EKG-øvestrimler
Testens spørgsmål er på engelsk.
Det her er en gratis smagsprøve på 15 spørgsmål i aflæsning af EKG-rytmestrimler. Hver strimmel er beskrevet i ord frem for vist som billede: du får frekvensen, regelmæssigheden, P-takkerne, PR-intervallet og QRS-bredden, og så navngiver du rytmen. Svar på alle 15 spørgsmål, se så din score og læs forklaringen til hvert spørgsmål.
A six second rhythm strip contains 7 QRS complexes. Using the six second method, what is the approximate heart rate?
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Øvelse i EKG-rytmer
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1. A six second rhythm strip contains 7 QRS complexes. Using the six second method, what is the approximate heart rate?
- A. 35 beats per minute
- B. 60 beats per minute
- C. 70 beats per minute
- D. 140 beats per minute
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Svar: C. 70 beats per minute
The six second method counts the QRS complexes on a six second strip and multiplies by 10, so 7 complexes is about 70 beats per minute. It is the fastest estimate and the only dependable one when the rhythm is irregular, because the interval based methods assume the beats are evenly spaced.
2. A strip shows a regular rhythm at 78 beats per minute. There is one upright P wave in front of every QRS, the PR interval is 0.16 seconds on every beat, and the QRS measures 0.08 seconds. Name the rhythm.
- A. Sinus bradycardia
- B. Normal sinus rhythm
- C. Sinus tachycardia
- D. Junctional rhythm
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Svar: B. Normal sinus rhythm
Normal sinus rhythm needs all of it at once: a rate of 60 to 100, a regular rhythm, one upright P wave before every QRS, a PR interval of 0.12 to 0.20 seconds and a QRS under 0.12 seconds. This strip meets every criterion, so there is nothing else to name.
3. A strip shows a regular rhythm at 46 beats per minute. Each QRS is preceded by one upright P wave, the PR interval is 0.16 seconds, and the QRS measures 0.08 seconds. Name the rhythm.
- A. Sinus bradycardia
- B. Junctional rhythm
- C. Second degree AV block type I
- D. Idioventricular rhythm
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Svar: A. Sinus bradycardia
Everything on this strip is normal except the rate, and a sinus rhythm under 60 is sinus bradycardia. The upright P wave in front of every QRS is what separates it from a junctional rhythm, which has no upright P wave and runs at its own rate of 40 to 60.
4. A strip shows a regular rhythm at 122 beats per minute. One upright P wave precedes each QRS, the PR interval is 0.14 seconds, and the QRS measures 0.08 seconds. Name the rhythm.
- A. Supraventricular tachycardia
- B. Atrial flutter with 2:1 conduction
- C. Sinus tachycardia
- D. Normal sinus rhythm
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Svar: C. Sinus tachycardia
A sinus rhythm above 100 is sinus tachycardia, and here the P waves are still clearly visible in front of every QRS. Rates in this range usually have a cause outside the heart, such as fever, pain, fear, dehydration or blood loss, so the cause gets treated rather than the rate.
5. A strip shows an irregularly irregular rhythm with a ventricular rate of about 110. No P waves can be identified anywhere, the baseline between QRS complexes is wavy, and the QRS measures 0.08 seconds. Name the rhythm.
- A. Atrial flutter
- B. Sinus rhythm with frequent premature beats
- C. Second degree AV block type I
- D. Atrial fibrillation
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Svar: D. Atrial fibrillation
No identifiable P waves plus an irregularly irregular ventricular response is the classic pair for atrial fibrillation. The atria quiver instead of contracting, so the AV node is bombarded with impulses and lets them through at unpredictable intervals.
6. Complete the sentence.
A strip shows a sawtooth baseline with flutter waves at about 300 per minute and regular QRS complexes at about 75 per minute, so the atrial flutter is conducting _____.
Muligheder for felt 1: 1:1, 2:1, 3:1, 4:1
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Svar: 4:1
300 divided by 75 is 4, so four flutter waves arrive for every QRS that gets through, which is 4:1 conduction. The AV node blocks most flutter impulses, and because the ratio here is fixed the ventricular rhythm stays regular.
7. A strip shows a regular rhythm at 190 beats per minute. No P waves can be found in front of the QRS complexes, and the QRS measures 0.08 seconds. Name the rhythm.
- A. Sinus tachycardia
- B. Atrial fibrillation
- C. Ventricular tachycardia
- D. Supraventricular tachycardia
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Svar: D. Supraventricular tachycardia
A regular narrow complex rhythm this fast with no findable P waves is supraventricular tachycardia, and the P waves are usually hidden inside the preceding T waves. The narrow QRS rules out ventricular tachycardia, and the regular rhythm rules out atrial fibrillation.
8. A strip shows a regular rhythm at 68 beats per minute. Every QRS is preceded by one upright P wave, the PR interval measures 0.24 seconds and is the same on every beat, the QRS measures 0.08 seconds, and no beats are dropped. Name the rhythm.
- A. Normal sinus rhythm
- B. Third degree AV block
- C. First degree AV block
- D. Second degree AV block type I
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Svar: C. First degree AV block
A PR interval longer than 0.20 seconds that stays constant, with every P wave still followed by a QRS, is first degree AV block. Nothing is truly blocked here: every impulse reaches the ventricles, it just takes longer than normal to cross the AV node.
9. A strip shows a regular atrial rhythm. The PR interval measures 0.16 seconds on the first beat, 0.24 on the second and 0.32 on the third, then one P wave appears with no QRS after it, and the pattern starts over. The QRS complexes measure 0.08 seconds. Name the rhythm.
- A. First degree AV block
- B. Second degree AV block type I
- C. Second degree AV block type II
- D. Third degree AV block
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Svar: B. Second degree AV block type I
PR intervals that lengthen beat by beat until one P wave fails to conduct is second degree AV block type I, also called Wenckebach. The block sits in the AV node itself, which tires a little more with each beat and then recovers during the dropped beat, so the cycle repeats.
10. A strip shows a regular P to P interval at 80 per minute. Every conducted beat has the same PR interval of 0.18 seconds, then without warning one P wave is not followed by a QRS. The conducted QRS complexes measure 0.13 seconds. Which statements about this strip are correct?
Vælg alle, der passer.
- A. The PR interval lengthens before the dropped beat
- B. The rhythm is second degree AV block type II
- C. The PR interval on the conducted beats stays constant
- D. The rhythm is harmless and needs no follow up
- E. The wide QRS suggests the block sits below the AV node
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Svar: B. The rhythm is second degree AV block type II, C. The PR interval on the conducted beats stays constant, E. The wide QRS suggests the block sits below the AV node
Type II is the dropped beat that arrives with no warning: the PR interval never changes, and then a QRS simply goes missing. The block usually sits below the AV node in the bundle branches, which is why the conducted QRS is wide, and why this rhythm is watched closely and often paced.
11. A strip shows P waves marching out regularly at 88 per minute and QRS complexes marching out regularly at 34 per minute. The QRS measures 0.14 seconds and the distance from each P wave to the next QRS is different on every beat. Which statements about this strip are correct?
Vælg alle, der passer.
- A. The rhythm is third degree AV block
- B. The PR interval is fixed and only slightly prolonged
- C. The atria and the ventricles are beating independently of each other
- D. The wide slow QRS points to an escape pacemaker down in the ventricles
- E. There are fewer P waves than QRS complexes on the strip
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Svar: A. The rhythm is third degree AV block, C. The atria and the ventricles are beating independently of each other, D. The wide slow QRS points to an escape pacemaker down in the ventricles
In third degree block nothing crosses the AV node, so the atria keep their own regular rate and an escape pacemaker below the block drives the ventricles at its own slower regular rate. A ventricular escape site fires around 20 to 40 and produces a wide QRS, while a junctional escape site fires around 40 to 60 with a narrow one.
12. Complete the sentence.
A strip shows a regular rhythm at 45 beats per minute with a QRS of 0.08 seconds, no upright P wave before any QRS, and a small inverted P wave just after each QRS, so the rhythm is _____.
Muligheder for felt 1: idioventricular rhythm, sinus bradycardia, junctional rhythm, first degree AV block
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Svar: junctional rhythm
The AV junction takes over at its intrinsic rate of 40 to 60 when the sinus node stops or slows, and it still uses the normal pathway down, which keeps the QRS narrow. The atria are depolarized backwards from the junction, so the P wave is inverted and can land just before, inside or just after the QRS.
13. A strip shows a regular rhythm at 170 beats per minute with wide QRS complexes measuring 0.16 seconds. No P waves can be identified, and the T waves point in the opposite direction to the QRS. Name the rhythm.
- A. Atrial flutter
- B. Supraventricular tachycardia
- C. Ventricular fibrillation
- D. Ventricular tachycardia
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Svar: D. Ventricular tachycardia
A QRS wider than 0.12 seconds at a rate above 100 with no P waves is ventricular tachycardia, because the beat starts in the ventricle and spreads slowly muscle cell to muscle cell instead of using the conduction system. Check the patient and not only the monitor: this same strip is treated one way when there is a pulse and another way when there is not.
14. A monitored patient collapses. The strip shows chaotic wavy deflections of changing height and width, with no identifiable P waves, QRS complexes or T waves and no measurable rate. Which statements about this strip are correct?
Vælg alle, der passer.
- A. The patient will have no pulse
- B. Synchronized cardioversion should be used instead
- C. The rhythm is ventricular fibrillation
- D. A rate can be counted with the six second method
- E. Defibrillation plus CPR is the treatment
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Svar: A. The patient will have no pulse, C. The rhythm is ventricular fibrillation, E. Defibrillation plus CPR is the treatment
Ventricular fibrillation is the ventricles quivering with no organized contraction, so there is no output and no pulse, and the only thing that restores a rhythm is defibrillation with good CPR between shocks. Synchronized cardioversion is impossible here because the machine has no R wave to synchronize with, and there is nothing to count for a rate.
15. Complete the sentence.
A pulseless, unresponsive patient shows an organized rhythm at 50 beats per minute with narrow QRS complexes on the monitor, which is called _____.
Muligheder for felt 1: asystole, ventricular fibrillation, sinus bradycardia, pulseless electrical activity
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Svar: pulseless electrical activity
Pulseless electrical activity means the monitor shows organized complexes while the heart is producing no pulse, which is why the rhythm on screen never replaces checking the patient. Asystole is the other end of the same problem, a flat line with no electrical activity at all, and neither rhythm responds to a shock, so both are treated with CPR and epinephrine while the reversible causes are searched for.
Hvad en prøve i rytmestrimler faktisk kræver af dig
Tolkning af strimler bliver testet mange steder, og det er ikke én standardiseret prøve. Sygeplejeuddannelser giver quizzer i dysrytmier, hospitaler kører grundlæggende og avancerede EKG-kurser, før de lader dig overvåge en monitor, og både telemetriteknikerkurser og ACLS har deres egen udgave. Antallet af strimler, tidsgrænsen og beståelsesgrænsen fastsættes af uddannelsen eller hospitalet, så et tal en medstuderende nævner, er ikke nødvendigvis det, du kommer til at sidde med.
Det, du skal levere, varierer også. Nogle prøver vil kun have navnet på rytmen. Andre vil have dig til at måle og skrive den atrielle frekvens, den ventrikulære frekvens, PR-intervallet og QRS-bredden ned, før du navngiver noget, og de giver delvise point for de målinger. Nogle giver dig en passer og en papirstrimmel, andre viser strimlen på en skærm. Spørg din underviser, hvilken udgave du får, for måleudgaven belønner en langsom, fast rutine, og navngivningsudgaven belønner mønstergenkendelse.
Selve indholdet er stabilt på tværs af dem alle. Du forventes at kunne genkende sinusrytmerne og deres hurtige og langsomme udgaver, de atrielle rytmer inklusive atrial fibrillation og atrial flutter, junktionale rytmer, AV-blokkene fra første grad til komplet AV-blok, de ventrikulære rytmer og hjertestoprytmerne. Næsten alle lister indeholder også asystole og pulseless electrical activity, for det er derfor, nogen overhovedet sidder og kigger på en monitor.
Sådan bruger du smagsprøven
Strimlerne på denne side er beskrevet i tekst frem for vist. Hvert spørgsmål giver dig de samme fem oplysninger, som du ville måle dig frem til på en rigtig strimmel: frekvensen, om rytmen er regelmæssig, om der er P-takker og hvordan de ser ud, PR-intervallet og QRS-bredden. Billedudgaver af strimlerne er på vej, og siden bliver opdateret, når de er klar.
At læse en strimmel i ord ligger tæt på den rutine, du bør bruge på en rigtig. Gå de samme spørgsmål igennem hver gang: hvad er frekvensen, er rytmen regelmæssig, er der en P-tak foran hvert QRS, ligner P-takkerne hinanden, er PR-intervallet normalt og konstant, og er QRS smalt eller bredt. Svar på dem i rækkefølge, så navngiver de fleste rytmer sig selv, før du er nødt til at gætte.
Tag alle 15 i ét stræk uden noter, og læs så forklaringen til hvert spørgsmål, også dem du svarede rigtigt på. Et forkert svar peger som regel på ét trin i rutinen frem for på én rytme. Hvis du blandede type I og type II andengrads AV-blok sammen, er det, du skal træne, at sammenligne PR-intervaller hen over en række slag, ikke at lære to navne udenad.
Sådan bygger StudyPDF fulde øveprøver ud fra dit eget materiale
Femten spørgsmål kan vise dig, hvilke rytmer du endnu ikke kan skelne fra hinanden. De kan ikke gøre dig klar alene, og en generisk spørgsmålsbank ved ikke, hvilke rytmer dit kursus bruger tiden på.
StudyPDF arbejder ud fra dit materiale i stedet. Du uploader udleverede materialer fra dit EKG-kursus, din ACLS-bog eller de forelæsningsslides, din underviser har lagt ud, og Bo, studieagenten, bygger fulde øveprøver ud fra præcis de sider. Hvert spørgsmål bygger på dit materiale, og hver forklaring henviser til hvor svaret kommer fra, så du kan tjekke kilden når noget ser forkert ud. Du kan lave nye prøver så tit du vil og holde dem på ét område som AV-blokkene.
Du behøver ikke et dokument for at komme i gang. Du kan også bare nævne et emne, for eksempel AV-blokke eller ventrikulære rytmer, så bygger Bo en øveprøve om det uden nogen upload. Gratis at komme i gang.
Skrevet af StudyPDF-teamet. Sidst opdateret 2026-08-19.