Advanced Patient Assessment Practice Exam

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What heart rate is observed when the AV node paces the heart?

  1. 40-60 BPM

  2. 80-100 BPM

  3. 40-60 BPM

  4. 20-40 BPM

The correct answer is: 40-60 BPM

When the AV node paces the heart, the heart rate typically falls within the range of 40 to 60 beats per minute (BPM). This occurs when the primary pacemaker of the heart, the sinoatrial (SA) node, fails to initiate impulses adequately. In such a case, the AV node can take over as a backup pacemaker. While it is not as efficient or as fast as the SA node, the AV node’s intrinsic pacing rate is relatively slow. This is due to the unique properties of the cells in the AV node, which have a lower automaticity compared to the SA node. Understanding the pacing hierarchy is crucial in advanced patient assessment, as it helps determine the underlying causes of bradycardia or other arrhythmias. The rates associated with other nodes are also essential in this context. For instance, if the heart is paced by the SA node, the rate would typically be between 60 to 100 BPM. If the heart is paced by the Purkinje fibers or bundles (which take over when both the SA and AV nodes fail), the heart rate may drop to 20-40 BPM. This highlights the AV node's role as an intermediate pacemaker in the event of SA node

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