ECG Question #30


The nurse is caring for a client who has hypomagnesaemia and hypokalemia. While watching the telemetry monitor, the nurse notices a twisting of the QRS complexes and immediately informs the health care provider that the monitor reveals which abnormality.


  1. Type III AV block
    • Rationale:
  2. First degree AV block
    • Rationale:
  3. Paroxysmal atrial tachycardia
    • Rationale:
  4. Torsade de pointes
    • Rationale:



Torsade de pointes occurs following a change in the QRS complex to a twisting of the complex around the isoelectric line. The dangerous rhythm may precipitate ventricular fibrillation. It is also called “twisting of the point”. A prolonged QT interval is associated with the condition. Low magnesium and low potassium may cause this dysrhythmia. Twisting of the QRS complex is not associated with type III AV block, first degree AV block, or paroxysmal atrial tachycardia.

Learning Outcomes

Test Taking Tip

Video Rationale