EKG Interpretation in Special Populations: Enhance Patient Care with Specialized Knowledge

Question 1

The presence of a large, pointed T wave in a patient with a history of myocardial infarction may suggest:

Accepted Answer

Digitalis toxicity

Answer

Hyperkalemia

Answer

Hypokalemia

Answer

Ventricular hypertrophy

Question 2

Which of the following medications can cause a prolonged QT interval on an EKG?

Accepted Answer

Quinidine

Answer

Aspirin

Answer

Ibuprofen

Answer

Morphine

Question 3

In a child with a ventricular septal defect, which EKG finding is typically observed?

Accepted Answer

Right ventricular hypertrophy

Answer

Right atrial enlargement

Answer

Left ventricular hypertrophy

Answer

Atrioventricular block

Question 4

For a neonate, which EKG finding represents normal sinus rhythm?

Accepted Answer

Heart rate of 120-160 bpm

Answer

Inverted P waves in leads II and III

Answer

Wide QRS complex

Answer

Short PR interval

Question 5

Which EKG change is associated with hypokalemia?

Accepted Answer

Tall, peaked T waves

Answer

Flattened T waves

Answer

Inverted T waves

Answer

Prolonged ST segment

Question 6

Which EKG finding is a sign of an acute myocardial infarction?

Accepted Answer

Elevated ST segment

Answer

Depressed ST segment

Answer

Inverted T wave

Answer

Widened QRS complex

Question 7

Which EKG finding is a sign of hypothermia?

Accepted Answer

Extended PR interval

Answer

Shortened QT interval

Answer

Elevated QRS amplitude

Question 8

A characteristic EKG finding in geriatric patients is:

Accepted Answer

Prolonged PR interval

Answer

Increased P wave amplitude

Answer

Shortened QRS complex

Answer

Elevated ST segment

Question 9

Atrial fibrillation is an arrhythmia characterized by:

Accepted Answer

Rapid, irregular atrial activity

Answer

Regular, fast atrial activity

Answer

Slow, irregular atrial activity

Answer

Absence of atrial activity

Question 10

In the context of electrolyte imbalances, a peaked T wave on an EKG may indicate:

Accepted Answer

Potassium imbalance

Answer

Calcium imbalance

Answer

Sodium imbalance

Answer

Magnesium imbalance

Question 11

Which EKG lead provides the optimal view of the left ventricle?

Accepted Answer

Lead V5

Answer

Lead I

Answer

Lead II

Answer

Lead III

Question 12

The R wave amplitude in an EKG is clinically significant as an indicator of:

Accepted Answer

Ventricular hypertrophy

Answer

Atrial depolarization

Answer

Heart rate

Answer

SA node conduction speed

Question 13

The most frequently observed EKG abnormality in emergency departments is:

Accepted Answer

Sinus tachycardia

Answer

Atrial fibrillation

Answer

Ventricular tachycardia

Answer

Complete heart block

Question 14

In patients with acute pericarditis, the most common EKG finding is:

Accepted Answer

ST segment elevation

Answer

T wave inversion

Answer

PR segment depression

Answer

QT interval prolongation

Question 15

What is the most frequent EKG abnormality observed in highly conditioned athletes?

Accepted Answer

Sinus arrhythmia

Answer

Ventricular tachycardia

Answer

Bradycardia

Answer

Atrioventricular block

Question 16

Which of the following EKG findings is most indicative of digitalis toxicity?

Accepted Answer

Prolonged QT interval greater than 500 milliseconds

Answer

Elevated ST segment

Answer

Depressed T waves

Answer

Narrowed QRS complex

Question 17

Which of the following is the most common cause of ST segment elevation in an EKG?

Accepted Answer

Myocardial infarction

Answer

Pericarditis

Answer

Hyperkalemia

Answer

Arrhythmia

Question 18

What is the characteristic EKG finding of Brugada syndrome?

Accepted Answer

Convex ST segment elevation in right precordial leads

Answer

Prominent J waves with ST depression

Answer

Prolonged PR interval greater than 250 milliseconds

Answer

Wide QRS complex greater than 120 milliseconds

Question 19

Which of the following EKG findings is associated with hypokalemia?

Accepted Answer

Flattened T waves

Answer

Shortened QT interval

Answer

Prolonged PR interval

Answer

Narrowed QRS complex

Question 20

In pediatric EKGs, ST-segment elevation typically indicates:

Accepted Answer

A benign finding that is not clinically significant

Answer

Myocardial infarction

Answer

Pericarditis

Answer

Electrolyte imbalance

Question 21

Which of the following is a characteristic EKG finding of Wolff-Parkinson-White syndrome in children?

Accepted Answer

Short PR interval and delta wave

Answer

Prolonged PR interval and widened QRS complex

Answer

Normal PR interval and normal QRS complex

Answer

Short PR interval and narrow QRS complex

Question 22

In elderly patients, a prolonged QTc interval may lead to:

Accepted Answer

Torsades de pointes

Answer

Heart block

Answer

Bradycardia

Answer

Tachycardia

Question 23

In geriatric patients, which of the following EKG changes is commonly observed?

Accepted Answer

Widened QRS interval

Answer

Shortened PR interval

Answer

Depressed ST-segment

Answer

Increased T-wave amplitude

Question 24

When interpreting an EKG in a patient with a pacemaker, it is essential to identify:

Accepted Answer

Artificial spikes

Answer

Narrow QRS complex

Answer

ST-segment depression

Answer

T-wave elevation

Question 25

Which of the following conditions can lead to a prolonged QT interval on an EKG?

Accepted Answer

A combination of the above

Answer

Hypokalemia

Answer

Hypothyroidism

Answer

Use of certain medications

Question 26

Which of the following arrhythmias is commonly observed in physically active individuals?

Accepted Answer

Sinus tachycardia

Answer

Atrial flutter

Answer

Ventricular fibrillation

Answer

Complete heart block

Question 27

When measuring the PR interval on an EKG, the appropriate landmarks to use are:

Accepted Answer

End of P-wave to start of QRS complex

Answer

Start of P-wave to start of QRS complex

Answer

Start of P-wave to end of QRS complex

Answer

End of P-wave to end of QRS complex

Question 28

Pregnant patients undergo physiological changes that affect EKG interpretation. Which of the following is a consideration?

Accepted Answer

Increased heart rate

Answer

Shortened QT interval

Answer

Prolonged PR interval

Answer

Absence of P waves

Question 29

An EKG finding suggestive of pericarditis is:

Accepted Answer

ST segment elevation

Answer

PR segment depression

Answer

T wave inversion

Answer

Q wave

Question 30

Which rhythm is characterized by rapid, irregular atrial activity without visible P waves?

Accepted Answer

Atrial fibrillation

Answer

Atrial tachycardia

Answer

Ventricular tachycardia

Answer

Atrioventricular block

Question 31

In geriatric patients, the most common EKG change observed is a:

Accepted Answer

Prolonged PR interval due to decreased conduction velocity.

Answer

Shortened QT interval due to faster repolarization.

Answer

Increased P wave amplitude due to atrial hypertrophy.

Answer

Absence of T waves due to myocardial ischemia.

Question 32

When interpreting an EKG in a patient with a pacemaker, the most crucial step is to:

Accepted Answer

Identify the pacemaker spikes and confirm their regularity to assess proper device function.

Answer

Measure the QT interval accurately, as it may indicate underlying heart disease.

Answer

Ignore the presence of P waves, as they may interfere with pacemaker timing.

Question 33

Which of the following conditions is known to cause a distinctive Brugada pattern on an EKG?

Accepted Answer

Sodium channel dysfunction, leading to delayed conduction and arrhythmias.

Answer

Magnesium deficiency, which can prolong the QT interval and increase the risk of torsades de pointes.

Answer

Potassium channel dysfunction, resulting in shortened QT intervals and potential arrhythmias.

Answer

Calcium channel dysfunction, causing decreased contractility and heart failure.

Question 34

In a patient diagnosed with Wolff-Parkinson-White (WPW) syndrome, an EKG may display:

Accepted Answer

A short PR interval and a characteristic delta wave before the QRS complex, indicating an accessory pathway.

Answer

A prolonged PR interval, indicating delayed conduction.

Answer

An absent QRS complex, suggesting complete heart block.

Question 35

A characteristic EKG finding in a patient with hyperkalemia is:

Accepted Answer

Tall, peaked T waves with a narrow base, resembling a 'Christmas tree' appearance.

Answer

Inverted P waves, suggesting atrial ischemia.

Answer

Shortened PR interval, indicating accelerated conduction.

Answer

Prolonged QT interval, increasing the risk of torsades de pointes.

Question 36

In a patient with hypothermia, the EKG may exhibit:

Accepted Answer

Prolonged PR and QTc intervals, as well as J waves, indicating delayed conduction and potential arrhythmias.

Answer

Shortened PR and QTc intervals, suggesting accelerated conduction.

Answer

Wide QRS complex, indicating ventricular hypertrophy.

Answer

Inverted T waves in multiple leads, suggesting myocardial ischemia.

Question 37

In a patient with left bundle branch block (LBBB), the EKG typically shows:

Accepted Answer

A wide QRS complex with a duration of more than 120 milliseconds and a notched or slurred R wave.

Answer

A prolonged PR interval, indicating delayed conduction.

Answer

A narrow QRS complex with an absent R wave, characteristic of right bundle branch block.

Answer

Inverted T waves in the inferior leads, suggesting ischemia.

Question 38

A common EKG finding associated with atrial fibrillation is:

Accepted Answer

Irregular RR intervals and the absence of distinct P waves, as the atria are not contracting in a coordinated manner.

Answer

Inverted T waves in all leads, indicating widespread ischemia.

Answer

Regular RR intervals and tall, peaked P waves, suggesting atrial tachycardia.

Answer

Prolonged PR interval and a widened QRS complex, indicative of ventricular conduction delay.

Question 39

In pediatric patients, what causes the QRS complex on an EKG to typically be shorter and narrower?

Accepted Answer

Faster heart rate

Answer

Slower heart rate

Answer

Thicker ventricular walls

Answer

Larger ventricular mass

Question 40

What change in the ST segment might be observed on an EKG in some geriatric patients?

Accepted Answer

Slight depression

Answer

Significant elevation

Answer

Always isoelectric

Answer

Always elevated

Question 41

What is the name of the characteristic pre-excitation wave observed on the EKG of a patient with Wolff-Parkinson-White syndrome?

Accepted Answer

Delta wave

Answer

QRS complex

Answer

T wave

Answer

P wave

Question 42

What is essential when interpreting the EKG of a patient with a pacemaker?

Accepted Answer

Identify pacemaker spikes and pacing rhythm

Answer

Ignore pacemaker spikes

Answer

Assume the pacemaker is functioning correctly

Answer

Focus only on the underlying rhythm

Question 43

What EKG change might be observed in a patient with hyperthyroidism?

Accepted Answer

Shortened PR interval

Answer

Prolonged PR interval

Answer

Flattened T waves

Answer

Wide QRS complex

Question 44

What is a key limitation of EKG interpretation in special populations?

Accepted Answer

Specificity may be lower

Answer

Positive predictive value is maximized

Answer

Sensitivity is always higher

Answer

Accuracy is not affected

Question 45

What EKG finding is commonly associated with a patient who has a ventricular assist device (VAD)?

Accepted Answer

Notched or slurred R waves

Answer

QRS complex is typically narrow

Answer

U waves are absent

Answer

T waves are always inverted