The Licensure Examination for Respiratory Therapists in the Philippines assesses a candidate's knowledge and competency in various medical and clinical subjects, including Diagnostic Procedures. One essential topic in this field is Electrocardiography (ECG), which is crucial for evaluating cardiac function and diagnosing heart-related conditions.
Basic Interpretation of ECG Tracings
A fundamental skill in ECG interpretation is understanding the normal components of an ECG tracing, including the P wave, QRS complex, and T wave. Candidates must be able to analyze heart rate, rhythm, wave morphology, and segment intervals, such as the PR interval, QRS duration, and QT interval. Additionally, they must differentiate between sinus rhythm, bradycardia, tachycardia, and heart blocks, which are essential in clinical respiratory therapy practice.
Identification of Common Cardiac Abnormalities
Respiratory therapists should be able to recognize arrhythmias such as atrial fibrillation, ventricular tachycardia, and premature ventricular contractions (PVCs). These conditions can significantly impact respiratory function and patient management. Another crucial aspect is detecting ischemia and myocardial infarction (MI) through ST-segment elevation or depression, T-wave inversion, and pathological Q waves. Early detection of these abnormalities helps in providing prompt medical interventions and improving patient outcomes.
RESPIRATORY THERAPIST REVIEWER
Welcome to our Respiratory Therapist Reviewer. In this session, you'll have the opportunity to test your understanding of key concepts in Electrocardiography (ECG). The quiz consists of multiple-choice questions covering various topics. Pay close attention to each question and select the best answer. After completing the exam, check the video or the answer key and explanations at the last part.
Basic ECG Interpretation
1. What is the normal duration of the PR interval on an ECG?
A. 0.08 – 0.12 seconds
B. 0.12 – 0.20 seconds
C. 0.20 – 0.30 seconds
D. 0.30 – 0.40 seconds
2. Which part of the ECG represents ventricular depolarization?
A. P wave
B. QRS complex
C. T wave
D. PR segment
3. What does a tall, peaked T wave indicate?
A. Hypokalemia
B. Hyperkalemia
C. Hypocalcemia
D. Hypercalcemia
4. A wide QRS complex (> 0.12 sec) suggests:
A. Atrial fibrillation
B. Ventricular conduction delay
C. Sinus tachycardia
D. First-degree heart block
5. What is the normal heart rate range in a normal sinus rhythm?
A. 40 – 60 bpm
B. 60 – 100 bpm
C. 100 – 120 bpm
D. > 120 bpm
6. Identification of Common Cardiac Abnormalities
Which ECG finding is characteristic of atrial fibrillation?
A. Regular rhythm with no P waves
B. Irregularly irregular rhythm with no distinct P waves
C. Wide QRS complexes
D. PR interval > 0.20 seconds
7. Which of the following rhythms is considered life-threatening and requires immediate defibrillation?
A. Atrial fibrillation
B. Sinus tachycardia
C. Ventricular fibrillation
D. First-degree AV block
8. What is the hallmark ECG change in myocardial infarction (MI)?
A. Peaked T waves
B. ST elevation
C. Widened PR interval
D. Deep Q waves
9. Which of the following suggests an old (previous) myocardial infarction?
A. T wave inversion
B. ST segment depression
C. Q waves
D. Prolonged PR interval
10. Which of the following best describes second-degree AV block Type I (Wenckebach)?
A. PR interval remains constant
B. PR interval progressively lengthens until a QRS is dropped
C. Wide QRS complexes with slow heart rate
D. Regularly irregular rhythm
Advanced ECG Analysis
11. Which rhythm is commonly seen in patients with chronic obstructive pulmonary disease (COPD)?
A. Sinus bradycardia
B. Multifocal atrial tachycardia (MAT)
C. Ventricular tachycardia
D. Atrial flutter
12. What is the heart rate in sinus tachycardia?
A. 60 – 100 bpm
B. > 100 bpm
C. < 60 bpm
D. 40 – 60 bpm
13. What ECG finding is seen in a patient with pulmonary embolism?
A. Peaked P waves
B. S1Q3T3 pattern
C. Widened QRS complexes
D. Prolonged PR interval
14. Which of the following is a characteristic finding of left ventricular hypertrophy (LVH) on ECG?
A. Widened PR interval
B. ST depression
C. Tall R waves in V5 and V6
D. Deep Q waves
15. What is the first-line treatment for stable supraventricular tachycardia (SVT)?
A. Defibrillation
B. Vagal maneuvers
C. Epinephrine
D. Atropine
16. Which ECG finding is indicative of hyperkalemia?
A. Flattened T waves
B. Tall, peaked T waves
C. ST segment depression
D. U waves
17. Which ECG abnormality is characterized by a sawtooth pattern?
A. Atrial fibrillation
B. Atrial flutter
C. Ventricular tachycardia
D. First-degree AV block
18. What is the primary characteristic of ventricular tachycardia (VT) on an ECG?
A. Narrow QRS complexes
B. Wide QRS complexes
C. Regular P waves
D. PR interval prolongation
19. Which electrolyte imbalance is most likely to cause prolonged QT interval?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hypocalcemia
20. Which rhythm is characterized by a complete absence of electrical activity on ECG?
A. Atrial fibrillation
B. Ventricular fibrillation
C. Asystole
D. Sinus arrest
21. Which medication is commonly used to treat atrial fibrillation with a rapid ventricular response?
A. Epinephrine
B. Amiodarone
C. Atropine
D. Adenosine
22. What ECG finding suggests pericarditis?
A. ST elevation in all leads
B. ST depression in all leads
C. Tall T waves
D. Inverted P waves
23. Which of the following indicates right bundle branch block (RBBB) on ECG?
A. Wide QRS with a slurred S wave in V6
B. Tall R waves in V5 and V6
C. RSR' pattern in V1 and V2
D. Prolonged PR interval
24. Which arrhythmia is most commonly associated with chronic alcohol use?
A. Atrial fibrillation
B. Sinus bradycardia
C. Ventricular tachycardia
D. Atrial flutter
24. Which finding is most suggestive of ischemia on an ECG?
A. ST elevation
B. ST depression
C. Peaked T waves
D. U waves
26. Which ECG change is expected in a patient with hypercalcemia?
A. Prolonged QT interval
B. Shortened QT interval
C. Peaked T waves
D. ST elevation
27. What is the characteristic finding of Wolff-Parkinson-White (WPW) syndrome on ECG?
A. Delta wave
B. Inverted T waves
C. Long PR interval
D. Irregularly irregular rhythm
28. Which of the following is true about third-degree (complete) heart block?
A. Regular P-P and R-R intervals with no relationship between them
B. Prolonged PR interval with some dropped beats
C. Wide QRS complexes with no P waves
D. Irregularly irregular rhythm
29. What is the typical rate of ventricular fibrillation (VF)?
A. 60 – 100 bpm
B. 100 – 200 bpm
C. 200 – 300 bpm
D. > 300 bpm
30. Which ECG finding is associated with hypothermia?
A. Tall T waves
B. Osborn (J) waves
C. Prolonged PR interval
D. Delta wave
ANSWER KEY HERE