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EKG Review

Total questions: 100

Worksheet time: 52mins

Name
Class
Date
1.

What are the 2 atrioventricular valves?

a)

Tricuspid and Aortic

b)

Mitral and Aortic

c)

Pulmonic and Tricuspid

d)

Tricuspid and Mitral

2.

What are the two semilunar valves?

a)

Tricuspid and Pulmonic

b)

Mitral and aortic

c)

Pulmonic and Aortic

d)

Tricuspid and mitral

3.

What is the difference between junctional and idioventricular rhythms?

a)

Junctional rhythms are 60-100 beats with normal QRS complex; idioventricular rhythms are 20 to 40 beats with wide QRS complex; Both rhythms are irregular rhythms

b)

Junctional rhythms are 40-60 beats with normal QRS complex; idioventricular rhythms are 20 to 40 beats with wide QRS complex; Both rhythms are regular rhythms

c)

Junctional rhythms are 40-60 beats with normal QRS complex; idioventricular rhythms are 60 to 100 beats with wide QRS complex; Both rhythms are regular rhythms

d)

Junctional rhythms are 60-100beats with normal QRS complex; idioventricular rhythms are 40 to 60 beats with wide QRS complex; Both rhythms are irregular rhythms

4.

What is an adverse effect of a beta blocker?

a)

myocardial infarction, hypertension and bronchospasm

b)

congestive heart failure, hypotension and bronchospasm

c)

Congestive heart failure, hypertension and bronchoconstriction

d)

hypotension, Bronchoconstriction and CHF

5.

If a pacemaker has a battery depletion (running out of batter) what may occur on the EKG?

a)

U waves will be seen

b)

varying QRS complexes

c)

varying P waves

d)

No T waves

6.

Standard precautions: prevent the spread of infection: what is it when the 2nd tier of precautions are activated because the patient has known or suspected of having an infectious agent?

a)

OSHA

b)

CDC infection control

c)

blood borne pathogens

d)

transmission -based precautions

7.

A noninvasive diagnostic procedure to determine the presence and severity of coronary artery disease:

(a)  

8.

These are symptoms of what? Yellowish vision, nausea, vomiting and drowsiness

a)

Digitalis Toxicity - it occurs in 20% of patients who take it

b)

Jaundice

c)

Nitroglycerin

d)

Amiodarone

9.

(a)   are infectious microorganisms in human blood that can cause disease in humans. Under standard precaution we need to assume that all patients are infected.

10.

the QRS interval tells what?

a)

How long it takes the atria to depolarize

b)

How long it takes the ventricles to repolarize

c)

How long it takes the ventricles to depolarize

d)

How long it takes the atria to repolarize

11.

Medication: traditional drug of choice for the pain and anxiety caused by acute myocardial infarction

a)

xanax

b)

valium

c)

tramadol

d)

morphine sulfate

12.

Referred to as irritability. This characteristic is shared by all cardiac cells and it is the ability to respond to external stimulus: electrical, chemical and mechanical

a)

automaticity

b)

excitability

c)

conductivity

d)

contractility

13.

Involves contact with a contaminated intermediated object in the patient's environment

a)

Indirect-contact transmission - Think stair rails, or door knobs

b)

direct - contact transmission

c)

droplet spread

d)

airborne

14.

Infarction means

a)

injury to cardiac tissue

b)

strain of cardiac muscle

c)

Death of cardiac tissue

d)

blood clot

15.

__________________ are designed to reduce the risk of transmission of microorganisms through direct or indirect contact

a)

airborne

b)

droplet

c)

Vaccines

d)

contact precautions

16.

The heart sounds are produced by the closure of valves. What are the heart sounds called?

(First sound closure of the mitral valve and second sound closure of the aortic and pulmonic

(a)  

17.

When a Holter Monitor ( or any exam) comes back with ST depression, this is said to be a positive or negative result?

a)

positive

b)

negative

18.

Droplet precautions require _____________ to be used to reduce the risks of droplet transmission of infectious agents.

a)

Gown

b)

Masks

c)

Shoe cover

d)

all PPE

19.

Broken skin, mucous membranes, and body systems that are exposed to the external environment (respiratory, gastrointestinal, and reproductive are all?

(a)  

20.

Gloves, gown and PPE are all needed when patients have an open wound that has an infection or have incontinent bowel and have C-diff. What type of precautions are these?

a)

droplet

b)

airborne spread

c)

indirect contact

d)

Direct-Contact Transmission Precautions

21.

The hallmark of infarction on an EKG is what?

a)

Pathological/Abnormal P waves

b)

Pathological/Abnormal Q waves

c)

Absent P waves

d)

Pathological/Abnormal T waves

22.

What is the last thing you do for a patient in any situation (holter, EKG, stress test)

a)

take vital signs

b)

Document the procedure

c)

Call doctor

d)

Explain the procedure

23.

Electrical impulses originate from somewhere else other than the sinus node

a)

Ectopic Rhythms

b)

Ventricular rhythms

c)

Atrial Rhythms

d)

AV node

24.

How much does 0.1 mV equal on the EKG paper?

a)

10mm

b)

5mm

c)

1mm

d)

2mm

25.

This is the ability of all cardiac cells to receive to other cardiac cells

a)

Contractility

b)

Excitability

c)

Automaticity

d)

conductivity

26.

This is the ability of the cardiac cells to shorten and cause cardiac muscle contraction in response to an electrical stimulus. This can be enhanced through administration of certain medication, such as digitalis, dopamine, and epinephrine

a)

Automaticity

b)

Excitability

c)

Conductivity

d)

Contractility

27.

Medication that increases the force of cardiac contraction as well as cardiac output?

a)

beta blockers

b)

Digitals

c)

calcium channel blockers

d)

Lopressor

28.

Several wave forms are referred to as a ______________________

a)

Interval

b)

Segment

c)

EKG

d)

Complex

29.

Idioventricular rhythms have no P wave or an inverted P wave; they have normal QRS complexes and have a regular rhythm; they beat at?

a)

60-100

b)

40-60

c)

20 to 40

d)

less than 20

30.

If ST depression is noted and/or a T wave inversion than you you know ischemia is occurring; the patient is probably complaining of ______________________

a)

fluttering

b)

rapid heart rate

c)

palpitations

d)

Angina

31.

Is speed measured horizontally or vertically on the paper and what is the normal speed?

a)

vertically; 25 mm/second

b)

Horizontally; 25 mm/second

c)

Horizontally; 50 mm/second

d)

vertically; 50 mm/second

32.

What is hypoxemia? What may occur if it is not treated quickly?

a)

Low oxygen saturation in the blood; less than 95%; cardiac arrest will occur if not treated quickly

b)

high oxygen saturation in the blood; oxygen toxicity

c)

Low oxygen saturation in the blood; hyperventilating

d)

low blood volume; shock

33.

What is this rhythm:

a)

Monomorphic ventricular tachycardia; all QRS complexes are symmetrical

b)

polymorphic ventricular; regular; varying amplitudes of QRS complexes

c)

Ventricular flutter

d)

atrial fibrillation

34.

What is this rhythm:

a)

monomorphic ventricular tachycardia; all QRS complexes are symmetrical

b)

Polymorphic ventricular tachycardia; regular; varying amplitudes of QRS complexes

c)

Ventricular flutter

d)

atrial fib

35.

Identify the artifact:

a)

wandering baseline

b)

loose lead

c)

muscle tremor

d)

60 cycle; AC interference (electrical appliance)

36.

Medication: reduces heart rate and blood pressure but causes myocardial contractility and increases oxygen to the heart; helps with angina and hypertension

a)

Digitalis

b)

calcium blockers

c)

Beta blockers - end in lol; propranolol, atenolol, metoprolol, esmolol

d)

Dopamine; causes intense contractions that will lead to pushing more blood through the body

37.

A pharmacologic stress test is done on patients with Physical limitations (amputees), elderly that do not have enough stamina to reach a target heart rate:

a)

True

b)

False

38.

What is a common side effect of nitroglycerin (remember it opens up blood vessels and drops blood pressure - patients may pass out

a)

vomiting

b)

diarrhea

c)

Headache

d)

palpitations

39.

Medication: used to treat paroxysmal supra ventricular tachycardia (PSVT) effective in terminating 90% of episodes!!! Can also treat high blood pressure.

a)

digitalis

b)

Verapamil

c)

beta blocker

d)

dopamine

40.

Name the type of patient that may be ordered an event monitor over a holter monitor

a)

ones that have symptoms that are infrequent and the holter monitor may not catch in a 24-48 hour period

b)

patients that are inpatients

c)

patients that are having frequent symptoms and angina

d)

patients that can do a stress test

41.

With _________________ the ventricular rate is over 300 and no identifiable QRS complexes; irregular rhythm

a)

V tach

b)

V fib

c)

A fib

d)

A flutter

42.

When do you stop a stress test that is bruce protocol?

a)

When the test is done

b)

When your heart rate reaches 220

c)

After the patient can not go on any longer or the patient reaches 85% of the max heart rate

d)

All the above

43.

When a patient is taking Verapamil what should you monitor?

a)

Respiratory rate for Hyperventilating

b)

Heart rate for bradycardia

c)

Temperature

d)

Blood pressure for Hypotension

44.

Where is the SA node located?

a)

Rt atrium

b)

Lt atrium

c)

Rt ventricle

d)

Lt ventricle

45.

If a patient has an above the knee amputation, on the right leg, where would the left and right leg electrodes be placed?

a)

Both electrodes on the left leg

b)

right and left electrodes placed on each side of the groin

c)

right electrode on the torso and left the ankle

d)

anywhere above the amputation

46.

I can be worn for over 30 days and when I have an issue, my button records the issue

a)

holter monitor

b)

telemetry monitor

c)

EKG

d)

loop monitor

47.

I am worn for 24-48 hours and you can not take a shower or bath with me. I require the use of a journal because if I strain when I potty my heart rate may increase

a)

holter monitor

b)

telemetry monitor

c)

EKG

d)

loop monitor

48.

What is this heart rhythm?

a)

First degree heart block

b)

Normal sinus rhythm

c)

Third degree heart block

d)

Second degree heart block

49.

When you breath out your heart speeds up and you breath slower your heart slows down.

a)

True

b)

False

50.

Broken lead wires, disconnected leads or a dirty stylus causes which artifact?

a)

Wandering Baseline

b)

Interrupted Baseline

c)

AC Interference

d)

Somatic Tremor

51.

This method us utilized when rhythms are too fast and is the most accurate way to count HR?

a)

P to P wave

b)

6 second method

c)

300 method

d)

1500 method

52.

What is the QT interval in seconds and milliseconds?

a)

0.24 seconds and 240 milliseconds

b)

0.28 seconds and 280 milliseconds

c)

0.36 seconds and 360 milliseconds

d)

0.40 seconds and 400 milliseconds

53.

When two different unusual QRS complexes are occurring back to back in a 6 second strip what is occurring?

a)

Multifocal PVCs

b)

Ventricular Quadrigeminy

c)

Coupled Multifocal PVC

d)

Ventricular trigeminy

54.

If a rhythm strip has progressively widened PR intervals prior to a dropped QRS complex, a variable in the atrial rate, and some irregularity in the rhythm, which rhythm is occurring?

a)

First degree AV block

b)

second degree AV block, Type 1

c)

Third degree AV block

d)

complete heart block

55.

What is the target HR of a 65 year old man? (85%)

a)

109

b)

128

c)

132

d)

155

56.

If a patient is wearing a Holter monitor and the electrode becomes loose, what should the patient do?

a)

Notify the doctor

b)

Take the holter monitor off due to inadequate equipment

c)

Leave it alone, you do not need all electrodes

d)

secure it with adhesive tape

57.

This lead is located at the 5th ICS midaxillary line

a)

V3

b)

V4

c)

V6

d)

V9

58.

If the calibration is 10mm/10mm the EKG tech would expect the paper speed to be?

a)

25mm/second

b)

50 mm/second

c)

10mm/second

d)

5mm/second

59.

Which monitor, monitors continuously and usually sends information to a central location to be evaluated?

a)

Telemetry

b)

Holter

c)

Loop

d)

Stress test

60.

Pathological Q waves in a symptomatic patient indicates?

a)

Heart block

b)

myocardial infarction

c)

Heart murmur

d)

All the above

61.

What makes up lead 11

a)

Rt arm and LT arm

b)

Rt arm and Rt leg

c)

Rt arm and Lt leg

d)

Lt and Lt leg

62.

With ischemia, what is noted on the EKG?

a)

QT depression

b)

Absent P waves

c)

ST depression

d)

ST elevation

63.

What is the following rhythm?

a)

Ventricular Fibrillation

b)

Atrial Flutter

c)

Agonal

d)

Ventricular Tachycardia

64.

What color is the grounding lead on a 5 lead EKG?

a)

White

b)

Green

c)

Red

d)

Black

65.

What is the following rhythm?

a)

Agonal

b)

Asystole

c)

Bradycardia

d)

Atrial Flutter

66.

What is the following rhythm?

a)

agonal

b)

asystole

c)

Junctional tachycardia

d)

Accelerated Junctional

67.

What is this rhythm?

a)

Bradycardia

b)

Normal sinus

c)

Junctional Escape

d)

first degree heart block

68.

What is this rhythm?

a)

first degree heart block

b)

normal sinus

c)

idioventricular

d)

junctional escape

69.

What is the following rhythm?

a)

Normal sinus

b)

idioventricular

c)

First degree heart block

d)

second degree heart block

70.

What is this rhythm?

a)

Multifocal PVC

b)

Idioventricular rhythm

c)

sinus bradycardia

d)

First degree heart block

71.

What is this rhythm?

a)

idioventricular rhythm

b)

junctional rhythm

c)

Unifocal PVC

d)

Multifocal PVC

72.

What is the heart rhythm?

a)

Agonal

b)

Normal sinus

c)

sinus bradycardia

d)

junctional

73.

What is the heart rhythm?

a)

Normal sinus

b)

atrial flutter

c)

ventricular tachycardia

d)

supraventricular tachycardia

74.

What is this heart rhythm?

a)

first degree heart block

b)

second degree type 11

c)

Third degree

d)

PVC's

75.

What is the heart rhythm?

a)

Atrial fibrillation

b)

Atrial Flutter

c)

Ventricular fibrillation

d)

Ventricular tachycardia

76.

What is the heart rhythm?

a)

ventricular tachycardia

b)

Atrial fibrillation

c)

Ventricular fibrillation

d)

Atrial flutter

77.

What is the heart rhythm?

a)

Atrial fibrillation

b)

Atrial Flutter

c)

ventricular fibrillation

d)

Ventricular tachycardia

78.

What is the heart rhythm?

a)

Normal sinus

b)

Atrial flutter

c)

complete heart block

d)

second degree type 1

79.

What is cyanosis?

a)

low potassium

b)

bluish skin (inadequate oxygenation)

c)

atherosclerosis

d)

narcosis

80.

What is the rhythm?

a)

atrial flutter

b)

second degree heart block

c)

third degree AV block

d)

atrial fibrillation

81.

What does the PR interval represent?

a)

SA node

b)

Atria filling

c)

delay of the AV node

d)

ventricles filling

82.

This rhythm has no P waves, is irregular and has normal QRS complexes

a)

Atrial fibrillation

b)

Atrial flutter

c)

ventricular fibrillation

d)

1st degree heart block

83.

Hypocalcemia causes what?

a)

heart palpitations

b)

low blood volume

c)

heart rate to increase

d)

heart rate to decrease

84.

Digoxin effect causes?

a)

ST segment elevation

b)

curved ST segment depression

c)

prolonged PR interval

d)

wide QRS complex

85.

Idioventricular rhythms have no what?

a)

P waves

b)

T wave

c)

S wave

d)

Q wave

86.

What is the rate for idioventricular rhythms?

a)

60-100

b)

40 to 60

c)

20 to 40

d)

below 20

87.

U waves are caused by?

a)

hypocalcemia

b)

hyponatremia

c)

hypokalemia

d)

hyperkalemia

88.

What is the QRS complex in seconds?

a)

.12 to .24 seconds

b)

more than .24 seconds

c)

less than .12 seconds

d)

.16 to .28 seconds

89.

Where is V8 placed?

a)

mid axillary 6th intercostal space

b)

left paraspinal region

c)

left posterior axillary

d)

tip of the left scapula

90.

What is this rhythm?

a)

ventricular fibrillation

b)

Ventricular tachycardia

c)

atrial fibrillation

d)

atrial flutter

91.

What 2 types of medication should the patient aviod when doing a stress test?

a)

statins and beta blockers

b)

beta blockers and calcium channel blockers

c)

statins and calcium channel blockers

d)

beta blockers and ace inhibitors

92.

while performing a 5 lead EKG, an EKG technician notices that lead 11 and lead 111 are not yielding a reading, which of the following limbs should the technician check to correct the error?

a)

lead 111 is not attached to the right arm. The right arm is involved in recording electrical activity in leads 1 and 11.

b)

The left leg is involved in recording electrical activity in leads 11 and 111. Therefore, the technician should check the left leg electrode to correct this error.

c)

Leads 1 and 11 are not attached to the right leg. The right leg is not involved in an electrical recording in leads 1, 11 and 111.

d)

Lead 11 is not attached to the left arm. The left arm is involved in electrical activity in leads 1 and 111.

93.

An EKG technician is instructing a patient about a transtelephonic event monitor using a heart card monitoring device. To which of the following sites should the patient apply the card to activate it during an event?

a)

over the manubrium

b)

over the middle to lower part of the sternum

c)

over the right side of the chest

d)

over the left side of the chest

94.

Which of the following is the most likely cause of the artifact in the tracing?

a)

Patient respirations can cause a wandering baseline, which is characterized by cyclical upward and downward movement of the EKG baseline.

b)

Electrical interference appears as regular and consistent lines with same amplitude

c)

somatic tremors are irregular and often affect the baseline

d)

a loose limb lead

95.

The atypical vertical projections is in the EKG below are likely the result of which of the following?

a)

ventricular rhythms cause these projections

b)

intrinsic vertical anomaly

c)

intrinsic R waves do not cause vertical projections

d)

vertical projections are common EKG results

96.

What percent of V-tach patients are unresponsive?

a)

20%

b)

40%

c)

50%

d)

100%

97.

What is this rhythm?

a)

Atrial flutter

b)

bundle branch block

c)

second degree heart block

d)

complete heart block

98.

on accelerated junctional rhythm what speed settings should an EKG tech use?

a)

50mm

b)

25mm

c)

10mm

d)

5mm

99.

When the myocardium does not respond to electrical stimuli from the pacemaker

a)

oversensing of the pacemaker

b)

failure to output

c)

low battery in the pacemaker

d)

loss of capture

100.

Which of the following actions should the EKG technician immediately do after attaching the telemetry lead wires to electrodes?

a)

check the monitor

b)

push the record button

c)

Check all colors to ensure attachment to correct electrodes.

d)

explain the procedure to the patient

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