Premature atrial contractions (PACs) are early contractions that come from the atria. These premature contractions are usually benign but can be serious in some cases. The nurse should be able to identify these premature contractions and be familiar with causes, characteristics, types of PACs, and treatments.
Don’t forget to watch the PAC lecture and read the premature atrial contraction notes before taking the PAC quiz.
Premature Atrial Contractions (PACs) EKG/ECG Quiz
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Premature Atrial Contractions (PACs) ECG/EKG Quiz
- Which rhythm above demonstrates premature atrial contractions (PACs) within an underlying normal sinus rhythm?
A
B
C
D
The answer is C. Rhythm C demonstrates normal sinus rhythm with premature atrial contractions (PACs). The rhythm starts with a normal sinus beat, followed by a premature atrial contraction (PAC), then another normal sinus beat, followed by another PAC, and a third normal sinus beat, followed by a final PAC. This demonstrates the PACs presenting in a bigeminy pattern. The rhythm then returns to normal sinus rhythm. Rhythm A is sinus rhythm with an isolated PVC. Rhythm B presents with PVCs as well (bigeminy). Rhythm D presents with PVCs presenting in a trigeminy pattern.
- What causes premature atrial contractions (PACs)?
A. Atrial enlargement
B. Decreased heart rate
C. Increase in the SA node activity
D. Atrial fibrillation
The answer is: A. Atrial enlargement. PACs are often caused by atrial enlargement, especially of the left atrium, along with other factors like stress, electrolyte imbalances, and tobacco use.
- What is a key characteristic of the P waves in PACs?
A. They are identical to the regular P waves.
B. They appear early and differ in shape or size from the regular P waves.
C. They are absent in PACs.
D. They are always followed by a QRS complex.
The answer is: B. They appear early and differ in shape or size from the regular P waves. The key characteristic of PACs is that they appear as early P waves that differ in shape or size compared to the regular P waves of the underlying rhythm.
- What happens in a conducted PAC?
A. The P wave is followed by a QRS complex.
B. The P wave is absent.
C. The QRS complex is prolonged.
D. There is no electrical signal reaching the ventricles.
The answer is: A. The P wave is followed by a QRS complex. In conducted PACs, the early P wave is followed by a QRS complex, indicating that the electrical signal reached and depolarized the ventricles.
- What is a common symptom of frequent PACs?
A. Chest pain
B. Palpitations or fluttering in the chest
C. Dizziness
D. Shortness of breath
The answer is: B. Palpitations or fluttering in the chest. Frequent PACs may lead to palpitations or a fluttering sensation in the chest. These symptoms are often reported by patients experiencing frequent PACs.
- Which of the following is a common cause of PACs?
A. Low sodium levels
B. Left atrial enlargement
C. High calcium levels
D. Right ventricular hypertrophy
The answer is: B. Left atrial enlargement. Left atrial enlargement is a common cause of PACs, along with other factors like stimulant use (e.g., caffeine), stress, and electrolyte imbalances.
- What does the presence of a pause following a PAC typically indicate?
A. The rhythm is irregular.
B. The electrical signal did not reach the ventricles.
C. The QRS complex is normal.
D. The SA node is not functioning properly.
The answer is: B. The electrical signal did not reach the ventricles. A pause after a PAC typically indicates that the electrical signal from the premature P wave did not reach the ventricles, especially in non-conducted PACs.
- How do PACs affect the underlying rhythm?
A. They cause the underlying rhythm to become irregular.
B. They cause the underlying rhythm to become regular.
C. They always lead to atrial fibrillation.
D. They have no effect on the underlying rhythm.
The answer is: A. They cause the underlying rhythm to become irregular. PACs cause the rhythm to become irregular because they introduce early beats. However, the underlying rhythm usually remains regular when PACs are infrequent.
- Which of the following medications can be used to treat frequent PACs?
A. Diuretics
B. Beta-blockers
C. Antihistamines
D. Anticoagulants
The answer is: B. Beta-blockers. Beta-blockers and calcium channel blockers can be used to treat frequent PACs by controlling the heart rate and reducing the frequency of the premature beats.
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