INI-CET EXAM -2025
Medical & Surgical Nursing
Easy
Which of the following conditions is associated with large P waves on an ECG?
Appeared in: INI-CET EXAM -2025
Explanation
- Large (tall) P waves on an ECG are referred to as P pulmonale.
- P pulmonale is the hallmark sign of right atrial enlargement (RAE).
- Tricuspid stenosis causes obstruction of blood flow from the right atrium to the right ventricle.
- This obstruction leads to increased pressure and volume in the right atrium, causing it to enlarge, which is reflected as P pulmonale on the ECG.
Why Other Options Were Wrong
- Option A: Mitral stenosis causes left atrial enlargement, not right atrial enlargement. The characteristic ECG finding is a broad, notched P wave known as P mitrale.
- Option C: Aortic regurgitation primarily causes left ventricular volume overload. Over time, this can lead to left atrial enlargement (P mitrale), but it does not directly cause right atrial enlargement.
- Option D: Systemic hypertension causes increased afterload on the left ventricle, leading to left ventricular hypertrophy and subsequently left atrial enlargement (P mitrale). It does not cause right atrial enlargement.
Related Visual
- Visual 1: ECG strip showing P pulmonale. The caption should highlight the tall, peaked P waves in lead II, with an amplitude greater than 2.5 mm, indicating right atrial enlargement.
- Visual 2: ECG strip showing P mitrale. The caption should point out the broad (>0.12s) and notched ('M'-shaped) P wave in lead II, indicating left atrial enlargement.
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain ECG interpretation of P wave abnormalities and their correlation with valvular heart disease as background academic context rather than a clinical decision trigger.
- Recognizing P wave abnormalities on an ECG is a crucial skill for nurses, as it can be an early indicator of underlying valvular heart disease or pulmonary conditions.
- Prompt identification allows for further diagnostic workup (like an echocardiogram) and timely management, preventing complications like heart failure and arrhythmias.
- What if? If the question described a broad, notched P wave instead of a large one, the correct answer would be Mitral Stenosis, as this finding (P mitrale) is characteristic of left atrial enlargement.
How to Approach the Question
- First, identify the key finding in the question: 'large P waves on an ECG'.
- Recall the clinical significance of this finding. Large (tall) P waves are called P pulmonale and signify right atrial enlargement.
- Next, analyze each option to determine which condition would cause right atrial enlargement.
- Tricuspid stenosis directly obstructs outflow from the right atrium, causing pressure to build up and the chamber to enlarge.
- Mitral stenosis, aortic regurgitation, and systemic hypertension primarily affect the left side of the heart, leading to left atrial enlargement (P mitrale), not right atrial enlargement.
- Therefore, connect the ECG finding (P pulmonale) to its cause (right atrial enlargement) and the underlying condition (tricuspid stenosis).
Concept Tested & Keywords
- Concept Tested: ECG interpretation of P wave abnormalities and their correlation with valvular heart disease.
- Stem keywords: large P waves, ECG, conditions
- Lead-in keywords: Which of the following
Question ID
QeC54WHGJRjHnhDk2lxSDu
Practise the full INI-CET EXAM -2025
Attempt every question from this paper in a timed mock, then review the full solution for each one.
More Cardiovascular, Circulatory, and Hematologic Function Questions
- A patient is undergoing blood transfusion and suddenly shows complaints of transfusion reaction. What will be the priority nursing intervention?
- The following all are blood transfusion complications from; EXCEPT:
- Identify the use of following machine used in pneumatic compression device:
- In iron deficiency anemia, the fingernails become spoon shaped, this condition is referred to as:
- Which gauze cannula is commonly used for blood transfusion?
- If 'P' wave is absent in ECG rhythm, it is an indication of:
- Normal compression to ventilation ratio:
- Trans-illumination procedure is done with:
- A patient in the ward experiences sudden cardiac arrest. What is the most appropriate technique for opening the airway to facilitate endotracheal int…
- A patient experiences complications after a blood transfusion. Which of the following signs and symptoms is indicative of circulatory overload?
More INI-CET EXAM -2025 Questions
- The highlighted structure in the provided image articulates with which bone?& x20;
- Through which of the following foramina does the nerve supplying the muscles of mastication pass?& x20;
- In the given image, which region is correctly paired with its corresponding brain structure? • Middle cerebellar peduncle • Fasciculus cuneatus • Sup…
- Which of the following muscles is NOT typically associated with dysphagia or dysarthria?
- A muscle of mastication involved in opening the mouth exhibits the following characteristics. Identify the incorrect statement about it:
- In the illustrated image, which of the following structures is NOT associated with the area marked by the arrow?& x20;
- Match the following embryonic aortic arches with their respective adult derivatives: A. 1st Arch 1. Maxillary artery& x20; B. 2nd Arch 2. Common caro…
- Which of the following histology image is not an endocrine structure?& x20;
- Marked structure separates which of the following:
- Which of the following bones of the skull gives passage to a nerve arising from the brain & x20;