in which of the following with the QRS complex have higher amplitude?

when there is fluid in the pericardial sac

The patient must undress from the waist up and put on a gown. What else is the patient instructed to do prior to EKG

remove any metal items change in cell phones from their pockets

if a patient has a limb amputated, where would the electrode be placed

tape the electrode to the sides of the amputation

where is the chest electrode V2 located

at the fourth intercostal space at the left margin of the sternum

The pericardial sac that surrounds the heart:

tough fibrous outer layer called visceral pericardium and an inner lining

During depolarization:

Impulses are generated and transmitted when positively charged

The most suitable type of patient education material is written using

language at a sixth grade level

which of the following is the best method for calculating the heart rate in an irregular rhythm

six second intervals X 10 method

The term dysrhythmia means the :

heart is beating in an unusual way

to view the limb leads, we place electrodes on the

right arm, left arm, and left leg,

what are the three layers of the heart wall

epicardium, myocardium, endocardium

Narcan is used to block or reverse the effects of opioid medication, the treatment is given and what part of the body

and a muscle in the outer thigh

which of the following PHI can be disclosed by the medical office without the patient’s permission

Insurance information and diagnostic reports

characteristics of premature ventricular complexes include that they

are followed by a noncompensatory pause

The skeleton of the heart:

separates the atria from the ventricles

A patient is regularly taking Digoxin for heart failure. The patient is instructed to do which of the following:

check their pulse on a regular basis

junctional tachycardia has

PR intervals less than 0.12 seconds

One preparing a patient to wear a Holter monitor, instruct the patient to

press the event marker for significant symptoms

characteristics of idioventricular rhythm include

A heart rate between 20 to 40 bpm

each small square running vertically represents 10 MM or 1.0 MV

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AMCA EKG review

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Questions 94

Answers

1
in which of the following with the QRS complex have higher amplitude?
when there is fluid in the pericardial sac
in women
The elderly
The precordial leads
2
The patient must undress from the waist up and put on a gown. What else is the patient instructed to do prior to EKG
perform jumping jacks to stimulate their heartbeat
remove any metal items change in cell phones from their pockets
go to the bathroom
apply lotion to overly dry skin
3
if a patient has a limb amputated, where would the electrode be placed
omit the electrode because of the missing limb
tape the electrode to the sides of the amputation
used to leads on the remaining limb
use only the 11 remaining leads
4
premature atrial complexes originate from the
AV junction
atria
bundle of His
SA node
5
which ECG limb lead does not record any electrical activity from the heart
left arm
right arm
left leg
right leg
6
where is the chest electrode V2 located
at the fifth intercostal space at the left mid clavicular line
at the horizontal level of V4 at the left anterior axillary line
at the fourth intercostal space at the right margin of the sternum
at the fourth intercostal space at the left margin of the sternum
7
HIPAA contains 4 standards. Which standard was put in place to ensure confidentiality of oral, electronic/written info
transactions and code sets
National identifier standards
security rule
privacy rule
8
if a patient is said to be in asystole, the characteristics would be described as
rapid rate and loss of consciousness
traumatic hypotension and slow thread pulse
rate of zero and no pulse
possible palpitations and rate of 60 bpm
9
The pericardial sac that surrounds the heart:
allows heart to contract/expand within chest cavity
is called the mediastinum
tough fibrous outer layer called visceral pericardium and an inner lining
is a thick, single walled closed sac
10
P waves resulting from impulses that originate outside the SA node are called
P neutral
P prime
R
retro P
11
The space between the ribs is known as
Chambers
ventricles
atria
intercostal space
12
blood vessels that carry blood from the heart to the lungs
pulmonary arteries
arterial blood vessels
ventricular blood vessels
pulmonary veins
13
During depolarization:
positively charged ions leave the cell causing the positive charge to lower
Impulses are generated and transmitted when positively charged
The cells have a higher concentration of negatively charged ions in cell
no electrical activity takes place
14
The most suitable type of patient education material is written using
technical and specialized medical language
only English words
language at a sixth grade level
medical jargon
15
which of the following is the best method for calculating the heart rate in an irregular rhythm
six second intervals X 10 method
300, 150, 100, 75, 60, 50
rate calculator
1500 method
16
waveforms may be displayed on a screen called an:
electrocardiogram
oscilloscope
leads
Graph
17
The term dysrhythmia means the :
ECG rhythm differs from normal sinus rhythm
heart is beating in an unusual way
ECG has all the normal characteristics
rhythm arises from a site outside the SA node
18
what is used as a reference point to identify the changing electrical impulses
PR interval
isoelectric line
p-wave
QRS complex
19
to view the limb leads, we place electrodes on the
left side of the chest
right arm, left arm, right leg
right arm, left arm, and left leg,
right side of the chest
20
each small square running horizontally represents
0.1 MV
0.04 seconds
three seconds
5MM
21
The heart receives most of its own blood supply via the:
ascending aorta
coronary veins
coronary arteries
coronary capillaries
22
The point at which the QRS complex meets the ST segment is called
RS point
QT Junction
J point
ST interval
23
The blood vessel that carries oxygenated blood to the body is the
pulmonary artery
pulmonary vein
aorta
superior vena cava
24
The prefix gast/r means
stomach
intestines
kidneys
lungs
25
Who must be present during an exercise electrocardiograph
A cardiologist
A medical assistant
A technician
an office manager
26
The heart valves that separate the atria from the ventricles are called the:
Aortic valve
pulmonary veins
Atrioventricular valves
semi lunar valves
27
what are the three layers of the heart wall
pericardium, myocardium, epicardium
pericardium, myocardium, endocardium
Myocyte, actin, myosin
epicardium, myocardium, endocardium
28
The most muscular chamber of the heart that forces blood through the aortic valve in the aorta would be the:
right atrium
left ventricle
right ventricle
left atrium
29
blood returns to the heart from the lungs via 4 blood vessels called:
pulmonary arteries
ventricular blood vessels
atrial blood vessels
pulmonary veins
30
Narcan is used to block or reverse the effects of opioid medication, the treatment is given and what part of the body
in the Brachium
in the gluteus maximus
and a muscle in the outer thigh
in the stomach
31
how much blood coming into the ventricles flow passively through the atria?
80%
60%
70%
50%
32
which of the following PHI can be disclosed by the medical office without the patient’s permission
The medical practices treatment, payment, and operation information
Home care reports and health history information
consent forms and HIPAA forms
Insurance information and diagnostic reports
33
characteristics of premature ventricular complexes include that they
have normal PR intervals
are followed by a noncompensatory pause
are preceded by an inverted P-wave
have a wide and bizarre QRS complex
34
The third step of analyzing an ECG rhythm is to
evaluate the QRS complex
determine the heart rate
examine the P waves
determine the regularity
35
which of the following topics will not be brought up in exam prep?
current medications
Insurance
name
date of birth
36
The skeleton of the heart:
joins the atria and ventricles together as one unit
is a plate of muscular tissue
separates the atria from the ventricles
is the hearts conduction system
37
The atrioventricular valve between the left atrium and the left ventricle is the:
pulmonary semilunar valve
aortic semi lunar valve
mitral valve
tricuspid valve
38
The contraction phase of the heartbeat is called
tachycardia
Systole
diastole
pacemaker
39
The wall that separates the two superior chambers of the heart is called:
atrioventricular septum
Interventricular septum
pulmonary septum
Interatrial septum
40
in Leads 1, 11, aVF, and V2 through V6 The deflection of the P-wave is
biphasic
negative or biphasic
upright
negative
41
shorter than normal PR intervals may be seen in:
ventricular escape rhythm
junctional escape rhythm
sinus dysrhythmia
sinus tachycardia
42
A patient is regularly taking Digoxin for heart failure. The patient is instructed to do which of the following:
continue taking digoxin even if side effects occur
take medication with antacids
continue with over-the-counter medications as they are safe with digoxin
check their pulse on a regular basis
43
junctional tachycardia has
inverted QRS complexes
an irregular rhythm
PR intervals less than 0.12 seconds
A rate between 60 and 180 bpm
44
The use of non-invasive and painless ultrasound to examine the heart, it’s chambers and valves is known as:
echocardiography
electro cardiogram
cardiac catheterization
Doppler imaging
45
Match the prefix Anesthesio- to the term that matches its definition
digestion
sensation
sound
breath
46
Which refers to the period in which the mechanical and electrical events of the heart are relaxed/involves repolarizatio
Diastole
systole
automaticity
cardiac cycle
47
and leads 1, 11, ,111, avL, avF, and v4-v6 The deflection of the QRS complex is characteristically:
upright
biphasic or inverted
biphasic
inverted
48
One preparing a patient to wear a Holter monitor, instruct the patient to
remove the monitor from the case at night
press the event marker for significant symptoms
where are the monitor in the shower for accurate readings
remove the monitor when exercising
49
characteristics of idioventricular rhythm include
T waves that take the same direction as the R waves
A heart rate between 20 to 40 bpm
P waves that follow the QRS complex is
narrow QRS complexes
50
with ECG paper
there is a grid of narrow horizontal and vertical lines that intersect
5 small squares which make up a larger box represent 0.20 seconds
each small square running horizontally represents 0.05 seconds in duration
each small square running vertically represents 10 MM or 1.0 MV
51
The breastbone is referred to as:
intercostal space
The mediastinum
The septum
The sternum
52
which of the following terms refers to the ventricular ectopic discharge at a rapid regular rate in excess of 100 bpm
atrial fabulation
atrial flutter
premature ventricular contraction
ventricular tachycardia
53
the most accurate way to measure heart rate is
6X 10 method
p-wave
300, 150, 100, 75, 50 method
1500 method
54
which of the following dysrhythmias arise from the ventricles
sinus dysrhythmia
Atrail tachycardia
accelerated junctional rhythm
idoventricular rhythm
55
The myocardium is the
double walled membranous sac and closing the heart
middle layer of the heart muscle, responsible for pumping action
external layer of the heart
modified cells found in distal areas of the bundle branches
56
the cardioaccelerator center:
as part of the parasympathetic nervous system
is part of the sympathetic nervous system
is located in the cortex of the brain
transmit signals to the heart by way of the vagus nerves
57
with lead two, the positive electrode is positioned on the
right arm
left shoulder
right side of the chest
left leg
58
abnormal ventricular wall motion that is reversible with nitroglycerin is associated with
myocardial ischemia
pericardial effusion
pericarditis
myocardial infarction
59
an over-the-counter medication that can be very effective as an anti-platelet is which of the following
antacid
pseudophed
naprocin
aspirin
60
which of the following is used to mark the ECG paper
A pen
A stylus
an ink jet
A marker
61
which of the following test does not permit the calculation of the cardiac ejection fracture
chest x-ray
2-D echo cardio gram
cardiac angiogram
cardiac nuclear study
62
dr. Jackson once charted in Mr. Smith’s EMR that a non-invasive procedure was done in office. Which procedure is charted
angioplasty
placement of a temporary pacemaker
placement of an intra-aortic balloon assist device
cardiovascular stress test
63
what is placed on the patient’s skin to detect the heart electrical activity
leads
oscilloscope
electrocardiogram
electrodes
64
The Q wave is
sometimes upright
The first negative deflection following the P-wave
normally absent
A negative deflection following the R wave
65
The ECG should be performed in a quiet environment because
transmission of micro organisms is minimized
interference is minimized
wandering baseline
it enables the patient to sleep
66
you should count the_____to get the atrial rate
paroxysmal
p-waves
QRS complex
PR interval
67
an electrical current traveling toward a positive electrode produces a waveform that
is mostly flat
is both up and down
points downward
points upward
68
what takes place as a result of myocardial infarction
A major artery becomes blocked
A major blood vessel burst
The heartbeat becomes very irregular
A portion of the heart muscle dies
69
on ECG paper horizontal measurements are used to determine the
heart rate
cardiac output
electrical voltage of the waveforms
amplitude of the wave forms
70
how many electrodes are used as part of a 12 lead EKG
8
6
12
10
71
The initiation of the impulse in the SA node and its movement through the atria produces a
p-wave
t-wave
PR interval
QRS complex
72
The three leaflet heart valve, located between the right atrium and ventricle is referred to as
The pulmonary semi lunar valve
The aortic valve
The mitral valve
The tricuspid valve
73
most superficial layer of heart made up of simple squamous epithelium tissue over loose areolar connective tissue is
epicardium
endocardium
pericardium
myocardium
74
The patient is asymptomatic during ECG recording and you notice normal sinus rhythm. What should you do?
check the ECG leads
notify the physician
continue recording
call 911
75
before placing electrodes on the patient’s body what should you do prior to shaving the patient
wash their skin and apply shaving cream
put them in the shower and ask them to shave
apply a depilatory and wipe of hair
Ask the patient’s permission before shaving them
76
The normal QRS complex:
has an amplitude of 5 to 15 MM
occurs before the PR interval
consists of two waveforms
has a duration of 0.06 to 0.12 seconds
77
what is the compression to breathing ratio for adult CPR
15 to 1
15 to 2
30 to 2
five to one
78
when a rhythm speeds up and slows down in a rhythmic fashion it is referred to as
frequent
patterned
slight
profound
79
regulation of the heart, speed of electrical conduction and strength of contraction are influenced by brain via the:
autonomic nervous system
somatic nervous system
voluntary nervous system
central nervous system
80
tall and symmetrically peaked P waves may be seen with
increased left atrial pressure and left atrial dilation
increase rate atrial pressure and right atrial dilation
impulses that originate outside the SA node
A delay in the movement of the electrical impulse between R and L atria
81
The QRS complexes appear normal if:
The impulse originates in the ventricles
conduction is delayed as the impulse progresses from the bundle of His
there is a conduction delay through the ventricles
The rhythm is initiated from the SA node, atria, or AV junction
82
which of the following is the first structure that will be seen when imaging from the suprasternal notch
pulmonary arteries
aortic arch
coronary arteries
IVC
83
pre-excitation:
produces a characteristically abnormal slurring at the onset of the QRS
when an impulse arises from a superventricular site-travels quicker
leads to a delayed depolarization of the ventricles
Leads to a longer than normal PR interval
84
when no abnormalities show during a resting ECG the physician may order an exercise ECG. Another name for this is
cardiac catheterization
Holter monitor
stress test
cardiac monitoring
85
A medication that can be used as a local anesthetic as well as a first line anti-arrhythmic
Lopressor
Lanozin
Tenormin
Xylocaine
86
characteristics of sinus rhythm include:
progressively longer PR intervals
an inverted P-wave which follows each QRS complex
and irregular rhythm
A rate of between 60 and 100 bpm
87
which of the following is treated with hydrochlorothiazide
High blood pressure and fluid retention
interstitual cystitis
nephritis
angina pectoris
88
The T-wave
has a peak which is closer to the end than the beginning
has a peek which is closer to the beginning in the end
is normally oriented in the same direction as the preceding QRS complex
is larger than the P-wave and completely symmetrical
89
choose the patient education process that requires gathering information about the patient present health care needs
assessment
planning
documentation
evaluation
90
A calibration mark is
10 MM tall
included just on those ECG tracing‘s which are abnormal
used to check the power supply on the ECG machine
created manually on all ECG machines
91
atrial fibrillation has
QRS complexes which appear wide and bizarre in configuration
an absence of discernible P waves
PR intervals of greater than 0.20 seconds
A regular rhythm
92
how do medication’s statins work
they treat hypertension in patients with high blood pressure
they reduce the incidence of heart attack and death for high cholesterol
they work at thinning the blood to reduce the chance of blood clots
they caused the heart to regulate the heartbeat
93
during which phase of the cardiac cycle do the coronary arteries fill?
late diastole
late systole
early diastole
early systole
94
an R on T PVC
occurs on or near the T-wave of the previous beat
produces a non-compensatory pause
May precipitate ventricular asystole
appears as a PVC squeezed between 2 regular complexes

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