IBEC ELECTROLYSIS STATE EXAM REVIEW QUESTIONS & VERY
CORRECT ANSWERS, 2024 /2025 ( A+ GRADED 100%
VERIFIED)
1. Cardiac Conduction Pathway System: SA node> AV node> Bundle of His> Left
and Right bundle branches> Purkinjie fibers
2. Pacemakers of the heart: Natural: SA Node = 60-100 beats/minute
Backup: AV Node = 40-60 beats/minute
Backup: Purkinje Fibers (ventricles) = 20-40 beats/minute
3. SA Node: • Intrinsic Pacemaker of the heart
• Rate 60-100 beats/min
• RA (Right Atrium), close to SVC (Superior Vena Cava)
• Blood supply from RCA (Right Coronary Artery) & LCA (Left Coronary Artery)
4. Interatrial/Internodal Tracts: Transmits impulses from the SA node to the AV node
through the RA & LA
5. AV node: • Slows conduction (40-60 beats/min)
• Physiologic delay allows atrial kick on floor of RA near tricuspid valve
6. Bundle of His: Bundle of cardiac muscle fibers that conducts the electrical impulses
from the AV node in the right atrium to the septum between the ventricles and then to
the left and right ventricles.
7. bundle branches: Right and Left (Left anterior & Left posterior fascicles)
, EKG Kaiser Study Guide
Study online at https://quizlet.com/_abmrda
8. Purkinjie Fibers: Fibers from Bundle Branches imbedded into the ventricle walls.
9. Depolarization vs Repolarization: Depolarization - electrical excitation of the cell
membrane, normally followed by mechanical contraction
Repolarization - return of cell membrane to its resting state, normally followed by
mechanical relaxation
10. Electrical and mechanical activity of the heart: The heart has two activities that
are performed rhythmically: electrical activity followed by mechanical activity
Electrical activity always precedes mechanical activity
It is possible to have electrical activity without mechanical response Always
check the patient - Do Not Depend on the Machine!!!
11. Measurement of the boxes in the ekg: A standard ECG is printed at 25mm per
second or 25 small squares per second. Since one second divided by 25 small boxes,
then each 1 mm box = 0.04 seconds. The larger boxes indicated by the heavier lines
are equal to 0.20 seconds.
Voltage is measured along the vertical axis and is expressed in millivolts (mV). The
standard calibration is that a 1 mV signal produces a 10-mm deflection (0.1 mV=1mm).
Simply put 10 small squares vertically is equal to 1 millivolt
12. EKG waveforms and intervals: P wave - rounded with upright deflection in lead
II, atrial depolarization PR interval- delay @ AV junction
• measure from beginning of P wave to beginning of QRS
• Normal duration 0.12 - 0.20 seconds •
S wave - Negative deflection following the R-wave
QRS complex - multiple components, Ventricular depolarization, - 0.06 -0.11
• Q wave - first negative deflection after P wave R wave
• Positive deflection after the Q
J point - marks where the QRS complex ends and the ST segment begins
ST segment - normally isoelectric line between QRS and the beginning of the T wave
QT interval - beginning of the QRS complex to the end of the T wave; changes with
heart rate, usually half of the R to R interval. beginning of vent activation through
Ventricular depolarization. 0.44 -0.48 (Rate dependent)
T wave - follows the QRS; typically, larger than the P wave and slightly asymmetric;
, EKG Kaiser Study Guide
Study online at https://quizlet.com/_abmrda
Ventricular repolarization
U wave - not usually seen, may be due to hypokalemia or digitalis toxicityIsoelectric
Line -No perceived electrical current
13. indication of a flat line at any time in the duration of a series of waves:
indicates no electrical activity at that particular moment
14. Nursing Responsibilities when theres changes in ECG rhythm: Print, measure,
interpret and post rhythm strips per unit standard.
Get a 12 lead ECG for any rhythm changes.
Get a set of vital signs for any rhythm changes.
Know your unit standards and when to notify the MD.
15. Why is normal conduction and heart rate important?: critical for adequate
filling & optimum cardiac output (CO)
16. Mechanism of dysrhythmias: Altered Automaticity: change in rate of pacer
cells; sympathetic vs. parasympathetic
17. Mechanism of dysrhythmias: Abnormal automaticity: non-pacer cells fire
spontaneously due to: • injury/ischemia, hypoxia,
• stretch with volume overload
• hypokalemia hypomagnesaemia
18. Mechanisms of Dysrhythmias: Altered Conductivity: blocks in normal conduction
• fibrotic changes, valvular disease, acute ischemia
19. Mechanisms of Dysrhythmias: Re-entry: a single impulse can depolarize the same
tissue more than once
20. Consequences of Dysrhythmias: Decrease HR ’decreased CO
Increased HR ’decreased CO
Premature beats ’decreased stroke volume
Loss of AV synchrony ’loss of atrial kick (~20%)
21. Rhythms originating from the Sino-Atrial Node: 1. Normal Sinus Rhythm
2. Sinus Arrhythmia
3. Sinus Bradycardia
4. Sinus Tachycardia
5. Sinus Arrest and Asystole
6. Sinoatrial Exit Block
7. Atrial Ectopic Beat (PAC- Premature Atrial Contraction)
8. Atrial Flutter
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