2 Flashcards
Which chamber of the heart receives deoxygenated blood from the bodys circulation
Right Atrium
Paroxysmal Supraventricular tachycardia is typically caused by
Overexcitement
which cardiac stress test method increases the speed and incline every three minutes
Bruce Protocol
the collection of electrical conducting cells that innervate the ventricles are called
Purkinje system
what typically happens to the rhythm after a pause in sinus arrest occurs
Escape
depolarization of the atrial myocardial cells result in
contraction of the atria
which is the correct method attaching the leads to the electrodes
connect the snap wire to the electrode before application
which of the following is the group pacemaker cells responsible for firing an action potential
Sinoatrial node
which of the following is true regarding microshock
the shock is caused by a damaged or frayed cord
which of the following is true regarding junctional bradycardia
treatment is immediate trancutaneous pacing
systole can be broken down into four phases. during which phase do the ventricles contract while the semilunar valves remain closed
isovolumetric contraction
there are three types of EKG leads. which type of leads are placed on the limbs, and contain only one positve pole
augmented leads
which of the following is the appropriate method of ventilating an unresponsive patient with an advanced airway
deliver one breath every six seconds
which of the following is true regarding sinus block
P waves are not affected
before mounting a completed EKG, what information should be written on the strip
Date,time, providers’s name special circumstances
which of the following statment is true regarding atrial fibrillation
if p waves are present, the rhythm is not atrial fibrillation
There are 5 types of arrhyhmias. which type causes the electrical current to bypass the normal conduction pathways by directing them to shortcuts
preexcitation syndrome
a 70 year old male comes to the emergency department with chest pain. As you prepare to place the electrodes for a 12 lead EKG, he askes how much pain will the EKG will cause him. What would you tell the patient
obtaining an EKG is a painless procedure
which of the following is not a criterion for an arrhythmia
Narrow qrs complexes
what is the single most important task to prevent the spread of pathogens
washing your hands
what type of rhythm is atrial fibrillation
irregular
which of the following is true concerning bipolar leads
the right arm is always negative
all of the following are normal findings in an infant patient except
a heart rate less than 100
which of the following is the group of pacemakers cells responsible for firing an action potential
Sinoatrial node SA
what great vessel sends oxygentated blood from the heart to the systemic circulation of the body
Aorta
which of the following term refers to dilation of a chamber of the heart
enlargment
where should the technician place the EKG strip after teh test is finished
in the patients medical record
you examine the EKG machine and after turning it on recieve an error message on the screen. what is the next best action.
call your facility’s biomedical engineering
which of the following is not normal symptom during the stress test
a drop in blood pressure
which of the following is true regarding electrocardiography
an upward QRS complex occurs when an electrical impulse travels towards a positive electrode
which of the following is true regarding ventricular rhythms
The p wave is lost in the abundance of wide QRS complexes
which of the following is an appropriate way to interact with patients during an exam
reassure the patient that this is a safe procedure
which heart valve is located between the aorta and the left ventricle
aortic valve
which of following is not an acceptable method of filing a HIPAA complaint
phone
which layer of the heart contains the coronary arteries
epicardium
which of the following statement is true regarding premature atrial complex
the premature p wave may or may not be followed by a QRS complex
what length of time do the five block oulined in the image represent
1 second the
broken recordings, a type of artifact,is caused by
a broken wire
what is the ratio chest compression of to breaths when performing two rescue cpr on an unconscious adult
30:2
which of the following statments best describes an action potential
spontaneous depolarization results in a wave of new action potentials
which of the following is true concerning J point elevaton
The EKG will return to baseline with exercise
what important ion is released into the myocardial cells to cause heart muscle contraction
calcium
which great vessel returns oxygenated blood from the lungs back to the heart
pulmonary vein
you prepare to place electrodes on a 55 year old female for a 12 lead EKG when she asks about risks associated with the test. what is your response
possible skin irritation from the adhesive
on a 3 lead EKG, which lead is the most reliable when identifying an artifact
lead V1
where is lead AVL located
Left arm
which of the following is true regarding P wave asystole
only the sinus node is firing
which of the following is true about the HIPPA privacy rule
the HIPPA privacy rule extends to protected health information in all form of medial, including paper, electronic, and oral
Somatic tremor, a type of artifact, can be caused by
a patient having tremors
which of the following lead placement is correct on a fie lead EKG
brown leads to chest
according to the national heart, lung and blood institute, of teh national insitute of health, which value is definition of high blood pressure
sytolic pressure of 140 mmhg or greater
you are an EKG tech who is working at the front desk during the night shift. A man comes up to the desk, frantic. He says that he is the uncle of a patients on your floor and would like an update regarding her condition. what is your response
verify the persons identity with the patient or the nurse before you disclose any information
systole can be broken down into four phases. During which phase do the ventricles contract while the semilunar valves remain closed
isovolumetric contraction
which great vessel returns deoxygenated blood to the right atrium from the upper body
superior vena cava
identify the correct sequence of numbers used in the memory method to determine the heart rate
300-150-100-75-60-50-43-37-30
select the correct path of blood flow through the human body
aorta-arteries-arterioles-capillary bed-venules-veins-vena cava
which of the following can cause a 60 cycle interference artifact
a patient using his smartphone
what is a serious adverse effect of prolonged atrial fibrillation
blood clots
when should the cardiac stress test be concluded
when the patient experiences fatigue
the six precordial leads ( leads v1-v6) are arranged across the chest along a horizontal plane. where is lead v2 placed
fourth intercostal space, left sternal border
what type of rhythm is atrial fibrilation
irregular
during disatole, artia slightly contract to squeeze its remaining amount of blood in the ventricles. what is this phase called
Atrial kick
which heart valve is located between the left atrium and left ventricle
mitral valve
which method of calculating heart rate on an ekg strip is considered the fastest.
the memory method
which great vessel returns deoxygenated blood to the heart from the lower body
inferior vena cava
which of the following is the correct way to place holter monitor leads
clipping a male patients chest hair to allow the electrodes to adhere properly
what represents atrial enlargment on an ekg strip
prolonged p wave
which of the following is not done prior to the stress test
an ergometer is applied to the patients upper arm
which of the following is true regarding accelerate junctional rhythms
the heart rate is usually between 60 and 100 beats per minute
when applying electrodes to a patient for holter monitoring, where do you place the white (RA) lead
directly below the clavicle and near the right shoulder
which of the following is true regarding ventricular fibrillation
its an irregular rhythm
you are taking vitals on a one month old female and find that her heart rate is 160. based on your knowledge of pediatric cardiac function, what do you do
document as a normal finding
there are five types of arrhythmias. the type that causes normal sinus rhythm to become too fast or too slow is called
arrhythmias of sinus origin
during continous monitoring, what does MCL1 access cor
WIde QRS complexes
which of the following is indicated as a treatment for atrial fibrilation lasting greater than 48 hours
IV heparin
which of the following temperatures would be expected in a hypothermic patient
94.8 f
which of the following is the appropriate measure for storing gel electrodes
place the electrodes in a resealable plastic bag
Electrical waves are sent from the SA node to the AV node, where conduction slows down. the reason for this pause in conduction is:
to allow time for the atria to contract completly before ventricular contraction
which of the following is true regarding sinus arrhythmia
its rate usually varies with the patients breathing pattern
the HIPAA privacy rule includes business associtates as entitlies that are required to comply with the privacy rue. which of the following is not a example of a business associate
a third party construction team hired to renovate a clinic
what is the providers correct response when a patient requests a copy of her medical records.
to contact the medical records deparment
which stress test method would be appropriate for a 75 year old male who recently recovered from a hip fracture
an iv infusion of dobutamine
an increase in muscle mass is called
hypertrophy
which of the following is true regarding torasdes de pointes
a prolonged QT interval is present
you are performing a cardiac stress test on a 51 year old male with a history of stable angina. which of the following would demonstrate a positive stress test
St segment elevation
systole can be broken down into four phases. During which phase does the pressure between the ventricles and pulmonary artery/aorta become equal
protodiastole
in what scenario can a provider open the medical record of a patient seen by one of his associates
if the provider becomes a part of the treatment team
which is an important first step before performing an EKG on a patient
explain the procedure to the patient
The way to distinguish Torsade de Pointes from ventricular tachycardia is
The QRS complexes in torsade de pointes vary in axis and amplitude
on an EKG strip, what is counted to determine a patients heart rate
the number of QRS complexes
on the EKG, what does the QRS interval measure
The duration of ventricular depolarization
which leads are involved with forming the triaxial diagram
leads I,II, III
in which of the following scenarios would you terminate a stress test
patient states that he wishes to stop test
which pair of leads are simultaneously recorded in the holter monitor
Leads V1 and II
which of the following is not appropriate care of EKG equipment
Cover all frayed broken wires with electrical tape to prevent electrical injuries
which of the following is true regarding junctional tachycardia
if there are no visible p waves, it is considered supraventricular tachycardia
Which of the following AV blocks forces the lower pacemaker of the heart( the ventricles) to assume control of conduction
Third degree AV Block
which of the following is included in the rules of mailgnancy for PVC
Runs of consecutive PVC
which characteristic of cardiac cells is mechanical
contractility
what is the indicated treatment for frequent sinus block rhythms
a cardiac pacemaker
which of the following leads are considered the anterior leads
V2,V3,V4
which of the following is not measured by pulse rate
Blood pressure
What are two consecutive PVCs called
Couplets
which of the following is considered an abnormal vital sign
SPO2 of 88%
Ventricular depolarization results in the contraction of the ventricles. This is illustrated on the EKG by which waveform.
QRS complex
what important question do you ask yourself when determining if the rhythm on the EKG is a normal sinus rhythm
are the QRS complexes narrow
which of the following is a regular but interrupted rhythm.
premature atrial complexes (PAC)
the location of myocardial infarction can be pinpointed by the affected leads. which leads show occlusion of the right coronary artery, or an inferior infarction
leads II,III,and aVF
which of the following is an indication for cardiac stress test
follow up after cardiac bypass surgery
which of the following organizations is not subjected to HIPAA privacy rule
Child protective services (CPS)
During a patient assessment, you find their pulse to be full, bounding, and rapid. what does this finding indicate
Heart Failure
which specialized cells of the conduction system innervate the ventricular walls, sending electrical impulses to the ventricle itself
purinje fibers
which of the following is true regarding a ventricular pacemaker
when the pacemaker fires a spike will be recorded followed by a QRS complex
which of the following is true regarding ventricular tachy cardia
it is a medical emergency
which of the following does not have an affect on a persons pulse rate.
height
What does a V stand for
augmented voltage
there are five types of arrhythmias. The type that causes electrical activity from a focus other than the sinus node is called:
ectopic rhythm
which layer of the heart is the heart valves made of
endocardium
which of the following true regarding oversensing of a pacemaker
the pacemaker picks up skeletal muscle artifact and believes it is not supposed to fire
you hook a patient up to a 12 lead EKG and see a small spike, followed by a normal P wave and QRS complex. Based on your knowledge of irregular waveforms, you recognize this as:
an atrial pacemaker
which of the following is appropriate regarding the use and care of the EKG machine ?
Turn off the EKG machine after use
which of the following lead placement is correct on a five lead EKG
white lead over the right arm
which of the following is an example of maintaining a clean work enviorment?
Keeping supplies stocked and stored when not in use
which of the following does not affect the EKG recording
patient breathing
you are on a telementry floor monitoring a patient when their rhythm suddenly flat lines. what is the next course of action.
Go in the patients room and assess their status
what is the definition of Vital Signs
measurment of the bodys function
the major differnce between sinus rhythm adn sinus tachycardia is
the rate
all of the following may cause bradycardia except
fever
where is lead AVL located
Left arm
which rhythm requires transcutaneous pacing
junctional bradycardia
which of the following is indicated as a treatment for atrial fibrilation lasting greater than 48 hours
Iv Heparin
systole can be broken down into four phases.during which phase do the ventricles relax and the valves close
isovolumetric relaxation
a 45 year old female comes to the clinic for a cardiac stress test on the treadmell. what is her target heart rate
175
which of the following is true regarding cardioversion
it delivers a shock in sync with the patients QRS complex
what is the purpose of mounting an EKG
to secure the strip to the patients chart
what length of time does the single small block
0.04
which of the following is true regarding bipolar lead placement
the right arm is always negative
what is the most crucial criterion to identify rhythms started by the sinus node
matching upright p waves in lead II
an increase in duration on an EKG wave represents
prolonged depolarization in a hypertrophic heart chamber
which of the following is not one of the steps to correctly interpreting a heart rhythm
how many p waves are present
which characteristic of the cardiac cells is responsible for thier ability to create an impulse.
automaticity
which lead is the most helpful in identifying a ventricular rhythm
lead V1
there are five types of arrhythmias. the type that causes unexpected delays in the electrical activity is called.
conduction block
when does sinus arrest occur
when the SA node stops firing
the location of a myocardial infarction can be pinpointed by the affected leads. which leads show occlusion of the left main artery( anterolateral infarction)
leads I, aVL, and Leads V1-V6
which leads are involved in forming the triaxial diagram
leads I,II,III
when the atrium takes over as teh pacemaker of the heart, it is known as
usurpation
Diastole can be broken down into three phases. during which phase do the artria contact, squeezing out the remainder of the blood into ventricles
atrial kick
what does the acronym PHI stand for
protected health information
what is the definition of an electrocardiogram
the printed EKG picture
lead III measures which current
left arm to left leg
the T wave on an EKG represents
ventricular repolarization
the location of a myocardial infarction can be pinpointed by the affected leads. which leads show occlusion of the right coronary artery, or a posterior infarction
VI and any other anterior leads
which of the following is true regarding Holter monitoring
the holter monitor can detect cardiac arrhythmias otherwise missed by the 12 lead ekg
when applying electrodes for a holter monitor on a patient where do you place the red (LL) lead
on the left lower abdomen
which goverment entity oversees HIPAA and ansers HIPPA complaints
us department of health and human services
the sinus node is firing at the rate of 70 bpm, howerver the av node begins to fire at a rate of 80 bpm. what is occuring.
usurpation
what is defining characteristics of ventricular fibrillation
lack of QRS complexes
what causes the sound of the heartbeat
the closing of the heart valves
what happens if the sinus node, the pacemaker of the cell, fails to send electrical implulses
the av junction takes control as teh pacemaker
a proper diagnosis of the left atrial enlargment includes which criteria
increased duration of the P wave
which of the following is reccomended for obtaining accurate blood pressure
sit with your arms posistioned at heart level, resting on a table
which of the following is true regarding junctional rhythms
its an escape rhythm
which of the following temperatures is consired a fever
100 degree fahernheiht
ventricular hypertrophy is caused by which of the following
pressure overload
which of the following is true regarding atrial flutter
the atrial rate will be between 250 and 360
there are instances where the Hipaa privacy rule allows disculosure of protected health information without patient authorization. which of the following is not included instance
if the patient is behind in paying thier medical bills
a proper diagnosis of left atrial enlargment includes which criteria.
increased duration of the p wave
what regulatory function is responsible for the rest and digest response which causes a decrease in heart rate
parasympathetic nervous system
which of the following leads do not contain a positive pole
Right leg
what is the normal amount of time for a pr interval
0.12-0.2 seconds
what is the normal time for the QR interval
0.06 -0.1 seconds
which of the following is true regarding idioventricular rhythms
there are no p waves
there are three types of EKG leads. which type measures the hearts’ electrical current between two limbs
bipolar leads
which of the following vital signs require immedidate attention
a respiratory rate of 8
which of the following is not a criterion for ventricular rhythms
premature, wide qrs complexes with a preceding p wave
which of the following leads are most commonly used for continous montering
leads II and V1
which of the following is true concerning first degree AV block
the PR interval is longer than 0.2 seconds
which of the following is true about normal sinus rhythm
p waves have the same shape
how many electrodes are placed on the patient for the holter monitor
five or more on the chest
which of the following arrhythmias is resolved by caratid massage
paroxysmal supraventricular tachycardia
all of the following are recommended treatments for atrial flutter except
defibrillation
which of the following is true regarding accelerated idioventricular rhythem
it is a benign rhythm seen during an acute infarction
you hook a patient up to a 12 lead EKG and see a spike following the QRS complex. based on your knowledge you recognize the cause to be
ventricular pacing
which chamber of the heart receives blood from the lungs
left atrium
an 85 year od make comes to the clinic for a stress test using an exercise bike. what is his target heart rate
135
where are the augmented leads placed
left arm
which of the following is true regarding the hipaa complaint process
a complaint can be filed via mail, fax, email or online
which of the following is not subject to regulations oulinded by the HIPAA enforcement rule
a third party construction team
what occurs when one of the lower pacemakers begins to fire at an accelerated rate, and sreals control from the predominate pacemaker
usurpation
which specalized cardiac cells are responsible for sending electrical impulses to the ventricles
bundle of his
in a 12 lead EKG, which leads are placed across the patients chest
six precordial leads
which of the following activites is safe to perform while wearing a holiter monitor
a light job
which of the following statments is true regarding sinus bradycardia
its slower than normal sinus rhythm
what is the target heart rate of a patient during a stress test
the patients age subtracted from 220
which of the following is true regarding sinus block
p waves are not affected
which type of cardiac cells are responsible for carrying electrical impulses from the SA node through the atria
interatrial tract
what does the bottom value of a blood pressure indicate
the pressure of the artieries as the heart relaxes
which of the following is not considered proteced health information
diagnosis
which of the following is the correct qrs deflection in the precordial leads
V1 negative
from which pacemaker cells do junctional rhythms orginate
AV junction
what occurs when a lower pacemaker takes over the predominate pacemaker, resulting in a slower rate
escape rhythm
where is the grounding electrode placed to minimize the risk of electrical shock
Right leg
single large box
0.2 seconds
you hook a patient up to a 12 lead EKG and notice a small spoke in the rhythm followed by a wide and bizzare QRS complex. based on your knowledge of irregular rhythems, you idendify this abnromailty as
the sign of a ventricular pacemaker
for continious monitoring, where is lead II placed
left abdomen
disatole can be broken down into three phases. in which phase does the pressure between the atria and ventricles become equal
diastasis
As you are performing an EKG, the tracing shows a 2nd degree mobitz block. The patient asks you if the readings normal. what is your answer?
instruct the patient that the doctor will talk to them
which type of cardiac cells sends electercial impulses from the atria to the Av node
intermodal tracts
if both the sinoatrial node and Av node fail to generate an impulse. the ventricle will take over as the pacemaker of the heart. How is this reflected on EKG paper
there is no P wave
what is an important step in determing the heart rate of a rhythm with a premature beat
skip the premature beats when counting qrs complexes
under what circumstances can your medical information not be shared by your provider
if requested by your employer
which of the following is considered a negative holter
normal sinus rhythm
which of the following is true regarding unifocial PVC
the pvs are shaped the same
there are 5 sections, or titles, in HIPPA. which title discussion the HIPAA privacy rule.
Title II
what is the heart’s biological attempt to return to a regular rhythm after a pvc
complete compensatory pause
upon removing the EKG leads, you notice mild skin erythema where the electrodes were placed. What is this
a normal finding
the part of the ekg that symbolizes atrial depolarization is the
P wave
which of the following is considered a normal pulse rate
85
in which of the following patients is stress testing contrainindicated
a patient who has an acute myocardial infarction less than 48 hours ago.
which of the following type of monitoring is used for cardiac stress testing
12 lead EKG
Which of the following is true regarding a first degree AV block
The PR interval is prolonged
which of the following heart rhythm is treated with atropine
bradycardia
which of the following is an example of maintaining a clean working enviorment
keeping the exam room floor clear and free of electrodes.
which heart valve is located between the right atrium and the right ventricle
triscuspid valve
during an acute myocardial infarction, what abnormally can you be seen on the EKG
ST segment elevation
which of the following demonstrates proper care of EKG leads
examine the cables for broken wires
what is diastole
when the ventricle relax and fill with blood
which of the following medications may the patient be adviced to avoid before their stress test
beta blockers
at what speed should the ekg machine machine be set
25 mm/second
what effect does the atria functioning as the orginal pacemaker have on the heart.
increased heart rate
which of the following lead placements is correct on a five lead ekg
red leads to left leg
what is the difference between sinus arrest and sinus block
the number of pauses in the rhythm
the type of cells responsible for intitiating depolarization are
pacemaker cells
which of the following rhythms requires cardioversion for treatment
junctional tachycardia
there are 5 types of arrhymias. the type that traps electrical activity within a various anatomic/myocardial configuration is called
reentract arrhythmias
the restoration of cardiac cells resting polarity is
repolarization
when should the EKG equipment be wiped down
after each patient use
what group of pacemakers cells take over when the SA node fails to initate conduction
AV node
what is the difference between wandering atrial pacemaker and multifocal atrial tachycardia
heart rate
treatment of atrail fibrillation depends on which factor
time
what is the r-r interval
the distance between two QRS complexes
which of the following is true regarding tachycardia
a drop in heart rate from tachycardia to normal in a cause for concern
which of the following leads illustrates negative QRS complexes on an EKG
aVR
which of the following is not considered a violation of hippa
discussing your patient with the tech who is releving you of your shift
what measure of time on the EKG does the PR segmen measure
the end of atrial depolarization to the start of ventricular depolarization
which of the following is not a protocol used in the cardiac stress test
modified naughton protocol
which of the following patients would not be appropritate for stress testing
a 42 year old woman whose current blood pressure is 170/80 without symptoms
what is the name of the spaces between in the ribs, where certain EKG leads are placed
intercoastal spaces
what is the differnce between wandering atrail pacemaker and multifocal tachycardia
the rate
when applying the electrodes to a patient for holter monitoring, where do you place the brown (v) lead?
on the chest depending on lead selection
what is important step in determining the heart rate of a rhythm with a premature beat.
skip the premature beat when counting qrs complex
which of the following medication is not used for pharmalogical stress testing
amiodarone(Cordarone)
what is shown on an ekg during typical angina
st segment depression
a 33 year old patient comes to the clinic for a cardicac stress test to be performed on the treadmill. What is the minimum heart rate she can achieve for the test to b valid
158
which leads are involved in forming the hexaxial diagram
leads I,II,III, AVR,AVL and aVF
what group of pacemaker cells take over the AV node fails to initiate conduction
Ventricles
which of the following is the appropriate action preparting for cardiac stress
Tape the EKG electrodes if necessary
types of heart rhythms on an ekg strip that shows r-r intervals that are interrupted by a premature beat called
regular but interrupted rhythms
which of the following is true regarding premature ventricular contractions
it is a regular but interrupted rhythm
