NCCT PRACTICE TEST QUESTIONS Flashcards
(150 cards)
1
Q
The ECG technician auscultates an apical pulse of 70 bpm in an older adult patient who is taking digoxin (Lanoxin). How should the ECG technician interpret this finding?
A. The patient is experiencing a pulse deficit.
B. The patient is experiencing bradycardia.
C. The patient’s heart rate is within normal limits.
D. The patient is experiencing tachycardia.
A
C. The patient’s heart rate is within normal limits.
2
Q
Before entering a private room with monitored negative air the ECG technician should prepare by following
A. airborne and droplet precautions.
B. standard and contact precautions
C. airborne and contact precautions.
D. standard and airborne precautions.
A
D. standard and airborne precautions.
3
Q
When performing an ECG on a child, the ECG technician should place:
A. V6 posterior wall of the chest.
B. V2 on the right side of the chest next to V1.
C. V4 two inches lower than on an adult.
D. V3 on the right side of the chest.
A
D. V3 on the right side of the chest.
3
Q
Which of the following variations in ECG results is likely for patients with a BBB?
A. Elevated ST segment
B. Presence of a pacing spike
C. Inverted P-wave
D. Decreased PR interval
A
B. Presence of a pacing spike
4
Q
Blood pressure measures cardiovascular function by measuring the force of blood exerted on:
A. venules.
B. veins.
C. capillaries.
D. arteries.
A
D. arteries.
5
Q
An adult patient with vital signs of T 37.0 C, P 72, R 18, B/P 192/102 mm Hg indicates which of the following conditions?
A. Hypoxia
B. Orthostatic hypotension
C. Hypertension
D. Tachycardia
A
C. Hypertension
6
Q
Ventricular pacemaker cells are found at the:
A. Purkinje fibers.
B. SA node.
C. right bundle branch.
D. left bundle branch.
A
A. Purkinje fibers.
7
Q
When a patient with a pacemaker has an ECG performed, the strip will contain:
A. small spikes where a P wave may not be seen.
B. an introverted T wave.
C. an elevated ST segment.
D. large spikes where a QRS complex is absent.
A
A. small spikes where a P wave may not be seen.
8
Q
A patient with the left arm amputated comes in for an ECG. Which of the following is the proper placement for the left arm lead on this patient?
A. Moved to the back on the side of the left shoulder moving the right lead to match
B. As close to the site as possible but higher on the limb and in a similar position
C. Moved to the back side of the left shoulder and in a similar position
D. The same as it would be for a patient without a left arm amputated
A
B. As close to the site as possible but higher on the limb and in a similar position
9
Q
In electrocardiography, the degrees of variation (horizontally and vertically) are known as the:
A. amplitude and voltage.
B. isoelectric line and baseline.
C. time and amplitude.
D. deflection and baseline.
A
C. time and amplitude.
10
Q
The ECG technician is performing a 12-lead ECG on a patient and notices that lead Ill does not appear on the tracing. Which of the following actions should the ECG technician take?
A. Ask the patient to lie still to reduce somatic
interference.
B. Add an extra electrode to the 5th intercostal
space.
C. Re-center the stylus and repeat the tracing.
D. Check for a loose wire, reconnect, and repeat the tracing.
A
D. Check for a loose wire, reconnect, and repeat the tracing.
11
Q
Which of the following is the pulse site MOST commonly used when taking a pulse rate for routine vital signs on the adult patient?
A. Brachial
B. Carotid
C. Apical
D. Radial
A
D. Radial
12
Q
Modified electrode placement is necessary for which of the following special circumstances?
A. Breast implants
B. L ventral wall abnormalities
C. Ventral burn scarring
D. Amputated limb
A
D. Amputated limb
13
Q
When sinus bradycardia is present, the patient’s heart rhythm is:
A. less than 60 BPM and all other measurements are normal.
B. less than 60 BPM and all other measurements are abnormal.
C. higher than 110 BPM and all other measurements are abnormal.
D. higher than 110 BPM and all other measurements are normal.
A
A. less than 60 BPM and all other measurements are normal.
14
Q
The presence of which of the following conditions is MOST likely to affect a patient’s temperature when measuring vital signs?
A. Infection
B. Tinnitus
C. Syncope
D. Atrophy
A
A. Infection
15
Q
Which of the following actions should the ECG technician take if a 3 second period of sinus arrest is observed on an asymptomatic patient?
A. Check the patient for a pulse.
B. Ask the patient to remain still.
C. Call a code.
D. Inform the physician about the pause.
A
D. Inform the physician about the pause.
16
Q
A somatic tremor on an ECG strip can be identified by:
A. irregularly spaced, jagged peaks.
B. small drifting spikes.
C. irregularly spaced, uniform peaks
D. small inverted spikes.
A
A. irregularly spaced, jagged peaks.
17
Q
Which of the following actions should the ECG technician take FIRST when flat lines appear on the ECG tracing?
A. Check the patient for responsiveness.
B. Recalibrate the ECG machine.
C. Untangle the electrodes.
D. Initiate cardiopulmonary resuscitation.
A
A. Check the patient for responsiveness.
18
Q
A female patient has come in for an ECG following a mastectomy. ECG electrodes should be placed:
A. three inches lower than the surgery site to avoid disruption of the site.
B. in the intercostal spaces above the heart to avoid the surgical site.
C. three inches above the surgery site to avoid
disruption of the site.
D. as close to the surgery site as possible without touching the site.
A
D. as close to the surgery site as possible without touching the site.
19
Q
Placement of the ground lead on an ECG is on the:
A. RL on the soft tissue of the leg.
B. LL on the muscular portion of the leg.
C. LL on the soft tissue of the leg.
D. RL on the muscular portion of the leg.
A
A. RL on the soft tissue of the leg.
20
Q
Which of the following patient conditions requires the lead placement shown in the diagram above?
A. Pregnancy
B. Dextrocardia
C. Left sided chest tube
D. Left sided mastectomy
A
B. Dextrocardia
21
Q
The expected time frame to obtain a reading when measuring a temperature with a digital thermometer is which of the following?
A. 2 to 3 minutes
B. A few seconds
C. Approximately 30 seconds
D. 3 to 4 minutes
A
B. A few seconds
22
Q
In a patient with a heart that deviates to the right of the sternum, the ECG technician should place the precordial leads in which of the following positions?
A. Anterior to the negative electrode
B. Right to left
C. Left to right
D. Posterior to the positive electrode
A
C. Left to right
23
Q
To correct a wandering baseline, the ECG technician should:
A. have the patient remove jewelry.
B. unplug the electrical equipment around the ECG.
C. secure loose electrodes.
D. replace broken cables.
A
C. secure loose electrodes.
24
What is the approximate amount of time for the QRS complex to record on an ECG?
**A.** 0.04-0.08 seconds
**B.** 0.12-0.20 seconds
**C.** 0.04-0.10 seconds
**D.** 0.06-0.12 seconds
**D.** 0.06-0.12 seconds
25
Which of the following are characteristic of premature atrial contractions (PACs)? **(Select the three answers.)**
**A.** QRS complexes remain within normal limits (0.06-0.10).
**B.** P waves are the same shape and configuration.
**C.** PR interval measures are within normal limits
(0.12-0.20).
**D.** Rhythm will be regular with occasional early
complexes.
**E.** Atrial and ventricular rates are different.
**A.** QRS complexes remain within normal limits (0.06- 0.10).
**C.** PR interval measures are within normal limits (0.12-0.20).
**D.** Rhythm will be regular with occasional early complexes.
26
A multiform of three PVCs in a heart rate above 100 is called:
**A.** atrial tachycardia.
**B.** atrial fibrillation.
**C.** ventricular fibrillation.
**D.** ventricular tachycardia.
**D.** ventricular tachycardia.
27
Which of the following is the small upward curve representing repolarization of the ventricles?
**A.** T wave
**B.** U wave
**C.** P wave
**D.** QRS Complex
**A.** T wave
28
Which of the following instructions regarding a Holter monitor should be given to a patient?
**(Select three answers.)**
**A.** Press and hold event marker for the duration of the symptoms.
**B.** Record activity, time, and symptoms for each occurrence.
**C.** Press and release event marker for extreme chest pain.
**D.** Remove the monitor when showering.
**E.** Record chest pain, palpitations, dizziness, or fainting.
**B.** Record activity, time, and symptoms for each
occurrence.
**C.** Press and release event marker for extreme chest pain.
**E.** Record chest pain, palpitations, dizziness, or
fainting.
29
When performing an ECG on a pregnant woman in her third trimester, the ECG technician should place the:
**A.** patient on her left side and lower limb leads on her upper thighs.
**B.** lower limb leads on the patient's ankles
**C.** lower limb leads on the patient's side.
**D.** patient on her right side and lower limb leads on the lower abdomen.
**A.** patient on her left side and lower limb leads on her upper thighs.
30
An ECG technician obtains the tracing shown above on a patient. Which of the following actions should the ECG technician take?
**A.** Check for incorrect lead placement.
**B.** Place the patient in Trendelenburg's position.
**C.** Remind the patient to remain as still as possible.
**D.** Ensure precordial lead wires are crossed to
balance polarization.
**C.** Remind the patient to remain as still as possible.
31
Which of the following are appropriate actions for the ECG technician to take when placing electrodes on a patient's skin for a 24-hour Holter monitor? **(Select three answers.)**
**A.** Place limb leads with tabs facing up.
**B.** Abrade the skin with an alcohol pad or dry 4x4.
**C.** Avoid scars and incisions.
**D.** Place the electrodes on the arms and torso.
**E.** Remove excessive hair from the electrode site.
**B.** Abrade the skin with an alcohol pad or dry 4x4.
**C.** Avoid scars and incisions.
**E.** Remove excessive hair from the electrode site.
32
The patient asks the ECG technician why vital signs are taken at every office visit. Which of the following is the **BEST** response?
**A.** "To obtain a baseline measurement of your overall health status."
**B.** "It is for diagnostic purposes.
**C.** "The physician requires it."
**D.** "To comply with health insurance reimbursement policies."
**A.** "To obtain a baseline measurement of your overall health status."
33
During a treadmill stress test, which of the following vital signs should be monitored **MOST** frequently?
**A.** Pulse oximetry
**B.** Respiration
**C.** Blood pressure
**D.** Pulse
**C.** Blood pressure
34
Which of the following calculation methods should be used to determine heart rate in the strip shown above?
**A.** 300 method
**B.** 6 second method
**C.** 1500 method
**D.** R-R method
**B.** 6 second method
35
A cardiac cycle is detected on the ECG monitor, but the patient has no pulse. This is known as
**A.** PEA.
**B.** PAC
**C.** SVT.
**D.** PVC.
**A.** PEA.
36
While obtaining vitals on an infant, how is the heart rate measured?
**A.** Auscultate the apical pulse for 60 seconds.
**B.** Auscultate the brachial pulse for 60 seconds
**C.** Palpate the femoral pulse for 60 seconds
**D.** Palpate the radial pulse for 60 seconds.
**A.** Auscultate the apical pulse for 60 seconds.
37
Which of the following chambers of the heart is responsible for pumping blood through the aorta to the body?
**A.** Left atrium
**B.** Right atrium
**C.** Left ventricle
**D.** Right ventricle
**C.** Left ventricle
38
Disinfecting an ECG machine and lead wire surfaces with antimicrobial wipes after each patient use is an example of which of the following?
**A.** Medical asepsis
**B.** Biohazard precautions
**C.** Sterile technique
**D.** Surgical asepsis
**A.** Medical asepsis
39
Which of the following diagnostic procedures uses ultrasound to display an image of the structure of the heart?
**A.** Electrocardiogram
**B.** Angiogram
**C.** Electroencephalogram
**D.** Echocardiogram
**D.** Echocardiogram
40
The ECG technician needs to obtain vital signs on an emaciated 86-pound geriatric female with an oxygen mask prior to obtaining her ECG. Which of the following equipment should the ECG technician have on hand? **(Select two answers.)**
**A.** Child sphygmomanometer
**B.** Temporal thermometer
**C.** Oral thermometer with probe cover
**D.** Standard adult sphygmomanometer
**E.** Body mass index (BMI) machine
**A.** Child sphygmomanometer
**B.** Temporal thermometer
41
Which of the following instructions should be given to patients prior to stress testing?
**(Select two answers.)**
**A.** Eat a light meal two hours prior to the test.
**B.** Wear comfortable clothes, including athletic shoes.
**C.** Take all prescribed medications two hours prior to the test.
**D.** No food or drink is allowed after midnight prior to the test.
**E.** Refrain from alcohol, tobacco and caffeine 48 hours prior to the test.
**A.** Eat a light meal two hours prior to the test.
**B.** Wear comfortable clothes, including athletic shoes.
42
While monitoring a stress test on a 56-year-old male, the ECG technician should stop the test when the:
**A.** ECG technician sees that the patient is starting to sweat.
**B.** physician recognizes asymptomatic heart rhythm changes.
**C.** patient's heart rate reaches 100.
**D.** patient has completed three stages of the test.
**B.** physician recognizes asymptomatic heart rhythm changes.
43
Which of the following pieces of equipment should the ECG technician anticipate using when taking a patient's blood pressure?
**A.** Speculum
**B.** Otoscope
**C.** Pulse oximeter
**D.** Sphygmomanometer
**D.** Sphygmomanometer
43
When the patient is receiving a routine ECG, the waveform that indicates an increased risk for certain dysrhythmias and sudden death is a shorter or longer than normal
**A.** QT interval.
**B.** PR segment.
**C.** PR interval
**D.** ST segment.
**A.** QT interval.
44
To determine the quality of atrial activity on an ECG strip, the ECG technician should examine which of the following portions of the cardiac cycle?
**A.** T wave
**B.** PR interval
**C.** QT interval
**D.** ST segment
**B.** PR interval
45
Which of the following precautions should the ECG
technician take for a patient with dormant tuberculosis?
**A.** Airborne
**B.** Droplet
**C.** Standard
**D.** Contact
**C.** Standard
46
48. Referring to the image, the medical professional will select which of the following sites to measure the heart rate when obtaining vital signs?
**A.** Radial artery
**B.** Cephalic vein
**C.** Brachial artery
**D.** Basilic vein
**A.** Radial artery
47
Which of the following arteries circulates blood to the kidneys?
**A.** Brachial
**B.** Carotid
**C.** Femoral
**D.** Renal
**D.** Renal
48
When performing a 12-lead ECG, which of the following positions demonstrates correct lead placement?
**A.** V4 is placed left midclavicular 4th intercostal space.
**B.** V5 is placed left midaxillary 5th intercostal space.
**C.** V5 is paced left midclavicular 4th intercostal space.
**D.** V4 is placed left midclavicular 5th intercostal space.
**D.** V4 is placed left midclavicular 5th intercostal
space.
49
Which of the following rhythms is shown in the strip above?
**A.** Ventricular fibrillation
**B.** Ventricular tachycardia
**C.** Trigeminy
**D.** Agonal rhythm
**B.** Ventricular tachycardia
50
A patient is being tested by way of ECG for a possible delay in electrical conduction from the SA node to the AV node. The ECG technician should look at which of the following parts of the ECG to confirm this diagnosis?
**A.** PR segment.
**B.** ST segment.
**C.** QRS complex.
**D.** P wave.
**A.** PR segment.
51
The ECG strip shown above indicates
**A.** an atrial paced rhythm.
**B.** a ventricular paced rhythm.
**C.** an SA block.
**D.** an AV block.
**A.** an atrial paced rhythm.
52
After performing an ECG, the ECG technician notices wandering baselines in the precordial leads. Which of the following is the **MOST** appropriate next step?
**A.** Re-evaluate chest leads.
**B.** Run the ECG again.
**C.** Make sure that all electronics are off in the room.
**D.** Replace electrodes on the limb leads.
**A.** Re-evaluate chest leads.
53
The physician orders an ECG on a patient with severe burns on his left arm. Which of the following alternate placements should the ECG technician use?
**A.** All upper limb leads symmetrically placed as close to the original site as possible
**B.** All upper limb leads placed substernally at the acromion process
**C.** Left upper limb lead placed as close to the original site as possible
**D.** Left upper limb lead placed substernally at the acromion process
**A.** All upper limb leads symmetrically placed as close to the original site as possible
54
Which of the following actions by the ECG technician should be performed prior to exercise stress testing? **(Select three answers.)**
**A.** Tell the patient which symptoms should be
reported if experienced during the test.
**B.** Inform the patient of expectations during the
testing.
**C.** Obtain the patient's medical history and current medications.
**D.** Ensure that the monitor has fresh batteries.
**E.** Make sure the patient is in the prone position.
**A.** Tell the patient which symptoms should be reported if experienced during the test.
**B.** Inform the patient of expectations during the testing.
**C.** Obtain the patient's medical history and current medications.
55
Which of the following vessels circulates blood away from the heart?
**A.** Arteries
**B.** Veins
**C.** Arterioles
**D.** Capillaries
**A.** Arteries
56
Which of the following is classified as the MOST dangerous arrhythmia?
**A.** Atrial fibrillation
**B.** Premature atrial contraction
**C.** Ventricular fibrillation
**D.** Premature ventricular contraction
**C.** Ventricular fibrillation
57
An ECG technician performs an ECG on a patient and upon completion the standardization mark appears as shown above. The ECG technician should recognize that the test was with the machine set to which of the following settings?
**A.** 20 mm/mV and 50 mm/sec.
**B.** 10 mm/mV and 25 mm/sec.
**C.** 5 mm/mV and 25mm/sec
**D.** 20 mm/mV and 25 mm/sec.
**D.** 20 mm/mV and 25 mm/sec.
58
The ECG technician is contacting a patient to request they make a follow-up appointment. Which of the following forms should the ECG technician verify prior to leaving this message on the patient's voicemail?
**A.** Consent to Treat
**B.** HIPAA Confidentiality and Privacy
**C.** Durable Power of Attorney for Healthcare
**D.** Assignment of Benefits
**B.** HIPAA Confidentiality and Privacy
59
Which of the following is the proper blood pressure cuff for a 9-year-old child weighing 145 pounds?
**A.** Standard adult
**B.** Thigh
**C.** Child
**D.** Large adult
**A.** Standard adult
60
On an ECG strip for a patient with a pacemaker, if there are pacing spikes present and there is no atrial or ventricular depolarization, the ECG technician should recognize which of the following pacemaker complications?
**A.** Loss of capture
**B.** Oversensing
**C.** Malsensing
**D.** Misfiring
**A.** Loss of capture
61
Which of the following characteristics should the ECG
technician look for when identifying the P wave?
**A.** Large deflections from baseline due to ventricular depolarization
**B.** Small upward curve resulting from atrial depolarization
**C.** Small sloping upward curve resulting from ventricular repolarization
**D.** Smaller upward curve due to repolarization of the Bundle of His and Purkinje fibers
**B.** Small upward curve resulting from atrial depolarization
62
The ECG technician should enter the medications that the patient is taking into the
**A.** electrocardiogram.
**B.** nurse's notes.
**C.** discharge summary report.
**D.** system review.
**A.** electrocardiogram.
63
An idioventricular rhythm has an absence of
**A.** P waves.
**B.** S waves.
**C.** T waves.
**D.** ST segment.
**A.** P waves.
64
Which of the following is represented by the electrical
impulse and standard duration shown in the strip above?
**A.** PR interval 0.12 - 0.20 seconds
**B.** PR segment 0.12 - 0.20 seconds
**C.** PR segment 0.10 - 0.12 seconds
**D.** PR interval 0.10 - 0.12 seconds
**A.** PR interval 0.12 - 0.20 seconds
65
Reminding patients to refrain from talking and moving, and keeping them warm during the ECG procedure are important to help eliminate:
**A.** a somatic tremor artifact.
**B.** an alternating current interference
**C.** a 60-cycle interference.
**D.** a wandering baseline artifact.
**A.** a somatic tremor artifact.
66
Male patients are properly prepared and positioned for an ECG if they are positioned in
**A.** supine with chest exposed.
**B.** Sims with chest exposed.
**C.** Sims with chest and extremities exposed.
**D.** supine with chest and extremities exposed.
**D.** supine with chest and extremities exposed.
67
A patient with dyspnea comes in for an ECG. In which of the following positions should the patient be placed for the procedure?
**A.** Trendelenburg
**B.** Sims
**C.** Semi Fowlers
**D.** Supine
**C.** Semi Fowlers
68
When working with a patient with methicillin-resistant Staphylococcus aureus (MRSA), the ECG technician should
**A.** use a special mask as it is an airborne pathogen.
**B.** take the precautions for a contact pathogen.
**C.** use the procedures for reverse isolation.
**D.** use gloves and a mask if the patient is being treated.
**B.** take the precautions for a contact pathogen.
69
The time interval after ventricular depolarization and before ventricular repolarization is the:
**A.** QRS complex.
**B.** ST segment.
**C.** QT interval.
**D.** PR interval.
**B.** ST segment.
70
Which patient responsibilities continue for the ECG technician after completion of the exercise portion of electrocardiography stress testing?
**(Select three answers.)**
**A.** Answer patient questions regarding the results of the stress test.
**B.** Advise the patient to avoid stimulants.
**C.** Allow the patient to leave when exercise is
completed.
**D.** Stay with the patient and monitor for any
changes.
**E.** Instruct the patient on proper rest.
**B.** Advise the patient to avoid stimulants.
**D.** Stay with the patient and monitor for any changes.
**E.** Instruct the patient on proper rest.
71
A constant PRI that exceeds 0.20 seconds indicates:
**A.** an AV block 2:1 conduction.
**B.** a third degree AV block.
**C.** a first degree AV block.
**D.** a second degree AV block.
**C.** a first degree AV block.
72
During an ECG, the right leg provides grounding for which leads?
**A.** Precordial
**B.** Chest
**C.** Augmented
**D.** Bipolar
**C.** Augmented
73
Which of the following should be adjusted by the ECG technician when running an ECG on an infant or child?
**A.** Stylus position
**B.** Amplitude
**C.** Speed
**D.** Sensitivity
**C.** Speed
74
While performing an ECG an emergency arises with the
patient. Which of the following should the ECG technician
assess NEXT? (Select the two (2) correct answers.)
**A.** Skin
**B.** Respiration
**C.** Temperature
**D.** Pulse
**E.** Eyes
**B.** Respiration
**D.** Pulse
75
Which of the following is considered the normal pulse range
for an adult patient?
**A.** 110-130 bpm
**B.** 130-140 bpm
**C.** 60-100 bpm
**D.** 96-115 bpm
**C.** 60-100 bpm
76
Which of the following represents the pressure of the heart as it relaxes between beats?
**A.** Pulse pressure
**B.** Diastolic pressure
**C.** Systolic murmur
**D.** Systolic pressure
**B.** Diastolic pressure
77
While performing an ECG on a patient, electrodes keep falling off. Which of the following should the ECG technician do?
**(Select two answers.)**
**A.** Place tape over the electrodes.
**B.** Ask the patient to sit on her hands
**C.** Clean the skin with soap and water.
**D.** Reposition the electrodes.
**E.** Clean the skin with 70% isopropyl.
**A.** Place tape over the electrodes.
**E.** Clean the skin with 70% isopropyl.
78
Where should the V4 electrode be placed on the body?
**A.** Left midaxillary line, 5th intercostal space
**B.** Left midclavicular line, 5th intercostal space
**C.** Right anterior axillary line, 5th intercostal space
**D.** Right midclavicular line, 5th intercostal space
**B.** Left midclavicular line, 5th intercostal space
79
To ensure accuracy during the ECG procedure, the ECG technician should:
**A.** limit instructions and explanations to avoid increasing patient anxiety.
**B.** maintain a pleasant conversation with the patient during the test to provide comfort.
**C.** tell the patient to undress from the waist up, donning the gown with the opening in the front.
**D.** assist the patient onto the table in the Fowler's position.
**C.** tell the patient to undress from the waist up, donning the gown with the opening in the front.
80
Which of the following artifacts are present in the ECG strip above?
**A.** Somatic tremor
**B.** Interrupted baseline
**C.** AC interference
**D.** Wandering baseline
**D.** Wandering baseline
81
The time from ventricular depolarization through repolarization is represented by the:
**A.** PR segment.
**B.** PR interval.
**C.** QRS complex.
**D.** QT interval.
**D.** QT interval.
82
Which of the following actions should the ECG technician take FIRST when performing an ECG?
**A.** Verify insurance information.
**B.** Explain the procedure to the patient.
**C.** Obtain consent for the procedure.
**D.** Identify herself by name and title.
**D.** Identify herself by name and title.
83
An ECG technician is preparing to perform an ECG on a patient with a total left arm amputation. How should the ECG technician place the arm electrodes?
**A.** Omit the left electrode and put the right on the upper outer arm.
**B.** Put the right on the upper outer arm and the left on the torso below the clavicle.
**C.** Put both the right and left on the torso, below the clavicle.
**D.** Place both the right and left on the upper outer shoulder area.
**C.** Put both the right and left on the torso, below the clavicle.
84
Which of the following is included in the ECG technician's scope of practice?
**A.** Diagnosing dysrhythmias on ECGs
**B.** Identifying special patient considerations
**C.** Correcting dysrhythmias on ECGs
**D.** Explaining the results to the patient
**B.** Identifying special patient considerations
85
Which of the following is shown in the strip above?
**A.** Interrupted baseline
**B.** Somatic tremor
**C.** AC interference
**D.** Sixty-cycle interference
**A.** Interrupted baseline
86
During a patient's yearly checkup, the physician orders an outpatient ECG. Which of the following instructions are likely to be given to the patient at the hospital?
**(Select two answers.)**
**A.** Wear comfortable clothing, including athletic shoes.
**B.** Remove all piercings.
**C.** Do not use any lotions or creams.
**D.** Remove any stockings and roll up pant legs, as needed.
**E.** Have someone available to drive you home.
**C.** Do not use any lotions or creams.
**D.** Remove any stockings and roll up pant legs, as needed.
87
Which of the following actions should be taken FIRST when the ECG technician observes occasional wide and distorted QRS complexes, distorted ST segments, and PR and QT intervals that cannot be measured?
**A.** Continue to monitor the patient.
**B.** Administer oxygen.
**C.** Alert the physician or nurse.
**D.** Initiate CPR.
**C.** Alert the physician or nurse.
88
The ECG technician has now completed the ECG procedure. Following Standard Precautions, the ECG technician should:
**A.** place all equipment outside the patient's room.
**B.** sterilize all equipment and return it to storage.
**C.** sanitize and disinfect reusable equipment and return it to storage.
**D.** remove all equipment and return it to storage.
**C.** sanitize and disinfect reusable equipment and return it to storage.
89
Lead II records the tracing between which of the following limbs?
**A.** Right arm, left leg
**B.** Left leg, right arm
**C.** Right leg, right arm
**D.** Left leg, right leg
**A.** Right arm, left leg
90
Which of the following should the ECG technician tell a patient who is preparing to wear a Holter monitor?
**A.** Depress the event marker every hour.
**B.** Avoid close contact with other electrical devices.
**C.** Stop recording after 12 hours.
**D.** Remove the monitor from its case before bed.
**B.** Avoid close contact with other electrical devices.
91
The ECG technician is preforming an ECG on a patient who is obese, and a wandering baseline is present. Which of the following actions should the ECG technician take?
**(Select two answers.)**
**A.** Ensure the patient's arms are folded over the
chest.
**B.** Ensure that the examination table is not touching
the wall.
**C.** Ensure the patient is not touching the frame or
side rail.
**D.** Ensure good skin preparation.
**E.** Ensure that new electrodes and clean clips are
used.
**D.** Ensure good skin preparation.
**E.** Ensure that new electrodes and clean clips are
used.
92
After notifying the physician, which of the following should be the ECG technician's NEXT action for a patient with strip shown above?
**A.** Initiate Emergency Response System or Code
Blue.
**B.** Check the precordial (V1-V6) leads and limb
placement.
**C.** Monitor the patient for deterioration of
symptoms.
**D.** Evaluate the patient's cardiac output.
**C.** Monitor the patient for deterioration of symptoms.
93
Which of the following occurs when a singular irritable impulse fires so rapidly it bombards the AV node, causing V shaped or upside down V shaped waves?
**A.** Ventricular tachycardia
**B.** Ventricular flutter
**C.** Atrial flutter
**D.** Atrial tachycardia
**C.** Atrial flutter
94
Which of the following rhythms is shown in the strip above?
**A.** Ventricular pacing
**B.** Failure to capture
**C.** Atrioventricular pacing
**D.** Atrial pacing
**A.** Ventricular pacing
95
Which of the following should be included in the medical history taken prior to an ECG?
**A.** SPO2
**B.** Current medications
**C.** Fasting status
**D.** Smoker versus non-smoker status
**B.** Current medications
96
Which of the following are factors affecting the QT interval?
**(Select three answers.)**
**A.** Heart rate
**B.** Diastolic blood pressure
**C.** Antidysrhythmic medications
**D.** Electrolyte imbalance
**E.** SA node firing
O_O
**A.** Heart rate
**C.** Antidysrhythmic medications
**D.** Electrolyte imbalance
97
How should a 38-year-old late term pregnant woman be positioned to reduce pressure on the inferior vena cava during an ECG?
**A.** Lithotomy
**B.** Supine
**C.** Semi-Fowler's
**D.** Dorsal recumbent
**C.** Semi-Fowler's
98
A patient presents for a STAT ECG. After hand washing, the ECG technician notices the patient has MRSA sores. The
NEXT step to take in order to prevent transmission is to:
**A.** don a protective mask.
**B.** reschedule the patient when the MRSA sores have healed.
**C.** use universal precautions.
**D.** implement reverse isolation.
**C.** use universal precautions.
99
Which of the following is the MOST routinely overlooked prep for providing ECG testing?
**A.** Checking the battery indicator
**B.** Ensuring that gown and drapes are available
**C.** Turning the machine on
**D.** Proper placement of ECG machine
**A.** Checking the battery indicator
100
In prepping for placement of a 24-hour Holter monitor, how should the ECG technician instruct the patient?
**A.** Do not use a hair dryer while wearing the monitor.
**B.** Avoid the intake of caffeinated beverages until the monitor is removed.
**C.** Refrain from exercising for the duration of the test.
**D.** Withhold prescription medications during the 24-
hour period
**A.** Do not use a hair dryer while wearing the monitor.
101
Which of the following does the P wave on an ECG represent?
**A.** Atrial contraction
**B.** Atrial contraction ends
**C.** Ventricle contraction
**D.** Ventricle contraction ends
**A.** Atrial contraction
102
A patient arrives late after witnessing an auto accident. In preparation for running the patient's ECG, the technician notes
an increased anxiety level. Which of the following should the ECG technician do? **(Select three answers.)**
**A.** Document the patient's state in the report.
**B.** Obtain vital signs promptly.
**C.** Speak clearly and softly to patient.
**D.** Run two ECGs ten minutes apart.
**E.** Allow time for the patient to relax.
**A.** Document the patient's state in the report.
**C.** Speak clearly and softly to patient.
**E.** Allow time for the patient to relax.
103
The physician has instructed the ECG technician to obtain the patient's temperature. Before the oral thermometer is placed in the patient's mouth, to ensure accuracy of the reading the ECG technician should ask the patient if she has:
**A.** recently ingested hot or cold food or beverages.
**B.** taken her prescribed medications today.
**C**. had a fever in the last 24 hours.
**D.** pain with swallowing.
**A.** recently ingested hot or cold food or beverages.
104
If the strip shown above is obtained on an adult patient, which of the following should the ECG technician do before obtaining another ECG reading?
**A.** Have the patient take off any jewelry.
**B.** Ask the patient to remove any electrical devices from her pockets.
**C.** Direct the patient to try to breathe normally and not hold his breath.
**D.** Apply tape to any electrodes that appear loose or not securely adhered.
**C.** Direct the patient to try to breathe normally and not hold his breath.
105
Which of the following actions should the ECG technician take to ensure proper monitoring of a patient during a stress test?
**(Select three answers.)**
**A.** Observe facial expressions, skin color and perspiration.
**B.** Instruct the patient to start at a rapid pace
**C.** Measure blood pressure and heart rate frequently.
**D.** Adjust the temperature of the room to the patient's preference.
**E.** Instruct the patient to report any symptoms.
**A.** Observe facial expressions, skin color and perspiration.
**C.** Measure blood pressure and heart rate frequently.
**E.** Instruct the patient to report any symptoms.
106
Which of the following arteries is MOST commonly used for blood pressure measurement?
**A.** Popliteal
**B.** Brachial
**C.** Radial
**D.** Carotid
**B.** Brachial
107
A three-month-old patient is fussy and moving his arms and legs. Which of the following should the ECG technician do in order to get proper electrode placement for an accurate ECG?
**(Select two answers.)**
**A.** Sooth the child with a pacifier.
**B.** Only place precordial leads.
**C.** Allow the child to get familiar with the equipment.
**D.** Allow the parent to hold the child.
**E.** Use a reward system
**A.** Sooth the child with a pacifier.
**D.** Allow the parent to hold the child.
108
In the event an ECG technician recognizes idioventricular rhythm on an ECG printout, how should the ECG technician respond?
**A.** Reposition the patient and run the test again.
**B.** Ask the patient to take several deep breaths.
**C.** Administer oxygen.
**D.** Notify the physician.
**D.** Notify the physician.
109
ST segment changes are likely to present with which of the
following conditions?
**A.** 1st degree heart block
**B.** Syncope
**C.** Bundle branch block
**D.** Myocardial ischemia
**D.** Myocardial ischemia
110
The closure of which valve(s) within the heart create(s) the "lub" sound of the heart beat's "lub dub" cycle?
**A.** Pulmonary semilunar valves
**B.** Atrioventricular valves
**C.** Bicuspid valve
**D.** Tricuspid valve
**B.** Atrioventricular valves
111
Which of the following is a major complication of atrial fibrillation?
**A.** Premature atrial complexes
**B.** Increased cardiac output
**C.** Widened QRS complexes
**D.** Thrombi formation
**D.** Thrombi formation
112
A patient on droplet precautions needs to be moved from his room to a testing facility for a stress test. Which of the
following precautions should the ECG technician take?
**(Select two answers.)**
**A.** Have the patient wear a mask.
**B.** Wear a mask and gloves.
**C.** Evacuate the route to the testing facility during the transport.
**D.** Put the patient in a clean gown with a mask and gloves.
**E.** Have the patient wear a HEPA or N mask.
**A.** Have the patient wear a mask.
**B.** Wear a mask and gloves.
113
The ECG technician is obtaining a blood pressure measurement on a patient with a right-sided mastectomy. At which of the following sites should the ECG technician take the blood pressure?
**A.** Right lower leg
**B.** Left upper arm
**C.** Right upper arm
**D.** Left lower leg
**B.** Left upper arm
114
A patient with a blood pressure of 158/96 mm Hg is considered:
**A.** hypertensive.
**B.** bradycardic.
**C.** hypotensive.
**D.** tachycardic.
**A.** hypertensive.
115
Which of the following arteries circulates blood flow to the brain?
**A.** Popliteal
**B.** Dorsalis pedis
**C.** Posterior tibialis
**D.** Carotid
**D.** Carotid
116
To prevent a wandering baseline artifact, the ECG technician should ensure the patient is:
**A.** moved away from the wall if in a hospital bed.
**B.** not wearing any metal jewelry.
**C.** positioned with his hands under the buttocks.
**D.** cleansed with alcohol prep pads.
**D.** cleansed with alcohol prep pads.
117
The classification of the rhythm strip shown above is
**A.** ventricular.
**B.** bundle block.
**C.** junctional.
**D.** atrial.
**A.** ventricular.
118
Proper electrode placement for continuous ECG monitoring
is identified by the use of:
**A.** 10 electrodes placed on the patient's torso.
**B.** 12 electrodes placed on the patient's extremities and torso.
**C.** 5 electrodes placed on the patient's extremities and torso.
**D.** 3 leads placed on the patient's torso.
**D.** 3 leads placed on the patient's torso.
119
Which of the following resources must be available for a patient undergoing a stress test?
**(Select three answers.)**
**A.** Protective gown and mask
**B.** Defibrillator
**C.** Oxygen
**D.** Crash cart
**E.** Special camera or scanner
**B.** Defibrillator
**C.** Oxygen
**D.** Crash cart
120
Which of the following valves separates the left atrium from the left ventricle?
**A.** Tricuspid
**B.** Bicuspid
**C.** Pulmonic
**D.** Aortic
**B.** Bicuspid
121
A patient with Parkinson's comes in for an ECG with noticeably severe tremors. Which of the following should the ECG technician do to ensure a proper reading?
**A.** Move the patient into the semi-fowlers position to ease breathing.
**B.** Have the patient slide their hands under their buttocks.
**C.** Have the patient grasp the side of the table.
**D.** Ask the patient to remain calm
**B.** Have the patient slide their hands under their buttocks.
122
In which of the following patients does the strip shown above present a normal finding?
**(Select three answers.)**
**A.** Infant
**B.** Patient with PAT (Paroxysmal Atrial Tachycardia)
**C.** Well-conditioned athlete
**D.** Older adults
**E.** School age child
**C.** Well-conditioned athlete
**D.** Older adults
**E.** School age child
123
Which of the following measurements indicates the difference between the systolic and diastolic blood pressure?
**A.** Body mass index
**B.** Pulse pressure
**C.** Point of maximum impulse
**D.** Heart rate
**B.** Pulse pressure
124
Which of the following is the MOST common lead used to evaluate components of the ECG strip?
**A.** Lead Il
**B.** Lead AVR
**C.** Lead V4
**D.** Lead I
**A.** Lead Il
125
If the arm limb electrodes are reversed on the patient, where on the ECG tracing will this change be depicted?
**A.** Il and AVL
**B.** I and AVR
**C.** Il and AVF
**D.** I and AVL
**B.** I and AVR
126
After validating an ECG order, collecting all the supplies, and ensuring the machine in is proper working order, the ECG technician 's NEXT action should be to:
**A.** apply the electrodes.
**B.** identify the patient.
**C.** provide for privacy.
**D.** explain the procedure.
**B.** identify the patient
127
During stress testing on a 50-year-old patient, which of the following is a reason for terminating the test?
**A.** A decrease in systolic blood pressure by 23 mmHg.
**B.** A respiratory rate of 25 per minute.
**C.** The patient is starting to exhibit diaphoresis.
**D.** A heart rate of 130.
**A.** A decrease in systolic blood pressure by 23 mmHg.
128
ST segment depression with T wave inversion indicates which of the following arrhythmias?
**A.** Hemiblock
**B.** AV block
**C.** First degree heart block
**D.** Bundle branch block
**D.** Bundle branch block
129
Which of the following is the correct classification for the strip shown above?
**A.** Irregularly irregular
**B.** Irregularly regular
**C.** Regularly regular
**D.** Regularly irregular
**D.** Regularly irregular
130
Three big boxes between the R-R intervals indicates:
**A.** 0.20 sec.
**B.** 75 bpm.
**C.** 100 bpm.
**D.** 1.0 sec.
**C.** 100 bpm.
131
Which of the following instructions must be followed while wearing the Holter monitor? **(Select two answers.)**
**A.** Avoid wearing jewelry, metal buttons, or buckles.
**B.** Continue normal exercise and work during monitoring.
**C.** Avoid stressful situations during monitoring.
**D.** The Holter monitor should stay in place for 72 hours.
**E.** Remove the monitor and electrodes while sleeping.
**A.** Avoid wearing jewelry, metal buttons, or buckles.
**B.** Continue normal exercise and work during monitoring.
132
When performing a stress test on a 42-year-old patient, the earliest the test can be concluded is when the patient reaches a heart rate of:
**A.** 220 bpm.
**B.** 188 bpm.
**C.** 178 bpm.
**D.** 262 bpm.
**C.** 178 bpm
(220 - age of patient)
133
Prior to an ECG a patient informs the ECG technician that he often experiences orthopnea. How should the ECG technician prepare this patient for the ECG procedure?
**A.** Position the patient in the semi-Fowlers position.
**B.** Place the limb electrodes on the shoulder/hip regions.
**C.** Position the patient in the supine position.
**D.** Place the chest electrodes on the right side of the chest
**A.** Position the patient in the semi-Fowlers position.
134
Which of the following patients requires modified placement of the electrodes?
**A.** Open heart surgery
**B.** Amputation
**C.** Mastectomy
**D.** Hairy chest
**B.** Amputation
135
While performing a stress test on a patient, the patient complains of chest pain and has the ECG shown above.
Which of the following should the ECG technician do NEXT?
**A.** Review the peak for possible changes.
**B.** Call a code.
**C.** Notify the physician/nurse and stop the treadmill.
**D.** Tell the patient to take deep breaths.
**C.** Notify the physician/nurse and stop the treadmill.
136
The importance of accurate anatomic positioning of leads on a patient when performing an ECG is to:
**A.** stimulate positive electrical impulses
**B.** capture true cardiac activity.
**C.** ensure proper machine calibration with universal measurements.
**D.** allow interruption of negative electrical conduction.
**B.** capture true cardiac activity.
137
For the ECG strip shown above, the heart rate would be calculated as 90 bpm if which of the following methods were used?
**A.** Small box method
**B.** 300 method
**C.** 6-second method
**D.** Large box method
**C.** 6-second method
138
The use of smaller electrodes while running an ECG on a four-year-old pediatric patient will require which of the following modifications?
**A.** Decrease the paper speed.
**B.** Place the patient in Sim's position.
**C.** Increase the paper speed.
**D.** Place the patient in a dorsal recumbent position.
**C.** Increase the paper speed.
139
Which of the following should the ECG technician do with a patient on contact precautions?
**(Select three answers.)**
**A.** Avoid contaminated surfaces.
**B.** Wear a mask.
**C.** Wear eye protection.
**D.** Wash hands.
**E.** Disinfect all equipment.
**A.** Avoid contaminated surfaces.
**D.** Wash hands.
**E.** Disinfect all equipment.
140
Improper grounding of the ECG during set-up is MOST likely to result in:
**A.** muscle artifact.
**B.** somatic tremor artifact.
**C.** alternating current artifact.
**D.** wandering baseline artifact.
**C.** alternating current artifact.
141
From the strip shown above, calculate the patient's heart rate.
**A.** 136
**B.** 110
**C.** 170
**D.** 187
**A.** 136
142
Which of the following indicates a normal sinus rhythm?
**A.** PR interval of 0.22 second, QRS complex of 0.10 second, QT interval of 0.40 second and HR of 78
**B.** PR interval of 0.22 second, QRS complex of 0.12 second, QT interval of 0.48 second and HR of 72
**C.** PR interval of 0.14 second, QRS complex of 0.12 second. QT interval of 0.48 second and HR of
72
**D.** PR interval of 0.14 second, QRS complex of 0.10 second. QT interval of 0.40 second and HR of 78
**D.** PR interval of 0.14 second, QRS complex of 0.10 second. QT interval of 0.40 second and HR of 78
143
The ECG strip shown above displays a prolonged:
**A.** QRS complex.
**B.** P wave.
**C.** PR interval.
**D.** QT interval.
**C.** PR interval.
144
Which of the following is the minimum number of variations of the P wave in a wandering atrial pacemaker rhythm?
**A.** Two
**B.** One
**C.** Four
**D.** Three
**D.** Three
145
An ECG technician should recognize that the MOST likely cause of a PVC on an ECG strip is:
**A.** an ectopic focus.
**B.** a loose electrode.
**C.** quivering of the heart ventricles.
**D.** movement of the patient.
**A.** an ectopic focus.
146
Which of the following is characterized by rapid incomplete contractions of the atria?
**A.** Ventricular fibrillation
**B.** Paroxysmal atrial tachycardia
**C.** Atrial fibrillation
**D.** Premature atrial contractions
**C.** Atrial fibrillation
147
An idioventricular rhythm has an absence of
A. T waves.
B. P waves.
C. S waves.
D. ST segment.
B. P waves.
148
Which of the following variations in ECG results is likely for patients with pacemakers?
A. Inverted P-wave
B. Elevated ST segment
C. Decreased PR interval
D. Presence of a pacing spike
D. Presence of a pacing spike
