3 class ekg nha Flashcards
which of the following is the minimum number of electrodes that may be attached to a patient for Holter monitoring
5
When preparing a patient for an EKG in the supine position, where should the technician stand to apply the electrodes.
Left
which of the following sinus rhythms has a heart rate of more than 100/min
Sinus Tachycardia
in which of the following rhythms is the PR interval absent
Ventricular Tachycardia
a technician must document which of the following information in a patients electronic medical record regarding an EKG procedure?
Date and time of the EKG
An EKG technican is preparing a patient for an EKG and notices that the patient is grabbing their chest and reporting chest pain. Which of the following conditions should the technician suspect?
Tachycardia
A technician is monitoring a patient who is experiencign angina during a treadmill stress test. Which of the following actions should the technician take?
Reduce the speed of the treadmill
which of the following findings is a contraindication to a patient is a contraindication to a patient undergoing a stress test?
Congestive heart failure
a technician is preparing to put the EKG machine away at the end of the day. Which of the following actions should the technician take?
Wipe the machine down with a nonabrasive cleaner
A technician is preparing to perform an EKG on a patient who has bilateral leg amputation. The technician should adjust which of the following leads for the patient?
Lower extremity leads
During an exercise stress test, a technician should observe the patient for which of the following
Fatigue
Which of the following tracings would indicate atrial flutter
the F wave have a saw toothed appearance
The septal wall of the heart is viewed by which of the following leads
V1 and V2
A technician is monitoring a patient who is undergoing a stress test. The technician should collect which of the following data from the patient
Oxygen saturation
While an EKG technician is preparing a patient for exercise stress testing, the patient complains of mild chest tightness. Which of the following steps should the technician take first
Obtain vitals form the patient
Which of the following is a contraindication to performing an exercise stress test
The patient is having a myocardial infarction
an EKG technician to preparing a patient for a 12 lead EKG. Which of the following limb electrodes produces the aVF reading
Left leg
After performing a nonstandard EKG on a patient, the gain setting should be returned to which of the following as the standard
10 mm/mV
Which of the following locations should a technician apply a spygmomananometer
Right Brachial
When running a 5 lead EKG on a patient, which of the following electrodes serves as the ground electrode
Green
Standard EKG paper is sensitive to damaging effects from which of the following
Heat
A technican is reviewing an EKG strip with a QRS complex of 0.02 seconds. The technician should identify the findings as a an indication of
Ventricles are firing at a quick pace
Which of the following methods of calculating heart rate involves counting the number QRS complexes and multiplying that
6 second methods
Which of the following colors is designated for the chest leads on an EKG machine
Brown
A patient reports dizziness when writing up following an EKG. The technician should anticipate which of the following findings
Postural hypotension
The Einthoven triangle is formed by which of the following leads
bipolar leads
a technician is assisting in a sleep study and recognize heart rate changes associated with respiration on a patients EKG tracing. which of the following terms best describes these changes
Occasionally irregular
Which of the following location should a technician use to measure blood pressure in a patient who is postopertative following mastectomy on her right side
left arm
A technician is performing and EKG on a preoperative patient and notices fine artifact in all of the leads. Which of the following actions should the technician take to solve this problem
instruct the patient to relax and breathe quietly
a technician is performing an EKG on a patient who has a permanent pacemaker. Which of the following findings indicates that he pacemaker is firing capture
the pacemaker spikes are not followed by complexes
which of the following actions is necessary to ensure a quality EKG recording is produced
Check the alligator clips for residual electrolyte get after each patient use
which of the following scenarios demonstrates an EKG technicians proper understanding of patient confidentiality
a technician tells his partner ???
The period of time from the start of ventricular depolarization to the end of ventricular repolarization is known as which of the following
QT interval
which of the following actions should a technician take to reduce artifacts while obtaining EKG tracings
clean the electrodes before reusing them
which of the following describes a positive deflection that occasionally happens prior to the P wave
U wave
Prior to performing exercise electrocardiography, how many electrodes are applied for the baseline EKG?
10
A technician is caring for a patient whose EKG monitor shows ventricular fibrilation. Which of the following actions should the technician take first
assess the patients responsivness
while monitoring a patient during exercise stress testing, and EKG technician should report which of the following
syncope
An EKG tech is performing a 12 lead EKG on a pt who is alert and responsive. The monitor reads no activity on the baseline. Which of the following is an appropriate action for the technican to take
clean the electrodes and reattach
an EKG technican is preparing to perform telemetry monitoring on a patient, in which of the following locations should the technican attach the electrodes
Chest
if present, the shallow wave that follows the T wave represents which of the following
late ventricular repolarzation
a technican should recognize which of the following as an abnormal waveform related to myocardial injury
T wave inversion
when placing electrodes for a holter monitor on a patient , which of the following resources should a technican consult
the manufactures guide
a tech is insstructing a on the use an ambulatory monitor. Which of the following statements by the patient indicattes understanding of the test instructions
I will check the monitor green light
a wide bizzare qrs complex is a characterstic of which of the following arrhythmias
ventricular arrhythmia
on a 12 lead EKG the 5th intercoastal space, left midaxillary line the location of which of the following electrodes
V6
a stress test must be stopped when a patient experinces which of the following
cold and clammy skin
a tech is teaching a patient about telemetry monitoring. which of the following statements by the pt indicates an understanding of of the instruction
I should avoid caffenine while being monitored
which of the following is the control on the EKG machine that increases or decreases the voltage of the tracing
milivolt
a technican completes an EKG and notes that the strip shows erratic spikes. which of te following is the cause of this artifact
wire is detached
Which of the following statements by the pt about HOlter monitor testing demonstrates understanding of the procedure
I should avoid caffenated beverge while wearing the holter monitor
which of the following describe an atroventricular paced rhytm
the pacemaker spikes are seen before every p wave and qrs complex
which of the following is the standard paper speed on an EKG machine
25mm/second
A tech performing a 12 lead EKG and notices the pt hear rate is 44/min. Which of the following does this heart rate reflect
bradycardia
which of the following istructions should the tech give when preparing a pt fo a period of holter monitoring
continue with your regular exercise routine
which of the following actions should an EKG technican take first when a pt EKG tracing appears to be life threating
notify the provider
a technician is performing a 12 lead EKG on a patient. The presence of deep or wide q waves of the tracing
should alert the technician to which of the following conditions
myocardial infarction
a technican is performing an ekg under the supervision of a physican on a patient who is experercing superventricular tachycardia. the paper is 50mm.second. which of the following actions should the technican take to ensure the best possible tracing
continue recording the EKG at 50mm/second
which of the following directions should a technican give to a patient who is scheduled for an exercise stress test
do not consume any caffeine for 3 hours prior to the test
T wave inversion st segment changes and the pathologic Q waves indicate which of the following conditions
completed myocardial infarction
which of the following is an appropriate action for a tech to take to ensure accuracy when performing a 12 lead EKG
place 12 electrodes on the patients torso and limbs
During the first stage of Bruce protocal stress test, the pt reports feeling lightheaded and states that he is going to pass out. which of the following actions should the technican expect the provider to take
stop the test and help the patient to a nearby chair
A tech notes mulitiple small spikes of identical shape on an EKG tracing. the tech should recognize that this finding indicates which of the following complications
alternating current interference
a technician is preparing to perform a EKG on a pt who has dextrocrardia. Which of the following actions should the technician take
reposition the precordial leads to the right side of the chest
an 80 year old patient who has a history of parkinson disease is scheduled for a routine EKG. Which of the following artifacts will most likley be present on the EKG due to the clients condition
somatic tremor
a technican is reviewing an EKG strip with a QRS complex of 0.20 seconds. the technican should identify this finding as an indication of which of the following
conduction through the ventricles is occuring at a slow pace
the standard leads measuring which of the following
the simulatenous flow of electrical currents in two directions
a technican is preparing to perform an EKG on a pedatric patient. which of the following actians should the tech take to prevent inaccurate readings
apply the chest lead v3 to the right side of the chest
A technician is assisting with a stress test for a 50 year old m patient. which of the following is the target heart rate for this pt.
170./min
a technican is connecting a holter monitor to a patient who asks why their heart is being moniored. which of the following responses by the technican is appropriate
I will see if the provider is available to answer your question
a technican is verifying the calibration of an EKG machine.the tech knows that the standard calibration mark should be which of the following amplitudes.
10 small boxes
which of the following parts of an ekg tracing should a tech review for information about venticular repolarization
t wave
a technican can move a patient’s bed away from the wall tohelp to resolve which of the following artifacts
alternating current interferene
the black lead on the 5 lead ekg is placed on which of the following
LA
a technican is applying the electrodes to a pt prior to a period of Holter monitoring The techican should recognize that the electrode wires are coded by which of the following
color
a tech is performing an ekg on a patient who has parkinsons disease and notices interference on the reading.Which of the following actions should the technican take
Have the pt put his hands palm down under his buttocks
Atrial conduction on an EKG is represnted by which folllowing
P wave
which of the following is the highest priority for a tech when monitoring a patient during an exercise stress test
provide for the patients safety
which part of the conduction system delays the electrical impulses to allow the atria to complete their contractions
Av node
which of the following statements should a tech include in the teachings when explaining telemetry monitoring to a patient
the device will allow for a 12 lead EKG recording to be printed at the bedside
while performing an EKG a tech notices a flatline racing on the monitor. Which of the following actions should the technican take
check the pt
a tech is performing an ekg on a patient, which of the following lines represents a period of zero electrical activity
isoelectric line
a technican is measuring a pt pulse oximetry. which of the following measurements should the tech use
oxygen saturation
a tech assisting with an exercise stress test for an adult pt who goes into cardiac arrest. which of the followng actions should the technican take
stop the test
a technican is preparing a 26 year old female pt who has intermittent palpitations for outpatient testing. Which of the following tests should the technican prepare to be prescribed for this patient
3 lead Holter
which of the following EKG measurements differentiates idioventricular rhytm from junctional escape rhytm
p wave direction
an ekg tech is preparing for Holter monitoring, which fof the following information should the technican include
you will be able to go home with he monitor
which of the following portions of the EKG reading is created by an electrode that is placed on the 4th intercoastal space o the left sternal border
V2
a technican is asked to calcuate a patients heart rate from an EKG. Which of the following methods is the most accurate for the tech to use
1500 method
the normal rate of the heart when the electrical impulse comes from the Sa node is
60-100
the chief pacemaker of the heart is the
SA node
The R wave is the first positive deflection after the P wave
True
The ability of the heart to initate an impulse is called
automaticity
The ability of the heart to initate an impulse is called
automaticity
The normalPR intervral is
.12 to .20 sec
the inherent rate of junction is
40-60
the wave represents
atrial depolarization
the normal QRS complex is
.04-.12 seconds
The wave on an EKG which represents ventricular repolarization is called the
T wave
the indications for a pacemaker are the following
symptomic sinus brady cardia, idioventicular rhytms, 2nd avb type mobitz II, 3rd degree heart block
this is what type of pacemaker
Av sequential pacemaker( paces atria and ventricles)
Three questions asked when analyzing an ECG strip with pacemaker spikes are
1 is the chammber being paced
is the pacemaker sensing the patients inherent rhyth
m is there a pulse with each the pacer rhythm
the three problems a pacemaker may have are
failure to fire
failure to capture
under sensing
what is the difference between an EKG and an ECG
thre is no differnce
what are types of blood pressure
systolic and diastolic
the first clear beat when taking blood presure is
the systolic blood pressure
the deflections that are encountered below the isoelectric line belong to
the negative field
the deflections that are encountered below the isoelectric line belongs to
the negative field
which are elements of an EKG reading
PQRST
what are normal electrocradiographic interals for a healthy adult
T wave 0.10 seconds
Pr interval of 0.14 seconds
QRS complex of 0.09 seconds
what part of an EKG is named after willem Einthoven
The placement of the limb electrodes
what are electrodes
conductor of electric current
which of the following is not a lead in an EKG
V10
what does depolarization mean
activation of the myocardial cells
which is the first element of an EKG
P wave
which of the following is an element of the electrical pathyway
bundle of his
purkinje fibers
sa node
which are the vital signs
respirations, blood presure, pulse and temperature
which of the following is a false statment
RR intervals represent atrial repolarization
which is the normal value of the systolic blood pressure in an adult
90-120 mm.hg
what are electrolytes
chemical elements capable of producing electricity
the precordial electrodes are attached to the patients
thorax
which of the following is considered a hypertensive value
180/90
which are the types of circulation
systemic and pulmonary
which system does the heart belong in
cardiovascular system
in order to take manual blood pressure, you will need
a sphygmomanometer and a stethoscope
How many leads does an EKG machine produce
12
which fingers are used in order to properly measure pulse
middle and ring finger
which is our first option when taking temperature
oral
During the first stage of a Bruce protocol stress test, the patient reports feeling lightheaded and states that he is going to pass out. which of the following actions should the technican expect the provider to take
stop the testand help the patient to a neraby chair
t waves inversions st segment changes and the pathological q waves indicates which of the following conditions
completed myocardial infarction
which of the following is the minimum number of electrodes that may be attached to a patient for holter monitoring
5
when preparing a patient for an EKG in the suspine position where should a technican stand to apply the electrodes
patients left side
which of the following sinus rhythms has a heart rate of more than 100.min
sinus tachycardia
which of the following tracing would indicate atrial flutter
the f waves have a saw tooth appearnce
when running a 5 lead EKG on a patient, which of the following electrodes serves as the ground electrode
green
standard EKG paper is senstive to daming effects from which of the following
heat
a technican is reviewing an EKG strip with a QRS complex 0.02 seconds. the technican should identify this finding as an indication of
ventricles are fireing at a quick pace
which of the following method of calculating heart rate involves counting the number of QRS complexes and multiplying that
6 second method
the einthoven traingle is formed by which of the following leads
bipolar leads
a tech is asisting in a sleep study and recognizes rate changes assoiated with respiration on a patients EKG tacing.
occasinally irregular
the locations a tech use to measure blood pressure in a pt who is postoprative following a masectomy on her right side
left arm
the period of time from the start of ventricular depolarization to the end of venticular polarization as which of the following
qt interval
describe a positive deflection that occationally hapens prior to the p wave
u wave
prior to performing exercise electrocardiography, how may electrodes are applied for the baseline ekg
10
a technican should recognize which of the following as an abnormal waveform related to myocardial injury
t wave inversion
a wide bizzare QRS complex is a characteristic of which of the following arrhythmias
ventricular arrhythmia
on a 12 lead EKG the 5th intercoastal space, left midaxillary line is the location for which of the following electrodes
v6
which of the following are considered bipolar leads
D1,DII, DIII
which of the following are considered unipolar leads
V1,V2,V3,v4,v5,v6,avr,avl,avf
the positive pole of the AVL goes
left arm
the positve pole of the AVR goes to
Right arm
teh positive pole of the AVF goes to
left foot
DIII leads is found in
left arm negative, left foot positive
in which of the following cases should the leads be inverted
patients with dextocardia and children
which of the following is he standard paper speed on an ekg machine
25mm/seconds
if present, the shallow wave that follows the t wave represent which of the following
late ventricular repolarization
which of the following describes a positive deflection that occaasinally happens prior to the pwave
U wave
after performing a nonstandard EKG on a patient, the gain setting should be returned to which of the following as teh standard.
10mm.mv
best way to diagnose cardiomegaly
meausre the cardiothorac ration on an xray
an unxpected sound during a cardiac cycle means
heart murmer
what is a common sign of tetralogy of fallout
cyanotic skin
which types of murmers are caused by growth spurts in children
functional
which of the following are common symptoms for cardiopathy
angina, faintness, and sharpness of breath
the apex of the heart is formed by
the tip of the left ventricle
The left atrium recieves blood from the
pulmonary veins
the heart is divided into __ chambers but functions as a__ sided pump
4,2
side of the heart is a low pressure system that pumps venous blood to the lungs
Right
side of the heart is a high presure system that pumps atrial blood to the systemic circulation
Left
the thick muscular layer of the heart wall that contains the atrial and ventricular muscle fibers necessary for contraction is the
myocardium
which blood vessel comes out of the left ventricle
the aorta
the right atria recieves blood from
the vena cava
the left artia recieves blood from
the pulmonary viens
the direction of blood flow through the heart is best described by which of the following
Right atrium Right ventricle Pulmonary artery lung pulminary viens left atrium left ventricle
blood flows from the right atrium through the__ valve into the right ventricle
triscupsid
Rapid ejection of blood from the ventricle chambers of he heart occurs because the___ and valves__ open
pulmonic, aortic
the inside layers of the heart to the outside are
endocardial, myocardial, and epicardial
which of the following are semiulunar valves
aortic and pulmonic
when the left ventricles contracts, freshly oxygenated blood flows through the __ valve into the __
aortic, aorta
heart is constuted by
2 atria and 2 ventricles
the valve that seperates the right atria from the right ventricle is called
tricuspid
the valve that seperates the left atria from the left ventricle is
mitral or bicuspid
the heart pacemaker is
the sa node
the electric impulse conductive way in the heart is
SA node, AV node, Bundle of His, and Purkinjer FIbers
the bipolar leads are
DI,DII, DIII
the monopolor leads are
V1,V2,V3,V4,V5,V6,AVR,AVL, AVF
the precordial leads are
V1, V2,V3,V4,V5,V6
where is teh positive electrode placed in lead I
left arm
where is positive electrode placed in leade III
left leg or foot
the V1 electrode is placed
4th intercostal space next to the sternum
the V2 electrode is placed in
4th left intercoastal space next to the sternum
the V3 electrode is placed in
between V2 and V4
the V4 electrode is placed
5th left intercostal space with media clavicle line
the V5 electrode is placed
5th left intercostal space with anterior axillar line
the V6 electrode is placed in
5th left intercostal space with media axillar line
The RA electrode is placed
Right Arm
the LL electrode is placed
Left leg
the DIII lead is found in
left arm negative, left positive foot
the DII lead is found in
RIght arm negative, left foot positive
the DI lead is found in
Right arm negative, left arm positive
P wave represents
atrial depolarization
the SA node is located in
the right atrium
The Q wave is
the first deflection to the bottom before R
the intrinsic electricy refers to
the electricity produced by the heart on its own
the QRS complex represents
ventricular depolarization
when a cardiac cell is relaxed, the state is known as
repolarization
the ground electrode is found in
the right leg
the t wave represents
ventricular repolarization
Pr segment wave represents
Delay at the AV node
the no electrical activity represents
isoelectric line
the R to R interval is the distance between
The R waves in successive beats
the normal value of a PR interval is
from 0.12 to 0.20 sec
the norma value of the QRS complex is
less than 0.10.sec 0.11.sec
the normal value of the P wave is
less than 0.11 sec
the intrinsic rate of the atrioventicular av bundle is__ eats/min
40-60
the intrinsic rate of the SA node is
60-100
the intrinisic rate of the ventricles is__ beats min
20-40
How do you determine whether the atrial rhythm on an ECG tracing is regular or irregular
compare p to p interval
in the hearts conduction system, the __ recieves an electrical impluse from the Bundle of His and relays it to the Purkinje fibers in the ventricle myocardium
right and left bundle branches
in the hearts conduction system, the__ recieves an electrical impulse from the left bundle branches and relays it to the ventricular myocardium
Purkinje Fibers
what does the QRS complex represent
venticular depolarization
the normal pacemakeer of he heart is the __ node, which is found in the__ atrium, and has and instricnic firing rate of__ beats.min
sinotrial, right, 60-100
on an ECG what is the first negative deflection seen after the P wave
Q wave
leads II records the differnce in electrical potential between the __ leg and__ arm
left, right
leads II, III, and AVF view the __ surface of the left ventricle
inferior
leads I, aVL, V5 and V6 view the__surface of the left ventricle
lateral
the absolute refractory periods begins with the onset of the __ and terminates__
QRS complex, at approxatley the apex of the T wave
the QT intervals is measured from the beginning of the __
QRS complex to the end of the T wave
in a adult, the normal duration of the QRS complex
0.10 seconds or less
the intrinsic rate of the purkinje fibers is__ beats/min
20-40
on the ECG, the T wave represents
ventricular repolarization
on the ECG, the time necessary for the spread of an electrical impulse through the AV node, bundle of His, right and left bundle branches, and purkinje fibers is reflected by the
Pr Segment
the portion of the ECG tracing between the QRS complex and the T wave is called the
ST segment
Which of the following is the first positive deflection seen on the ECG after the P wave
R wave
__ cells are working cells of the heart that contain contractile filaments and form the muscular layer of the atrial walls and the thicker muscular layer of the ventricular walls
myocardial
__ when the cardiac muscles cell is stimulated, the cell is said to
depolarize
on the ECG the p wave represents atrial __ and the QRS complex represents ventricular__
depolarization, depolarzation
the nurse notes that a patients heart monitor shows that every other beat is earlier than expected. has no visable p wave, and has a qrs complex that is wide and bizare in shape. How will the nurse document the rhytm
venticular bigeminy
when analyzing the rhythm of a patient electrocardiogram (ECG) the health care will need to investigate further upon finding
QRS interval of 0.14 seconds
a patient has ST segment changes that suggest an acute inferior wall myocardial infarction. Which lead would be best to monitoring the patient
II
when analyzingan ECG rhythm strip on a patients regular heart rythm the tech counts 30 small boxes from one R wave to the next. the technican calculates the patients heart rate as__
50 there are 1500 small blocks in a minute, and the nurse will divivide 1500 into 30
the peaked t waves observed on the ECG are most commonly seen in patients with
hyperkalemia
which of the following correctly reflects examples of ectopic (latent)pacemakers
the av junction and ventricles
The Pr inversal is considered prolonged if its more than_ seconds in duration
0.20
in sinus arrhythmia a gradual increasing of the heart rate is usually associated with
inspiration
the rate of sinus tachycardia__ is beats/min
faster than 100
an ECG rhythm strip shows a ventricular rate of 46 BPM a regular rhythm, a PR interval of 0.14 seconds, a QRS duration of 0.06 seconds and one upright P wave before QRS. This rhythm is
Sinus bradycardia
An ECG rhythm strip in a ventricular rate of 128bpm a regular rhythm a pr interval of 0.16 seconds, a QRS duration of 0.8 seconds, and one upright P wave before each QRS. This rhythm is sinus
Tachycardia
the rate of sinus rhytm is __ beats/min
60-to 100
which of the following correctly reflects the ECG criterteria a sinus rhythm
P waves that look alike and upright in Lead II, one before each QRS
the rate of sinus bradycardida__ beats.min
slower than 60
which of the following correctly describes multifocal atrial tachycardia
atrial and ventricular rhythms are irregular
The most common type of supraventricular tachycardia (svt) is
AV nodal reentrant tachycardida(AVNRT)
a wandering atrial pacemaker rhythm with a ventricular rate of 60 to 100 min may also be referred to
multiformed atrial rhythm
to determine whether the ventricular rhytm on an EKG tracing is regular or irregular compare__ Intervals
R to R
atrial fibriillation is characterised by
an erratic, wavy baseline and irregular ventricular rhythm
in a junctional rhythm viewed in lead II, where is the locationof the P wave of the ECG if atrial and venttricular depolarization occur simulatenously
During the QRS complex
if seen the P wave of a rhythm orginating in the AV junction will appear-___ in lead In
inverted
the PR interval of second degree AV block
is constant with more than 0.20 seconds in duration
2:1 AV block is characterized by
irregular P to P intervals and regular R to R
Second degree AV block type is characterised by__ intervals
irregular R to R
second degree AV block typoe1 is characterized by __ intervals
regular p to p intervals and irregular R to R
in third degree AV block
there is no PR interval because the atria and ventricles beat independently of each other
which leads look adjoining tissue in the anterior region of the left ventricle
V2,V3,V4
Lead V1 views the
septum
Lead AvL views the
lateral wall of the left ventricle
Which of the following leads should be used to view the right
V4R
lead V3 views the__ wall of the left ventricle
anterior
Which leads look at adjoining tissue in the inferior region of the left ventricle
II,III, aVF
lead V5 views the __ wall of the left ventricle
lateral
the inferior wall of the left ventricle is supplied by the __ coronary artery in most of the population
Right
where should be the positive electrodes for lead VI be posistioned
Right side of the sternum, fourth intercoastal space
An ECG machine sensitivity must be calibrated so that a I -mV electrical signal will produce a deflection measuring exactly__ mm tall
10
Each small box on ECG paper represents
0.04 seconds
Each large box on ECG paper represents
0.20
the axes of leads I,II,III form an equilaterial traingle with the heart at the center (einthovens traingle) if the augmented limb leads are added to this configuration and the axes of the six leads moved in a way in wich they bisect each other, the result is
Hexaxial reference system
