employee:   by having and developing good communication skills; by cultivating empathy and compassion; by remaining flexible  
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The healthcare environment is busy and stressful; the technician can decrease his/her personal stress by:   getting enough exercise and rest; eating properly.  
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The cardiac patient has diseases of the:   heart  
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Cardiac risk factors:   are conditions which increase the probability of developing heart disease  
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Cardiac risk factors include:   age, smoking,family health history, male gender  
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Modifiable cardiac risk factors include:   smoking & diet  
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Losing weight and exercising three times a week are examples of: A   modifiable risk factors; changing lifestyle and decreasing risk of heart disease.  
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Angina is:   the result of ischemia; chest pain, squeezing, pressure, and/or left arm pain; a symptom of heart disease; the result of CAD.  
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The importance of the coronary arteries is:   they bring oxygen rich blood to the heart tissue  
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Atherosclerosis is a disease:   which involves accumulation of fatty deposits within the artery wall.  
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All tissue in the body, including the heart require:   oxygen to function  
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A heart attack is:   aka myocardial infarction; caused by complete blockage of a coronary artery; caused by fatty deposits, plaque, & blood clots; a cardiac disease or event.  
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Ischemia means:   lack of blood and oxygen being supplied to a part of the body.  
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Infarction means:   death of tissue and cells caused by complete blockage of arteries.  
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PTCA is:   percutaneous transluminal coronary angioplasty.  
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CABG is:   coronary artery bypass grafting  
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A difference between CABG and PTCA is:   CABG requires open heart surgery and PTCA is a radiology technique that doesn't require surgery.  
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What are the pieces of equipment needed to perform a blood pressure?   Stethoscope, spygmomanometer  
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The top number of the blood pressure reading is called:   systolic  
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The bottom number of the blood pressure reading is called:   diastolic  
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Blood pressure is measured in units called:   mmhg  
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Factors that can result in an inconsistent blood pressure reading include:   diet, exercise, stress, improper cuff size  
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3 situations that would prevent you from obtaining a blood pressure using a particular arm:   IV or Heplock is place; Dialysis or Fistula; Same side as Mastectomy.  
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T/F: The main organs of the cardiopulmonary syste are the heart and blood vessels.   False  
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T/F: The heart is a double-sided pump.   True  
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T/F: The ventricles function as reservoirs for blood.   False  
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T/F: Contractility is an electrical function of the heart.   False  
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The upper chambers of the heart are known as the ___ and the lower chambers of the heart are known as the ____.   atrias; ventricles.  
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Name four valves of the heart:   pulmonic; mitral; tricuspid; aortic.  
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___ carry blood Away from the heart.   Arteries  
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___ carries blood back to the heart.   Veins  
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Movement of blood from the right ventricle to the lungs is called the:   Pulmonary Circulation  
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Cardiac muscle tissue receives its blood supply from the:   Coronary arteries  
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Automaticity is the ability of cardiac cells to:   Initiate their own electrical impulse  
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The ability of cardiac cells to transmit an electrical impulse is:   Conductivity  
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The inferior and superior vena cava deliver oxygen poor blood from the rest of the body to:   the right atrium  
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Oxygen rich blood is delivered by the pulmonary veins from the lungs to the:   left atrium  
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Oxygen poor blood is pumped from the right atria to:   right ventricle  
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Oxygen rich blood is pumped from the left ventricle and into:   the aorta  
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Oxygen poor blood is pumped from the right ventricle into:   the pulmonary artery  
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The purpose of the heart valves is to:   Encourage forward flow of blood and prevent backward leakage into the previous chamber  
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The aorta receives oxygen rich blood from the left ventricle and delivers blood to the:   the brain; the arms and legs; the kidneys; the liver.  
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The flow of the blood through the heart is in this order:   vena cava, right atrium, right ventricle, pulmonary artery, lungs, pulmonary vein, left atrium, left ventricle, aorta.  
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The SA node or sinoatrial node:   is located in the upper right atrium; is the pacemaker of the heart.  
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The AV junction or the atrio-ventricular junction:   located in the lower right atrium; is a backup pacemaker that will pace the heart if the SA node fails to do so.  
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The electrical conduction in the heart:   occurs before the mechanical contraction  
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The cardiac cycle is:   the timed events of the electrical conduction that results in mechanical action and produces a blood pressure and pulse.  
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The electrical impulse is delivered to the ventricles via the:   Bundle branches and Purkinje fibers  
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The electrical impulse of the heart is recorded by the:   ECG  
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Systole means:   the heart muscle is contracting  
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Diastole means:   the heart muscle is at rest and relaxing  
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The atrial kick is:   The additional 30% of blood pushed into the ventricle when the atria contract  
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Cyanosis is:   Bluish-gray color of the lips, skin, and nail beds caused by a lack of oxygen  
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Electrical current through the tissues is caused by:   Movement of electrolytes across a semi-permeable membrane.  
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Polarization is a state in which the cells are:   in the resting state during which time there is a low probability of an electrical discarge.  
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Depolarization is:   the state when a threshold is reached and the electrolytes move across the semi-permeable membrane and a current is discharged.  
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Repolarization is:   electrolytes move across the semi-permeable membrane back to the resting state.  
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The events of polarization, depolarization, and repolarization are represented on:   ECG recording  
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The EKG is a recording of the electrical waveforms onto:   graph paper  
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On the EKG recording, polarization is represented by:   the baseline or isoelectric line  
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The depolarization of the heart occurs in a synchronized manner in this sequence:   SA Node, atria, AV node, bundle of His, right and left bundle branches, Purkinje fibers  
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Atrial depolarization is represented on the ECG recording by:   the P wave  
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Atrial repolarization is represented on the ECG recording by:   it is not visible  
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Ventricular depolarization is represented on the EKG recording by:   the QRS complex  
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Ventricular repolarization is represented on the ECG recording by:   the T wave  
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The recording of the electrical events of the P wave, QRS complex, T wave, and baseline is:   done routinely by recording the EKG; able to be analyzed and can help in the diagnosis of cardiac disease.  
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The refractory period:   occurs during repolarization; is when the heart cannot respond to an electrical stimulus.  
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The U wave is:   a normal variant and occurs at the end of the T wave.  
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After the P wave, or atrial depolarization, then:   the atria contract.  
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After the QRS complex:   the ventricles contract.  
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The electrical impulses of the heart become an ECG tracing through:   sensors or electrodes placed on the chest, attached by cables to the EKG machine which translates electrical information into the mechanical action that creates the waveforms.  
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The horizontal axis on the ECG graph paper represent:   time  
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The vertical axis on the EKG graph paper represent:   voltage  
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Indicate the inherent rate for the sinoatrial (SA)node:   60-100  
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Indicate the inherent rate for the atrioventricular (AV) node:   40-60  
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Indicate the inherent rate for the ventricles:   20-40  
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The EKG monitor shows:   the electrical impulses through the heart, not the actual contraction of the heart muscle.  
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The P wave represents the depolarization of both the right and left:   atria  
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The 12 lead EKG is helpful in diagnosing heart disease and conditions including:   MI, Ischemia, Pericarditis, Ventricular hypertrophy.  
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A doctor or nurse may order an EKG on patients experiencing:   chest pain or tightness, fainting, and shortness of breath.  
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When preparing a patient for an ECG:   explain the procedure and the equipment; make it a habit to identify the patient and verify the orders.  
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The electrode:   has a gel coating that enhances skin contact & improves conduction of electrical impulses through the skin.  
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The electrode:   has a tab that allows the cables of the EKG machine to be attached to it.  
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The electrode:   are placed at specific anatomical locations on the body.  
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The electrocardiograph detects:   electrical activity of the heart.  
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Calibration means:   setting a machine to a standardized scale to allow comparison of the results.  
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On the EKG machine the "filter" acts to:   diminish electrical activity that may be present in the environment and that might interfere with the tracing.  
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Artifact on the ECG recording indicates:   poor connections, muscle movement, or electrical interference.  
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The isoelectric line:   is a flat straight line with no waveforms present; means that no electrical activity is detected.  
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The anatomical landmarks crucial when performing a standard 12 lead ECG are the:   right & left sternal border, midclavicular line, 4th & 5th intercostals spaces, anterior & midaxillary lines.  
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The standard limb leads are bipolar leads and are:   created by electrodes placed on the arms and legs.  
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The augmented limb leads are unipolar and are:   increased in size by 50%.  
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V leads are:   also called the chest leads or precordial leads; also unipolar leads.  
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V1 is located at the:   4th intercostals space at the right sternal border.  
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V2 is located at the:   4th intercostals space at the left sternal border.  
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V3 is located at the:   halfway point between v2 and v4.  
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V4 is located at the:   5th intercostals space at the midclavicular line.  
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V5 is located at the:   level of V4 at the anterior axillary line.  
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V6 is located at the:   level of V4 at the midaxillary line.  
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Leads II, III, and aVF look at the:   inferior wall of the heart.  
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Leads V1, V2, and V3 look at the:   anterior wall and intraventricular septum.  
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The electrocardiograph machine was developed by:   Einthoven  
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The surface of the heart is divided into six sections:   anterior wall, anteroseptal wall, lateral wall, inferior wall, posterior wall, apical wall.  
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Procedure for obtaining an EKG includes:   wash hands, identify the patient, and place electrodes in proper anatomical locations.  
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The term "lead" refers to a particular "view" of the heart and:   the cables connected to the electrodes.  
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One large box on the EKG graph paper equals:   0.20 sec  
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One small box on the EKG graph paper equals:   0.04 sec  
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The steps in a systemic rhythm analysis:   make general observation about rhythms, determine the HR, determine if the rhythm is regular, determine whether there is a P wave for every QRS complex, measure the waveforms.  
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On the EKG, time is measured along:   the horizontal axis.  
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Hash marks at the top of a rhythm strip occur at intervals of:   every 15 boxes or every 3 sec.  
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Calipers are:   useful in measuring waveforms; used in determining regularity of a rhythm; a metal tool with two arms that adjust & lock into place.  
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If calipers are not used, how can you determine regularity:   place the edge of a blank paper over the tracing, mark the R to R interval for 2 clycles, & move it down 1 cycle to see if the marks line up with the next R to R cycle.  
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There are many ways to determine HR including:   counting the QRS complexes during a 6 second period and multiplying by 10; count the large boxes between one R to R interval & divide that number into 300.  
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When measuring the PR interval remember:   start the measurement at the beginning of the P wave & end at the beginning of the QRS; the PR interval is normally 0.12-0.20 sec.  
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When measuring the QRS complex:   start at the beginning of the QRS & end when the waveform returns to the baseline; the QRS has several morphologies including a mostly positive waveform as well as a mostly negative waveform.  
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The QRS complex normally is:   0.04-0.10 sec  
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Characteristics of NSR include:   there is a P wave for every QRS complex; the rhythm is regular.  
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Variations of NSR include:   sinus bradycardia and sinus arrhythmia  
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Criteria for sinus bradycardia includes:   HR less than 60 bpm and P wave for every QRS complex.  
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Criteria for tachycardia includes:   HR greater than 100 bpm.  
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Criteria for sinus arryhthmia includes:   slightly irregular, varies with respiration.  
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Sinus tachycardia is a normal physiologic response to:   exercise, pain, fever and blood loss.  
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Sinus bradycardia is normal and may be:   a response to medication, a response to rest or sleep, a byproduct of athletic training.  
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The baseline or isoelectric line is:   the absence of electrical activity.  
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T/F: When interpreting a rhythem strip, it is important to check wave formation, rhythm and rate.   True  
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T/F: The SA node generates an electrical impulse at a rate of 60-100 bpm.   True  
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T/F: Sinus bradycardia has a rate greater than 100 bpm.   False  
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T/F: A PAC is an atrial contraction that occurs later than the next expected complex of the underlying rhythm.   True  
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T/F: In sinus arrhythmia, the heart rate increases with inspirations and decreases with expirations.   True  
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T/F: Ventricular tachycardia is a dysrhythmia that originates from many ventricular sites.   True  
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T/F: Asystole occurs when there is no electrical activity in the atria or the ventricles.   False  
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T/F: If two PVCs occur in a row, it is called ventricular tachycardia.   True  
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T/F: Multifocal PVCs mean that the PVCs are coming from the same location.   False  
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T/F: Bigeminy PVCs occur every other beat.   True  
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T/F: An agonal rhythm is the heart's last cry for help.   False  
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An extra atrial contraction followed by a QRS complex that occurs earlier than predicted is:   Premature atrial contraction  
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PAC's that occur every other beat are called:   Bigeminy  
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The reduction in cardiac output that occurs with SVT can cause:   Syncope, Lightheadedness, and Dizzyness.  
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Atrial Flutter is characterized by:   Flutter waves with saw-toothed appearance.  
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Atrial Fibrillation is characterized by:   an irregular, irregularity; P waves being replaced by fibrillatory waves; and a loss of the "Atrial Kick"  
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A patient with AFib can be converted to Sinus Rhythm by:   medication and cardioversion.  
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In Atrial Flutter and Atrial Fibrillation, which waveform cannot be seen?   P wave  
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Paroxysmal means:   sudden onset and sudden end.  
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Special conductive tissue located in the lower right atrium.   AV node  
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Carries deoxygenated blood from the right side of the heart to the lungs.   pulmonary artery  
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Special conductive tissue that extends into the right and left ventricle.   bundle branches  
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Receives blood from the left side of hte heart to be distributed to the rest of the body.   aorta  
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Pacemaker of the heart.   SA node  
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Lower chambers or main pumping chambers.   ventricles  
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Relating to the lungs.   pulmonary  
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Conductive tissue leading from the AV node to the ventricular septum between the right and left ventricle.   bundle of His  
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Large vein returning deoxygenated blood to the right side of the heart.   vena cava  
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The resting phase of the heart.   diastole  
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Conductive tissue that transmits electrical impulses from the bundle branches to the ventricular tissue.   Purkinje fibers  
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Relating to the system of blood vessels.   vascular  
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Carries oxygenated blood from the lungs to the left side of the heart.   pulmonary vein  
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The upper chambers.   atria  
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The time during which the heart is contracting or working.   systole  
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The series of electrical and mechanical events that comprise each heart beat.   cardiac cycle  
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Very small charged particle.   ion  
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A heart test that uses ultrasound waves to obtain pictures of heart structures such as the valves and heart chambers.   echocardiogram  
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Decreased blood flow to the tissue, resulting in decreased levels of oxygen and nutrients.   ischemia  
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Blood vessels that bring oxygen-rich blood to the heart muscle.   coronary arteries  
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Death of heart muscle tissue caused by blockages in the coronary arteries.   MI  
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Chest pain caused by the decrease of blood flow to the heart muscle.   angina  
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Relating the heart.   cardiac  
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Disturbance in the heart rhythm.   arrhythmia  
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A procedure in which dye is injected into the coronary arteries and a moving x-ray is taken to detect blockages.   angiogram  
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Heart disease caused by blockages in the coronary arteries.   CAD  
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Lead I   Records the electrical current through the heart, from the right arm to the the left arm.  
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Lead I   RA Sensor is negative; LA Sensor is positive.  
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Lead I   The heart is viewed from the positive electrode, or LA, which views the lateral wall of the heart.  
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Lead II   Records the electrical current downward through the heart's long axis, from the right arm to the left leg.  
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Lead II   RA Sensor is negative; LA Sensor is positive.  
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Lead II   The heart is viewed from the positive electrode, or LL, which iews the inferior wall of the heart.  
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Lead III   Records the electrical current from the left arm to the left leg.  
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Lead III   LA Sensor is negative; LL Sensor is positive.  
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Lead III   The heart is viewed from the positive electrode, or LL, which views the inferior wall of the heart from another angle.  
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aVF   Top; Positive LL looks at the inferior wall of the heart.  
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aVR   Left of Heart; Positive RA looks at the top of the heart.  
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aVL   Right of Heart; Positive LA looks at the superior lateral wall of the heart.  
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V1, V2, and V3   These leads look at the interventricular septum and anterior wall.  
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V4   This lead looks at the anterior wall.  
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V5 and V6   These leads look at the apical and low lateral walls.  
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