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EKG
EKG
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1
What rhythm is characterized by upright P waves, narrow QRS complexes, and a ventricular rate between 60 and 100/min?
Atrial flutter
Ventricular tachycardia
Sinus Bradycardia
Sinus Rhythm
2
If all waveforms are negative in Lead I, which limb electrode connections should the EKG tech check?
Right leg
Right arm and left arm
Left leg
Right leg
3
What should an EKG technician do next after noticing an accelerated idioventricular rhythm on an EKG tracing?
Immediately defibrillate the patient
Administer a does of adenosine
Call for help and stay with the patient
Ignore the finding. This is a normal variant
4
Which of the following is the correct section to measure the QRS complex
Beginning of the P wave to the end of the T wave
Beginning of the Q wave to the end of the S wave
Beginning of the Q wave to the end of the T wave
End of the P wave to the beginning of the S wave
5
To spread out the tracing of a patient with a rapid heart rate on an EKG, what paper speed should be used?
50 mm
10 mm
5 mm
20 mm
6
What patient right is violated when an EKG technician releases a patient’s diagnosis to their employer?
Right to informed consent
Patient confidentiality
Right to a second opinion
Right to refuse treatment
7
What should an EKG technician do if the QRS complex is too tall to fit on the EKG paper?
Continue recording as this is a normal finding
Increase paper speed
Ask pt to hold their breath
Change the gain control to 5mm/mv
8
Which EKG lead records the electrical activity of the septal wall?
Lead III
Leads V1 and V2
Lead I
Lead II
9
What lead is created by the placement of the electrode located to the right of the sternum in the 4th intercostal space
aVL
aVR
V1
V6
10
What should an EKG tech do to accurately measure a patient’s respiratory rate when chest movements are hard to see?
Ask the pt to take deep breaths
Count the pulse rate
Ignore chest movements and estimate rate
Place a hand on the middle of the pt back to count the respirations
11
What EKG finding indicates impaired conduction through the AV node?
Shortened PR interval
Absent P wave
Prolonged PR interval
Narrow QRS segment
12
What is the anticipated QRS complex pattern in V4 for a normal patient?
Deeply inverted
Wide and slurred
Half positive, half negative
Notched and bipashic
13
What are patients restricted from doing while wearing a Holter Monitor
Sleeping
Eating
Taking a shower
Walking
14
What interval is used to determine the regularity of ventricular depolarization?
QT interval
ST segment
PR interval
R-R wave interval
15
What activities should an EKG tech tell a patient to record in their Holter monitor diary?
The amount of food eaten
Running
The number of people interacted with
Number of hours slept
16
What is the only calculating method available for both regular and irregular rhythms?
50 second method
10 second method
6 second method
25 second method
17
What lead group represents Einthoven’s Triangle
I, II, V2
aVL, aVR, V5
I, II, III
I, V4, V6
18
What is the minimum length of a rhythm strip needed to identify rate and rhythm?
10 seconds
2 seconds
5 seconds
6 seconds
19
How should an EKG tech adjust lead placement for a patient with a left leg amputation?
Skip the left leg lead entirely.
Place the lower extremity lead on the left groin
Attach the left leg lead to the left arm.
Place both leg leads on the chest
20
How many monitor leads are placed on a patient when applying a Holter monitor?
12
5
2
10
21
What wave should an EKG technician measure to evaluate for atrial depolarization?
QRS complex
P wave
U wave
T wave
22
When should a provider stop an exercise stress test
Normal sinus rhythm
Increased heart rate
Mild sweating
Dizziness
23
Which lead is placed along the paraspinous border in a posterior EKG?
V3R
V5
V9
V1
24
What condition is characterized by ST segment depression and T wave inversion?
Myocardial Ischemia
Left bundle branch block
Right bundle branch block
Myocardial infarction
25
What should an EKG technician do to EKG cables to prevent the transmission of microorganisms?
Store cables in a plastic bag
Wipe with disinfectant
Soak cables in bleach
Wipe cables with a dry cloth
26
What should an EKG technician identify an elevated ST segment observed during an exercise stress test as?
Signs of acute myocardial injury
Normal finding
Hypokalemia
Artifact
27
Tech just provided pt education prior to a stress test. What statement made by the pt indicates an understanding of prep
I can shower
I can take the leads off anytime I want
I may smoke the night before my exam
I will replace the leads if they fall off
28
What is the most likely cause of electrical interference on an EKG?
Properly placed electrodes
New EKG cables
A frayed wire
Calibrated EKG machine
29
Which electrode is used to create leads I, II, and aVR?
Right leg
Left leg
Chest
Right arm
30
What statement made by a new EKG technician about artifact shows a knowledge deficit?
Movement artifact can be reduced by ensuring good electrode contact
Muscle tremors can cause artifact on the EKG tracing
Cell phones can not be a cause of electrical interference on the EKG
Artifact is caused by electrical interference from other devices
31
Which lead is most sensitive to right ventricular ischemia during a right-sided EKG?
V3
V2
V4R
V5
32
If an EKG tech notices none of the leads are giving a reading, which limb should they check first?
Right arm
Left leg
Right leg
Left arm
33
What should an EKG technician suspect when observing ST segment depression and T wave inversion in multiple leads?
Pulmonary embolism
Myocardial ischemia
Hypokalemia
Pericarditis
34
What is the bipolar lead group
V3, V4, V5
Leads I, II, III
V7, III, V1
I, II, aVL
35
What is a final step an EKG technician should take when applying a Holter monitor
Perform a blood draw
Obtain the pt weight
Administer an EKG
Document the procedure in the pt health records
36
What symptom would cause an EKG technician to stop a stress test?
Increased sweating
Slight increase in blood pressure
Dizziness
Increased heart rate
37
What is an appropriate explanation for why a pt might need an ambul monitor after having an EKG 2 days prior
Your dr wants to study your heart over a longer period of time
The ambul. monitor will check for blockages in the arteries around heart
We need to make sure you don’t have electrical activity in your heart
The EKG showed your heart stopped for a few seconds
38
What is the hr of a adult (older than 15 yrs old)
50-70 bpm
60-100 bpm
70-90 bpm
60-80 bpm
39
What is the expected shape and direction of the P wave in lead II for a normal patient?
Negative and biphasic
Inverted and wide
Round and upright
Flat or absent
40
In what position should a patient be placed for a 12-lead EKG?
Standing
Sitting upright
Trendelenburg
Supine
41
A thin spike before the P wave indicates a pacemaker has been implanted to pace what?
Atria
QRS complex
T wave
U wave
42
What medical history finding would prevent a patient from participating in an exercise stress test?
Well controlled hypertension
Seasonal allergies
Congested heart failure
Recent ankle sprain
43
How should an EKG technician respond to a patient who says they run 5 miles daily during Holter monitor application?
Running won’t affect the monitors reading
Continue to exercise as usual while wearing the monitor
You will need to avoid running while wearing the monitor
That’s great. Your heart must be very healthy
44
What is the expected hr for ages 3-5 yrs old
90-120 bpm
40-60 bpm
70-90 bpm
80-120 bpm
45
What is the site for measuring the hr of a 5 yr old pt
Brachial
Carotid
Dorsalis Pedis
Radial
46
An EKG tech detects a U wave and the patient reports chest pain and discomfort. What actions should the tech take
Call a code blue and get the AED
Administer CPR
Stop the test
Notify the patients provider
47
What is the preferred artery for measuring heart rate in an adult patient after a stress test?
Femoral
Popliteal
Dorsalis pedis
Radial
48
What site is used to measure heart rate of a 28 yr old
Radial pulse
Pupil
Xiphoid process
Patella
49
What is used to ensure an EKG machine is working properly?
Change the gain speed
Calibration
Stethoscope
Sphygmomanometer
50
What sensitivity setting would produce a calibration box that measures 10 mm tall?
2.5
5
1
20
51
What is the correct method for calculating a patient’s heart rate from an EKG?
Lead Placement Method
Calibration Method
Electrode Placement Method
Divide 1500 by the number of small boxes between two R waves
52
What heart block is the most serious
2nd degree type 1 (Wenckebach)
2nd degree type 2 (Mobitz II)
1st degree
Third degree AV block
53
An EKG has 2 mm ST elevation in leads I, AVL, V5, and V6. What type of infarction would this represent
Notify the provider
Lateral Infarction
Myocardial Infarction
Myocardial Ischemia
54
Where is lead V7 placed during a posterior EKG?
Right posterior axillary line, horizontal to V6
Right posterior axillary line
Left anterior axillary line, horizontal to V4
Left midscapular line, 5th intercostal space
55
What wave should an EKG technician measure to evaluate for atrial enlargement?
T wave
P wave
QRS complex
ST segment
56
What situation could result in a wandering baseline artifact on an EKG tracing?
Clean EKG cables
Loose electrodes
Properly placed electrodes
Patient remaining still
57
What type of consent is a patient giving when they follow an EKG tech, voluntarily undress, and lie on the table?
Written
Implied
Informed
Verbal
58
What is the expected reference range for the respiratory rate of a newborn patient?
10-20/min
60-80/min
20-49/min
100-120/min
59
When is it acceptable for a CET to share a patient’s protected health information?
When discussing the patients case with colleagues in the hallway
An inquiry from the quality assurance office
When posting about the patients case on social media
When a family member asks for an update
60
What lead is created between the left arm and the left leg?
Lead III
Lead I
Lead aVR
Lead II
61
Which EKG lead should be placed on the right lower side of the anterior torso during an exercise stress test?
Lead aVL
Lead II
Lead I
Lead RL
62
What should the EKG tech do if the pt loses consciousness and the EKG reveals ventricular fibrillation
Call for help and begin CPR
Call the pt vital signs
Check the pt vital signs
Continue monitoring the pt EKG
63
Which of the following leads look at the intraventricular septum
I and II
V1 and V2
aVL and aVR
V3 and V4
64
What should an EKG technician do to reduce artifacts when preparing a Holter monitor for placement?
Use a single lead for the monitoring
Instruct the patient to remain still for the duration of the monitoring
Place the electrodes over bony prominences
Use stress loops on the electrodes to reduce tension on the leads
65
What should an EKG technician do to resolve a wandering baseline on a patient’s EKG tracing?
Apply lotion to the patients skin
Relieve tension from the wires
Ask patient to hold their breath
Increase paper speed
66
Where should the green ground electrode be placed for 5-lead ambulatory monitoring?
On the rib on the lower left side
Left arm
Right arm
On the rib on the lower right side
67
Where should the right leg electrode be placed on a patient with a below-the-knee amputation of the left leg?
Left side of the abdomen
Right side of the abdomen
Left thigh
Lower right thigh
