Reading an ECG and knowing what to do next is a core med-surg skill. These CMSRN questions cover common rhythms and the appropriate nursing response, each with a full rationale.
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Three CMSRN practice questions on ecg interpretation — tap an answer for instant feedback. The app has 5,200+, timed and scored.
Question 1
What is the significance of a Q wave on ECG?
Pathological Q waves (>1mm wide, >25% of R wave height) indicate old myocardial infarction with scar tissue. Necrotic tissue doesn't conduct electricity, creating the Q wave. Active ischemia shows ST changes. Small Q waves can be normal in some leads.
Question 2
A patient develops atrial fibrillation with rapid ventricular response (HR 158). What is the immediate priority?
For hemodynamically stable patients with rapid ventricular response in AFib, rate control with medications like diltiazem or metoprolol is the immediate priority. Cardioversion is for unstable patients. Anticoagulation is important but not immediate. Carotid massage is not first-line for AFib.
Question 3
What is the correct interpretation of this rhythm: regular rhythm, rate 180 bpm, narrow QRS, no visible P waves?
SVT presents with regular rhythm, rate >150 bpm (often 150-250), narrow QRS complexes, and P waves buried in T waves or not visible. Sinus tach rarely exceeds 150. VT has wide QRS. Atrial flutter has sawtooth pattern.
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Question 1
A patient develops atrial fibrillation with rapid ventricular response (HR 158). What is the immediate priority?
For hemodynamically stable patients with rapid ventricular response in AFib, rate control with medications like diltiazem or metoprolol is the immediate priority. Cardioversion is for unstable patients. Anticoagulation is important but not immediate. Carotid massage is not first-line for AFib.
Question 2
What is the correct interpretation of this rhythm: regular rhythm, rate 180 bpm, narrow QRS, no visible P waves?
SVT presents with regular rhythm, rate >150 bpm (often 150-250), narrow QRS complexes, and P waves buried in T waves or not visible. Sinus tach rarely exceeds 150. VT has wide QRS. Atrial flutter has sawtooth pattern.
Question 3
What is the significance of a Q wave on ECG?
Pathological Q waves (>1mm wide, >25% of R wave height) indicate old myocardial infarction with scar tissue. Necrotic tissue doesn't conduct electricity, creating the Q wave. Active ischemia shows ST changes. Small Q waves can be normal in some leads.
Question 4
A patient develops atrial fibrillation with rapid ventricular response (HR 158). What is the immediate priority?
For hemodynamically stable patients with rapid ventricular response in AFib, rate control with medications like diltiazem or metoprolol is the immediate priority. Cardioversion is for unstable patients. Anticoagulation is important but not immediate. Carotid massage is not first-line for AFib.
Question 5
What is the correct interpretation of this rhythm: regular rhythm, rate 180 bpm, narrow QRS, no visible P waves?
SVT presents with regular rhythm, rate >150 bpm (often 150-250), narrow QRS complexes, and P waves buried in T waves or not visible. Sinus tach rarely exceeds 150. VT has wide QRS. Atrial flutter has sawtooth pattern.
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A patient develops atrial fibrillation with rapid ventricular response (HR 158). What is the immediate priorit…
