Answer 44

44.  Choice C is the correct answer.  There are two pacer spikes occurring towards the end of the EKG strips.  Some pacer are only demand pacers and will capture when needed.  This is why there is two pacer spikes.  If it is an atrial pacer the spikes will occur before there P wave.  If it is a ventricular pacer the pacer spike will occur before the QRS complex.