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WorksheetsEKG Certification
Total questions: 112
Worksheet time: 3600secs
Which of the following waves on an EKG tracing relates to electrical activity in the atria?
Q wave
T wave
P wave
R wave
Which of these questions is an appropriate way of checking one patient identifier before performing an EKG test?
"Is your name George Disher?"
"What is your last name, George?"
"Can you please state your first and last names?"
"Are your initials G.D.?"
Widened QRS complexes on an EKG tracing are signs of
Myocardial infarction
A ventricular dysrhythmia
An atrial dysrhythmia
Hypertension
A patient is nearing the target heart rate during an exercise stress test when he becomes diaphoretic and complains of intense chest pain. Which response from the EKG technician is best?
Stop the test and alert the doctor immediately.
Tell the patient to hold on just a bit longer since hitting the target heart rate will provide better information about why he's experiencing chest pain.
Stop the test and begin CPR immediately.
Continue the test while administering oxygen.
Under which of the following circumstances can an EKG technician discuss the details of a patient's EKG or treatment? (Choose two correct answers.)
When a patient asks the technician for an interpretation of the EKG right after it is performed.
When the technician is delivering the completed EKG and the patient's chart to the cardiologist who ordered the test.
When the patient's insurance company calls to confirm that an EKG was ordered and conducted.
When the patient's employer calls to ask if he is fit to continue working.
Which of these sentences demonstrates patient understanding of directions for Holter monitoring?
"I will call the office each time I experience symptoms."
"I will cover the electrodes, lead wires, and monitor with plastic when I swim or shower."
"I will change the electrodes every 12 hours."
"I will make a note in the diary when I exercise."
This patient would require no changes to positioning or electrode placement:
An elderly man with orthopnea
A 35-year-old woman who is 20 weeks pregnant
An 8-year-old child
A 40-year-old man with a full cast on his right leg.
Which of these electrodes is not involved in creating Einthoven's triangle?
Right arm
Left arm
Right leg
Left leg
An intellectually disabled adult patient is frightened of the EKG machine and does not want to lie down for the test. What should the EKG technician do?
Gently but firmly assist the patient to lie down.
Tell the patient she will give him a lollipop after the test is over.
Offer to show the machine to the patient and answer and questions.
Reschedule the test for later time.
Which leads will show changes if an EKG technician has reversed the right and left arm leads?
Leads II and aVL
Leads I and aVR
Leads V2 and V4
Leads III and aVf
An EKG technician sees pacing spikes on a patient's EKG but no electrical activity following the spikes. This is likely due to a pacemaker error known as
Failure to capture
Failure to sense
Failure to fire
Failure to pace
Which of the following should patients be advised not to do before an early-morning resting EKG?
Apply lotion or bath oil
Eat breakfast
Take their usual medications
Shower
Which of these series represents the depolarization and repolarization of the ventricles?
P wave, QRS complex
QRS complex, T wave, U wave
T wave, U wave, P wave
QRS complex, T wave
What type of stress test is likely to be performed on a patient who does not have use of her legs?
Exercise stress test
Nuclear stress test
Pharmacologic stress test
Physiologic stress test
Narrow and wide are words often used to describe
P waves
QT intervals
ST segments
QRS complexes
Under which of these circumstances may an EKG technician share her interpretation of an EKG with the patient?
If the patient confirms that she understands the technician is not a doctor.
If the patient's EKG shows a potentially lethal dysrhythmia.
If the patient's EKG is normal.
The EKG technician must not share her interpretation with the patient.
Measuring vital signs includes
Checking pulse, body temperature, blood pressure, and respirations.
Checking pulse, body temperature, blood pressure, and pain level.
Checking pulse, blood pressure, oxygen saturation, and pain level.
Checking pulse, regularity of heart rhythm, bood pressure, and oxygen saturation.
Which electrode is shared by leads I and III
LA
LL
RA
RL
At standard gain a calibration mark will measure
Three large blocks high
Two large blocks high
Four large blocks high
One large block high
A rhythm in which P-P intervals are regular and R-R intervals are regular but there is no clear relationship between the activity of the atria and ventricle is
Ventricular tachycardia
SA block
Wandering atrial pacemaker
Third-degree heart block
Acceptable locations for the LL and RL electrodes include the following (select two):
On the soles of the feet
On the upper thighs
On the lower torso
On the knees
Behind the knees
Before performing an EKG on a patient under contact precautions the technician should
Don a full set of PPE
Don gloves
Ask the patient to place adhesive bandages over any open wounds
Clean the EKG machine and lead wires with disinfectant
An ectopic focus is a group of cells in the heart that initiates an impulse
In an abnormal location
Later than it should be
Earlier than it should be
That does not cause a contraction
Which of these introductions is appropriate for an EKG technician to make?
"I'm Mario and I'll be doing your test today."
"I'm Mario Bedoya. I do EKG's."
"I'm Mario and I'm helping Dr. Hamlin today with EKG's."
"I'm Mario Bedoya and I'm an EKG technician."
When placing elecrodes for an EKG on a 5-year-od child where should the technician place the V4 electrode?
On the right side of the chest at the fifth intercostal space at the midclavicular line.
On the left side of the chest at the fifth intercostal space at the midclavicular line.
On the right side of the chest immediately beside the V1 electrode.
On the left side of the chest at the fourth intercostal space just to the left of the sternum.
How many electrodes are placed on the back when conducting a posterior EKG?
All of the electrodes are moved to the back.
All of the precordial lead electrodes are moved to the back.
One electrode is moved to the back.
Three electrodes are move to the back.
An EKG tracing in which the P waves are not uniform may indicate a dysrhythmia originating in the
Sinus node
Atria
Bundle branches
Purkinje fibers
After leaving the room to give a patient privacy for gowning, the EKG technician knocks and does not hear a response. She enters cautiously and finds that the patient is unconscious, does not have a pulse, and is not breathing. What is the best response?
Start CPR immediately.
Go find the cardiologist.
Shout out for someone to call 911 and the start CPR.
Get out the automated external defibrillator.
The bottom row in a 12-lead EKG tracing
Alternates between the bipolar leads
Alternates between the unipolar leads
Shows only lead I
Shows only lead II
A QRS complex that measures 4 small boxes wide would be considered
Abnormally wide
Normal
Narrow
Wide but within normal range
When is the best time to count respirations and record a patient's respiratory rate?
While measuring the patient's blood pressure
Immediately after measuring radial pulse, while still holding the wrist.
When the patient is in the supine position for the EKG.
As a final step after recording the EKG.
Which of the following would need to be reported to a doctor right away?
A patient with a pacemaker set to fire at 70 BPM has a pulse of 75 BPM.
A patient's QRS intervals regularly measure 0.12 s.
A patient's EKG shows a sinus arrest period of four seconds.
A patient's EKG shows a three-millimeter elevation of the ST segment.
Which of these measures can help reduce artifact during ambulatory monitoring?
Suggesting that the patient wear tight-fitting clothes.
Ensuring that the lead wires are pulled taut.
Looping the lead wires and securing them with tape.
Wrapping the lead wires around to the patient's back and taping them there.
A blood pressure reading of 145/80 is considered
Hypertensive
Prehypertensive
Hypotensive
Potentially letha
When a patient's EKG tracing shows distinct spikes before widened QRS complexes this is a sign
That the patient requires immediate emergency treatment.
That the patient has an artificial pacemaker pacing the ventricles.
That the patient has an artificial pacemaker pacing the atria.
That the patient's pacemaker is not functioning properly.
Which of these questions relates to a patient's medical history?
"Has anyone in your family ever had heart disease?"
"Are you now or were you ever a smoker?"
"How many alcoholic beverages do you drink per week, on average?"
"Have you ever had surgery of any kind?"
The best approach for performing an EKG on a frightened toddler is to
Explain to the child how the EKG works
Assure the child it does not hurt and allow him to stay in his parent's arms
Perform an EKG on the parent first so he can see it is harmless
Ask the doctor to come in and assist
What should an EKG technician do before uploading a patient's EKG to the patient's EHR?
Call the medical records office to make sure they are ready to receive it.
Confirm that the EKG is free of artifact and that the EHR correctly matches the identity of the patient.
Discuss any potentially dangerous rhythms with the patient.
Conduct a second EKG so the doctor will have two records to compare.
Semi-Fowler's position would be an appropriate position for which of the following patients?
A 10-month-old child
A 30-year-old prone to seizures
An elderly man with Parkinson's disease
An elderly woman with congestive heart failure
Which of the following are acceptable ways of communicating with a patient who does not speak English? (Choose two correct answers.)
Bringing in a medical interpreter
Using a translation app on the EKG technician's phone
Using a web-based medical interpretation service
Using signs and gestures
Speaking through a friend or family member of the patient who speaks both languages fluently
A cardiac rhythm with a name that includes the word tachycardia is
Faster than normal
Slower than normal
Originating below the sinoatrial node
Potentially lethal
What is a heart card?
It is a card carried in the wallet to describe the type of pacemaker a patient has implanted.
It is a card capable of monitoring a patient's cardiac activity when held over the sternum.
It is a card indicating whether a patient wishes to donate her heart in case of a lethal accident.
It is a card used to analyze heart rhythm during stress testing.
The path in which electrical signals pass through a healthy heart is
AV node, SA node, bundle branches, bundle of His, Purkinje fibers
Pukinje fibers, bundle branches, bundle of His, AV node, SA node
SA node, AV node, bundle of His, bundle branches, Purkinje fibers
Bundle of His, bundle branches, Purkinje fibers, SA node, AV node
When preparing a patient for an upcoming stress test, which of these statements would be most appropriate?
"It doesn't matter what you wear because we will provide a hospital gown and footwear."
"You should not eat or drink anything starting 24 hours before the test."
"If you are a smoker you will be given a chance to smoke before the test begins, but cannot smoke during the test."
"After the test you will need to avoid exertion."
Which of the following conditions are potential complications of atrial fibrillation? (Choose two correct answers.)
Cerebrovascular accident
Hypertension
Arteriosclerosis
Chronic obstructive pulmonary disease
Thrombus formation
An impulse that travels backward in the cardiac conduction system is called
Retrograde
Renegade
Reversed
Recalcitrant
Which of the following cardiac rhythms requires immediately alerting a doctor to the patient's situation?
Junctional escape rhythm
Second-degree heart block Mobitz type I
Sinus arrhythmia
Ventricular tachycardia
Which of the following are forms of ambulatory monitoring? (Choose three correct answers.)
Continuous monitor
Event monitor
Holter monitor
Computed tomography
Mobile cardiac telemetry
What should an EKG technician always do before applying an ambulatory monitor to a patient?
Ask the doctor to calibrate the monitor
Check that the batteries are fresh
Acquire a new monitor
Complete a brief test run with the monitor
Sharing details of a patient's health with a colleague who is not involved in the patient's treatment is a violation of
HIPPA
The HITECH Act
Slander laws
Libel laws
In sinus arrhythmia the patient's heart rhythm often changes in relation to
The patient's blood pressure
The patient's breathing
The patient's mood
The patient's anxiety
A run of ventricular tachycardia is occurring when three ... appear in a row.
Premature junctional contractions
Ventricular escape beats
Bundle branch blocks
Premature ventricular contraction
If a patient does not have a palpable pulse that patient's
Heart is not beating
Pulse cannot be felt
Cardiac output is high
EKG will show no electrical activity
Some forms of atrioventricular block are marked by prolonged
PR intervals
QRS complexes
R-R intervals
P-P intervals
Which of these items might be used to prepare a patient's skin for electrode placement? (Choose two correct answers.)
A fine-grain nail file
A brading tape
A washcloth and soapy water
Medical clippers
A disposable razor
Wandering baseline artifact is most often caused by
Reversal of the limb leads
Electrical activity in the room where the test is being conducted
Patient seizures
Inadequate electrode adhesion
If a patient is experiencing a very rapid heart rate the doctor may request that an EKG be performed
With the patient under anesthesia
With the paper speed at 50 mm/s
With the patient in semi-Fowler's position
With the gain set to 20 mm/mV
Which of the following cardiac rhythms will have different atrial and ventricular rates?
Junctional tachycardia
Sinus bradycardia
Atrial flutter
Supraventricular tachycardia
Electrical interference may be caused by
Fluorescent lights in the exam room
Sweat on the patient's skin
Inadequate electrode placement
Low battery levels in the EKG machine
A Spanish-speaking patient says that she understands English but seems to be having difficulty answering the EKG technician's questions. What should the EKG technician do?
Speak louder
Write her questions down for the patient to read
Try to phrase the questions differently
Contact an interpreter or initiate interpretation service
In which of the following situations would electrodes for leads V2-V6 be placed on the right side of the patient's chest? (Choose two correct answers.)
Patient has had a left-sided masectomy
Patient is eight-years-old
Patient has dextrocardia
Patient is eight-months-old
Patient is suspected of having an occluded circumflex artery
What is injected into a patient's bloodstream during a nuclear stress test?
A drug that stimulates the cardiac stress of exercise
A radioactive tracer
A saline solution
A drug that stabilizes irregular heartbeats
Which electrode may also be called the ground electrode?
Right arm
Left arm
Right leg
Left leg
How are signals from a telemetry packed monitored?
By uploading data from the unit at the end of the monitoring period
By viewing the EKG on an ongoing basis at a central monitoring site
By regularly scheduled visits from the EKG technician to the patient's hospital room
By generating a printed EKG strip every hour to two hours
At what point should an EKG technician confirm the identity of the patient?
Before delivering the EKG tracing to the doctor or uploading it to the patient's EHR
Before entering the room to perform the EKG
After introducing himself and before providing any care
After introducing himself and before applying electrodes to the patient
If a patient is experiencing the cardiac rhythm called wandering atrial pacemaker, which wave will show a number of variations?
The P wave
The U wave
The T wave
The R wave
ST segment depression is
Normal in geriatric patients
An indication of hypertension
An indication of myocardial ischemia
An indication of myocardial infarction
A patient with his left arm amputated at the shoulder will require alternate placement of
The LA electrode
The RA electrode
Both the RA and LA electrodes
All limb electrodes
The EKG technician must wear gloves during EKG testing
If the patient has open wounds on his chest or limbs
If the patient is under droplet precautions
If the patient has known tuberculosis
For every patient
Sinus bradycardia is not of clinical concern unless
The patient is a well-conditioned athlete
The patient's blood pressure is 100/70 or below
The patient is elderly
The patient shows signs of cardiac compromise
If the R waves on an EKG tracing are too high for the paper, which adjustment needs to be made?
The speed needs to be increased
The speed needs to be decreased
The gain need to be increased
The gain needs to be decreased
A supraventricualar rhythm may initiate
In the Purkinje fibers
In the atrioventricular node
In the bundle branches
In the bundle of His
The normal range for oxygen saturation is
85-100%
95-100%
90-100%
85-99%
An EKG technician wheels a facility computer terminal in a patient's room with the previous patient's information still displayed. The terminal screen displays the previous patient's information while the EKG technician introduces herself, confirms the patient's identity, and asks her initial questions. Which of the following is true?
This is an intentional breach of confidentiality.
Thus is an unintentional breach of confidentiality.
This is not considered a breach of confidentiality because the EKG technician was unaware that the information was visible.
Whether or not this is a breach of confidentiality depends on the facility's policy.
A 57-year-old patient is undergoing an exercise stress test. What is the heart rate the patient must reach during testing in order for the test to be valid?
163 BPM
220 BPM
114 BPM
139 BPM
Which of the following situations is most likely to result in a doctor ordering ambulatory monitoring?
Patient comes to the emergency room experiencing severe chest pain
Patient's resting EKG is normal but patient requests frequent palpitations
Patient's resting EKG shows sinus bradycardia but patient is asysymptomatic
Patient has a very busy schedule and is unable to come in for a resting EKG
Which cardiac test provides direct information about the mechanical activity of the heart?
Ambulatory monitoring
Electrocardiogram
Echocardiogram
Pharmocologic stress test
An escape beat is a heartbeat that is
Fast
Strong
Early
Late
An EKG shows normal sinus rhythm, but the patient has no pulse. Electrodes are securely in place and lead wires are connected, and so the technician can assume that the patient is experiencing
Cardiac arrest
Ventricular fibrillation
Pulseless electrical activity
Agonal rhythm
Which of the following PR interval measurements would be most consistent with first-degree heart block?
260 milliseconds
200 milliseconds
140 milliseconds
100 milliseconds
Which set of heart rhythm names below shows different names for the same rhythm?
Ventricular tachycardia/ ventricular fibrillation
Junctional escape rhythm/ premature junctional contractions
Sinus arrhythmia/ sinus arrest
Wenckebach block/ Mobitz type I
Torsades de pointes is an indication of
Sinus rhythm
Heart block
Ventricular tachycardia
Ventricular fibrillation
A patient whose EKG shows asystole is conscious and alert. What should the EKG technician do?
Call the doctor
Check that electrodes are secure and all lead wires connected
Acquire a different EKG machine
Administer oxygen for five minutes and the repeat the EKG
Which of the following is common guidance given when setting up a Holter monitor?
Note the time of any symptoms and any activities/ exercise in your diary.
Refrain from exercise during the monitoring period.
Refrain from drinking caffeine or alcohol during the monitoring period.
Press the event button only if symptoms seem to be triggered by your activity.
What is the largest artery in the body?
The femoral artery
The carotid artery
The aorta
The brachial artery
Which form of atrial fibrillation features a high number of conducted beats?
Atrial fibrillation with rapid ventricular response
Controlled atrial fibrillation
Atrial flutter with 3.1 conduction
Asymptomatic atrial fibrillation
The normal range for body temperature in pediatric patients is
The same as in adult patients
Lower than in adult patients
Higher than in adult patients
Lowest for infants and gradually increasing to adult range as the child ages
Leads aVR, aVL, aVF, V1, V2, V3, V4, V5, and V6 are all
Bipolar leads
Contiguous leads
Unipolar leads
Concentric leads
The EKG technician's scope of practice includes the following actions (choose two):
Selecting the EKG test most appropriate for each patient
Working to remove as much of the artifact as possible from the EKG tracing
Describing the rhythms that appear on the EKG tracing to the patient
Putting the patient at ease before performing an EKG procedure
Noting possible diagnoses on the EKG before submitting it to the doctor
When are vital signs measured during an exercise stress test?
Before, every 2.5 minutes during, and after the stress test
Before and immediately after the stress test
Before and then every 5, 10, and 15 minutes after the stress test
Every five minutes during, and 5, 10, and 15 minutes after the stress test
It is a violation of confidentiality to speak about a patient
With the doctor who ordered the EKG for the patient
With the nurse who is on duty during the performance of the stress test on the patient
With a doctor who works at a different facility but specializes in treating the condition the patient suffers from
With the facility's billing office
Agonal rhythm is named for the fact that it is
Extremely painful
Associated with the throes of death
Generally seen in old age
A sign of certain death
In what circumstances should an EKG technician wash their hands after conducting an EKG?
After the EKG is performed
Only after performing an EKG on a patient under contact precautions
After performing an EKG on a patient who is either under contact precautions or has open wounds
After performing an EKG on a patient who is under any Transmission-Based precautions or has open wounds
NSTEMI is a type of heart attack in which
There is no ST segment evaluation
ST segment elevation is no greater than 2 mm
ST segment elevation is transient
ST segment depression replaces ST segment elevation
Pulmonary embolism occurs when ... enters the lungs.
Fluid
Blood
A blood clot
Mucus
An EKG technician is receiving error messages on the EKG machine and cannot resolve the problem using the manufacturer's troubleshooting information. Which department should she contact?
The facility management department
The biomedical engineering department
The nursing department
The operations department
Which of these types of identifying information are best used to confirm a patient's identity?
Last
Full name
Home address
Date of birth
Facility room number
Which leads all use the right arm electrode?
Leads I, II, and aVL
Leads I, II, and aVR
Leads I, III, and aVR
Leads aVR, V1, and V2
If an R wave has an amplitude of 5 mm at the standard gain setting, what will its amplitude be at a 1.5 setting?
5 mm
7.5 mm
10 mm
12.5 mm
The rhythm shown in this tracing is known as
Sinus arrest
Sinus bradycardia
Normal sinus rhythm
Sinus arrhythmia
The PR intervals in this tracing could be described as
Concurrently identical
Progressively identical
Progressively prolonged
Consecutively distorted
What would be the best method for calculating the rate shown in the strip above?
Small block method
300 method
Six-second method
1500 method
The complexes in this EKG tracing could be describes as
Uniform
Monomorphic
Polymorphic
Variegated
The irregular beat in this EKG tracing is
An escape beat
A premature beat
A junctional beat
A nonconducted beat
This tracing shows a dysrhythmia called
Multiformed atrial tachycardia
Atrial fibrillation
Ventricular fibrillation
Atrial flutter
The waveforms shown in the images above are characteristics of
Bundle branch block
SA block
Third-degree heart block
Wenckebach block
Which of the following actions is most likely to correct the artifact shown in the strip above?
Securing the electrodes to the patient's skin with medical tape.
Asking the patient to place his hands palms-up beneath his buttocks.
Plugging the EKG machine into a grounded outlet away from other electrical equipment.
Moving the limb lead electrodes closer to the patient's torso.
The pattern of complexes shown in the strip above is called
Transposition
Bigeminy
Polymorphism
Trigeminy
What can be said about the P waves in the EKG tracing above?
They are prolonged
They are not present
They are hidden in the previous T wave
They vary in appearance
Which of the following situations is likely to be true of the tracing above?
The electrodes did not have perfect contact with the patient's skin.
The patient had a cellular phone in his pocket.
The room was illuminated with fluorescent lights.
The patient was experiencing a seizure.
This strip shows a ryhthm that originates
In the SA node
In the atrial tissue
In the junctional tissue
In the ventricles
The P wave shown in this image is best describes as
Biphasic
Inverted
Notched
Pointed
