AIIMS M.Sc. Nsg Entra…: & x20;The following ECG Represrepresent?

AIIMS M.Sc. Nsg Entrance exam-2026

Medical & Surgical Nursing

Medium

Appeared in: AIIMS M.Sc. Nsg Entrance exam-2026

Explanation

The ECG strip shows a rhythm where every normal sinus beat is followed by a premature ventricular contraction (PVC).
This consistent one-to-one (1:1) pattern is the definition of ventricular bigeminy.
The PVC is identified by its wide QRS complex (greater than 0.12s), bizarre morphology, and the absence of a preceding P wave.
A compensatory pause typically follows the PVC before the next normal beat occurs.

Option A: The ECG does not show a sustained, rapid rhythm (typically above 150 bpm) with narrow QRS complexes, which is characteristic of SVT.
Option C: Second-degree heart block involves a conduction problem from the atria to the ventricles, resulting in 'dropped' beats (P waves not followed by a QRS). This ECG shows extra beats (PVCs), not dropped beats.
Option D: Atrial fibrillation is a chaotic, irregularly irregular rhythm with no clear P waves. The ECG shown has a distinct and regular repeating pattern, which is the opposite of the chaotic nature of atrial fibrillation.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain ECG Interpretation: Ventricular Arrhythmias as background academic context rather than a clinical decision trigger.
Ventricular bigeminy can be benign in individuals without heart disease, but it can also be a sign of underlying cardiac issues like ischemia, electrolyte imbalances (hypokalemia, hypomagnesemia), or cardiomyopathy.
A nurse's primary role is to assess the patient for symptoms such as palpitations, dizziness, or shortness of breath, check vital signs (especially blood pressure, as PVCs may not produce a palpable pulse), and notify the physician.
What if? If the patient with ventricular bigeminy also complains of chest pain and is hypotensive, this becomes a medical emergency. The nurse should immediately activate the rapid response team, as this could indicate acute myocardial ischemia leading to a life-threatening arrhythmia.

How to Approach the Question

First, analyze the overall rhythm of the ECG strip. Notice that it is not consistently regular but has a repeating pattern.
Second, examine the QRS complexes. Identify that there are two different morphologies: one narrow and one wide/bizarre.
Third, determine the relationship between the two types of beats. Observe that one narrow (normal) beat is consistently followed by one wide (abnormal) beat.
Fourth, recall the definitions of different arrhythmias. A 1:1 pattern of normal beats to PVCs is termed 'bigeminy'.
Finally, evaluate the other options. Rule out SVT (fast, narrow QRS), heart block (dropped beats), and atrial fibrillation (chaotic, irregular) based on the visual evidence.

Concept Tested & Keywords

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E6 Medicine Harrison 22e Part 1 pp. 1996-1998, 2003-2005