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WorksheetsNHA CET practice
Total questions: 109
Worksheet time: 55mins
For a resting EKG, what location should an EKG tech place the leads. The patient is immobile and in a fetal position
On the patient's back
On the patient's right side
On the standard sites
On the limbs only
What would be the expected pulse rate for a 2-year-old patient?
60
75
120
150
How many seconds long should a rhythm strip be to accurately identify rhythm and rate?
2 seconds
4 seconds
6 seconds
8 seconds
What is the correct placement for leads V7, V8, and V9?
Evenly spaced on the back between the axillary line and the vertebral column at the fifth intercostal space
Evenly spaced on the right chest between the sternum and the right axillary line at the fifth intercostal space
On the axillary plane at the fifth intercostal space
On the frontal plane at the sixth intercostal space
Which of the following recommendations reflects proper infection control practices in health care settings?
artificial nails should be no longer than 1.27 cm (0.5 in) in length
Use an alcohol-based hand rub if there is visible contamination on the hands
Remove soiled gloves prior to touching uncontaminated surfaces
Wear the same gloves while performing different procedures on the same patient
You (the EKG tech) are working at the central monitoring station and notice that a patient has gone into ventricular tachycardia. What do you do first?
Prepare for defibrillation of the patient
Document the rhythm in the patient's medical record
Notify a licensed practitioner to evaluate the patient
Verify the time of the last dose of the patient's cardiac medications
You get a reading of 88% on a pulse oximetry reading. What term describes the patients condition?
Rales
Hypoxemia
Hemoptysis
Orthopnea
You notice that your patient's respiration variations correlate with the EKG tracing. What irregularity does this indicate?
Sinus arrest
Sinus dysrhythmia
tachycardia
bradycardia
You are reviewing the EKG tracing of a patient with ventricular hypertrophy. Which findings would you expect?
An ST segment depression of 2mm
Increased amplitude of the QRS complex
Prolongation of the PR interval
Irregularity of the P-P interval
What intervention would you expect a provider to prescribe for a patient experiencing heart palpitations?
Vasodilator medication
Holter monitor
Cardiac inotropic medication
Chemical stress test
What is the most appropriate site to take the pulse of an infant?
Brachial artery
Carotid artery
radial artery
Femoral artery
Which action should you take to prepare for a standard 12-lead EKG?
Encourage the patient to ask questions during the procedure
Instruct the patient to hold their breath
Place electrodes over the patient's chest hair
Have the patient remove any jewelry
The smallest boxes on EKG graph paper represent what length of time?
0.02 seconds
0.04 seconds
0.10 seconds
0.40 seconds
When a patient is experiencing ventricular tachycardia, which sign is often present?
multiple premature ventricular contractions in a row
Decreased heart rate
Absence of R-R interval
Narrow QRS complexes on the EKG tracing
Which of the following methods can be used to calculate both irregular and regular rhythms?
6 second method
P-P method
1500 method
300 method
Your patient has dextrocardia. In which location should you place the electrode for lead V1?
Right sternal border, fourth intercostal space
Left sternal border, fourth intercostal space
Left mid-clavicular line, fifth intercostal space
Right mid-clavicular line, fifth intercostal space
Calculate the heart rate
140/min
150/min
160/min
170/min
Which statement would indicate that a patient understands wearing a cardiac event monitor at home?
I can take showers while wearing this monitor
The monitor will keep track of all my daily activities
I can continue to use my electric blanket while wearing the monitor
If the batteries fail, I will replace them myself
Which action should a tech take when performing an exercise stress test on a patient to evaluate for coronary artery disease?
Report unexpected dysrhythmias during the test
Evaluate the need for the patient to follow an exercise program
Prescribe oxygen if the patient reports shortness of breath during the test
Instruct the patient to cease cardiac medications after the test
In a healthy adult patient, which of the following is the expected shape and direction of the P wave in lead II?
Peaked and upright
Peaked and inverted
Rounded and inverted
Rounded and upright
You observe elevated ST segments while performing an exercise stress test on a patient. You should identify these findings as what?
Expected EKG changes as a result of running
Expected EKG changes due to hypokalemia
Signs of pulmonary embolism
Signs of acute myocardial injury
An EKG tech is performing a posterior 12-lead EKG for a patient. Which of the following leads should the tech place along the paraspinous border?
Lead V7
Lead V8
Lead V9
Lead V7R
What should you instruct patients to record in the Holter monitor diary?
Bike riding
swimming
Driving
Sleeping position
Which of the EKG machine functions is used to control and regulate the height of the EKG waveform?
speed
Output display
Artifact filter
Gain
You are obtaining and EKG on a patient who is at 25 weeks gestation. Which position should the tech place the patient?
Supine with head elevated
Partially upright with legs supported
Slightly on the left side with a pillow supporting the right hip
supine with the feet flat on the table
Which blood pressure reading is in the expected reference range for an adolescent?
60/40 mm Hg
78/48 mm Hg
86/60 mm Hg
98/78 mm Hg
You are instructing a patient about using a transtelephonic event monitor using a Heart Card monitoring device. Which site should the patient apply the card to activate it during an event?
Over the right side of the chest
Over the left side of the chest
Over the middle to lower part of the sternum
Over the manubrium
You are reviewing a tracing for a patient with a ventricular pacemaker. What rhythm pattern should you expect after the pacing spike?
regular P waves
AV delay between 0.12 and 0.16 seconds
QRS interval between 0.06 and 0.10 seconds
Wide QRS interval
Which position is appropriate for a patient during a nuclear stress test while the camera is scanning?
Supine with the arms at the side
Supine with the arms above the head
Right-side lying with the arms slightly extended
Sitting upright with the head tilted back
You are taking a radial pulse and find that it's irregular. The provider then takes the apical pulse. What location is used for an apical pulse?
Between the larynx and the left sternocleidomastoid muscle
Between the fifth and sixth ribs, at the midclavicular line
The antecubital aspect of the left or right elbow
The thumb side of the left wrist
Which of the following situations is an allowable disclosure of patient information according to HIPAA?
Patients write their names on basic sign-in sheet at the registration desk
An employer calls the clinic to verify an employee's excused absence
A patient can read the demographics screen of another patient's electronic chart while checking in at the desk
An employee gives a coworker access to their username and password to retrieve a patient's laboratory report
Which finding indicates myocardial infarction?
Cyanosis
Facial drooping
Arm weakness
Aphasia
Your patient is on contact precautions and you need to do a 12-lead EKG. What precautions do you need to take?
Wear an N-95 mask if there is a potential exposure to blood
Disinfect the EKG machine immediately prior to entering the room
Remove gloves before leaving the patient's room
Keep the door to the patient's room closed
Normal sinus rhythm
First degree AV heart block
Second-degree AV heart block Mobitz type II
Junctional rhythm
What is an expected finding of impaired conduction through the AV node?
Decreased QT interval
Prolonged QRS interval
Prolonged QT interval
Prolonged PR interval
Which interval is used to determine the regularity of ventricular depolarization?
P-P wave interval
R-R wave interval
QT interval
PR interval
Which of the following information is recorded by lead 1?
Electrical activity between the right arm and left leg
Electrical activity between the right arm and left arm
Electrical activity between the left arm and left leg
Electrical activity between the right leg and left leg
Which statement indicates that a patient understands the instructions you gave him about the Holter monitor?
I am able to shower and bathe
I can use moisturizing lotion around the electrodes
I should activate the event marker if I have chest pain
I should only record activities that cause chest pain
Which action should you take after performing a 12 lead EKG on a patient?
Remove the electrodes and assist the patient to a sitting position
Remove the EKG tracing from the machine and provide privacy for the patient to get dressed
Check that the tracing is free from artifacts and then disconnect the patient from the machine
Tell the patient that the test is complete and the provider will be in shortly
Which is the most commonly used paper speed?
5 mm/second
10 mm/second
25 mm/second
50 mm/second
Using the 6-second method, calculate the ventricular rate:
30/min
40/min
50/min
60/min
Which method should you use to calculate a patient's heart rate from the EKG tracing?
Calculate the mean rate and divide 1500 by that rate
Count the number of small boxes in two cardiac cycles
Divide 300 by the number of large boxes between two R waves
Count the number of large boxes between P and T waves
How should you prepare the patient for application of the electrodes?
Cleanse the patient's skin with chlorhexidine
Apply tape and remove in a quick motion to remove the patient's hair
Use a razor or clippers to remove the patient's hair
Cleanse the patient's skin with povidine-iodine
You notice an accelerated idioventricular rhythm on a tracing. What action should you take?
Tell the patient the results show significant findings and ask if she feels any different
Call for help and stay with the patient
Ask another technician to run an EKG
Upload the tracing to the EHR and notify the provider that the tracing is ready for interpretation
What should you say to prepare a patient for telemetry monitoring?
I will clean your skin with an alcohol pad
You may feel a slight warming sensation after the electrodes are placed on the skin
A mild rash or skin redness should be expected around the electrodes after 24 hours
Electrodes will be replaced once per week while you're in the hospital
Which finding would indicate that the patient undergoing an exercise stress test is experiencing an adverse reaction?
Increase in blood pressure from 110/70 to 120/78
An oxygen saturation of 95%
Presence of sinus tachycardia with a regular R-R interval
Report of tingling sensations in the lower extremities
If you heard another staff member make derogatory comments about a patient's appearance, what tort would that be an example of?
libel
assault
slander
battery
While doing an EKG your patient has accelerated junctional rhythm. Which of the following speed settings should the tech use?
5 mm/second
10 mm/second
25mm/second
50 mm/second
Measure the PR interval:
0.10
0.52
0.16
0.28
What should you say to prepare a patient for an exercise stress test?
Be sure to eat a light meal 6 to 8 hours prior to the test
Wear tight clothing around your lower abdominal area so the electrodes stay in place
Refrain from caffeine, smoking or alcohol for at least 3 hours prior to the test
The procedure should take abut 10 to 15 minutes
Which finding differentiates junctional rhythm from accelerated idioventricular rhythm?
accelerated idioventricular rhythm has P waves
The ventricular rate in accelerated idioventricular rhythm is slower than junctional rhythm
accelerated idioventricular rhythm is indicated by an irregular rhythm
accelerated idioventricular rhythm has wide QRS complexes
Where do you place the grounding electrode in telemetry?
on the right upper arm
On the left upper arm
On the left lower leg
On the right lower leg
Which lead records the electrical activity of the septal wall?
lead aVL and V5
Leads 1 and V6
Leads V1 and V2
Leads III and aVF
Which lead is created between the left arm and left leg?
Lead aVL
Lead AVF
Lead III
Lead I
You eliminate artifact on a 3-lead EKG tracing by plugging the machine into a different wall outlet. What caused the artifact?
Somatic tremor
AC interference
Interrupted baseline
Wandering baseline
What is the expected temperature range for an adult?
35.3 to 36 C (95.6 to 96.8 F)
36.1 to 36.4 C (96.9 to 97.5 F)
36.5 to 37.2 C (97.7 to 99.0 F)
37.3 to 37.6 C (99.1 to 99.7 F)
Which finding would you report while performing an exercise stress test?
Decreased heart rate
Increased respiratory rate
Increased sweating
Decreased premature beats
Which finding on an ECG might mean a previous myocardial infarction?
small P waves
Prolonged PR interval
Narrow QRS complexes
Pathologic Q waves
Which action should be done right after attaching the telemetry lead wires to the electrodes?
Check a baseline EKG tracing for monitor clarity
Check the wire colors and identifications to ensure attachment to the correct electrodes
Place the patient in the correct anatomical position
Tape the lead wires to the patient's skin to prevent disconnection from the electrodes
Which is correct regarding this EKG?
The patient is in sinus bradycardia
The patient has a ventricular pacer
The heart rate is 75/min
Cardiomegaly is evident
While preparing a patient for a holter monitor they tell you they run 5 miles each day. What should you repsond?
You should continue exercising as usual while wearing the monitor
Make sure to increase your cardiac medications while wearing the monitor to offset the activity
You should talk to your provider about continuing that activity while wearing the monitor
Take someone with you when you are running while wearing the monitor
Which lead is created using a placement to the right of the patient's sternum at the fourth intercostal space?
V1
Lead 1
Lead aVT
Lead MCL2
Which electrode is used to create leads I, II, and aVR
left arm
right arm
left leg
right leg
Which patient might you expect to see somatic interference with?
60 -year-old patient sweating profusely
20-year-old patient experiencing a seizure
10-year-old patient watching TV
30-year-old patient using a cell phone
Which action could you take if the EKG complex is too tall to fit on the EKG paper?
Change the gain control to 20mm/mV
Change the paper speed to 10 mm/second
Change the gain control to 5mm/mV
Change the paper speed to 50 mm/second
How should you store electrodes?
Loose in the EKG cart
In a folded paper bag
In an open plastic bag
In the original, foil-lined packaging
Which finding would you expect would make the provider stop and exercise stress test?
Electrode detachment
dizziness
sweating
increased respiratory rate
You are doing a 5 lead EKG and notice that lead II and lead III are not yielding a reading. What should you check to correct the error?
Right arm
left arm
Right leg
left leg
During an exercise stress test your patient reports fatigue and you notice this on the EKG. What should you do?
Notify the provider
Begin chest compressions
Defibrillate the patient
Administer rescue breathing
You are getting ready to perform an EKG on a patient with a heart rate of 150/min. Which of the following speed controls should the technician select?
5 mm/second
10 mm/second
25 mm/sec
50 mm/second
What action might protect the patient's health information in accordance with HIPAA?
Sending the EKG in an encrypted file to the patient's employer
Using corrective fluid on he patient's name, address, and physical description on the EKG printout
Restricting the patient's access to the EKG file
Hand-delivering the EKG to the patient's provider
What should you say to a patient who is upset that you cannot share the results of the EKG with them?
I'm sorry, but I only run the strip. I'm not trained to know what's on it.
I understand your frustration. My role as the tech is to conduct the test correctly. The provider is qualified to interpret the results.
I know it's difficult to wait, but from what I can see, you have nothing to worry about.
I wish I could help you. Some providers allow techs to discuss the tracing, but your provider won't let me communicate results to patients
What should you do if you are taking respirations and have a difficult time seeing chest movement?
Instruct the patient to take deeper breaths so they are easier to count
Document that the respiratory rate could not be assessed
Place a hand on the middle of the patient's back to count the respirations
Estimate a respiratory rate based on the assessed pulse
A patient reports heaviness on his chest and becomes diaphoretic during and exercise stress test. What condition does this manifest?
Transient ischemic attack
Cerebrovascular accident
Congestive heart failure
myocardial infarction
You observe ST segment depression and T wave inversion in multiple leads on a patient's EKG tracing. Which of the following should the tech suspect?
Myocardial infarction
Myocardial injury
Myocardial ischemia
Heart block
If you write defamatory comments in a patient's chart this is what tort?
Assault
Slander
Libel
Battery
You are performing a second standard EKG immediately after a first one. Why would you not use resting tab electrodes for more than two tracings?
The electrodes cannot conduct the signal after two EKG tracings
The electrodes will not conduct accurately after two tracings.
The electrodes need to be cleaned after two EKG tracings
The electrodes will not re-adhere to the skin after being removed between tracings
You are entering a patient's history into the EHR. What should you enter under social history?
I have smoked cigarettes for a long time
My parents both had heart attacks
I had an appendectomy 1 year ago
I had chicken pox when I was 10 years old
Your patient had a 12-lead EKG and doesn't understand why she now needs and ambulatory monitor. What should you tell her?
An ambulatory monitor records differently than an EKG
Your provider wants to study your heart over a longer period of time
It is standard practice to attach an ambulatory monitor shortly after an EKG
The provider wants to perform another test before he communicates his concerns
What dysrhythmia is this?
Bundle branch block
Sinus dysrhythmia
Premature ventricular contraction
Complete heart block
What is the correct placement for lead V4?
The fifth intercostal space at the midclavicular line
The fourth intercostal space at the midaxillary line
The fifth intercostal space at the midaxillary line
The fourth intercostal space at the midclavicular line
Your patient starts exhibiting ventricular fibrillation during an exercise stress test. What action do you take first?
Determine if the patient is responsive
Check the patient for breathing
Begin chest compressions
Apply automated external defibrillator (AED) pads
What should you say to an 8-year-old patient you are preparing for a 12 lead EKG?
I am going to apply some stickers to your belly, arms, and legs for the test
I am going to apply these adhesive electrodes to your chest and extremities for the EKG
I am going to conduct an electro cardiogram on your heart
I need you to hold still while I attach these wires to you for the electrocardiogram
Electrical interference on a 12-lead EKG tracing is most likely from what?
Patient movement
Expired electrodes
Crossed lead wires
Insufficient skin preparation
Your patient has a below-the-knee amputation of the left leg. Where should you put the right leg electrode?
On the lower right foot
On the lower right abdomen
On the lower left torso
On the lower right leg
When instructing a patient about a transtelephonic monitor with loop memory what should you tell the patient?
Press the record button on the device when you begin to feel dizzy or have chest pain
Remove the monitor when connecting to the phone or internet to send the recording to the central monitoring location
Record a notation in your diary that describes the time and activity that you were doing when the pain started
Contact the tech at the central monitoring station whenever you begin to experience chest pain
How do you resolve wandering baseline on an EKG tracing?
Relieve tension from the lead wires
Clean the lead wires after each use
Provide a blanket to the patient
Have the patient remove any personal electronic devices
Which term is used to document the rhythm of the pulse?
weak
stong
bounding
irregular
A patient wearing a holter monitor reports to you over the phone that she is having severe chest pain and shortness of breath. What action should you take?
Have someone call emergency services while you stay on the phone with the patient
Remind the patient to document the incident in the patient diary
Place the patient on hold and consult with the patient's provider
Tell the patient to hang up the phone and call emergency services
Which site is most accurate for measuring body temp?
oral
axillary
temporal
tympanic
You are doing an EKG and none of the leads are giving a recording. Which limb should you check first?
Right arm
Left arm
Right leg
Left leg
Which artery is best to measure the heart rate for an adult following and exercise stress test?
Radial
Carotid
Femoral
Brachial
What should you do to reduce the chance of artifact when preparing a patient for Holter monitor placement?
Ensure the patient has not eaten for at least 2 hr prior to placement
Instruct the patient to replace any loose electrodes in an adjacent spot on her chest
Have the patient wear tight-fitting clothes to hold the electrodes in place
Use stress loops on the electrodes to reduce tension on the leads
Identify this rhythm:
Multifocal atrial tachycardia (MAT)
atrial fibrillation
Wandering atrial pacemaker (WAT)
Atrial flutter with variable conduction
You are doing an EKG on a 9-year old. In which location should you place V6?
Right midclavicular space
Left midclavicular space
Right midaxillary line
left midaxillary line
Which type of heart block might cause signs and symptoms of decreased cardiac output that could lead to cardiac arrest?
First degree heart block, type I
Second degree AV block, Mobitz I
Second degree AV block, Mobitz II
Third degree AV block
Your patient appears to be hyperventilating during an exercise stress test. What should you do first?
Administer oxygen
Slow down the test
Stop the exercise portion of the test
Check the patient's respiratory rate
If you see a thin spike before the P wave what has the pacemaker been implanted to pace?
atria
ventricles
early repolarization
late repolarization
Which lead should you place on the right lower side of the anterior torso for and exercise stress test?
Lead V1
Lead V6
Lead RA
Lead RL
Patients are restricted from what activity while wearing a Holter monitor?
Yoga
smoking
Sexual activity
Showering
Why should you not use electrodes for more than two consecutive EKG tracings?
The electrodes cannot conduct the signal after two EKG tracings
The electrodes will not conduct accurately after two EKG tracings
The electrodes need to be cleaned after two EKG tracings
The electrodes will not re-adhere to the skin after being removed between tracings
What is this rhythm?
Normal sinus rhythm
First degree heart block, type I
Second degree AV heart block Mobitz type II
Junctional rhythm
Which artifact is in this tracing?
Electrical interference
Somatic tremor
Wandering Baseline
Interrupted baseline
Which EKG control regulates the height of the EKG waveform?
speed
output display
artifact filter
gain
What is the best method to remove hair for electrode placement?
Dry shave
Wet shave
Tape
Clippers
You note a period of sinus arrest on your patient's EKG. You should consider this a medical emergency if it reaches which duration?
6 seconds
4 seconds
3 seconds
1 second
Which of the following lead groups are bipolar leads?
Leads aVR, aVL, and aVF
Leads I, II, and III
Leads V1, V2, V3
Leads V4, V5, and V6
Which statement show patient understanding of wearing a cardiac event monitor?
I can take showers while wearing this monitor
The monitor will keep track of all my daily activities
I can continue to use my electric blanket while wearing the monitor
If the batteries fail, I will replace them myself
The electrical activity of the septal wall is recorded by which leads?
Leads aVL and V5
Leads I and V6
Leads V1 and V2
Leads III and aVF
