EKG Question #6


The nurse analyzes the following strip and determines that the interpretation is:


  1. 2nd Degree Mobitz II
    • Rationale:
  2. Third Degree (Complete) Heart Block
    • Rationale:
  3. 1st Degree with BBB
    • Rationale:
  4. Atrial flutter
    • Rationale:



The ECG above reveals upright P waves with some buried (see the first impulse reveals a P wave buried in the ST segment), variable P-R interval, and a wide QRS of 0.14 sec. P waves and QRS complexes will be occurring at different rates. The QRS complexes may be coming from impulses in the HIS bundle or Purkinje. A wide bizarre QRS with a heart rate of < 40 may indicate that the Purkinje network is where the impulses are originating. There is a blockage that prevents electrical cardiac impulses in the atria from entering the ventricular conduction system. The atria and ventricles are electrically dissociated from each other.

Learning Outcomes

Test Taking Tip

Video Rationale